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[ "Do cognitive perceptions influence CPAP use?<||||>Nonadherence to CPAP increases health and functional risks of obstructive sleep apnea. The study purpose was to examine if disease and treatment cognitive perceptions influence short-term CPAP use.", "Do cognitive perceptions influence CPAP use?<||||>A prospective longitudinal study included 66, middle-aged (56.7 ± 10.7 yr) subjects (34 [51.5%] Caucasians; 30 [45.4%]African Americans) with severe OSA (AHI 43.5 events/hr ± 24.6). Following full-night diagnostic/CPAP polysomnograms, home CPAP use was objectively measured at 1 week and 1 month. The Self Efficacy Measure for Sleep Apnea (SEMSA) questionnaire, measuring risk perception, outcome expectancies, and self-efficacy, was collected at baseline, post-CPAP education, and after 1 week CPAP treatment. Regression models were used.", "Do cognitive perceptions influence CPAP use?<||||>CPAP use at one week was 3.99 ± 2.48 h/night and 3.06 ± 2.43 h/night at one month. No baseline SEMSA domains influenced CPAP use. Post-education self-efficacy influenced one week CPAP use (1.52 ± 0.53, p=0.007). Self-efficacy measured post-education and after one week CPAP use also influenced one month CPAP (1.40 ± 0.52, p=0.009; 1.20 ± 0.50, p=0.02, respectively)." ]

[ "Clinical signs of hypoxia with high-Dk soft lens extended wear: is the cornea convinced?<||||>To assess the effectiveness of high-Dk soft contact lenses with oxygen transmissibility (Dk/L) beyond the critical level required to avoid corneal edema during overnight wear.", "Clinical signs of hypoxia with high-Dk soft lens extended wear: is the cornea convinced?<||||>The most up-to-date data available on clinical signs of hypoxia with high-Dk contact lenses is reviewed.", "Clinical signs of hypoxia with high-Dk soft lens extended wear: is the cornea convinced?<||||>Chronic corneal edema associated with hypoxia is responsible for the development of large numbers of microcysts, limbal hyperemia, neovascularization, and small increases in myopia. Silicone hydrogel lenses worn continuously for up to 30 nights prevent corneal edema during overnight wear and do not induce a microcyst response. Long-term clinical trials indicate the mean level of limbal redness for patients wearing high-Dk lenses during continuous wear are equivalent to nonlens wearers. No changes in refractive error are associated with continuous wear of high-Dk lenses." ]

[ "Does cryotherapy affect refractive error?<||||>To evaluate the effect of cryotherapy on refractive error status between ages 3 months and 10 years in children with birth weights of less than 1251 g in whom severe retinopathy of prematurity (ROP) developed in one or both eyes during the neonatal period.", "Does cryotherapy affect refractive error?<||||>Randomized clinical trial.", "Does cryotherapy affect refractive error?<||||>Two hundred ninety-one children in whom severe ROP developed during the neonatal period.", "Does cryotherapy affect refractive error?<||||>Cryotherapy for ROP.", "Does cryotherapy affect refractive error?<||||>Cycloplegic Refraction", "Does cryotherapy affect refractive error?<||||>The children underwent repeated follow-up eye examinations, including cycloplegic retinoscopy, between 3 months and 10 years after term due date. Refractive error data from all eyes that were randomized to cryotherapy were compared with data from all eyes that were randomized to serve as controls. Refractive error data were also compared for a subset of children who had both a treated and a control eye that could be refracted.", "Does cryotherapy affect refractive error?<||||>At all ages, the proportion of treated eyes that were unable to be refracted because of retinal detachment, media opacity, or pupillary miosis was approximately half the proportion of the control eyes that were unable to be refracted. When data from all eyes that could be refracted were considered, the distribution of refractive errors between fewer than 8 diopters (D) of myopia and more than 8 D of hyperopia was similar for treated and control eyes at all ages. The proportion of eyes with 8 D or more of myopia was much higher in treated than in control eyes at all ages after 3 months. In the subset of children who had a treated eye and a control eye that could be refracted, distributions of refractive errors in treated versus control eyes were similar at most ages." ]

[ "The diagnostic pathway for solid pancreatic neoplasms: are we applying too many tests?<||||>The single best diagnostic and staging test for pancreatic cancer remains a contrast-enhanced computed tomography scan. It is frequently the only imaging test required before surgical resection for solid pancreatic lesions. Unfortunately, many patients undergo additional testing that often delays definitive care.", "The diagnostic pathway for solid pancreatic neoplasms: are we applying too many tests?<||||>A retrospective review of all patients with solid pancreatic lesions concerning for adenocarcinoma referred to a high volume Hepato-Pancreato-Biliary (HPB) service over 4 y (2008-2012) was completed. The time intervals between the initial imaging test and both consultation with HPB surgery and operative intervention, as well as the number of additional tests, were evaluated. Standard statistical methodology was used (P < 0.05).", "The diagnostic pathway for solid pancreatic neoplasms: are we applying too many tests?<||||>Among 130 patients with solid pancreatic lesions, the index imaging modality was ultrasonography and computed tomography for 75 (58%) and 52 (40%), respectively. Patients underwent a mean of 1.3 diagnostic tests after the index study and before consultation with HPB surgery (range: 0-5). There was a significant increase in time to HPB consultation and operative intervention with an increasing number of interval imaging tests. The mean time to surgical consultation and operation if 0 interval diagnostic tests were performed was 15.9 and 45.4 d, respectively. If four interval tests were conducted, the mean was 69.4 and 122.6 d, respectively. Sixty-two patients (48%) were initially referred to a nonsurgical service. The mean time to surgical consultation and operation if an intervening referral occurred was 36.6 and 66.8 d, respectively. This compares to 19.8 and 48.1 d, respectively, in cases of direct referral to an HPB surgeon. The mean number of diagnostic tests performed before HPB consultation if a nonsurgical referral occurred was 2.1 (versus 0.7 if direct HPB surgeon referral)." ]

[ "Does additional support by nurses enhance the effect of a brief smoking cessation intervention in people with moderate to severe chronic obstructive pulmonary disease?<||||>Smoking cessation is the primary disease modifying intervention for chronic obstructive pulmonary disease (COPD).", "Does additional support by nurses enhance the effect of a brief smoking cessation intervention in people with moderate to severe chronic obstructive pulmonary disease?<||||>A Regional Respiratory Centre (RRC) out-patient department in Northern Ireland.", "Does additional support by nurses enhance the effect of a brief smoking cessation intervention in people with moderate to severe chronic obstructive pulmonary disease?<||||>A randomised controlled trial (RCT) evaluated the effectiveness of brief advice alone or accompanied by individual nurse support or group support facilitated by nurses. Smoking status was biochemically validated and stage of change, nicotine addiction and dyspnoea were recorded at 2, 3, 6, 9 and 12 months.", "Does additional support by nurses enhance the effect of a brief smoking cessation intervention in people with moderate to severe chronic obstructive pulmonary disease?<||||>Ninety-one cigarette smokers with COPD were enrolled in the study (mean age 61 years, 47 female).", "Does additional support by nurses enhance the effect of a brief smoking cessation intervention in people with moderate to severe chronic obstructive pulmonary disease?<||||>After 12 months cessation rates were not significantly different between groups (p=0.7), but all groups had a significant reduction in their nicotine addiction (p=0.03-0.006). No changes in subjects' motivation or dyspnoea were detected over the 12 months." ]

[ "Illegal intra-corporeal packets: can dual energy CT be used for the evaluation of cocaine concentration?<||||>The recent implementation of the dual energy technology on CT-scanners has opened new perspectives in tissue and material characterization. This study aims to evaluate whether dual energy CT can be used to assess the concentration of cocaine of intra-intestinal illegal packets.", "Illegal intra-corporeal packets: can dual energy CT be used for the evaluation of cocaine concentration?<||||>The study was approved by the institutional review board of our institution (CER 13_027_R). From November 2010 to May 2013, all consecutive conveyors in whom a low-dose abdominal CT (LDCT) revealed the presence of illegal intra-corporeal drug packets underwent a dual energy CT series (gemstone spectral imaging) targeted on one container. The mean radiological density (HU) of these packets was measured on the LDCT series, and on the monochromatic dual energy series, at 40 and 140 keV. The difference between the HU at 40 and 140 keV was reported as ∆HU. The effective atomic number Z(eff) was also measured on the monochromatic series. A chemical analysis was performed after expulsion to select cocaine containing packets, and to determine their cocaine concentrations. A correlation analysis was performed between HU, ∆HU and Z(eff), with regard to the percentage of cocaine.", "Illegal intra-corporeal packets: can dual energy CT be used for the evaluation of cocaine concentration?<||||>Fifty-four cocaine conveyors were included. The mean cocaine content of the packets was 36.8% (range 11.2-80, SD 15.4), the mean radiologic density 105 HU, the mean Z(eff) 8.7 and the mean ∆HU 163. The cocaine content was correlated with the ∆HU (0.57, p < 0.001), with the Z(eff) (r = 0.56, p < 0.001) but not with radiologic density (r = 0.25, p = 0.064). ∆HU>200 was 0.9 (9 of 10) sensitive and 0.82 (36 of 44) specific to predict a cocaine concentration higher than 50%." ]

[ "Predicting the response to air travel in passengers with non-obstructive lung disease: are the current guidelines appropriate?<||||>Air travel guidelines recommend using baseline arterial oxygen levels and the hypoxic challenge test (HCT) to predict in-flight hypoxaemia and the requirement for in-flight oxygen in patients with lung disease. The purpose of the present study was to (i) quantify the hypoxaemic response to air travel and (ii) identify baseline correlate(s) to predict this response in passengers with non-obstructed lung disease.", "Predicting the response to air travel in passengers with non-obstructive lung disease: are the current guidelines appropriate?<||||>Fourteen passengers (seven women) with chronic non-obstructed lung disease volunteered for this study. The study involved three phases: (i) respiratory function testing; (ii) in-flight measures (SpO(2), cabin pressure and dyspnoea); and (iii) a HCT. The in-flight hypoxaemic response was compared with the baseline arterial oxygen level, respiratory function and the HCT.", "Predicting the response to air travel in passengers with non-obstructive lung disease: are the current guidelines appropriate?<||||>All subjects flew without oxygen and no adverse events were recorded in-flight. Mean cabin pressure was 593 +/- 16 mm Hg. Pre-flight SpO(2) was 95 +/- 3% and significantly decreased to 85 +/- 9% in-flight, with further significant falls in subjects who walked during the flight (nadir SpO(2) 78 +/- 11%). The pre-flight SpO(2) showed the strongest correlation with in-flight SpO(2) (r = 0.91, P<0.001). The HCT SpO(2) was moderately correlated to the in-flight SpO(2) (r = 0.58, P<0.05). Spirometry, D(L,CO) and TLC measurements did not correlate with in-flight SpO(2)." ]

[ "Do we practice what we teach about childhood immunization in New Jersey?<||||>Although childhood immunization is a benchmark for preventive service delivery in family practices, no data have been reported on childhood immunization in New Jersey family practice residencies. This study assesses immunization coverage among 2-year-olds in nine residencies and evaluates childhood immunization knowledge and barriers in 10 residency programs.", "Do we practice what we teach about childhood immunization in New Jersey?<||||>We performed a retrospective review of immunization records of 2-year-olds, using the Centers for Disease Control's Clinic Assessment Software Application, and analyzed a survey of knowledge and barriers to immunization completed by residents, nurses, and faculty.", "Do we practice what we teach about childhood immunization in New Jersey?<||||>Among 726 children with four or more office visits, the mean percent of children immunized with the combination of four diphtheria-tetanus-pertussis, three polio, and one measles-mumps-rubella was 53% (range 31%-69%). The age-appropriate immunization rate was highest at 3 months (78%) and lowest at 16 months (29%). Among the 294 survey respondents, the mean knowledge score was 75% overall and 82% for faculty, 77% for nurses, and 71% for residents. There was moderate to good correlation of audit levels with knowledge, with 49% of the variation in immunization coverage explained by variation in knowledge. Lack of immunization records was reported by 47% as the most important office-related barrier." ]

[ "Does routine intraoperative cholangiography prevent bile duct transection?<||||>The role of routine intraoperative cholangiography is controversial. The aim of this study was to assess the impact of routine intraoperative cholangiography on the incidence of common bile duct injuries, and to evaluate the operative outcome of laparoscopic cholecystectomy carried out in a major teaching hospital and review the literature.", "Does routine intraoperative cholangiography prevent bile duct transection?<||||>Prospectively collected data on 3,145 laparoscopic cholecystectomies performed mainly by surgical trainees in the period 1990 to 2002 using routine intraoperative cholangiography with fluoroscopy were reviewed.", "Does routine intraoperative cholangiography prevent bile duct transection?<||||>The mean age of the study sample (65.6% male, 34.4% female) was 54 years, and 16.9% of the patients had clinical acute cholecystitis. The conversion rate to open cholecystectomy was 4.3%. Intraoperative cholangiography was attempted for 90.7% of the patients with a 95.9% success rate. Five patients (0.16%) had common bile duct injuries. Four injuries had occurred in the first 5 years. One injury (0.06%) had occurred after 1995. This injury was identified intraoperatively and repaired laparoscopically. Routine intraoperative cholangiography prevented one definite common bile duct transection." ]

[ "The impact of perioperative warm-up jackets on surgical site infection: cost without benefit?<||||>On July 1st, 2012, the University of Minnesota Medical Centers adopted a policy requiring all personnel to wear cover jackets in perioperative areas. This policy is based on the Association of Perioperative Registered Nurses recommended practice for cover jacket usage. We hypothesized that the cover jacket policy had no effect on the surgical site infection rate.", "The impact of perioperative warm-up jackets on surgical site infection: cost without benefit?<||||>We compared surgical site infection data from 1 year before the policy and 1 year after the policy. Twenty six thousand three hundred procedures were included: 13,302 before the policy and 12,998 after the policy. Rates between periods were compared using the z-test for proportions.", "The impact of perioperative warm-up jackets on surgical site infection: cost without benefit?<||||>The SSI rate precover and postcover jacket policy was 2.42% and 2.76% respectively. The P value was .1998. Our hypothesis was rejected because the change in rate was not statistically significant." ]

[ "Young adults with Type 1 diabetes in tertiary education: do students receive adequate specialist care?<||||>To examine the clinical characteristics of, and diabetes management provided for, young people with Type 1 diabetes in tertiary education.", "Young adults with Type 1 diabetes in tertiary education: do students receive adequate specialist care?<||||>The medical case records of a group of 55 students aged 18-24 years, all of whom had Type 1 diabetes and had been referred to a hospital diabetes clinic, were examined.", "Young adults with Type 1 diabetes in tertiary education: do students receive adequate specialist care?<||||>A mean (SD) attendance of 80% (28%) was observed for all clinic appointments. Despite greater use of intensified insulin therapy (increasing from 37% to 83%) of students neither mean HbA1c nor mean body mass index changed significantly. Microvascular complications were infrequent. Documentation in the case notes of the frequency of home blood glucose monitoring was inadequate in 25% of patients as was the recorded frequency of mild (self-treated) hypoglycaemia in (20%) of patients." ]

[ "Does greater workload lead to reduced quality of preventive and curative care among community health workers in Bangladesh?<||||>Community health workers (CHWs) perform a range of important tasks; however, limited evidence is available regarding the association between their workload and the quality of care they provide.", "Does greater workload lead to reduced quality of preventive and curative care among community health workers in Bangladesh?<||||>To analyze the quality of preventive and curative care provided by two groups of CHWs with different workloads in southern Bangladesh.", "Does greater workload lead to reduced quality of preventive and curative care among community health workers in Bangladesh?<||||>One group of CHWs provided preventive care in addition to implementing community case management (CCM) of acute respiratory infection and diarrhea, and another group additionally treated severe acute malnutrition (SAM). Preventive care was measured by case management observation at a routine household visit. Curative care was measured by case scenarios. Qualitative methods were used to contextualize CHWs' performance by examining their perceptions of challenges related to their workload. A total of 338 CHWs were assessed.", "Does greater workload lead to reduced quality of preventive and curative care among community health workers in Bangladesh?<||||>CHWs managing cases of SAM worked significantly more hours than the other group (16.7 +/- 6.9 hours compared with 13.3 +/- 4.6 hours weekly, p<.001) but maintained quality of care on curative and preventive work tasks. Effectively treating cases of SAM appeared to motivate CHWs." ]

[ "Is it Trauma- or Fantasy-based?<||||>The Trauma Model of dissociative identity disorder (DID) posits that DID is etiologically related to chronic neglect and physical and/or sexual abuse in childhood. In contrast, the Fantasy Model posits that DID can be simulated and is mediated by high suggestibility, fantasy proneness, and sociocultural influences. To date, these two models have not been jointly tested in individuals with DID in an empirical manner.", "Is it Trauma- or Fantasy-based?<||||>This study included matched groups [patients (n = 33) and controls (n = 32)] that were compared on psychological Trauma and Fantasy measures: diagnosed genuine DID (DID-G, n = 17), DID-simulating healthy controls (DID-S, n = 16), individuals with post-traumatic stress disorder (PTSD, n = 16), and healthy controls (HC, n = 16). Additionally, personality-state-dependent measures were obtained for DID-G and DID-S; both neutral personality states (NPS) and trauma-related personality states (TPS) were tested." ]

