The care and feeding of evidence based medicine.

Wide interest in evidence based medicine (EBM) and its value in patient care, insurance payment decisions, and public health planning has triggered intense medical journal and media coverage that merits review, explanation, and comment. Published EBM data vary in quality for reasons that have been the subject of many perceptive literature reviews. Study design can be faulted, and conflicts of interest, personal and economic, can potentially bias study results and their publication.

Reproducibility of ultrasound scan in the assessment of volume flow in the veins of the lower extremities.

Purpose: The purpose of this study was the identification of the optimal settings of ultrasound scan flow measurement in the veins and the determination of whether the standardization of these settings can provide acceptable reproducibility of the venous flow measurements in individual segments of the lower extremity veins.

Methods: The venous cross-sectional area, the time average mean velocity, and the venous volume flow of 25 healthy volunteers were examined with duplex ultrasound scanning. Reproducibility was examined with different measurement settings.

Rifampin, a useful drug for nonmycobacterial infections.

Rifampin has clinical efficacy against a wide variety of organisms, including Staphylococcus aureus, Legionella pneumophila, group A Streptococcus, Brucella sp, Haemophilus influenzae, and Neisseria meningitidis, as well as in vitro activity against penicillin-resistant Streptococcus pneumoniae, Neisseria gonorrhoeae, Chlamydia trachomatis, Haemophilus ducreyi, and many gram-negative rods. Rifampin is a useful drug for several types of bacterial infections because of its broad spectrum of activity, excellent tissue penetration, and low side effect profile. In combination with other antibiotics, it may be effective when conventional therapies are not.

Effects of pentachlorophenol and other chemical preservatives on the health of wood-treating workers in Hawaii.

The morbidity and mortality of workers occupationally exposed to wood treating chemicals used in Hawaii for the years 1960 to 1981 were evaluated. The specific chemical exposures investigated were CCA (chromated copper-arsenate), TBTO (tributyl tin oxide) and PCP (pentachlorophenol). Results of detailed medical histories, laboratory and physiological tests, and physical examinations of 88 wood treaters were compared with those of 58 matched controls.