How do eating disorder specialist clinicians apply DSM-IV diagnostic criteria in routine clinical practice? Implications for enhancing clinical utility in DSM-5.

The clinical utility of the DSM-IV eating disorder (ED) diagnostic criteria among practicing clinicians has not been formally evaluated, despite the considerable diagnostic challenges these disorders present. This study evaluated inter-rater reliability between research and clinical diagnoses, identified discrepantly rated diagnostic criteria, and evaluated ED subtype use in a naturalistic treatment setting. Seventy-six adolescent and young adult female patients consecutively admitted to a residential ED program were evaluated independently by clinicians (unstructured clinical interview) and research assessors (Structured Clinical Interview for DSM-IV).

The combined effects of balloon valvuloplasty and surgical weight loss in treatment of aortic stenosis.

We report a case of a patient with a congenitally bicuspid aortic valve and extreme obesity who developed severe aortic stenosis. She dramatically improved after the combined use of balloon valvuloplasty and Roux en Y gastric bypass. Gastric bypass surgery has promise for patients with congenital cardiac disease whose treatment is complicated by extreme obesity.

Cost analysis of ligature versus stapling techniques of laparoscopic appendectomy in children.

Background: Although longer operative times and specialized instrumentation render laparoscopic appendectomies (LA) more expensive to perform than open appendectomies, the documented advantages of the laparoscopic approach have led many surgeons to prefer it. LAs are currently performed using either the ligature or the stapling technique. The decision as to which technique to employ is currently based on the surgeon's personal preference rather than on a knowledge of comparative costs.