ABSTRACT
In a double-blind crossover study of 26 long-stay schizophrenic patients, no correlation was found between caffeine consumption and levels of anxiety and depression. No significant changes in patients' behaviour or levels of anxiety and depression occurred when the wards changed to decaffeinated products. Serum caffeine levels confirmed compliance. No evidence was found to support a removal of caffeinated products from this group of patients.
Subject(s)
Anxiety Disorders/chemically induced , Caffeine/adverse effects , Depressive Disorder/chemically induced , Hospitalization , Psychoses, Substance-Induced/psychology , Schizophrenia/chemically induced , Schizophrenic Psychology , Adult , Aged , Anxiety Disorders/psychology , Caffeine/administration & dosage , Depressive Disorder/psychology , Dose-Response Relationship, Drug , Double-Blind Method , Female , Humans , Long-Term Care/psychology , Male , Middle Aged , Psychiatric Status Rating Scales , Social EnvironmentABSTRACT
The incidence of skeletal tuberculosis in New Zealand as measured by both hospital morbidity and notification data has fallen since the introduction of chemotherapy to low levels comparable with other developed societies. The decline has been greatest in the 5-14 year age group and least in the over 65 group. Individual surgeons can now expect to see few cases in a practising lifetime. Effective chemotherapy is the key to successful treatment. Adequate biopsy is essential, but apart from the drainage of large abscesses the place of surgery in the early management of osteoarticular tuberculosis is discretionary. Early activity can usually be encouraged once chemotherapy is instituted, late reconstruction by joint arthroplasty being available if adequate function is not achieved.
Subject(s)
Antitubercular Agents/therapeutic use , Hip Joint , Lumbar Vertebrae , Tuberculosis, Osteoarticular/epidemiology , Tuberculosis, Spinal/epidemiology , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , New Zealand , Tuberculosis/drug therapy , Tuberculosis, Osteoarticular/diagnosis , Tuberculosis, Osteoarticular/therapy , Tuberculosis, Spinal/diagnosis , Tuberculosis, Spinal/therapyABSTRACT
Records of 110 cases of subacute osteomyelitis were reviewed. Twenty percent of the cases with a subacute clinical course had diffuse radiological changes more characteristic of an acute disease. Classic metaphyseal (Brodie) abscesses were most common. Diaphyseal lesions, of which over half were in adults, had a significantly higher rate of recurrence. The distribution by site and age of metaphyseal lesions resembled that of acute osteomyelitis. Staphylococcus aureus was the most common isolate, but 10% of lesions grew S. epidermidis. A modification of current classification is suggested which offers a basis for management and studies of outcome.
Subject(s)
Osteomyelitis/diagnostic imaging , Acute Disease , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Osteomyelitis/classification , Osteomyelitis/microbiology , Osteomyelitis/therapy , RadiographyABSTRACT
A family with multiple musculoskeletal abnormalities is reported. The disorder is characterised by platyspondyly, abnormality of the upper femoral epiphyses, and the development of precocious osteoarthritis. It is proposed that this family represents an example of autosomal dominantly inherited spondyloepiphyseal dysplasia tarda (SED tarda).
Subject(s)
Mucopolysaccharidosis IV/genetics , Adolescent , Adult , Child , Epiphyses/abnormalities , Female , Femur/abnormalities , Humans , Male , Middle Aged , Mucopolysaccharidosis IV/diagnostic imaging , Osteoarthritis/genetics , Pedigree , Radiography , Spine/abnormalitiesABSTRACT
The outcome of primary management of acute osteomyelitis in 655 children treated in New Zealand between 1947 and 1976 is examined. Failure occurred in 20 per cent of children, in four-fifths of whom it was manifest by one year, and half of whom experienced one recurrence only. Lower failure rates were associated with use of bactericidal antibiotics, certain favourable sites, and age over 16 years. Surgical intervention was associated with significantly higher failure rates. The place of surgical intervention and the optimal duration of antibiotic treatment can only be determined by prospective clinical trials.
