Impact of qualified (indeterminate) diagnoses on the accuracy of renal, thyroid, and breast fine-needle aspiration biopsy.

A qualified (indeterminate) diagnosis (QD), such as "suggestive of malignancy," is thought to complicate patient management by heightening clinical uncertainty. We report that QDs increase the overall effectiveness of renal, thyroid, and breast fine-needle aspiration (FNA) biopsy and that the probability that a qualified diagnosis is negative (QDN) can be predicted by the formula QDN = number of QDs x (proportion of false-negative outcomes/disease prevalence expressed as a proportion). Results of renal (n = 24), thyroid (n = 163), and breast (n = 456) FNA biopsies performed from January 1992 through December 1998 were reviewed and correlated with results of tissue biopsies.

The Americans with Disabilities Act: II. Implications and suggestions for compliance for medical schools.

There is a need for more information about the Americans with Disabilities Act that is tailored to colleges of medicine so that faculty, staff, and administrators can understand and carry out their responsibilities under the Act. This report (Part II) and the previous one (Part I) in the same issue of Academic Medicine address this need. In Part I, key terms of the Act are defined; the present report focuses on the educational relationship between medical schools, applicants, and students in the context of the Act.

The Americans with Disabilities Act: I. History, summary, and key components.

This report presents (1) a brief history and summary of the Americans with Disabilities Act and (2) an extensive section of definitions and explanations of key components--such as disability, qualified individual with a disability, reasonable accommodation, and undue hardship--and their relevance to medical schools. While these definitions are numerous and somewhat technical, an understanding of them is essential for medical school faculty, staff, and administrators to assess the Act's impact on and implications for their institutions and to assure adequate and appropriate compliance. Gaining such understanding is important, for although some authorities believe that the Act will have minimal impact on most colleges and universities, the author maintains that experience at her medical school does not support this view.

Intake of 25 g of soybean protein with or without soybean fiber alters plasma lipids in men with elevated cholesterol concentrations.

Twenty-one mildly hypercholesterolemic men consumed a diet that was low in fat (< 30% of energy) and cholesterol (300 mg/d) and were given muffins containing 25 g protein + 20 g dietary fiber daily from either isolated soybean protein + soybean cotyledon fiber, isolated soybean protein + cellulose, casein + soybean cotyledon fiber or casein + cellulose. All subjects progressed through the low fat, low cholesterol baseline period, lasting 2 wk, and then through all four dietary treatments, lasting 4 wk each, according to a Latin square design. Plasma concentrations of total, LDL, HDL and VLDL cholesterol, total and VLDL triacylglycerols, and apolipoprotein A-I and B were measured at the end of each period.

Depression of plasma cholesterol in men by consumption of baked products containing soy protein.

The effects of soy-protein consumption with and without soy fiber on plasma lipids in 26 mildly hypercholesterolemic men were studied. Four, 4-wk dietary treatments included 50 g protein and 20 g dietary fiber from soy flour (SF), isolated soy protein/soy cotyledon fiber (ISP/SCF), ISP/cellulose (ISP/C), or nonfat dry milk/C (NFDM/C) in conjunction with a low-fat, low-cholesterol diet. Plasma total cholesterol (TC) concentrations were lowest for both ISP dietary treatments compared with baseline (P < 0.