The PCL is usually injured as the result of stretching deformation; on MRI, the ligament maintains continuity as a single structure with apparent thickening. On sagittal T2-weighted images, an anteroposterior diameter of 7 mm or more is highly suggestive of a torn PCL. Increased intrasubstance signal intensity in the PCL on proton-density images with lower signal intensity on T2-weighted images is another common feature.
Clindamycin phosphate was used in the treatment of 29 children with osteomyelitis of whom 25 had an acute and four a chronic type of infection. The usual dose was 50 mg/kg/day intravenously for approximately three weeks followed by oral clindamycin palmitate at home in a dose of 30 mg/kg/day for an additional six weeks. Staphylococcus aureus was isolated in 22 of 29 cases: 96% of strains were penicillin resistant. The clinical and bacteriologic results in the present series were good to excellent. There was prompt clinical and bacteriologic response shortly after initiation of clindamycin therapy. Good bone penetration of the drug was observed. Long-term evaluation revealed satisfactory clinical and roentgenographic progress in all patients. No diarrhea or manifestations of enterocolitis appeared in any patient in spite of high doses of the drug for intervals up to nine weeks.
Gallstone disease is a main public health problem. The overall prevalence data range from 3.9% in the pre-echographic era to 13.7% when ultrasonography was used as a diagnostic tool. This study is aimed to determine the prevalence of gallstone disease in a medium income level population in Lima, as well as the relationship with some risk factors: age, sex, familiar history and obesity. A total of 534 adult men and women from a medium economic level underwent ultrasonographic examination of abdomen for detection of gallstone disease (July 2003). The echographic evaluation was performed by 10 general surgeons trained in ultrasonography. Likewise, 4 risk factors--age, gender, familial history, and obesity--were analyzed. Pearson chi2 test (2-sided) was used with a probability of <0.05 for statistical significance and logistic regression analyses for assessment of confounding factors. The prevalence founded was 15%. Eighty-one of 534 participants had lithiasis. Compared to the age group under 30, the odds ratio for the 31 to 50 years and >50 years of age group was 0.9 and 1.1, respectively. The female-male ratio was 1.07 and the odds ratio 0.8. The prevalence of gallstone disease in people reporting a first-degree relative with lithiasis was 21%, whereas in participants without such a condition, it was 13%. On the other hand, a familial history was present in 38% of the lithiasis group and in 25% of the nonlithiasis group. The odds ratio for familial history was 1.8 (P = 0.01, 95% confidence interval 1.1-2.9). The prevalence of the disease for body mass index <24, 25 to 29, and higher than 30 was 17%, 14% and 13%, respectively. Compared to the reference group (body mass index <24), the other 2 groups (body mass index 25-29 and >30) both had a similar odds ratio, 0.8. Logistic regression analyses showed an odds ratio of 1.9 for familiar history (95% confidence interval 1.1-3.2), whereas the odds ratio of the overweight (body mass index 25-29) and obese group (body mass index >30) when compared to the normal group, BMI <24, was 0.7 and 0.9, respectively. The prevalence data for gallstone disease remain slightly higher than those previously reported. Although the familiar history was the only characteristic with a statistically significant positive relationship with lithiasis, additional studies are needed because few biases could not be completely avoided and some confounding factors were not controlled.
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