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PubMed2004

Occupational exposure to diesel and gasoline engine exhausts and risk of lung cancer among Finnish workers.

BACKGROUND: Studies on engine exhausts and lung cancer have given inconsistent results. METHODS: Economically active Finns were followed-up for lung cancer during 1971-95 (33,664 cases). Their Census occupations in 1970 were converted to exposures to diesel and gasoline engine exhausts with a job-exposure matrix. The relative risks (RRs) for cumulative exposure (CE) were defined by Poisson regression, adjusted for smoking, asbestos, and quartz dust exposure, and socioeconomic status. RESULTS: RR for engine exhausts among men did not increase with increasing CE. In women, RR for gasoline engine exhaust was 1.58 (95% CI 1.10-2.26) in the CE-category of 1-99 mg/m(3)-y and 1.66 (1.11-2.50) among those with > or =100 mg/m(3)-y (lag 20 years). With a lag of 10 years RR for the middle/highest diesel exhaust category in women was 1.42 (0.94-2.13). CONCLUSIONS: Occupational exposure to engine exhausts was not consistently associated with lung cancer in this study, possibly due to low exposure levels.

Adult↗
PubMed2001

Effect of a community action intervention on cervical cancer screening rates in rural Australian towns: the CART project.

BACKGROUND: The effect of community action on cervical cancer screening rates was explored in 20 rural Australian towns. METHODS: Town quarterly Pap test counts, from the Australian Health Insurance Commission, were converted to town rates using Census populations. Pap test rates for 12 quarters before and after mobilization were examined. RESULTS: Wilcoxon-Mann-Whitney tests demonstrated significantly higher per capita Pap test rates pre- to postmobilization for intervention towns compared to matched control towns for women whose last Pap test was more than 2 years ago (P=0.008). Maximum efficiency robust tests examining the equality of mean differences (intervention-control) of per capita rates between pre- and post-mobilization periods also found significant differences for Pap tests where last procedure was between 1 and 2 years ago (R = 13.9, P = 0.039) and near significance for Pap tests where last procedure was less than one year ago (R = 10.6, P = 0.087). CONCLUSIONS: It appeared that underscreened women were more likely and overscreened women were less likely to have a Pap test in response to the intervention. The results indicate that a community action program can positively impact cervical cancer screening rates.

Adult↗
PubMed2004

Ecological study on residences in the vicinity of AM radio broadcasting towers and cancer death: preliminary observations in Korea.

OBJECTIVES: Public health concern about the health effects of radio-frequency electromagnetic fields (RF-EMFs) has increased with the increase in public exposure. This study was to evaluate some health effect of RF exposure by the AM radio broadcasting towers in Korea. METHODS: We calculated cancer mortality rates using Korean death certificates over the period of 1994-1995 and population census data in ten RF-exposed areas, defined as regions that included AM radio broadcasting towers of over 100 kW, and in control areas, defined as regions without a radio broadcasting tower inside and at least 2 km away from the towers. RESULTS: All cancers-mortality was significantly higher in the exposed areas [direct standardized mortality rate ratio (MRR) = 1.29, 95%CI = 1.12-1.49]. When grouped by each exposed area and by electrical power, MRRs for two sites of 100 kW, one site of 250 kW and one site of 500 kW, for all subjects, and for one site of 100 kW and two sites of 250 kW, for male subjects, showed statistically significant increases without increasing trends according to the groups of electric power. Leukemia mortality was higher in exposed areas (MRR = 1.70, 95% CI = 0.84-3.45), especially among young adults aged under 30 years (0-14 years age group, MRR = 2.29, 95% CI = 1.05-5.98; 15-29 age group, MRR = 2.44, 95% CI = 1.07-5.24). CONCLUSIONS: We observed higher mortality rates for all cancers and leukemia in some age groups in the area near the AM radio broadcasting towers. Although these findings do not prove a causal link between cancer and RF exposure from AM radio broadcasting towers, it does suggest that further analytical studies on this topic are needed in Korea.

Adolescent↗
PubMed2006

Spatial distribution of primates in a mosaic of colonizing and old growth forest at Ngogo, Kibale National Park, Uganda.