[ "Adjusting our lens: can developmental differences in diagnostic reasoning be harnessed to improve health professional and trainee assessment?<||||>Research in cognition has yielded considerable understanding of the diagnostic reasoning process and its evolution during clinical training. This study sought to determine whether or not this literature could be used to improve the assessment of trainees' diagnostic skill by manipulating testing conditions that encourage different modes of reasoning.", "Adjusting our lens: can developmental differences in diagnostic reasoning be harnessed to improve health professional and trainee assessment?<||||>The authors developed an online, vignette-based instrument with two sets of testing instructions. The \"first impression\" condition encouraged nonanalytic responses while the \"directed search\" condition prompted structured analytic responses. Subjects encountered six cases under the first impression condition and then six cases under the directed search condition. Each condition had three straightforward (simple) and three ambiguous (complex) cases. Subjects were stratified by clinical experience: novice (third- and fourth-year medical students), intermediate (postgraduate year [PGY] 1 and 2 residents), and experienced (PGY 3 residents and faculty). Two investigators scored the exams independently. Mean diagnostic accuracies were calculated for each group. Differences in diagnostic accuracy and reliability of the examination as a function of the predictor variables were assessed.", "Adjusting our lens: can developmental differences in diagnostic reasoning be harnessed to improve health professional and trainee assessment?<||||>The examination was completed by 115 subjects. Diagnostic accuracy was significantly associated with the independent variables of case complexity, clinical experience, and testing condition. Overall, mean diagnostic accuracy and the extent to which the test consistently discriminated between subjects (i.e., yielded reliable scores) was higher when participants were given directed search instructions than when they were given first impression instructions. In addition, the pattern of reliability was found to depend on experience: simple cases offered the best reliability for discriminating between novices, complex cases offered the best reliability for discriminating between intermediate residents, and neither type of case discriminated well between experienced practitioners." ]

[ "Does Combination Therapy with Tamsulosin and Tolterodine Improve Ureteral Stent Discomfort Compared with Tamsulosin Alone?<||||>Ureteral stent discomfort is a significant postoperative problem for many patients. Despite the use of narcotics and α-blockers patients often experience bothersome lower urinary tract symptoms and pain, which impair daily activities. We compared combination therapy with an α-blocker and an anticholinergic to monotherapy with an α-blocker.", "Does Combination Therapy with Tamsulosin and Tolterodine Improve Ureteral Stent Discomfort Compared with Tamsulosin Alone?<||||>A double-blind, randomized, controlled trial was performed from December 2012 to April 2014. A total of 80 patients were randomized, including 44 to the combination group (tamsulosin 0.4 mg and tolterodine early release 4 mg) and 36 to the monotherapy group (tamsulosin 0.4 mg and placebo). Patients with preexisting ureteral stent placement or current anticholinergic therapy were excluded from study. Patients completed USSQ (Urinary Stent Symptom Questionnaire) before stent placement on the day of surgery, the day after stent placement, the morning of stent removal and the day after stent removal. The questionnaire included questions regarding urinary symptoms, general health, body pain, and work and sexual history.", "Does Combination Therapy with Tamsulosin and Tolterodine Improve Ureteral Stent Discomfort Compared with Tamsulosin Alone?<||||>A total of 80 patients (40 males and 40 females) were studied. Mean age was 51.5 vs 51.3 years (p = 0.95) and mean body mass index was 33.6 vs 31.9 kg/m(2) (p = 0.44) in monotherapy group 1 vs combination therapy group 2. Between the 2 groups there was no significant difference in urinary symptoms, body pain and activities of daily living from baseline to just before stent removal (p = 0.95, 0.40 and 0.95, respectively). Although there was no difference between the groups, both showed improvement in urinary symptoms from the time of initial stent insertion to just prior to stent removal (difference -0.50 for combination therapy and -0.40 for monotherapy). The mean stent indwelling time of 9.6 and 8.7 days in the combination and monotherapy groups, respectively, did not differ (p = 0.67). On ANOVA it had no significant impact on results (p = 0.64)." ]

[ "Can trans-anal reinforcing sutures after double stapling in lower anterior resection reduce the need for a temporary diverting ostomy?<||||>The data of patients who received trans-anal reinforcing sutures were compared with those of patients who did not receive them after low anterior resection. Patients who underwent laparoscopic low anterior resection and the double-stapled anastomosis technique for primary rectal cancer between January 2008 and December 2011 were included in this study. Patients with no anastomosis, a hand-sewn anastomosis, high anterior resection, or preoperative chemoradiation were excluded. The primary outcomes measured were the incidence of postoperative anastomotic complications and placement of a diverting ileostomy.", "Can trans-anal reinforcing sutures after double stapling in lower anterior resection reduce the need for a temporary diverting ostomy?<||||>Among 110 patients, the rate of placement of a diverting ileostomy was significantly lower in the suture group (SG) compared with the non-suture control group (CG) [SG, n = 6 (12.8%); CG, n = 19 (30.2%), P = 0.031]. No significant difference was observed in the rate of anastomotic leakage [SG, n = 3 (6.4%); CG, n = 5 (7.9%)]." ]

[ "Are CD4+CD25-Foxp3+ cells in untreated new-onset lupus patients regulatory T cells?<||||>Our previous study has reported that, in patients with untreated new-onset lupus (UNOL), there was an abnormal increase in the number of CD4+CD25-Foxp3+ T cells that correlated with disease activity and significantly decreased after treatment. However, little is known about the nature of this cell entity. The aim of this study was to explore the nature of abnormally increased CD4+CD25-Foxp3+ T cells in UNOL patients.", "Are CD4+CD25-Foxp3+ cells in untreated new-onset lupus patients regulatory T cells?<||||>The expressions of surface (CD4, CD25, CD127, chemokine receptor 4 [CCR4], glucocorticoid-induced tumor necrosis factor receptor [GITR], and cytotoxic T lymphocyte-associated antigen 4 [CTLA-4]) and intracellular (Foxp3) molecules as well as cytokine synthesis of peripheral blood mononuclear cells from 22 UNOL patients were analyzed by flow cytometry. The proliferative and suppressive capacities of different T-cell subgroups from UNOL patients were also assessed.", "Are CD4+CD25-Foxp3+ cells in untreated new-onset lupus patients regulatory T cells?<||||>In UNOL patients, the percentages of CD127(low/-) in CD25(high), CD25(low), and CD25- subpopulations of CD4+Foxp3+ T cells were 93.79% +/- 3.48%, 93.66% +/- 2.31%, and 91.98% +/- 2.14%, respectively (P>0.05), whereas the expressions of Foxp3 showed significant differences in CD25(high) (91.38% +/- 2.57%), CD25(low) (71.89% +/- 3.31%), and CD25- (9.02% +/- 2.21%) subpopulations of CD4+CD127(low/-) T cells (P<0.01). The expressions of surface CCR4, GITR, and CTLA-4 on CD4+CD25-Foxp3+ T cells were significantly less than CD4+CD25+Foxp3+ T cells (P<0.05). Moreover, unlike CD4+CD25+Foxp3+ T cells, CD4+CD25-Foxp3+ T cells also synthesized interferon-gamma, interleukin (IL)-4, IL-2, and IL-17 (P<0.05), though less than CD4+CD25+Foxp3- T cells. The suppressive capacity was most prominent in CD4+CD25(high)CD127(low/-), followed by CD4+CD25(low)CD127(low/-). CD4+CD25-CD127- T cells showed the least suppressive capacity, which was similar to the effector T cells." ]

[ "Providing patients web-based data to inform physician choice: if you build it, will they come?<||||>Despite growing emphasis on public reporting of health care quality data, available data are often ignored.", "Providing patients web-based data to inform physician choice: if you build it, will they come?<||||>To evaluate the usefulness of web-based physician-level data for patients choosing a new primary care physician (PCP).", "Providing patients web-based data to inform physician choice: if you build it, will they come?<||||>Patients seeking a new PCP (n = 2225) were invited to view web-based information including PCP credentials, personal characteristics, office location and hours, and patient experience scores. Patient experience scores included validated measures of interpersonal quality, appointment access, care coordination, health promotion, and patient recommendations of the PCP. After viewing the website, participants indicated their preferred PCP and completed a study questionnaire.", "Providing patients web-based data to inform physician choice: if you build it, will they come?<||||>Of the invited participants, 17% visited the website (n = 382). Patient experience scores were cited most frequently as important to physician choice (51%). Among these measures, patients' highest priorities were interpersonal quality (37%) and patient recommendations of the PCP (41%). For patients citing these priorities, the odds of choosing a highly scored physician after viewing the data was nearly 10 times that of choosing such a physician by chance (odds ratio (OR) = 9.52 and 9.71, respectively)." ]

[ "Do recent life events and social support explain gender differences in depressive symptoms in patients who had percutaneous transluminal coronary angioplasty?<||||>Previous studies have documented that among patients with coronary artery disease (CAD), depressive symptoms are more common in women than in men. The objective of this study was to determine if this disparity was explained by gender differences in stressful life events and in perceived social support.", "Do recent life events and social support explain gender differences in depressive symptoms in patients who had percutaneous transluminal coronary angioplasty?<||||>This was a cross-sectional study involving patients who recently had percutaneous transluminal coronary angioplasty (PTCA). Logistic regression was used to test the associations among gender, depressive symptoms, stressful life events, and social support. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D).", "Do recent life events and social support explain gender differences in depressive symptoms in patients who had percutaneous transluminal coronary angioplasty?<||||>Of the 660 patients enrolled, 27% were women. A higher proportion of women than men were classified as having substantial depressive symptoms based on a cutoff score of>or =16 on the CES-D (43% vs. 29%, p<0.01). More women reported experiencing personal stressful life events than men (33% vs. 23%, p<0.05). Fewer women than men reported having tangible support, which in this study was defined as having someone available to help with chores (68% vs. 85%, p<0.001). On mediation analysis, the strength of the association between gender and depressive symptoms was diminished after personal stress and tangible social support variables were added to the logistic regression model." ]

[ "Do temperature and atmospheric pressure affect the incidence of serious odontogenic infection?<||||>The purpose of this study was to investigate the popular belief that the incidence of odontogenic cellulitis is weather-related. Two meteorologic parameters were examined: temperature and atmospheric pressure.", "Do temperature and atmospheric pressure affect the incidence of serious odontogenic infection?<||||>To test the hypothesis being studied, a retrospective cohort study design was used. Medical reports of all patients with serious odontogenic cellulitis who were treated at the Salpêtrière University Hospital between January 1, 1995, and December 31, 1995, (a total of 301 cases) were evaluated in relation to the weather. Hypothesizing that the incidence of odontogenic cellulitis was constant over a period of 1 year, the authors calculated the probability of observed incidence for each month over a 12-month period. The mean number of cases of odontogenic cellulitis (+/- standard error of the mean) for days on which (1) the temperature was within the same 2 degrees -C (3.6 degrees -F) interval and (2) the atmospheric pressure was within the same 3-hPa (2.25-mmHg) interval was also calculated.", "Do temperature and atmospheric pressure affect the incidence of serious odontogenic infection?<||||>When the monthly incidence of odontogenic cellulitis and either the average temperature or the average atmospheric pressure for each month were examined together, fluctuation in the former seemed to be independent of the latter. Similarly, when we calculated the mean number of cases of odontogenic cellulitis for several intervals of temperature and atmospheric pressure without taking the calendar into account, no direct relationship could be observed." ]

[ "Diabetes mellitus onset in geriatric patients: does long-term atypical antipsychotic exposure increase risk?<||||>Diabetes mellitus (DM) in common in adults using psychotropic medications. However, it remains largely unknown whether there is an additional risk of diabetes mellitus (DM) in elderly psychiatric outpatients, particularly those with long-term exposure to atypical antipsychotics (AP).", "Diabetes mellitus onset in geriatric patients: does long-term atypical antipsychotic exposure increase risk?<||||>In this retrospective longitudinal study, 61 atypical AP-exposed and 64 atypical AP-unexposed geriatric psychiatric patients were compared to a group of 200 psychotropic-naïve controls. Our main composite outcome was diabetes incidence over a 4-year period, defined by fasting blood glucose ≥ 7.0 mmol/L or a new-onset oral hypoglycaemic or insulin prescription during the 4-year period.", "Diabetes mellitus onset in geriatric patients: does long-term atypical antipsychotic exposure increase risk?<||||>The 4-year incidence of DM did not differ significantly between groups: 12.3%, 6.7%, and 11.9% in the atypical AP-exposed, atypical AP-unexposed, and control groups, respectively (χ(2) = 1.40, P = 0.50). Depression and antidepressant, cholinesterase inhibitor, and valproate use were independently associated with increases in fasting glucose. However, hyperglycaemia and hypoglycaemic prescriptions were not more common in geriatric psychiatric patients." ]

[ "Does high-frequency pseudo-random rotational chair testing increase the diagnostic yield of the eng caloric test in detecting bilateral vestibular loss in the dizzy patient?<||||>To assess the incremental diagnostic yield of testing vestibulo-ocular (VOR) gain with high-frequency pseudo-random rotational chair (PsRRC) over testing with bithermal electronystagmography caloric tests in the dizzy patient, particularly in detecting bilateral vestibular loss.", "Does high-frequency pseudo-random rotational chair testing increase the diagnostic yield of the eng caloric test in detecting bilateral vestibular loss in the dizzy patient?<||||>One hundred ninety-eight patients presenting with dizziness underwent PsRRC and caloric testing. The VOR gain on PsRRC was measured at 0.32 to 5.0 Hz, with gain categorized as normal or decreased. PsRRC results were compared with caloric responses, also categorized as normal, or into graded categories of unilateral or bilateral vestibular loss.", "Does high-frequency pseudo-random rotational chair testing increase the diagnostic yield of the eng caloric test in detecting bilateral vestibular loss in the dizzy patient?<||||>Reduced PsRRC gain was found in 29 (15%) patients, and reduced caloric tests responses in 70 (35%), with 25 (13%) having bilateral loss. Of patients with reduced chair gain, 25 of 29 (86%) demonstrated bilateral caloric loss. PsRRC gain was normal in most patients with unilateral caloric weakness, but was decreased in all patients with bilateral caloric weakness. The probability of a patient with completely normal caloric responses having an abnormal rotation chair in this study group was under 1% (1 of 128)." ]

[ "Synbiotics in Surgery for Chronic Pancreatitis: Are They Truly Effective?<||||>Postoperative infectious complications in patients undergoing pancreatic surgery are a significant cause for morbidity and mortality. Although synbiotics have beneficial effects on human health, their clinical value in surgical patients remains unclear given a paucity of applicable clinical studies.AIM: To determine the impact of perioperative synbiotic therapy on postoperative infectious complications, morbidity and mortality in patients undergoing pancreatic surgery for chronic pancreatitis.", "Synbiotics in Surgery for Chronic Pancreatitis: Are They Truly Effective?<||||>A trial was conducted in patients with chronic calcific pancreatitis undergoing Frey's procedure. Group A received a specific synbiotic composition, 5 days prior and 10 days after the surgery. Group B received a placebo. Primary study endpoint was the occurrence of postoperative infection during the first 30 days. Secondary outcome measures were mortality, length of hospital stay, days in intensive care unit, and duration of antibiotic therapy. Using previously accrued data, with α of 0.05 and power 80%, the sample size was calculated as 35 patients for each group with a dropout rate of 10%.", "Synbiotics in Surgery for Chronic Pancreatitis: Are They Truly Effective?<||||>Of the 79 patients enrolled, 75 completed the trial [group A (n = 39) and group B (n = 36)]. The incidence of postoperative infectious complications (12.8% vs 39%; P<0.05), duration of antibiotics therapy (P<0.05), and length of hospital stay (P<0.05) were significantly lower in the synbiotic group." ]

[ "Is fungal infestation of paranasal sinuses more aggressive in pediatric population?<||||>Comparison of characteristic features, radiology, management and recurrence pattern of fungal sinusitis between children and adults.", "Is fungal infestation of paranasal sinuses more aggressive in pediatric population?<||||>A prospective study conducted in the department of Otorhinolaryngology, Head and Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh in which all the cases presenting with the features of allergic fungal sinusitis (AFS) between January 2000 and January 2005 were enrolled. These cases were divided into two groups, group 1 comprised of cases with age less than 15 years and group 2 with age more than 15 years. Detailed history, physical examination and nasal endoscopic examination and computed tomography (CT) scan of the paranasal sinuses was done in all the cases. The cases with prior history of sinonasal surgery were excluded from the study. All patients refractory to medical management were subjected to endoscopic sinus surgery. All the cases were followed up for a period ranging from 6 to 39 months to see for the recurrence. The data of both the groups was analysed statistically using chi square test.", "Is fungal infestation of paranasal sinuses more aggressive in pediatric population?<||||>The study population comprised of 200 cases, with 68 cases in group 1 and 132 cases in group 2. The most common symptom in both the groups was presence of nasal obstruction. The children had higher incidence of having unilateral disease (46 out of 68) compared with adults, where it was 38 out of 132. The bony erosion was seen more often in group 1. Surgery was done endoscopically in all the cases. The intra orbital or intra cranial extension was seen in 58 cases of group 1 and 47 cases of group 2 (p<0.001). Recurrence was seen in 18 (15 with intraorbital and 3 with intracranial extension) cases in group 1 and 13 cases (11 with intraorbital and 2 with intracranial extension) in group 2 (p<0.005)." ]

[ "Should male gender assignment be considered in the markedly virilized patient With 46,XX and congenital adrenal hyperplasia?<||||>We assess the outcome in 46,XX men with congenital adrenal hyperplasia who were born with Prader 4 or 5 genitalia and assigned male gender at birth.", "Should male gender assignment be considered in the markedly virilized patient With 46,XX and congenital adrenal hyperplasia?<||||>After receiving institutional review board approval and subject consent we reviewed the medical records of 12 men 35 to 69 years old with 46,XX congenital adrenal hyperplasia, of whom 6 completed social and gender issue questionnaires.", "Should male gender assignment be considered in the markedly virilized patient With 46,XX and congenital adrenal hyperplasia?<||||>All subjects were assigned male gender at birth, were diagnosed with virilizing congenital adrenal hyperplasia at age greater than 3 years and indicated a male gender identity with sexual orientation to females. Ten of the 12 subjects had always lived as male and 2 who were reassigned to female gender in childhood subsequently self-reassigned as male. Nine of the 12 men had long-term female partners, including 7 married 12 years or more. The 3 subjects without a long-term female partner included 1 priest, 1 who was reassigned female gender, married, divorced and self-reassigned as male, and 1 with a girlfriend and sexual activity. All except the priest and the subject who was previously married when female indicated a strong libido and frequent orgasmic sexual activity. Responses to self-esteem, masculinity, body image, social adjustment and symptom questionnaires suggested adjustments related to the extent of familial and social support." ]

