[The efficacy of bronchoalveolar lavage in the diagnosis of pulmonary tuberculosis]. / Rentabilidad del lavado broncoalveolar en el diagnóstico de la tuberculosis pulmonar.

In order to analyze the usefulness of bronchoalveolar lavage (BAL) for conventional microbiological diagnosis of tuberculosis (TB) and other mycobacteria, and to assess the need to use it or not as a routine diagnostic technique in these diseases, we studied 30 patients with mycobacteria (26 TB and 4 Mycobacterium avium-intracellulare infections) by bronchoscopy, with BAL and bronchoaspirate (BAS) bacteriological analyses also available. The results were compared with those obtained for sputum taken before and after bronchoscopy when these specimens were available. The overall yield for BAL and BAS cultures was 90%, with BAL (83.3%) specimens being more productive than BAS (73.3%) specimens. Both performed far better than the 53.8% recorded for cultures of pre-bronchoscopy sputum and 60% for post-bronchoscopy sputum. BAL was the only diagnostic specimen from 7 patients, while BAS the only one from 4. Sensitivity was similar for the two mycobacteria studied. The results for direct bacilloscopy, however, at 30% for the two specimens, rose to 36.6% when they were analyzed together with BAS and BAL. We conclude that bronchoscopy should be performed on all patients suspected of mycobacterial infection when sputum bacilloscopy is negative and patients have no expectoration. Performance of BAL should be routine since this simple and usually uncomplicated technique produces the most productive specimens.

[External fixators in the treatment of fractures and fractures/luxations of the pelvis]. / I fissatori esterni nel trattamento delle fratture e fratture/lussazioni del bacino.

Combined fractures of the two pelvic arches and severe disjunction of the pubic symphysis are acute lesions which are difficult to treat; in order to avoid poor functional results, the use of external fixatives have now become a routine orthopedic surgical practice. Two cases are reported to illustrate the large numbers of patients treated by the Orthopedic and Traumatological Division of the Ospedale Civile in Alessandria.

[Review of 64 cases of hallux valgus surgically treated with the Keller-Lévière technique]. / Revisione di 64 casi di alluce valgo operati con la tecnica di Keller-Lélièvre.

Sixty four cases of hallux valgus treated using the Keller-Lélièvre technique during the period from January 1982 to December 1987 are examined. The results achieved reveal the validity and limits of this surgical technique. Having established the prescriptions of the technique, it still represents the simplest and safest method for treating this affection in adult/old-aged patients.

[A case of a fracture of the clavicle associated with an acromio-clavicular luxation]. / Su un caso di frattura di clavicola associata a lussazione acromion-claveare.

The study reports a rate case of a girl with associated clavicular fracture and acromioclavicular dislocation following a care accident. The pathogenetic mechanism may be attributed to a trauma on the medial shoulder stump which having fractured the clavicle then provoked the acromioclavicular dislocation by continued pressure on that point. It is important to observe that the patient fully recovered, virtually without therapy.

[Our experience in the use of Thompson's endoprosthesis in medial fractures of the femur neck]. / La nostra esperienza nell'uso dell'endoprotesi di Thompson nelle fratture mediali di collo di femore.

The study reports the results of a study of a random sample of 40 patients with medial fractures of the collum femoris in whom the caput femoris was substituted by Thompson's cemented prosthesis, taken from a series of 189 operations performed between 1981 and 1987. In conclusion, Thompson's prosthesis is demonstrated to be still valid in patients over 75 years old.

[Treatment of subcutaneous rupture of the extensor pollicis longus tendon]. / Sul trattamento delle rotture sottocutanee del tendine estensore lungo del pollice.

The authors present the results of 13 cases operated for subcutaneous rupture of the extensor pollicis longus. Transferral of the extensor indicis proprius was employed in 12 cases and tenodesis involving the extensor pollicis brevis was performed in 1. Results are best when abduction and retropulsion of the thumb are restored. Testing of the correct tension of the transferral procedure is emphasized.