Inferior vena cava diameter change after intravenous furosemide in patients diagnosed with acute decompensated heart failure.

Purpose: Measurement of the inferior vena cava (IVC) diameters may improve decision-making for patients hospitalized with acute decompensated heart failure. Nevertheless, little is known about how the IVC is affected by loop diuretics. We sought to determine if bolus infusions of intravenous furosemide affect IVC diameters measured by hand-carried ultrasonography.

Correlating Papanicolaou Smear, Colposcopic Impression, and Biopsy: Results from the Women's Interagency HIV Study.

Objective: To determine associations among cervical cytology, colposcopy, and biopsy in HIV-seropositive women.

Materials And Methods: HIV-seropositive women and uninfected comparison women in a multicenter prospective cohort study underwent colposcopy for protocol indications. Women were eligible if they had a cervix, satisfactory cytology, and colposcopy between October 1994 and September 1999.

Immunogene therapy as a treatment for malignant brain tumors in young mice.

Object: New and innovative forms of effective treatments for malignant brain tumors in children are urgently needed. The authors have previously shown that intracerebral injection into the tumor bed of allogeneic fibroblasts genetically engineered to secrete interleukin-2 (IL-2) results in prolongation of survival and an antitumor immunocytotoxic response in adult mice that harbor intracerebral gliomas. The first goal of this study was to determine if malignant gliomas (GI261) could be treated in mice (C57BL/6) in the pediatric age group (weanlings [2-3 weeks old] and adolescents [3-4 weeks old]).

Leprosy (Hansen's Disease).

Leprosy (Hansen's disease) causes the most common treatable form of neuropathy in the world. Several endemic countries account for the majority of the world's cases and most of the cases seen in the US are amongst immigrants. However, endemic cases of leprosy occur in the US.

Physical examination in the care of medical inpatients: an observational study.

Background: Little is known about the clinical importance of skilled physical examination in the care of patients in hospital.

Methods: Hospital records of a systematic consecutive sample of patients admitted to a general medical inpatient service were reviewed retrospectively to determine whether physical findings by the attending physician led to important changes in clinical management. Patients with pivotal physical findings were defined by an outcomes adjudication panel as those whose diagnosis and treatment in hospital changed substantially as a result of the attending physician's physical examination.

Treatment of difficult-to-control blood pressure in a multidisciplinary clinic at a public hospital.

Cardiovascular morbidity and mortality in disadvantaged populations remains high. Few innovative strategies or services to treat chronic diseases have been critically analyzed in these patients. We evaluated our initial experiences with a newly established multidisciplinary clinic For the treatment of difficult-to-control hypertension and describe reasons for poor blood pressure control as well as treatment strategies.

HIV-infected inpatients in the HAART era: how do hepatitis C virus coinfected patients differ?

We compared the demographics and clinical characteristics of HIV-infected patients with and without hepatitis C virus (HCV) coinfection hospitalized at Cook County Hospital, Chicago, Illinois, from October 1999 through September 2000. Two hundred three (40%) of the 510 patients were coinfected with HCV. HCV coinfected patients were less likely to be on highly active antiretroviral therapy (HAART) and were frequently hospitalized with higher CD4 counts for non-HIV-related medical problems including complications of liver disease.

Prevalence and predictors of Toxoplasma seropositivity in women with and at risk for human immunodeficiency virus infection.

We assessed the prevalence and predictors of latent Toxoplasma infection in a large group of human immunodeficiency virus (HIV)-infected and HIV-uninfected at-risk US women. The prevalence of latent Toxoplasma infection was 15% (380 of 2525 persons) and did not differ by HIV infection status. HIV-infected women aged > or =50 years and those born outside of the United States were more likely to have latent Toxoplasma infection, with prevalences of 32% and 41%, respectively.

Parvovirus B19-related anemia in HIV-infected patients.

Persistent infection with parvovirus B19 (B19) is an important treatable cause of anemia in HIV-infected patients. B19 has a tropism for erythroid progenitors and causes pure red cell aplasia (PRCA). The failure to produce neutralizing antibodies to the virus following B19 infection in immunodeficient persons may result in persistent viremia and chronic PRCA (B19-PRCA).

Azithromycin for acute bronchitis: a randomised, double-blind, controlled trial.

Background: The value of azithromycin for treatment of acute bronchitis is unknown, even though this drug is commonly prescribed. We have investigated this question in a randomised, double-blind, controlled trial.

Methods: Adults diagnosed with acute bronchitis, without evidence of underlying lung disease, were randomly assigned azithromycin (n=112) or vitamin C (n=108) for 5 days (total dose for each 1.

Triage of patients with chest pain in the emergency department: a comparative study of physicians' decisions.

Purpose: Little is known about physicians' triage decisions for patients with chest pain in the emergency department. We sought to understand better the variability and accuracy of physicians' triage decisions.

Subjects And Methods: We used 20 simulated cases to compare triage decisions by 147 physicians (46 emergency medicine, 87 internal medicine, and 14 cardiology physicians) with triage decisions recommended by a previously validated prediction rule.

Osteoarticular tuberculosis: current diagnosis and treatment.

Tuberculous synovitis frequently presents as a monoarthritis of weight-bearing joints such as the hip, knee, or ankle. Owing to its low incidence in developed countries, the diagnosis is often delayed for months to years. Early diagnosis with a synovial biopsy permits prompt antituberculous therapy and substantially improves the prospect of preservation of joint structure and function.

Controlling antimicrobial resistance in hospitals: infection control and use of antibiotics.

Antimicrobial-drug resistance in hospitals is driven by failures of hospital hygiene, selective pressures created by overuse of antibiotics, and mobile genetic elements that can encode bacterial resistance mechanisms. Attention to hand hygiene is constrained by the time it takes to wash hands and by the adverse effects of repeated handwashing on the skin. Alcohol-based hand rubs can overcome the time problem and actually improve skin condition.

Topotecan for recurrent cervical cancer after platinum-based therapy.

The activity and toxicity of topotecan in women with recurrent cervical cancer are described from a case series of women with recurrent cervical cancer who had measurable disease and were not amenable to cure by surgery or radiation. All patients had prior platinum-based chemotherapy and developed progressive disease. Topotecan was given as 1 mg/m2/day over 30 min for 5 days every 3 weeks until progression of disease or prohibitive toxicity.