External stabilization of a replanted upper extremity: case report

A case replantation of the upper extremity is presented using external fixation as the method to achieve bony stability. Although internal fixation may remain the method of choice for stabilization of a replanted limb, external fixation can also provide bony stability where more conventional methods are not applicable.

Female gonorrhea: its relation to abnormal uterine bleeding, urinary tract symptoms, and cervicitis

Data are presented from an investigation of the assocation of presenting complaints with gonococcal infection in females seeking primary care in an urban emergency room. Over 27% of patients in the study had cultures positive for Neisseria gonorrhoeae (GC). The GC positivity rates which were significantly higher than expected were found in patients with abnormal uterine bleeding, urinary tract symptoms, and cervicitis, as well as acute PID. Clinical findings suggest an etiologic role for the gonococcus in the pathogenesis of these disorders. Where the incidence of gonorrhea is high, new approaches in the managment of patients with these presenting complaints are necessary in order to prevent the more serious complications of gonorrhea and further spread of the disease.

Glucose tolerance and insulin sensitivity in malnourished children

1. In malnourished, compared with recovered children, fasting blood glucose concentrations were low and there was impaired peripheral glycolysis as shown by a failure of blood lactate to rise after glucose was injected intravenously.

2. Homogenates of muscle biopsies from malnourished and recovered children produced equal amounts of lactate when incubated anaerobically with various substrates, but when compared with homogenates of biopsies from normal children the pattern suggested an impairment of glycolysis.

3. The rate of glucose disappearance after intravenous glucose was slow in the malnourished child and there was possibly diminished sensitivity to exogenous insulin.

4. Isocaloric diets relatively high or low in fat were fed to children who had recovered from malnutrition. Glucose tolerance, insulin sensitivity, fasting plasma insulin and insulin response to intravenous glucose were all the same in children on either diet.