[ "Should we reconsider the routine use of placebo controls in clinical research?<||||>Modern clinical-research practice favors placebo controls over usual-care controls whenever a credible placebo exists. An unrecognized consequence of this preference is that clinicians are more limited in their ability to provide the benefits of the non-specific healing effects of placebos in clinical practice.", "Should we reconsider the routine use of placebo controls in clinical research?<||||>We examined the issues in choosing between placebo and usual-care controls. We considered why placebo controls place constraints on clinicians and the trade-offs involved in the choice of control groups.", "Should we reconsider the routine use of placebo controls in clinical research?<||||>We find that, for certain studies, investigators should consider usual-care controls, even if an adequate placebo is available. Employing usual-care controls would be of greatest value for pragmatic trials evaluating treatments to improve clinical care and for which threats to internal validity can be adequately managed without a placebo-control condition." ]

[ "Central precocious puberty after interpersonal transfer of testosterone gel: just a coincidence?<||||>Over the last 10 years, several children, fetuses and women have been reported to be virilized through interpersonal transfer of testosterone (T) gel used by fathers or partners. Long-term exposure to androgens in children, such as in poorly controlled congenital adrenal hyperplasia, is known to promote central precocious puberty.", "Central precocious puberty after interpersonal transfer of testosterone gel: just a coincidence?<||||>Clinical case report.", "Central precocious puberty after interpersonal transfer of testosterone gel: just a coincidence?<||||>We report on a 5-year-old boy who developed central precocious puberty after long-term (starting prenatally) exposure to testosterone through interpersonal transfer of T gel used by his father. We also report on another case illustrating that the recommended precautions are not sufficient to avoid interpersonal transfer of T gel among household contacts. Plasma testosterone levels and history-taking revealed the cause of virilisation and the testosterone contamination source in both cases. Given the increased testicular volume and persisting testosterone elevation after cessation of gel use in the first patient, a GnRH test was carried out and confirmed central precocious puberty." ]

[ "Should we treat auditory hallucinations with repetitive transcranial magnetic stimulation?<||||>Abnormal activations of neural networks implicated in auditory stimuli processing are hypothesized to generate auditory hallucinations (AH) in schizophrenia spectrum disorders. Because repetitive transcranial magnetic stimulation (rTMS) has the potential to modulate neural network activity, several studies have explored its use in treating medication-resistant AH, with mixed results in small-to-medium patient samples. Our aim is to apply a metaanalytic approach to exploring the efficacy of rTMS in treating medication-resistant AH.", "Should we treat auditory hallucinations with repetitive transcranial magnetic stimulation?<||||>A search of the electronic databases for studies comparing low-frequency (1 Hz) rTMS over the left temporoparietal cortex to sham stimulation in patients suffering from medication- resistant AH was performed. Our search was completed by cross-referencing the articles, searching the Current Controlled Trials website, and direct contact with relevant researchers.", "Should we treat auditory hallucinations with repetitive transcranial magnetic stimulation?<||||>From 265 possible abstracts, 6 parallel-arm, double-blind placebo-controlled and 4 crossover controlled trials, all randomized, matched the inclusion and exclusion criteria (n = 232). The primary outcome measure (effect of active treatment on AH at the end of the treatment) was tested with a random effect model and reached a significant homogeneous ES estimate (Hedges' g = 0.514; P = 0.001; 95CI%, 0.225 to 0.804; Q = 13.022; P = 0.162)." ]

[ "Vaginal delivery of vertex-nonvertex twins: a fading skill?<||||>Delivery of the second twin is one of the most challenging events for practicing obstetricians. Due to the increased incidence of twin gestations and lack of well-designed clinical trials, evidence-based recommendations are lagging behind clinical demand.", "Vaginal delivery of vertex-nonvertex twins: a fading skill?<||||>The present review examines the practice of second nonvertex twin deliveries.", "Vaginal delivery of vertex-nonvertex twins: a fading skill?<||||>A review of the literature was conducted using the term vertex-nonvertex; twin gestation; mode of delivery; and cesarean delivery.", "Vaginal delivery of vertex-nonvertex twins: a fading skill?<||||>There is a lack of evidence supporting the appropriate approach to second nonvertex twin deliveries. Larger studies with increased power are needed to examine the variations regarding gestational period, birth weight, and institutional experience. In the mean time, unless otherwise contraindicated, it is reasonable to attempt vaginal delivery and total breech extraction and proceed to assisted delivery or cesarean delivery if unsuccessful." ]

[ "Is functional capacity related to the daily amount of steps in postmenopausal women?<||||>The aim of this study was to investigate the relationship between functional capacity, muscle function, and daily step count in postmenopausal women.", "Is functional capacity related to the daily amount of steps in postmenopausal women?<||||>Fifty-seven postmenopausal women aged 50 to 70 years were recruited. Body composition (body weight, body mass index, fat mass, and skeletal muscle mass), energetic metabolism (maximal oxygen consumption, total energy expenditure, daily step count), and functional capacity (muscle strength, muscle quality, chair stand, balance and alternate step tests) were measured. Women were divided into three groups (sedentary [n = 19],<7,500 steps; moderately active [n = 20], 7,500-10,000 steps; active [n = 18],>10,000 steps).", "Is functional capacity related to the daily amount of steps in postmenopausal women?<||||>A higher number of steps per day was associated with higher maximal oxygen consumption (mL/min per kg; P = 0.001) and total energy expenditure (P = 0.004) as well as lower body weight (P = 0.035) and fat mass (P = 0.048). Surprisingly, no differences for skeletal muscle mass, muscle strength, muscle quality, and functional capacity were observed between the groups, although this could have been because of the small sample size." ]

[ "Is There a Benefit to Highly Crosslinked Polyethylene in Posterior-stabilized Total Knee Arthroplasty?<||||>Polyethylene wear and osteolysis remain a concern with the use of modular, fixed-bearing total knee arthroplasty (TKA). A variety of highly crosslinked polyethylenes (XLPs) have been introduced to address this problem, but there are few data on the results and complications of this polyethylene in posterior-stabilized knee prostheses.QUESTIONS/", "Is There a Benefit to Highly Crosslinked Polyethylene in Posterior-stabilized Total Knee Arthroplasty?<||||>In a randomized prospective study design comparing standard polyethylene (SP) tibial inserts with XLP inserts, we asked the following questions: (1) Are there any differences in the clinical results (as measured by the classic Knee Society scoring system) and radiographic results (as measured by an evaluation for radiolucencies and osteolysis) between these groups? (2) What is the frequency of reoperation in these two groups? (3) Are there any specific complications related to XLP liners?", "Is There a Benefit to Highly Crosslinked Polyethylene in Posterior-stabilized Total Knee Arthroplasty?<||||>These are preliminary data from a single surgeon of a planned interim analysis of a prospective randomized study of one modular posterior-stabilized TKA. One hundred ninety-two patients (236 knees) were randomized to receive a SP compression-molded liner or a XLP (6.5 CGy electron beam-irradiated and remelted) polyethylene liner. There was no difference in the number of knees who were lost or refused followup (14 knees [13%] with XLP and 21 knees [17%]with SP). Patients were evaluated clinically using the original Knee Society scores, Lower Extremity Activity Score (LEAS), presence of knee effusion, and by standard radiographs for radiolucent lines and osteolytic lesions. This analysis was performed at a mean followup of 4.5 years (range, 2-8 years).", "Is There a Benefit to Highly Crosslinked Polyethylene in Posterior-stabilized Total Knee Arthroplasty?<||||>There were no clinical differences between 99 knees with SP and 94 knees with XLP in original Knee Society total score (SP mean 95, SD 5; XLP mean 94, SD 7 [p = 0.16]); change in total score (SP mean 41, 95% confidence interval [CI], 39-41; XLP mean 43, 95% CI, 39-48 [p = 0.56]); knee function score (SP mean 64 [SD 25]; XLP mean 64 [SD 24] p = 0.98; change in function score (SP mean 22, 95% CI, 17-27; XLP mean 21, 95% CI, 17-27 [p = 0.79]); LEAS score (both SP and XLP 9 [SD 2]; p = 0.88); and change in LEAS (both SP and XLP mean 1, 95% CI, 1-2 [p = 0.0.38]). There were no differences, with the numbers available, in the presence of effusion (two of 94 XLP and five of 99 SP) with 2 years minimum followup. There were no differences in the frequency of radiolucent lines (13 knees with SP and 15 with XLP) or of osteolysis (two knees with SP and none with XLP). There was no difference in frequency of reoperation between the two groups (three infections in 110 knees allocated to the XLP group and five (two infections, one femoral loosening, one instability, one fracture plating) in 122 knees allocated to the standard group. There were no complications related to the XLP liner." ]

[ "Is testosterone treatment good for the prostate?<||||>For men with androgen deficiency on testosterone replacement therapy (TRT), clinical concern relates to the development of prostate cancer (PCa).AIM: An updated audit of prostate safety from the UK Androgen Study was carried out to analyze the incidence of PCa during long-term TRT.", "Is testosterone treatment good for the prostate?<||||>Diagnosis of PCa in men receiving TRT, by serum prostate-specific antigen (PSA) testing and digital rectal examination (DRE), and its relation to different testosterone preparations.", "Is testosterone treatment good for the prostate?<||||>One thousand three hundred sixty-five men aged 28-87 (mean 55) years with symptomatic androgen deficiency and receiving TRT have been monitored for up to 20 years. All patients were prescreened for PCa by DRE and PSA along with endocrine, biochemical, hematological, and urinary profiles at baseline and every 6 months. Abnormal findings or rising PSA were investigated by transrectal ultrasound and prostate biopsy. The data were compared for the four different testosterone preparations used in TRT, including pellet implants, Restandol, mesterolone, and Testogel.", "Is testosterone treatment good for the prostate?<||||>Fourteen new cases of PCa were diagnosed at one case per 212 years treatment, after 2,966 man-years of treatment (one case per 212 years). Time to diagnosis ranged from 1 to 12 years (mean 6.3 years). All tumors were clinically localized and suitable for potentially curative treatment. Initiating testosterone treatment had no statistically significant effect on total PSA, free PSA or free/total PSA ratio, and any initial PSA change had no predictive relationship to subsequent diagnosis of cancer." ]

[ "Does abdominal sonography provide additional information over abdominal plain radiography for diagnosis of necrotizing enterocolitis in neonates?<||||>To explore whether addition of abdominal sonography (AUS) to plain radiography is helpful in the management of premature newborns with necrotizing enterocolitis (NEC).", "Does abdominal sonography provide additional information over abdominal plain radiography for diagnosis of necrotizing enterocolitis in neonates?<||||>This study is a prospective analysis of 93 premature neonates with NEC who were followed-up in our neonatal intensive care unit between October 2007 and April 2009.", "Does abdominal sonography provide additional information over abdominal plain radiography for diagnosis of necrotizing enterocolitis in neonates?<||||>Patients were classified into two groups; group I with suspected NEC (stage I) (n = 54) and group II with definite NEC (stage ≥II) (n = 39). Pneumatosis intestinalis (PI) (n = 29), free air (n = 9), and portal venous gas (PVG) (n = 1) were observed in group II on plain radiography. In the same group, echoic free fluid (EFF) (n = 9), PVG (n = 6), PI (n = 5), and focal fluid collection (n = 3) were the most prominent sonographic findings. In patients with intestinal perforation, whereas EFF and bowel wall thinning were observed on AUS, free air was not detected on plain radiography as a sign of intestinal perforation." ]

[ "Does the age of achieving pubertal landmarks predict cognition in older men?<||||>Earlier pubertal maturation in women may be associated with better cognition. It is unclear whether or not this also occurs in men. We tested the hypothesis that earlier pubertal development in men was associated with better cognition in later adulthood in a developing Chinese population.", "Does the age of achieving pubertal landmarks predict cognition in older men?<||||>Multivariable linear regression was used in cross-sectional study of 2463 older, Chinese men from the Guangzhou Biobank Cohort Study. Mean pubertal age was calculated as the mean of recalled ages of first nocturnal emission, voice breaking and pubarche. We assessed the association of mean pubertal age with delayed 10-word recall and mini-mental state examination (MMSE) scores.", "Does the age of achieving pubertal landmarks predict cognition in older men?<||||>Adjusted for age and education, 1 year earlier mean pubertal age was associated with higher delayed 10-word recall (0.06 [95% confidence interval = 0.02-0.10]) and higher MMSE (0.08 [0.03-0.13]) scores. Additional adjustment for childhood and adulthood socio-economic position, sitting height, and leg length did not change the results." ]

[ "Does early surgical decompression in cauda equina syndrome improve bladder outcome?<||||>We analyzed retrospectively whether early surgery for cauda equina syndrome (CES) within 24, 48, or 72 hours of onset of autonomic symptoms made any difference to bladder function at initial outpatient follow-up.", "Does early surgical decompression in cauda equina syndrome improve bladder outcome?<||||>CES potentially causes loss of autonomic control including bladder dysfunction, resulting in significant disability. There is significant debate regarding appropriate timing of surgery.", "Does early surgical decompression in cauda equina syndrome improve bladder outcome?<||||>We conducted a retrospective cohort study of 200 patients between 2000 and 2011 who underwent decompressive surgery for CES at a regional neurosurgical center. Data collected were from clinical admission and at initial follow-up. Presentation was categorized into CES with retention (CESR) and incomplete CES (CESI) and duration of autonomic symptoms before surgical intervention.", "Does early surgical decompression in cauda equina syndrome improve bladder outcome?<||||>A total of 200 patients had complete clinical records; 61 cases with CESR and 139 cases with CESI. Average initial follow-up time was 96 days. For the 36 cases with CESI less than 24 hours, normal bladder function was seen at follow-up in all patients except 4 (11.1%), but with 103 cases with CESI more than 24 hours, 48 (46.6%) had bladder dysfunction (Pearson χP = 0.000). For the 64 cases with CESI less than 48 hours, normal bladder function was seen at follow-up in all except 10 (15.6%), but with 75 cases with CESI more than 48 hours, 42 (56%) had bladder dysfunction (Pearson χP = 0.000). For the 35 patients with CESR, operating within 24, 48, or 72 hours made no obvious difference to bladder outcome. Data were also reanalyzed changing the dataset groups to CESI less than 24 hours, 24 to 48 hours, and more than 48 hours to calculate odds ratios regarding normal bladder outcome." ]

[ "The use of fresh frozen plasma after major hepatic resection for colorectal metastasis: is there a standard for transfusion?<||||>Major hepatic resection is indicated for selected patients with colorectal metastasis to the liver. Transfusion of fresh frozen plasma (FFP) might be required after major hepatectomy because of blood loss or coagulopathy, but there are no standard criteria for the use of FFP in this setting.", "The use of fresh frozen plasma after major hepatic resection for colorectal metastasis: is there a standard for transfusion?<||||>We identified 260 patients from our prospective database who underwent major (>or =3 Couinaud segments) hepatectomy between May 1997 and February 2001 for colorectal metastasis. FFP use was determined and tested for its relationship to clinical and pathologic factors. A survey on FFP use was sent to 12 other hepatobiliary centers worldwide.", "The use of fresh frozen plasma after major hepatic resection for colorectal metastasis: is there a standard for transfusion?<||||>There were 142 (55%) men, 118 (45%) women, and the median age was 63 years. The most common hepatic resections performed were right lobectomy (37%) and extended right lobectomy (33%). There were 83 (32%) patients who received FFP. In these patients, a total of 405 units of FFP were administered with a median of 4 units. The majority of patients who received FFP were transfused within the first two postoperative days, while there were only five (2%) patients who initially received FFP beyond that time. FFP was administered for a median prothrombin time of 16.9. Only one (0.4%) patient required reoperation for bleeding. Right lobectomy and extended right lobectomy were found to predict FFP use on multivariate analysis. Postoperative complications did not correlate with FFP use. The criteria used for FFP administration at other major hepatobiliary centers were found to be variable." ]

[ "Is surgical intervention still indicated in recurrent aortic arch obstruction?<||||>Introduction of balloon dilatation has become the standard treatment for recurrent aortic arch obstruction and has changed the therapeutic approach to patients with this disorder.", "Is surgical intervention still indicated in recurrent aortic arch obstruction?<||||>Whether all patients with recurrent aortic arch obstruction are candidates for balloon dilatation remains unanswered. In addition, only few reports have tried to compare the results between patients undergoing balloon dilatation or redo operations.", "Is surgical intervention still indicated in recurrent aortic arch obstruction?<||||>Since 1983, 97 patients underwent reintervention for recurrent aortic arch obstruction (42 dilations and 55 reoperations). Eight had immediate unsuccessful dilatation and were shifted to the surgical group (n = 63). The median age at reintervention was 21.7 months (10 days-45 years), and the median delay was 13.6 months (7 days-17 years). Anatomy of the aortic arch oriented the surgical approach to treat arch hypoplasia. It could be performed through a left thoracotomy in 52 patients, with extended end-to-end anastomosis in 34 patients, subclavian flap repair in 9 patients, conduit insertion in 6 patients, and patch enlargement in 3 patients. More recently, an anterior approach with cardiopulmonary bypass without circulatory arrest was applied to enlarge the patch in all the aortic arches.", "Is surgical intervention still indicated in recurrent aortic arch obstruction?<||||>There was one early death in the surgical intervention group and 2 late deaths in the dilation group. Major complications and recurrence were higher in the dilated group (4 vs 0, P<.01, and 14 vs 5, P<.0004, respectively). At a mean follow-up of 11.8 +/- 4.1 years in the surgical intervention group and 7.5 +/- 2.5 years in the dilated group, systemic hypertension was normalized in all but 5 patients in the surgical intervention group and 6 patients in the dilated group." ]