Primate censuses were conducted in a mosaic of colonizing (two locations) and old-growth forests using line transect methods at the Ngogo study site, Kibale National Park, Uganda. Black and white colobus monkeys (Colobus guereza) were encountered more frequently in the colonizing forests than in the old growth forest, while chimpanzees (Pan troglodytes) were encountered more frequently in the old growth forest than in colonizing forests. Although not significant, results suggest that blue monkeys (Cercopithecus mitis) frequented colonizing forests more often than old growth forest. The encounter rates of mangabey (Lophocebus albigena), and redtail (Cercopithecus ascanius) groups were ambiguous with their density being higher in some colonizing forests but not others as compared to old-growth forest. No significant differences were detected for baboons (Papio anubis), L'hoest's (Cercopithecus lhoesti), and red colobus monkeys (Piliocolobus tephroscales). The conversion of forests to farmland is one of the major problems encountered in primate conservation. This study shows that secondary forests replacing anthropogenic grasslands have the potential of supporting some primate species such as black and white colobus, redtail monkeys, and possibly blue monkeys. Therefore, such areas should not be given up but should be conserved for the benefit of primates that can survive in secondary forests; as the forests mature further, primate species that are adapted to old growth forest will colonize the area provided there is a nearby source.

Animals↗
PubMed2006

A method for observing physical activity on residential sidewalks and streets.

Assessment of physical activity needs to improve in order to gain a more comprehensive understanding of the relationship between characteristics of the environment and physical activity. Our study evaluated a method [Block Walk Method (BWM)] for observing physical activity along residential sidewalks and streets. The BWM was utilized in 12 U.S. Census block groups over a three-month period. Examination transportation routes (ETRs), 1,524 m in length, were constructed and examined in each block group. On 6 days, ETRs were traversed by a trained observer for 50 min. Physical activities, street names, and geographical locations (e.g., addresses) were recorded. We found encouraging results for the BWM. The level of agreement between independent observers was >98% for activity type. The number of individuals seen walking, running, or biking did not differ significantly between the days of the week or observation times. The number of individuals observed was correlated with block group characteristics (e.g., percent walking/biking to work) and weather (e.g., temperature). The BWM is an easy to use, economically viable observational approach to obtaining reliable information concerning physical activities performed on residential streets and sidewalks. Its use could help advance our understanding about the environment-physical activity relationship.

Censuses↗
PubMed1996

A study of factors influencing ED patients' length of stay at one community hospital.

OBJECTIVE In 1993 the administration of Kennewick General Hospital selected a facilitator to assist an ED task force in isolating and testing aspects of operations for quality improvement. The primary problem selected was reducing the length of stay (LOS) for patients. The department had an annual census in excess of 33,000, with seven rooms and 96 hours of registered nurse staffing per day. METHODS The task force selected 11 factors considered to possibly reduce LOS. The Taguchi method of robust quality improvement, an engineering quality improvement method, was used to determine the best average impact for each factor. Testing was conducted for an 11-day period. RESULTS The top three factors with significant impact on decreasing patient LOS were adding an additional physician, an additional laboratory professional, and implementation of a policy that allowed the emergency physician to hold a patient for possible admission in an inpatient unit while attempting to locate and communicate with the patient's private physician. DISCUSSION The study results met some expectations but also provided some unexpected findings for the ED staff. Some factors were implemented to reduce patient LOS and others for a different improvement value to patient care (i.e., a private triage room). Some highly effective factors were not implemented because of significant changes in department volume.

Bed Occupancy↗
PubMedDate not supplied

Suicide and the unique prevalence pattern of schizophrenia in mainland China: a retrospective observational study.

BACKGROUND: Unlike almost every other country in the world, the prevalence of both schizophrenia and suicide in China is higher in women than in men. Schizophrenia and suicide are important public-health problems for China that might be related to each other. We present prevalence data for schizophrenia and estimate relative and attributable risk of suicide in people with schizophrenia in mainland China. METHODS: We used data from the national psychiatric epidemiology study, the Ministry of Health's mortality registry, the census, and the national psychological autopsy study to estimate frequencies and rates of schizophrenia, suicide, and suicide in people with schizophrenia aged 15 years and older in mainland China during 1995-99. FINDINGS: We estimated 4.25 million people with schizophrenia in China, and 284614 suicides and 28737 suicides in people with schizophrenia yearly. Prevalence of schizophrenia was higher in women than men (relative risk 1.77 [95% CI 1.15-2.72]), and greater in urban than rural areas (1.62 [1.10-2.40]). Risk of suicide was greater in women than men (1.22 [1.20-1.23]) and in rural than urban areas (3.61 [3.56-3.66]). Relative risk of suicide in individuals with schizophrenia compared with those without was 23.8 (18.8-30.2); the proportion of all suicides attributable to schizophrenia was 9.7% (7.7-12.1). Relative risk of suicide in rural residents with schizophrenia versus those without was higher in men than in women (ratio of two relative risks 2.02 [1.13-3.63]), but in urban residents with schizophrenia the ratio was lower in men than women (0.56 [0.21-.49]). INTERPRETATION: Risk factors for suicide vary in people with different mental disorders, so identification of illness-specific risk profiles would improve prediction of suicide and help tailor prevention efforts. The difference in suicide rates by sex and residential location in individuals with schizophrenia might be one of several contributing factors to the unique epidemiological pattern of schizophrenia in China.

