Minerva

Minerva

BMJ 1997; 314 doi: http://dx.doi.org/10.1136/bmj.314.7093.1562 (Published 24 May 1997) Cite this as: BMJ 1997;314:1562

The enigma of primary frozen shoulder has been solved, says a review in the Annals of the Royal College of Surgeons of England (1997;79:210-3). It is due to a fibrous contracture of the rotator interval and the coracohumeral ligament of the shoulder joint by tissue that shows the same histological features as in Dupuytren's contracture. Logically, therefore, the treatment should be similar–surgical release of the contracture.

Monkeypox is related to smallpox and cowpox and can be transmitted to humans, but transmission between people is unusual. In a recent outbreak of the disease in people living in Zaire, at least 71 cases occurred and there were six deaths (Eurosurveillance 1997;2:33-50). This is the largest cluster of human cases ever reported, and transmission between people seems to have been responsible for most of the spread of the disease. Vaccinia vaccination protects against monkeypox and may need to be considered if further outbreaks occur.

Women who have symptoms of illness that they attribute to silicone breast implants do seem to feel better after the implants have been removed–or that was the experience of 24 out of 25 women treated in Alabama (The American Surgeon 1997;63:421-9). In 20 of the 25, the silicone implants were replaced with new ones filled with saline: only one woman was dissatisfied with the results of revision surgery two years afterwards.

Botulinum A toxin has established its place …

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