A comparison of upper gastrointestinal endoscopy and radiography

One hundred symptomatic patients were evaluated independently with upper gastrointestinal radiography and fiberoptic endoscopy, and the results were compared. Of the two endoscopists sequentially examining the same patient, one was informed of available clinical and radiographic details and the other was not. Knowledge of the x-ray examination by the informed endoscopist did not improve his accuracy. Each endoscopist made four errors of interpretation. The endoscopic and x-ray findings agreed in 46 of the 100 patients, most often (68%) in esophagus, least often (29%) in the stomach and half the time (45%) in the duodenum. Ulcer craters seen endoscopically were detected radiographically in 36% of patients. We conclude that: 1) knowledge of results of prior upper gastrointestinal radiography did not alter endoscopic results; 2) experienced endoscopists are accurate but make mistakes; and 3) endoscopic findings would have been unaltered had radiography not been performed.     

A comparison of radiographic and electrogoniometric angles in adolescent idiopathic scoliosis

STUDY DESIGN: This was a cross-sectional study of a consecutive group of adolescent patients presenting to a scoliosis clinic for routine assessment or monitoring of their scoliosis, excluding postsurgical patients. SUMMARY OF BACKGROUND DATA: In vitro studies suggested electrogoniometry could be useful in the evaluation of scoliosis. No prior in vitro study had been performed. OBJECTIVES: To determine the reliability and validity of an electrogoniometric instrument, the Metrecom Skeletal Analysis System, in assessing adolescent idiopathic scoliosis. METHODS: Thirty-one patients were examined, radiographed, and scanned with the Metrecom Skeletal Analysis System twice by two different examiners. The magnitudes of the curves derived from the Metrecom Skeletal Analysis System scans were compared with each other and with the Cobb angles measured from standing radiographs. RESULTS: The intraclass correlation coefficient (a measure of agreement, ranging from 0 to 1, where 1 represents complete agreement) for the intraexaminer reliability of the Metrecom Skeletal Analysis System ranged from 0.71 to 0.83. The interexaminer reliability intraclass correlation coefficient of the Metrecom Skeletal Analysis System was 0.58, with a mean difference between examiners of 5.5 degrees (SD = 5 degrees), and limits of agreement (mean difference +/-2 SD) ranging from -4.5 degrees to 15.6 degrees. The Metrecom Skeletal Analysis System and the radiographically derived Cobb angle correlation was 0.64, but the mean difference between the methods was 3.7 degrees (SD = 11.1), with limits of agreement from 18.4 degrees to 25.9 degrees. CONCLUSION: The Metrecom Skeletal Analysis System does not provide sufficient clinical precision to substitute for the Cobb angle measured from spinal radiographic measurements in the management of adolescents with scoliosis.     

Treatment of idiopathic scoliosis in children

This is an update on the surgical and orthopedic management of scoliosis in children. After a review of the biomechanical factors underlying the scoliotic deformity in the three dimensions, methods and indications of conservative treatment combining physiotherapy and full-time or part-time bracing are discussed. Development of new segmental spinal instrumentation devices has modified the surgical treatment of scoliosis by allowing three-dimensional correction of deformities and obviating the need for postoperative immobilization in a cast or corset. Results of conservative treatment are analyzed in an original series of 56 children with progressive scoliosis treated when the angulation was still under 30 degrees. Mean follow-up since the end of treatment is 14 years. Results show that proper conservative treatment arrests progression and modifies the natural history of scoliosis. Outcome after surgical treatment is analyzed in an original and recent series composed of the 50 first children who had posterior surgery with the new Cotrel-Dubousset instrumentation. Results of anterior surgery (V.D.S. instrumentation), which is still indicated in some cases, are analyzed in an older series of 18 cases. When the deformities are too severe to allow conservative treatment, short segment fusion effectively corrects the scoliosis and reliably provides good cosmetic and functional results.     

Multiple comparison methods.

Takes exception to L. F. Petrinovich and C. D. Hardyck's (see record 1969-07531-001) conclusion that the Scheffé test is the most generally suitable multiple comparison method and suggests that the t-test and the Tukey tests are most desirable. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mapping cognitive structure: A comparison of methods.