Adolescent↗
PubMed2002

Gall bladder cancer, extrahepatic bile duct cancer and ampullary carcinoma in New Zealand: Demographics, pathology and survival.

INTRODUCTION: The aim of present paper was to document the incidence of gall bladder cancer, cancer of the extrahepatic bile ducts and ampullary carcinoma in New Zealand. METHODS: Data were collected from the New Zealand Cancer Registry from 1980 to 1997 and combined with national census statistics to give crude and age standardized incidence rates. RESULTS: Over the 18-year study period, 226 carcinomas of the ampulla of Vater, 608 gall bladder cancers, and 486 extrahepatic cholangiocarcinomas were registered. The age standardized incidence rates for gall bladder carcinoma in all New Zealanders were 0.41/100 000 in men and 0.74/100 000 in women. The age standardized incidence rates for gall bladder cancer in Maori were 1.49/100 000 in Maori men and 1.59/100 000 in Maori women. The corresponding age standardized incidence rates for extrahepatic bile duct cancers were 0.67/100 000 in men and 0.45/100 000 in women. There were insufficient cases to calculate an age standardized incidence in Maori or Pacific Islanders. For carcinoma of the ampulla, the age standardized rates were 0.34/100 000 in men and 0.25/100 000 in women. There were insufficient cases to calculate an age standardized incidence rate for Maori or Pacific Islanders. When histology was defined adenocarcinoma was the most common form of cancer occurring in 66% of gall bladder cancers, 91% of extrahepatic bile duct cancers and 70% of ampullary cancers. Most tumours were advanced at presentation with regional or distant metastases present in 72% of gall bladder cancers, 63% of extrahepatic bile duct cancers and 69% of ampullary tumours at diagnosis. Survival was poor with median survivals of 86 days, 151 days and 440 days recorded for gall bladder cancer, extrahepatic bile duct cancer and ampullary cancer, respectively. CONCLUSIONS: The demographic profile, pathology and survival of patients with gall bladder cancer, extrahepatic bile duct cancer and ampullary carcinoma are similar in New Zealand to that of other Western countries. However New Zealand Maori have a relatively high incidence of gall bladder cancer, and the incidence is equal in both Maori men and women, while cancers of the extra-hepatic bile duct and ampulla of Vater are rare in Maori. In comparison, cancers of the gall bladder, extrahepatic bile ducts and ampulla are rare in Pacific Islanders.

Adenocarcinoma↗
PubMed1995

Survival after the age of 80 in the United States, Sweden, France, England, and Japan.

BACKGROUND: In many developed countries, life expectancy at birth is higher than in the United States. Newly available data permit, for the first time, reliable cross-national comparisons of mortality among persons 80 years of age or older. Such comparisons are important, because in many developed countries more than half of women and a third of men now die after the age of 80. METHODS: We used extinct-cohort methods to assess mortality in Japan, Sweden, France, and England (including Wales) and among U.S. whites for cohorts born from 1880 to 1894, and used cross-sectional data for the year 1987. Extinct-cohort methods rely on continuously collected data from death certificates and do not use the less reliable data from censuses. RESULTS: In the United States, life expectancy at the age of 80 and survival from the ages of 80 to 100 significantly exceeded life expectancy in Sweden, France, England, and Japan (P < 0.01). This finding was confirmed with accurate cross-sectional data for 1987. The average life expectancy in the United States is 9.1 years for 80-year-old white women and 7.0 years for 80-year-old white men. CONCLUSIONS: For people 80 years old or older, life expectancy is greater in the United States than it is in Sweden, France, England, and Japan. This finding suggests that elderly Americans are receiving better health care than the elderly citizens of other developed countries.

