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[ "Do predictive parameters exist for therapy with duloxetine in women with stress urinary incontinence?<||||>To determine whether predictive parameters exist for successful duloxetine therapy in women with stress urinary incontinence (SUI).", "Do predictive parameters exist for therapy with duloxetine in women with stress urinary incontinence?<||||>Secondary analysis was performed of 1,714 women who received duloxetine in the Stress Urinary Incontinence Treatment (SUIT) study, a 12-month longitudinal observational study to evaluate the results and direct costs of SUI treatment. Data of 1,087 women were analyzed. Univariate and multivariate analyses (stepwise forward logistic regression) were performed to investigate factors for discontinuation of treatment.", "Do predictive parameters exist for therapy with duloxetine in women with stress urinary incontinence?<||||>Parameters that significantly reduced the probability of treatment termination were smoking and a body mass index (BMI)<20, while obesity (BMI>30) increased the probability in the univariate analysis. In the multivariate analysis significantly reduced likelihoods of duloxetine treatment discontinuation were found for an age>65 years, country, and 7 to 13 incontinence episodes per week. Co-medication, particularly anti-cholinergics, was significantly associated with therapy termination. Previous SUI surgery had no effect." ]

[ "Births in Finland and Estonia from 1992 to 1996: convergent differences?<||||>To describe the differences in childbearing, in prenatal and obstetrical practices, and in perinatal health outcome in Finland and Estonia.", "Births in Finland and Estonia from 1992 to 1996: convergent differences?<||||>Registry study using the data from the Finnish and Estonian medical birth registries for years 1992 to 1996 (in total 324,021 and 74,297 newborns, respectively).", "Births in Finland and Estonia from 1992 to 1996: convergent differences?<||||>In 1992 the birth rates were 51 per 1,000 women aged 15 to 49 in Finland and 48 per 1,000 in Estonia. The birth rate declined in the study period in both countries, but the decline was more rapid in Estonia (-26%) than in Finland (-6%). In the same period the rates of induced abortion declined in both countries (-34% and -6%, respectively), but the rate in 1996 was still much higher in Estonia (46/1,000) than in Finland (8/1,000). Compared with Finnish mothers, Estonian mothers were younger, had fewer multiple births, less prenatal care and fewer interventions during pregnancy and delivery. The intervention rates increased in both countries during the study period, but this increase was more rapid in Estonia. The infant outcomes were poorer in Estonia, but the differences between Estonia and Finland decreased during the 1990's." ]

[ "Adolescents on neuroleptic medication: is this population at risk for tardive dyskinesia?<||||>The assess the incidence of tardive dyskinesia (TD) in a sample of adolescents treated with neuroleptic medication and to identify the presence of any risk factors for TD within the affected group.", "Adolescents on neuroleptic medication: is this population at risk for tardive dyskinesia?<||||>A retrospective chart review was conducted for 40 cases. The Abnormal Involuntary Movement Scale (AIMS) was used to measure side effects from medication at 6-month intervals over 2 years. Drug exposure was converted to chlorpromazine (CPZ) equivalent and the presence of risk factory for TD, such as a diagnosis of affective disorder, medication noncompliance, early age of illness onset, and concomitant antiparkinsonian medication, was also noted.", "Adolescents on neuroleptic medication: is this population at risk for tardive dyskinesia?<||||>Of the 40 cases reviewed, 2 patients (5%) met diagnostic criteria for TD, and another 5 patients (12.5%) showed symptoms of TD." ]

[ "Can the increase of bone mineral density following bisphosphonates treatments be explained by biomechanical considerations?<||||>We hypothesized that bone mineral density increase following bisphosphonates treatments may be explained by the influence of the drug on the mechanical bone remodeling parameters.", "Can the increase of bone mineral density following bisphosphonates treatments be explained by biomechanical considerations?<||||>Patients treated with bisphosphonates continuously increase their bone mineral density. This increase is explained in the first 12-18 months following the treatment by the filling of the transient remodeling deficit. Recently, results of a clinical study of alendronate treatment over 7 years still show a continuous increase of bone mineral density. These results raised several questions regarding our understanding of bisphosphonates mode of action.", "Can the increase of bone mineral density following bisphosphonates treatments be explained by biomechanical considerations?<||||>Bone remodeling is influenced by different factors including mechanical forces. In the present study, we propose then to consider the effect of bisphosphonates also under biomechanical considerations.", "Can the increase of bone mineral density following bisphosphonates treatments be explained by biomechanical considerations?<||||>Identification of the model with the clinical data showed that daily treatment of 10 and 20 mg alendronate decreased the bone turnover rate by 2% and 11%, respectively, in comparison with the 5 mg alendronate treatment. Moreover, the alendronate treatments decreases the resorption threshold stimulus by 19% (25%, 28%) for the 5 mg (10 and 20 mg, respectively) compared to placebo." ]