Compared 3 methods of mapping cognitive structure. Free and controlled word association tests and a tree-construction test, all using the same 15 mechanics concept words as stimuli or units, were administered to 28 graduate science students. Very similar patterns of relations among the words, well represented by a digraph model, were revealed by the 3 techniques, and graphic representations of these structures were produced. No agreement was obtained among individual measures of the degree of concept interconnectedness derived from each test. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of methods of scoring the MMPI-168.

Three methods of converting raw scores from the 168-item short form of the MMPI to their long-form equivalents were compared using samples of 1,258 normals and 1,181 psychiatric inpatients. A set of conversion equations to be used in future research is proposed on the basis of these comparisons. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of two methods of testing logical thinking.

Administered parallel forms of a logical game situation to 40 intelligent students in each of Grades 6, 8, 10, and 12. The "Butch and Slim Game" and the "Shape Game," differed mainly in that reported speech was used in the former. The Shape Game proved easier at each grade level. This was attributed to several uncontrolled sources of variation in format. There was also evidence of significant age and sex differences in performance. Examination of individual items did not reveal pronounced developmental trends in difficulty levels. Items involving implicatory reasoning and operations of negation are examined in detail. It is concluded that formal logic possesses considerable limitations as a rationale for the construction of psychometric instruments. (French summary) (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of three methods of group vocational counseling.

Superimposed a group discussion process over a typical vocational counseling process in which the primary focus was on test information, and over 2 atypical vocational counseling processes, one in which occupational information was primary and the other in which test information and occupational information were optional and randomly presented upon a group member's request. All Ss selected goals in the initial stages of counseling. 57 undergraduates were studied in 6 single-sex experimental groups and 2 control groups. Data from a levels-of-decision-making scale, the Edwards Personal Preference Schedule, and the Kuder Occupational Preference Inventory show that the atypical groups learned significantly more and retained longer than did both the typical and control groups. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Primary diagnosis of osseous carpal area injuries--a comparison of conventional examination methods with digital luminescence radiography

Despite recent progress in improving diagnostic methods carpal bone lesions are still a major problem of primary diagnosis. Diagnostic imaging with digital luminescence radiography (DLR) allows the reliable presentation of traumatologically relevant carpal structures. In this study on 39 patients with suspected carpal bone injuries individually worked over DLR images were superior to "standard" DLR and conventional X-ray film/screen images. Though "standard" DLR images were inferior to film images edge-enhanced DLR images showed definite advantages in the demonstration of soft tissues. Fractures undetectable in conventional X-rays could not be recognized by digital imaging. In our experience bone-scanning remains the most reliable method for definite exclusion of carpal bone fractures after standard and digital X-ray methods are exhausted.     

A multimethod comparison of popular and unpopular children.

Differences between 101 popular and unpopular 3rd and 4th graders were assessed by teacher reports, classroom observations, the Peabody Individual Achievement Test, the Children's Depression Inventory, ratings on role-play situations, interviews that elicited information on Ss' knowledge of social skills, and responses to hypothetical situations. Unpopular Ss were perceived as being more depressed and deviant by teachers than were popular Ss. Classroom observations indicated that unpopular Ss spent significantly less time on-task than popular Ss and engaged in significantly more negative interactions. There was a trend for popular Ss to perform at a higher academic level than unpopular Ss, and the latter Ss were more depressed than Ss in the former group. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Value of thoracic radiography in the assessment of cardiac size. A comparison with left ventricular cardiography

PURPOSE: To determine the value of standard chest radiographs in the assessment of cardiac size. METHODS: In 193 patients cardiac size was compared between standard chest radiographs in the posteroanterior and lateral projection and left ventricular angiograms. The following parameters were determined: transverse diameter, lateral horizontal transverse diameter, cardiothoracic ratio and end-diastolic volume index (EDVI) and ejection fraction (EF). RESULTS: Subjective assessment of the left ventricular size resulted in a mean sensitivity/specificity/accuracy of 69.7%/87.4%/82.0% respectively, in comparison to EDVI. Estimation of global heart size yielded a mean sensitivity/specificity/accuracy of 48.8%/93.6%/77.8%, respectively, in comparison to EF. Cardiothoracic ratio for the detection of pathological EDVI or EF had a sensitivity of 77.3%/57.4% a specificity of 79.3%/80.8% and an accuracy of 78.9%/72.5%. CONCLUSIONS: Standard chest radiographs with the determination of cardiothoracic ratio remain a clinically relevant procedure for screening and follow-up of heart disease.     