Aged↗
PubMed1997

Discarded needles do not increase soon after the opening of a needle exchange program.

This study examines the effect of a Needle Exchange Program (NEP) on the quantity and geographic distribution of discarded needles on the streets of Baltimore, Maryland, and presents methods to survey discarded needles in the community. A random sample of 32 city blocks located within high-drug-use census tracts, stratified by east and west sides of the city and by proximity to the NEP, was selected for survey. Three teams surveyed the number of needles and the number of drug vials and unbroken glass bottles ("trash") to control for practice effects. Surveillance was conducted prior to initiation of the NEP in August 1994 and 1 and 2 months thereafter. Over the three study periods, the absolute count of discarded needles was 106, 130, and 128, respectively; the number of vials and bottles was 3,048, 3,825, and 3,796, respectively. The initial nonstatistically significant increase in needles (mean change = 0.38, 95% confidence interval (CI) -0.18 to 0.93) was offset by accounting for background trash. Regression models fitted with the generalized estimating equation method, which accounted for within-block correlation over time, showed no significant increase in the number of needles after adjustment for trash during the first 2 months of the NEP's operation. These data suggest that the initiation of NEPs does not result in an increase in the number of discarded needles on the street.

Baltimore↗
PubMed1995

Serum retinol levels among preschool children in Central Java: demographic and socioeconomic determinants.

BACKGROUND: Vitamin A deficiency is a significant problem in many countries in the developing world. Reports have noted demographic and socioeconomic risk factors for vitamin A deficiency. 'Deficiency' has usually been defined by clinical signs and symptoms which represent only a small proportion of those children at increased risk for vitamin A preventable morbidity and mortality. METHODS: As part of a population-based trial of vitamin A to prevent childhood morbidity, we collected census data (n = 666), baseline socioeconomic data (n = 636) and sera (n = 666) from children aged 6-48 months in 25 adjacent villages in a rural area in Central Java, Indonesia; there was more than 95% participation. We used t tests, ANOVA, and a multiple variable linear regression model in our analyses. RESULTS: Differences in mean retinol level were detected for the following variables: village (P < 0.001), child's age (P = 0.03), size of sibship (P < 0.001), mother's occupation (P < 0.01), mother's education (P = 0.05), father's education (P = 0.03), monthly household earnings (P = 0.02), land ownership (P = 0.03), possession of ducks (P = 0.06), radio or tape player (P = 0.02), or a watch or clock (P = 0.07), and presence of a natural well (P = 0.09). Our regression model verified the predictive value of village, age, sibship, land ownership and earnings. CONCLUSIONS: We found that owning land and that the highest and lowest categories of reported household income were associated with higher serum retinol levels. We also noted clustering of serum retinol levels by village and discovered that children from larger sibships and infants had significantly lower serum retinol levels. Vitamin A supplementation of lactating mothers, particularly of high parity, and/or their infants should be considered.

Analysis of Variance↗
PubMed1996

Cancer mortality of Chinese in New York City 1988-1992.

BACKGROUND: This study examines cancer mortality among Chinese migrants in New York City, and compares it with that of residents of China as well as New York City whites. METHOD: Mortality records for 1988-1992 from the New York City Department of Health, and the 1990 US census data for New York City were used for the analysis. Age-specific deaths and the population of urban China reported by the World Health Organization were also used for comparison. Age-adjusted death rates by gender for Chinese and whites in New York City, as well as for Chinese in China were computed using the world standard population. RESULTS: New York Chinese had lower mortality rates for all causes, total cancer, oesophageal and lung cancer deaths than did either New York whites or Chinese in China in both genders. However, they had lower death rates than New York whites, but similar to those in China, for colon cancer in both genders, and breast cancer in females. By contrast, New York Chinese had higher death rates for nasopharyngeal cancer than either New York City whites or Chinese in China. Stomach and liver cancer death rates in New York Chinese fell between those in China and New York City whites. CONCLUSIONS: Cancer mortality rates among Chinese migrants in New York City being the lowest for total cancer and some types of cancers, did not follow the usual pattern of migrants (an intermediate position between rates of native New Yorkers and Chinese in homeland China). However, substantial variations in certain cancer-specific mortality by geography were observed.

Adult↗
PubMed1999

Secondary matching: a method for selecting controls in case-control studies on environmental risk factors.

