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.

Use of tissue plasminogen activator for intraocular fibrinolysis in dogs.

Fibrin clots were induced in eyes of dogs by injection of autogenous citrated plasma into the anterior chamber. Twenty-four hours after clot formation, 0.01 ml of tissue plasminogen activator at a concentration of 1 microgram/100 microliters (group 1, n = 5) or 25 micrograms/100 microliters (group 2, n = 5) was injected into 1 anterior chamber of each dog.

Effects of intracameral injection of tissue plasminogen activator on corneal endothelium and intraocular pressure in dogs.

Contact wide-field specular microscopy was performed on eyes of 16 healthy dogs after tissue plasminogen activator at a concentration of 25 micrograms/100 microliters (group 1, n = 8) or 50 micrograms/100 microliters (group 2, n = 8) was injected into 1 anterior chamber of each dog. The contralateral eye served as a nontreated control. Applanation tonometry was used to measure intraocular pressure in both eyes for up to 168 hours.

Does infant feeding method influence maternal postpartum weight loss?

We conducted a retrospective study of 411 women to determine whether a significant relationship existed between method of infant feeding (breast vs bottle) and postpartum weight loss at 6 weeks and 12 months. In addition to method of infant feeding, the variables parity, gravidity, mode of delivery, maternal age, maternal prepregnancy weight, infant sex, and payment status (whether receiving assistance from the Aid to Dependent Children [ADC] program) were studied in terms of their association with weight loss. In general, no consistent relationship was found between method of infant feeding and postpartum weight loss.

Quantitative noninvasive assessment of liver size in clinically normal dogs.

Measurements of liver size were made from radiographs of 16 clinically normal anesthetized dogs. Two measurements were made from each of 3 views: right and left lateral and ventrodorsal. Each measurement was correlated with liver weight and volume.

Effects of intracameral injection of viscoelastic solutions on corneal endothelium in dogs.

Contact in vivo wide-field specular microscopy was performed on right eyes of 20 healthy dogs after sodium hyaluronate (1%, n = 5), sodium chondroitin sulfate (4%) and sodium hyaluronate (3%, n = 5), hydroxypropyl methylcellulose (2%, n = 5), or balanced salt solution (control, n = 5) was injected into the anterior chamber. Using computerized morphometric analysis and pachymetry, changes in endothelial cell density, cell morphologic features, and corneal thickness from baseline values were evaluated at postinjection hour (PIH) 72 and PIH 168. Changes were not seen in endothelial cell density or cell morphologic features in any treated eye.

A model for the induction of Pasteurella multocida type-A pneumonia in pigs.

A model for the induction of pneumonia caused by Pasteurella multocida type-A was developed. Anesthetized pigs were dosed intratracheally with 10(10) colony forming units of P. multocida type-A suspended in a total dose of saline based on the pig's body weight (8 mL/kg).

Effects of intracameral injection of viscoelastic solutions on intraocular pressure in dogs.

Intraocular pressure (IOP) was determined in right eyes of 20 healthy dogs after sodium hyaluronate (1%, n = 5), sodium chondroitin sulfate (4%) and sodium hyaluronate (3%, n = 5), hydroxypropyl methylcellulose (2%, n = 5), or balanced salt solution (control, n = 5) was injected into the anterior chamber. Applanation tonometry was used to measure IOP in both eyes of each dog for up to 168 hours. The 3 viscoelastic solutions resulted in an increased mean IOP by postinjection hours (PIH) 2; from PIH 12 until PIH 72, the IOP was significantly (P less than 0.

Treatment and follow-up of obesity in adolescent girls.

An intervention program was conducted for 12 postmenarche, 12-15-year-old obese girls. Weight Winners, a multicomponent and multidisciplinary after-school intervention program, was developed in which behavior modification, aerobic exercise, and modeling appropriate behaviors for weight control were emphasized. Evaluation made before and immediately after the intervention and at a nine-month follow-up suggested that the after-school treatment program was successful in: 1) reducing the rate of gain and decreasing body weight by 11% while maintaining lean tissue and resting energy expenditure (REE), and 2) improving eating and exercise behaviors.