Comparison of laparoscopic and minilap cholecystectomy for acute cholecystitis

The charts of all patients with acute cholecystitis undergoing either laparoscopic or minilap cholecystectomy at the Chinle Comprehensive Health Care Facility between October 1, 1991, and August 15, 1993, were retrospectively reviewed. During that period, 54 patients underwent laparoscopic cholecystectomy and 45 patients had minilap procedures. The two groups had similar mean age, sex distribution, temperature, leukocyte count, gallbladder wall thickness, and duration of preoperative symptoms. While laparoscopic cholecystectomy took an average of 16 min longer to perform than minilap cholecystectomy, patients who had laparoscopic cholecystectomy had less blood loss, reduced postoperative narcotic needs, and shorter hospital stays.     

The attrition dilemma: Toward a new strategy for psychotherapy research.

Presents an analysis of the attrition dilemma in psychotherapy research and reviews the methods used to compensate for data loss. It is argued that attrition is not ultimately a problem of bias but a problem of lack of information. A reformulation is offered that integrates single-case studies with traditional group comparison methodology in an attempt to find optimal causal relations of treatments to outcomes. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial factors in sunbathing and sunscreen use.

Interviewed 120 sunbathing and nonsunbathing beachgoers about their health practices, knowledge about skin cancer, moods, and social rewards obtained through sunbathing. Ss also completed personality questionnaires. Data were considered using a theoretical perspective combining aspects of health belief, social influence, social learning, and risk-taking models. Results indicate that sunbathing was related to having a positive attitude toward risk taking, having little knowledge about skin cancer, reporting a relaxed mood, having friends who sunbathe, and engaging in activities related to maintaining a positive physical appearance. Sunscreen use was related to sex, having knowledge about skin cancer, knowing people who have had cancer, and reporting high levels of anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Respiratory complications following tonsillectomy/UPPP: is step-down monitoring necessary?

We conducted a study to determine if the risk of airway compromise following tonsillectomy with uvulopalatopharyngoplasty justifies the added cost and inconvenience of step-down monitoring in an intensive care unit. We performed a retrospective chart review of 130 patients with obstructive sleep apnea who had undergone isolated tonsillectomy with uvulopalatopharyngoplasty at our tertiary care center. The average length of stay in the step-down unit was 18 hours. We found that only eight of these patients (6.2%) had a postoperative desaturation level of less than 90%, including three of 12 patients (25%) who had comorbid conditions. No patient had an adverse respiratory event. We conclude that step-down monitoring in an intensive care unit is not necessary, although caution should be exercised in monitoring patients with comorbidities because they appear to be more prone to desaturation. A complete lack of adverse respiratory events has not been reported in previous studies.     

Scopolamine impairs human recognition memory: Data and modeling.

Eight subjects studied a set of complex visual images after administration of 0.4 mg scopolamine. Another 8 subjects performed the same task without drug administration. On a subsequent item recognition test, subjects rated, on a 5-point scale, their confidence that the studied pictures and an equal number of unstudied lures were actually presented. Results showed that scopolamine affected responses to studied items, but not unstudied lures, demonstrating an unambiguous effect of scopolamine on recognition memory. To describe the scopolamine-injected subjects' data, the authors constructed a new model of 2-process recognition that includes the A. P. Yonelinas (1994) model as a limiting case. The model analysis suggests that scopolamine affected both familiarity and recollection. In particular, scopolamine did not affect the frequency with which recollection took place, but rather, affected the amount of recollected information. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Human papillomavirus-specific serologic response in vulvar neoplasia

We describe a case of positional dyspnea due to compression of the tracheobronchial tree by an extensive thoracic aneurysm. In a 77-year-old woman with long-standing systemic hypertension, intermittent anterior chest pain gradually developed over several years. She had no history of asthma or thoracic trauma. She was admitted to our hospital because of sudden, severe shortness of breath. The breathlessness was markedly worse when she lay on her back or on her right side. On physical examination, she was in acute respiratory distress with cyanosis, severe hypertension (180/110 mmHg), tachycardia, and inspiratory stridor. A chest X-ray film showed loss of volume and nearly complete radiopacity of the left hemithorax. Arterial blood gas analysis revealed an arterial oxygen partial pressure of 54.8 mmHg, a carbon dioxide partial pressure of 39.8 mmHg, and an oxygen saturation of 84.5 percent on room air. Computed tomographic examination of the thorax showed dilation of the aortic arch and descending aorta, and marked compression of the trachea and the left main bronchus. Examination with a fiberoptic bronchoscope revealed extrinsic compression of the trachea just proximal to the carina. The patient's symptoms stabilized. However, she did not undergo surgery because of her age and because of the size of the aneurysm. She died due to rupture of the aneurysm.