[ "Does adenosine response predict clinical recurrence of atrial fibrillation after pulmonary vein isolation?<||||>Approximately 30% of patients undergoing pulmonary vein isolation (PVI) for atrial fibrillation (AF) have clinical recurrence of AF, and a great majority of these patients have recovery of vein conduction. Adenosine can be associated with acute recovery of conduction to the pulmonary veins immediately after isolation. However, it is not known whether this is prognostic for permanent recovery of conduction or recurrence of AF.", "Does adenosine response predict clinical recurrence of atrial fibrillation after pulmonary vein isolation?<||||>Patients with paroxysmal AF underwent PVI, with administration of adenosine after electrical isolation. Those with transient conduction recovery (TCR+) underwent no further ablation and were compared to those without (TCR-) for clinical AF recurrence and conduction recovery at second procedure.", "Does adenosine response predict clinical recurrence of atrial fibrillation after pulmonary vein isolation?<||||>Seventy-two consecutive PVI patients were studied (mean age 56.7 ± 9.2, 61 male). Twenty-five (35%) patients had transient recovery of conduction with adenosine. After 1 year, 18 patients (25%) had symptomatic recurrence of AF. In this group of 18 patients, 6 were TCR+ at initial ablation (sensitivity 33%, NPV = 74%). In the remaining group of 54 patients free from AF recurrence, 35 patients (65%) were TCR- at initial ablation (specificity 65%, PPV = 24%). All 18 patients with recurrent AF underwent repeat procedure and had at least 1 pulmonary vein with recurrent conduction. The initial adenosine test correctly predicted 13 out of 36 (36%) veins, with positive predictive value 90% and negative predictive value 15%." ]

[ "Symptom perception in healthy menopausal women: Can we predict concordance between subjective and physiological measures of vasomotor symptoms?<||||>Perception of physical symptoms is an important factor in medical help-seeking. We aimed to examine both physiological and subjective measures of a commonly reported physical symptom-vasomotor symptoms (hot flushes and night sweats; HF/NS), and to investigate factors that might influence symptom perception, that is, concordance, over-reporting, and under-reporting of symptoms in healthy menopausal women.", "Symptom perception in healthy menopausal women: Can we predict concordance between subjective and physiological measures of vasomotor symptoms?<||||>One hundred and forty women completed questionnaires assessing depressed mood, anxiety, stress, somatic symptoms, beliefs about HF/NS, and somatic amplification. Subjective and objective (24-h sternal skin conductance) measurements of HF/NS were obtained to assess concordance.", "Symptom perception in healthy menopausal women: Can we predict concordance between subjective and physiological measures of vasomotor symptoms?<||||>Thirty-seven percent of HF/NS were concordant while 47 and 16 % were under-reported and over-reported, respectively. Depressed mood, anxiety, somatic symptoms, and negative beliefs about HF/NS were associated with (higher) concordance, (less) under-, or (more) over-reporting. Negative beliefs about night sweats and sleep were the strongest predictors of concordance, whereas additional somatic symptoms and smoking predicted over-reporting." ]

[ "Aortic Regurgitation Is Common in Ankylosing Spondylitis: Time for Routine Echocardiography Evaluation?<||||>The aim of this study was to assess the prevalence of aortic regurgitation and any relation to disease activity and specific human leukocyte antigen (HLA)-B27 subtypes in patients with ankylosing spondylitis.", "Aortic Regurgitation Is Common in Ankylosing Spondylitis: Time for Routine Echocardiography Evaluation?<||||>Transthoracic echocardiography was performed in 187 patients (105 men), mean age (SD) 50 (13) years, and mean disease duration 24 (13) years, and was related to demographic, clinical, radiographic, electrocardiographic, and laboratory data.", "Aortic Regurgitation Is Common in Ankylosing Spondylitis: Time for Routine Echocardiography Evaluation?<||||>Aortic regurgitation was found in 34 patients (18%; 95% confidence interval [CI], 12%-24%): mild in 24, moderate in 9, and severe in one. The prevalence was significantly higher than expected from population data. Conduction system abnormalities were documented in 25 patients (13%; 95% CI, 8%-18%), and significantly more likely in the presence of aortic regurgitation (P = .005), which was related to increasing age and longstanding disease, and increased from ~20% in the 50s to 55% in the 70s. It was also independently associated with disease duration, with higher modified Stoke Ankylosing Spondylitis Spine Score, and with a history of anterior uveitis. HLA-B27 was present in similar proportions in the presence vs absence of aortic regurgitation. For comparison, clinically significant coronary artery disease was present in 9 patients (5%; 95% CI, 2%-8%)." ]

[ "Does a short cessation of HRT decrease mammographic density?<||||>Hormone replacement therapy (HRT) is known to increase breast density, thus decreasing the sensitivity of cancer screening by mammography. Some authors recommend short cessation of HRT before mammography, but evidence showing the effect of such short cessation is limited. The purpose of this study is to examine whether a short cessation of HRT changes mammographic density.", "Does a short cessation of HRT decrease mammographic density?<||||>Forty-eight women taking HRT agreed to have mammograms taken before and after stopping HRT for 4 weeks. Mammographic density was measured by Wolfe's four-point classification, six-categorical visual scale and two different computer methods (interactive-thresholding and SMF). Density values of mammography before and after the cessation of HRT were compared using Wilcoxon signed-rank test for categorical variables and paired t-test for continuous variables. Changes in breast pain and tenderness during mammography, radiation dose, compression force, and breast thickness were also recorded.", "Does a short cessation of HRT decrease mammographic density?<||||>No significant changes in mammographic density were observed by either visual or computer methods. There were no significant changes in breast pain or in tenderness on mammograms before and after the month's cessation of HRT. Radiographic measurements were not significantly altered by the 4-week cessation of HRT." ]

[ "Is there a gender bias in recommendations for further rehabilitation in primary care of patients with chronic pain after an interdisciplinary team assessment?<||||>To examine potential gender bias in recommendations of further examination and rehabilitation in primary care for patients with chronic musculoskeletal pain after an interdisciplinary team assessment.", "Is there a gender bias in recommendations for further rehabilitation in primary care of patients with chronic pain after an interdisciplinary team assessment?<||||>The population consisted of consecutive patients (n = 589 women, 262 men) referred during a 3-year period from primary healthcare for assessment by interdisciplinary teams at a pain specialist rehabilitation clinic. Patient data were collected from the Swedish Quality Registry for Pain Rehabilitation. The outcome was defined as the examination or rehabilitation that was specified in the patient's record.", "Is there a gender bias in recommendations for further rehabilitation in primary care of patients with chronic pain after an interdisciplinary team assessment?<||||>Men had a significantly higher likelihood than women of being recommended physiotherapy and radiological examination, and the gender difference was not explained by confounding variables and covariates (age, marital status, ethnicity, education, working status, pain severity, pain interference, pain sites, anxiety and depression). There was no significant gender difference in recommendations to treatment by specialist physician, occupational therapist, psychologist or social worker." ]

[ "Autoimmune thrombocytopenia. Is it a different disease or different aspects of a single disease?<||||>To evaluate the association between autoimmune thrombocytopenia with other autoimmune disorders, to show if they are different autoimmune diseases or one disease with different presentations at the same time, and to study the effect of treatment on platelet count in different thyroid condition.", "Autoimmune thrombocytopenia. Is it a different disease or different aspects of a single disease?<||||>In this retrospective study, we included 141 patients with thrombocytopenic purpura. The result of thyroid function test, thyroid autoantibodies, Coombs' reactivity, anti-nuclear antibody, and double-stranded DNA were analyzed. This study was conducted in the Clinical Hematology Department, King Abdulaziz University Hospital, Jeddah, Saudi Arabia between June 2003 and August 2010.", "Autoimmune thrombocytopenia. Is it a different disease or different aspects of a single disease?<||||>There were 51 (36.2%) patients with laboratory evidence of autoimmune disease, 13 (9.2%) with hypothyroidism, and 6 (4.3%) with hyperthyroidism. In addition, 5 (3.5%) patients showed laboratory evidence of Evan syndrome and 3 (2.1%) patients had isolated positive thyroid antibodies. There was non-significant difference (p=0.61) in platelets count after one month of treatment of patients with different thyroid condition." ]

[ "Bioprosthetic replacement after bioprosthesis failure: a hazardous choice?<||||>Following bioprosthetic failure, replacement is usually done with mechanical valves to avoid repeated reoperations.", "Bioprosthetic replacement after bioprosthesis failure: a hazardous choice?<||||>From 1986 to 1996 we operated on 130 patients with bioprosthetic failure, implanting a new bioprosthesis; this group included patients with contraindication to anticoagulation, tricuspid replacement, and specific patient requests. Mean age was 63+/-8 years.", "Bioprosthetic replacement after bioprosthesis failure: a hazardous choice?<||||>The perioperative mortality was 13.8%. At 10 year follow-up the actuarial estimate of survival was 77.4%+/-6.6%. Freedom from structural valve deterioration was estimated at 81.8%+/-6.3%. Freedom from a third operation was estimated at 85.5%+/-5.2%. No patient was permanently anticoagulated. Freedom from thromboembolism was estimated at 91.5%+/-4%, and there were no hemorrhages. Freedom from cardiac-related deaths was estimated at 85.7%+/-5%." ]

[ "Sneddon syndrome: vasculitis or thrombotic disorder?<||||>Livedo reticularis generalisata (LR) in combination with affection of CNS is referred to as Sneddon's syndrome (SNS). Latest data suggest chronic progressive systemic disorder with occlusion of small and medium sized vessels (e.g., cutis, brain, kidneys, heart, eyes). No conclusive etiology is known, though there are correlations to the antiphospholipid syndrome, systemic secondary vasculitis and coagulopathies. Hereditary and toxic factors seem to play a role in pathogenesis in some cases.", "Sneddon syndrome: vasculitis or thrombotic disorder?<||||>Diagnostic procedure and clinical course of a 56-year-old woman with dementia and hemiparesis proceeded by LR is reported. MRI-, SPECT- and TCD-findings were congruent with diffuse ischemic lesions of the brain due to affection of small- and medium-sized vessels. Histopathological specimens of the brain, meninges and cutis were non diagnostic. Some laboratory findings suggested vasculitis as an underlying cause. LR improved under immunosuppressive therapy with prednisolone and azathioprin." ]

[ "Do depression treatments reduce suicidal ideation?<||||>Many well-researched treatments for depression exist. However, there is not yet enough evidence on whether these therapies, designed for the treatment of depression, are also effective for reducing suicidal ideation. This research provides valuable information for researchers, clinicians, and suicide prevention policy makers.", "Do depression treatments reduce suicidal ideation?<||||>Analysis was conducted on the Treatment for Depression Research Collaborative (TDCRP) sample, which included CBT, IPT, medication, and placebo treatment groups. Participants were included in the analysis if they reported suicidal ideation on the HRSD or BDI (score of ≥1).", "Do depression treatments reduce suicidal ideation?<||||>Multivariate linear regression indicated that both IPT (b=.41, p<.05) and medication (b =.47, p<.05) yielded a significant reduction in suicide symptoms compared to placebo on the HRSD. Multivariate linear regression indicated that after adjustment for change in depression these treatment effects were no longer significant. Moderate Cohen׳s d effect sizes from baseline to post-test differences in suicide score by treatment group are reported.", "Do depression treatments reduce suicidal ideation?<||||>These analyses were completed on a single suicide item from each of the measures. Moreover, the TDCRP excluded participants with moderate to severe suicidal ideation." ]

[ "Are heterogenous results of EGFR immunoreactivity in renal cell carcinoma related to non-standardised criteria for staining evaluation?<||||>To assess whether heterogeneity of epidermal growth factor receptor (EGFR) immunoreactivity in renal cell carcinoma (RCC) is related to non-standardised criteria for staining evaluation.", "Are heterogenous results of EGFR immunoreactivity in renal cell carcinoma related to non-standardised criteria for staining evaluation?<||||>EGFR expression was investigated in 132 primary and 55 metastatic conventional RCCs using a tissue microarray technique.", "Are heterogenous results of EGFR immunoreactivity in renal cell carcinoma related to non-standardised criteria for staining evaluation?<||||>Overall, membranous and/or cytoplasmic EGFR immunostaining was present in 123 of 132 (93%) primary and 49 of 53 (92%) metastatic RCCs, with extensive immunoreactivity (>50% of tumour cells) in 110 of 132 (83%) primary tumours and 39 of 53 (73%) metastases. Cytoplasmic staining was associated with high tumour stage and high tumour grade. In addition, strong membranous staining (score 3+) prevailed in high grade RCCs. Cytoplasmic immunostaining was associated with an unfavourable prognosis, whereas overall (cytoplasmic and membranous) immunoreactivity and intensity of membranous staining were not." ]

[ "Health service utilisation of rural-to-urban migrants in Guangzhou, China: does employment status matter?<||||>To describe the self-reported health status and service utilisation of employed, retired and unemployed migrants in Guangzhou, a megacity in southern China.", "Health service utilisation of rural-to-urban migrants in Guangzhou, China: does employment status matter?<||||>A cross-sectional study adapted from the National Health Service Survey was conducted between September and December in 2014. Based on the distribution of occupation of migrants, multistage sampling was used to recruit individuals. Logistic regression was applied to explore the factors influencing their service utilisation.", "Health service utilisation of rural-to-urban migrants in Guangzhou, China: does employment status matter?<||||>Of 2906 respondents, 76.6% were employed, 9.2% retired and 14.2% unemployed. Only 8.1% reported having an illness in the previous 2 weeks, and 6.5% reported having been hospitalised in the previous year. Employed migrants had the lowest recent physician consultation rate (3.4%) and the lowest annual hospitalisation rate (4.5%) (P<0.05); unemployed migrants had the highest rates (6.8% and 14.5% respectively, P<0.05). Retired migrants were more likely to return to their hometown for health care (8.6%) than employed (1.5%) and unemployed migrants (3.4%) (P<0.05). After adjusting for age and gender, employment status remained significant in explaining the recent two-week treatment-seeking behaviour of migrants (P<0.05)." ]

[ "Skin responses to topical dehydroepiandrosterone: implications in antiageing treatment?<||||>Although low dehydroepiandrosterone (DHEA) is suspected to have a role in skin ageing, little information is available on the mechanisms potentially involved.", "Skin responses to topical dehydroepiandrosterone: implications in antiageing treatment?<||||>To obtain information on androgen receptor (AR) and procollagen expression in ageing skin during DHEA treatment.", "Skin responses to topical dehydroepiandrosterone: implications in antiageing treatment?<||||>A placebo-controlled, randomized, prospective study was performed with 75 postmenopausal women aged 60-65 years. The women were treated twice daily for 13 weeks with 3·0 mL of placebo or 0·1%, 0·3%, 1% or 2% DHEA cream applied on the face, arms, back of hands, upper chest and right thigh where 2-mm biopsies were collected before and after treatment.", "Skin responses to topical dehydroepiandrosterone: implications in antiageing treatment?<||||>Although the overall structure of the epidermis was not significantly affected at the light microscopy level, AR expression examined by immunocytochemistry was markedly increased by DHEA treatment. In the dermis, the expression levels of procollagen 1 and 3 mRNA estimated by in situ hybridization were increased by DHEA treatment. In addition, the expression of heat shock protein (HSP) 47, a molecule believed to have chaperone-like functions potentially affecting procollagen biosynthesis, was also found by immunocytochemistry evaluation to be increased, especially at the two highest DHEA doses." ]

[ "Does aspirin consumption affect the presentation or severity of acute myocardial infarction?<||||>While consumption of aspirin has been shown to decrease the occurrence of nonfatal cardiac events, the majority of studies have not demonstrated any impact of aspirin intake on cardiovascular mortality. The present population-based study explores the possibility that aspirin consumption affects the presentation and severity of acute myocardial infarction (AMI), and hence the likelihood of clinical detection.", "Does aspirin consumption affect the presentation or severity of acute myocardial infarction?<||||>We monitored the use of aspirin before admission for 2114 patients with a validated diagnosis of AMI in 16 hospitals in the Worcester, Mass, metropolitan area during 1986, 1988, and 1990. The AMIs were characterized as Q wave vs non-Q wave and large (peak creatine kinase levels more than five times normal) vs small (peak creatine kinase levels less than two times normal).", "Does aspirin consumption affect the presentation or severity of acute myocardial infarction?<||||>A total of 332 patients (16%) with validated AMI took aspirin before hospital admission. Nearly 65% of aspirin users had non-Q wave AMIs, compared with 49% of nonaspirin users. Thirty percent of aspirin users sustained small AMIs, compared with 22% of nonaspirin users. These findings persisted after stratifying for previous AMI, history of coronary disease, receipt of thrombolytic therapy, and exclusion of early hospital deaths. Using multivariable regression models to control for age, gender, previous evidence of coronary disease, and use of other medications, prior aspirin consumption remained independently associated with AMI type (non-Q-wave AMI) and smaller infarct size." ]

[ "Ectopic human chorionic gonadotrophin (HCG) production: is the detection by serum analysis of HCG of clinical relevance in transitional cell carcinoma of the bladder?<||||>To assess the potential value of ectopic beta-human chorionic gonadotrophin (beta HCG) measurement in the clinical management of transitional cell carcinoma (TCC).", "Ectopic human chorionic gonadotrophin (HCG) production: is the detection by serum analysis of HCG of clinical relevance in transitional cell carcinoma of the bladder?<||||>A prospective serological study of 163 consecutive patients undergoing cystoscopy as new or review cases was performed to assess any correlation between beta HCG production and histological grading or stage.", "Ectopic human chorionic gonadotrophin (HCG) production: is the detection by serum analysis of HCG of clinical relevance in transitional cell carcinoma of the bladder?<||||>Ten per cent of patients with TCC had a raised beta HCG level but there was no correlation with tumour differentiation, staging or prognosis." ]

