Surgery for obesity.

As were most types of gastrointestinal surgery, antiobesity surgery was dominated by the development of laparoscopic techniques during the last decade. The feasibility of performing any primary antiobesity operation safely laparoscopically was convincingly demonstrated during the last 2 years. This represents a significant continued improvement in the perioperative safety of "bariatric" surgery.

In vitro activity of GAR-936 against Chlamydia pneumoniae and Chlamydia trachomatis.

We evaluated the in vitro activity of GAR-936, a novel glycylcycline antibiotic, against ten isolates of Chlamydia pneumoniae and five strains of C. trachomatis. Susceptibility testing was done in HEp-2 cells.

Surgical prevention of otitis media.

Increasing concerns over drug-resistant bacteria mandate that alternative methods of treatment and prevention, including surgery, be considered to reduce antibiotic usage for acute otitis media (AOM). Meta-analysis of five randomized trials of tubes versus no surgery showed a mean absolute decrease in AOM incidence of 1.0 episode per child-year (95% CI, 0.

The Diagnosis and Management of Syphilis in the HIV-Infected Patient.

In the 1980s, the number of cases of syphilis in the United States increased concurrently with the onset of the HIV epidemic. Within a short time, clinicians began to note unusual presentations of syphilis and inappropriate responses to standard therapy for syphilis in dually infected patients. Whether these cases collectively represented a new aspect of the natural history of syphilis remains to be elucidated.

Is Chlamydia pneumoniae present in brain lesions of patients with multiple sclerosis?

We investigated the presence of Chlamydia pneumoniae in 81 normal and pathological specimens obtained from postmortem brain tissues of patients with multiple sclerosis and with other neurological or nonneurological diseases. The assays used included PCR amplification of all DNA samples in the initial study. Culture and a second PCR amplification of the organism in a subset of 19 brain specimens were also performed in two separate laboratories.

The role of tiagabine in the treatment of intractable epilepsy of childhood with multifocal independent spikes: a case report.

Multifocal independent spike syndrome (MISS) is an identifiable electroclinical syndrome, which combines intractable motor seizures, mental retardation and multifocal independent spike discharges. Similarities to the Lennox Gastaut syndrome cause frequent misdiagnosis; however, MISS is a distinct electroclinical syndrome in children with a better prognosis and a different EEG pattern. We report an 8-year-old boy with MISS, whose intractable seizures were completely controlled for the first time with tiagabine as add-on therapy.

Dismal rehabilitation in predominantly type II diabetics on dialysis in Inner-City Brooklyn.

Aim: In order to define their demographics and medical conditions, 218 diabetic patients undergoing hemodialysis in Brooklyn were interviewed and their charts reviewed.

Methods: Patient rehabilitation was assessed with the Karnofsky score, and the urea reduction rate as well as serum albumin and hematocrit levels evaluated adequacy of hemodialysis.

Results: The majority of patients (167) were African-American, 25 were Whites, 19 patients were Hispanic and 6 were Asian.

Medical hazards of the tear gas CS. A case of persistent, multisystem, hypersensitivity reaction and review of the literature.

A 30-year-old incarcerated man was sprayed with the "tear gas" ortho-chlorobenzylidene malononitrile (CS). He was hospitalized 8 days later with erythroderma, wheezing, pneumonitis with hypoxemia, hepatitis with jaundice, and hypereosinophilia. During the subsequent months he continued to suffer from generalized dermatitis, recurrent cough and wheezing consistent with reactive airways dysfunction syndrome, and eosinophilia.

Trilinear modeling of event-related potentials.

This paper describes a method for estimating a set of spatial components (brain maps) and temporal components (waveforms) of brain potentials. These components play the role of bases of a coordinate system, in the sense that the brain potentials of any subject can be represented as superpositions of these components. The representation is unique given the spatial and temporal components, and this decomposition is particularly appealing for comparing the brain potentials of different subjects (say alcoholics and controls).

Functional impairment in older schizophrenic persons. Toward a conceptual model.

The authors examined the determinants and consequences of impaired functioning in older schizophrenic persons by adapting a model of impairment developed by Berkman and Gurland. The sample consisted of 117 persons age 55 or older with a DSM-III-R diagnosis of schizophrenia. In logistic-regression analysis, the overall model attained significance in predicting functional impairment, and three predictor variables-abnormal movements, use of antiparkinsonian agents, and negative symptoms-attained independent significance.

First place--resident clinical science award 1999. Quality of life for children with obstructive sleep apnea.

