Atypical Chronic Ankle Instability in a Pediatric Population Secondary to Distal Fibula Avulsion Fracture Nonunion.

Chronic ankle instability is a disabling condition, often occurring as a result of traumatic ankle injury. A paucity of published data is available documenting chronic ankle instability in the pediatric population. Much of the data has been confined to the adult population.

Elective versus symptomatic intravenous antibiotic therapy for cystic fibrosis.

Background: Pseudomonas aeruginosa is the commonest micro-organism associated with respiratory infections in cystic fibrosis. Retrospective studies have suggested that using an aggressive policy of intravenous anti-pseudomonal antibiotics at regular intervals, irrespective of symptoms, increases survival.

Objectives: To determine whether there is evidence that an elective (regular) versus symptomatic intravenous antibiotic regimen is associated with an improvement in clinical status and survival rates in people with cystic fibrosis.

An unusual case of low-grade tubulopapillary adenocarcinoma of the sinonasal tract.

Background: Low-grade papillary adenocarcinomas of the sinonasal tract are rare neoplasms. Over recent years, little doubt remains that this tumour represents a separate entity based on morphology, ultrastructural features and behaviour. We outline a case of this rare entity displaying a not hitherto described immunophenotype.

Noninsertional Achilles tendinopathy.

The treatment of noninsertional Achilles tendinopathy remains, to a large extent, empirical. Neither different operative techniques nor nonoperative regimes have been subjected to controlled trials. Rather, the condition is still treated on the basis of anecdotal evidence combined with personal experience.

Appraisal, assessment and career development for doctors in training: the Mersey Deanery personal development portfolio.

Objectives: To develop a robust valid and exportable appraisal and assessment process for doctors in training which is portfolio based and works at all hospitals within the deanery. It is called the personal development portfolio.

Design: For every senior house officer, there was a recorded meeting with his or her supervisor, at the beginning, midterm and at the end of the post.

Severe eosinophilic cystitis in a woman with anorexia nervosa.

Eosinophilic cystitis is a rare inflammatory disorder. It is considered to be self limiting necessitating only supportive therapy. Surgical intervention is unusual.

Immediate dual energy X-ray absorptiometry reveals a high incidence of osteoporosis in patients with advanced prostate cancer before hormonal manipulation.

Objective: To examine the incidence of osteoporosis in patients with advanced prostate cancer (using forearm densitometry) before commencing androgen deprivation therapy (ADT), as osteoporotic fractures are more frequent in patients with prostate cancer who have undergone either medical or surgical castration, because of rapid loss of bone mass.

Patients And Methods: In all, 174 patients (mean age 74.6 years, range 46-90) with advanced prostate cancer presented over 2 years.

Long-term outcome of the 'Beefburger' procedure in patients unsuitable for two-stage revision following infected total knee replacement.

A 5-year review of a group of 13 patients with infected total knee replacements deemed unsuitable for two-stage revision is presented. The 'Beefburger' procedure was initially performed in all the patients as a 'definitive' procedure. Eight patients had no further procedure performed, three patients were deemed suitable for a subsequent arthrodesis, and two went on to above-knee amputation.

Prevalence of mental illness in a rehabilitation unit for older adults.

The prevalence of psychiatric disorders was studied in 78 elderly people in a rehabilitation unit for older adults. The patients were assessed using the Evans Liverpool depression rating scale, Hospital Anxiety and Depression scale and Mini-Mental State Examination. Twenty-eight (35.