Assessment of the medial longitudinal arch in children and adolescents with obesity: footprints and radiographic study.

The purpose of this study was to evaluate foot arch types of obese children and adolescents aged 9-16.5 years using both indirect and direct measures. Fifty-eight obese children/adolescents attending the paediatric endocrinology unit of the University Hospital "Lozano Blesa" in Zaragoza were selected as experimental subjects. Fifty-eight gender and age matched, normal-weight children/adolescents were selected as control subjects. To assess the medial longitudinal arch (MLA) height, which is used as a main reference for the diagnosis of flatfoot, footprints from both feet were collected (in both groups) and lateral weight-bearing radiographs of both feet were taken (of 49 of the 58 obese children). Footprint angle (FA) and the Chippaux-Smirak index (CSI) were calculated from the footprints. Talus-first metatarsal (TFMA) and calcaneal inclination angles (CIA) were obtained from lateral feet radiographs. In the normal-weight group, mean values of FA and CSI indicated a normal MLA. In the obese group, morphological flatfoot was identified. Comparison between both groups, by side and gender, showed a decrease of FA (p<0.001) and an increase of CSI (p<0.001) in obese subjects. Mean values of TFMA and CIA in the obese group indicated a lowering of the MLA. Obese children/adolescents between 9 and 16.5 years of age had significantly lower values of FA and higher CSI, related to a lower MLA. Radiographic parameters supported these findings and mean values were associated with a fall of this arch.

An economic model to assess the cost and benefits of the routine use of silver alloy coated urinary catheters to reduce the risk of urinary tract infections in catheterized patients.

Prevalence studies generally find nosocomial urinary tract infections to be the most common type of nosocomial infection, accounting for between 21% and 45% of all HAIs. The main risk factor appears to be the presence of a urinary catheter, with an estimated 80% of these infections being associated with their use. This paper describes a model which quantifies the extent of the burden of these infections in terms of the number of patients affected and the costs incurred by the hospital sector; and identifies the potential benefits of the routine use of silver alloy coated catheters, as a means of reducing the incidence of this type of infection. An illustrative model of the annual costs and benefits associated with the routine use of this intervention in adult, non-day case patients admitted to the medical and surgical specialties of NHS hospitals throughout England is presented. The results suggest that a 14.6% reduction in the incidence of urinary tract infections in catheterized medical patients, and a 11.4% reduction in catheterized surgical patients, would cover the cost of the intervention. Any further reduction in incidence would result in net positive benefits.

Assessment of MEDLINE search strategies for randomized controlled trials in prosthodontics.

PURPOSE: The purpose of this study was to evaluate the sensitivity, specificity, and precision of MEDLINE search strategies for detecting randomized controlled trials (RCTs) in prosthodontics. MATERIALS AND METHODS: A list of RCTs was obtained by hand-searching the International Journal of Prosthodontics, Journal of Prosthetic Dentistry, and Journal of Prosthodontics published between 1988 and 1997. RCTs identified served as the "gold standard" with which different MEDLINE search strategies were compared. Subject headings, keywords, MEDLINE checktags, publication types, and combinations thereof were used, and their results were compared with the "gold standard". RESULTS: Sensitivity ranged from 9% to 67%, specificity was at least 96% for all searches, and precision ranged from 22% to 59%. The most productive searches were by publication type clinical trial and publication type randomized controlled trial. Combining search terms did not improve sensitivity for detecting RCTs published in prosthodontic journals (p > .10). CONCLUSION: These findings support the need for more detailed reporting of trial methodologies to facilitate accurate indexing of prosthodontic articles in MEDLINE.

Costo de la atencion a personas mordidas por perros en Ciudad Juarez, Mexico. / The cost of medical care for persons bitten by dogs in Ciudad Juarez, Mexico

La incidencia de rabia humana en Ciudad Juarez, Chihuahua, llevo a efectuar un estudio del costo del tratamiento de las personas que acudieron al Centro Antirrabico de esa ciudad por haber tenido contacto o haber sido mordidas por un animal que se sospechaba rabioso