Cystic dysplasia of the testis associated with multicystic dysplasia of the kidney.

A child with cystic dysplasia of the testis (CDT) that presented as a solid mass by ultrasound imaging is reported. The child also had ipsilateral multicystic dysplasia of the kidney (MCDK). A search of the literature revealed that unilateral renal agenesis (URA) is commonly associated with CDT.

Effectiveness of cholecystokinin-stimulated cholescintigraphy in the diagnosis and treatment of acalculous gallbladder disease.

We retrospectively reviewed the medical records of 107 patients in two community hospitals who had undergone cholecystokinin-stimulated cholescintigraphy with ejection fraction to determine whether this test is reliable in identifying patients whose symptoms will improve following cholecystectomy. Patients with cholelithiasis or incomplete medical records and patients who could not be interviewed were excluded from the study. Forty-two of 58 study patients (72%) had an abnormal ejection fraction (defined as 35% or less); 27 of 42 patients (64%) underwent cholecystectomy.

Indirect enantiomeric separation of 2-arylpropionic acids and structurally related compounds by reversed phase HPLC.

A reversed-phase high-performance liquid chromatographic method, using an organic modifier-phosphate buffered mobile phase, for the determination of the enantiomeric composition of 2-arylpropionic acids and other structurally related compounds in microbial media is described. The method is based on the resolution of diastereoisomeric amides formed from the reaction of the arylpropionic acid with either (-)-(S)-alpha-methylbenzylamine or (-)-(S)-1-(naphthen-1-yl)ethylamine in the presence of 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide HCl and 1-hydroxybenzotriazole and incorporating an internal standard. The addition of sodium pentanesulphonate to the mobile phase as an ion-pairing agent was necessary to remove unreacted amine to avoid rapid column deterioration.

Management outcomes in splenic injury: a statewide trauma center review.

Objective: Clinical pathways now highlight both observation and operation as acceptable initial therapeutic options for the management of patients with splenic injury. The purpose of this study was to evaluate treatment trends for splenic injury in all North Carolina trauma centers over a 6-year period.

Methods: Splenic injuries in adults over a 6-year period (January 1988-December 1993) were identified in the North Carolina Trauma Registry using ICD-9-CM codes.

Transected thoracic aorta: age-specific differences in incidence and possible reasons.

The objective of this study was to determine the incidence of aortic transaction in relation to age, and to examine possible reasons for the observed differences. Data from the North Carolina Medical Database over a 7-year period were examined for the total number of motor vehicle accident victims and for the subset with aortic rupture, based on age at presentation. Data were then divided into 10-year intervals and the differences analyzed using chi-square analysis.

Optimization of the chiral inversion of 2-phenylpropionic acid by Verticillium lecanii.

Previous studies have demonstrated that Verticillium lecanii might be used as a microbial model of the inversion of 2-arylpropionic acids in man. This paper describes the optimization of the inversion process in respect of culture medium, pH, cell density and substrate concentration. The study demonstrates that optimum inversion occurs in Sørensen's phosphate buffer at pH 5.

Newborn screening for inborn errors of metabolism: a systematic review.

OBJECTIVES. To establish a database of literature and other evidence on neonatal screening programmes and technologies for inborn errors of metabolism. To undertake a systematic review of the data as a basis for evaluation of newborn screening for inborn errors of metabolism.

A mechanistic investigation of the microbial chiral inversion of 2-phenylpropionic acid by Verticillium lecanii.

Previous investigations have described the development of nongrowing suspensions of Verticillium lecanii as a microbial model of the mammalian chiral inversion of the 2-arylpropionic acids (2-APAs). Mechanistic studies in mammals have shown that inversion involves loss of the alpha-methine proton but retention of the original atoms at the beta-methyl position, and a mechanism has been proposed involving enzymatic epimerisation of acyl-CoA thioester derivatives of the substrate. Inversion of the 2-APAs by V.

Nosocomial pneumonia in ventilated trauma patients during stress ulcer prophylaxis with sucralfate, antacid, and ranitidine.

