Antibiotics for acute maxillary sinusitis.

Background: For adults seeking care in ambulatory medical practices, sinusitis is the most common diagnosis treated with antibiotics.

Objectives: We examined whether antibiotics are indicated for acute sinusitis, and if so, which antibiotic classes are most effective.

Search Strategy: Relevant studies were identified from searches of MEDLINE and EMBASE in December 2001, contacts with pharmaceutical companies and bibliographies of included studies.

Antibiotics for acute maxillary sinusitis.

Objectives: For adults seeking care in ambulatory practices, sinusitis is the most common diagnosis treated with antibiotics. We examined whether antibiotics are indicated for acute sinusitis, and if so, which antibiotic classes are most effective.

Search Strategy: Relevant studies were identified from searches of MEDLINE and EMBASE in October 1998, contacts with pharmaceutical companies and bibliographies of included studies.

Gallstone size and risk of pancreatitis.

Background: The treatment of patients with gallstones who have suffered a first episode of acute biliary pain is controversial. Recent guidelines suggest that such patients may choose to observe the "pattern" of their pain over time before deciding about therapy.

Objective: To determine clinical factors that would identify patients at high risk for 2 important complications: acute biliary pancreatitis and acute cholecystitis.

Quantitative assessments from the clinical examination. How should clinicians integrate the numerous results?

Objective: To describe strategies for using multiple clinical examination items to estimate disease probabilities; and to evaluate the diagnostic accuracy of each strategy.

Design: Prospective observational study.

Setting: Medical preoperative evaluation clinic at a university-affiliated Veterans Affairs Medical Center.

Predicting daily visits to a walk-in clinic and emergency department using calendar and weather data.

We studied the association between calendar and weather variables and daily unscheduled patient volume in a walk-in clinic and emergency department. Calendar variables (season, week of month, day of week, holidays, and federal check-delivery days) and weather variables (high temperature and snowfall) forecasted clinic volume, explaining 84% of daily variance and 44% of weekday variance. Staffing according to predicted volume could have decreased overstaffing from 59% to 15% of days, but would have increased understaffing from 2% to 18% of days.

Clinical correlates of gallstone composition: distinguishing pigment from cholesterol stones.

Objectives: The prevalence of cholelithiasis has been established in population-based surveys employing ultrasonography, and major risk factors have been identified. However, the clinical and epidemiological features that distinguish patients with pigment gallstones from those with cholesterol stones have received little attention.

Methods: We prospectively surveyed 551 patients undergoing cholecystectomy for gallstones at two teaching hospitals.

Randomized controlled trial of 3 vs 10 days of trimethoprim/sulfamethoxazole for acute maxillary sinusitis.

Objective: To compare 14-day outcomes and relapse and recurrence rates among patients with acute maxillary sinusitis randomized to 3-day (3D) vs 10-day (10D) treatment with trimethoprim/sulfamethoxazole (TMP/SMX).

Setting: University-affiliated Veterans Affairs general medical and acute care clinics.

Patients: Consecutive patients with sinus symptoms and radiographic evidence of maxillary sinusitis (complete opacity, air-fluid level, or > or = 6 mm of mucosal thickening).

Measuring shoulder function with the Shoulder Pain and Disability Index.

Objective: To extend the validity of the Shoulder Pain and Disability Index (SPADI) by (1) making it suitable for telephone administration; (2) determining its convergent validity with other health status measures; and (3) assessing the responsiveness of the SPADI to clinical change.

Methods: Consecutive primary care patients with shoulder discomfort were followed for 3 months. At enrollment, a detailed shoulder specific history was obtained by a trained research assistant, and the Health Assessment Questionnaire (HAQ), the Medical Outcomes Study SF-20 (SF-20), and numeric and visual analog versions of the SPADI were completed by the patient.

Usual care and outcomes in patients with sinus complaints and normal results of sinus roentgenography.

Objective: To describe the usual care and outcomes of patients with sinus symptoms and normal sinus roentgenograms.

Design: Prospective cohort with 60-day follow-up.

Setting: Medical outpatient clinics at a university-affiliated Veterans Affairs medical center.

Gallstone characteristics in Mexican Americans and non-Hispanic whites.

Mexican Americans have an elevated risk of gallstones. Their increased rates may be due to genetic admixture with Native Americans, who have extremely high prevalences of cholelithiasis. Native Americans are believed to have almost exclusively cholesterol stones, whereas only 73% of non-Hispanics are reported to have such stones.

Resident recognition of open-angle glaucoma: effects of an educational intervention.

To test an educational intervention's effect on improving detection of glaucoma by direct ophthalmoscopy, 14 medicine residents examined five patients, two with ophthalmoscopic changes of glaucoma and three with normal fundi. The residents observed a standardized slide/narrative educational intervention reviewing glaucomatous ophthalmoscopic changes and then re-examined the same patients eight to 12 weeks later. The intervention's odds of improving residents' diagnostic impression were significant (OR = 2.

The effect of sleeved arms on oscillometric blood pressure measurement.

The authors measured the blood pressures of 36 subjects who had bare and sleeved arms to determine the effect of wearing sleeves on automatic oscillometric blood pressure measurements. They found no statistically significant effect of sleeves on the measurement of either systolic or diastolic blood pressure (p > 0.15).

Diagnosis of obstructive airways disease from the clinical examination.

Objective: To determine the operating characteristics of history and physical examination items for pulmonary airflow obstruction.

Design: Prospective observational study.

Setting: Medical Preoperative Evaluation Clinic at the Durham Veterans Affairs Medical Center.

Analytical procedures for estimating milk intake and yield in steady-state and nonsteady-state systems.

A tracer method for determining milk intake, introduced earlier, was based on the transfer of tritiated water from a lactating female to a nuring offspring via milk. The analysis of the tracer data assumed a steady state system, i.e.

Validation of doubly labeled water method using a ruminant.

CO2 production (CDP, ml CO2 . g-1 . h-1) by captive caribou and reindeer (Rangifer tarandus) was measured using the doubly labeled water method (3H2O and H2(18)O) and compared with CO2 expiration rates (VCO2), adjusted for CO2 losses in CH4 and urine, as determined by open-circuit respirometry.

Postnatal changes in body composition of laboratory maintained brown lemmings, Lemmus sibiricus.

Postnatal changes in the body composition components, namely, body water, fat-free dry solids, and fat, were determined for laboratory-maintained brown lemmings, Lemmus sibiricus. The proportion of body water decreased while the proportion of fat-free dry solids and fat increased from birth to approximately 15 weeks of age. From 20 through 80 weeks of age, the proportions of all body composition components as well as total body weight remained relatively constant.

Specificity of antitumor immune reactions mediated by xenogeneic immune RNA.

Evidence that xenogeneic immune RNA (I-RNA) mediated specific cytotoxic immune responses against human tumor-associated antigens was obtained from in vitro studies in two autologous melanoma systems. In these systems, malignant melanoma target cells, matching normal fibroblast target cells, lymphocyte effector cells, and melanoma and normal skin tissue used to immunize RNA donor animals were derived from the same autochthonous hosts. When incubated with autologous lymphocytes, I-RNA extracted from the lymphoid organs of donor animals immunized with melanoma tissue mediated immune reactions against autologous melanoma target cells in vitro.