Dislocation after total hip replacement in relation to metal-on-metal bearing surfaces.

Metal-on-metal (MOM) is a commonly used bearing notable for its 'suction fit' when lubricated. In this study, we examined the capacity for MOM bearings to protect against dislocation after total hip replacement (THR). We undertook a clinical investigation to compare the rate of dislocation of MOM bearings with those of ceramic-on-polyethylene (COP) bearings and found that one MOM bearing dislocated in a series of 109 hips (0.

Evaluation of the effects of several zoanthamine-type alkaloids on the aggregation of human platelets.

Ten zoanthamine-type alkaloids from two marine zoanthids belonging to the Zoanthus genus (Zoanthus nymphaeus and Zoanthus sp.) along with one semisynthetic derivative were evaluated for their antiplatelet activities on human platelet aggregation induced by several stimulating agents. 11-Hydroxyzoanthamine (11) and a synthetic derivative of norzoanthamine (16) showed strong inhibition against thrombin-, collagen- and arachidonic acid-induced aggregation, zoanthenol (15) displayed a selective inhibitory activity induced by collagen, while zoanthaminone (10) behaved as a potent aggregant agent.

Emphysematous gastritis and severe aplastic anemia.

Emphysematous gastritis is a life-threatening disease. It is characterized by the presence of gas within the wall of the stomach. The etiology includes firstly infections with gas-forming organisms; other predisposing causes are the ingestion of corrosive substances and alcohol abuse.

Hip arthroscopy: complications in 1054 cases.

Although arthroscopic surgery of the hip is becoming a more frequently done operation, there is relatively few data in the literature regarding the frequency of complications. In the current prospective study of 1054 consecutive hip arthroscopies, the authors report an overall complication rate of 1.4%.

When children die: a seminar series for pediatric residents.

Objective: Our goals were to assist residents in acquiring skills needed to care for children at the end of life and to increase their comfort level regarding critical aspects of caring for dying children.

Methods: We designed and implemented a 6-part seminar series for pediatric residents in their postgraduate year-2 at the University of Arizona Pediatric Residency Program. The series consisted of small group sessions regarding medical and legal issues facing physicians at the time of a pediatric patient's death, symptom management in dying children, approaches to limitation of care and discussion of impending death of a child, cultural and developmental factors impacting on the care of children at the end of life, parent and sibling bereavement after the death of a child, and physician's personal responses to the death of pediatric patients.

Low frequency magnetic response in antiferromagnetically coupled Fe/Cr multilayers.

The magnetic field and temperature dependence of the low frequency magnetic response of antiferromagnetically coupled Fe/Cr(100) multilayers has been studied between +/-500 Oe, from 2 to 300 K. At T = 2 K the losses exhibit an unusually strong frequency dependence which can be described within a single relaxation time scheme. This relaxation time proves to be strongly field dependent.

Use of light handles in the laminar flow operating theatre--is it a cause of bacterial concern?

Airborne bacteria introduced during routine joint replacement surgery are known to be an important source of joint sepsis with disastrous results. Recently, Robinson et al. [Robinson AHN, Bentley G, Drew S, Anderson J, Ridgway GL.

Injury to the ligamentum teres. Mechanism, findings, and results of treatment.

In this article we discuss the role of the ligamentum teres in relation to the hip joint. The anatomy of the ligamentum teres is used to help with an understanding of the mechanism of the ligament's actions. This action and the modes of injury to the ligament are explored.

The efficacy of arthroscopy in the treatment of hip osteoarthritis.

We evaluated the utility and the safety of arthroscopy for diagnosing and treating symptoms in patients with osteoarthritis (OA) of the hip. We studied 133 patients consecutively treated for hip OA, using a modified Harris Hip Score (HHS) for the clinical assessment: There were no related complications or infections. At an average follow-up of 18 months, 61% of patients showed an improvement of their preoperative score, although only 36% of those actually presented good or excellent results.

Is titanium so bad? Medium-term outcome of cemented titanium stems.

Early failures have seen titanium fall from favour as a material for cemented femoral stems. Between 1989 and 1994, we performed a prospective review of a consecutive series of 122 cemented total hip replacements using the Ultima straight textured titanium stem, and report the five- to ten-year clinical and radiological outcomes. There were no revisions for loosening of the femoral stem.