[ "Same-Day Sinus and Brain CT Imaging in the Medicare Population: Are Practice Patterns Changing in Association with Medicare Policy Initiatives?<||||>Monitoring the frequency of same-day sinus and brain CT (Outpatient Measure 14, \"OP-14\") is part of a recent large Centers for Medicare and Medicaid Services hospital outpatient quality initiative to improve imaging efficiency. This study investigates patient-level claims data in the Medicare population focusing on where same-day sinus and brain CT imaging is performed and how the frequency of same-day studies changed with time before and during OP-14 measure program implementation.", "Same-Day Sinus and Brain CT Imaging in the Medicare Population: Are Practice Patterns Changing in Association with Medicare Policy Initiatives?<||||>Research Identifiable Files were used to identify all sinus and brain CT examinations from 2004 through 2012 for a 5% random patient sample of Medicare fee-for-service beneficiaries. Overall and site of service use rates were calculated for same- and non-same-day examinations. Changes were mapped to policy initiative timetables.", "Same-Day Sinus and Brain CT Imaging in the Medicare Population: Are Practice Patterns Changing in Association with Medicare Policy Initiatives?<||||>The number of same-day sinus and brain CT studies from 2004 to 2012 increased 67% from 1.85 (95% CI, 1.78-1.91) per 1000 Medicare beneficiaries in 2004 to 3.08 (95% CI, 3.00-3.15) in 2012. The biggest driver of increased same-day studies was the emergency department setting, from 0.56 (95% CI, 0.53-0.60) per 1000 to 1.78 (95% CI, 1.72-1.84; +215.7%). Overall use of brain CT from 146.0 (95% CI, 145.1-146.9) per 1000 to 176.3 (95% CI, 175.4-177.2; +21%) and sinus CT from 12.6 (95% CI, 12.4-12.8) per 1000 to 15.4 (95% CI, 15.2-15.6; +22%) increased until 2009 and remained stable through 2012." ]

[ "Does human melanoma express carcinoembryonic antigen?<||||>Several investigators have proposed that carcinoembryonic antigen (CEA), an immunogenic antigen expressed by colon carcinoma, may also be expressed by human melanoma. Because sialyl Lewisx (sLex), the carbohydrate moiety of CEA, has been identified in melanoma, we compared CEA and sLex levels in colon carcinoma cells and melanoma cells.", "Does human melanoma express carcinoembryonic antigen?<||||>CEA levels were assessed for expression on the cell surface and in cell lysates of cutaneous melanoma cell lines by two different kinds of ELISA, and by Western blot analysis of immunoprecipitated CEA using monoclonal antibodies (Mabs) T84-66 and COL-1, which have defined specificities for CEA. Colon carcinoma cells and purified CEA were positive controls.", "Does human melanoma express carcinoembryonic antigen?<||||>Both Mabs reacted strongly with cell surface and cell lysates of colon cancer. Mab T84-66 reacted well with cell surface but not cell lysates of melanoma. COL-1 reacted poorly with cell surface but its binding increased with the density of melanoma cell lysates. Both Mabs intensely stained the blots of purified CEA and colon carcinoma lysates immunoprecipitated with the respective Mabs, but failed to stain the immunoprecipitates of melanoma cell lysates. Both Mabs bound to lysates immunoprecipitated with anti-sLex Mab in colon carcinoma, but not in melanoma. Cell-surface expression of CEA and sLex was significantly correlated (r2: 0.88) in colon cancer cells but not in melanoma." ]

[ "Can hospital rankings measure clinical and educational quality?<||||>A relative dearth of relevant data hampers efforts to demonstrate a link between educational and clinical quality and may preclude residency applicants from identifying programs with the best clinical outcomes. Existing clinical rankings could fill this gap if they are based on sound judgments about quality.", "Can hospital rankings measure clinical and educational quality?<||||>To explore the potential of the U.S. News&World Report \"America's Best Hospitals\" clinical rankings in measuring the quality of clinical and learning environments, the author systematically reviewed the U.S. and Canadian literature for 1975 through 2007 regarding quality indicators and teaching hospitals. Individual data elements of the rankings were examined to assess the extent to which they included accepted measures of clinical performance.", "Can hospital rankings measure clinical and educational quality?<||||>A total of 187 articles met the inclusion criteria of addressing clinical quality criteria relevant to the rankings and quality assessment in teaching hospitals. Statistical examination of the data underlying the rankings and their relationship with measures of educational and clinical quality showed the rankings are largely based on institutional \"prestige.\" Ranked clinical programs and institutions consistently outperform counterparts on available indices, suggesting that the data elements underlying the rankings may provide valid assessments about the quality of care in educational settings." ]

[ "Do histologic criteria predict biologic behavior of giant cell lesions?<||||>To determine whether the clinical behavior of giant cell lesions (GCLs) or their anatomic location can be differentiated by histologic criteria alone.", "Do histologic criteria predict biologic behavior of giant cell lesions?<||||>We performed a retrospective study of patients with GCLs treated at Massachusetts General Hospital between 1993 and 2008. Predictor variables were histologic parameters: number of giant cells (GCs) per high-power field, number of nuclei per GC, GC size, stromal cellularity, stromal type, presence of hemorrhage and reactive osteoid, and blinded pathologists' prediction of location and behavior. Outcome variables were clinical behavior (aggressive or nonaggressive) and GCL location, that is, maxillofacial (MF) or axial/appendicular (AA). Descriptive and bivariate statistics were computed with statistical significance set at P ≤ .05.", "Do histologic criteria predict biologic behavior of giant cell lesions?<||||>The sample included 88 subjects: 41 MF GCLs (35 aggressive) and 47 AA GCLs (28 aggressive). Aggressive AA lesions had more GCs per high-power field, larger mean GC size, and increased stromal cellularity, and they more frequently had a mononuclear stroma when compared with aggressive MF lesions (P<.05). There were no significant histologic differences between aggressive and nonaggressive MF lesions or between nonaggressive MF and nonaggressive AA lesions. Aggressive AA lesions had more nuclei/GC than nonaggressive AA lesions (P = .03). Using histologic criteria only, blinded pathologists predicted clinical behavior in only 45% of cases (κ = 0.19, P = .09). They predicted a lesion's location in 82% of cases with fair agreement (κ = 0.44, P<.01)." ]

[ "A time and motion study of junior doctor work patterns on the weekend: a potential contributor to the weekend effect?<||||>Patients admitted to hospital on weekends have a greater risk of mortality compared to patients admitted on weekdays. Junior medical officers (JMO) make up the majority of medical staff on weekends. No previous study has quantified JMO work patterns on weekends.AIM: To describe and quantify JMO work patterns on weekends and compare them with patterns previously observed during the week.", "A time and motion study of junior doctor work patterns on the weekend: a potential contributor to the weekend effect?<||||>Observational time and motion study of JMO working weekends using the Work Observation Method by Activity Timing (WOMBAT; Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia) software. Descriptive statistics were used to determine the proportion of total observed time spent in tasks.", "A time and motion study of junior doctor work patterns on the weekend: a potential contributor to the weekend effect?<||||>Weekend JMO predominately spent time in indirect care (32.0%), direct care (23.0%) and professional communication (22.1%). JMO spent 20.9% of time multitasking and were interrupted, on average, every 9 min. Weekend JMO spent significantly more time in direct care compared with weekdays (13.0%; P < 0.001) and nights (14.3%; P < 0.001). Weekend JMO spent significantly less time on breaks (8.5%), with less than 1 h in an 11-h shift, compared with JMO during weekdays (16.4%; P = 0.004) and nights (27.6%; P = <0.001). Weekend JMO were interrupted at a higher rate (6.6/h) than on weekdays (rate ratio (RR) 2.9, 95% confidence intervals (CI) 2.6, 3.3) or nights (RR 5.1, 95% CI 4.2, 6.1). Multitasking on weekends (20.9%) was comparable to weekdays (18.9%; P = 0.19) but significantly higher than nights (6.4%; P = <0.001)." ]

[ "Are the elderly more vulnerable to psychological impact of natural disaster?<||||>The association between ages and psychological impact of natural disasters has not been well characterized. A population-based study was conducted 15 months after the 2008 Sichuan earthquake to assess whether elderly survivors were more likely to develop posttraumatic stress disorder (PTSD) and general psychiatric morbidity.", "Are the elderly more vulnerable to psychological impact of natural disaster?<||||>A population-based survey of 327 survivors (152 elders, 175 younger adults) was conducted in severely affected areas by the earthquake, using a multi-stage systematic sampling design.", "Are the elderly more vulnerable to psychological impact of natural disaster?<||||>Compared with the younger adult survivors, the elderly were more likely to have symptoms of PTSD (22.5% vs. 8.0%, p = 0.001) and general psychiatric morbidity (42.0% vs. 25.4%, p = 0.003). Risk factors, such as being elderly, having been in serious danger, having lost family members, and having felt guilt concerning one's death or injury were significantly associated with developing PTSD; being elderly, having family members or friends seriously injured, and having felt guilt concerning one's death or injury were significantly associated with developing general psychiatric morbidity. Utilization of mental health services is strongly associated with the decreased risk for developing both of the symptoms." ]

[ "Is glycosuria a reliable indicator of adequacy of glucose infusion rate in preterm infants?<||||>Adequacy of glucose infusion may be monitored via the glycosuria levels, as there is a relationship between glycemia and glycosuria regulated by the renal glucose threshold. In the neonatal period, however, this relationship is not so clear.", "Is glycosuria a reliable indicator of adequacy of glucose infusion rate in preterm infants?<||||>To evaluate the occurrence of glycosuria in preferm infants submitted to glucose infusion and to verify the relationship between glycosuria and blood glucose level.", "Is glycosuria a reliable indicator of adequacy of glucose infusion rate in preterm infants?<||||>Accuracy study.", "Is glycosuria a reliable indicator of adequacy of glucose infusion rate in preterm infants?<||||>Neonatal intensive care unit of General Maternity Hospital.", "Is glycosuria a reliable indicator of adequacy of glucose infusion rate in preterm infants?<||||>40 Preterm newborns receiving glucose infusion.", "Is glycosuria a reliable indicator of adequacy of glucose infusion rate in preterm infants?<||||>511 concomitant determinations of glycemia and glycosuria were performed. These 511 pairs were divided into stable and unstable, according to the clinical status of the newborn at the time of data collection, and they were studied in relation to the gestational age, birth weight and glucose infusion rate.", "Is glycosuria a reliable indicator of adequacy of glucose infusion rate in preterm infants?<||||>The results revealed a greater frequency of glycosuria in gestational age<or = 30 weeks, birth weight<1500 g and glucose infusion rate>6 mg/kg/min. Eight (25.8%) episodes of positive glycosuria occurred in the absence of hyperglycemia, indicating only a moderate concordance between them." ]

[ "Are electronic medical records helpful for care coordination?<||||>Policies promoting widespread adoption of electronic medical records (EMRs) are premised on the hope that they can improve the coordination of care. Yet little is known about whether and how physician practices use current EMRs to facilitate coordination.", "Are electronic medical records helpful for care coordination?<||||>We examine whether and how practices use commercial EMRs to support coordination tasks and identify work-around practices have created to address new coordination challenges.", "Are electronic medical records helpful for care coordination?<||||>Semi-structured telephone interviews in 12 randomly selected communities.", "Are electronic medical records helpful for care coordination?<||||>Sixty respondents, including 52 physicians or staff from 26 practices with commercial ambulatory care EMRs in place for at least 2 years, chief medical officers at four EMR vendors, and four national thought leaders.", "Are electronic medical records helpful for care coordination?<||||>Six major themes emerged: (1) EMRs facilitate within-office care coordination, chiefly by providing access to data during patient encounters and through electronic messaging; (2) EMRs are less able to support coordination between clinicians and settings, in part due to their design and a lack of standardization of key data elements required for information exchange; (3) managing information overflow from EMRs is a challenge for clinicians; (4) clinicians believe current EMRs cannot adequately capture the medical decision-making process and future care plans to support coordination; (5) realizing EMRs' potential for facilitating coordination requires evolution of practice operational processes; (6) current fee-for-service reimbursement encourages EMR use for documentation of billable events (office visits, procedures) and not of care coordination (which is not a billable activity)." ]

[ "Is LabTutor a helpful component of the blended learning approach to biosciences?<||||>To evaluate the use of LabTutor (a physiological data capture and e-learning package) in bioscience education for student nurses.", "Is LabTutor a helpful component of the blended learning approach to biosciences?<||||>Knowledge of biosciences is important for nurses the world over, who have to monitor and assess their patient's clinical condition, and interpret that information to determine the most appropriate course of action. Nursing students have long been known to find acquiring useable bioscience knowledge challenging. Blended learning strategies are common in bioscience teaching to address the difficulties students have. Student nurses have a preference for hands-on learning, small group sessions and are helped by close juxtaposition of theory and practice.", "Is LabTutor a helpful component of the blended learning approach to biosciences?<||||>An evaluation of a new teaching method using in-classroom voluntary questionnaire.", "Is LabTutor a helpful component of the blended learning approach to biosciences?<||||>A structured survey instrument including statements and visual analogue response format and open questions was given to students who participated in Labtutor sessions. The students provided feedback in about the equipment, the learning and the session itself.", "Is LabTutor a helpful component of the blended learning approach to biosciences?<||||>First year (n = 93) and third year (n = 36) students completed the evaluation forms. The majority of students were confident about the equipment and using it to learn although a few felt anxious about computer-based learning. They all found the equipment helpful as part of their bioscience education and they all enjoyed the sessions." ]

[ "Is the etiology of pretibial cyst formation after absorbable interference screw use related to a foreign body reaction?<||||>Arthroscopically assisted anterior cruciate ligament reconstruction using a bioabsorbable tibial fixation screw is occasionally complicated by pretibial cyst formation. The few case reports describing pretibial cyst formation noted several graft types and fixation techniques, making it difficult to establish one etiology. Some literature suggests cysts form from communication between the joint and pretibial area leading to extravasation of joint fluid, maturing into a cyst. We propose the development of cysts after PLLA screw use may be related to a foreign body reaction.QUESTIONS/", "Is the etiology of pretibial cyst formation after absorbable interference screw use related to a foreign body reaction?<||||>We propose this foreign body reaction (1) relates to the biochemical breakdown of bioabsorbable materials; and (2) differs from cystic formations resulting from joint communication.", "Is the etiology of pretibial cyst formation after absorbable interference screw use related to a foreign body reaction?<||||>We retrospectively reviewed seven patients who developed pretibial cysts at least 2 years after original primary ACL reconstruction surgery. MRI was used to visualize the extent of cystic formation. Cysts were treated by débridement with specimens sent for histologic analysis. Cyst appearance had a 3-year incidence of 5%.", "Is the etiology of pretibial cyst formation after absorbable interference screw use related to a foreign body reaction?<||||>No cyst had an infectious etiology. In all cases, the tibial screw outline was present on MRI, although intraoperatively, the screw was substantially decomposed. Grafts were well incorporated and none of the knees demonstrated anterior laxity. Histologically, cyst material contained fragments of PLLA surrounded by foamy histiocytes, suggesting a foreign body reaction. No cysts recurred." ]

[ "Is shared care with annual hospital review better value for money than predominantly hospital-based care in patients with established stable rheumatoid arthritis?<||||>To assess the cost effectiveness and cost effectiveness acceptability of symptom control delivered by shared care (SCSC) and aggressive treatment delivered in hospital (ATH) for established rheumatoid arthritis (RA).", "Is shared care with annual hospital review better value for money than predominantly hospital-based care in patients with established stable rheumatoid arthritis?<||||>Economic data were collected within the British Rheumatoid Outcome Study Group randomised controlled trial of SCSC and ATH. A broad perspective was used (UK National Health Service, social support services and patients). Cost per quality adjusted life year (QALY) gained, net benefit statistics and cost effectiveness acceptability curves were estimated. Costs and outcomes were discounted at 3.5%. Sensitivity analysis tested the robustness of the results to analytical assumptions.", "Is shared care with annual hospital review better value for money than predominantly hospital-based care in patients with established stable rheumatoid arthritis?<||||>The mean (SD) cost per person was 4540 pounds (4700) in the SCSC group and 4440 pounds (4900) in the ATH group. The mean (SD) QALYs per person for 3 years were 1.67 (0.56) in the SCSC group and 1.60 (0.60) in the ATH group. If decision makers are prepared to pay>or = 2000 pounds to gain 1 QALY, SCSC is likely to be cost effective in 60-90% of cases." ]

[ "Does lymph node involvement affect the patterns of recurrence in stage IB cervical cancer?<||||>We reviewed the medical records of 170 patients who had undergone type III radical hysterectomy and systematic lymphadenectomy from 1993 to 2007.", "Does lymph node involvement affect the patterns of recurrence in stage IB cervical cancer?<||||>Among the patients in the study group, 115 did not have lymph node metastases, whereas 55 did. A total of 27 patients developed recurrences. Twelve were in the lymph node-negative group, and 15 were in the lymph node-positive group. The recurrence rate was higher in lymph node-positive group (27.3% versus 10.4%, P = 0.011). The recurrence pattern was not affected by lymph node involvement. However, distant recurrence was more common in the lymph node-positive group (53.3% versus 25%, P = 0.137). Additionally, distant failure was observed only in the patients in the lymph node-negative group who received adjuvant radiotherapy. In this group, 3 patients who did not receive adjuvant radiotherapy developed recurrences only in the pelvic region." ]