[ "Can saline be an alternative to aesthetic surgery in extended breast quadrantectomy?<||||>To explore other simpler options sparing the patients the morbidity and cost in extended breast quadrantectomy.", "Can saline be an alternative to aesthetic surgery in extended breast quadrantectomy?<||||>This prospective study was undertaken at King Fahd Hospital of the University, Al-Khobar, Eastern Province of Saudi Arabia between 1999-2005. Factors considered for patients undergoing breast-conserving surgery were based on age, tumor size, pathological characteristics, and patient's preference. Frozen section was adopted in all procedures to insure negative margins. After extended quadrantectomy, 200-400 cc was injected into the cavity to retain breast contour. Magnetic resonance imaging was used for postoperative assessment.", "Can saline be an alternative to aesthetic surgery in extended breast quadrantectomy?<||||>Twenty-four patients were included, aged 28-43 years and tumor size 3-5 cms. All margins were negative on frozen section. The contour of the breast was restored with saline, MRI was employed for follow up at the immediate post operative period and at 4-6 months, it demonstrated restored breast contour and the saline filled cavity replaced by lipo-fibrous tissue. Follow up after 4-24 months showed that all patients noticed some degree of asymmetry, yet were satisfied with the result, none required or requested additional surgery." ]

[ "Does metabolic syndrome have an impact on the quality of life and mood of hemodialysis patients?<||||>Little is known about the association between metabolic syndrome (MetSyn), health-related quality of life (HRQoL), and depressive symptoms in hemodialysis (HD) patients. We hypothesized that MetSyn may be associated with lower HRQoL and depression in HD patients.", "Does metabolic syndrome have an impact on the quality of life and mood of hemodialysis patients?<||||>This was a cross-sectional study.", "Does metabolic syndrome have an impact on the quality of life and mood of hemodialysis patients?<||||>The trial involved HD patients at a tertiary-care hospital.", "Does metabolic syndrome have an impact on the quality of life and mood of hemodialysis patients?<||||>We evaluated 115 patients (41 women and 74 men; mean age, 48.4 +/- SD 11.9 years SD).", "Does metabolic syndrome have an impact on the quality of life and mood of hemodialysis patients?<||||>MetSyn was defined according to National Cholesterol Education Panel criteria. The Medical Outcomes Study Short Form-36 (SF-36) and Beck Depression Inventory (BDI) were used to assess HRQoL and signs of depression, respectively. We compared HRQoL and clinical and psychosocial characteristics among participants with and without MetSyn.", "Does metabolic syndrome have an impact on the quality of life and mood of hemodialysis patients?<||||>Fifty patients (43.5%) had MetSyn, and 65 patients (56.5%) were free of MetSyn. Comparisons of SF-36 and BDI scores between HD patients with and without MetSyn revealed no statistically significant differences. The Physical Component Summary Score (PCS) of SF-36 was independently associated with HD duration (beta = -0.274, P = .002), age (beta = -0.206, P = .024), sleep disturbance (beta = -0.175, P = .045), albumin (beta = +0.252, P = .006), and hemoglobin (beta = +0.270, P = .002) in stepwise linear regression analysis. The MetSyn was not associated with PCS. The Mental Component Summary Score of SF-36 was independently associated with hemoglobin (beta = +0.235, P = .016) and BDI score (beta = -0.218, P = .025)." ]

[ "Are multiple cerebral infarcts synergistic?<||||>The goal of this study was to characterize the cumulative effects of multiple strokes on cognition.", "Are multiple cerebral infarcts synergistic?<||||>We conducted a prospective, longitudinal case study with neuropsychological, neurological, and radiological evaluations.", "Are multiple cerebral infarcts synergistic?<||||>Research was conducted at the Boston (Mass) Veterans Administration Medical Center, Neurology Service, on successive inpatient hospital admissions.", "Are multiple cerebral infarcts synergistic?<||||>We followed up a 66-year-old right-handed man with multiple subcortical lacunae during a 3.5-year period during which he suffered two additional cortical infarctions.", "Are multiple cerebral infarcts synergistic?<||||>Each evaluation included approximately 3 hours of neuropsychological testing spanning a range of cognitive domains (attention, language, memory, visuospatial functions, response inhibition, and mental flexibility), full neurological examination, and computed tomographic scan.", "Are multiple cerebral infarcts synergistic?<||||>The patient's stepwise cognitive decline was characterized by unexpected exacerbation of \"frontal\" neurobehavioral features following the occurrence of two posterior cortical lesions. At initial evaluation, the computed tomographic scan showed bilateral subcortical lacunae in basal ganglia and periventricular white matter, and symptoms included dysarthria and perseveration. The second evaluation, following a left posterior parietal lesion, revealed a range of new frontal features, including impulsivity, pull-to-stimulus, and difficulty shifting set. Following a subsequent right occipital infarct, further frontal lobe impairments emerged: forced grasp reflex and incontinence." ]

