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[ "Is it ADEM, POLG, or both?<||||>To describe a child with apparent brain biopsy-confirmed acute disseminated encephalomyelitis (ADEM) but genetic confirmation of compound heterozygosity for DNA mutations of the polymerase gamma (POLG) gene.", "Is it ADEM, POLG, or both?<||||>Case report.", "Is it ADEM, POLG, or both?<||||>Tertiary referral center.", "Is it ADEM, POLG, or both?<||||>A 4-year-old boy presented with ataxia and encephalopathy.", "Is it ADEM, POLG, or both?<||||>Magnetic resonance imaging demonstrated multiple focal areas of T2 prolongation. The patient's family refused steroid treatment. His symptoms improved then progressed. Magnetic resonance imaging findings also progressed. A cerebrospinal fluid specimen revealed myelin basic protein and oligoclonal bands. A brain biopsy specimen demonstrated demyelination, suggesting progression of ADEM. However, polymerase chain reaction amplification and sequencing revealed 2 heterozygous mutations of the POLG gene, suggesting mitochondrial disease. The patient died 9 months after his initial presentation." ]

[ "Local excision of rectal carcinoma: a safe alternative for more advanced tumors?<||||>Local excision of rectal carcinoma has primarily been limited to patients with small (<or =3 cm), early rectal carcinoma. We wanted to determine whether local excision (transanal or transacral), when combined with selective chemoradiation therapy, would be adequate treatment for patients with larger (>3 cm) and more advanced T3 and N1 tumors.", "Local excision of rectal carcinoma: a safe alternative for more advanced tumors?<||||>A prospective study of 20 patients with clinical T1-T3, N0-N1 rectal carcinoma was initiated in 1990. Local excision (transanal or transacral) was performed on all patients. Sixteen patients were treated with postoperative 5-fluorouracil (5-FU) and leucovorin (LV) combined with radiation therapy; six high-risk patients (T3 or N1) received an additional 6 months of 5-FU and LV. All patients were followed for a minimum of 4 years.", "Local excision of rectal carcinoma: a safe alternative for more advanced tumors?<||||>Tumor size ranged from 2 to 5.5 cm (mean, 3.6 cm). Histology revealed well or moderate differentiation (19/20), gross or microscopic ulceration (14/20), and vessel invasion (5/20). Mucosal margins were 3-12 mm (mean, 8.3 mm); radial margins were clear in all patients except one (microscopically positive). Five patients had T3 tumors; two had node positive tumors (N1). With a median follow-up of 56 months (48-71), there have been no local or regional failures and two patients have died from metastatic disease." ]

[ "Do hypoxia/normoxia culturing conditions change the neuroregulatory profile of Wharton Jelly mesenchymal stem cell secretome?<||||>The use of human umbilical cord Wharton Jelly-derived mesenchymal stem cells (hWJ-MSCs) has been considered a new potential source for future safe applications in regenerative medicine. Indeed, the application of hWJ-MSCs into different animal models of disease, including those from the central nervous system, has shown remarkable therapeutic benefits mostly associated with their secretome. Conventionally, hWJ-MSCs are cultured and characterized under normoxic conditions (21 % oxygen tension), although the oxygen levels within tissues are typically much lower (hypoxic) than these standard culture conditions. Therefore, oxygen tension represents an important environmental factor that may affect the performance of mesenchymal stem cells in vivo. However, the impact of hypoxic conditions on distinct mesenchymal stem cell characteristics, such as the secretome, still remains unclear.", "Do hypoxia/normoxia culturing conditions change the neuroregulatory profile of Wharton Jelly mesenchymal stem cell secretome?<||||>In the present study, we have examined the effects of normoxic (21 % O2) and hypoxic (5 % O2) conditions on the hWJ-MSC secretome. Subsequently, we address the impact of the distinct secretome in the neuronal cell survival and differentiation of human neural progenitor cells.", "Do hypoxia/normoxia culturing conditions change the neuroregulatory profile of Wharton Jelly mesenchymal stem cell secretome?<||||>The present data indicate that the hWJ-MSC secretome collected from normoxic and hypoxic conditions displayed similar effects in supporting neuronal differentiation of human neural progenitor cells in vitro. However, proteomic analysis revealed that the use of hypoxic preconditioning led to the upregulation of several proteins within the hWJ-MSC secretome." ]

[ "Factors associated with the thickness of the ligamentum flavum: is ligamentum flavum thickening due to hypertrophy or buckling?<||||>Ligamentum flavum (LF) thickness was measured by using lumbar magnetic resonance imaging in patients with low back or leg pain.", "Factors associated with the thickness of the ligamentum flavum: is ligamentum flavum thickening due to hypertrophy or buckling?<||||>This study investigated whether LF thickening is due to hypertrophy or buckling related to disc degeneration and examined the correlations between the thickness of the LF and age, sex, body mass index (BMI), degree of pain, lumbar spinal stenosis (LSS), and disc herniation.", "Factors associated with the thickness of the ligamentum flavum: is ligamentum flavum thickening due to hypertrophy or buckling?<||||>\"LF thickness\" and \"LF hypertrophy\" are used interchangeably in the literature, although they are not necessarily the same thing. Thickness may increase by buckling without a change in the mass of the LF, and whether LF thickening is due to tissue hypertrophy or buckling remains controversial.", "Factors associated with the thickness of the ligamentum flavum: is ligamentum flavum thickening due to hypertrophy or buckling?<||||>The thickness of 896 LFs at the L2-L3, L3-L4, L4-L5, and L5-S1 levels of 224 (mean age, 47.8 ± 16.7 yrs) patients was measured prospectively on axial T1-weighed magnetic resonance images, obtained at the facet joint level. The presence of disc degeneration, spinal stenosis, and disc herniation was evaluated.", "Factors associated with the thickness of the ligamentum flavum: is ligamentum flavum thickening due to hypertrophy or buckling?<||||>At all of the levels investigated, LF thickness was significantly greater in patients with grades IV to V degeneration compared with the patients with grades I to III degeneration (P<0.05). LF thickness at all levels increased significantly with age (P<0.05). Sex and the degree of pain were not correlated with the thickness of the LF. Patients with a BMI of 25 kg/m or greater had the thickest LF at the L3-L4 level (P<0.01). LF thickness was significantly greater at the L2-L3, L3-L4, and L4-L5 levels in subjects with LSS and significantly greater at all levels in subjects with disc herniation (P<0.05)." ]

[ "Is alanine aminotransferase level a surrogate biomarker of hepatic apoptosis in nonalcoholic fatty liver disease?<||||>24 patients with NAFLD and normal ALT were compared with 26 subjects with NAFLD and elevated ALT. Liver oxidative stress was estimated on the basis of malondialdehyde, superoxide dismutase and glutathione. Immunohistochemistry was performed for activated caspase 3 and 8, nuclear factor-kappaB, antiapoptotic Bcl-2 protein and serum TNF receptor levels were measured.", "Is alanine aminotransferase level a surrogate biomarker of hepatic apoptosis in nonalcoholic fatty liver disease?<||||>The mean caspase 3 and 8 activity scores, oxidative stress parameters, necroinflammatory grade and prevalence of severe fibrosis were comparable across the groups with normal versus elevated ALT. Patients with nonalcoholic steatohepatitis had significantly higher caspase 3 and 8 activity (percentage of cells with positive staining per high power field), and serum malondialdehyde (mmol/l) levels than those with simple steatosis. ALT elevation was not a risk factor for advanced necroinflammatory grade and fibrosis. A receiver operating characteristic curve did not demonstrate sensitivity and specificity for discriminative power of ALT." ]

[ "Should expectations about the rate of new antiretroviral drug development impact the timing of HIV treatment initiation and expectations about treatment benefits?<||||>Many analyses of HIV treatment decisions assume a fixed formulary of HIV drugs. However, new drugs are approved nearly twice a year, and the rate of availability of new drugs may affect treatment decisions, particularly when to initiate antiretroviral therapy (ART).", "Should expectations about the rate of new antiretroviral drug development impact the timing of HIV treatment initiation and expectations about treatment benefits?<||||>To determine the impact of considering the availability of new drugs on the optimal initiation criteria for ART and outcomes in patients with HIV/AIDS.", "Should expectations about the rate of new antiretroviral drug development impact the timing of HIV treatment initiation and expectations about treatment benefits?<||||>We enhanced a previously described simulation model of the optimal time to initiate ART to incorporate the rate of availability of new antiviral drugs. We assumed that the future rate of availability of new drugs would be similar to the past rate of availability of new drugs, and we estimated the past rate by fitting a statistical model to actual HIV drug approval data from 1982-2010. We then tested whether or not the future availability of new drugs affected the model-predicted optimal time to initiate ART based on clinical outcomes, considering treatment initiation thresholds of 200, 350, and 500 cells/mm3. We also quantified the impact of the future availability of new drugs on life expectancy (LE) and quality-adjusted life expectancy (QALE).", "Should expectations about the rate of new antiretroviral drug development impact the timing of HIV treatment initiation and expectations about treatment benefits?<||||>In base case analysis, considering the availability of new drugs raised the optimal starting CD4 threshold for most patients to 500 cells/mm3. The predicted gains in outcomes due to availability of pipeline drugs were generally small (less than 1%), but for young patients with a high viral load could add as much as a 4.9% (1.73 years) increase in LE and a 8% (2.43 QALY) increase in QALE, because these patients were particularly likely to exhaust currently available ART regimens before they died. In sensitivity analysis, increasing the rate of availability of new drugs did not substantially alter the results. Lowering the toxicity of future ART drugs had greater potential to increase benefit for many patient groups, increasing QALE by as much as 10%." ]

[ "Is weekly docetaxel an active and gentle chemotherapy in the treatment of metastatic breast cancer?<||||>Docetaxel is a very active drug against breast cancer, but at the standard dose causes severe myelosuppression. In order to reduce the toxicity while maintaining the activity, weekly docetaxel administration was tested.", "Is weekly docetaxel an active and gentle chemotherapy in the treatment of metastatic breast cancer?<||||>We enrolled 30 patients with metastatic breast cancer, who had been treated with intravenous infusion of weekly docetaxel 35 mg/m2 in 100 ml of normal saline over 30 minutes for six weeks, followed by two weeks' rest from docetaxel therapy (one cycle).", "Is weekly docetaxel an active and gentle chemotherapy in the treatment of metastatic breast cancer?<||||>The overall response rate was 33% (95% CI +/- 16.8%) and the estimated time to progression was 8 months. Acute toxicity was mild. Nail loss, excessive tearing and dysgeusia worsened the quality of life of the patients." ]

[ "Epidural blood patch in a patient with multiple sclerosis: is it safe?<||||>Multiple sclerosis (MS) is a chronic inflammatory and degenerative disease of the central nervous system resulting in demyelination and axonal injury. Epidural blood patch (EBP) to treat postdural puncture headache (PDPH) in an MS patient may be of concern because of the potential for this to interfere with axonal conduction. Even with normal axons, pressure can interfere with impulse conduction, and it is unknown whether affected axons of the MS patient are particularly vulnerable to the increase in epidural pressure that occurs as a consequence of the EBP. We describe our experience with EBP in an MS patient. While peridural pressure changes were not measured, we attempted to quantify any pressure-induced interference with axonal conduction by measuring changes in somatosensory evoked responses.", "Epidural blood patch in a patient with multiple sclerosis: is it safe?<||||>A 50-yr-old female MS patient required an EBP for a PDPH after a diagnostic lumbar puncture. The first EBP (20 mL autologous blood, L3-4 interspace) was followed by a transient improvement in PDPH and then a worsening with increased lower-extremity weakness. A second EBP was performed (12 mL autologous blood, L3-L4 interspace) with concomitant evoked potential recordings (stimulating electrodes over the left posterior tibial nerve and recording electrodes at CZ-FZ coordinates). Postdural puncture headache symptoms were permanently relieved, and the effects of the EBP on evoked P40 latency responses (39.7 msec and 44.3 msec pre- and post-EBP, respectively) were considered to be physiologically insignificant." ]

[ "High nerve growth factor blood concentration in renal transplantation: a new prognostic marker?<||||>Nerve growth factor (NGF) belongs to the family of neurotropic proteins NGF is markedly expressed in proteinuric renal diseases and in end-stage renal disease; it might be involved in kidney physiopathology. To date, little is known about NGF concentrations in kidney transplant recipients (KTRs). Because NGF exerts its action on cell survival and differentiation, tissue repair, and inflammatory responses, it may also be implicated in the pathogenesis of chronic allograft nephropathy. The aim of this study was to determine circulating NGF concentrations in KTRs and to ascertain their use as a prognostic marker for kidney transplant outcomes.", "High nerve growth factor blood concentration in renal transplantation: a new prognostic marker?<||||>Using enzyme-linked immunosorbent assay, we performed quantification of NGF in the serum of 40 prevalent KTRs at baseline and at 6 months.", "High nerve growth factor blood concentration in renal transplantation: a new prognostic marker?<||||>NGF concentrations in KTRs averaged 1.16 ± 0.67 ng/mL. They negative-linearly correlated with recipient age. Logistic multivariate regression analysis showed NGF to be independently associated with increased proteinuria over the 6-month follow-up." ]

[ "Injection of the rheumatoid knee: does intra-articular methotrexate or rifampicin add to the benefits of triamcinolone hexacetonide?<||||>Does the addition of 600 mg rifampicin or 50 mg methotrexate improve pain relief after injection of the rheumatoid knee with 20 mg triamcinolone hexacetonide (TH)?", "Injection of the rheumatoid knee: does intra-articular methotrexate or rifampicin add to the benefits of triamcinolone hexacetonide?<||||>Eighty-two patients on stable therapy were allocated at random to receive intra-articular TH alone, TH and methotrexate (TH+M) or TH and rifampicin (TH+R). Pain was recorded by a weekly chart and analysed using the area under the curve (AUC), periods of total pain relief and duration of effect. Examinations and microwave thermography were performed by an independent meteorologist at baseline, 3 and 6 months.", "Injection of the rheumatoid knee: does intra-articular methotrexate or rifampicin add to the benefits of triamcinolone hexacetonide?<||||>Using the AUC, pain was significantly better in the TH+R group compared with TH alone (P=0.039, Mann Whitney U). The median duration of improved pain scores was 13.5 weeks with TH alone, 10 with TH+M and 19 with TH+R. Examination and microwave thermography revealed improvements compared with baseline, but there were no significant differences between the groups. Eleven of 28 patients treated with TH + R developed a flare of post-injection pain." ]

[ "Comparison of visual inspection and Papanicolau (PAP) smears for cervical cancer screening in Honduras: should PAP smears be abandoned?<||||>To compare visual inspection with acetic acid (VIA) to Papanicolau (PAP) smears in a community setting in a developing nation.", "Comparison of visual inspection and Papanicolau (PAP) smears for cervical cancer screening in Honduras: should PAP smears be abandoned?<||||>Women undergoing cervical cancer screening in Honduras received either VIA and PAP smears (VIA/PAP group) or PAP smears alone (PAP-only group). Local healthcare providers performed PAP screening. A VIA-trained nurse performed VIA exams. All PAP smears were processed in Honduras. PAP smears from the VIA/PAP group were reviewed in the United States. Women with positive VIA or PAP tests were offered colposcopy. We compared the relative accuracy of PAP smears and VIA and the proportions of women completing follow-up colposcopy after positive screening tests.", "Comparison of visual inspection and Papanicolau (PAP) smears for cervical cancer screening in Honduras: should PAP smears be abandoned?<||||>In total, 1709 PAP smears were performed including women from both the VIA/PAP and PAP-only groups. Nine PAP smears were positive (0.5%). Three women completed colposcopy (33%). All three had biopsy-confirmed dysplasia. In the VIA/PAP group (n = 339), 49 VIA exams were abnormal (14%) and two PAP smears were abnormal when read in Honduras (0.6%). When reviewed in the United States, 14 of the 339 PAP smears were abnormal (4%). Forty women (83%) completed follow-up colposcopy after a positive VIA exam. Twenty-three had biopsy-proven dysplasia. All 23 dysplasia cases had negative PAP smear readings in Honduras; four PAP smears were reclassified as positive in the United States." ]

[ "Accessibility plan: can offer a higher quality for a lower cost?<||||>Redirect demand pathology severity level IV-V of the hospital emergency room (ED) to the Primary Health Care (AP) reference, increase in technical consultation and assess the effectiveness of the proposed Accessibility Plan (PA). Improving the quality of care offered, lowering the cost to achieve it.", "Accessibility plan: can offer a higher quality for a lower cost?<||||>Quality research study conducted in January-2010 data collected throughout 2009, and compare them versus those obtained in 2008.", "Accessibility plan: can offer a higher quality for a lower cost?<||||>Population allocated to the ABS Sagrada Familia (23,265 users).", "Accessibility plan: can offer a higher quality for a lower cost?<||||>Beneficiaries in HUS AP and population due to specialized care, population scheduled diagnostic and therapeutic procedures (radiology, laboratory echo-doppler, cryosurgery ...), total annual visits, attendance, repetition,...", "Accessibility plan: can offer a higher quality for a lower cost?<||||>Increased 86.5% of emergency radiographs in AP (avoiding lead to ED), 7.4% fewer referrals to the emergency; implantation circuit urgent analytical (laboratory of HUS not collapsed) 13.6% fewer referrals to vascular surgery (the Eco-Doppler), 5.92% less analytical (thank Cardio-Check), 297 fewer referrals to dermatology (for cryotherapy), 9.65% less refe- rrals to psychiatry (through group workshops mental health), decreased frequency (1.4%) and recurrence (2.3%) over 2007, 23.9% of referrals to ED pathology avoided level IV-V served in AP; save ∈ 57,335 on 2007." ]

