Neurogenic intermittent claudication in association with spondylolisthesis

Diarrhea and Fecal Incontinence

In brief Two endurance athletes developed diarrhea and fecal incontinence each time they exercised strenuously. Such gastrointestinal difficulties are usually benign, but physicians determined that the disorders were an unusual presentation of lumbar spondylolisthesis in a runner and of jejunal diverticulosis in a cyclist. The runner's diarrhea and incontinence resolved when she avoided activities that precipitated her symptoms, and the cyclist's condition resolved with oral tetracycline.

Asymptomatic carotid stenosis: is prophylactic endarterectomy justifiable?

Carotid endarterectomy is well established in the treatment of selected cases of atherosclerosis of the carotid bifurcation; however, its role in the management of asymptomatic stenosis of the internal carotid artery remains controversial. Over a 4 year period 190 patients with 209 asymptomatic stenoses of the internal carotid artery were prospectively studied by means of Doppler ultrasound in combination with real time spectral analysis to determine the natural history of asymptomatic carotid stenosis. We report a cumulative stroke-free survival of 97 per cent at 3 years and we therefore question the merit of prophylactic endarterectomy in the management of asymptomatic carotid disease.