[ "Open vs closed type congenital cholesteatoma of the middle ear: two distinct entities or two aspects of the same phenomenon?<||||>The clinical features and surgical results of \"closed type\" versus \"open type\" congenital cholesteatoma were compared in order to analyse the differences between the two forms; whether the morphology of the disease may have a role in the staging systems has been also evaluated.", "Open vs closed type congenital cholesteatoma of the middle ear: two distinct entities or two aspects of the same phenomenon?<||||>We reviewed retrospectively 95 patients (96 ears) who underwent surgery for congenital cholesteatoma over a 15-year period focusing on the clinical differences between open and closed type congenital cholesteatoma.", "Open vs closed type congenital cholesteatoma of the middle ear: two distinct entities or two aspects of the same phenomenon?<||||>Seventy-one patients (74%) had a closed-type and 25 (26%) an open type congenital cholesteatoma. Our study confirmed the higher prevalence of the closed type, as well as, a younger age at initial diagnosis compared with the open type congenital cholesteatoma. Other differences between the two forms were: modality of diagnosis (pathognomonic otoscopy in 100% of the closed type and in 40% of the open type), positive history for otitis media with effusion (51.4% in closed type vs 20% in open type), involvement of the tympanic membrane quadrants (anterior quadrants were more frequently involved in the closed forms, whereas posterior quadrants were more frequently involved in the open forms), disease extension and aggressiveness. A residual cholesteatoma was found in 6 out of the 71 patients (8.4%) with a closed type congenital cholesteatoma and in 10 out of the 25 patients (40%) with an open type congenital cholesteatoma. After adjusting for potential confounders, open-type congenital cholesteatoma was significantly associated with residual cholesteatoma compared to the closed-type (odds ratio [OR] 7.39, 95% confidence interval [CI]1.10-49.77, p=0.03)." ]

[ "Diagnosis of diabetes using hemoglobin A1c: should recommendations in adults be extrapolated to adolescents?<||||>To compare test performance of hemoglobin A1c (HbA1c) for detecting diabetes mellitus/pre-diabetes for adolescents versus adults in the United States.", "Diagnosis of diabetes using hemoglobin A1c: should recommendations in adults be extrapolated to adolescents?<||||>Individuals were defined as having diabetes mellitus (fasting plasma glucose [FPG] ≥ 126 mg/dL; 2-hour plasma glucose (2-hr PG) ≥ 200 mg/dL) or pre-diabetes (100 ≤ FPG<126 mg/dL; 140 ≤ 2-hr PG<200 mg/dL. HbA1c test performance was evaluated with receiver operator characteristic (ROC) analyses.", "Diagnosis of diabetes using hemoglobin A1c: should recommendations in adults be extrapolated to adolescents?<||||>Few adolescents had undiagnosed diabetes mellitus (n = 4). When assessing FPG to detect diabetes, an HbA1c of 6.5% had sensitivity rates of 75.0% (30.1% to 95.4%) and 53.8% (47.4% to 60.0%) and specificity rates of 99.9% (99.5% to 100.0%) and 99.5% (99.3% to 99.6%) for adolescents and adults, respectively. Additionally, when assessing FPG to detect diabetes mellitus, an HbA1c of 5.7% had sensitivity rates of 5.0% (2.6% to 9.2%) and 23.1% (21.3% to 25.0%) and specificity rates of 98.3% (97.2% to 98.9%) and 91.1% (90.3% to 91.9%) for adolescents and adults, respectively. ROC analyses suggested that HbA1c is a poorer predictor of diabetes mellitus (area under the curve, 0.88 versus 0.93) and pre-diabetes (FPG area under the curve 0.61 versus 0.74) for adolescents compared with adults. Performance was poor regardless of whether FPG or 2-hr PG measurements were used." ]

[ "A phenomenological study of day-to-day experiences of living with heart failure: do cultural differences matter?<||||>Although there is a significant body of literature addressing heart failure (HF) epidemiology, physiology, and treatment, little is known about the experiences of Thai patients living with this chronic condition. The primary goal of this study was to gain a better understanding of how Thai patients with HF live with chronic and debilitating illness.", "A phenomenological study of day-to-day experiences of living with heart failure: do cultural differences matter?<||||>A phenomenological approach was chosen to investigate the experience of living with HF. Fifteen Thai men and women with HF in New York Heart Association classes I to III, aged between 47 and 75 years, were interviewed with open-ended questions. Data were analyzed using qualitative inductive content analysis.", "A phenomenological study of day-to-day experiences of living with heart failure: do cultural differences matter?<||||>Three themes emerged from the data analysis: identifying losses or changes in their lives, accepting the losses, and regaining some control. Unlike their western counterparts, the Thai patients with HF incorporated their karma, a Buddhist belief system, as a tool to rationalize the occurrence of their HF experience. The participants of this study used kreng jai as a cultural desire not to disrupt the happiness of others, even at the expense of efficiency, or to burden others, which might affect their own quality of life." ]

[ "Does experience influence perception of dyspnea?<||||>The perception of somatic sensations like dyspnea can be influenced by such factors as an individual s personality, experiences, or ability to adapt to stimuli. Our aim was to determine whether the perception of acute bronchoconstriction is different for patients with asthma and patients who have never experienced an episode of airway obstruction.", "Does experience influence perception of dyspnea?<||||>We studied 2 groups of patients. The first consisted of 24 subjects with intermittent rhinitis and asthma (10 females and 14 males) with a mean (SD) age of 25 (7) years. All reported not feeling dyspnea at rest on a Borg scale. The second group consisted of 24 subjects who only had rhinitis but no lung disease (no episode of asthma) or dyspnea at rest (12 females and 12 males) with a mean age of 27 (6) years. There were no significant differences between the groups with regard to sex, smoking, economic or educational level, anxiety (determined by the trait portion of the State-Trait Anxiety Inventory), depression (Beck Depression Inventory), or spirometric parameters. All took a histamine bronchial provocation test in which the patient assessed dyspnea on a modified Borg scale after each histamine dose. The provocation dose needed to produce a 20% decrease (PD20) in forced expiratory volume in the first second (FEV1) was calculated. We also recorded dyspnea perception score when FEV1 fell 5%, 10%, 15%, and 20%.", "Does experience influence perception of dyspnea?<||||>No dyspnea was perceived at PS20 by 12.5% of the asthmatics and by 45% of nonasthmatics (P<.0001). The mean PS20 was 2.4 (2.1) (range, 0-7) in the first group and 0.37 (0.48) (range, 0-3) in the second (P<.0001). More asthma patients than nonasthmatics perceived dyspnea at all degrees of bronchial obstruction. PD20 was different in the 2 groups (1.6 [2] vs 6.03 [5]for the first and second groups, respectively; P<.003), but there was no significant relation between PD20 and PS20 (Spearman s correlation coefficient, 0.19; P= .221)." ]

[ "Aortic valve sclerosis and aortic atherosclerosis: different manifestations of the same disease?<||||>The aim of this study was to examine the association between atherosclerosis risk factors, aortic atherosclerosis and aortic valve abnormalities in the general population.", "Aortic valve sclerosis and aortic atherosclerosis: different manifestations of the same disease?<||||>Clinical and experimental studies suggest that aortic valve sclerosis (AVS) is a manifestation of the atherosclerotic process.", "Aortic valve sclerosis and aortic atherosclerosis: different manifestations of the same disease?<||||>Three hundred eighty-one subjects, a sample of the Olmsted County (Minnesota) population, were examined by transthoracic and transesophageal echocardiography. The presence of AVS (thickened valve leaflets), elevated transaortic flow velocities and aortic regurgitation (AR) was determined. The associations between atherosclerosis risk factors, aortic atherosclerosis (imaged by transesophageal echocardiography) and aortic valve abnormalities were examined.", "Aortic valve sclerosis and aortic atherosclerosis: different manifestations of the same disease?<||||>Age, male gender, body mass index (odds ratio [OR]: 1.07 per kg/m(2); 95% confidence interval [CI]: 1.02 to 1.12), antihypertensive treatment (OR: 1.93; CI: 1.12 to 3.32) and plasma homocysteine levels (OR: 1.89 per twofold increase; CI: 0.99 to 3.61) were independently associated with an increased risk of AVS. Age, body mass index and pulse pressure (OR: 1.21 per 10 mm Hg; CI: 1.00 to 1.46) were associated with elevated (upper quintile) transaortic velocities, whereas only age was independently associated with AR. Sinotubular junction sclerosis (p = 0.001) and atherosclerosis of the ascending aorta (p = 0.03) were independently associated with AVS and elevated transaortic velocities, respectively." ]

[ "Faecal incontinence: an unrecognised epidemic in rural North Queensland?<||||>We explored the prevalence of faecal incontinence (FI) in a referral hospital outpatient population, to explore suspicions that FI is inadequately studied, underestimated and poorly appreciated in the rural North Queensland (NQ) community.", "Faecal incontinence: an unrecognised epidemic in rural North Queensland?<||||>Prospective cross-sectional study using a specifically designed questionnaire.", "Faecal incontinence: an unrecognised epidemic in rural North Queensland?<||||>The Townsville Hospital, a referral centre serving rural NQ.", "Faecal incontinence: an unrecognised epidemic in rural North Queensland?<||||>A total of 435 consecutive patients attending the gynaecology (n = 261) and colorectal clinics (n = 174) between 31 January and 12 June 2003 were enrolled (participating proportion 96.5%).", "Faecal incontinence: an unrecognised epidemic in rural North Queensland?<||||>FI prevalence, severity, impact on patients' lives, and risk factors.", "Faecal incontinence: an unrecognised epidemic in rural North Queensland?<||||>The prevalence of FI in the study population (median age 53 years) was 20.7%. Amongst affected patients (n = 90) the median duration of FI was 2 years with more than half of those affected soiling themselves at least once a month. Many patients with FI (42%) reported feeling hopeless at least some of the time. Rectal prolapse, chronic constipation, psychiatric problems, colon disease, and urinary incontinence were all significantly associated with FI. A CART analysis revealed that many patients (45%) with urinary incontinence and chronic constipation also experienced FI." ]

[ "Does measured behavior reflect STD risk?<||||>Many studies measure sex behavior to determine the efficacy of sexually transmitted disease (STD)/HIV prevention interventions.", "Does measured behavior reflect STD risk?<||||>To determine how well measured behavior reflects STD incidence.", "Does measured behavior reflect STD risk?<||||>Data from a trial (Project RESPECT) were analyzed to compare behavior and incidence of STD (gonorrhea, chlamydia, syphilis, HIV) during two 6-month intervals.", "Does measured behavior reflect STD risk?<||||>A total of 2879 persons had 5062 six-monthly STD exams and interviews; 8.9% had a new STD in 6 months. Incidence was associated with demographic factors but only slightly associated with number of partners and number of unprotected sex acts with occasional partners. Many behaviors had paradoxical associations with STD incidence. After combining behavior variables to compare persons with highest and lowest risk behaviors, the STD incidence ratio was only 1.7." ]

[ "The reliability of clinical and biochemical assessment in symptomatic late-onset hypogonadism: can a case be made for a 3-month therapeutic trial?<||||>To assess whether testosterone (T) supplementation in men considered to have symptomatic late-onset hypogonadism (SLOH) can be evaluated clinically and biochemically.", "The reliability of clinical and biochemical assessment in symptomatic late-onset hypogonadism: can a case be made for a 3-month therapeutic trial?<||||>To assess the relevance of the clinical and biochemical diagnosis of hypogonadism we investigated patients referred for the diagnosis and treatment of SLOH. Patients were assessed clinically and completed a screening questionnaire. The pituitary-adrenal-gonadal axis was comprehensively assessed biochemically. Those with a clinical diagnosis of hypogonadism and serum levels of T supporting such a diagnosis received exogenous T for>/= 3 months and were assessed for any clinical and biochemical response. Of an initial group of 45 men (mean age 59.2 years) 38 completed the study.", "The reliability of clinical and biochemical assessment in symptomatic late-onset hypogonadism: can a case be made for a 3-month therapeutic trial?<||||>Most men presented with symptoms of sexual dysfunction, lack of energy and/or depression. There were differences before and after treatment only in bioavailable T (BT), with none in the levels of total T (TT). There was a strong correlation before and after treatment in the levels of luteinizing hormone and follicle-stimulating hormone, and a weak negative correlation between gonadotrophins and BT. Neither TT nor BT had predictive value for the treatment response. There was a trend to a correlation between BT levels and treatment success. Changes in serum prostate specific antigen were insignificant during the limited period." ]

[ "Surgery for ischemic mitral regurgitation: should the valve be repaired?<||||>Patients with ischemic cardiomyopathy undergoing coronary artery bypass grafting (CABG) often have concomitant mitral regurgitation (MR). Repairing the valve at the time of surgery is not universally accepted. The results of CABG with or without mitral valve annuloplasty (MVA) were compared in patients with reduced left ventricular (LV) function and ischemic MR.", "Surgery for ischemic mitral regurgitation: should the valve be repaired?<||||>Among a total of 195 patients, 108 underwent isolated CABG, and 87 underwent CABG with MVA. The study end-points included survival, degree of MR, and NYHA functional class.", "Surgery for ischemic mitral regurgitation: should the valve be repaired?<||||>Patients in the MVA group were younger (mean age 63 +/- 10 versus 68 +/- 9 years; p<0.001), but had a more severe cardiac pathology, with severe LV dysfunction in 45% versus 26% (p = 0.006) and severe MR in 82% versus 14% (p<0.001). The operative mortality was 9%, and similar in both groups. The follow up was complete, with a mean survival period of 87 +/- 50 months. Although, overall, no improvement was seen in LV function, symptomatic improvement was more pronounced in the MVA group (p = 0.006). At follow up, residual MR was present in 2% of the MVA group and in 47% of the CABG-only group (p<0.0001). For the MVA and CABG-only groups, respectively, survival at five and 10 years was 68% and 46% versus 77% and 52% (p = NS). By multivariate analysis, neither degree of MR nor LV function at follow up had any impact on survival." ]

[ "Thyroid Dysfunction in Patients with Metastatic Carcinoma Treated with Sunitinib: Is Thyroid Autoimmunity Involved?<||||>Sunitinib is a tyrosine kinase inhibitor (TKI) inducing thyroid dysfunction, but the precise mechanism(s) involved remains to be explained, including the role of thyroid autoimmunity. The objective of this study was to evaluate thyroid function, parameters of autoimmunity, and thyroid ultrasound findings in patients with metastatic cancer and normal thyroid function/autoimmunity before the initiation of sunitinib therapy. This was a prospective, observational cohort study.", "Thyroid Dysfunction in Patients with Metastatic Carcinoma Treated with Sunitinib: Is Thyroid Autoimmunity Involved?<||||>Twenty-seven patients with metastatic carcinomas at comparable tumor stages were evaluated over 12-18 months after initiating therapy with sunitinib given at a daily oral dose of 50 mg for four weeks (ON), followed by one to two weeks off therapy (OFF). Serum thyrotropin (TSH), free thyroxine (fT4), free triiodothyronine (fT3), and antithyroglobulin (TgAb), and antithyroid peroxidase (TPOAb) autoantibodies were measured in all cases. Thyroid morphology and volume were evaluated by echo-color Doppler ultrasound.", "Thyroid Dysfunction in Patients with Metastatic Carcinoma Treated with Sunitinib: Is Thyroid Autoimmunity Involved?<||||>A total of 16/27 patients (60%) became hypothyroid (TSH range 7-114 mIU/L) within 30-120 days of therapy. The thyroid volume decreased in 24/27 (89%) patients (from M = 14.6 mL, SD = 6.4 mL to M = 3.8 mL, SD = 2.6 mL after 12 months; p < 0.001), together with the appearance of mild to severe hypoechogenicity. TPOAb (40-3000 IU/mL) became detectable in 7/27 (25%) patients, and TPOAb-positive patients displayed a higher degree of hypothyroidism and volume reduction. The progression-free survival (PFS) was significantly longer in patients developing TPOAb (10.8 months) than in the other group of patients (5.8 months)." ]

[ "Auto-CPAP therapy for obstructive sleep apnea: induction of microarousals by automatic variations of CPAP pressure?<||||>To investigate the frequency of microarousals (MA) associated with pressure changes during auto-CPAP therapy (APAP) for obstructive sleep apnea (OSA).", "Auto-CPAP therapy for obstructive sleep apnea: induction of microarousals by automatic variations of CPAP pressure?<||||>Patients with OSA were studied by polysomnography during APAP therapy (Somnosmart). The MA were classified on the basis of concomitant changes in APAP pressure.", "Auto-CPAP therapy for obstructive sleep apnea: induction of microarousals by automatic variations of CPAP pressure?<||||>Sleep laboratory of a university hospital", "Auto-CPAP therapy for obstructive sleep apnea: induction of microarousals by automatic variations of CPAP pressure?<||||>30 patients with moderate to severe OSA.", "Auto-CPAP therapy for obstructive sleep apnea: induction of microarousals by automatic variations of CPAP pressure?<||||>The mean AHI during APAP was 4.7+/-4.7, the mean arousal index was 14.5+/-6.6 per hour. During epochs with a pressure variation greater than 0.5 mbar, significantly more MA occurred (0.30+/-0.17 MA per epoch) than in epochs with constant treatment pressure (0.10+/-0.054 MA per epoch; p<0.001). There were more MA during pressure-increase epochs than during pressure-decrease epochs (0.42+/-0.24 vs. 0.16+/-0.12 MA per epoch; p<0.001). 82.5 percent of the MA were not preceded by a significant change in pressure (at least 0.5 mbar within 30 sec.), 10.6% were associated with a significant prior increase and 6.9% with a significant prior decrease in pressure. The percentage of MA preceded by a significant pressure variation varied between 2.3% and 61%, with a mean of 18.9%." ]