[ "Is There a Causal Relation between Maternal Acetaminophen Administration and ADHD?<||||>Recent epidemiological studies reported an association between maternal intake of acetaminophen (APAP) and attention deficit hyperactivity disorder (ADHD) in their children. However, none of these studies demonstrated causality. Our objective was to determine whether exposure to APAP during pregnancy result in hyperkinetic dysfunctions in offspring, using a murine model.", "Is There a Causal Relation between Maternal Acetaminophen Administration and ADHD?<||||>Pregnant CD1 mice (N = 8/group) were allocated to receive by gavage either APAP (150 mg/kg/day, equivalent to the FDA-approved maximum human clinical dose), or 0.5% carboxymethylcellulose (control group), starting on embryonic day 7 until delivery. Maternal serum APAP and alanine transaminase (ALT) concentrations were determined by ELISA and kinetic colorimetric assays, respectively. Open field locomotor activity (LMA) in the 30-day old mouse offspring was quantified using Photobeam Activity System. Mouse offspring were then sacrificed, whole brains processed for magnetic resonance imaging (MRI; 11.7 Tesla magnet) and for neuronal quantification using Nissl stain. The association between APAP exposure and LMA in mouse offspring was analyzed using a mixed effects Poisson regression model that accounted for mouse offspring weight, gender, random selection, and testing time and day. We corrected for multiple comparisons and considered P<0.008 as statistically significant.", "Is There a Causal Relation between Maternal Acetaminophen Administration and ADHD?<||||>Maternal serum APAP concentration peaked 30 minutes after gavage, reaching the expected mean of 117 μg/ml. Serum ALT concentrations were not different between groups. There were no significant differences in vertical (rearing), horizontal, or total locomotor activity between the two rodent offspring groups at the P level fixed to adjust for multiple testing. In addition, no differences were found in volumes of 29 brain areas of interest on MRI or in neuronal quantifications between the two groups." ]

[ "Is Quasi-moyamoya Disease a Uniform Disease Entity?<||||>Quasi-moyamoya disease (MMD) or moyamoya syndrome is based on various underlying diseases and radiologically simulates MMD, but its disease entity is still unclear. Recent studies have proven specific shrinkage of the involved arteries in MMD. Using 3-dimensional constructive interference in steady state (3D-CISS), therefore, this study aimed to analyze the outer diameter of the involved arteries in quasi-MMD.", "Is Quasi-moyamoya Disease a Uniform Disease Entity?<||||>This study included 9 patients with quasi-MMD (unilateral type, n = 2; bilateral type, n = 7). Using 3D-CISS, the outer diameter was quantified in the internal carotid artery distal to the posterior communicating artery (C1), the horizontal portion of the middle and anterior cerebral arteries (M1 and A1, respectively), and the basilar artery. Control values were obtained from 17 healthy subjects.", "Is Quasi-moyamoya Disease a Uniform Disease Entity?<||||>In 7 of 9 patients, the outer diameters of C1, M1, and A1 were significantly smaller than those of the controls. On the other hand, the values were normal in other 2 patients. There was no significant difference in the underlying disorders between the 2 groups. All 3 pediatric patients are categorized into the arterial shrinkage group, but 2 of 6 adult patients were not." ]

[ "Can preoperative spiral CT scans alone determine the feasibility of endovascular AAA repair?<||||>To determine whether computed tomography (CT) alone can be used for excluding patients from endovascular repair for abdominal aortic aneurysms (AAA).", "Can preoperative spiral CT scans alone determine the feasibility of endovascular AAA repair?<||||>Among 71 patients evaluated for endovascular AAA repair using spiral CT imaging and angiography, 31 were selected who had both studies performed within 6 months of each other using a graduated measuring catheter or guidewire. Measurements of aneurysm neck diameter, neck length, and infrarenal aortic length were made from the CT and angiographic images using handheld calipers with calibration markers as guides. Infrarenal aortic length and neck length were determined from CT images by multiplying the width of the cuts by the number of slices between the lowest renal artery and the aortic bifurcation or the top of the aneurysm, respectively.", "Can preoperative spiral CT scans alone determine the feasibility of endovascular AAA repair?<||||>CT neck diameter measurements differed significantly from the angiographic dimensions (6.3 +/- 5.1-mm mean difference, p<0.001). In the majority of patients (25, 81%), CT neck diameters were larger (mean 7.3 +/- 3.8 mm). The mean difference in neck length measurements was 0.5 +/- 15.9 mm (p = NS). Twenty-two (71%) patients had aortic length measurements that were longer on the angiogram (mean 15.4 +/- 17.2 mm, p = NS). Five patients who would have been excluded as candidates based on overestimated CT neck diameter measurements subsequently underwent successful endovascular aneurysm repair." ]

