A Software Program to Calculate Goodman and Kruskal\u27s Gamma: a Method to Monitor Surgical-Site Infection Rates.

Several studies have described a need for a valid statistical methodology to facilitate interhospital and intrahospital infection rates for their operative procedures. Physician awareness of postoperative surgical-site infection rates has been demonstrated as an effective means to reduce infection rates in both high- and low-risk surgical patients. This article presents a new software program that allows for simple data entry and provides results including the gamma statistic, sample size, variance, standard error, and Z value and P value of the gamma result. This software also provides a data interpretation table, allowing infectious disease department physicians or staff to determine if a significant relation exists between operative procedure infection rates and patient risk factors

Gastrointestinal Manifestations of Chronic Fatigue Syndrome (CFS): Symptom Perceptions and Quality of Life.

Objectives: This study examines the differences in symptoms and Quality of Life (QOL) among patients presenting to a gastrointestinal (GI) service with combinations of chronic fatigue syndrome (CFS) and GI complaints. Methods: We conducted a clinical examination of patients from a private GI practice and divided them into three groups: A combination group consisting of patients diagnosed with both CFS and functional bowel disease (FBD) (Group 1, n = 5); those positively diagnosed with CFS, who also reported GI symptoms, but without a prior GI diagnosis (Group 2, n = 6); and those with FBD, but without a diagnosis of CFS (Group 3, n = 11). These groups were prospective-ly surveyed, using the Medical Outcomes Study Short Form-36 (SF-36) and the Symptom Index Survey (SIS). Results: Data indicate CFS patients report more symptoms than non-CFS patients, as measured by the SIS, in these areas: Allergies, Digestive Tract, Ears, Eyes, Head, Immune, Joints/Muscles and Metabolism/Endocrine. SF-36 data indicated lower QOL for CFS patients compared to FBD alone (Group 3) patients in the General Health and Energy/Fatigue subscales. Conclusions: CFS patients with GI complaints demonstrate a significant relationship between both diagnoses. Since the observed differences occur between Groups 1 and 3, both with GI diagnoses, this indicates that these differences are a result of the presence or absence of CFS. Also, since these differences occur between CFS/FBD and FBD-only, the classification of irritable bowel syndrome (IBS) should be modified to include a subset of patients who have a combination of CFS and IBS. Key Words

Ultrasonography in the Diagnosis of Acute Appendicitis.

The purpose of this study was to assess our results of using graded compression ultrasonography (US) to confirm the diagnosis of acute appendicitis. Graded compression US was performed on 94 patients who presented at the Lehigh Valley Hospital, Allentown, Pennsylvania with an equivocal clinical picture of acute appendicitis. When used to diagnose acute appendicitis, US provided a specificity of 93.7%, sensitivity of 74.2%, and accuracy of 87.2%. We conclude that graded compression US was useful to rule out the diagnosis of acute appendicitis and helped to avoid unnecessary appendectomies and reduced negative laparotomies. Our results proved to be comparable to previously reported studies

Effects of Paroxetine CR on Depressive and Anxiety Symptoms: In a Community Sample of Adult Hispanic Women with Major Depression or Generalized Anxiety Disorder.

OBJECTIVE: Previous research reports higher rates of depression in Hispanic women than Caucasian or African American women. The effectiveness and tolerability of paroxetine CR (controlled release) was examined in women of Hispanic heritage with depression or anxiety. METHODS: Thirty-six Hispanic female patients 18 years or older meeting DSM-IV criteria for major depression or generalized anxiety disorder diagnosis with an initial Hamilton Depression Rating scale (17 item) Ž20 or Hamilton Anxiety Rating scale Ž18 measuring no less than 4 on the Clinical Global Impression Severity scale received paroxetine CR (12.5-50mg/day) for 29 weeks of open label treatment. Analysis was conducted using repeated measures methodology. RESULTS: Significant symptom reduction was observed on all scales. Mean dose was 31.7mg. The side effect of sexual dysfunction (17%) appeared most frequently but did not cause any patients to cease study participation. CONCLUSIONS: Paroxetine CR was an effective and generally well tolerated treatment in this population

Radiographic comparison of standing medial cuneiform arch height in adults with and without acquired flatfoot deformity.

BACKGROUND: Adult acquired flatfoot (AAF) is characterized by decreased arch height, talar depression, medial arch depression and elongation, and forefoot abduction. We have measured standing arch height in AAF patients and in a control group of patients using the standing lateral medial cuneiform arch height radiographic measurement. METHODS: Fifteen (25 feet) patients were selected with the clinical diagnosis of symptomatic AAF with no secondary diagnoses. A control group consisted of 36 (72 feet) patients with no foot deformities or prior foot surgeries. Arch height was measured in millimeters using the standing medial cuneiform height on the lateral radiographic view. RESULTS: The mean standing medial cuneiform arch height in the control group was 18.38 mm. The mean arch height in the AAF group was 11.04 mm (p \u3c 0.001). There were no differences between right and left feet in the control group or symptomatic and contralateral feet in the AAF group. Body mass index (BMI) in the control group was 26.17 and in the AAF 33.74. (p = 0.007). CONCLUSION: These data provide a control value for the arch height using the medial cuneiform as reference. The decrease in arch height is a strong indicator of AAF. A study with larger numbers of patients is necessary