Mycobacterium malmoense septic arthritis.

We report a case of septic arthritis of an interphalangeal joint and osteomyelitis of the phalanx due toMycobacterium malmoense in a 61-year-old man with a 20 year history of rheumatoid arthritis treated with steroids and azathioprine. This was successfully treated with ethambutol, rifampicin and clarithromycin. To our knowledge this is the only reported case of septic arthritis due to this pathogen which is usually associated with respiratory disease or cervical lymphadenitis.

Laboratory control of oral anticoagulant therapy: preservation of prothrombin time specimens using a polypropylene collection system.

Previous studies have shown a marked time and temperature dependent shortening of the prothrombin time (PT) when blood is exposed to borosilicate (glass) or siliconized borosilicate tubes. Current recommendations are that samples for PT estimation should be tested within 2 h of collection. In this study using polypropylene collection tubes, blood obtained from 30 patients on oral anticoagulant therapy showed no significant change in International Normalized Ratio (INR) value after 24 h storage--either at 4 degrees C or room temperature. After 48 h. changes in INR values from refrigerated samples were still clinically insignificant. After 48 h storage at room temperature, however, a minority of samples showed an increase in INR value which may be of clinical importance. The range of INRs studied was 1.0-9.1. In a second evaluation, replicate specimens from 22 orally anticoagulated patients with INRs ranging from 1.0 to 9.6 showed no significant change after 24 h at either temperature--even when samples had been subjected to 30 min of gentle agitation prior to storage and analysis. Overall, the results indicate that when polypropylene collection tubes are used, prothrombin time specimens can be successfully preserved for up to 24 h at room temperature or up to 48 h when refrigerated.

Asthma, IgE and environment in northern Nigeria.

Sixty-four asthmatics and seventy-five control subjects from rural villages and various urban settings have been investigated. Rural asthmatics had a significantly higher IgE level than both urban asthmatics and village controls. Urban asthmatics had similar IgE levels to urban controls. There was no relationship between IgE levels and the results of skin tests for asthma allergens. Stool parasites were found as frequently in asthmatics as in controls. Our findings do not support the theory that parasitic infestation, high IgE levels or rural living protect from asthma.

Regional lung function in ankylosing spondylitis.

Xenon-133 was used to study regional pulmonary function in nine patients with chest cage rigidity due to ankylosing spondylitis. In comparison with normal subjects, the patients showed an overall diminution in lung volume and the proportion of inhaled xenon reaching the lung apices was reduced but the distribution of injected xenon was normal. The possible relationship between these findings and apical lung disease in ankylosing spondylitis is mentioned.

Regional lung function in unilateral diaphragmatic paralysis.

Radioactive xenon-133 was used to study the regional lung function of five patients with unilateral diaphragmatic paralysis unassociated with intrathoracic disease. All patients showed a reduction in total lung capacity to which the affected side contributed an average of 37%. There was a decrease in the amount of inhaled xenon and a lesser decrease in the amount of injected xenon reaching the lung base on the paralysed side.The distribution in the opposite lung did not differ significantly from that found in normal subjects although the proportion of inhaled xenon reaching the lung base was rather less than in the normal group. The washout of injected xenon was normal except for slight impairment at the lung base on the paralysed side in one patient and at both bases in another.