Direct effect of deferoxamine on hemoglobin synthesis in patients on hemodialysis treated with recombinant human erythropoietin.

We have studied the response of hemoglobin (Hb), hematocrit, reticulocytes, mean corpuscular volume, ferritin, serum iron, total iron-binding capacity (TIBC) and the transferrin saturation index in 9 patients on chronic hemodialysis (HD) with minimal aluminum overload who were treated with recombinant human erythropoietin (rHuEPO) when a single dose of deferoxamine (DFO; 40 mg/kg b.w.) was administered. Analytical determinations were performed basally and 48 h, 7 days and 14 days after a DFO test. Hb increased from a basal value of 10 +/- 0.28 to 10.7 +/- 0.33 (p < 0.05), 10.4 +/- 0.33 (p < 0.05) and 10.1 +/- 0.31 g/dl (NS), respectively, and similar increases were seen with the hematocrit. Serum iron increased from 52 +/- 7.62 to 89.2 +/- 14.48 (p < 0.01), 94 +/- 18.73 (p < 0.01) and 85 +/- 14.01 micrograms/dl (p < 0.01), respectively. TIBC and ferritin did not change but the transferrin saturation index increased significantly. DFO produces an immediate improvement of the anemia in HD patients treated with rHuEPO and who have minimal aluminium accumulation: it should be related to an increased iron availability to erythroid precursors either releasing stored iron or decreasing aluminum-bound transferrin.

Functional treatment of recent ruptures of the fibular ligament of the ankle.

A prospective randomised study was undertaken to compare the results of functional and operative treatment of recent ruptures of the fibular ligament of the ankle in 80 patients, aged from 18 to 45 years, with similar injuries. The best results were obtained from functional treatment and it is to be hoped that early movement and a stable ankle will avoid later osteoarthritis.

[Long-term roentgenologic studies in peak performance javelin throwers]. / Röntgenologische Langzeitbeobachtungen bei Speerwerfern der Spitzenklasse.

The example of the javelin thrower demonstrates that an unphysiological movement sequence at the elbow joint (valgus stress) leads to regular arthrotic alterations by summation of such strains: these are known as "javelin elbow". Since the new javelin introduced in 1986 requires a greater explosive force, a tendency to an increased incidence of these alterations must be reckoned with in the future. Further observations are necessary to clarify whether there will be an increase in degenerative alterations in the lumbar spine by abrupt hyperlordosis and trunk rotation in producing the bow tension of the javelin thrower; whether the above-average incidence of patients with spondylolysis amongst competitive javelin throwers is coincidental; whether the processes of remodelling in the interarticular portion of javelin throwers constitute zones of fatigue; and, finally, whether the unilateral trunk strain of the javelin thrower influences the scoliotic posture.

[Conservative functional treatment of fibular capsule ligament rupture even in the performance athlete?]. / Die konservative funktionelle Behandlung der fibularen Kapselbandruptur auch beim Leistungssportler?

In a prospective randomised study we examined 80 men and women of 18 to 45 years of age and 40 competitive sportsmen and sportswomen with fresh ruptures of the talofibular and calcaneofibular ligaments treated either surgically or conservatively by functional bracing. We controlled the results by anamnesis and by clinical and radiological follow-up. Conservative treatment leads to the same results after 3-8 months as surgical treatment (5 +/- 2 degrees of talar angulation). Functional conservative treatment results in earlier painless weight bearing in comparison to the surgical treatment which was, however, combined with three weeks immobilization directly after surgery. This proves the superiority of the early functional conservative treatment as long as there are no bony capsuloligamentous tears, osseocartilaginous lesions of the joint surface with splintered-off chips or "flakes" of cartilage ("flake fractures") or reruptures of a chronically unstable ankle joint. The similarly good results achieved in the group of 40 sportsmen and sportswomen by early functional conservative treatment do not justify operation of ruptures of the talofibular and calcaneofibular ligaments.