[Periodicity and quality of clinical diagnostics of protracted pneumonia in a tuberculosis clinic].

Analysis of the quality and modes of clinical diagnostics of protracted pneumonia in a tuberculosis clinic revealed the most frequent causes of this condition responsible for hyperdiagnostics of tuberculosis. These are concomitant diseases, pneumosclerosis, chronic bronchitis, fibrous transformation of the bronchial tree, complicated clinical course of pneumonia, age above 60 years, history of tuberculosis, inadequate or short-term antibiotic therapy at the initial stages of diagnostics. Motivational prerequisites for high-quality diagnostic work include compliance with standards and guidelines for the examination and management of patients suspected of having pneumonia with a view to detecting tuberculosis. Such approach would decrease the frequency of ungrounded hospitalization of patients at tuberculosis clinics.

[Causes of hospitalization of non-tuberculous patients in a tuberculosis hospital]. / Prichiny gospitalizatsiii neprofil'nykh bol'nykh v spetsializirovannyi tuberkuloznyi stantsionar.

In present epidemiological and economic conditions tuberculosis suspects should be hospitalized to specialized tuberculosis hospitals only after they are carefully examined for cancer of the lungs and lingering pneumonia. For this an obligatory diagnostic minimum should be introduced.

Calcaneal ostectomy for Haglund disease.

From 1967 to 1987, operative treatment was performed on 28 feet in 22 patients with retrocalcaneal bursitis due to prominent posterior superior margin of the calcaneus (Haglund disease). Through a lateral or medial approach, the prominent bone was removed. The results indicated that excision of the retrocalcaneal bursa was not necessary. Preoperative planning and intraoperative examination was necessary in order to remove an adequate amount of bone, which was the key for a successful result.

Two component femoral head prosthesis-endoprosthesis S-73.

A two component femoral head prosthesis consisting of a metal femoral stem with a small low friction head and HDP cup fitting the acetabulum was used in 80 patients with intra-articular femoral neck fracture; this allowed immediate and relatively painless ambulation and weight bearing. Most of the movement occurs between the stem and cup, so the pain in the joint is eliminated. Except for two cases of technical error there were no signs of instability. It appears that this kind of endoprosthesis may be an answer to the problem of early and painless ambulation in elderly patients with subcapital femoral fracture.

Carpal tunnel syndrome due to thrombosed persisting median artery. A case report.

Surgical intervention for carpal tunnel syndrome in a seventy year old woman revealed thrombosis of a double persisting median artery. The persisting median artery is a rare anomaly and its association with a thrombotic process to cause carpal tunnel syndrome is even rarer. Carpal tunnel syndrome is a widely-known phenomenon about which much has been written in the medical literature. A persisting median artery accompanying the nerve into the carpal tunnel is uncommon, occurring in only about 10% of such cases (Pecket, 1973) and thrombosis of such an artery as a cause for carpal tunnel syndrome is very rare (Burnham, 1963; DeAbreu & Godoy Moreira, 1958). We describe a case in which thrombosis is a double persisting median artery was discovered to be the cause of carpal tunnel syndrome at operation.

Fractures of the femoral neck in childhood. Results of conservative treatment.

Experience with nine patients with fracture of the femoral neck in childhood, eight of whom were treated conservatively by closed reduction and fixation with a plaster cast, and one in whom Steinmann pins and open reposition had to be employed to accomplish fixation, is presented in brief. In six children the results were evaluated as good and in three (including the one case of open reduction) as fair. No serious complications were observed. The problem of nonsurgical versus surgical approach is discussed in the light of the relevant literature. It is suggested that while there can be no set rule as to which treatment should be used, conservative management yields results which are comparable with those attained with a more aggressive approach.

Spontaneous tendon ruptures in patients treated by chronic hemodialysis.

Patients with renal failure treated by chronic hemodialysis tend to spontaneous tendon ruptures. In five out of 35 patients, 8 ruptured tendons have been found--four quadriceps and four finger tendon ruptures. Finger tendon ruptures are usually ignored by the patients because of the low disabling factor in the presence of more vital problems. Secondary hyperparathyroidism was found in all patients who had tendon ruptures and may possibly be the major disposing factor. The patients with tendon ruptures in our series were significantly younger than those without ruptures and had been treated for a longer period of time by hemodialysis, indicating that, whatever the reason for the ruptures, it seems to be a time-related phenomenon.

Conservative treatment of a BCG osteomyelitis of the femur.

A 3-year-old boy presented with an osteolytic lesion and periosteal reaction in the distal metaphysis of the right femur which failed to respond to immobilization and intensive antibiotic treatment. Since the infection seemed to be of low virulence and fewer than 4 years had elapsed since BCG vaccination BCG osteomyelitis was suspected. Tuberculostatic treatment led to rapid recovery and surgical measures were unnecessary.