Objective: To compare the incidence of nosocomial pneumonia in critically injured patients randomized to one of three stress ulcer prophylaxis regimens.

Design: Prospective, randomized clinical trial.

Methods: Mechanically ventilated patients admitted to the trauma intensive care unit of a Level I trauma center received sucralfate, antacid, or ranitidine.

Work-related musculoskeletal disorders among physical therapists.

Background And Purpose: Increasing evidence suggests that musculoskeletal disorders are common in workers in the United States health care industry. Physical therapists, who commonly treat patients with these disorders, are also at risk for work-related musculoskeletal disorders (WMD) in the upper limbs and low back. The purpose of this study was to determine the prevalence of WMD during a 12-month period and the job factors that may be associated with these disorders in physical therapists.

Thoracic aorta injuries: management and outcome of 144 patients.

Rupture of the thoracic aorta from blunt injury is often lethal. Methods of operative repair vary, based on the surgeon's preference and circumstances. The primary hypothesis of this study was that operative management choices would correlate with outcome.

Enforcement of drunken driving laws in cases involving injured intoxicated drivers.

Study Objective: To determine the frequency of driving while impaired (DWI) charges among alcohol-intoxicated drivers injured in motor vehicle crashes (MVCs) and any differences in the group of those charged compared with those not charged.

Methods: We performed a retrospective analysis of linked data from medical and judicial sources. Our setting was an urban emergency department of a trauma center serving a population of 1 million.

A comparison of the effects of insulin-like growth factor-I, insulin and combined infusions of insulin and insulin-like growth factor-I on glucose metabolism in dogs.

The effect of infusions of recombinant insulin-like growth factor-I (IGF-I) (34, 103 or 688 pmol kg-1 min-1), insulin (3.4, 10.3 or 68.

Field triage of trauma patients based upon the ability to follow commands: a study in 29,573 injured patients.

Unlabelled: If a trauma system is to deliver "the right patient to the right hospital at the right time," a simple triage tool that can be used in the field to rapidly identify patients with a significant risk of morbidity and mortality is vital.

Objective: The purpose of this study was to evaluate the effectiveness of the Glasgow Coma Scale's Motor Response Component (GMR) in identifying such patients.

Methods: From patient records in a well established state trauma registry, the predictive power of the Glasgow Motor Score was compared with the predictive power of the Injury Severity Score (ISS), Trauma Score, and whole Glasgow Coma Scale Score (GCS), using discriminant analysis and logistic regression.

Compliance devices preferred by elderly patients.

Many elderly patients take several medications for chronic conditions, a situation which causes problems in compliance with drug regimens. This study surveyed patients' preferences among four devices designed to make compliance easier: rub-off reminder labels, medication organizer trays, a container cap with a modified alarm clock, and a digital elapsed timer. Thirty-one enrolled patients used each device for one month then reported their ratings of four device attributes--clarity of directions for use, ease of use, convenience, and effectiveness in preventing dosing errors.

Effects of insulin-like growth factor-I (IGF-I), insulin and combined IGF-I-insulin infusions on protein metabolism in dogs.

The effect of infusions of recombinant insulin-like growth factor-I (IGF-I) (34, 103 or 688 pmol min-1 kg-1), insulin (3.4, 10.3 or 68.

Ectopic pregnancy in a blunt trauma patient.

Trauma during pregnancy is a frequent occurrence, and early pregnancies are likely to be unrecognized in the routine evaluation of female trauma patients. We present the case of a 16-year-old woman injured in a motor vehicle crash who sustained a closed head injury and was found to have a right ectopic tubal pregnancy. Since several physiologic responses and pathologic conditions occur during pregnancy, which complicate the diagnosis and treatment of a pregnant patient, it is important to detect pregnancy early in the patient's evaluation.

Implementing the new Joint Commission information management standards: one hospital's approach.

The Information Management Council is a beginning for truly managing information in our facility. We recognized the need for such a group and have defined its membership and focus. We have identified data collection in our facility and are now addressing redundant data collection.