The results of 42 patients with displaced proximal humeral fractures treated by conservative means were reviewed. The system advocated by Neer was used to classify the fractures. Of the patients, 16 had two-fragment fractures, 17 three-fragment fractures and 9 four-fragment fractures. In 21 patients, fractures were treated with a sling for 1 week, and in 21 with a hanging cast for 1 week. All patients received physiotherapy after immobilization. Follow-up evaluation included clinical and radiographic examination at a median of 2 years after the trauma. The results were assessed using Neer's protocol. The patients were asked to assess the results. The patients assessed the results better than the Neer score (P less than 0.001). The patients with two-fragment fractures assessed the results as excellent or satisfactory and better than the three- and four-fragment ones (P less than 0.01). The patient response to non-operative treatment was satisfactory. It is concluded that the Neer classification of the results underestimates the degree of satisfaction achieved by the patients. It is concluded that displaced proximal humeral fractures can be treated satisfactorily by non-operative methods.

Adult↗

PubMed1991

[Diagnostic instability in psychiatry].

The purpose of this investigation was to investigate how often psychiatric patients changed diagnosis on readmission to hospitals. On the basis of the most recent discharge diagnosis it was registered how many patients who had been diagnosed in other major diagnostic groups over a 10-year period, and a mobility of 40.6% was found. By comparison with other investigations it was shown, that the changes most often took place in the first two years. The mobility was most marked for the neurosis-group and was approximately uniform for the other groups.

Denmark↗

PubMed1991

[Possible cross hepatotoxicity between tricyclic and tetracyclic antidepressive agents].

The case is reported of a patient in whom acute hepatitis was induced first by a tricyclic antidepressant (dothiepin) and then by a tetracyclic antidepressant (mianserine). This observation does not confirm previous suggestions that the tricyclic ring is responsible for liver toxicity. However, this theory cannot be rejected as the mechanisms causing toxic hepatitis from tricyclic and tetracyclic antidepressants may well differ. The basis of this hepatoxicity is thus still unexplained. A spateine test was performed and this revealed that the patient was a normal metabolizer.

Acute Disease↗

PubMed1991

[Albania. Going along in the new labor movement].

Explore the source record for details and available documents.

Albania↗

PubMed1991

[Albania. Hospital Tirana paralyzed by lack of money].

Explore the source record for details and available documents.

Albania↗

PubMed1991

[Increasing incidence of femoral neck fractures in Alborg].

The object of this investigation was to analyse the frequency of medial and pertrochanteric fractures of the femoral neck and to calculate the future number. During the period 1976-1988, 3,099 patients aged over 50 years were admitted to hospital with fractures of the femoral neck. 60% were medial femoral neck fractures. The sex ratio women:men was 2.94. The median age rose from 78 to 80 years. The annual number of fractures rose from 151 to 344. The population over 50 years of age had increased by 5.4%. The incidence increased from 3.31 per 1,000 in 1976 to 7.15 per 1,000 in 1988. By means of linear regression, the frequency in year 2010 was calculated to be 14.5 per 1,000 and the number of fractures 794. During the course of the coming 17 years, doubling of the number of medial and pertrochanteric femoral neck fractures may be anticipated, provided linear increase in the frequency occurs.

Aged↗

PubMed1991

[Arthroscopic synovial resection of the talocrural joint].

Arthroscopic resection of the synovial membrane was employed in the treatment of chronic pain antero-laterally in the talo-crural joint in eight patients. The ages of the patients varied from 12 to 45 years (median age 24 years). Ten patients had previously sustained traumatic sprains. The duration of the symptoms was, on an average, two years (1-15 years). Radiographic examination of the talo-crural joint revealed normal findings in all of the patients. Arthroscopically, in all of the patients, impingement of hypertrophic synovial tissue at the upper lateral corner of the talus was found. Trans-arthroscopic resection was performed with a shaver. A total of six patients became symptom-free and two experienced considerable relief of symptoms. The present authors have found the method to be suitable in selected cases of chronic pain in the talo-crural joint.

Adolescent↗

PubMed1991

[Recurrent ventricular tachyarrhythmias primarily diagnosed as epilepsy].

In Denmark, 6,000-10,000 persons die annually from sudden cardiac death. The majority of these die on account of ventricular fibrillation. A patient is presented here who suffered from recurrent lipothymic seizures which were primarily diagnosed as epilepsy. On account of absence of paraclinical documentation and because of suspected depression, treatment with a cyclic antidepressive agent was commenced, which further increases the tendency to sudden cardiac death. The patient was then brought to hospital with Lidocaine-resistant ventricular fibrillation which responded partly to Ajmalin and partly to Disopyramide. The lipothymic seizures were then interpreted as being precipitated by intermittent malignant episodes of cardiac arrhythmia. During the subsequent six months, the patient has felt well and has been free from lipothymic seizures while receiving 200 mg Mexiletin thrice daily. Attention is drawn to the value of Holter monitoring in the investigation of lipothymic seizures. Lidocaine (despite the existence of resistant cases) must still be considered to be the preparation of first choice on account of extensive knowledge about and confidence in the preparation.

Aged↗

PubMed1991

Detection of Chlamydia psittaci using DNA probes and the polymerase chain reaction.

Fewer than 10(5) elementary bodies of Chlamydia psittaci could be detected by using DNA hybridisation with a plasmid probe specific for avian chlamydial strains. PCR amplification of chlamydial DNA using primers specific for conserved regions of the major outer membrane protein gene enabled the detection of fewer than 10 elementary bodies. DNA could be amplified from 22 of the 24 chlamydial strains tested including avian, feline, ovine, caprine, koala and lymphogranuloma venereum strains.

Animals↗

PubMed1991

Efficacy and safety of alprazolam, imipramine and placebo in treating panic disorder. A Scandinavian multicenter study.

As part of the cross-national collaborative panic study, a double-blind comparison of alprazolam, imipramine and placebo was performed in Scandinavian outpatients with panic disorder according to DSM-III; 41 patients were randomly allocated to each drug. Doses were increased for 3 weeks to an average of about 6 mg alprazolam, 150 mg imipramine and a corresponding number of placebo capsules, which were then given for 5 weeks. No more than supportive psychotherapy was given. Key symptoms were rated weekly. The drugs were tapered for 4 or 8 weeks and the patients were followed up for 6 months. Compliance at 3 weeks was 95% for alprazolam, 83% for imipramine and 88% for placebo; at 8 weeks 95% for alprazolam, 73% for imipramine and 46% for placebo. At 3 weeks plasma determination showed that the proportion taking diazepam outside the protocol was 0% for alprazolam, 19% for imipramine and 31% for placebo; at 8 weeks the corresponding proportions were 3%, 11% and 16%. Intention-to-treat analysis showed that freedom from panic attacks was obtained for 68% with alprazolam, 61% with imipramine and 34% with placebo. Alprazolam was more effective than imipramine and placebo on anticipatory anxiety and phobic symptoms. Globally rated by physicians and patients, about 60% had complete remission with alprazolam and imipramine and 30% on placebo. At least partial remission was obtained in about 85% with alprazolam, 70% with imipramine and 40% with placebo. Alprazolam had a more rapid onset of action than imipramine on all symptoms. Side effects were generally mild, with a preponderance of drowsiness for alprazolam and anticholinergic effects for imipramine. Tapering was uneventful without significant discontinuation phenomena. During taper and follow-up, several patients in remission relapsed, leaving approximately 30% patients in complete remission in all groups. To obtain more stable improvement, either long-term drug treatment or combinations of drug treatment and psychotherapy should be evaluated.

Adolescent↗