The caregivers of 61 eligible children (6 months to 12 years old) completed a 20-item (OSA-20) health-related quality-of-life survey after polysomnography was performed to psychometrically validate the OSA-20. Excellent test-retest reliability was obtained for the individual survey items (R>0.74).

Endoscopic features of smooth muscle tumors in children with AIDS.

Background: Smooth muscle tumors are the second most common malignancy encountered in children with acquired immunodeficiency syndrome (AIDS). This study reviewed the incidence and endoscopic appearance of smooth muscle tumors in the gastrointestinal tract of children with AIDS undergoing endoscopy.

Methods: Retrospective review of all endoscopic records (n = 70) of children with AIDS from August 1988 to December 1997 at a tertiary care inner city hospital.

Post-extubation stridor: risk factors and outcome.

Post-extubation stridor is a potential complication of endotracheal intubation. The incidence, risk factors, and outcome in adult patient populations are poorly defined. It was our clinical impression that the occurrence of post-extubation stridor in our medical intensive care unit was more frequent than generally reported.

Activity of gemifloxacin and other new quinolones against Chlamydia pneumoniae: a review.

Quinolones are currently used as empirical therapy for treatment of community-acquired lower respiratory infections as they are effective against a broad range of conventional bacterial and 'atypical' pathogens, including Chlamydia pneumoniae. C. pneumoniae is estimated to be associated with 10-20% of community-acquired pneumonia in adults, and has recently been suggested to play a role in several non-respiratory conditions, including atherosclerosis.

HIV in older Americans: an epidemiologic perspective.

The elderly population is increasing as baby boomers are beginning to approach retirement. People 65 years of age or older already constitute approximately one eighth of the U.S.

Impact of tympanostomy tubes on child quality of life.

Background: The objective benefits of tympanostomy tubes for otitis media are well established, but the subjective impact of surgery on child quality of life (QOL) has not been systematically studied.

Objectives: To determine the subjective impact of tympanostomy tubes on child QOL, and to compare the variability in QOL before surgery with that observed after surgery.

Design: Prospective, observational, before-and-after trial.

Epidemiology of cardiovascular disease in systemic lupus erythematosus.

Awareness of the impact of cardiovascular disease on the late morbidity and mortality in patients with Systemic Lupus Erythematosus (SLE) is increasing. Clinical events secondary to accelerated atherosclerosis have been documented in lupus cohorts across the globe. We review the history and epidemiology of cardiovascular disease in patients with SLE.

Obesity potentiates AOM-induced colon cancer.

Obesity and diet affect the incidence and severity of various types of cancer, including colon cancer. It is not known whether obesity, independent of diet, is a risk factor for colon adenocarcinoma. We used azoxymethane (AOM) to induce colon cancer in mature genetically obese male Zucker rats (fa/fa) on low-fat crude diet (LFC, 10% fat) and their lean counterparts (Fa/fa and Fa/fa) on high-fat crude diet (HFC, 40% fat) for three months.

Current update of pediatric hepatitis vaccine use.

Vaccines are now available for the prevention of hepatitis A and hepatitis B. In this article, biologics are reviewed with special attention to their use in the pediatric patient. Special attention is paid to issues that developed in 1999.

Low HDL cholesterol, aggression and altered central serotonergic activity.

Many studies support a significant relation between low cholesterol levels and poor impulse, aggression and mood control. Evidence exists also for a causal link between low brain serotonin (5-HT) activity and these behaviors. Mechanisms linking cholesterol and hostile or self-destructive behavior are unknown, but it has been suggested that low cholesterol influences 5-HT function.

Effects of traditional versus delayed resuscitation on serum lactate and base deficit.

Objective: To test the hypothesis that delayed resuscitation of hemorrhagic shock produces a less severe shock insult than traditional resuscitation, characterized by repeated episodes of alternating hypotension and normotension.

Methods: Female pigs were divided into three groups. Sham operated controls (C) (n = 4), sustained hypotension (SS) (n = 6), and hypotension with multiple cycles of shock and resuscitation (SR) (n = 6).

Activity of quinolones against Chlamydia pneumoniae.

Quinolones are currently being used as empirical therapy for the treatment of community-acquired pneumonia and other respiratory infections as they cover a broad range of conventional bacterial and 'atypical' pathogens, including Chlamydia pneumoniae. C. pneumoniae has been associated with 10 to 20% of community-acquired pneumonia in adults and recently has been implicated as being associated with several nonrespiratory conditions, including atherosclerosis.