Atraumatic rupture of the spleen: a cautionary note.
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Biomedical subjects
Publications and source records attributed to J Spearman.
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Beginning in 1983, the principles of staple capsulorrhaphy of the shoulder utilizing arthroscopic techniques were applied to the treatment of patients with recurrent anterior shoulder instability. This paper describes the results of arthroscopic staple capsulorrhaphy of the shoulder in the first 25 consecutive cases in which these techniques were utilized. The patient population includes 4 females and 19 males, 2 of whom underwent bilateral staged procedures. Eleven of the patients had documented recurrent anterior dislocations while the remaining 12 patients were determined to have subluxation of the shoulder. The average age of the patient population was 23 years. Follow-up averaged 36 months. Results were determined by utilizing a strict 100 point rating scale as described by Rowe. Utilizing this scale, 67% of patients achieved good or excellent results. Five patients came to undergo additional surgical procedures. There were no complications of infection or neurovascular injury, but one patient suffered staple impingement upon the humeral head leading to excoriation thereof and secondary pain. An average loss of external rotation of 9 degrees, as compared to the contralateral shoulder, was noted postoperatively.
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In the past, shigellosis in Seattle-King County has been primarily a disease of children, their parients, and foreign travelers. During the 18 months beginning in July 1975, an outbreak of shigellosis in Seattle's community of gay men involved both Shigella flexneri and Shigella sonnei. They accounted for nearly 30% of all cases of shigellosis reported to the health department. Fellatio and/or oral-anal contact was reported by 90% of the infected homosexual men; this was probably the mechanism of transmission of most infections. Intercity spread was determined by case histories and by the finding of S. flexneri 3, a previously unusual organism in Seattle.
From July 1972 to December 1975, an unusual outbreak of diphtheria in Seattle, Wash., resulted in a total of 558 cases and carriers, mostly among heavy alcohol users. Skin infections were predominant. Four white men died. The highest attack rate was among native American Indians. Environmental contamination and poor personal hygience were believed to be important in continuation of the epidemic, but could not be proved. Control measures included casefinding, isolation and quarantine, sanitizing dwelling units and mass immunization with Td toxoid. The high-risk geographic area was the city's Skid Road. This area continues to be the reservoir of continuing infection, but not all population subgroups there have been at equal risk. Spread to other geographic areas of the city and county has been minimal and remains under control.