[ "Do 'auditory processing' tests measure auditory processing in the elderly?<||||>To examine the associations between measures of auditory processing and measures of auditory or cognitive function in elderly listeners with impaired hearing.", "Do 'auditory processing' tests measure auditory processing in the elderly?<||||>Multiple measures of auditory processing, auditory function, and cognitive function were obtained and linear, multiple-regression analyses were conducted to examine the relations between these sets of variables. In particular, four measures of auditory processing were obtained from each of 213 elderly participants. Measures of auditory processing included duration discrimination for a 1000-Hz pure tone, temporal-order discrimination for mid-frequency pure tones, dichotic syllable identification, and recognition of 45% time-compressed monosyllables. Each participant also completed additional measures of auditory function, including pure-tone thresholds, auditory brain stem responses for each ear and at two presentation rates (11.1 and 71.1 clicks per second), and performance-intensity functions for monosyllabic words (PI-PB rollover). Finally, three measures of cognitive function, all from the Wechsler Adult Intelligence Scale-Revised, were obtained from the 213 participants.", "Do 'auditory processing' tests measure auditory processing in the elderly?<||||>For three of the four measures of auditory processing examined in this study (duration discrimination, temporal-order discrimination, and dichotic CV identification), a measure of cognitive function (IQ) and age were the two primary predictors of individual differences in performance. For these three measures of auditory processing, 11 to 14% of the total variance could be accounted for by the predictor variables. For the remaining measure of auditory processing (recognition of time-compressed monosyllables), 56% of the total variance could be accounted for by a set of four predictor variables, but most of this variance (54% of the total variance) was associated with individual differences in hearing loss. When hearing loss was removed as a predictor for this measure of auditory processing, 14% of the total variance was explained by four variables: age, IQ, and two measures derived from auditory brain stem response wave-V latency." ]

[ "Is the food frequency consumption essential as covariate to estimate usual intake of episodically consumed foods?<||||>BACKGROUNDS/", "Is the food frequency consumption essential as covariate to estimate usual intake of episodically consumed foods?<||||>The aim of this paper is to verify the performance of the frequency of consumption as variable for prediction of the usual intakes of foods.SUBJECTS/", "Is the food frequency consumption essential as covariate to estimate usual intake of episodically consumed foods?<||||>In total, 725 individuals who answered two nonconsecutive 24-h recall and one food frequency questionnaire (FFQ) in the 'Healthy Survey-Sao Paulo-Brazil'. An additional indicator variable indicating if one is usual consumer was created before analyzing. The Multiple Source Method and National Cancer Institute method were used to estimate usual intake of selected food considering different models of prediction: with no covariates; with FFQ; with FFQ plus indicator variable; and with only indicator variable.", "Is the food frequency consumption essential as covariate to estimate usual intake of episodically consumed foods?<||||>For foods that are consumed every day or almost every day, the inclusion of the FFQ and/or the indicator variable as covariates resulted in similar percentiles of consumption when compared with the model with no covariates. For episodically consumed foods, the models with FFQ plus indicator variable and with only indicator variable estimated similar percentiles of intake." ]

[ "Can nitric oxide induce migraine in normal individuals?<||||>For many years, scientists have debated the possibility that an individual \"migraine threshold\" determines the likelihood with which individuals may express migraine attacks.", "Can nitric oxide induce migraine in normal individuals?<||||>Recent discoveries provided evidence for both genetic and environmental influences on individual migraine expression. The question is whether any person may express a migraine attack given a sufficiently strong stimulus or provocation. Here, we reviewed and discussed the ability of nitric oxide to induce migraine-like attacks in normal individuals." ]

[ "Physicians' attitudes toward preventive therapy for coronary artery disease: is there a gender bias?<||||>While much of the gender difference in the treatment of coronary artery disease (CAD) results from the fact that the women being treated are older and have more comorbidities, it remains to be established whether a true gender bias exists. We compared physicians' attitudes and practice toward preventive therapy in men and women with CAD.", "Physicians' attitudes toward preventive therapy for coronary artery disease: is there a gender bias?<||||>Physicians perceive the prevention of CAD in men as more important than in women.", "Physicians' attitudes toward preventive therapy for coronary artery disease: is there a gender bias?<||||>In the \"attitude study,\" we obtained data on the attitudes of 172 physicians toward treatment, using hypothetical case histories of 58-year-old male and postmenopausal female patients with identical clinical and laboratory data and mild coronary atherosclerosis on angiography. In the \"actual practice study,\" we evaluated the lipoprotein levels and prescription of lipid-lowering medications from medical records of 344 male and female patients with angiographic evidence of CAD.", "Physicians' attitudes toward preventive therapy for coronary artery disease: is there a gender bias?<||||>In the hypothetical case histories, physicians in general considered the male patient to be at higher risk and prescribed aspirin (91 vs. 77%, p<0.01) and lipid-lowering medications (67 vs. 54%, p<0.07) more often for the male patient. Evaluation of medical charts of patients with CAD revealed that in patients with baseline low-density lipoprotein cholesterol>110 mg/dl, 77% of the males received a lipid-lowering medication, compared with only 47% of the female patients (p<0.001)." ]

[ "Ionizing radiation exposure in patients with inflammatory bowel disease: are we overexposing our patients?<||||>Imaging techniques are accurate and reliable in diagnosing inflammatory bowel disease (IBD). However, the main disadvantage of computed tomography (CT) compared with magnetic resonance imaging (MRI) is radiation exposure and the potential risk of cancer, especially since IBD patients are at increased risk of malignancies. This study aims to quantify and characterize effective radiation exposure of IBD patients.", "Ionizing radiation exposure in patients with inflammatory bowel disease: are we overexposing our patients?<||||>A cohort of IBD patients were retrospectively enrolled in the Clínica las Condes IBD registry between 2011 and 2013. High cumulative radiation exposure (CED) was defined as ≥-50 mSv.", "Ionizing radiation exposure in patients with inflammatory bowel disease: are we overexposing our patients?<||||>A total of 325 IBD patients were enrolled in our registry, including 243 (74.8%) with UC and 82 (25.2%) with CD. The patients with CD were more commonly to reach a high CED seen compared with those with UC (19.5% vs 2.5%). Higher exposure to radiation was associated with longer duration of disease, ileal involvement, stricturing behavior, treatments with steroids and biological agents and CD-related hospitalization or surgery. Abdominopelvic CT and enteroclysis CT accounted for 93.6% of total CED." ]

[ "Is there a standard trochanteric entry site for nailing of subtrochanteric femur fractures?<||||>To evaluate the variability of the ideal trochanteric starting point as a possible cause for malreduction of subtrochanteric fractures and to analyze the accuracy of contralateral templating to predict correct entry site.", "Is there a standard trochanteric entry site for nailing of subtrochanteric femur fractures?<||||>Standardized anteroposterior pelvis radiographs of 50 patients were evaluated by two independent reviewers. Patients with advanced osteoarthritis, severe hip deformity, and radiographs with asymmetric hip rotation were excluded. Ideal nail entry site was established using a template for a trochanteric nail with a 6° proximal bend. The distance from the greater trochanteric tip to the ideal nail entry site was measured. Additionally, offset of the greater trochanter tip from the femoral longitudinal axis was measured. Interobserver reliability and accuracy of contralateral templating were evaluated.", "Is there a standard trochanteric entry site for nailing of subtrochanteric femur fractures?<||||>The ideal entry point ranged from 16 mm medial to 8 mm lateral to the trochanteric tip (mean, 3 mm medial; standard deviation, 5 mm). In 70% of patients, the ideal entry point was medial to and in 23% lateral to the tip of the greater trochanter. Ideal entry points were located within 2 mm of the trochanteric tip in 29% and within 4 mm in 44% of patients. The location of the ideal entry point relative to the trochanteric tip had a weak correlation with patient height and neck shaft angle (r: -0.23 and r: -0.35, respectively). Interobserver reliability and agreement between left and right side measurements were strong (intraclass correlation coefficient:>0.94 and>0.88, P<0.001, respectively). The mean measurement differences between sides was 0 mm (95% confidence interval: -1 to 1). Greater trochanter offset averaged 15 mm (range, 5-26 mm; standard deviation: 5) on the right and 15 mm (range, 5-25 mm; standard deviation: 5.1) on the left (P = 0.95)." ]

[ "Does hyperexpansion of the native lung adversely affect outcome after single lung transplantation for emphysema?<||||>The authors evaluated the effect of the native emphysematous lung on graft function after single lung transplantation.", "Does hyperexpansion of the native lung adversely affect outcome after single lung transplantation for emphysema?<||||>Thirty-two patients who underwent single lung transplantation were examined with radiography preoperatively for degree of emphysema and postoperatively for hyperexpansion of the native lung. All patients underwent ventilation-perfusion scanning before transplantation and ventilation scanning after transplantation. Pulmonary function tests and measurement of arterial partial pressure of oxygen were also measured before and after surgery. The postoperative course was graded on a subjective scale.", "Does hyperexpansion of the native lung adversely affect outcome after single lung transplantation for emphysema?<||||>Hyperexpansion of the native lung was seen in 16 of the 32 patients in the postoperative period. On the basis of serial measurements of forced expiratory volume in 1 minute, these patients fared poorly in the postoperative period compared with patients without hyperexpansion. Pulmonary blood flow to the native lung, as measured with perfusion scintigraphy, paradoxically increased in 11 patients after transplantation. Nine of these 11 patients demonstrated hyperinflation of the native lung, suggesting that graft compression adversely affects blood flow to the transplanted lung." ]

[ "Does the tonsillar surface flora differ in children with and without tonsillar disease?<||||>To investigate whether the tonsillar flora differ in children with and without adenotonsillar disease.", "Does the tonsillar surface flora differ in children with and without tonsillar disease?<||||>Tonsil surface swabs were taken from 218 children indicated for adenotonsillectomy because of moderate symptoms of recurrent tonsillopharyngitis or adenotonsillar hypertrophy (T+Ads group). Control swabs were taken from 100 children without symptoms of adenotonsillar disease who visited the ophthalmology clinic. Potential respiratory pathogens were identified.", "Does the tonsillar surface flora differ in children with and without tonsillar disease?<||||>Potential respiratory pathogens were found in 54% of the T+Ads group, compared to 41% of the control group (p = 0.04). Haemophilus influenzae was the commonest pathogen in both groups, being found in 41% of the T+Ads group and 34% of the control group. Moraxella catarrhalis was found more often in the T+Ads group compared to the control group: 7% vs 0% (p = 0.004). H. influenzae was found in 32% of the children with recurrent tonsillitis, compared to 48% of the children with symptoms of tonsillar hypertrophy (p = 0.03)." ]

[ "Are third-trimester adipokines associated with higher metabolic risk among women with gestational diabetes?<||||>A total of 221 women with GDM (according to IADPSG criteria) were enrolled between 2011/11 and 2013/6 into a prospective observational study (IMAGE), and categorized as having elevated fasting blood glucose (FBG) or impaired fasting glucose (IFG, n = 36) if levels were ≥ 92 mg/dL during a 75-g oral glucose tolerance test (OGTT), impaired glucose tolerance (IGT, n = 116) if FBG was<92 mg/dL but with elevated 1-h or 2-h OGTT values, or impaired fasting and stimulated blood glucose (IFSG, n = 69) if both FBG was ≥ 92 mg/dL and 1-h or 2-h OGTT values were elevated.", "Are third-trimester adipokines associated with higher metabolic risk among women with gestational diabetes?<||||>Pre-gestational body mass index (BMI) was higher in women with IFG or IFSG compared with IGT (P<0.001), as were leptin levels in women with IFG vs IGT [34.7 (10.5-119.7) vs 26.6 (3.56-79.4) ng/L; P = 0.008]. HOMA2-IR scores were higher in women with IFG or IFSG vs IGT (1.87 ± 1.2 or 1.72 ± 0.9 vs 1.18 ± 0.8, respectively; P<0.001). Also, those with IFSG vs those with IGT had significantly lower HOMA2-B scores (111.4 ± 41.3 vs 127.1 ± 61.6, respectively; P<0.05) and adiponectin levels [5.00 (1.11-11.3) vs 6.19 (2.11-17.7) μg/mL; P<0.001], and higher levels of IL-6 [1.14 (0.33-20.0) vs 0.90 (0.31-19.0); P = 0.012]and TNF-α [0.99 (0.50-10.5) vs 0.84 (0.45-11.5) pg/mL; P = 0.003]. After adjusting for age, parity, and pre-gestational and gestational BMI, the difference in adiponectin levels remained significant." ]

[ "Are tuberculosis advisory committees well-functioning?<||||>To evaluate the function status of TB advisory committee to assess treatments of tuberculosis.", "Are tuberculosis advisory committees well-functioning?<||||>Estimate by questionnaire sheets to public health nurses attending to seminars on tuberculosis at Research Institute of Tuberculosis.", "Are tuberculosis advisory committees well-functioning?<||||>137 answers are available for analysis. Of these, 57 (41.6%) TB advisory committees are estimated not to assess treatments of tuberculosis at all and/or to assess treatments without necessary informations on drug sensitivity in more than around half of the cases. In 13 (16.3%) committees of the other 80, many cases are in fact self-assessed. Number of committees that are estimated to functioning well is only 44 (32.1%)." ]

[ "Is serum uric acid level associated with all-cause mortality in high-functioning older persons: MacArthur studies of successful aging?<||||>To explore the effect of serum uric acid level on subsequent all-cause mortality in high-functioning community-dwelling older persons. It is controversial whether high serum uric acid level is a true independent risk factor for cardiovascular and total mortality or the association is due to other confounding variables. Furthermore, it remains unclear whether the predictive value of uric acid level on mortality observed in younger cohorts can be extended to older people.", "Is serum uric acid level associated with all-cause mortality in high-functioning older persons: MacArthur studies of successful aging?<||||>Prospective cohort study.", "Is serum uric acid level associated with all-cause mortality in high-functioning older persons: MacArthur studies of successful aging?<||||>A sample of community-dwelling older people.", "Is serum uric acid level associated with all-cause mortality in high-functioning older persons: MacArthur studies of successful aging?<||||>A cohort of 870 participants from the MacArthur Studies of Successful Aging.", "Is serum uric acid level associated with all-cause mortality in high-functioning older persons: MacArthur studies of successful aging?<||||>Baseline information was obtained for serum uric acid level, C-reactive protein (CRP), interleukin-6 (IL-6), prevalent medical conditions, and health behaviors. Crude and multivariate logistic regression analyses were used to examine the association between serum uric acid levels and 7-year all-cause mortality, while adjusting for potential confounders.", "Is serum uric acid level associated with all-cause mortality in high-functioning older persons: MacArthur studies of successful aging?<||||>In men, the multiply adjusted risk ratios for 7-year total mortality were 1.07 (95% CI=0.61-1.88) for the mid tertile of uric acid level and 1.24 (95% CI=0.70-2.20) for the top tertile. In women, the multiply adjusted risk ratios were 0.58 (95% CI=0.29-1.18) and 0.47 (95% CI=0.22-0.99), for the mid and top tertiles respectively. CRP and IL-6 were important confounders in the relationship between serum uric acid and overall mortality." ]

[ "Do sexual health services encourage teenagers to use condoms?<||||>Sexual health services have the potential to encourage teenagers' condom use through both the free supply of condoms and counselling. This study investigated whether 15/16-year-olds who attended sexual health services used condoms more and had different beliefs about condoms compared to those who did not use these services.", "Do sexual health services encourage teenagers to use condoms?<||||>First, a cross-sectional multivariate model investigated the association between service visits and condom consistency (a ratio of the number of times a condom was used to the number of times a teenager had sexual intercourse in the past year) in teenagers at age 15/16 years (n = 1013). Second, a longitudinal multivariate model examined links between service use and changes in condom-related cognitions measured at age 13/14 and age 15/16 years (n = 3432).", "Do sexual health services encourage teenagers to use condoms?<||||>Visiting a service for free condoms was linked with greater condom consistency, after controlling for attitudes towards condoms, condom purchase and other factors. Visiting a service for other purposes was associated with lower consistency. Obtaining free condoms from services predicted greater condom self-efficacy and personal responsibility, and lower negative feelings relating to sexual pleasure when condoms were used. However, visiting a service for other purposes predicted less positive attitudes towards dual protection." ]

[ "Do video reviews of therapy sessions help people with mild intellectual disabilities describe their perceptions of cognitive behaviour therapy?<||||>This study examined the potential of a retrospective video reviewing process [Burford Reviewing Process (BRP)] for enabling people with intellectual disabilities to describe their experiences of cognitive behaviour therapy (CBT). It is the first time that the BRP, described in this paper, has been used with people with intellectual disabilities and the aim was to assess the feasibility of the procedure and gain a picture of the information it might yield.", "Do video reviews of therapy sessions help people with mild intellectual disabilities describe their perceptions of cognitive behaviour therapy?<||||>Using the BRP, 12 clients reviewed tapes of their fourth and ninth CBT sessions and six reviewed the fourth session only. All reviews were audio recorded for later verbatim transcriptions of clients' comments. Reviews and transcriptions were conducted by non-clinical researchers. Thematic analysis was applied to the transcripts by a researcher who was not CBT-trained.", "Do video reviews of therapy sessions help people with mild intellectual disabilities describe their perceptions of cognitive behaviour therapy?<||||>All clients were able to follow the instructions for the BRP. Three broadly based themes encapsulated their responses - how they felt about themselves, how they felt the therapist was helping and how CBT was helping. A fourth theme referred to comments on issues that were currently troubling clients, which were prompted by watching the video but did not refer to actual events on screen." ]

[ "Adolescents engaging in unhealthy weight control behaviors: are they at risk for other health-compromising behaviors?<||||>This study sought to determine whether adolescents engaging in weight control behaviors are at increased risk for tobacco, alcohol, and marijuana use; suicide ideation and attempts; and unprotected sexual activity.", "Adolescents engaging in unhealthy weight control behaviors: are they at risk for other health-compromising behaviors?<||||>Data were collected on a nationally representative sample of 16,296 adolescents taking part in the 1993 Youth Risk Behavior Survey.", "Adolescents engaging in unhealthy weight control behaviors: are they at risk for other health-compromising behaviors?<||||>Adolescents using extreme weight control behaviors were at increased risk for health-compromising behaviors, while associations with other weight control behaviors were weak and inconsistent." ]

