Treatment of nonseptic olecranon bursitis

Article Abstract:

The olecranon is the portion of the ulna, a bone of the forearm, that makes up the elbow. Tendons which cross this area are protected from physical abrasion by the interposition of a small connective tissue sac or bursa, which is filled with tissue fluid. Olecranon bursitis involves inflammation of the bursa of the olecranon. The value of draining the bursa of fluid and injecting any of several anti-inflammatory drugs into the bursa was compared with oral steroid treatment and with placebo treatment. Olecranon bursitis is common, and in a study of patients visiting a Veterans Administration outpatient clinic, it was found that three patients in every 1,000 were diagnosed with this condition. Forty-two male patients with uninfected olecranon bursitis were selected for the study. The degree of swelling was used to measure the patients' progress; measurements were taken at onset, and again at one, three, and six weeks. Treatment with the anti-inflammatory drug methylprednisolone acetate injected into the bursa was found both to bring the greatest short-term improvement and to result in the fewest number of patients who required further removal of fluid from the bursa. This study demonstrates that direct intrabursal steroid injection is vastly superior to other forms of treatment.

Evaluation, Synovial fluid, Methylprednisolone, Bursitis, Bursa (Anatomy), Bursae

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The use of porcine factor VIII concentrate (Hyate: C) in the treatment of patients with inhibitor antibodies to factor VIII: a multicenter US experiment

Article Abstract:

The response to porcine factor VIII (anti-hemophiliac factor produced from pigs) was evaluated in 45 bleeding episodes in 38 patients with classic hemophilia (a genetically-based disease in which an antibody prevents factor VIII from carrying on its normal role in blood clotting). Most of the patients had a life- or limb-threatening hemorrhage for which other treatments had not been successful. In 32 of the 45 episodes the results were good to excellent. Adverse reactions were minimal and were treated with antihistamines or steroids. No predictor of how an individual patient would respond to porcine factor VIII was identified. It was concluded that porcine factor VIII is a valuable treatment for serious hemorrhages in patients with classic hemophilia and should be used early in the course of treatment.

Physiological aspects, Hemorrhage, Hemophilia, Blood coagulation factor VIII, Factor VIII (Blood coagulation)

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Large phosphate shifts with treatment for hyperglycemia

Article Abstract:

Low blood phosphate levels (hypophosphatemia) often accompanies treatment for high blood glucose levels, or hyperglycemia. However, it is not generally understood that this condition can be seriously life-threatening. Two patients are described who had a sudden onset of hypophosphatemia while receiving insulin intravenously. It was concluded that phosphate levels should be monitored frequently during therapy for hyperglycemia and that phosphate should be administered if the level falls below 0.5 mmol per liter. Three reasons are cited: blood phosphate levels do not reflect the total body stores of phosphate, rapid shifts in phosphates can occur in the body, and severe hypophosphatemia is potentially life-threatening.

Complications and side effects, Hyperglycemia, Insulin, Hypophosphatemia

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