Cost effectiveness and clinical efficacy of patent foramen ovale closure as compared to medical therapy in cryptogenic stroke patients: A detailed cost analysis and meta-analysis of randomized controlled trials.

Background: Up to half the patients with cryptogenic stroke under the age of 55 years have been found to have a PFO. Observational studies have demonstrated a benefit from closure of PFO and several RCTs have shown a trend toward benefit. The cost and clinical effectiveness of PFO closure is unclear.

Recognizing and managing mycobacterial diseases in clients with AIDS.

Mycobacterial diseases are common in people infected with human immunodeficiency virus. Mycobacterium tuberculosis (MTB) and Mycobacterium avium intracellulare (MAI), the specific pathogens most frequently involved, cause pulmonary tuberculosis and disseminated MAI infections. Pulmonary tuberculosis incidence was on the decline from 1950 to 1985, but since 1985 has been on the rise worldwide.

The effect of altitude on umbilical cord blood gases.

Objective: Analysis of umbilical cord blood acid-base status has proven useful in the immediate care and resuscitation of the newborn and provides an objective measure of the intrapartum fetal environment. Our study was designed to determine whether there are any significant differences in the acid-base status of neonates delivered at a relatively high altitude of 6000 ft compared with sea-level controls.

Methods: Our study population consisted of 300 women who had undergone spontaneous vaginal delivery after uncomplicated labor; 150 delivered at an institution located at an elevation of 5900 ft and the remainder at an elevation of 87 ft.

Nonrotation of the midgut presenting in the adolescent and adult.

The most common abnormality of midgut rotation and fixation is nonrotation of the midgut. This most commonly presents in the neonatal period with duodenal obstruction or midgut volvulus. However, this condition can present outside the neonatal period as chronic abdominal pain, or as an abdominal emergency.