[ "Do patients with obstructive sleep apnea wake up with headaches?<||||>There is a controversy regarding the association of obstructive sleep apnea (OSA) and morning headaches. This study investigates whether this relationship exists.", "Do patients with obstructive sleep apnea wake up with headaches?<||||>This is a retrospective study of 80 consecutive patients with OSA who underwent sleep polysomnography from December 1996 to March 1997. Patients were interviewed about their headache history. Headaches were classified according to International Headache Society criteria and the severity graded by the Chronic Pain Index. Headache characteristics were compared with those of 22 control patients with periodic limb movement disorder. Headache response to continuous positive airway pressure or uvulopalatopharyngoplasty in the patients with OSA was also assessed.", "Do patients with obstructive sleep apnea wake up with headaches?<||||>Forty-eight (60%) patients had headaches in the year prior to study. Twenty-five of the 48 patients had headaches that did not fit any category. Of these 25 patients, 23 (48% of total group) reported awakening headaches. These awakening headaches were significantly more common in the OSA group compared with the periodic limb movement disorder group, 9 (41%) of whom had headaches, none of which occurred on awakening. The proportion of common types of headaches in both groups was similar. The awakening headaches were brief (shorter than 30 minutes), and their occurrence and severity correlated with OSA severity. Of the 29 patients with OSA who were treated with continuous positive airway pressure or uvulopalatopharyngoplasty, awakening headaches improved by a mean of 80% compared with minimal improvement of migraine, tension, and cervicogenic headaches." ]

[ "Do dose-volume metrics predict pulmonary function changes in lung irradiation?<||||>To examine the ability of standard dose-volume metrics to predict pulmonary function changes as measured by pulmonary function tests (PFTs) in a group of patients with non-small-cell lung cancer treated with nonconventional beam arrangements on a Phase I dose-escalation study. In addition, we wanted to examine the correlation between these metrics.", "Do dose-volume metrics predict pulmonary function changes in lung irradiation?<||||>Forty-three patients received a median treatment dose of 76.9 Gy (range 63-102.9). Eight patients also received induction chemotherapy with cisplatin and vinorelbine. They all had pre- and posttreatment PFTs>/=3 months (median 6.2) after treatment. The volume of normal lung treated to>20 Gy, effective volume, and mean lung dose were calculated for both lungs for all patients. Linear regression analysis was performed to determine whether correlations existed between the metrics and changes in the PFTs. Additionally, the three metrics were compared with each other to assess the degree of intermetric correlation.", "Do dose-volume metrics predict pulmonary function changes in lung irradiation?<||||>No correlation was found between the volume of normal lung treated to>20 Gy, effective volume, and mean lung dose and changes in the PFTs. Subgroup analyses of patients without atelectasis before irradiation, Stage I and II disease, or treatment without induction chemotherapy were also performed. Again, no correlation was found between the dose-volume metrics and the PFT changes. The intermetric correlation was good among all three dose-volume metrics." ]

[ "Pretreatment cerebral metabolic activity correlates with antidepressant efficacy of vagus nerve stimulation in treatment-resistant major depression: a potential marker for response?<||||>Pretreatment brain activity in major depressive disorder correlates with response to antidepressant therapies, including pharmacotherapies and transcranial magnetic stimulation. The purpose of this trial was to examine whether pretreatment regional metabolic activity in selected regions of interest (ROIs) predicts antidepressant response following 12 months of vagus nerve stimulation (VNS) in 15 patients with treatment-resistant major depression (TRMD).", "Pretreatment cerebral metabolic activity correlates with antidepressant efficacy of vagus nerve stimulation in treatment-resistant major depression: a potential marker for response?<||||>Fluorodeoxyglucose positron emission tomography (FDG PET) was used to assess regional mean relative cerebral metabolic rate for glucose (CMRGlu) in four ROIs (anterior insular, orbitofrontal, anterior cingulate, and dorsolateral prefrontal cortices) at baseline (prior to VNS activation). Depression severity was assessed at baseline and after 12 months of VNS using the Hamilton Depression Rating Scale (HDRS), with response defined as ≥ 50% reduction in HDRS from baseline.", "Pretreatment cerebral metabolic activity correlates with antidepressant efficacy of vagus nerve stimulation in treatment-resistant major depression: a potential marker for response?<||||>Baseline CMRGlu in the anterior insular cortex differentiated VNS responders (n=11) from nonresponders (n=4) and correlated with HDRS change (r=.64, p=.01). In a regression analysis, lower anterior insular cortex CMRGlu (p=.004) and higher orbitofrontal cortex CMRGlu (p=.047) together predicted HDRS change (R(2)=.58, p=.005). In a whole brain, voxel-wise analysis, baseline CMRGlu in the right anterior insular cortex correlated with HDRS change (r=.78, p=.001).", "Pretreatment cerebral metabolic activity correlates with antidepressant efficacy of vagus nerve stimulation in treatment-resistant major depression: a potential marker for response?<||||>Sample size was small, limiting statistical power; patients remained on their psychiatric medications; study was open-label and uncontrolled." ]

[ "Body mass index: a risk factor for 30-day or six-month mortality in patients undergoing aortic valve replacement?<||||>In recent studies, the impact of a low or high body mass index (BMI) on outcome after cardiac surgery has been the subject of controversy. A retrospective study was conducted to determine the influence of BMI on 30-day and six-month mortality after aortic valve replacement (AVR).", "Body mass index: a risk factor for 30-day or six-month mortality in patients undergoing aortic valve replacement?<||||>A multivariable logistic regression was performed on data from 1,241 consecutive patients (mean age 69 +/- 11 years) who underwent AVR either with (n = 514; 41%) or without coronary artery bypass grafting CABG between 2000 and 2003. A wide spectrum of periprocedural variables was collected, including laboratory data as markers for nutritional status and comorbidity. Patients were followed up for six months after AVR (99% complete).", "Body mass index: a risk factor for 30-day or six-month mortality in patients undergoing aortic valve replacement?<||||>Mortality rates after 30 days and after six months were 3.9% (n = 49) and 7.6% (n = 94), respectively. A low BMI was identified as an independent risk factor for 30-day (OR (odds ratio) 0.87; CI (confidence interval) 0.8-0.94) and six-month mortality (OR 0.91; CI 0.86-0.96). The relationship between the logit function and BMI was linear; however, a BMI value of 24 was considered an appropriate cut-off point. Both models containing the BMI linearly or dichotomic were equivalent. As patients with a lower BMI differ in their preoperative risk profile compared to those with a higher BMI, a saturated propensity score estimating the propensity towards having a BMI<24 was calculated. The propensity score was not significant in the final models for 30-day and six-month mortality (0.24 and 0.73, respectively), and the OR for BMI remained largely unaltered (0.89 and 0.91, respectively)." ]

[ "Can the neurovascular compression volume of the trigeminal nerve on magnetic resonance cisternography predict the success of local anesthetic block after initial treatment by the carbamazepine?<||||>Whether NVC volume on magnetic resonance (MR) cisternography might be related to the success of local anesthetic block by tetracaine (TNB) as an additional treatment after carbamazepine (CBZ) treatments in patients with trigeminal neuralgia (TN) was evaluated.", "Can the neurovascular compression volume of the trigeminal nerve on magnetic resonance cisternography predict the success of local anesthetic block after initial treatment by the carbamazepine?<||||>Detectable NVC volumes were measured from MR cisternography in 65 patients with TN treated by TNB after CBZ treatments. The correlation between the success of TNB and the NVC volume or the improvement in pain by CBZ was evaluated retrospectively.", "Can the neurovascular compression volume of the trigeminal nerve on magnetic resonance cisternography predict the success of local anesthetic block after initial treatment by the carbamazepine?<||||>A significant difference was found between the improvement in pain by CBZ and the success of TNB, but not between NVC volume on MR cisternography and the success of TNB." ]

[ "Can the 2-(13)C-uracil breath test be used to predict the effect of the antitumor drug S-1?<||||>S-1 is an oral anticancer drug containing tegafur (FT), a pro-drug of fluorouracil, combined with two modulators, 5-chloro-2,4-dihydroxypyridine and potassium oxonate (Oxo), at a molar ratio of 1:0.4:1. CYP2A6 genetic polymorphism and dihydropyrimidine dehydrogenase (DPD) inhibition are important for the antitumor effect of S-1. Exploiting the usefulness of the 2-(13)C-uracil breath test (UrBT) as an indicator of DPD activity, we examined whether the results of CYP2A6 genetic polymorphism analysis and UrBT could be used to predict the antitumor effect of S-1.", "Can the 2-(13)C-uracil breath test be used to predict the effect of the antitumor drug S-1?<||||>Thirty-four patients with advanced or recurrent cancer (15, 16 and 3 with gastric, colorectal and pancreatic cancer, respectively) were orally administered 40 mg/m(2) S-1 twice daily in the morning and evening. Eighteen patients with a complete response (CR)/partial response (PR) (2 with CR, 16 with PR) and 16 with progressive disease (PD) were compared with respect to CYP2A6 genetic polymorphisms (1- vs. 2-allele mutation), UrBT results, and plasma FT and 5-fluorouracil levels at 3 h after S-1 ingestion in the morning.", "Can the 2-(13)C-uracil breath test be used to predict the effect of the antitumor drug S-1?<||||>On multivariate analysis between the CR/PR and PD groups, only the UrBT results was an independent factor of CR/PR to S-1 (95% CI 1.02-1.10)." ]

[ "Persistence of human papillomavirus infection after therapeutic conization for CIN 3: is it an alarm for disease recurrence?<||||>The aims of this study were (1) to examine whether HPV DNA is persistently detected in the cervix after therapeutic conization for CIN 3 and (2) to explore whether a patient with persistence of HPV infection is at risk of developing recurrent disease.", "Persistence of human papillomavirus infection after therapeutic conization for CIN 3: is it an alarm for disease recurrence?<||||>Of 74 patients referred with CIN 3, 58 who were tested for HPV DNA in the pretreatment cervical lesions were enrolled in the study. After standard therapeutic conization, patients were followed prospectively at the outpatient clinic. Our follow-up protocol was to follow patients without therapeutic intervention as long as they developed no recurrence or recurrence of CIN 1 or 2, while patients who experienced recurrence of CIN 3 were recommended for reconization or hysterectomy. The polymerase chain reaction for detecting HPV DNA was performed using fresh cell samples from the cervix.", "Persistence of human papillomavirus infection after therapeutic conization for CIN 3: is it an alarm for disease recurrence?<||||>In 56 of 58 patients (96.6%), HPV DNAs were detected in their primary cervical lesions prior to conization. With regard to the distribution of HPV types, HPV type 16 family (types 16, 31, and 35) was identified in 28 cases (50.0%), type 18 family (types 18, 33 and 58) in 15 (26.8%), and type X in 18 (32.1%). Up to August 1999, all of the 58 patients have been followed with a mean follow-up period of 31.8 months (range: 12 to 73 months). After treatment, HPV DNA was persistently detected in 11 (19.6%) but negative in 45 (80.4%) of 56 HPV DNA-positive patients. HPV DNA was not detected in both HPV DNA-negative patients. Five of 11 persistently HPV DNA-positive patients (45.5%) developed CIN recurrence, while none of 45 persistently HPV DNA-negative patients did. Thus, there was a significant difference between the recurrence rates of these two groups (P<0.0001). Both patients who were initially HPV DNA-negative developed no recurrence. Accordingly, the overall recurrence following conservative treatment for CIN 3 was 5 of 58 patients (8.6%)." ]

[ "Is nuchal translucency screening associated with different rates of invasive testing in an older obstetric population?<||||>Our objective was to assess the impact of nuchal translucency screening for aneuploidy on chorionic villus sampling and amniocentesis rates in an older obstetric population.", "Is nuchal translucency screening associated with different rates of invasive testing in an older obstetric population?<||||>Our study population included women>/=35 years old who were delivered at our hospital from January 1, 2000 through December 31, 2002. Records were reviewed to determine whether women underwent nuchal translucency, chorionic villus sampling, and amniocentesis. The chi-squared test for trend was used to evaluate changes in nuchal translucency, chorionic villus sampling, and amniocentesis rates over six 6-month intervals. Maternal characteristics were compared with the use of Mann-Whitney U test and Fisher's exact test.", "Is nuchal translucency screening associated with different rates of invasive testing in an older obstetric population?<||||>The 4029 women who met the inclusion criteria had a median age at delivery of 37 years (interquartile range, 36-39 years). The rates of nuchal translucency screening increased from 0% to 41.6% over the study interval. Women who underwent nuchal translucency screening when it was available were older than the women who did not (median age, 37 years [interquartile range, 36-40 years] vs median age, 37 years [interquartile range, 36-39 years]; P=.003). A higher proportion of women who were>/=40 years old underwent nuchal translucency screening when it was available than did women who were 35 to 39 years old (24.9% vs 20.4%; P=.01). Women who underwent nuchal translucency screening were less likely to have chorionic villus sampling compared with women who did not undergo screening (1.9% vs 7.1%; P<.001). Rates of chorionic villus sampling declined over time, although amniocentesis rates remained unchanged. The overall rate of invasive testing declined. Different trends were noted in women who were 35 to 39 years old compared with women who were>/=40 years old." ]

[ "Are drug detection dogs and mass-media campaigns likely to be effective policy responses to psychostimulant use and related harm?<||||>Agent-based simulation models can be used to explore the impact of policy and practice on drug use and related consequences. In a linked paper (Perez et al., 2011), we described SimAmph, an agent-based simulation model for exploring the use of psychostimulants and related harm amongst young Australians.", "Are drug detection dogs and mass-media campaigns likely to be effective policy responses to psychostimulant use and related harm?<||||>In this paper, we use the model to simulate the impact of two policy scenarios on engagement in drug use and experience of drug-related harm: (i) the use of passive-alert detection (PAD) dogs by police at public venues and (ii) the introduction of a mass-media drug prevention campaign.", "Are drug detection dogs and mass-media campaigns likely to be effective policy responses to psychostimulant use and related harm?<||||>The findings of the first simulation suggest that only very high rates of detection by PAD dogs reduce the intensity of drug use, and that this decrease is driven mainly by a four-fold increase in negative health consequences as detection rates rise. In the second simulation, our modelling showed that the mass-media prevention campaign had little effect on the behaviour and experience of heavier drug users. However, it led to reductions in the prevalence of health-related conditions amongst moderate drug users and prevented them from becoming heavier users." ]

[ "Medicaid HMO penetration and its mix: did increased penetration affect physician participation in urban markets?<||||>To use changes in Medicaid health maintenance organization (HMO) penetration across markets over time to test for effects on the extent of Medicaid participation among physicians and to test for differences in the effects of increased use of commercial versus Medicaid-dominant plans within the market.DATA SOURCES/", "Medicaid HMO penetration and its mix: did increased penetration affect physician participation in urban markets?<||||>The nationally representative Community Tracking Study's Physician Survey for three periods (1996-1997, 1998-1999, and 2000-2001) on 29,866 physicians combined with Centers for Medicare and Medicaid Services (CMS) and InterStudy data.", "Medicaid HMO penetration and its mix: did increased penetration affect physician participation in urban markets?<||||>Market-level estimates of Medicaid HMO penetration are used to test for (1) any participation in Medicaid and (2) the degree to which physicians have an \"open\" (i.e., nonlimited) practice accepting new Medicaid patients. Models account for physician, firm, and local characteristics, Medicaid relative payment levels adjusted for geographic variation in practice costs, and market-level fixed effects.", "Medicaid HMO penetration and its mix: did increased penetration affect physician participation in urban markets?<||||>There is a positive effect of increases in commercial Medicaid HMO penetration on the odds of accepting new Medicaid patients among all physicians, and in particular, among office-based physicians. In contrast, there is no effect, positive or negative, from expanding the penetration of Medicaid-dominant HMO plans within the market. Increases in cost-adjusted Medicaid fees, relative to Medicare levels, were associated with increases in the odds of participation and of physicians having an \"open\" Medicaid practice. Provider characteristics that consistently lower participation among all physicians include being older, board certified, a U.S. graduate and a solo practitioner." ]

[ "Does fatigue occur in MS patients without disability?<||||>Motor dysfunction and fatigue are the most common impairments that are associated with multiple sclerosis (MS). Walk tests and scales demonstrate the presence of fatigue in patients with MS with different levels of disability.", "Does fatigue occur in MS patients without disability?<||||>To evaluate objective and subjective fatigue in MS patients without disability.", "Does fatigue occur in MS patients without disability?<||||>Were selected MS patients with relapsing remitting clinical course, from 18 to 55 years old and EDSS 0 to 1.5; controls were paired for age, gender, body mass index, and physical activity level. Fatigue caused by pulmonary diseases, anemia, diabetes, thyroid disease, psychiatry diseases (except depression), and orthopedic and rheumatologic diseases are excluded. All participants performed the 6-minute walk test (6MWT), the MS Functional Composite (MSFC), and completed the Modified Fatigue Impact Scale (MFIS) and the Beck Depression Inventory. A multivariate model was applied to identify the variables associated with fatigue.", "Does fatigue occur in MS patients without disability?<||||>54 individuals were selected (31 patients; 23 controls). In the MSFC and 6MWT, no significant difference was observed between the groups. A MFIS total score indicated fatigue in 35% of the patients, 42% in the physical domain, 25.8% in the cognitive domain, and 29% in the psychosocial domain, which differed from the controls in all comparisons. Fatigue was associated with MS, low-physical activity, and mood disorders." ]