[ "Can a single cephalometric measurement predict obstructive sleep apnea severity?<||||>To look for an association between the vertical position of the hyoid, as measured by the sella-hyoid (S-H) distance and the severity of obstructive sleep apnea (OSA). A previously published study on this subject showed a significant correlation between S-H distances more than 120 mm and severe OSA.", "Can a single cephalometric measurement predict obstructive sleep apnea severity?<||||>A retrospective study of patients who were treated with a mandibular advancement splint (MAS) for sleep disordered breathing during June 2000 to May 2005 at the orthodontic department of Colchester University Hospital.", "Can a single cephalometric measurement predict obstructive sleep apnea severity?<||||>One hundred and six consecutive patients who were treated with MAS during the period.", "Can a single cephalometric measurement predict obstructive sleep apnea severity?<||||>Lateral cephalograms were taken and traced prior to the provision of MAS therapy, and the distance S-H was measured. The mean S-H distance was 125.5 mm (103-148 mm) with a median of 126 mm. Four out of 8 patients (50%) with severe OSA had a S-H distance more than 120 mm, as did 38 out of 50 (76%) with mild to moderate OSA (AHI 5-30), and 17 out of 22 patients (77.27%) with an AHI of 0 to 4. No significant correlations between the S-H distance and the severity of OSA were found (Pearson correlation coefficient -0.034 and 95% confidence interval: -0.25, 0.18)." ]

[ "Is lower-dose digital fluorography diagnostically adequate compared with higher-dose digital radiography for the diagnosis of fallopian tube stenosis?<||||>In an effort to reduce patient radiation dose during selective fallopian tube catheterization, the diagnostic adequacy of fluoroscopic images was compared with digital radiographic images in both a phantom study and a clinical study.", "Is lower-dose digital fluorography diagnostically adequate compared with higher-dose digital radiography for the diagnosis of fallopian tube stenosis?<||||>For the phantom study polyethylene tubes with inner diameters of 1.30, 0.95, 0.80, 0.57, and 0.45 mm were used. Randomly selected tubes with/without stenoses, recorded by digital radiographic and last-image hold fluoroscopic images, were presented to five blinded radiologists, and receiver-operating characteristic (ROC) analyses were performed. For the clinical study tubal visualization as well as detectability of stenoses and occlusions were analyzed in 14 women using a 2-way analysis of variance for nonrepeated measures.", "Is lower-dose digital fluorography diagnostically adequate compared with higher-dose digital radiography for the diagnosis of fallopian tube stenosis?<||||>The phantom study showed no significant differences between the two imaging techniques for 0.57-mm-diameter and larger tubes; in contrast, fluoroscopic images provided significantly lower detectability of stenoses in 0.45-mm-diameter tubes (p<0.05). The clinical study showed inferior tubal visualization and diagnostic performance for fluoroscopic images." ]

[ "Street outreach rapid HIV testing in university settings: a priority strategy?<||||>To evaluate an HIV testing program in the university environment by analyzing the prevalence of infection, risk behaviors and history of sexually transmitted infections and by performing HIV tests.", "Street outreach rapid HIV testing in university settings: a priority strategy?<||||>During October-November of 2008 and November-December of 2009, 1668 persons received rapid HIV testing in a mobile unit located in university campuses in the cities of Madrid, Málaga and Salamanca (Spain). While waiting for the test results, participants completed a brief questionnaire.", "Street outreach rapid HIV testing in university settings: a priority strategy?<||||>A total of 15.7% were men who had sex with men (MSM), 28.6% were exclusively heterosexual men (HTX), and 55.7% were women. Nearly three-quarters (73.3%) were under 25 years of age, 8.5% were born abroad and only 4% had no secondary education. Fifty-one percent of HTX, 42% of women and 6.3% of MSM had casual sexual partners in the past 12 months without always using a condom. This behavior was also reported by 41.5% of MSM with same sex partners. A sexually transmitted infection had previously been diagnosed in 24.7% of MSMs, 14.7% of women and 5.6% of HTX. Four positive results were found, all in MSM who had been tested in the previous 2 years. The prevalence was 1.6% (95% CI: 0.43-3.95) within this group, and 0.2% overall (95% CI: 0.07-0.62)." ]

[ "Are patients with non-muscle-invasive bladder cancer a suitable population for a lung cancer screening trial?<||||>Prognosis (case series) Level of Evidence 4.", "Are patients with non-muscle-invasive bladder cancer a suitable population for a lung cancer screening trial?<||||>To estimate the relative risk of developing a second primary neoplasm, in particular lung cancer, after having non-muscle-invasive bladder cancer (NMIBC).", "Are patients with non-muscle-invasive bladder cancer a suitable population for a lung cancer screening trial?<||||>Patients were included in the study if they had developed NMIBC between 1995 and 2003. All clinical data were extracted from the medical records of our institution's database. The interval between neoplasms, smoking habits, histological subtypes and survival were also analysed. Patient follow-up was>or=5 years.", "Are patients with non-muscle-invasive bladder cancer a suitable population for a lung cancer screening trial?<||||>We found 231 patients with NMIBC, 39 of which had a second primary neoplasm: 10 lung cancer, one pancreas, one gastric, one pharynx, one liver, one parathyroid, one oesophageal, five basal cell carcinoma, three larynx, two colon, three rectal and 10 prostate. In patients with lung cancer, NMIBC was the first primary tumour. Overall, the median (range) interval between occurrence of NMIBC and lung cancer was 54.2 (8-168) months. For the relationship between the observed and expected cases of lung cancer, after normalizing our frequencies to the sex ratio and age of our group of patients, the risk of lung cancer was 10.27-fold higher in patients with NMIBC as compared with the general population of Catalonia (95% confidence interval 4.92-18.88)." ]

[ "Conference attendance: do we meet the new residency review committee requirements?<||||>To characterize the attendance at and presenters of conferences given to emergency medicine residents and to determine the ability of emergency medicine residents to attend conferences while working in the emergency department and on off-service rotations.", "Conference attendance: do we meet the new residency review committee requirements?<||||>Descriptive study of an anonymous mail survey.", "Conference attendance: do we meet the new residency review committee requirements?<||||>Residency directors of all approved emergency medicine residency programs in the United States.", "Conference attendance: do we meet the new residency review committee requirements?<||||>Seventy-six of 95 questionnaires (80%) were returned. We defined \"high attendance\" at emergency medicine conferences as a reported average of at least 75% attendance by emergency medicine resident physicians. Fifty percent of respondents reported high attendance. Conversely, 17% of programs reported poor attendance, which we defined as an average attendance by 50% or fewer emergency medicine resident physicians. Forty-eight percent of programs reported that emergency medicine faculty conducted more than 50% of the conferences, and 16% reported that the faculty conducted 25% or fewer conferences. Ninety-six percent of programs allowed residents to attend conferences during off-service rotations. Ninety-two percent of programs relieved residents of clinical responsibilities during scheduled shifts in the emergency department so that they might attend lectures." ]

[ "Does peak nasal inspiratory flow relate to peak expiratory flow?<||||>Measurement of Peak Nasal Inspiratory Flow (PNIF) seems to be a cheap and easily performed method to assess nasal patency. As demonstrated in a previous work, PNIF is influenced by SEX, AGE and HEIGHT. However there is a large degree of between-patient variability in PNIF levels. The purpose of this analysis is to determine whether the measurement of the pulmonary ventilatory capacity, by mean of Peak Expiratory Flow (PEF), enables more precise determination of PNIF.", "Does peak nasal inspiratory flow relate to peak expiratory flow?<||||>Repeated measurements of PNIF and PEF were performed in 112 volunteers. 100 of these fulfilled the study criteria (55 females and 45 males) and all of them were non-smokers, non-asthmatic, without nose and paranasal sinuses problems, with ages ranging from 15 to 71 years. Statistical analysis was undertaken to determine whether a relationship existed between PNIF and age, sex and height, but which also considered PEF. The data from both experiments were analysed together. In both groups there is a clear tendency for PNIF to increase with PEF. As clearly demonstrated in this work the value of PEF is informative in predicting PNIF and that the larger the value of PEF, the larger the value of PNIF." ]

[ "Does sucralfate reduce early side effects of pelvic radiation?<||||>", "Does sucralfate reduce early side effects of pelvic radiation?<||||>A double-blind placebo-controlled study randomized 108 patients to investigate the effect of sucralfate on gastrointestinal side effects of pelvic radiation.", "Does sucralfate reduce early side effects of pelvic radiation?<||||>Overall, pelvic radiation with the administered doses and fields and performed according to nowadays technical standards, was well tolerated. Comparison of the mean scores and the peak reactions for radiotherapy discomfort, diarrhoea and number of stools per day in the 80 evaluable patients showed no statistically significant difference between sucralfate and placebo." ]

[ "Do German DRGs appropriately explain the resource consumption of hospitals?<||||>The revenues of German hospitals are mainly determined by DRG-based payments. Therefore DRGs should appropriately explain the resource consumption of hospitals in order to avoid unintended consequences. So far little is known about the ability of German DRGs to adequately reflect the cost of a hospital stay.", "Do German DRGs appropriately explain the resource consumption of hospitals?<||||>Regression techniques were applied using anonymised year 2008 cost and performance data of 50,156 cases from 29 hospitals for 10 common episodes of care in order a) to analyse the impact of patient and treatment characteristics on costs and b) to test if DRG variables are better in explaining resource consumption than this set of patient variables.", "Do German DRGs appropriately explain the resource consumption of hospitals?<||||>Depending on the episode of care, patient and treatment variables have a different impact on hospital costs. However, they are better in explaining resource consumption than the DRG variables for each episode of care. In addition, independent of the patient characteristics hospitals have an impact on costs which might be due to factors that are not considered by the DRG-system." ]

[ "Does the extent of resection impact survival for duodenal adenocarcinoma?<||||>Because duodenal adenocarcinoma (DA) is relatively rare, few studies have investigated the impact of resection type on long-term outcomes.", "Does the extent of resection impact survival for duodenal adenocarcinoma?<||||>The Surveillance, Epidemiology, and End Results database was used to identify all patients between 1988 and 2010 with DA. Patients were divided into two groups based on the type of surgery received: simple resection (SR), defined as a simple removal of the primary site, and radical resection (RR), defined as removal of the primary site with a resection in continuity with other organs. Differences in disease-specific survival (DSS) and overall survival (OS) were compared.", "Does the extent of resection impact survival for duodenal adenocarcinoma?<||||>Of the 1,611 patients included, 746 (46.3 %) underwent SR and 865 (53.7 %) underwent RR. As expected, patients undergoing RR were more likely to present with poorly differentiated and large tumors, as well as advanced stage disease. Despite greater lymph node (LN) retrieval (11.0 vs. 6.8; p < 0.0001), RR was not associated with improved survival (5-year DSS and OS rates of 52.8 and 41.3 % for SR vs. 48.8 and 37.6 % for RR; p > 0.05). On univariate Cox proportional hazards regression analysis, the type of surgery was not associated with OS (odds ratio [OR] 0.98; 95 % confidence interval [CI]0.87-1.11). Increasing TNM stages, tumor grade, fewer LNs removed, LN ratio, and absence of radiation were associated with worse survival. After controlling for confounding factors, type of surgery still did not influence OS (OR 1.11; 95 % CI 0.97-1.27)." ]

[ "Does sperm origin affect embryo morphokinetic parameters?<||||>The purpose of our study was to use time-lapse in order to evaluate the impact of sperm origin (fresh ejaculate or surgically retrieved) on embryo morphokinetic parameters and clinical outcome in intracytoplasmic sperm injection (ICSI) cycles.", "Does sperm origin affect embryo morphokinetic parameters?<||||>This retrospective monocentric study was conducted in 485 unselected couples undergoing 604 ICSI cycles with embryo culture in the Embryoscope®. Among them, 445 couples underwent ICSI cycle with fresh ejaculated sperm and 40 with surgically retrieved sperm (26 with testicular sperm and 14 with epididymal sperm). Embryo morphokinetic parameters and clinical cycle outcome were compared between fresh ejaculated sperm and surgically retrieved sperm. A subgroup analysis was also conducted between testicular and epididymal sperm ICSI cycles.", "Does sperm origin affect embryo morphokinetic parameters?<||||>Clinical outcome was comparable between groups according to sperm origin. Although most early morphokinetic parameters were comparable between ejaculated and surgical sperm groups, a few parameters were significantly different between both groups, but with a considerable overlap in their distribution. Late cellular events occurred significantly later in the surgical sperm group than in the ejaculated sperm group." ]

[ "Peroneal nerve neuropathy in cancer patients: a paraneoplastic syndrome?<||||>To investigate the occurrence of symptomatic peroneal neuropathy (PN) in cancer patients, as well as that of cancer in PN patients and to seek possible factors in the aetiology of PN.", "Peroneal nerve neuropathy in cancer patients: a paraneoplastic syndrome?<||||>Clinical, neurographical, and myographical data of patients with PN, in two general neurology clinics during a 5-year period (1988-1992) were analysed retrospectively. A population-based cancer registry was consulted for epidemiological data in the area.", "Peroneal nerve neuropathy in cancer patients: a paraneoplastic syndrome?<||||>The catchment population of the two clinics consisted of 433,142 people, and 8,766 new cancer patients were diagnosed. PN was diagnosed in 372 patients, of whom 74 suffered from cancer (in 56 PN was believed to be related to cancer). The crude relative risk of PN in patients with cancer compared with patients without cancer was 8.6. After correction for differences in age and sex between the compared groups, the relative risk dropped to 3.4 (2.8 for women and 3.6 for men). The crude relative risk of cancer for patients with PN relative to people without PN was 7.5. The relative risk, after correction for age and sex, was 2.8 (2.5 for women and 2.9 for men). All relative risks were significant (P<0.001), but did not differ between the sexes (P>0.4). Weight loss was established in 35/56 patients, but in 17/56 it was unknown. PN has not been found to be part of a polyneuropathy. Chemotherapy did not play a causal part. In some patients PN preceded the diagnosis of cancer." ]

[ "'You become a man in a man's world': is there discursive space for women in surgery?<||||>The UK set a target of 20% of the surgical consultant workforce to be represented by women by 2009; in 2012, it remains 7%. Studies have attributed this shortfall to the nature of careers in surgery and differing career aspirations among women.", "'You become a man in a man's world': is there discursive space for women in surgery?<||||>Rather than exploring barriers to participation, this study aims to explore the self-narratives of those women who do undertake surgical careers and who do come to see themselves as surgeons.", "'You become a man in a man's world': is there discursive space for women in surgery?<||||>The study comprises 15 individual interviews with women in surgical careers, from those aspiring to be surgeons, to senior and retired surgeons. Data were explored using discourse analysis with a priori themes derived from the literature on women in surgery and Holland et al.'s theoretical framework of Figured Worlds.", "'You become a man in a man's world': is there discursive space for women in surgery?<||||>Discourses of being a surgeon and discourses of being a woman, existed in competition. Female surgeons figured surgery as a career requiring 100% dedication, as they did motherhood, although the demands of the two roles differed and consequently the roles were not discursively compatible. Many related powerfully negative experiences in which their gender had marked them out as 'other' within surgery. Women described how they were expected to show masculine traits as surgeons and the ways to consequently become legitimate in the surgical world as a 'woman surgeon'. They found creative ways to articulate how women in general, and feminine qualities in particular, enhanced surgery. Finally, some women engaged in identity work, termed 'world making', - the creative orchestration of discourses of surgeonhood and motherhood to be mutually sustaining." ]

[ "Does the proven benefit of mammography extend to breast cancer patients over age 70?<||||>Prospective randomized studies show reduced breast cancer mortality among women offered mammographic screening; yet, few women 70 or older were represented in these trials. We examine the impact of mammography on stage at diagnosis of breast cancer, over the years when mammography came into general use, comparing women aged 40 to 69 with those aged 70 and older.", "Does the proven benefit of mammography extend to breast cancer patients over age 70?<||||>We reviewed the records of 1,001 consecutive patients 40 and older treated for invasive or in situ breast cancer in the surgical practice of one of us (H.S.C.) between 1979 and 1993, comparing trends in mammography use, means of diagnosis, tumor size, axillary node status, and pathology.", "Does the proven benefit of mammography extend to breast cancer patients over age 70?<||||>The proportion of cases diagnosed by mammography increased over time to a comparable degree in both age groups, as did the proportion of T1 and DCIS or microinvasive cancers. This trend toward earlier stage appears entirely due to an increasing use of mammography." ]

[ "Does administration of isosorbide mononitrate affect cellular proliferation in oral squamous cell carcinoma?<||||>There has been much interest in the role that the signaling molecule nitric oxide (NO) plays in cancer. NO has both tumor-promoting and tumor-inhibiting effects that are dependent on its local tissue concentration. In animal studies, the administration of exogenous NO has reduced both tumor growth and dissemination, and in vitro NO administration causes death of oral cancer cell lines. We evaluated the oral administration of the NO donor drug isosorbide mononitrate (ISMO) on cellular proliferation in patients with oral squamous cell carcinoma.", "Does administration of isosorbide mononitrate affect cellular proliferation in oral squamous cell carcinoma?<||||>A prospective randomized double-blind study was performed on 31 patients with biopsy-confirmed oral squamous cell carcinoma. Following incisional biopsy, patients were randomized to receive either ISMO (at a dose of 20 mg twice a day) or placebo tablets for 2 weeks before definitive resection. Cellular proliferation was compared between biopsy and resection specimens, using the immunohistochemical marker Ki-67.", "Does administration of isosorbide mononitrate affect cellular proliferation in oral squamous cell carcinoma?<||||>No statistical difference was found between Ki-67 indices in initial biopsy and resection specimens after ISMO (P =.23) or placebo (P =.5) administration. There were no obvious clinical changes seen in the tumor during the clinical trial as a result of ISMO administration." ]

