An evaluation of ultrasonography in early dilatation and aneurysm is presented. Fifty-nine patients with prominent abdominal pulsation were examined and aneurysm was demonstrated in 22. There was a high degree of correlation between the size of the aneurysm demonstrated by ultrasound and the size displayed at operation. It was also possible to demonstrate increasing dilatation by measurement on subsequent occasions.
Osteoporosis was studied in 307 patients with "definite" or "classical" rheumatoid arthritis by measurement of the clavicular cortical thickness (C.C.T.). Bone loss, as measured by this index, fell with advancing age, and was significantly greater than in non-rheumatoid control subjects matched for age and sex. Bone loss from the clavicles was not greater in patients treated with corticosteroid drugs. Loss of bone from the clavicle correlated with osteoporosis in other parts of the skeleton, as determined by the femoral and metacarpal indices. This suggests that osteoporosis in rheumatoid arthritis is a generalised phenomenon rather than a localised process secondary to adjacent joint inflammation.
Raised Intracranial Pressure-Duffy MEDICAL JOURNAL 40 of an inflammatory process involving the ear, nose, or sinuses, followed after a period by meningitic signs and symptoms. Initial lumbar puncture produces a fluid containing inflammatory cells but with a doubtfully low sugar content and in which and from which no organisms can be seen or cultured. In these cases the possibility of the presence of an intracranial abscess should be carefully considered and investigated but not by further lumbar puncture. The conversion of a patient with an eminently treatable cerebral abscess into one with secondary irreversible brain-stem damage from tentorial pressure cone formation is an iatrogenic tragedy that should be avoidable.I am grateful to Dr. E. R. Bickerstaff, Mr. J. G. Hamilton, Mr. J. M. Small, and Mr. E. A. Turner for allowing me to study those cases admitted under their care.
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