[ "Incisional hernia in patients at risk: can it be prevented?<||||>Incisional hernia is a long-term complication of laparotomy. Its exact frequency varies according to different authors, but is always around 10-15%. There are patients who present with systemic associated diseases [chronic obstructive pulmonary disease (COPD), obesity, severe cardiopathies, immunodeficiencies, etc.]that favour or increase the risk of appearance of an incisional hernia. The aim of the present study was to assess whether the prophylactic placement of a polypropylene mesh in patients at risk can reduce or avoid the appearance of an incisional hernia.", "Incisional hernia in patients at risk: can it be prevented?<||||>Seventy-two selected patients with clear risk factors and colon pathology underwent surgical intervention through median infraumbilical laparotomy. During laparotomy the preperitoneal space was dissected at a point where a low-molecular weight polypropylene mesh was to be placed when closing the peritoneum. Meshes were about 7-8 cm wide and had a variable length that depended on the length of the surgical incision. Of the 72 patients, 41 were obese (BMI>30 kg/m(2)), 45 presented with COPD, and 42 with colorectal neoplasia; 29 patients had two risk factors, and 15 had three risk factors. The mesh was held in place with polypropylene stitches in 28% of cases, and with fibrin glue in 72% of cases.", "Incisional hernia in patients at risk: can it be prevented?<||||>All patients were assessed by a protocol that included interview, examination of the surgical wound, and abdominal CT scan. Follow-up was between 3 and 5 years. There were no noteworthy complications or operative mortality. No mesh had to be removed in any patient. Two patients developed liver metastasis, and in a second surgery the good condition of the abdominal wall and the absence of hernia were confirmed. Twenty patients required postoperative chemotherapy. Two patients died at 37 and 43 months after surgery because of progression of the neoplastic disease. Fourteen patients were monitored for more than 5 years after surgery, and 46 patients were monitored for 48 months. None of the 72 patients developed an incisional hernia." ]

[ "Gender Aspects in Extranodal Marginal Zone B-Cell Lymphoma of the Mucosa-Associated Lymphoid Tissue: Does Sex Matter?<||||>Gender-related aspects have been investigated in a variety of tumor entities including results on sex-specific differences in non-Hodgkin lymphoma. However, there are no data on gender differences in mucosa-associated lymphoid tissue (MALT) lymphoma.", "Gender Aspects in Extranodal Marginal Zone B-Cell Lymphoma of the Mucosa-Associated Lymphoid Tissue: Does Sex Matter?<||||>We have analyzed 327 patients treated between 1999 and 2015 with a median follow-up time of 55.2 months.", "Gender Aspects in Extranodal Marginal Zone B-Cell Lymphoma of the Mucosa-Associated Lymphoid Tissue: Does Sex Matter?<||||>There was a female predominance, with 197 female (60.2%) and 130 male patients (39.8%, female-to-male ratio 1.5). The mean age was comparable between female and male patients (61.2 vs. 61.7 years, p = 0.777). Female patients less frequently had gastric MALT lymphoma (31.5 vs. 39.2%), but this was not statistically significant (p = 0.149). Extragastric manifestations were equally distributed, except for parotid (p = 0.003) and breast lymphoma (n = 8, 100% female) showing a female predominance. This was most likely related to a higher rate of active autoimmune disorders in women (35.6 vs. 11.0%, p<0.001). β2-Microglobulin elevation at diagnosis occurred more often in female patients (42.8 vs. 26.0%; p = 0.008). However, this did not translate into a worse progression-free survival for female (56.0 months, 95% CI 30.1-81.9) versus male patients (49.0 months, 95% CI 25.4-72.5, p = 0.433). Overall survival did not differ between groups." ]

[ "Is there any relationship between lipids and vitamin B levels in persons with elevated risk of atherosclerosis?<||||>There is increasing evidence that plasma homocysteine level is an independent risk factor for atherosclerosis. Low levels of serum folates, cobalamin and pyridoxine are associated with increased risk of cardiovascular disease. Most dietary products contain cholesterol as well as methionine, so hyperlipidemia could be associated with a higher level of homocysteine and inversely with lower levels of B vitamins. The aim of this study was to investigate the differences in levels of lipids and vitamins affecting homocysteine metabolism in different groups of patients.MATERIAL/", "Is there any relationship between lipids and vitamin B levels in persons with elevated risk of atherosclerosis?<||||>We examined 38 healthy persons, 55 patients hospitalised for cardiac surgery, and 62 patients without clinical evidence of atherosclerosis but with one of the atherosclerosis risk factors (hypercholesterolemia, NIDDM or chronic renal insufficiency). The levels of total cholesterol, triglycerides, vitamin B12, folic acid and vitamin B6 index in serum were determined using routine laboratory methods.", "Is there any relationship between lipids and vitamin B levels in persons with elevated risk of atherosclerosis?<||||>We found no association between lipids and B vitamins in any examined group. There were significant differences between concentrations of analysed parameters in all groups of patients as compared to controls." ]

[ "Should total gastrectomy and total colectomy be considered for selected patients with severe tumor burden of pseudomyxoma peritonei in cytoreductive surgery?<||||>This study aims to evaluate the safety and efficacy of cytoreductive surgery (CRS) including total gastrectomy and total colectomy in selected pseudomyxoma peritonei (PMP) patients with entire stomach and colon covered by mucinous tumor.", "Should total gastrectomy and total colectomy be considered for selected patients with severe tumor burden of pseudomyxoma peritonei in cytoreductive surgery?<||||>A total of 48 patients received this extensive treatment between January 2006 and January 2014. The main focus of this study was survival after CRS as well as perioperative morbidity and mortality.", "Should total gastrectomy and total colectomy be considered for selected patients with severe tumor burden of pseudomyxoma peritonei in cytoreductive surgery?<||||>Twenty-eight patients were male, and median age was 52.5 years. Median peritoneal cancer index was 33. Complete cytoreduction was achieved in all 48 patients, and 26 patients received hyperthermic intraperitoneal chemotherapy (HIPEC). Until last follow-up, the estimated median survival after CRS was 54.0 months (95% CI 36.5-71.6 months). The 1-, 2-, 3-, and 5-year survival rates were 91.7%, 81.3%, 70.1%, and 48.6%, respectively. Histology was significantly associated with survival (P = 0.020). The median disease-free survival was 32.0 (95% CI 25.7-38.3) months. HIPEC (P = 0.048) and histology (P = 0.002) was significantly associated with disease-free survival after CRS. Overall Grade 3-5 complications occurred in 18 (37.5%) patients with mortality of 2.1%. For patients who received surgery over 6 months, they could gradually have an acceptable quality-of-life similar as other patients receiving ordinary CRS and HIPEC." ]

[ "Thoracoscopic reduction pneumoplasty for severe emphysema: do pleural adhesions affect outcome?<||||>Pleural adhesions are frequently encountered in patients undergoing reduction pneumoplasty. We evaluated the impact that pleural adhesions had on the surgical technique and outcome of thoracoscopic reduction pneumoplasty.", "Thoracoscopic reduction pneumoplasty for severe emphysema: do pleural adhesions affect outcome?<||||>59 operated patients were divided into 2 groups depending on the presence (group A) or absence (group B) of pleural adhesions.", "Thoracoscopic reduction pneumoplasty for severe emphysema: do pleural adhesions affect outcome?<||||>At inter-group comparison (A versus B) a significant difference was found for mean duration of operation (128+/-55 min versus 73+/-33 min; p<0.005), morbidity (14 versus 9 patients; p<0.05), and hospital stay (14.1+/-11.8 days versus 12.0+/-7.4 days; p<0.001). Complications occurred less frequently in the last 29 patients than in the first 30 patients (11 versus 24; p<0.03). At histopathologic analysis subpleural (p<0.005) and interstitial fibrosis (p<0.001), and interstitial granulomas (p<0.012) were more frequent in group A specimens. At six months dyspnea index, six-minute-walk test, FEV1, FVC, PaO2, and prednisone and oxygen independence improved significantly in both groups. However FEV1 increased less in group A (1.20+/-0.2L vs 1.31+/-0.3L; p<0.01)." ]

[ "Monocyte chemoattractant protein-1: a dichotomous role in cardiac remodeling following acute myocardial infarction in man?<||||>Monocyte chemoattractant protein-1 (MCP-1) is elevated after acute myocardial infarction (AMI), and potentiates left ventricular (LV) remodeling in murine models of AMI. We examined the relationships between serum MCP-1, change in LV function and biomarkers related to remodeling in a cohort of AMI patients.", "Monocyte chemoattractant protein-1: a dichotomous role in cardiac remodeling following acute myocardial infarction in man?<||||>Serum MCP-1 concentrations were measured in 100 patients (age 58.9+/-12.0 years, 77% male) admitted with AMI and LV dysfunction, at baseline (mean 46 h), 12 and 24 weeks; cardiac magnetic resonance imaging and measurement of matrix metalloproteinase-2 (MMP-2), MMP-3 and MMP-9 occurred at each time-point.", "Monocyte chemoattractant protein-1: a dichotomous role in cardiac remodeling following acute myocardial infarction in man?<||||>MCP-1 increased significantly from 697 [483, 997]pg/mL at baseline to 878 [678, 1130]pg/mL at 24 weeks (p<0.001). MMP-3 concentration increased while MMP-9 decreased significantly over time; MMP-2 concentration did not change significantly. BASELINE MCP-1 correlated with change in (Delta) LV end-systolic volume index (DeltaLVESVI; r= -0.48, p=0.01) and with DeltaLV ejection fraction (DeltaLVEF; r=0.50, p=0.02). However, DeltaMCP-1 correlated positively with DeltaLVESVI (r=0.40, p=0.006) and negatively with DeltaLVEF (r= -0.36, p=0.004). MCP-1 had no relationship with any MMP." ]

[ "Does elastography reduce the need for thyroid FNAs?<||||>Ultrasound elastography (USE) assesses lesion stiffness by evaluating tissue distortion in response to stress; it is emerging as a potentially useful tool to augment the ultrasound characterisation of thyroid nodules. The aim of this study was to assess the accuracy of USE examination of thyroid nodules compared with pathological outcome, especially to determine whether USE could reliably detect benign nodules and reduce the numbers of ultrasound guided fine needle aspiration cytology (USgFNAC).", "Does elastography reduce the need for thyroid FNAs?<||||>Over a three-year period, thyroid nodules were initially characterised by B-mode ultrasound (US) findings. Where USgFNAC was indicated by clinical concern and/or the sonographic appearances, the lesion was then subjected to USE by an experienced operator prior to the USgFNAC.", "Does elastography reduce the need for thyroid FNAs?<||||>147 thyroid nodules were examined by USE and USgFNAC in 146 patients.", "Does elastography reduce the need for thyroid FNAs?<||||>The elastographic appearance was subjectively categorized at the time of the examination (soft, intermediate or hard) and subsequently compared with the cytological/histological outcome.", "Does elastography reduce the need for thyroid FNAs?<||||>A total of 122 nodules were non-neoplastic, 5 nodules were benign neoplasms, 10 nodules had indeterminate cytology and 10 were malignant neoplasms. The sensitivity of USE for malignancy was 90.0%, specificity was 79.6%, PPV was 24.3%, NPV was 99.1% and accuracy was 80.3%." ]

[ "Occupation, marital status, and low-grade inflammation: mutual confounding or independent cardiovascular risk factors?<||||>We explored the relationships between inflammatory proteins, occupation, and marital status, and their independent associations with incidence of cardiovascular disease (CVD).", "Occupation, marital status, and low-grade inflammation: mutual confounding or independent cardiovascular risk factors?<||||>Five inflammation-sensitive proteins (ISPs) (fibrinogen, ceruloplasmin, haptoglobin, alpha1-antitrypsin, orosomucoid) were measured in 6075 apparently healthy men. Incidence of coronary events and stroke was followed over 18 years in relation to occupation and marital status. All ISPs showed higher concentrations in divorced men and in manual workers. Except for fibrinogen, this remained significant after adjustments for confounding factors. Adjusted for traditional cardiovascular risk factors, incidence of coronary events was significantly increased in unskilled manual workers and in divorced men. The relative risks were slightly reduced after further adjustments for ISPs (from 1.79 to 1.70 in unskilled manual workers; from 1.58 to 1.51 in divorced men). All ISPs were significantly associated with incidence of coronary events, after adjustments for traditional risk factors. This relationship was essentially unchanged after further adjustments for occupation and marital status." ]

[ "Is homeostatic sleep regulation under low sleep pressure modified by age?<||||>We have previously shown that healthy older volunteers react with an attenuated frontal predominance of sleep electroen-cephalogram (EEG) delta activity in response to high sleep pressure. Here, we investigated age-related changes in homeostatic sleep regulation under low sleep pressure conditions, with respect to regional EEG differences and their dynamics.", "Is homeostatic sleep regulation under low sleep pressure modified by age?<||||>Analysis of the sleep EEG during an 8-hour baseline night, during a 40-hour multiple nap protocol (150 minutes of wakefulness and 75 minutes of sleep) and during the following 8-hour recovery night under constant posture conditions.", "Is homeostatic sleep regulation under low sleep pressure modified by age?<||||>Centre for Chronobiology, Psychiatric University Clinics, Basel, Switzerland", "Is homeostatic sleep regulation under low sleep pressure modified by age?<||||>Sixteen young (20-31 years) and 15 older (57-74 years) healthy volunteers", "Is homeostatic sleep regulation under low sleep pressure modified by age?<||||>N/A.", "Is homeostatic sleep regulation under low sleep pressure modified by age?<||||>All-night EEG spectra revealed an increase in spindle activity (13-15.25 Hz) for both age groups, but only in the young did we find a significant decrease of delta activity (0.5-1.25 Hz) in response to low sleep pressure conditions, predominantly in occipital brain regions. However, delta activity during the first non-rapid eye movement (NREM) sleep episode was equally reduced in both age groups. This response lasted significantly longer in the young (across the first 2 NREM sleep episodes) than in the older participants (only the first NREM sleep episode)." ]

[ "Lateral tunnel Fontan in the current era: is it still a good option?<||||>Construction of a total cavopulmonary anastomosis using an intra-atrial lateral tunnel Fontan (LTF) is known to yield good early and midterm results. Given the current controversy regarding indications for a total extracardiac conduit Fontan, we reviewed the long-term outcomes after a LTF operation and compared them with recently published series using one or both techniques.", "Lateral tunnel Fontan in the current era: is it still a good option?<||||>Between 1992 and 2008, 220 of 280 patients (median age, 2.5 years; range, 1 to 45) with a wide range of underlying diagnoses underwent a fenestrated or nonfenestrated LTF operation at our institution. Current follow-up information was available for 215 patients (98%; mean follow-up, 6.7 +/- 3.9 years). Risk factor analysis included patient-related and procedure-related variables, with death, failure (takedown or transplantation), and bradyarrhythmia or tachyarrhythmia as outcome variables.", "Lateral tunnel Fontan in the current era: is it still a good option?<||||>There was 1 early death, 10 late deaths, 3 takedown operations, and 1 heart transplantation. Kaplan-Meier estimated survival was 96% at 5 years and 95% at 10 and 15 years, and freedom from failure was 94% at 5 years and 93% at 10 years. Freedom from new supraventricular tachyarrhythmia was 98% at 5 years and 95% at 10 years; freedom from new bradyarrhythmia was 97% at 5 years and 96% at 10 years. Six patients have protein-losing enteropathy, and 2 of 6 have had Fontan takedown. Multivariable risk factors for development of supraventricular tachyarrhythmia included atrioventricular valve abnormalities (p = 0.02), and preoperative bradyarrhythmia (p = 0.01). Risk factors for bradyarrhythmia included the need for early postoperative pacing (p = 0.001). None of the patient-related variables significantly influenced survival." ]

[ "Pain responses in repeated end-range spinal movements and psychological factors in sick-listed patients with low back pain: is there an association?<||||>Repeated end-range spinal movements producing specific pain responses (i.e. centralization or non-centralization) may be used for diagnostic and prognostic purposes. However, possible associations between psychological factors and pain responses have been reported. The aim of this study was to investigate the associations between pain responses in repeated end-range spinal movement tests and psychological factors.", "Pain responses in repeated end-range spinal movements and psychological factors in sick-listed patients with low back pain: is there an association?<||||>Cross-sectional clinical study.", "Pain responses in repeated end-range spinal movements and psychological factors in sick-listed patients with low back pain: is there an association?<||||>Data from 331 patients sick-listed for 4-12 weeks due to low back pain with or without sciatica.", "Pain responses in repeated end-range spinal movements and psychological factors in sick-listed patients with low back pain: is there an association?<||||>Initially the patients completed a questionnaire including questions about psychological factors. Then they underwent a standardized physical test procedure and were classified according to centralized or non-centralized pain response.", "Pain responses in repeated end-range spinal movements and psychological factors in sick-listed patients with low back pain: is there an association?<||||>Statistically significant associations were found between non-centralization and mental distress (p<0.009) as well as depressive symptoms (p<0.049). These associations remained present after adjustment for potential confounders by logistic regression: mental distress odds ratio (OR) 1.16 (95% confidence interval (CI) 1.03-1.30) (p = 0.013), depressive symptoms OR 1.23 (95% CI 1.01-1.51) (p = 0.044)." ]

[ "The asymptomatic lung embolism: should every patient with deep vein thrombosis be examined using thoracic ultrasound?<||||>Examination of the prognostic importance of sonographically diagnosed pleural defects in patients with deep vein thrombosis (DVT) who are clinically asymptomatic for lung emboli (LE).", "The asymptomatic lung embolism: should every patient with deep vein thrombosis be examined using thoracic ultrasound?<||||>n = 124 patients with a sonographically diagnosed DVT and without clinical symptoms for an LE were accepted for this retrospective study. The thorax was subsequently sonographically examined in all patients. The patients were split into two groups (group 1: with pleural defects; group 2: without pleural defects). These groups were observed for an average of 36.6 months. The endpoints death and recurrence of pulmonary embolism or thrombosis were documented. The survival time was calculated using the Kaplan-Meier analysis.", "The asymptomatic lung embolism: should every patient with deep vein thrombosis be examined using thoracic ultrasound?<||||>Of the 124 patients, n = 50 (40.3 %) had pleural defects (group 1) and n = 74 (59.7 %) had no pleural defects (group 2) on thoracic sonography. During the time of observation, n = 9 patients experienced a recurrent event of thrombosis or pulmonary embolism. In total, n = 39 (31.5 %) patients died (group 1: n = 16, group 2: n = 23 patients). The one-year mortality rate for patients with pleural defects was 24 % in group 1 and 22 % in group 2. The differences in the survival curves were not statistically significant (p = 0,7581)." ]