[ "Is the pulsed xenon ultraviolet light no-touch disinfection system effective on methicillin-resistant Staphylococcus aureus in the absence of manual cleaning?<||||>Methicillin-resistant Staphylococcus aureus (MRSA) has been shown to survive on ambient surfaces for extended periods of time. Leftover MRSA environmental contamination in a hospital room places future patients at risk. Manual disinfection supplemented by pulsed xenon ultraviolet (PX-UV) light disinfection has been shown to greatly decrease the MRSA bioburden in hospital rooms. However, the effect of PX-UV in the absence of manual disinfection has not been evaluated.", "Is the pulsed xenon ultraviolet light no-touch disinfection system effective on methicillin-resistant Staphylococcus aureus in the absence of manual cleaning?<||||>Rooms that were previously occupied by a MRSA-positive patient (current colonization or infection) were selected for the study immediately postdischarge. Five high-touch surfaces were sampled, before and after PX-UV disinfection, in each hospital room. The effectiveness of the PX-UV device on the concentration of MRSA was assessed employing a Wilcoxon signed-rank test for all 70 samples with MRSA in 14 rooms, as well as by surface location.", "Is the pulsed xenon ultraviolet light no-touch disinfection system effective on methicillin-resistant Staphylococcus aureus in the absence of manual cleaning?<||||>The final analysis included 14 rooms. Before PX-UV disinfection there were a total of 393 MRSA colonies isolated from the 5 high-touch surfaces. There were 100 MRSA colonies after disinfection by the PX-UV device and the overall reduction was statistically significant (P<.01)." ]

[ "Implications of depression in rheumatoid arthritis: do subtypes really matter?<||||>To examine depressive disorders and health status in patients with rheumatoid arthritis (RA), controlling for potential confounds.", "Implications of depression in rheumatoid arthritis: do subtypes really matter?<||||>Subjects (n = 426) completed measures of depressive symptoms (Center for Epidemiological Studies Depression Scale [CES-D]) and health status (Arthritis Impact Measurement Scales 2 [AIMS2]), via cross-sectional survey. Subjects (n = 299) with few depressive symptoms (CES-D<or = 10) were not evaluated further. Subjects with CES-D>or = 11 were interviewed using the Primary Care Evaluation of Mental Disorders to diagnose major depressive disorder (MDD; n = 46), dysthymic disorder (DD; n = 21), or minor depressive disorder (MND; n = 18).", "Implications of depression in rheumatoid arthritis: do subtypes really matter?<||||>Regression analyses examined differences between the depressive disorders on AIMS2 subscales. Health status scores were similar between the depressive disorder subcategories; significant differences were found between MDD and MND on AIMS2 Physical scores and MDD and DD on AIMS2 Symptom scores." ]

[ "Pemphigus vulgaris and herpesviruses: is there any relationship?<||||>Pemphigus is an autoimmune disorder, which results from interaction of exogenous and endogenous factors. One of these environmental factors is viral infections particularly, herpesviruses. We aimed to detect the presence of HSV 1 and 2 (herpes simplex virus) and HHV8 (human herpesvirus 8) in our patients who were suffering from pemphigus vulgaris.", "Pemphigus vulgaris and herpesviruses: is there any relationship?<||||>In this cross-sectional study, 38 patients (19 male and 19 female patients) with pemphigus vulgaris were entered, 32 skins and six peripheral blood cells samples were obtained from the study population. Thereafter, the presence of HHV8 and HSV DNA were evaluated by using polymerase chain reaction (PCR).", "Pemphigus vulgaris and herpesviruses: is there any relationship?<||||>The mean age of patients was 45.05 ± 17.24 years (range: 16-81 years). Twelve patients mentioned history of herpes labial in the past (31.57%). Results of PCR test for detection of HSV and HHV8 DNA in all 32 skin samples and five peripheral blood samples and one case with skin and blood samples were reported negative." ]

[ "Recipient age impact on outcome after cardiac transplantation: should it still be considered in organ allocation?<||||>Improvement of clinical results in heart transplantation (HTx) has favoured the expansion of indication criteria towards aged population. The impact of increasing recipient age is controversial and, owing to donor shortage, the debate still remains whether HTx is justified for older patients. We analysed age as a prognostic factor at long-term after HTx and if it should be a determinant in organ allocation.", "Recipient age impact on outcome after cardiac transplantation: should it still be considered in organ allocation?<||||>Data of 364 consecutive patients who underwent cardiac transplantation between 1999 and 2014 at the University Hospital of Udine were analysed. Patients were divided into three groups according to age (Group 1: 18-40, Group 2: 41-59, Group 3: ≥ 60 years) and survival and major complications were evaluated at long-term (mean follow-up 6.7 ± 4.5 years, range 1-15.7 years).", "Recipient age impact on outcome after cardiac transplantation: should it still be considered in organ allocation?<||||>Preoperatively, renal failure (2.9, 16.1, 39.5%, P<0.01) and cardiovascular factors such as diabetes (1.2, 17.1, 36.4%, P<0.01), systemic hypertension (5.9, 31.5, 40.8%, P<0.01) and dyslipidaemia (5.9, 40.3, 42.9%, P<0.01) were more common in older patients (Group 3), as well as ischaemic cardiopathy (0, 42.6, 49.7%, P<0.01). Donor age was lower in younger recipients (Group 1) (33 ± 15, 39 ± 14, 45 ± 14 years, P<0.01). Older patients showed a worse long-term survival (hazard ratio 1.7; 1.1-2.5), also after adjusting for major cardiovascular risk factors, renal failure and donor age. In fact, 15-year survival was 100% in Group 1, while at 1, 5, 10 and 15 years survival was 88, 78, 69 and 56% in Group 2, and 87, 68, 49 and 43% in Group 3, respectively. Even major long-term complications were less frequent in younger patients in terms of neoplasms (P<0.01), rehospitalizations (P<0.01) and a tendency to higher freedom from other complications such as cytomegalovirus infections, renal failure and dialysis." ]

[ "Is increased choroidal thickness association with primary angle closure?<||||>To investigate whether increased choroidal thickness is a risk factor for primary angle closure.", "Is increased choroidal thickness association with primary angle closure?<||||>The study consisted of 162 patients with primary angle-closure (primary angle-closure suspect [PACS], 73 eyes; primary angle closure [PAC], 33 eyes; and primary angle-closure glaucoma [PACG], 56 eyes) and 87 healthy controls with no ophthalmic symptoms. EDI-OCT was used to measure and to compare the macular choroidal thickness between the primary angle-closure and normal eyes. The association between the choroidal thickness and the presence of primary angle closure was evaluated using logistic regression models to determine the odds ratio.", "Is increased choroidal thickness association with primary angle closure?<||||>The primary angle-closure eyes had a thicker choroid than the control eyes at all macular locations (all p < 0.05). It remained significantly thicker after controlling for age, axial length (AL) and gender, except at 1 mm, 3 mm superior and 3 mm nasal from the fovea. Univariate analysis showed that the subfoveal choroidal thickness (SFCT) was significantly associated with primary angle closure. After adjustment for the anterior chamber depth (ACD), vitreous chamber depth (VCD) and lens thickness (LT), the SFCT was still significantly associated with primary angle closure. The odds ratio (OR) and 95% confidence interval (CI) was 1.008 (1.003, 1.014). The choroidal thickness at most macular locations was positively associated with primary angle closure. The area under the curve (AUC) for detecting primary angle closure was 0.619 with SFCT, and the result was statistically significant (p = 0.002)." ]

[ "Balanced orbital decompression combined with fat removal in Graves ophthalmopathy: do we really need to remove the third wall?<||||>To compare the reduction of proptosis and the incidence of new-onset diplopia after 3-wall (medial, lateral, and inferior) orbital decompression versus balanced medial and lateral wall decompression combined with orbital fat excision in patients with Graves ophthalmopathy.", "Balanced orbital decompression combined with fat removal in Graves ophthalmopathy: do we really need to remove the third wall?<||||>Three-wall orbital decompression including medial, inferior, and lateral walls was performed in 13 eyes of 7 patients (group 1), and balanced medial and lateral wall decompression combined with fat removal was performed in 18 eyes of 11 patients (group 2). A transnasal endoscopic approach was used for medial wall removal. A lateral canthotomy incision combined with a short upper eyelid incision was used for extended lateral wall removal, and this was combined with an inferior conjunctival fornix incision when floor decompression was performed.", "Balanced orbital decompression combined with fat removal in Graves ophthalmopathy: do we really need to remove the third wall?<||||>The mean reduction of proptosis was 6.9+/-1.6 mm and 6.5+/-1.3 mm in the first and second groups, respectively; the difference was not statistically significant (P=0.37). After 3-wall decompression, 57.1% of the patients had permanent new-onset diplopia (group 1), whereas none of the patients had permanent postoperative diplopia after balanced medial and lateral wall decompression combined with fat removal (group 2). The difference in permanent new-onset postoperative diplopia between two groups was statistically significant (P<0.001)." ]

[ "Do depressive symptoms mediate the relationship between hopelessness and diurnal cortisol rhythm?<||||>Research has revealed a well-established relationship of depressive symptoms and hopelessness with a variety of physical illnesses that are associated with a dysfunction of the hypothalamic-pituitary-adrenal-axis.", "Do depressive symptoms mediate the relationship between hopelessness and diurnal cortisol rhythm?<||||>The purpose of this study was to test if depressive symptoms mediate the relationship between hopelessness and cortisol, a measure of the hypothalamic-pituitary-adrenal-axis.", "Do depressive symptoms mediate the relationship between hopelessness and diurnal cortisol rhythm?<||||>Hopelessness, depressive symptoms, and diurnal cortisol rhythm were measured in 257 adults (128 women and 129 men; age range, 20-74 years) in this cross-sectional study. To test the hypothesis, two linear regression analyses and asymmetrical confidence intervals around the regression weights were conducted. A second set of analyses was calculated to be able to exclude the possibility of hopelessness as a mediator between depressive symptoms and cortisol.", "Do depressive symptoms mediate the relationship between hopelessness and diurnal cortisol rhythm?<||||>As predicted, after adjusting for age, gender, awakening time, and medication use, more hopelessness predicted more depressive symptoms and more depressive symptoms predicted a flatter diurnal cortisol rhythm. The 95% confidence intervals revealed that the indirect relationship between hopelessness and diurnal cortisol rhythm was significant. The analyses with hopelessness as a potential mediator revealed that hopelessness does not mediate the association between depressive symptoms and cortisol." ]

[ "Hip fracture surgery: does type of anesthesia matter?<||||>Hip fracture surgery is a common procedure, and the geriatric population with its multiple comorbid conditions is at most at risk of developing anesthesia-related complications. Data on the impact of type anesthesia on postoperative morbidity and mortality is limited. The effects of regional and general anesthesia on postoperative outcomes need to be clearly elucidated.", "Hip fracture surgery: does type of anesthesia matter?<||||>In this study, all patients who underwent dynamic hip screw (DHS) fixation for intertrochanteric fractures, between January 2005 and December 2010, at the Aga Khan University Hospital, were included. Patients were divided into two groups; group A included those patients who received general anesthesia, and group B consisted of patients who had received regional anesthesia. The two groups were compared for differences in morbidity, mortality, and intraoperative complications based on the type of anesthesia administered.", "Hip fracture surgery: does type of anesthesia matter?<||||>During this period, 194 patients underwent DHS fixation. One hundred and seven patients received general anesthesia whereas eighty-seven patients received regional anesthesia. The mean operative time was significantly lower in the group receiving regional anesthesia (1.25 ± 0.39 hrs) as compared to those who received general anesthesia (1.54 ± 0.6 hrs) (P<0.05). There were no statistically significant differences in the rates of wound infections, length of hospital stay, postoperative ambulation status, intraoperative blood loss, postoperative complications, and mortality between the regional and general anesthesia groups." ]

[ "Infrainguinal arterial reconstruction for claudication: is it worth the risk?<||||>Infrainguinal reconstruction traditionally has been reserved for patients with limb-threatening ischemia. Surgery for debilitating claudication, however, has been discouraged as a result of the perceived fear of bypass graft failure, limb loss, and significant perioperative complications that may be worse than the natural history of the disease. In this study, the results of infrainguinal reconstructions for claudication performed during the past 10 years were evaluated for bypass graft patency, limb loss, and long-term survival rates.", "Infrainguinal arterial reconstruction for claudication: is it worth the risk?<||||>Data were collected and reviewed from the vascular registry, the office charts, and the hospital records for patients who underwent infrainguinal bypass grafting for claudication.", "Infrainguinal arterial reconstruction for claudication: is it worth the risk?<||||>From 1987 to 1997, 409 infrainguinal reconstructions were performed for claudication (9% of all infrainguinal reconstructions in our unit). The patient population had the following demographics: 73% men, 28% with diabetes, 54% smokers, and an average age of 64 years (range, 24 to 91 years). Inflow was from the following arteries: iliac artery/graft, 10%; common femoral artery, 52%; superficial femoral artery, 19%; profunda femoris artery, 16%; and popliteal artery, 2%. The outflow vessels were the following arteries: 165 above-knee popliteal arteries (40%), 150 below-knee popliteal arteries (37%), and 94 tibial vessels (23%). The operative mortality rate was 0%, and one limb was lost in the series from distal embolization. The primary patency rates were 62%, 77%, and 86% for above-knee popliteal artery, below-knee popliteal artery, and tibial vessel reconstructions at 4 years, and the secondary patency rates were 64%, 81%, and 90%, respectively. Cumulative patient survival rates were 93% and 80% at 4 and 6 years as compared with 65% and 52%, respectively, for infrainguinal reconstructions performed for limb salvage." ]

[ "Is there clinical benefit to routine enzyme testing of patients on statins?<||||>Statin-treated patients undergo frequent laboratory tests. This study evaluated the clinical impact of abnormal liver or muscle enzyme results.", "Is there clinical benefit to routine enzyme testing of patients on statins?<||||>This clinical process evaluation study took place in six primary care clinics in Israel. Four hundred and eight patients (average age 63.8 ± 10.9 years) undergoing statin treatment, with at least one enzyme level>10% normal, were categorized by symptomatology possibly related to statins. Aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and creatine phosphokinase were measured. Management and etiology of the elevation were assessed.", "Is there clinical benefit to routine enzyme testing of patients on statins?<||||>Changes in statin regimen.", "Is there clinical benefit to routine enzyme testing of patients on statins?<||||>Thirty-six (8.8%) patients were symptomatic at the index encounter. One enzyme was elevated in 74.8%. Patients experiencing side effects had more repeat tests (36.1 vs 17.7%, p<0.001). Musculoskeletal symptoms resulted in a change in treatment more than digestive symptoms did (73.3 vs 16.7%, p<0.001). Of 40 (9.8%) patients who had additional evaluation, two symptomatic patients had treatment changes." ]

[ "Is Kauppila method able to detect the progression of vascular calcification and predict cardiovascular events in patients undergoing hemodialysis?<||||>Cardiovascular disease (CVD) is the main cause of death in hemodialysis (HD) patients. Vascular calcification (VC) is common in these patients. The main objective of this study was to evaluate if a semiquantitative radiographic method is able to detect VC progression in a prospective cohort of patients and predict the risk of cardiovascular events. Secondarily, we intend to identify predictors of the presence and progression of VC.", "Is Kauppila method able to detect the progression of vascular calcification and predict cardiovascular events in patients undergoing hemodialysis?<||||>49 patients undergoing HD for ≥ 90 days were included. At the beginning and after 12 months, the VC score (VCS) was determined by the Kauppila method, and clinical, nutritional, and laboratory markers were measured. The rates of fatal and nonfatal cardiovascular events were analyzed from months 13 to 24.", "Is Kauppila method able to detect the progression of vascular calcification and predict cardiovascular events in patients undergoing hemodialysis?<||||>Of 49 patients, 55.1% were male, 46.9% diabetic, and the mean age was 59.5 ± 14.4 years. At the beginning of the follow-up, 65.3% of the patients exhibited VC with a median VCS of 4 points. The intracellular water was negatively associated with VC and its intensity. The presence of VC was the only independent predictor of VC progression. Among patients with VC, 17 showed rapid progression, and 15 showed slow progression. The VCS was independently associated with rapid progression, while ΔCS (final VCS - initial VCS) was an independent predictor of cardiovascular events." ]

[ "Atrial fibrillation in older inpatients: are there any differences in clinical characteristics and pharmacological treatment between the frail and the non-frail?<||||>Frailty is common in patients with atrial fibrillation and may impact on antithrombotic and anti-arrhythmic treatment.AIM: To describe differences in clinical characteristics, prescription of antithrombotic and anti-arrhythmic medications and incidence of haemorrhage and stroke, between frail and non-frail older inpatients.", "Atrial fibrillation in older inpatients: are there any differences in clinical characteristics and pharmacological treatment between the frail and the non-frail?<||||>Prospective observational study in patients aged ≥65 years with atrial fibrillation admitted to a teaching hospital in Sydney, Australia. Frailty was assessed using the Reported Edmonton Frail Scale, stroke risk with CHA2DS2-VASc score and bleeding risk with HAS-BLED score. Participants were followed after 6 months for haemorrhages and strokes.", "Atrial fibrillation in older inpatients: are there any differences in clinical characteristics and pharmacological treatment between the frail and the non-frail?<||||>We recruited 302 patients (mean age 84.7 ± 7.1 years, 53.3% frail, 50% female, mean CHA2DS2-VASc 4.61 ± 1.44, mean HAS-BLED 2.97 ± 1.04). Frail participants were older and had more co-morbidities and higher risk of stroke but not haemorrhage. Upon discharge, 55.7% participants were prescribed with anticoagulants (49.3% frail, 62.6% non-frail, P = 0.02). Thirty-three per cent received antiplatelets only and 11.1% no antithrombotics, with no difference by frailty status. For anti-arrhythmics, 52.6% received rate-control drugs only, 11.8% rhythm-control drugs only and 13.5% both and 22.1% were not prescribed either, with no difference by frailty status. On univariate logistic regression, frailty decreased the likelihood of anticoagulant prescription (odds ratio (OR) 0.58, 95%CI 0.36-0.93), but this was not significant on multivariate analysis (OR 0.66, 95%CI 0.40-1.11). After 6 months, overall incidence of ischaemic stroke was 2.1%, and in patients taking anticoagulants, incidence of major/severe bleeding was 6.3%, with no significant difference between frailty groups." ]