BACKGROUND: The problem of control selection was considered in a population-based case-control study on pleural mesothelioma in Spain. Random sampling from the population was discarded because of potential selection bias due to low participation. Selection of hospital controls by matching them to cases by hospital seemed unsuitable for investigating environmental exposures, as the choice of hospital may be related to the place of residence; controlling for residence may avoid bias but could produce overmatching. METHODS: A three-step procedure was proposed. First, a random sample of primary controls from the population census of the province of Barcelona was obtained. Second, the hospital closest to the residence of the primary control was identified as the control hospital. Third a secondary control was chosen among patients admitted to the hospital matched to the primary control by sex, age and municipality. RESULTS: An overall participation rate of 85% was achieved. The hospital control group showed a distribution of residences similar to that of the general population, and independent of the distribution of cases. CONCLUSIONS: This procedure may be considered as an alternative for control selection when studying environmental factors or, generally, when matching cases and controls by hospital is to be avoided. Its validity was assessed according to the principles of comparability with cases regarding the study base, accuracy of information, deconfounding and efficiency.

Adult↗
PubMed2003

Child survival in relation to mother's HIV infection and survival: evidence from a Ugandan cohort study.

OBJECTIVE: To analyse the contribution of maternal survival and HIV status to child (under-5 years) mortality in a rural population cohort in South-west Uganda. METHODS: Approximately 10 000 people residing in 15 neighbouring villages were followed between 1989 and 2000 using annual censuses and serological surveys to collect data on births, deaths, and adult HIV serostatus. Mother-child records were linked, child mortality risks (per 1000 births) and hazard ratios (HRs) for child mortality according to maternal HIV serostatus were computed, allowing for time-varying covariates. RESULTS: A total of 3727 children were born, of whom 415 died during 14 110 child years of follow-up. Mother's HIV status at birth was ascertained unambiguously for 3004 children, of whom 218 were born to HIV-positive mothers. Infant mortality risk was higher for HIV seropositive than seronegative mothers (225 versus 53) as was child mortality risk (313 versus 114). Child mortality risk was also higher for mothers who died (571) than for surviving mothers (128). After controlling for child's age and sex, independent predictors of mortality in children were: mother's terminal illness or death (HR = 3.8); mother being HIV positive (HR = 3.2); child being a twin (HR = 2.0); teenage motherhood (HR = 1.7) and maternal absence (HR = 1.7). CONCLUSION: Maternal survival and HIV status are strong predictors of child survival. The higher mortality in HIV-infected women compounds mortality risks for their children, regardless of children's HIV status. Programmes aimed at the welfare of children should take into account the independent effect of mothers' HIV and vital status.

Adolescent↗
PubMed2005

Active and passive cigarette smoking and the risk of cervical neoplasia.

OBJECTIVE: Evidence links active cigarette smoking to cervical neoplasia, but much less is known about the role of passive smoking. Using a prospective cohort design, we examined personal cigarette smoking and household passive smoke exposure in relation to the risk of cervical neoplasia. METHODS: Cohorts were established based on data collected on the smoking status of all household members during private censuses of Washington County, Maryland in 1963 (n = 24,792) and 1975 (n = 26,381). Using the Washington County Cancer Registry, the occurrence of cervical neoplasia in the two cohorts was ascertained from 1963-1978 and from 1975-1994. Poisson regression models were fitted to estimate the relative risk of developing cervical neoplasia associated with active and passive smoking in both cohorts. The referent category for all comparisons was never smokers not exposed to passive smoking. RESULTS: The adjusted relative risk and 95% confidence limits for passive smoking was 2.1 (1.3, 3.3) in the 1963 cohort and 1.4 (0.8, 2.4) in the 1975 cohort. The adjusted relative risk and 95% confidence limits for current smoking were 2.6 (1.7, 4.1) and 1.7 (1.1, 2.6) in the 1963 and 1975 cohort, respectively. CONCLUSION: The associations were in the direction of increased risk for both passive smoking and current active smoking in both the 1963 and 1975 cohorts, but were stronger in the 1963 cohort. The results of this long-term, prospective cohort study corroborate the association between active cigarette smoking and cervical neoplasia and provide evidence that passive smoking is a risk factor for cervical neoplasia.

Adult↗
PubMed2005

Could mainstream anti-smoking programs increase inequalities in tobacco use? New Zealand data from 1981-96.

