Time trends in use of the CHADS and CHA DS VASc scores, and the geographical and specialty uptake of these scores from a popular online clinical decision tool and medical reference.

Background: The impact of the utilisation of such e-health approaches, including mHealth (use of mobile phones and other wireless technology in the delivery of medical care) assessments of health parameters, or the use of decision aids and online risk calculators over time have not been previously described. The objective of this analysis is to assess the time trends in use of the CHADS and CHA DS VASc scores in e-health, and the geographical and specialty uptake of these scores, using data gleaned from a popular online clinical decision tool and medical reference, MDCalc. We hypothesised that the change in use of the scores would reflect the changes in guidelines and trends in clinical practice.

Septic arthritis of the acromioclavicular joint.

Septic arthritis of the acromioclavicular (AC) joint is a rare but rapidly destructive etiology of acute shoulder pain. We report a case of septic AC joint in the absence of trauma or intravenous drug use. A diabetic man presented with severe right shoulder pain and was later diagnosed with septic arthritis of the AC joint by magnetic resonance imaging (MRI) and positive blood cultures.

Hemorrhagic complications of pancreatitis: radiologic evaluation with emphasis on CT imaging.

Objective: To analyze and describe the incidence, pathophysiology, radiographic diagnosis and the initial management of hemorrhagic complications associated with pancreatitis.

Material And Methods: Among 1,910 patients diagnosed of having pancreatitis in the last 10 years, 26 developed hemorrhagic complications (1.3%).

Meta-analysis of the Risk of Torsades de Pointes in patients treated with intravenous racemic sotalol.

Objective: Intravenous (IV) racemic sotalol is useful for the treatment of multiple tachydysrhythmias. The authors hypothesized that the risk of torsades de pointes (TdP) in patients treated with a single IV infusion of sotalol is lower than the 2-4% risk associated with chronic oral sotalol therapy.

Methods: A MEDLINE search under the subject heading "sotalol" was made of all publications involving humans written in English or German from 1966 to October 1, 2000.

Ischemic colitis: CT evaluation of 54 cases.

Purpose: To review the computed tomographic (CT) scans and medical records of 54 patients with proved ischemic colitis, define the spectrum of CT findings, and assess the effect of CT imaging on treatment.

Materials And Methods: The mean age of the patients was 72 years. CT scans were analyzed for the presence of colonic abnormalities and associated findings.

Incidence of breast cancer in a 22-year study of women receiving estrogen-progestin replacement therapy.

Objective: To review the incidence of breast cancer in a continuous 22-year study of conjugated estrogen-medroxyprogesterone acetate hormone replacement therapy.

Methods: Eighty-four pairs of continuously hospitalized postmenopausal women who were matched for age, smoking history, and medical diagnosis were treated with estrogen-progestin hormone replacement therapy or placebo in a prospective and double-blind manner for 10 years. In the subsequent 12 years, the women were offered the choice of starting, stopping, or continuing hormone replacement therapy.

Schizophrenia with childhood onset: a phenomenological study of 38 cases.

Thirty-eight hospitalized children, ages 5.7 to 11.11 years, diagnosed with schizophrenic disorder by DSM-III criteria, are characterized regarding age, sex, race, socioeconomic status, pre- and perinatal complications, electroencephalogram, intelligence quotient, and family history of major psychiatric disorder.

CT of the gastrointestinal tract: principles and interpretation.

The experience accumulated in daily abdominal CT scanning and CT evaluation of gastrointestinal lesions has generated helpful technical guidelines and some reliable principles of interpretation. These general principles are briefly discussed in this review, and the importance of performing a CT examination that is adequate for the detection and evaluation of gastrointestinal lesions is stressed. CT features useful in differentiating benign from malignant lesions, limitations and pitfalls in CT interpretation, overlap in the CT appearance, and classical CT features leading to specific diagnoses are described and illustrated.

Computerized tomography in acute gastrointestinal disorders.

In recent years, computerized tomography (CT) has become one of the most important imaging modalities in evaluation of patients with acute gastrointestinal disorders. Its role, diagnostic accuracy, indications, and limitations in some of the most commonly encountered acute abdominal conditions are succinctly presented and reviewed. CT should not be used indiscriminantly, but is best considered a valuable primary or complimentary diagnostic tool in critically ill patients.

The demise of vaginal operative obstetrics: a suggested plan for its revival.

Predictions made more than a quarter of a century ago regarding excessive use of cesarean delivery for cases of dystocia have been realized. Breech presentation, correctable dystocia, and twin gestation are increasingly being delivered by the abdominal route. Recent studies have shown that neonatal morbidity is not inherently improved by cesarean birth, and in fact have reported comparable results with vaginal operative procedures in properly selected and managed cases.

Microvascular transplantation of expanded free scalp flaps between identical twins.

Long-term follow-up of a previous free scalp transplant between identical twins is provided. A recent third transplant between these twins is presented in which donor flap expansion is used prior to transplantation, and the postoperative use of medicinal leeches is discussed.

Volume adjustment of mechanics and diffusion in interstitial lung disease. Lack of clinical relevance.

Relationships of lung mechanics and diffusion to lung volume were examined in 38 patients with interstitial lung disease to determine whether patterns of reduction relate to severity of disease, distinguish histologic characteristics or predict prognosis for reversibility. Normal volume-related values for both mechanics and diffusion were seen throughout the range of severity of disease. The ratio of mechanics to lung volume did not correlate with the ratio of diffusion to lung volume in the same patient.

Background ventilatory stimulus as a determinant of load compensation.

Compensation for inspiratory flow-resistive loading was compared during progressive hypercapnia and incremental exercise to determine the effect of changing the background ventilatory stimulus and to assess the influence of the interindividual variability of the unloaded CO2 response on evaluation of load compensation in normal subjects. During progressive hypercapnia, ventilatory response was incompletely defended with loading (mean unloaded delta VE/delta PCO2 = 3.02 +/- 2.

CT diagnosis and staging of acute pancreatitis.

Computed tomography is the single most important imaging modality in evaluating patients with acute pancreatitis. It has a high sensitivity and specificity in diagnosing "moderate" and "severe" pancreatitis, as well as in detecting serious complications which often are clinically unsuspected. In addition, computed tomography plays a valuable role as an early predictive indicator of disease severity.

THE PATHOLOGIC EFFECTS OF INTRAVENOUSLY ADMINISTERED SOLUBLE ANTIGEN-ANTIBODY COMPLEXES : II. ACUTE GLOMERULONEPHRITIS IN RATS.

The intravenous administration to rats of soluble antigen-antibody complexes in antigen excess resulted in acute glomerulonephritis. This occurred with both rabbit antiovalbumin and rabbit anti-BSA systems. The rats so treated regularly showed proteinuria and elevation of blood urea nitrogen.