[ "Does obesity affect surgical outcomes in degenerative scoliosis?<||||>Retrospective cohort analysis of prospectively collected data.", "Does obesity affect surgical outcomes in degenerative scoliosis?<||||>To determine whether an association exists between body mass and surgical outcomes in patients with degenerative scoliosis after long instrumented spinal arthrodesis (≥ 4 discs).", "Does obesity affect surgical outcomes in degenerative scoliosis?<||||>Obesity is thought to be associated with increased surgical complications and inferior clinical outcomes in adults. There are no studies analyzing the effect of obesity on surgical outcomes in patients with degenerative scoliosis after long instrumented spinal arthrodesis.", "Does obesity affect surgical outcomes in degenerative scoliosis?<||||>Eighty-four consecutive patients with degenerative scoliosis (69 females and 15 males; mean age, 68.6 ± 8.0 yr) with a minimum follow-up of 2 years were included in this study. Patients were divided into 3 groups according to body mass index (BMI): obese (BMI ≥ 30 kg/m², n = 19), overweight (BMI = 25-29.9 kg/m², n = 35), and normal weight (BMI<25 kg/m², n = 30). Radiographical measures, Oswestry Disability Index, visual analogue scale score, as well as comorbidities and complications were reviewed and analyzed for all patients preoperatively and at 1- and 2-year follow-ups.", "Does obesity affect surgical outcomes in degenerative scoliosis?<||||>Compared with the normal weight group, no significant differences in surgical methods, comorbidities, complication rates, curve correction, or radiographical measures were found in the obese and overweight groups, except for a greater preoperative lumbar lordosis in the overweight group (-40.3° ± 13.8° vs. -26.0° ± 18.9°, P<0.05). At 2-year follow-up, Oswestry Disability Index and visual analogue scalescores improved significantly in all groups compared with preoperatively (P<0.01). The changes of Oswestry Disability Index and visual analogue scalescores from preoperatively to final follow-up were similar in the 3 groups (P>0.05)." ]

[ "Bilateral Internal Thoracic Artery Grafting: Is It Reasonable in Octogenarians?<||||>The feasibility of using bilateral internal thoracic artery (BITA) grafts for coronary artery bypass grafting (CABG) in octogenarians is not clear. This study aimed to compare outcomes between use of BITA and single internal thoracic artery (SITA) grafts in octogenarians undergoing isolated CABG.", "Bilateral Internal Thoracic Artery Grafting: Is It Reasonable in Octogenarians?<||||>Isolated CABG was performed in 1,566 patients at the Sakakibara Heart Institute between September 2004 and December 2012. Of these, 125 consecutive octogenarians were included and divided into two groups, according to the use of BITA grafts (101 subjects) or SITA grafts (24 subjects). Early and late outcomes were compared between groups.", "Bilateral Internal Thoracic Artery Grafting: Is It Reasonable in Octogenarians?<||||>The preoperative patient characteristics were similar between the two groups. Early outcomes were similar, including hospital death or deep sternal infection. The estimated 5-year survival rate was similar in the BITA and SITA groups (78% vs 62%, p = 0.269). Freedom from major adverse cardiac or cerebrovascular events was significantly higher in the BITA group than in the SITA group after 5 years (90% vs 75%, p = 0.032)." ]

[ "Is canine fossa access necessary for successful maxillary fungus ball treatment?<||||>Sinus fungus ball (FB) is a non-invasive mycosis that affects immunocompetent hosts, most frequently localized in the maxillary sinus. The current golden standard treatment is surgical removal.", "Is canine fossa access necessary for successful maxillary fungus ball treatment?<||||>To evaluate the effectiveness of an endonasal endoscopically assisted approach to remove a maxillary FB combined or not with a transoral approach (sinusoscopy via canine fossa).", "Is canine fossa access necessary for successful maxillary fungus ball treatment?<||||>A retrospective evaluation of paranasal FB treated by functional endoscopic sinus surgery (FESS) + transoral approach, compared to those treated by a sole FESS procedure.", "Is canine fossa access necessary for successful maxillary fungus ball treatment?<||||>In total, 65 out of 90 patients presented with a maxillary localization and were treated by FESS. Thirthy-three patients received a combined FESS + transoral approach and 32 received solely a FESS procedure. Antimycotic medical therapy was not used in any case. With a mean follow-up of 93 months, the treatment was successful in 62 patients (95,4%) without significant differences between the two groups." ]

[ "Does antidepressant medication use affect persistence with diabetes medicines?<||||>This study aimed to examine the effect of antidepressant use on persistence with newly initiated oral antidiabetic medicines in older people.", "Does antidepressant medication use affect persistence with diabetes medicines?<||||>A retrospective study of administrative claims data from the Australian Government Department of Veterans' Affairs, from 1 July 2000 to 30 June 2008 of new users of oral antidiabetic medicines (metformin or sulfonylurea). Antidepressant medicine use was determined in the 6 months preceding the index date of the first dispensing of an oral antidiabetic medicine. The outcome was time to discontinuation of diabetes therapy in those with antidepressant use compared with those without. Competing risks regression analyses were conducted with adjustment for covariates.", "Does antidepressant medication use affect persistence with diabetes medicines?<||||>A total of 29,710 new users of metformin or sulfonylurea were identified, with 7171 (24.2%) dispensed an antidepressant. Median duration of oral antidiabetic medicines was 1.81 years (95% CI 1.72–1.94) for those who received an antidepressant at the time of diabetes medicine initiation, by comparison to 3.23 years (95% CI 3.10–3.40) for those who did not receive an antidepressant. Competing risk analyses showed a 42% increased likelihood of discontinuation of diabetes medications in persons who received an antidepressant (subdistribution hazard ratio 1.42, 95% CI 1.37–1.47, p < 0.001)." ]

[ "Is heart rate adequately controlled in chronic systolic heart failure patients in Germany?<||||>Elevated resting heart rate is associated with increased morbidity and mortality in patients with chronic systolic heart failure (CHF). Lowering of heart rate improves cardiovascular outcome in these patients. Therefore, heart rate reduction is an important element of therapeutic management and consistently reflected in current European guidelines for heart failure. Methods: The INDICATE study was initiated as a multicenter nationwide cross-sectional survey aiming to analyze the current quality of care in outpatients with CHF (documented left ventricular systolic dysfunction) in Germany. 20 consecutive patients were to be included in the survey from February until June 2012 by 793 cardiologic private practices. Detailed documentation of each patient was performed using a standardized questionnaire.", "Is heart rate adequately controlled in chronic systolic heart failure patients in Germany?<||||>CHF was known for more than 6 months in 88 % of the 15 148 included patients. Mean heart rate in the study population was 73 ± 13 min⁻¹. In 42 % of patients the heart rate was ≥ 75 min⁻¹. 86 % were treated with betablockers. However, higher doses of betablockers were not associated with lower resting heart rate. 27 % of patients remained on heart rates ≥ 75 min⁻¹ although receiving at least 50 % of betablocker target dose." ]

[ "Preimplantation genetic diagnosis of aneuploidy: were we looking at the wrong chromosomes?<||||>Our purpose was to study aneuploidy frequencies of chromosomes 1, 4, 6, 7, 14, 15, 17, 18, and 22 in cleavage-stage embryos. These frequencies were compared to spontaneous abortion data to determine differences in survival rate of their aneuploidies.", "Preimplantation genetic diagnosis of aneuploidy: were we looking at the wrong chromosomes?<||||>One hundred ninety-four embryos were analyzed with multicolor fluorescence in situ hybridization. Embryos were divided into three maternal age groups: 20 to 34.9 years, (2) 35 to 39.9 years, and (3) 40 years and older. Embryos were also divided into two developmental and morphological groups; arrested and nonarrested embryos.", "Preimplantation genetic diagnosis of aneuploidy: were we looking at the wrong chromosomes?<||||>The rate of aneuploidy was 14.51%, 14.10%, and 31.48% for age groups 1, 2, and 3, respectively (P<0.005). The chromosomes most frequently involved in aneuploidy events were 22, 15, 1, and 17." ]

[ "Pelvic actinomycosis. Is long-term antibiotic therapy necessary?<||||>To describe 11 cases of actinomycosis and analyze whether long-term antibiotic use in necessary.", "Pelvic actinomycosis. Is long-term antibiotic therapy necessary?<||||>Analysis of 11 cases of pelvic actinomycosis diagnosed and treated during the last nine years. Four patients had an intrauterine device (IUD) for 6-20 years, three patients had an IUD for 3-5 years, and four patients had no known etiology. In most patients the symptoms lasted from several days to one month. The actinomycotic lesions involved one or both ovaries in all 11 cases. In five patients the lesion extended to other areas, such as the uterus, omentum, parametrium, pelvic walls, colon, bladder, cul-de-sac and gallbladder.", "Pelvic actinomycosis. Is long-term antibiotic therapy necessary?<||||>All patients underwent surgery that included removal of the lesions with the ipsilateral or both adnexa and, in specific cases, with extension of the lesions, hysterectomy, omentectomy, hemicolectomy and cholecystectomy. Confirmation of the diagnosis of actinomycosis was done by histology in all cases, and antibiotic treatment usually began 1-14 days after surgery. The drug of choice was penicillin. The duration of treatment was 12 months in 6 patients, 6 months in 3 and<or = 3 months in two. All patients were alive and well after two to nine years of follow-up." ]

[ "Measuring leg length and offset with an imageless navigation system during total hip arthroplasty: is it really accurate?<||||>A novel imageless measurement algorithm to assess leg length (LL) and offset (OS) changes during total hip arthroplasty (THA) has been established, the purpose of this study was to describe the process and establish whether or not it is accurate.", "Measuring leg length and offset with an imageless navigation system during total hip arthroplasty: is it really accurate?<||||>THA was performed on 17 cadaver hip specimens. LL and OS changes were determined intra-operatively, using an imageless navigation system. Pre- and postoperatively, all specimens had a computed tomography scan (CT) and the LL and OS changes were analysed by two blinded investigators.", "Measuring leg length and offset with an imageless navigation system during total hip arthroplasty: is it really accurate?<||||>With mean differences of less than 1 mm (LL, 0.74; SD, 2.4 mm; OS, 0.89; SD, 1.8 mm) supported by substantial significant correlations [r = 0.83 (LL) and r = 0.92 (OS)] imageless navigation values demonstrated a high accuracy when compared to CT measurements." ]

[ "Is there a gender difference in the associations of birthweight and adult hypothalamic-pituitary-adrenal axis activity?<||||>Increased hypothalamic-pituitary-adrenal (HPA) axis activity in men of low birthweight may be an important link between early life and the adult metabolic syndrome. In animal models females are more sensitive than males to HPA axis programming, but whether gender influences susceptibility in humans is unknown.", "Is there a gender difference in the associations of birthweight and adult hypothalamic-pituitary-adrenal axis activity?<||||>Birth cohort study.", "Is there a gender difference in the associations of birthweight and adult hypothalamic-pituitary-adrenal axis activity?<||||>We studied 106 women aged 67-78 years, from Hertfordshire, UK, in whom birthweight was recorded. Negative feedback sensitivity was assessed by an overnight low-dose (0.25 mg) dexa-methasone suppression test, and adrenal sensitivity by a low-dose (1 microg) ACTH(1 - 24) stimulation test. Cortisol and its metabolites were analysed in a 24 h urine collection. Data were compared with previously published identical measurements in 205 men aged 66-77 years from the same cohort.", "Is there a gender difference in the associations of birthweight and adult hypothalamic-pituitary-adrenal axis activity?<||||>In women, plasma cortisol levels after dexamethasone were lower (P<0.0001) and peak cortisol following ACTH(1 - 24) were higher (P<0.0001) than in men, suggesting a more responsive HPA axis. As in men, women with lower birthweight had enhanced plasma cortisol responses to ACTH(1 - 24) (P = 0.05 for trend) but no difference in plasma cortisol after dexamethasone or in urinary cortisol metabolite excretion. The strength of the association in women was not different from that in men; a 1 lb decrease in birthweight was associated with an incremental rise in cortisol of 12.6 nmol/l (95% confidence interval (CI) 1.4, 23.8) in men, P = 0.03, and 14.8 nmol/l (95% CI -0.4, 29.9) in women, P = 0.05 (P = 0.82 for birthweight x gender interaction). In a combined analysis of men and women adjusted for gender (n = 302), a 1 lb decrease in birthweight was associated with a 13.4 nmol/l (95% CI 4.5, 22.4) greater incremental rise in plasma cortisol, P = 0.003." ]

[ "Can a battery of functional and sensory tests corrobrate the sensorineural complaints of subjects working with vibrating tools?<||||>The objective of the present paper is to study the relationship between the early sensorineural symptoms, classified according to the Stockholm scale, and the results of the main functional and sensory tests described in the literature, in subjects working with vibrating tools.", "Can a battery of functional and sensory tests corrobrate the sensorineural complaints of subjects working with vibrating tools?<||||>Three groups of male workers were selected from industry: one group (69 subjects) exposed to hand-arm vibration in several workplaces, one group (62) performing heavy and repetitive hand and arm work but without exposure to vibration, and one control group (46) performing light and non-repetitive tasks without vibration. All the workers were interviewed by questionnaire, about their personal characteristics, their health status, their actual and past working conditions and the episodes of tingling at the level of the fingers. From these reported symptoms, the sensorineural stage of the hand-arm vibration was determined using the Stockholm scale. Based on the review of the literature, we selected six functional and sensory tests: maximum voluntary grip force, maximum angles of the wrist, pressure perception threshold test, vibration perception threshold test, distal sensory latency and the Purdue Pegboard test. Each test was performed by the workers in the three groups.", "Can a battery of functional and sensory tests corrobrate the sensorineural complaints of subjects working with vibrating tools?<||||>No main differences were observed between the personal characteristics of the three groups. According to the Stockholm scale, the sensorineural symptoms were mainly at stage SN1, with 9% at stage SN2 and none at stage SN3. These symptoms are associated with exposure to vibration, and had a prevalence of 40% in group 1, versus 20% in the two other groups. Furthermore, 25% of the workers exposed to vibration complained of symptoms at least once a week, compared with only 2% in the other groups. The multivariate logistic regression analysis showed an association between the existence of symptoms and a decrease in the maximum flexion angle of the wrist and an increase in the pressure perception threshold. This association, however, was too low to determine limit values with a sensitivity and specificity sufficiently high to make a reliable diagnosis." ]

[ "Is the area of the orbital opening in humans related to climate?<||||>The aim of this study was to evaluate whether climatic conditions impact the size of the anterior orbital opening in humans. The previous research has shown that morphology of the human orbit, a trait strongly related to the shape of the cranium, varies significantly among populations. However, the mechanisms of this variation are still debatable. Besides such evolutionary forces as genetic drift, climatic conditions may be involved. Thermoregulatory processes affect skull shape, and thus may also influence orbital morphology.", "Is the area of the orbital opening in humans related to climate?<||||>A total of 846 dry skulls of male and female adults from three climatic areas (i.e., warm, temperate, and cold) of Europe were evaluated. The areas of the left and right orbital openings were measured using the three-dimensional contact scanner MicroScribe G2L, and analyzed with regard to climate.", "Is the area of the orbital opening in humans related to climate?<||||>The results reveal a statistically significant association with climatic conditions on the area of orbital opening in accordance with Bergmann's rule. The anterior orbital opening area was smaller in male individuals from the cold climate, and larger in individuals from the warm climate areas." ]

[ "Low-pressure hydrocephalus: indication for custom-made catheters?<||||>Low-pressure hydrocephalus (LPH) is characterized by ventriculomegaly with persistent low intracranial pressure (ICP). Sub-zero drainage is needed for its management and multiple solutions have been described. Our aim is to report our experience with custom-made peritoneal catheters with larger inner diameter as an alternative treatment option.", "Low-pressure hydrocephalus: indication for custom-made catheters?<||||>We made a retrospective review of all patients diagnosed with LPH and treated with custom-made peritoneal catheters at the Virgen del Rocío Pediatric Neurosurgical Unit. Catheters were coated with antibiotic or silver. The inner diameter of ventricular catheters was 1.4 mm; peritoneal catheters were larger than usual (1.9 mm inner diameter).", "Low-pressure hydrocephalus: indication for custom-made catheters?<||||>We identified four patients in whom five custom-made peritoneal catheters were used over a 3-year period. There were two males and the mean age was 10 years (6 months-17 years). In all patients, placement of an EVD was necessary for sub-zero drainage, with maximum negative pressure of -8 cm H20. The mean time of maintenance of EVD was 102 days (10 days-1 year). Finally, three ventriculoperitoneal (VP) valveless systems, one with antigravitation device, and one Pro-GAV VP shunt were placed, all of them with larger custom-made peritoneal catheters. After a mean follow-up period of 2.3 years (6 months-3 years), two patients are completely recovered, one patient is partially dependent for daily activities with good cognitive status, and the last one is a child who died due to his brain tumor." ]

