Use of the appropriateness evaluation protocol for estimating the incremental costs associated with nosocomial infections

Existing methods for estimating additional days of hospital stay due to nosocomial infections (NI) have a number of documented limitations. An alternative method described in this paper uses the Appropriateness Evaluation Protocol (AEP) to determine whether each day of acute inpatient care is appropriate based on the need for care of the NI, original cause of hospitalization (OC), or combined NI-OC requirements. Using this method to identify specific days of hospitalization due to Staphylococcus aureus nosocomial infection, we find: 1) length of stay is increased for only a minority of patients (38%); 2) an average of 20 additional days of stay occurred for patients with 1 or more days attributed to NI; and 3) an average of 52% of length of stay of patients with 1 or more days attributed to NI can be attributed to the NI. Application of the AEP-based method is a useful alternative for identifying additional days of stay due to NI.     

Treatment of Raynaud's syndrome with calcium entry blockers

The authors have presented the results of a 14-day open randomized trial of the efficacy of 3 calcium inlet blocking agents: nifedipine, verapamil and phendilin in 61 patients with Raynaud's syndrome. In the group of patients receiving 30-80 mg of nifedipine (20) there was a significant decrease in the frequency and expression of Raynaud's syndrome attacks, a positive effect of varying degree was noted in 19 patients. The drug raised slightly the skin and muscular blood flow and skin temperature. The use of 120-360 mg of verapamil in 21 patients caused no significant inhibition of Raynaud's syndrome and rise of hemocirculation. Phendilin (150-300 mg) though being comparable with nifedipine in efficacy, often produced side-effects resulting in the drug cancellation (8 out of 20). The efficacy of the calcium inlet blocking agents, especially nifedipine, for therapy of Raynaud's syndrome was emphasized.     

Sources of stress in Australian adolescents: factor structure and stability over time

Adolescent stress is an emerging area of importance in considerations of the health of young people. Exposure to stress predicts a range of both physical and mental health problems in adolescents and relates, as well, to the initiation of important health risk behaviours. Yet the measurement of stress in adolescents has been as fraught with methodological difficulty as it has been for adults. This paper examines the Adolescent Stress Questionnaire (ASQ) which was developed specifically to address the domain of stressors specific to adolescent experience and looks at three cohorts of responses to this questionnaire over time (1995, 1998 and 2001). It assesses the stability of the original 7‐factor structure of the ASQ over time, and while confirmatory factor analysis indicates that stability to be acceptable, it also suggests that either adolescent stressors themselves, or the language by which they are reported, vary sufficiently over time to warrant the refinement of the instrument. Copyright © 2002 John Wiley & Sons, Ltd.     

Endoscopic endonasal removal of an intra-suprasellar Rathke's cleft cyst: case report and surgical considerations.

An endoscopic endonasal approach was performed to remove an intra-suprasellar Rathke's cleft cyst. Rathke's cleft cyst are benign lesions, rarely diagnosed because they are often asymptomatic. To the best of our knowledge, at least 475 cases of Rathke's cleft cysts have been reported. They seem to arise from remnants of Rathke's pouch, an invagination of the stomodeum. A 52-year-old woman, complaining of bilateral frontal headaches, was operated on by using an endoscopic endonasal approach, for an intra-suprasellar tumor. The pre-operative diagnosis was non-functioning pituitary adenoma. Intra-operatively a creamy-coloured viscous tissue was found. After the removal of the cyst contents and of the capsule, the suprasellar structures were seen well. The chiasmatic cistern, the chiasm, the pituitary stalk and the pituitary gland were visualized with 0 and 30 degree endoscopes. The pathological findings showed a well-differentiated cuboidal epithelium. The diagnosis was Rathke's cleft cyst. No post-operative complications were observed. The endoscopic technique was particularly suitable in this case, both for the Rathke's cleft features and for an excellent outcome. The Rathke's cleft cyst was easily removed by suction and the cyst wall was entirely removed with curettes and pituitary punches. The hypophysis was distinguished from the cyst and was preserved. The surgical manoeuvres were all done under direct visual control. The absence of nasal packing and of breathing difficulties made comfortable the post-operative outcome. Thus, the endoscopic endonasal approach can be considered the favourite technique in case of either intra- and/or suprasellar Rathke's cleft cysts.     

Primary papillary serous cystadenocarcinoma of broad ligament

A rare case of an advanced primary broad ligament carcinoma is discussed, with a review of the literature regarding its incidence, presentation and management. This patient showed a complete response to adjuvant cisplatin-based chemotherapy following panhysterectomy and is presently without any evidence of disease, 15 months after completion of her treatment.     

Synthesis and the Antiinflammatory Activity of New N-Acyl-5-Bromanthranilamides

Nineteen N-acyl-5-bromanthranilic acid amides were synthesized via acylation of 5-bromanthranilamide with suitable anhydrides. The antimicrobial activity of the synthesized compounds with respect to Staphylococcus aureus and Escherichia coli was evaluated. Compounds with diphenyl, furoyl, and tetrachlorophthalyl moieties in the acyl part of the molecule showed significant inhibition of microbial growth. The minimum inhibiting concentrations of this compounds were 15.6 μg/ml against S. aureus and 15.6 – 31 μg/ml against E. coli. Other tested amides were considerably less active.__________Translated from Khimiko-Farmatsevticheskii Zhurnal, Vol. 39, No. 1, pp. 17 – 18, January, 2005.