Rotator cuff tear: clinical experience with sonographic detection

Between June 1986 and April 1988, 86 sonographic examinations of the shoulder were performed on patients suspected of having rotator cuff tears. Major sonographic diagnostic criteria included (a) a well-defined discontinuity usually visible as a hypoechoic focus within the cuff, (b) nonvisualization of the cuff and (c) an echogenic focus within the cuff. Seventy-five patients underwent both sonography and arthrography. Compared with arthrography alone, ultrasound examinations enabled detection of 92% of rotator cuff tears (24 of 26 tears), with a specificity of 84% and a negative predictive value of 95%. Correlation was obtained in 30 of these patients who underwent surgery for rotator cuff tear or other soft-tissue abnormality. In this group, the sensitivity of sonography for detection of a tear was 93%, with a specificity of 73%, while for arthrography sensitivity was 87% and specificity was 100%. These data indicate that sonography is a useful, noninvasive screening procedure for patients suspected of having rotator cuff injury.     

Quality assessment and assurance in diagnostic imaging. Theoretical and practical considerations and a quality audit of the excretory urogram

Concepts necessary to an understanding of the basics of quality assurance audits are presented. Included are specific examples that bridged theory and practice by applying the protocol to a real-life diagnostic imaging situation. This method meets the present requirements of the Joint Commission of the Accrediation of Hospitals.     

Comparison of weight status among two cohorts of US Air Force recruits

BACKGROUND: Overweight and obesity are increasing rapidly in the US and the Department of Defense (DoD). We examined whether weight trends evidenced in the general population and DoD are occurring among individuals entering US Air Force (USAF) Basic Military Training (BMT). METHODS: Individuals entering the USAF in 1996 (AF1996; N = 29,036) and 2000 (AF2000; N = 31,080), ages 17-29 years were surveyed. The two recruit cohorts were compared to age-matched individuals from the 1996 (N = 22,153) and 2000 (N = 31,861) Behavioral Risk Factor Surveillance System Survey (BRFSS). RESULTS: Crude rates for all age groups and age- and gender-standardized prevalence rates reflected significant increases in overweight/obesity among recruits. The direct standardized prevalence of overweight/obesity increased nearly 24%, from 14.8% in AF1996 to 18.3% in AF2000. The increase in overweight/obesity was particularly large among male recruits ages 25-29 (i.e., from 36.4% to 44.5%) between 1996 and 2000. CONCLUSIONS: USAF cohorts were less likely to be overweight than corresponding BRFSS samples. There were 19.1 and 20.2 percentage point differences between overall crude rates of overweight/obesity between AF1996 and BRFSS 1996 and AF2000 and BRFSS 2000, respectively. Nevertheless, overall rates of overweight and obesity are increasing among young recruits in the USAF at a fairly marked rate (approximately one percentage point per year).     

Colon perforation following percutaneous nephrostomy and renal calculus removal

Two patients had colonic perforation as a result of percutaneous nephrostomy placement followed by track dilatation and renal calculus removal. We present the technical aspects of nephrostomy placement and stone removal, as well as the clinical diagnosis and management of these cases. Both patients recovered well with conservative therapy and required no surgical intervention. This report reviews the anatomic considerations for percutaneous nephrostomy in patients undergoing renal stone removal.     

Relationships among smoking status,ethnicity, socioeconomic indicators,and lifestyle variables in a biracial sample of women

BACKGROUND: Smoking prevalence rates remain high among women and smoking initiation has increased for young adults. Little is known about the unique patterns of smoking, risk factors, and correlates of quitting in Black versus White women of child-bearing age. METHOD: This study examined the relationships among smoking, ethnicity, socioeconomic status (SES), and lifestyle variables among 715 women (43.6% Blacks and 56.4% Whites). Stringent inclusion criteria were used for ethnicity, which allows for distinct comparisons but may reduce generalizability of results. RESULTS: Black current smokers smoked fewer cigarettes per day and reported initiating smoking at a later age than Whites. Current versus never smoking was associated with income, education, and caffeine intake. There was a significant ethnicity by alcohol interaction (at lower levels of alcohol intake Whites were more likely to smoke but at higher levels of alcohol there were no ethnic differences). Former smoking versus current smoking was associated with alcohol intake, education, and pack years of smoking. CONCLUSIONS: The results of the study suggest several ethnic differences in smoking patterns as well as several correlates of smoking status. These results have implications for the tailoring of interventions and illustrate the association of other health risk factors with smoking status.