[ "Is muscle strength ratio a criterion for diagnosis of site-specific muscle loss?<||||>A total of 55 men aged 18-79 years had muscle thickness (MTH) measured by ultrasound at three sites on the anterior (30% and 50% of thigh length) and posterior (70% of thigh length) aspects of the thigh. MTH ratios were calculated to assess the site-specific muscle loss (anterior 30% : posterior 70% MTH [A30:P70] and anterior 50% :posterior 70% MTH [A50:P70]). Walking performance, maximum isometric knee extension/flexion, toe-grasping and handgrip strength were measured.", "Is muscle strength ratio a criterion for diagnosis of site-specific muscle loss?<||||>Age was inversely correlated with the ratios of A30:P70 (r=-0.332) and A50:P70 (r=-0.466). There were no significant correlations between the A30:P70 and A50:P70 ratios, and height and bodyweight. The A30 : P70 and A50 : P70 ratios were also not correlated with maximal walking speed. However, the A50:P70 ratio was significantly correlated with zig-zag walking (r=-0.350) and handgrip strength (r=0.334). In addition, these MTH ratios were also correlated with knee extension (r=0.309 and r=0.405), flexion (r=0.306 and r=0.412) and toe-grasping strength (r=0.265 and r=0.336). After adjusting for physical activity, the MTH ratios were still not correlated with ratio of muscle strength." ]

[ "Discharge of thoracic patients on portable digital suction: Is it cost-effective?<||||>A portable suction drainage device for patients undergoing thoracic surgical procedures was introduced into our service in January 2010. Patients who met strict discharge criteria were allowed to continue their treatment at home with the device. They were monitored in a designated follow-up clinic. Data were collected to identify the impact of this service in relation to the duration of follow-up required, bed-days saved, and potential cost/benefits.", "Discharge of thoracic patients on portable digital suction: Is it cost-effective?<||||>All patients who underwent a thoracic procedure from March 2012 to April 2014 and required suction postoperatively for air leak were included in the study. Patients were identified as suitable according to the discharge criteria. Data regarding patient demographics were collected prospectively on the thoracic database, and data on the drainage device were logged in a specific data sheet. Visits to the follow-up clinic were also recorded.", "Discharge of thoracic patients on portable digital suction: Is it cost-effective?<||||>During the study period, 50 patients stayed a total 1125 days on the portable suction system. Twenty were discharged home, equating to 772 bed-days saved (GBP 270,000 cost-saving). Clinic attendance totalled 162 visits (GBP 24,300 cost reimbursement for attendance). Six (30%) patients were readmitted on 9 occasions due to device malfunction or inability to cope at home." ]

[ "Coronary heart disease prevention in clinical practice: are patients with diabetes special?<||||>To assess whether the extent of primary and secondary coronary heart disease (CHD) prevention in older British men and women differs between patients with and without diabetes.", "Coronary heart disease prevention in clinical practice: are patients with diabetes special?<||||>Two prospective cardiovascular cohort studies.", "Coronary heart disease prevention in clinical practice: are patients with diabetes special?<||||>24 British towns.", "Coronary heart disease prevention in clinical practice: are patients with diabetes special?<||||>4252 men and 4286 women aged 60-79 years examined between 1998 and 2001.", "Coronary heart disease prevention in clinical practice: are patients with diabetes special?<||||>Use of aspirin, statin, and blood pressure lowering treatment and risk factor control, examined by diabetic status and history of established CHD.", "Coronary heart disease prevention in clinical practice: are patients with diabetes special?<||||>About 20% of the men and 12% of the women had established CHD at age 60-79 years and 7% of the men and 5% of the women had diabetes. In primary CHD prevention, patients with diabetes were more likely to receive CHD risk reducing medications than those without diabetes, but the proportions receiving preventive treatments in both groups were low. In secondary prevention, diabetic and non-diabetic patients received similar levels of treatment, with the exception of angiotensin converting enzyme inhibitors and (for women only) blood pressure lowering treatment, which were more widely used among diabetic patients. There were no clear differences in blood pressure control or cigarette smoking by diabetic status in primary or secondary prevention. Mean total cholesterol concentrations were lower in diabetic patients independently of treatment with statins." ]

[ "Does hope predict adjustment to end-stage renal failure and consequent dialysis?<||||>Hope is important in determining positive outcomes in a range of chronic illnesses. This study examined the role of hope in adjustment to end-stage renal failure (ESRF) and consequent dialysis.", "Does hope predict adjustment to end-stage renal failure and consequent dialysis?<||||>A cross-sectional design examined the ability of hope to predict adjustment to ESRF over and above other relevant variables.", "Does hope predict adjustment to end-stage renal failure and consequent dialysis?<||||>Individuals receiving dialysis at 4 units in the North-West UK were invited to take part in the study. 103 questionnaire packs were included in the analysis. Multiple regression equations determined whether hope was able to predict significant variance in adjustment over and above that accounted for by other factors (demographic and illness-related factors, perceived control, and social support). Measures of anxiety, depression, and quality of life constituted a multidimensional measure of adjustment to ESRF.", "Does hope predict adjustment to end-stage renal failure and consequent dialysis?<||||>Each of the regression models was significant. Hope emerged as an independent significant predictor in five of the multiple regressions: anxiety; depression; effects and symptoms of kidney disease; and mental health quality of life. Age also emerged as an important predictor of outcome." ]

[ "Can MR measurement of renal artery flow and renal volume predict the outcome of percutaneous transluminal renal angioplasty?<||||>Predicting therapeutic benefit from percutaneous transluminal renal angioplasty (PTRA) in patients with renal artery stenosis (RAS) remains difficult. This study investigates whether magnetic resonance (MR)-based renal artery flow measurements relative to renal parenchymal volume can predict clinical outcome following PTRA.", "Can MR measurement of renal artery flow and renal volume predict the outcome of percutaneous transluminal renal angioplasty?<||||>The data on 23 patients (13 men, 10 women; age range 47-82 years, mean age 64 years) were analyzed. The indication for treatment was hypertension (n = 18) or renal insufficiency (n = 5). Thirty-four cases of RAS were identified: bilateral disease was manifest in 11 and unilateral disease in 12 patients. The MR imaging protocol included a breath-hold, cardiac-gated cine phase-contrast sequence for renal flow measurement and a fast multiplanar spoiled gradient-echo sequence for renal volume measurement. MR measurements were performed on the day prior to and the day following PTRA. Clinical success was defined as (a) a reduction in diastolic blood pressure>15% or (b) a reduction in serum creatinine>20%. Kidneys were categorized as normal volume or low volume. A renal flow index (RFI) was calculated by dividing the renal flow (ml/min) by the renal volume (cm3).", "Can MR measurement of renal artery flow and renal volume predict the outcome of percutaneous transluminal renal angioplasty?<||||>Clinical success was observed in patients. Twelve patients did not benefit from angioplasty. Normal kidney volume was seen in 10 of 11 responders and in 8 of 12 nonresponders, resulting in a sensitivity of 91%, specificity of 33%, a positive predictive value (PPV) of 56% and a negative predictive value (NPV) of 80%. A RFI below a threshold of 1.5 ml/min/cm3 predicted successful outcome with 100% sensitivity, 33% specificity, 58% PPV, and 100% NPV. The combination of normal renal volume and a RFI below 1.5 ml/min/cm3 identified PTRA responders with a sensitivity of 91%, a specificity of 67%, a PPV of 71%, and a NPV of 89%. PTRA resulted in a greater increase in renal flow in responders compared with nonresponders (p<0.001)." ]

[ "Are accelerometers a useful tool for measuring disease activity in children with eczema?<||||>Actigraphy, which uses accelerometers to record movement, has been proposed as an objective method of itch assessment in eczema. Previous studies have found strong correlations with actigraphy and video surveillance, disease severity and biological markers in patients with eczema.", "Are accelerometers a useful tool for measuring disease activity in children with eczema?<||||>To assess the validity of accelerometer data, its responsiveness to change and the practicality and acceptability of accelerometers when used as an outcome measure in a clinical trial.", "Are accelerometers a useful tool for measuring disease activity in children with eczema?<||||>This study used data collected from 336 participants of the Softened Water Eczema Trial (SWET). Accelerometer data were compared with three standardized scales: Six Area, Six Sign Atopic Dermatitis (SASSAD) severity score, Patient Oriented Eczema Measure (POEM) and Dermatitis Family Impact (DFI). Spearman's rank testing was used for correlations.", "Are accelerometers a useful tool for measuring disease activity in children with eczema?<||||>Only 70% of trial participants had complete data, compared with 96% for the primary outcome (eczema severity - SASSAD). The convergent validity of accelerometer data with other measures of eczema severity was poor: correlation with SASSAD 0·15 (P = 0·02) and POEM 0·10 (P = 0·13). Assessing for divergent validity against quality of life measures, the correlation with the DFI was low (r = 0·29, P<0·0001). Comparing the change scores from baseline to week 12 for SASSAD, POEM and DFI with the change in accelerometer scores we found low, negative correlations (r = -0·02, P = 0·77; r = -0·12, P = 0·06; and r = -0·01, P = 0·87, respectively). In general, the units were well tolerated but suggestions were made that could improve their usability in children." ]

[ "The associations of SES, obesity, sport activity, and perceived neighborhood environments: is there a model of environmental injustice penalizing Portuguese children?<||||>This study analyses the associations between children's obesity, sports activity (SA), and perceived environmental characteristics with the children's SES.", "The associations of SES, obesity, sport activity, and perceived neighborhood environments: is there a model of environmental injustice penalizing Portuguese children?<||||>A sample of 1,885 Portuguese children, aged 3-10 years, living in Coimbra, Portugal, was observed. Weight and height were measured and obesity was defined by age-and sex-specific, BMI cut-off points. Questionnaires included variables on SA levels, SES and parental neighborhood perceptions were done. A CATPCA was performed and two neighborhood dimensions were achieved. The independent associations of SES with obesity, SA and perceived neighborhood dimensions was analyzed using ordered logistic regressions.", "The associations of SES, obesity, sport activity, and perceived neighborhood environments: is there a model of environmental injustice penalizing Portuguese children?<||||>Children of low [odds ratio (OR) = 1.76; confidence interval (CI) = 1.25-1.99] and medium SES (OR = 1.57; CI = 1.34-2.33) were more likely to be obese than their high-SES peers, less likely to participate in SA (low SES OR = 0.177; CI = 0.12-0.26; medium SES OR = 0.357; CI = 0.24-0.53), and their parents were less likely to have positive perceptions of their built environment (low SES OR = 0.516; CI = 0.38-0.70; medium SES OR = 0.565; CI = 0.37-0.86)." ]

[ "Do different measures of early life socioeconomic circumstances predict adult mortality?<||||>Father's occupational position, education and height have all been used to examine the effects of adverse early life socioeconomic circumstances on health, but it remains unknown whether they predict mortality equally well.", "Do different measures of early life socioeconomic circumstances predict adult mortality?<||||>We used pooled data on 18,393 men and 7060 women from the Whitehall II and GAZEL cohorts to examine associations between early life socioeconomic circumstances and all-cause and cause-specific mortality.", "Do different measures of early life socioeconomic circumstances predict adult mortality?<||||>During the 20-y follow-up period, 1487 participants died. Education had a monotonic association with all mortality outcomes; the age, sex and cohort-adjusted HR for the lowest versus the highest educational group was 1.45 (95% CI 1.24 to 1.69) for all-cause mortality. There was evidence of a U-shaped association between height and all-cause, cancer and cardiovascular mortality robust to adjustment for the other indicators (HR 1.41, 95% CI 1.03 to 1.93 for those shorter than average and HR 1.36, 95% CI 0.98 to 1.88 for those taller than average for cardiovascular mortality). Greater all-cause and cancer mortality was observed in participants whose father's occupational position was manual rather than non-manual (HR 1.11, 95% CI 1.00 to 1.23 for all-cause mortality), but the risks were attenuated after adjusting for education and height." ]

[ "Do patients with Down syndrome develop appendicitis?<||||>Given the number of individuals with Down syndrome (DS) and the high incidence of acute appendicitis (AA) in the general population, one would expect a certain number of patients with DS to develop AA. However, clinical experience suggests that AA is uncommon in patients with DS. This study was undertaken to determine whether the incidence of AA is significantly decreased in patients with DS.", "Do patients with Down syndrome develop appendicitis?<||||>A 13-year cross-sectional study of the state's hospital discharge database was performed to estimate the annual incidence of AA in patients with DS and in the general population. Estimates were generated for both pediatric (0-17 years) and adult (≥ 18 years) populations and were compared using 95% confidence intervals (CIs). In addition, the authors' hospital database was queried over a 10-year time frame.", "Do patients with Down syndrome develop appendicitis?<||||>Incidence estimates of AA in children with DS and in the general pediatric population were 2.5 and 8.9 per 1000, respectively. In adults, the incidence estimates were 2.7 and 5.7 per 1000." ]

[ "Is a combined therapy more effective than either CBT or SSRI alone?<||||>To establish whether the combination of cognitive-behavioral therapy (CBT) and pharmacotherapy (SSRI) was more effective in treating panic disorder (PD) than either CBT or SSRI alone, and to evaluate any differential effects between the mono-treatments.", "Is a combined therapy more effective than either CBT or SSRI alone?<||||>Patients with PD (n = 150) with or without agoraphobia received CBT, SSRI or CBT + SSRI. Outcome was assessed after 9 months, before medication taper.", "Is a combined therapy more effective than either CBT or SSRI alone?<||||>CBT + SSRI was clearly superior to CBT in both completer and intent-to-treat analysis (ITT). Completer analysis revealed superiority of CBT + SSRI over SSRI on three measures and no differences between CBT and SSRI. ITT analysis revealed superiority of SSRI over CBT on four measures and no differences between CBT + SSRI and SSRI." ]

[ "Noninvasive diagnosis of bronchiolitis obliterans due to sulfur mustard exposure: could high-resolution computed tomography give us a clue?<||||>Previous pathological investigations have reported bronchiolitis obliterans (BO) as the major long-term sequela of exposure to sulfur mustard. In this study, we investigated whether high-resolution computed tomography (HRCT) could be used as a noninvasive imaging modality to differentiate between mustard lung (as a subtype of BO) and other respiratory disorders.", "Noninvasive diagnosis of bronchiolitis obliterans due to sulfur mustard exposure: could high-resolution computed tomography give us a clue?<||||>Three groups of patients with sulfur-mustard-induced lung injury (BO), severe chronic asthma (resistant asthma) and smoking habit, respectively, were recruited. Also 30 nonsmoking participants were recruited randomly as the control group. Pulmonary function tests (PFT) and HRCT were performed. Images were viewed with a window level of -450 and window width of 1,400 HU. All images were evaluated by an expert radiologist who was blinded regarding the patients' diagnoses and clinical situations.", "Noninvasive diagnosis of bronchiolitis obliterans due to sulfur mustard exposure: could high-resolution computed tomography give us a clue?<||||>Airway involvement was higher and more frequent than parenchymal involvement in the groups with chemical-induced injury and asthma in comparison with smokers. On the other hand, parenchymal involvement was more frequent than airway involvement in the smokers' group in comparison with the other groups." ]

[ "Electrical impedance tomography: a method for monitoring regional lung aeration and tidal volume distribution?<||||>To demonstrate the monitoring capacity of modern electrical impedance tomography (EIT) as an indicator of regional lung aeration and tidal volume distribution.", "Electrical impedance tomography: a method for monitoring regional lung aeration and tidal volume distribution?<||||>Short-term ventilation experiment in an animal research laboratory.", "Electrical impedance tomography: a method for monitoring regional lung aeration and tidal volume distribution?<||||>One newborn piglet (body weight: 2 kg).", "Electrical impedance tomography: a method for monitoring regional lung aeration and tidal volume distribution?<||||>Surfactant depletion by repeated bronchoalveolar lavage, surfactant administration.", "Electrical impedance tomography: a method for monitoring regional lung aeration and tidal volume distribution?<||||>EIT scanning was performed at an acquisition rate of 13 images/s during two ventilatory manoeuvres performed before and after surfactant administration. During the scanning periods of 120 s the piglet was ventilated with a tidal volume of 10 ml/kg at positive end-expiratory pressures (PEEP) in the range of 0-30 cmH(2)O, increasing and decreasing in 5 cmH(2)O steps. Local changes in aeration and ventilation with PEEP were visualised by EIT scans showing the regional shifts in end-expiratory lung volume and distribution of tidal volume, respectively. In selected regions of interest EIT clearly identified the changes in local aeration and tidal volume distribution over time and after surfactant treatment as well as the differences between stepwise inflation and deflation." ]

[ "Consumer Decision-Making Based on Review Websites: Are There Differences Between Choosing a Hotel and Choosing a Physician?<||||>Web users are increasingly encouraged to rate and review consumer services (eg, hotels, restaurants) and, more recently, this is also the case for physicians and medical services. The resemblance in the setup and design of commercial rating websites (CRWs) and Web-based physician rating websites (PRWs) raises the question of whether choice-making processes based on the two types of websites could also be similar.", "Consumer Decision-Making Based on Review Websites: Are There Differences Between Choosing a Hotel and Choosing a Physician?<||||>This qualitative study sought to explore the extent to which consumer decision making based on Web-based reviews is the same for consumer services (ie, choice of a hotel) and health services (ie, choice of a pediatrician), while providing an in-depth understanding of potential differences or similarities.", "Consumer Decision-Making Based on Review Websites: Are There Differences Between Choosing a Hotel and Choosing a Physician?<||||>Between June and August 2015, we carried out a total of 22 qualitative interviews with young parents residing in the German-speaking part of Switzerland. Participants were invited to complete 2 choice tasks, which involved (1) choosing a hotel based on the commercial Web-based rating website TripAdvisor and (2) selecting a pediatrician based on the PRW Jameda. To better understand consumers' thought processes, we instructed participants to \"think aloud\", namely to verbalize their thinking while sorting through information and reaching decisions. Using a semistructured interview guide, we subsequently posed open-ended questions to allow them to elaborate more on factors influencing their decision making, level of confidence in their final choice, and perceived differences and similarities in their search for a hotel and a physician. All interviews were recorded, transcribed, and analyzed using an inductive thematic approach.", "Consumer Decision-Making Based on Review Websites: Are There Differences Between Choosing a Hotel and Choosing a Physician?<||||>Participants spent on average 9:57 minutes (standard deviation=9:22, minimum=3:46, maximum=22:25) searching for a hotel and 6:17 minutes (standard deviation=4:47, minimum=00:38, maximum=19:25) searching for a pediatrician. Although the choice of a pediatrician was perceived as more important than the choice of a hotel, participants found choosing a physician much easier than selecting an appropriate accommodation. Four main themes emerged from the analysis of our interview data that can explain the differences in search time and choice confidence: (1) trial and error, (2) trust, (3) competence assessment, and (4) affect and likeability." ]