Comparison of leaf construction costs in woody species with differing leaf life-spans in contrasting ecosystems.

•  The construction costs (CC) are reported of leaves from 162 wild woody species from 14 contrasting environments (desert to rain forest) and with different leaf life-spans. •  Calorimetric methods were used to estimate the CC of deciduous, semideciduous and evergreen leaves. •  Leaf CC showed a wide range (78%) between species, and deciduous species showed a slightly lower CC (6%) than both semideciduous and evergreen species.

Relative growth rate in phylogenetically related deciduous and evergreen woody species.

Relative growth rate (RGR) and other growth parameters were studied in eight pairs of closely related deciduous and evergreen species (within the same genus or family). The main objective of this study was to test the association between leaf turnover rate and RGR, specific leaf area (SLA, leaf area/leaf dry weight) and other growth variables. Plants were grown for 6 months in a greenhouse under favourable water and nutrient conditions.

Hill-Sachs type lesion of the femoral head in a case of hip instability.

A Hill-Sachs lesion of the shoulder is an indicator of shoulder instability. Hip instability is also a well-recognized phenomenon. However, no operative or arthroscopic features have previously been reported that support the diagnosis of hip instability.

Acetabular labral tears: result of arthroscopic partial limbectomy.

Acetabular labral tears are a rare but well recognized cause of hip symptoms in young adults. Both clinical and radiographic diagnoses are difficult. The treatment of choice in the past has been either conservative or open arthrotomy.

Complications of arthroscopy of the hip.

Although arthroscopy of the hip is being carried out increasingly, little is known about the rate of associated complications. We describe a prospective study of 640 consecutive procedures in which a consistent technique was used. The overall complication rate was 1.

Is diagnostic arthroscopy of the hip worthwhile? A prospective review of 328 adults investigated for hip pain.

We describe a prospective study of 328 patients undergoing arthroscopy of the hip. Arthrography, CT or MRI was performed when clinically indicated. A preoperative diagnosis was reached in 174 patients (53%), while the remaining 154 were diagnosed as having 'idiopathic hip pain'.

Do obese patients bleed more? A prospective study of blood loss at total hip replacement.

This study compares blood loss at total hip replacement in obese and non-obese patients. We made a prospective study of intra-operative and postoperative blood loss in 80 consecutive primary cemented hip replacements. Patients' obesity was classified according to body mass index (BMI).

Investigation of multidrug-resistant Salmonella serotype typhimurium DT104 infections linked to raw-milk cheese in Washington State.

Context: Multidrug-resistant Salmonella Typhimurium DT104 has recently emerged as a cause of human and animal illness in Europe and North America. In early 1997, health officials in Yakima County, Washington, noted a 5-fold increase in salmonellosis among the county's Hispanic population.

Objectives: To characterize bacterial strains and identify risk factors for infection with Salmonella Typhimurium in Yakima County.

A massive epidemic of multidrug-resistant typhoid fever in Tajikistan associated with consumption of municipal water.

From 1 January through 30 June 1997, 8901 cases of typhoid fever and 95 associated deaths were reported in Dushanbe, Tajikistan. Of 29 Salmonella serotype Typhi isolates tested, 27 (93%) were resistant to ampicillin, chloramphenicol, nalidixic acid, streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole. In a case-control study of 45 patients and 123 controls, Salmonella Typhi infection was associated with drinking unboiled water (matched odds ratio, 7; 95% confidence interval, 3-24; P<.

Arthroscopic findings in the initial stages of hip osteoarthritis.

Standard radiographic projections have poor diagnostic ability in detecting early degenerative changes of the hip. Comparison of arthroscopic and radiographic findings is the best method to assess the accuracy of conventional radiography. This study reviewed the records and radiographs of 234 hip arthroscopies.

Outbreak of type A botulism and development of a botulism surveillance and antitoxin release system in Argentina.

Context: Botulism is an important public health problem in Argentina, but obtaining antitoxin rapidly has been difficult because global supplies are limited. In January 1998, a botulism outbreak occurred in Buenos Aires.

Objectives: To determine the source of the outbreak, improve botulism surveillance, and establish an antitoxin supply and release system in Argentina.