Multiple abnormalities in the feet and associated changes elsewhere in the skeleton: The case of 3A-7 from a Capsian Site in Algeria.

A skeleton with a number of abnormalities is described involving full discussion of alternative diagnoses. In this complex case, the primary diagnosis is of avulsion of the stem of the bifurcate ligament causing a fracture of the anterior process of the calcaneus. The bilateral fracture identified in Skeleton 3A-7 from Site 12, a Capsian site in Algeria, is a result of the feet being inverted and plantar flexed: the fracture is prone to non-union, which is asymmetrical here. There is also a separate anatomical variation of the feet, 3rd cuneiform and 3rd metatarsal coalition, which was not the cause of trauma. The bifurcate ligament is a major stabilizer of the lateral transverse talar joint, and the trauma could lead to further issues: however, multiple other traumatic changes in 3A-7 most likely occurred at the same time, rather than as the result of pre-existing foot trauma. The asymmetry of the calcaneal condition and asymmetry of the sequelae of the original trauma led to long bone asymmetry, the result of locomotor difficulties.

Group therapy with sexually abused adolescents.

The sexually abused adolescent girl is attempting to cope with a disturbing past, threatening present, and disrupted future. She may also be feeling cut off or different from her friends at a time when, developmentally, peer contact is vital. This paper describes a group therapy experience offered to six 13 and 14 year old abuse victims in order to help them feel better about themselves, improve their social skills and reconnect with others their own age. The group focused on the girl's present, everyday functioning and the effects the family disturbances and abuse have had on them. The male and female co-therapists attempted to create an atmosphere of trust and mutual aid; discussions centered on the relationships among group members and the connections the girls make with their important others, including family, friends, and social agencies. As the sessions progressed, four main themes of concern emerged; the girls shared feelings of violation, loss, anger and, finally, hope for their future. The paper illustrates these themes, delineates some of the girls' group experiences, and changes they underwent, and points out some organizational issues for the therapists in running this type of group.

Metastatic cardiac tumor demonstrated by 201thallium scan.

A patient with bronchogenic carcinoma had an electrocardiogram that was initially thought to be consistent with myocardial infarction and possible left ventricular aneurysm. A heart scan with radioactive 201thallium showed an area of sharply diminished uptake ("cold spot"); however, subsequent thoracotomy showed that this was caused by local pericardial and myocardial infiltration by tumor. This suggests a role for radioactive 201thallium in the detection of cardiac metastatic tumors.

Group work with patients on peritoneal dialysis.

The patient in end-stage renal failure, whose life depends on an artificial kidney machine, must make major emotional and physical adjustments. The author describes how in-hospital group treatment can help these patients cope with their new life situation.