[ "Does systemic clarithromycin therapy have an inhibitory effect on tympanosclerosis?<||||>To demonstrate the inhibitory effects of clarithromycin on in vitro tympanosclerosis.", "Does systemic clarithromycin therapy have an inhibitory effect on tympanosclerosis?<||||>Twenty-eight rats were divided into three groups: a clarithromycin group, a non-clarithromycin group and a negative control group. Those in the first two groups were injected with Streptococcus pneumoniae following a myringotomy, and tympanosclerosis was experimentally induced. Oral clarithromycin therapy was administered in the clarithromycin group. The other groups received no medical treatment.", "Does systemic clarithromycin therapy have an inhibitory effect on tympanosclerosis?<||||>All eardrums in the clarithromycin and non-clarithromycin groups developed myringosclerosis, but there was only one eardrum, in the clarithromycin group, with very severe myringosclerosis. In the clarithromycin group, 11 ears showed no inflammation and there were no ears with severe inflammation. In the non-clarithromycin group, there were 11 ears with severe inflammation. The mean eardrum thickness in the clarithromycin group was 20.93 µm and in the non-clarithromycin group it was 42.71 µm." ]

[ "Asthma management in primary care: does increasing patient medication improve symptoms?<||||>We set out to observe the General Practitioner (GP) management of a cohort of asthma patients over a 2-year period by comparing asthma health status, spirometry, British Thoracic Society treatment step, inhaled medication uptake and psychological status. Changes in these parameters were assessed over the 2-year period.", "Asthma management in primary care: does increasing patient medication improve symptoms?<||||>One hundred fourteen subjects were recruited from four GP practices, two in the inner city and two in suburbia. Subjects were assessed at baseline and at 2 years using the Juniper asthma quality of life questionnaire, the locally devised Q score (a simple patient-focused morbidity index) and the hospital anxiety and depression (HAD) scale. Spirometry (forced expiratory volume in 1 s, forced vital capacity and peak expiratory flow) was recorded using a Micro Medical portable spirometer (Micro Medical Ltd, Chatham, UK); the best values from three acceptable attempts were recorded.", "Asthma management in primary care: does increasing patient medication improve symptoms?<||||>Data for 90 subjects reviewed at baseline and at 24 months were compared to the original cohort of 114 subjects. Patients who had the treatment increased showed no apparent benefit over 2 years. They had similar physiology and symptom scores at baseline but had higher HAD scores (particularly depression element P<0.05) initially. The picture remained constant over the 2 years." ]

[ "Are the metabolic effects of rosiglitazone influenced by baseline glycaemic control?<||||>To compare the metabolic effects of rosiglitazone, an antidiabetic agent of the thiazolidinedione class, in patients with type 2 diabetes with fair to moderate glycaemic control (glycosylated haemoglobin (HbA(lc))<9%) and poor glycaemic control (HbA(lc)>or = 9%).", "Are the metabolic effects of rosiglitazone influenced by baseline glycaemic control?<||||>Data were pooled from two 26-week, randomised, placebo-controlled, double-blind studies of rosiglitazone (4 and 8 mg/day).", "Are the metabolic effects of rosiglitazone influenced by baseline glycaemic control?<||||>After 26 weeks of treatment, HbA(lc) was significantly reduced (p<0.05) compared with baseline and placebo in patients taking rosiglitazone 8 mg/day for both HbA(lc) stratifications, with greater reductions in patients with baseline HbA(lc)>or = 9%. After 26 weeks of treatment, reductions in fasting plasma glucose (FPG) were significant (p<0.05) compared with baseline and placebo in both rosiglitazone treatment groups for both HbA(lc) stratifications, with greater reductions in the group with poor glycaemic control. Rosiglitazone significantly improved insulin sensitivity (p<0.05) compared with baseline in patients with baseline HbA(lc)<9%. Rosiglitazone significantly improved beta-cell function (p<0.05) compared with baseline with more improvement in the group with baseline HbA(lc)>or = 9%. These improvements were statistically significant compared with placebo, regardless of HbA(lc) stratification." ]

[ "Is heat shock protein 60 associated with type 2 diabetes mellitus?<||||>HSP60 plays a protective role against heat, oxidative injury and ultraviolet. Recently, animal and clinical studies have suggested that HSP60 plays a role in various diseases. However, few epidemiological studies have demonstrated an association between HSP60 levels and type 2 diabetes mellitus. Therefore, an epidemiological study was conducted to examine the association of HSP60 with type 2 diabetes mellitus.", "Is heat shock protein 60 associated with type 2 diabetes mellitus?<||||>This study included 83 type 2 diabetes mellitus patients and 161 controls that were recruited from male employees who received annual health check-ups between 2005 and 2007. The serum HSP60 levels were measured using the ELISA method.", "Is heat shock protein 60 associated with type 2 diabetes mellitus?<||||>Because the HSP60 levels were not detectable (<3.125 ng/mL) in 48.0% of the study subjects, HSP60 levels were divided into two categories (detectable or undetectable). A logistic regression analysis showed that the subjects in the undetectable had a 2.03 times higher risk of diabetes mellitus than those in the detectable after adjustment for age, BMI and rate of hypertension medication." ]

[ "Do surgeons wish to become doctors?<||||>To gauge opinion among otolaryngologists about their wish to retain the title Mr, Miss, Ms or Mrs or to adopt the title of doctor.", "Do surgeons wish to become doctors?<||||>An e-mail questionnaire sent to all members of ENT-UK (The British Association of Otolaryngologists-Head and Neck Surgeons), who had registered an e-mail address with the ENT-UK secretariat.", "Do surgeons wish to become doctors?<||||>The specialty group of otolaryngologists in the UK.", "Do surgeons wish to become doctors?<||||>723 recipients of e-mails, who were members or fellows of a surgical Royal College and, by convention in the UK, entitled to adopt the title Mr, Miss, Ms or Mrs.", "Do surgeons wish to become doctors?<||||>304 recipients of the e-mail questionnaire responded. 39% were not aware of any proposals to change the convention, addressing surgeons as 'doctor' in the future. Overall, 61.8% were in favour of retaining the current convention and retaining the title Mr or a female equivalent. Applying the null hypothesis that most surgeons would not like to change a title, the chi(2) test produced a highly significant P value of 0.0002. Of female respondents, however, only 43% supported retention of the current convention. Using Fisher's exact test to compare female and male respondents, the two-sided P value was highly significant at 0.006, with female respondents favouring the title of doctor." ]

[ "Do the effects of posture change and climbing stairs on nasal patency differ in acoustic rhinometry?<||||>Divergent results concerning nasal patency during positional body changes are found using acoustic rhinometry. Only small numbers of healthy subjects have been tested. The present study shall examine a larger number of healthy subjects providing a basis for later findings in sick nasal mucosa.", "Do the effects of posture change and climbing stairs on nasal patency differ in acoustic rhinometry?<||||>40 healthy subjects (20 female, 20 male; average age: 32.8+/-13.8 years) without any nasal and cardiovascular disease were examined. Using acoustic rhinometry, the total nasal volume (Vt) and the total minimum nasal cross-sectional area (Ft) were calculated from the collected data. Six measurements were made: in sedentary rest position, standing, lying dorsally, after standing up, after climbing stairs and in iteration in sedentary rest position.", "Do the effects of posture change and climbing stairs on nasal patency differ in acoustic rhinometry?<||||>In healthy subjects, the total nasal volume (i. e. the nasal respiration space of the two nasal passages) did not change during standing and lying, after rapid standing up and in a repeat measurement 5 hours later. After climbing stairs, the nasal mucosa decongested significantly, chiefly dorsal to the isthmus nasi. The birhine partial volume (V2) increased by an average of 33 %." ]

[ "Is the Framingham risk function valid for northern European populations?<||||>To examine the validity of estimates of coronary heart disease (CHD) risk by the Framingham risk function, for European populations.", "Is the Framingham risk function valid for northern European populations?<||||>Comparison of CHD risk estimates for individuals derived from the Framingham, prospective cardiovascular Münster (PROCAM), Dundee, and British regional heart (BRHS) risk functions.", "Is the Framingham risk function valid for northern European populations?<||||>Sheffield Hypertension Clinic. Patients-206 consecutive hypertensive men aged 35-75 years without preexisting vascular disease.", "Is the Framingham risk function valid for northern European populations?<||||>There was close agreement among the Framingham, PROCAM, and Dundee risk functions for average CHD risk. For individuals the best correlation was between Framingham and PROCAM, both of which use high density lipoprotein (HDL) cholesterol. When Framingham was used to target a CHD event rate>3% per year, it identified men with mean CHD risk by PROCAM of 4.6% per year and all had CHD event risks>1.5% per year. Men at lower risk by Framingham had a mean CHD risk by PROCAM of 1.5% per year, with 16% having a CHD event risk>3.0% per year. BRHS risk function estimates of CHD risk were fourfold lower than those for the other three risk functions, but with moderate correlations, suggesting an important systematic error." ]

[ "Melatonin/circadian rhythm. Is there a feedback between epiphysis and hypophysis?<||||>The study evaluates the circadian rhythm of melatonin in relation to sex and age and identified contemporary alterations in the secreton of some hypophyseal hormones, suggesting that melatonin may exert a modulatory action on the latter.", "Melatonin/circadian rhythm. Is there a feedback between epiphysis and hypophysis?<||||>The melatonin metabolite (6-hydroxymelatonin sulfate) was assayed in urine samples from 48 subjects of both sexes aged between 25 and 60 years old using the RIA method described by Arendt, modified for the ise of iodine markers. A blood sample was taken from the same subjects to assay hypophyseal hormones.", "Melatonin/circadian rhythm. Is there a feedback between epiphysis and hypophysis?<||||>Melatonin secretion does not remain constant over 24 hours in young subjects of both sexes, but instead is rhythmic. This rhythmic secretion is lacking in adults, revealing a daytime pineal secreton that is surprisingly higher than in younger persons. A difference in secretion levels was also found between sexes, a higher melatonin peak in females compared to males. Some young female subjects reveal a contemporary hypersecretion of the somatotropic hormone in line with the falling nocturnal peak of melatonin. Subjects with latent hypothyroidism show a diminished melatonin peak compared to that in euthyroid subjects." ]

[ "Does a growing tumour volume induce lymphangiogenesis?<||||>Tumour cell metastasis to regional lymph nodes is an early event in the spread of metastatic tumour. We postulated that an increased primary tumour volume (PTV) may modulate cervical nodal metastasis by altering lymphangiogenesis.", "Does a growing tumour volume induce lymphangiogenesis?<||||>We investigated 48 patients who had previously been diagnosed with cancer of the oral cavity and oropharynx.", "Does a growing tumour volume induce lymphangiogenesis?<||||>The tumour area was manually outlined from an axial magnetic resonance imaging series. The three-dimensional reconstruction software automatically calculated the PTV. Immunohistochemical staining was performed with vascular endothelial growth factor (VEGF)-C, VEGF-D, and D2-40 monoclonal antibodies on the paraffin-embedded tissues obtained from the primary tumour.", "Does a growing tumour volume induce lymphangiogenesis?<||||>The associations among the semiquantitative scores of the VEGF-C/D stained cancer cells, lymphatic vessel density (LVD), and PTV were investigated.", "Does a growing tumour volume induce lymphangiogenesis?<||||>PTV had a significant relationship with LVD (p  =  .037) and N+ disease (p  =  .024). VEGF-C expression was significantly associated with lymph node metastasis (p  =  .018), increased LVD (p<.001), and tumour differentiation (p  =  .015) . However, we found no significant relationship between VEGF-C expression and the PTV. Similarly, among the various clinical factors, we found that the N stage (p  =  .001) and LVD (p  =  .008) were significantly associated with VEGF-D expression. However there was no association between VEGF-D expression and the primary PTV." ]

[ "Do diabetic patients receiving conventional dialysis solutions benefit from peritoneal dialysis?<||||>In this cross-sectional study we compared the influence of long term use of GBPDS on sixteen parameters related to the peritoneal glucose load, hydration status, inflammation, blood pressure, lipid profile and left ventricular mass in 45 stable PD patients (20 diabetic and 25 non-diabetic) receiving GBPDS.", "Do diabetic patients receiving conventional dialysis solutions benefit from peritoneal dialysis?<||||>At 24 months HbA1c, peritoneal glucose load index (PGLI), fluid overload (FO), plasma BNP, hsCRP and IL-6 levels, WBC count, blood pressure, triglycerides, LDL-C and left ventricular mass index (LVMI) were higher in diabetic patients compared to non-diabetic subjects (P ≤ 0.04). Of 16 tested variables, 14 had deteriorated at 24 months in diabetic patients. PGLI values>3 g/kg/day or FO>1.0 L were associated with abnormal values of HbA1c, plasma BNP, CRP and plasma IL-6 levels. 60% of diabetic patients had PGLI>3g/kg/day compared to 32% of non-diabetic patients (P<0.001). Seventy per cent of diabetic patients had FO>1.0 L compared to 28% of non-diabetic patients (P<0.001). Only 12% of diabetic patients had nocturnal blood pressure dipping compared to 45% of non-diabetics (P = 0.03). 57.8% of the studied patients had increased LVMI. Diabetic patients had higher LVMI values compared to non-diabetics (P<0.001). The presence of DM was found to be the most powerful predictor for the development of LVH (P<0.001)." ]

[ "Does colposcopically directed punch biopsy reduce the incidence of negative LLETZ?<||||>To evaluate the role of punch biopsy in reducing the occurrence of negative histology provided by large loop excision of the transformation zone in the management of cervical intraepithelial neoplasia.", "Does colposcopically directed punch biopsy reduce the incidence of negative LLETZ?<||||>Retrospective review of computerised data base and clinic files.", "Does colposcopically directed punch biopsy reduce the incidence of negative LLETZ?<||||>Colposcopy Clinic, Groote Schuur Hospital, Cape Town, South Africa.", "Does colposcopically directed punch biopsy reduce the incidence of negative LLETZ?<||||>Two hundred and ninety-eight women considered suitable for the local outpatient management of cervical intraepithelial neoplasia.", "Does colposcopically directed punch biopsy reduce the incidence of negative LLETZ?<||||>Two groups of patients were identified: group A consisted of women who had cervical intraepithelial neoplasia confirmed colposcopically and who underwent directed punch biopsy; group B consisted of women who had cervical intraepithelial neoplasia confirmed colposcopically and were referred for large loop excision of the transformation zone without confirmatory punch biopsy.", "Does colposcopically directed punch biopsy reduce the incidence of negative LLETZ?<||||>In Group A (n = 184) 123 women had cervical intraepithelial neoplasia diagnosed on punch biopsy. Large loop excision of the transformation zone was performed on 116 women and 7 were lost to follow up. The procedure confirmed cervical intraepithelial neoplasia in 95 cases (82%), but there was no cervical intraepithelial neoplasia in 21 cases (18%). Sixty-one women had negative punch biopsies. Of these, 13 underwent large loop excision of the transformation zone, 31 had persistently negative follow up cytology, and 9 had positive cervical smears of which 7 were treated with large loop excision of the transformation zone, and 8 were lost to follow up. Overall, 25% of all negative punch biopsies were falsely negative. In group B 114 were treated with large loop excision of the transformation zone and cervical intraepithelial neoplasia was confirmed in 97 cases (85%); one woman had unsuspected microinvasion (1%) and 16 women (14%) had no cervical intraepithelial neoplasia. Negative histology after large loop excision of the transformation zone was not statistically different in groups A and B." ]

[ "Does competitive food and beverage legislation hurt meal participation or revenues in high schools?<||||>There is limited evidence to evaluate the influence of competitive food and beverage legislation on school meal program participation and revenues.", "Does competitive food and beverage legislation hurt meal participation or revenues in high schools?<||||>A representative sample of 56 California high schools was recruited to collect school-level data before (2006–2007) and the year after (2007–2008) policies regarding limiting competitive foods and beverages were required to be implemented. Data were obtained from school records, observations, and questionnaires. Paired t-tests assessed significance of change between the two time points.", "Does competitive food and beverage legislation hurt meal participation or revenues in high schools?<||||>Average participation in lunch increased from 21.7% to 25.3% (p<0.001), representing a 17.0% increase, while average participation in breakfast increased from 8.9% to 10.3% (p = 0.02), representing a 16.0% increase. There was a significant (23.0%) increase in average meal revenue, from $0.70 to $0.86 (per student per day) (p<0.001). There was a nonsignificant decrease (18.0%) in average sales from à la carte foods, from $0.45 to $0.37 (per student per day). Compliance with food and beverage standards also increased significantly. At end point, compliance with beverage standards was higher (71.0%) than compliance with food standards (65.7%)." ]

