Is the Patellar Pubic Percussion Test useful to diagnose only femur fractures or something else? Two case reports.

In the literature, the utility of the Patellar Pubic Percussion Test (PPPT) to diagnose occult fractures of the femur is well described. However, up to now there are no studies demonstrating the efficacy of this test in recognizing fractures of the pelvis. In this two case report a positive PPPT allowed the therapist to recognize clinical conditions requiring caution, protecting patients from a potentially unsuitable treatment. Both patients had a negative pelvis and femur x-ray after a fall, but the clinical findings and a positive PPPT lead the physiotherapist to suggest further examinations. In these two cases the PPPT seemed to be a useful diagnostic tool to identify periacetabular, ileo-pubic and ischio-pubic ramus fractures. These findings suggest that PPPT could be positive even for a bone lesion in any of the transit points of the vibration, from the patella to the pubic symphysis.

Methisoprinol restoration of leukocyte chemotaxis inhibition by blocking factors in immunoproliferative diseases.

The ability of methisoprinol to antagonize the serum-inhibiting activity present in the sera of patients affected by immunoproliferative diseases (Hodgkin's disease and multiple myeloma) was investigated. Using a chemotaxis test, it was found that whereas donor leukocytes preincubated in patient sera exhibited impaired chemotaxis, the presence of methisoprinol (500 micrograms/ml) during the preincubation caused a significant recovery of this leukocyte function. Since the results exclude the assumption of a non-specific stimulation of cell motility, two hypotheses appeared possible for the action of methisoprinol: either an antagonistic activity against the blocking factor at the receptor or the metabolic level, or a direct inactivation of this factor. The clinical implications, with regard to the prophylaxis of infections and a better response to chemotherapy, are discussed.