A meta-analytic comparison of the effectiveness of smoking cessation methods.

Meta-analysis was used to cumulate the results from 633 studies of smoking cessation, involving 71,806 Ss, that reported the proportion of successful quits. Self-care methods do not appear to be as effective as formal intervention methods. Instructional programs involving physicians were not more effective than other instructional programs. Conditioning-based techniques such as aversive methods had success rates similar to those of instructional methods, and among the instructional methods, those incorporating social norms and values were more successful than those relying solely on didactic approaches. Cumulation of quit rates from all available control groups indicated that, on average, 6.4% of the smokers could be expected to quit smoking without any intervention. This figure must be subtracted from the raw success rate to obtain the net success rate for each program. Directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Low-dose dobutamine stress echocardiography in children and young adults

Dobutamine stress echocardiography has become widely accepted in the evaluation of adult patients with coronary heart disease. We wanted to assess the feasibility and the physiologic responses of stress echocardiography at low doses of dobutamine in a population of normal children and adults. Once achieved, we submitted a group of post-anthracycline patients to the test to assess the sensitivity of low-dose dobutamine stress echocardiography in the detection of cardiac dysfunction. Thirty-two healthy children and young adults (19 male and 13 female subjects, median age 15 years [range 6 to 26]) were studied. After the initial study of normal subjects, we submitted a cohort of 39 patients (18 female and 21 male, aged 6 to 25 years), who completed anthracycline chemotherapy, to the same protocol. Dobutamine was infused at rates of 0.5 to 2.5 and 5 microg/kg/min and echocardiographic measurements were obtained at rest and at the end of each stage. The test could be completed in 100% of the subjects without major complications. Statistically significant differences between resting echocardiographic values of systolic and diastolic function and values at 2.5 and 5 microg/kg/min of dobutamine were found. Moreover, dobutamine revealed or enhanced differences between normal subjects and the post-anthracycline patients. Thus, low-dose dobutamine stress echocardiography is feasible and safe in older children. The test is very sensitive for the detection of subclinical cardiac dysfunction in post-anthracycline patients and could possibly assess functional myocardial reserve.     

Early identification of learning disabilities: A comparison of two methods.

Computed discrepancy scores (multiple regression equations using IQs from the Slosson Intelligence Test, SES, sex, and age of child to predict reading and math achievement raw scores) and an unadjusted low-achievement criterion (discrepancy between achievement and potential) for 218 1st graders from normal classrooms in 6 rural elementary schools. In addition to determining the predictor variables already mentioned, the authors also administered the Behavior Problem Checklist, the Bender Visual Motor Gestalt Test for Children, the Visual Matching subtest of the Metropolitan Readiness Test, Level I—Form P, the Wepman Auditory Discrimination Test, and measures of audio-visual integration, handedness, finger localization, finger tapping, lateral dominance, letter and number recognition, motor coordination, name writing, and quantitative concepts. A rating of academic performance was obtained from each teacher. Data show that unadjusted low-achievement criteria misidentified as learning disabled (LD) a significant number of Ss who were achieving at levels commensurate with overall abilities, while failing to identify a significant number of truly LD children. Many of the variables that significantly discriminated low achievers from high achievers did not significantly discriminate LD from non-LD children. (68 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining classification criteria: A comparison of three cut score methods.

This study compared 3 different methods of creating cut scores for a screening instrument, T scores, receiver operating characteristic curve (ROC) analysis, and the Rasch rating scale method (RSM), for use with the Behavioral and Emotional Screening System (BESS) Teacher Rating Scale for Children and Adolescents (Kamphaus & Reynolds, 2007). Using the BESS norm data set, we compared the methods across 7 classification indices. Additional information about accuracy was used with a subset of children who had been given a prior diagnosis for selected disorders. The results showed that the methods were generally in concordance, with similarities identified across methods. RSM and ROC analysis methods performed similarly, with both methods identifying the same optimal cut-point. The method based on T scores appeared to be more conservative, identifying a lower cut score as optimal. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Directed forgetting in implicit and explicit memory tests: A comparison of methods.