[ "Can Better Outdoor Environments Lead to Cost Benefits in Assisted Living Facilities Through Increased Word-of-Mouth Referrals?<||||>This study explores how better outdoor environments may produce cost benefits for assisted living providers by raising occupancy levels through increased resident satisfaction and word-of-mouth referrals.", "Can Better Outdoor Environments Lead to Cost Benefits in Assisted Living Facilities Through Increased Word-of-Mouth Referrals?<||||>Older adults who spend even minimal time outdoors may reap substantial health benefits. However, many existing outdoor areas in assisted living facilities are reportedly underutilized, in part because of design issues. Providers may be more willing to improve outdoor areas if they produce cost benefits for provider organizations.", "Can Better Outdoor Environments Lead to Cost Benefits in Assisted Living Facilities Through Increased Word-of-Mouth Referrals?<||||>This study used data from a recent assisted living survey to assess the relationship between satisfaction with outdoor spaces, time spent outdoors, and resulting improvements in mood. A financial analysis was developed to estimate potential benefits from improved outdoor areas attributable to increased occupancy and decreased marketing costs associated with increased word-of-mouth referrals.", "Can Better Outdoor Environments Lead to Cost Benefits in Assisted Living Facilities Through Increased Word-of-Mouth Referrals?<||||>Increasing resident satisfaction with outdoor areas (from approximately 29% to 96%) results in residents spending more time outdoors (increase of 1½ hours per week per resident) and improved psychological well-being (12% increase in feeling better). This greater overall satisfaction leads to 8% more residents willing to refer potential residents to their community. Because word-of-mouth referrals by current residents are a major factor in resident recruitment, improving outdoors areas leads to an estimated 4% increase in new residents, resulting in over $170,000 of increased revenue per year for a community of 100 residents." ]

[ "Enteropathogenic Escherichia coli (EPEC): Does it have a role in colorectal tumourigenesis?<||||>Despite the characterization of many aetiologic genetic changes. The specific causative factors in the development of sporadic colorectal cancer remain unclear. This study was performed to detect the possible role of Enteropathogenic Escherichia coli (EPEC) in developing colorectal carcinoma.", "Enteropathogenic Escherichia coli (EPEC): Does it have a role in colorectal tumourigenesis?<||||>Fresh biopsy specimens have been obtained from the colonic mucosa overlying the colorectal cancer as well as from the colon of the healthy controls. Culture, genotyping and virulence of EPEC were done using (nutrient broth culture, and PCR). Strains biochemically identified as Escherichia coli were selected from the surface of a MacConkey's plate and were serogrouped by slide agglutination tests.", "Enteropathogenic Escherichia coli (EPEC): Does it have a role in colorectal tumourigenesis?<||||>From January 2011 to June 2014, 213 colorectal cancer patients (Group 1) and 248 healthy controls (Group 2) were prospectively enrolled in this study. EPEC was positive in 108 (50.7%) in group 1 and 51 (20.6%) in group 2 (P = 0.0001). A significant difference between both groups was observed regarding serotyping, genotyping (eae gene) and virulence category (P = 0.0001). A significant difference between the 2 subgroups of colorectal cancer cases was observed regarding genotyping (eae, bfb genes) and virulence category." ]

[ "Simple cyst-appearing renal masses at unenhanced CT: can they be presumed to be benign?<||||>To determine renal cancer incidence in simple cyst-appearing renal masses detected at unenhanced computed tomography (CT).", "Simple cyst-appearing renal masses at unenhanced CT: can they be presumed to be benign?<||||>Institutional review board approval and an informed consent waiver for this retrospective HIPAA-compliant study were obtained. Patients who had renal masses with homogeneous water attenuation, hairline-thin smooth walls, and no calcifications or septations were identified by applying a validated natural language processing algorithm to radiology reports for 15 695 unique patients who underwent unenhanced abdominal CT at our institution between 2000 and 2005. Reports that included renal masses were selected, then categorized through manual report review as pertaining to simple cyst-appearing renal masses, nonsimple or solid renal masses, or no renal masses. Medical records were reviewed for subsequent renal cancer diagnoses. Patients without renal cancer were evaluated for a minimum of 5 years (mean, 8 years; range, 5-12 years). The Cox proportional hazards regression model was used to compare renal cancer incidence for patients who had simple cyst-appearing renal masses with those who had nonsimple cystic or solid renal masses and those who had no renal masses.", "Simple cyst-appearing renal masses at unenhanced CT: can they be presumed to be benign?<||||>Simple cyst-appearing renal masses were identified in 2669 patients (17%), no renal masses in 11844 (75%), and nonsimple cystic or solid renal masses in 1182 (8%). Of 1159 patients with simple cyst-appearing renal masses and a minimum of 5 years of follow-up, six (0.52%) subsequently developed renal cancers, all of which were separate from the simple cyst-appearing renal mass, rather than within it. Of 446 patients with nonsimple or solid renal masses and sufficient follow-up, 50 (11%) developed renal cancer. There was no difference in renal cancer incidence in patients with simple cyst-appearing renal masses versus those without renal masses (P = .54). The incidence of renal cancer was significantly lower in patients with simple cyst-appearing renal masses than that in nonsimple cystic or solid renal masses (P<.0001)." ]

[ "Does hand osteoarthritis predict future hip or knee osteoarthritis?<||||>To evaluate the risk of future hip or knee osteoarthritis (OA) in subjects with hand OA at baseline and to evaluate whether the concurrent presence of hand OA, other risk factors for OA, or an OA biomarker (type II collagen C-telopeptide degradation product [CTX-II]) further increases the risk.", "Does hand osteoarthritis predict future hip or knee osteoarthritis?<||||>Radiographs of the hands (baseline) and the hips and knees (baseline and 6.6 years later) were obtained in a randomly selected subset of participants in the Rotterdam Study who were ages 55 years and older. Radiographs were scored for the presence of OA using the Kellgren/Lawrence (K/L) system. A total of 1,235 subjects without OA of the hip/knee (K/L score 0-1) at baseline were included in the study. CTX-II levels were measured at baseline. The independent risk of future hip/knee OA in subjects with hand OA at baseline was assessed by logistic regression, as stratified for age, sex, body mass index, family history of OA, and heavy workload.", "Does hand osteoarthritis predict future hip or knee osteoarthritis?<||||>Overall 12.1% of the participants (19.7% of those with hand OA versus 10.0% of those without) developed hip or knee OA (odds ratio [OR] 2.1 [95% confidence interval (95% CI) 1.3-3.1]). Subjects with hand OA had an increased risk of future hip OA (OR 3.0 [95% CI 1.6-5.4]), which was further increased in those with a family history of OA. Subjects with hand OA had an OR of 1.6 [95% CI 1.0-2.8) for the future development of knee OA, which was further increased in those who were overweight. Concurrent hand OA and high levels of CTX-II further increased the risk of having hip or knee OA at followup (OR 4.2 [95% CI 2.3-7.8])." ]

[ "Does arteriosclerotic calcinosis of vessel walls imitate osteogenesis?<||||>For it is supposed that calcification of arteriosclerotic plaques imitates osteogenesis, it was studied whether the morphology of different stages of calcification supports such an assumption.", "Does arteriosclerotic calcinosis of vessel walls imitate osteogenesis?<||||>Investigations were performed on one operation specimen of a dissecting aneurysm of the aorta and five human autopsy aortas. From different arteriosclerotic plaques, paraffin sections without and after EDTA-decalcification were prepared. Light microscopic, scanning (SEM) and transmission electron microscopic (TEM) investigations as well as X-ray microanalysis were performed.", "Does arteriosclerotic calcinosis of vessel walls imitate osteogenesis?<||||>By light microscopy, it became obvious that the intensity of calcification of arteriosclerotic plaques is not reflected by the conventional H&E stain--the real amount of calcium-phosphorus deposits becomes only evident by using a special stain, such as the alizarin red S reaction. In the SEM, arteriosclerotic plaques with granular calcification were characterized by accumulations of isolated calcified globules often reflecting the structure of necrotic cells. TEM exhibited even accumulations of calcified bodies corresponding to the shape of cells; cell remnants were present in the neighborhood. X-ray microanalysis of the granules detected calcium and phosphorus and a relative high content of magnesium, reflecting the composition of calcospherites in granular media calcification (71). By SEM, solid calcifications exhibited associations of calcified bodies resembling those of the isolated granules in early calcification but with one stuck onto the other. X-ray microanalysis revealed that these deposits are characterized by high amounts of calcium and phosphorus and a minor component of magnesium in comparison to the isolated granules." ]

[ "Mass lesions in the brain: tumor or multiple sclerosis?<||||>25 patients with TDL in our center were followed and clinical, magnetic resonance imaging (MRI), magnetic resonance spectroscopy, cerebrospinal fluid (CSF) findings and disease course were retrospectively evaluated.", "Mass lesions in the brain: tumor or multiple sclerosis?<||||>Mean age at symptom onset was 29 years. Motor and sensory deficits were most common symptoms and 18 of them were polysymptomatic. Mostly frontal and parietal regions were affected. 10/25 patients were initially misdiagnosed clinically as brain abscess, primary central nervous system tumor metastasis. T2-hypointense rim, incomplete ring enhancement of the lesions on post-gadolinium T1- weighted imaging on brain MRI enabled accurate diagnosis of TDLs. 13 of 21 patients with first-TDL presentation sustained a monophasic course, remaining 8 patients converted to multiple sclerosis (MS) at a mean 38.4 months follow-up. Clinical isolated syndrome (CIS) patients were older than patients who developed MS and Expanded Disability Status Scale was lower (0.96 vs 3.7)." ]

[ "High concentrations of circulating macrophage migration inhibitory factor in patients with severe blunt trauma: Is serum macrophage migration inhibitory factor concentration a valuable prognostic factor?<||||>To determine serum concentrations of macrophage migration inhibitory factor and other cytokines in severe blunt trauma patients in critical settings and to evaluate their association with patient outcome.", "High concentrations of circulating macrophage migration inhibitory factor in patients with severe blunt trauma: Is serum macrophage migration inhibitory factor concentration a valuable prognostic factor?<||||>Prospective, observational study.", "High concentrations of circulating macrophage migration inhibitory factor in patients with severe blunt trauma: Is serum macrophage migration inhibitory factor concentration a valuable prognostic factor?<||||>Emergency department and surgical intensive care unit of a university hospital.", "High concentrations of circulating macrophage migration inhibitory factor in patients with severe blunt trauma: Is serum macrophage migration inhibitory factor concentration a valuable prognostic factor?<||||>Fifty-four severe blunt trauma patients with systemic inflammatory response syndrome requiring intensive care, emergency surgical intervention, or both were enrolled in the study. Forty-four patients with minor injuries were the controls.", "High concentrations of circulating macrophage migration inhibitory factor in patients with severe blunt trauma: Is serum macrophage migration inhibitory factor concentration a valuable prognostic factor?<||||>Serum macrophage migration inhibitory factor concentrations were measured in the emergency department<4 hrs postinjury (day 1) and the surgical intensive care unit 24 hrs later (day 2). Blood samples for determination of tumor necrosis factor-alpha, interleukin-6, interleukin-8, and interleukin-10 were measured both in patients with severe blunt trauma and in controls. The Acute Physiology and Chronic Health Evaluation II, Injury Severity Score, Revised Trauma Score, and Trauma Revised Injury Severity Score were used for clinical evaluation of trauma severity.", "High concentrations of circulating macrophage migration inhibitory factor in patients with severe blunt trauma: Is serum macrophage migration inhibitory factor concentration a valuable prognostic factor?<||||>Serum macrophage migration inhibitory factor concentrations were higher in severe blunt trauma patients than in controls; were significantly correlated with Acute Physiology and Chronic Health Evaluation II, Revised Trauma Score, and Trauma Revised Injury Severity Score scores in severe blunt trauma patients but not in controls; and were higher in nonsurvivors than in survivors." ]

[ "Bax, cytochrome c, and caspase-8 staining in parotid cancer patients: markers of susceptibility in radiotherapy?<||||>Negative bcl-2 and HLA-DR protein expression have been associated with responsiveness to adjuvant radiotherapy in surgically treated parotid cancer patients. The aim of this study was to investigate the prognostic significance of bax, cytochrome c, and caspase-8 protein expression in a group of surgically treated patients to determine whether they also suggest markers of responsiveness to adjuvant radiotherapy.", "Bax, cytochrome c, and caspase-8 staining in parotid cancer patients: markers of susceptibility in radiotherapy?<||||>Historical cohort study.", "Bax, cytochrome c, and caspase-8 staining in parotid cancer patients: markers of susceptibility in radiotherapy?<||||>Otolaryngology department in a university hospital.", "Bax, cytochrome c, and caspase-8 staining in parotid cancer patients: markers of susceptibility in radiotherapy?<||||>The immunohistochemical expression of bax, cytochrome c, and caspase-8 were studied in paraffin-embedded tissue specimens originating from 27 surgically treated parotid cancer patients and nine patients with Warthin parotid tumors (control group) and correlated with the patients' clinicopathological characteristics and clinical outcome.", "Bax, cytochrome c, and caspase-8 staining in parotid cancer patients: markers of susceptibility in radiotherapy?<||||>Caspase-8 negative staining was more frequently observed in higher TNM stages and in tumors measuring more than 4 cm (P = 0.009 and P = 0.018, respectively). Caspase-8 (-)/cytochrome c (-) patients carried low-grade lesions without nodal involvement (P = 0.01 and P = 0.05, respectively). Caspase-8 (-) patients who received postoperative radiotherapy presented a significantly increased disease-free survival compared to those who did not (P = 0.04). Patients bearing bax (-) tumors who received postoperative radiotherapy presented an improved four-year disease-free survival compared to bax (-) patients who did not receive any type of adjuvant radiotherapy (P = 0.017)." ]

[ "Should women younger than 40 years of age with invasive breast cancer have a mastectomy?<||||>Optimal local management for young women with early-stage breast cancer remains controversial. This study examined 15-year outcomes among women younger than 40 years treated with breast-conserving surgery plus whole-breast radiation therapy (BCT) compared with those treated with modified radical mastectomy (MRM).", "Should women younger than 40 years of age with invasive breast cancer have a mastectomy?<||||>Women aged 20 to 39 years with early-stage breast cancer diagnosed between 1989 and 2003 were identified in a population-based database. Primary outcomes of breast cancer-specific survival (BCSS), overall survival (OS) and secondary outcomes of local relapse-free survival (LRFS), locoregional relapse-free survival (LRRFS), and distant relapse-free survival (DRFS) were calculated using Kaplan-Meier methods and compared between BCT and MRM cohorts using log-rank tests. A planned subgroup analysis was performed on patients considered \"ideal\" for BCT (ie, T1N0, negative margins and no extensive ductal carcinoma in situ) and in whom local therapy may have the largest impact on survival because of low systemic risk.", "Should women younger than 40 years of age with invasive breast cancer have a mastectomy?<||||>965 patients were identified; 616 had BCT and 349 had MRM. The median follow-up time was 14.4 years (range, 8.4-23.3 years). Overall, 15-year rates of BCSS (76.0% vs 74.1%, P=.62), OS (74.2% vs 73.0%, P=.75), LRFS (85.4% vs 86.5%, P=.95), LRRFS (82.2% vs 81.6%, P=.61), and DRFS (74.4% vs 71.6%, P=.40) were similar between the BCT and MRM cohorts. In the \"ideal\" for BCT subgroup, there were 219 BCT and 67 MRM patients with a median follow-up time of 15.5 years. The 15-year BCSS (86.1% vs 82.9%, P=.57), OS (82.6% vs 82.9%, P=.89), LRFS (86.2% vs 84.2%, P=.50), LRRFS (83.1% vs 78.3%, P=.24), and DRFS (84.8% vs 79.1%, P=.17) were similar in the BCT and MRM cohorts." ]

[ "Can early computed tomography angiography after endovascular aortic aneurysm repair predict the need for reintervention in patients with type II endoleak?<||||>This study was designed to identify parameters on CT angiography (CTA) of type II endoleaks following endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA), which can be used to predict the subsequent need for reinterventions.", "Can early computed tomography angiography after endovascular aortic aneurysm repair predict the need for reintervention in patients with type II endoleak?<||||>We retrospectively identified 62 patients with type II endoleak who underwent early CTA in mean 3.7 ± 1.9 days after EVAR. On the basis of follow-up examinations (mean follow-up period 911 days; range, 373-1,987 days), patients were stratified into two groups: those who did (n = 18) and those who did not (n = 44) require reintervention. CTA characteristics, such as AAA, endoleak, as well as nidus dimensions, patency of the inferior mesenteric artery, number of aortic branch vessels, and the pattern of endoleak appearance, were recorded and correlated with the clinical outcome.", "Can early computed tomography angiography after endovascular aortic aneurysm repair predict the need for reintervention in patients with type II endoleak?<||||>Univariate and receiver operating characteristic curve regression analyses revealed significant differences between the two groups for the endoleak volume (surveillance group: 1391.6 ± 1427.9 mm(3); reintervention group: 3227.7 ± 2693.8 mm(3); cutoff value of 2,386 mm(3); p = 0.002), the endoleak diameter (13.6 ± 4.3 mm compared with 25.9 ± 9.6 mm; cutoff value of 19 mm; p<0.0001), the number of aortic branch vessels (2.9 ± 1.2 compared with 4.2 ± 1.4 vessels; p = 0.001), as well as a \"complex type\" endoleak pattern (13.6 %, n = 6 compared with 44.4 %, n = 8; p = 0.02)." ]

[ "Infectious diseases in the 21st century. Are we entering the hot zone?<||||>The emergence and re-emergence of several infectious diseases in the latter part of the 20th century has created considerable concern, but what real impact will these and other infectious diseases have in the 21st century?", "Infectious diseases in the 21st century. Are we entering the hot zone?<||||>To assess trends in infectious disease mortality, both globally and within Australia.", "Infectious diseases in the 21st century. Are we entering the hot zone?<||||>Mortality related to infectious disease has declined throughout the 20th century in both developed and developing regions. In Australia, over the period 1979-1994 infectious disease mortality declined 17%, with similar trends seen in several other developed countries. In contrast, over a similar period infectious disease mortality increased in the United States by approximately 40%. Despite an escalating global HIV epidemic and continuing high tuberculosis incidence, infectious disease mortality is projected to decline further in the early part of the 21st century, in developed and developing regions. By 2020 an infectious disease category will not appear in the top 10 causes of death in developed regions or top five causes of death in developing regions." ]