OBJECTIVE: To examine changes in the socio-economic and ethnic distribution of smoking in the New Zealand population from 1981 to 1996, and to consider the implication of these data for policies aimed at reducing tobacco consumption. METHODS: Cross-sectional data were taken from 4.7 million respondents to the 1981 and 1996 New Zealand Censuses and 4,619 participants in a 1989 national survey, aged 15 to 79 years. Smoking prevalence rates were calculated by socio-economic position and ethnicity. RESULTS: Smoking prevalence fell in the period 1981-96 in every population group. However, socio-economic and ethnic differences in smoking increased in relative terms. Smoking prevalence ratios comparing the least advantaged with the most advantaged groups increased in men from 1.20 to 1.53 by income, 1.54 to 1.85 by education, and 1.49 to 1.67 by ethnicity. In women, prevalence ratios increased from 1.17 to 1.51 by income, 1.55 to 2.02 by education, and 1.85 to 2.20 by ethnicity. The greatest increase in socio-economic differences may have occurred during the 1980s, the period of greatest overall decline in total population smoking. CONCLUSIONS: Socio-economic and ethnic disparities in New Zealanders' smoking patterns increased during the 1980s and '90s, a period of significant decline in overall smoking prevalence. IMPLICATIONS: Public health programs aimed at reducing tobacco use should pay particular attention to disadvantaged, Indigenous and ethnic minority groups in order to avoid widening relative inequalities in smoking and smoking-related health outcomes.

Adolescent↗
PubMed2000

Teaching patient empathy: the ED visit program.

OBJECTIVE: Residency programs only are not challenged with developing competent emergency clinicians, but should strive to develop caring, empathetic, and community-minded physicians. An exercise was designed to help residents experience emergency department (ED) visits from the patient's perspective. METHODS: This study occurred in emergency medicine residency program at an urban teaching institution with an annual ED census of 94,000. On the first day of residency orientation, each resident was given a clinical scenario and registered through triage into the ED. Nurses were blinded to the study. The study concluded when the examining physician entered the exam room. Residents were then presented with a simulated bill based on their scenario. Residents completed a survey initially and at six months. Survey ratings were measured using a 100-mm visual analog scale (VAS) (0 = not at all; 100 = a great deal). RESULTS: Twenty-five residents participated over two years. Sixty-four percent had never been an ED patient before. Median length of stay was 139 minutes. This exercise was found to improve resident empathy for patients on initial survey, 66 mm (range 16-71), and at follow-up, 66 mm (range 23-91). Residents found the exercise useful both initially, 50 mm (range 4-86), and at follow-up, 49 mm (range 15-81). Ninety-two percent of the residents thought the goals of the exercise had been met. Residents also stated the study changed their approach to patient care (45 mm, range 4-76) and made them a better physician (49 mm, range 5-80). CONCLUSIONS: The ED visit study enhanced patient empathy within residents and was useful in improving patient care attitude.

Adult↗
PubMed2001

Emergency evaluation of patients presenting with acute scrotum using bedside ultrasonography.

UNLABELLED: Acute scrotal pain is not a rare emergency department (ED) complaint. Traditional reliance on medical history and physical examination can be precarious as signs and symptoms can overlap in various etiologies of acute scrotal pain. OBJECTIVE: To determine the accuracy with which emergency physicians (EPs) using bedside ultrasonography are able to evaluate patients presenting to the ED with acute scrotal pain. METHODS: The study was performed at an urban community hospital ED with a residency program and an annual census of 70,000. A retrospective chart review identified 36 patients who presented with complaints of acute scrotal pain and were evaluated by EPs using bedside ultrasound. A 5.0- or 7.5-MHz linear-array transducer with color and power Doppler capability was used to scan the scrotum. Patients were seen between July 1998 and September 1999. Diagnoses were verified by radiology or surgery. Sensitivity and specificity with 95% confidence intervals were calculated. RESULTS: The EP ultrasound examinations agreed with confirmatory studies for 35 of 36 patients, resulting in a sensitivity of 95% (95% CI = 0.78 to 0.99) and a specificity of 94% (95% CI = 0.72 to 0.99). Diagnoses included three testicular torsions, six cases of epididymitis, four cases of orchitis, one testicular fracture, three hernias, three hydroceles, and 15 normal examinations. One case of epididymitis was misdiagnosed as an epididymal mass. CONCLUSIONS: This study suggests that EPs using bedside ultrasonography are able to accurately diagnose patients presenting with acute scrotal pain. In addition, they appear able to differentiate between surgical emergencies, such as testicular torsion, and other etiologies.

Acute Disease↗