Directed forgetting has been studied by instructing Ss to forget either (1) an initial list or (2) individually selected words. Differential encoding was hypothesized to be responsible for word-method directed forgetting, and retrieval inhibition for list-method directed forgetting. In Exps 1 and 2, directed forgetting was observed in recognition with the word method but not with the list method. Release from directed forgetting occurred in final recall after recognition but only with the list method. These results are interpreted in terms of a theoretical framework that integrates distinctive-relational processing theory with revised generation-recognition theory. In Exps 1–3, predictions from that framework were generally well supported on implicit and explicit retention tests that provided the same stimulus conditions. Consistent with processing theory, list-method directed forgetting was absent on data-driven or conceptually driven implicit tests, and word-method directed forgetting was absent on data-driven implicit tests. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of preschool curricula for disadvantaged children: A Canadian study.

The effects of a Piaget-based preschool curriculum for disadvantaged Canadian children ( N = 35) were compared with the effects of both a traditional program ( N = 18) and a no-treatment condition ( N = 18). Gain scores from pre- to posttest revealed significant differences between the Piagetian group and the no-treatment control condition on measures of verbal IQ (Peabody Picture Vocabulary Test), mental age, seriation, and conservation. Moreover, the Piagetian group made significantly greater gains than the traditional class on measures of mental age, seriation, and classification. The only significant gain score (classification) difference between the children attending the traditional nursery and those not attending preschool at all favored the latter group. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of three methods of estimating the standard deviation of performance in dollars.

196 supervisors in a national convenience store organization were asked to make the ratings needed to estimate standard deviation of performance in dollars (SDD), using (1) the method suggested by F. L. Schmidt et al (see record 1981-02231-001), (2) the CREPID procedure outlined by W. F. Cascio (1982), and (3) the 40% rule, suggested as an alternative by F. L. Schmidt et al (see record 1982-29165-001). Results show that Methods 2 and 3 produced comparable results. The SDD derived from Method 1 was 1.8 times as large as that produced by Method 2. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Low-dose theophylline increases urine output in diuretic-dependent critically ill children

BACKGROUND: The pathogenesis of unstable angina involves the presence of intracoronary thrombus which may have potential bearing on the therapeutic efficacy of intracoronary stenting to reduce acute complications and restenosis rate. METHODS: In order to evaluate in-hospital and long-term outcome of coronary stenting in patients with unstable angina, we retrospectively examined our experience in 311 consecutive patients. Braunwald class III angina (B or C) was present in 35% of the cases. Three hundred seventy one stents were implanted in 315 lesions, most of them (62.4%) with complex morphology. Angiography identified an intraluminal thrombus in 22 target sites. Stent indication was elective in 146 cases (46.9%), for suboptimal results in 149 (47.9%) and for bail-out in 16 (5%). RESULTS: Procedural success was obtained in 96.3% of the study population. Major complications occurred in 12 (3.7%) patients: myocardial infarction in 6 (1.9%) cases, emergency bypass surgery in 3 (0.9%) and death in 3 (0.9%), none of them related to acute stent thrombosis. Vascular complications occurred in 5 patients (1.6%). The mean hospital stay after stenting was 2.8 +/- 1.6 days. Subacute stent thrombosis occurred in one patient and led to a Q-wave anterior myocardial infarction. Follow-up (9 +/- 5 months) status was ascertained in 216 patients and revealed an overall clinical success rate of 87.3%. Restenosis occurred in 23.5% of 157 patients who underwent angiographic follow-up. Late events included 3 non-fatal myocardial infarction, 6 new PTCA, 3 elective bypass surgery and 1 cardiac death. CONCLUSIONS: Intracoronary stenting appears safe and effective in patients with unstable angina, despite the presence of a thrombogenic milieu. Optimal immediate angiographic results, related to the mechanical properties of stents, together with a vigorous antithrombotic regimen, contributes to the favorable outcomes in this adverse setting.