[ "Efficacy of beta-blockade after isolated blunt head injury: does race matter?<||||>Several retrospective clinical studies and recent prospective animal models demonstrate improved outcomes with beta-blocker administration after isolated blunt head injury. However, no investigations to date have examined the influence of race on the potential therapeutic effectiveness of these medications. Our hypothesis was that mortality benefits associated with beta-blocker exposure after isolated blunt head injury varies based on ethnicity.", "Efficacy of beta-blockade after isolated blunt head injury: does race matter?<||||>The trauma registry and the surgical intensive care unit (ICU) databases of an academic Level I trauma center were used to identify all patients sustaining blunt head injury requiring ICU admission from July 1998 to December 2009. Patients sustaining major associated extracranial injuries (Abbreviated Injury Scale [AIS] score ≥ 3 in any body region) were excluded. Patient demographics, injury profile, Injury Severity Score, and beta-blocker exposure were abstracted. The primary outcome evaluated was in-hospital mortality stratified by ethnicity.", "Efficacy of beta-blockade after isolated blunt head injury: does race matter?<||||>During the 11-year study period, 3,750 patients were admitted to the Los Angeles County + University of Southern California Medical Center trauma ICU because of blunt trauma. Of these, 65% (n = 2,446) had an \"isolated\" head injury. When stratified by race, most patients were Hispanics (60%), followed by Whites (21%), Asians (11%), and African Americans (8%). After adjusting for confounding variables with multivariate regression, only those of Asian and Hispanic descent demonstrated significantly improved outcomes associated with beta-blocker administration." ]

[ "Assessing exercise capacity, quality of life and haemodynamics in heart failure: do the tests tell us the same thing?<||||>The objective measurement of exercise tolerance is an important component of heart failure trials. The use of laboratory-based treadmill exercise testing has attracted criticism, however, as being unrepresentative of patients' true capabilities.AIM: To examine the relationships between tests of exercise capacity, quality of life and haemodynamics in patients with stable symptomatic heart failure.", "Assessing exercise capacity, quality of life and haemodynamics in heart failure: do the tests tell us the same thing?<||||>Thirty-six patients with mild-moderate chronic heart failure were studied. Exercise capacity was assessed in the laboratory by maximal treadmill tests and self-paced corridor walk tests, and in the patients' homes by hip-borne pedometers. Quality of life was assessed by a disease-specific questionnaire. Cardiac output and limb blood flow were measured by non-invasive techniques.", "Assessing exercise capacity, quality of life and haemodynamics in heart failure: do the tests tell us the same thing?<||||>Customary activity as assessed by pedometer scores correlated with quality of life questionnaire scores (r(S) = 0.47, P = 0.04), and both variables correlated with limb (calf) blood flow (pedometer scores: r(S) = 0.39, P = 0.03; quality of life scores: r(S)= 0.50, P = 0.04). The laboratory-based maximal treadmill test correlated with the self-paced corridor walk test, but neither of these tests correlated with pedometer scores, quality of life or haemodynamics." ]

[ "Are aluminium potroom workers at increased risk of neurological disorders?<||||>To determine whether long term potroom workers in an aluminium smelter are at increased risk of neurological disorders.", "Are aluminium potroom workers at increased risk of neurological disorders?<||||>Cross sectional study of 63 current and former aluminium potroom workers first employed before 1970 and with at least 10 years of service. A group of 37 cast house and carbon plant workers with similar durations of employment and starting dates in the same smelter were used as controls. The prevalence of neurological symptoms was ascertained by questionnaire. Objective tests of tremor in both upper and lower limbs, postural stability, reaction time, and vocabulary were conducted. All subjects were examined by a neurologist.", "Are aluminium potroom workers at increased risk of neurological disorders?<||||>No significant differences in age, race, or education were found between the two groups. Although the potroom group had higher prevalences for all but one of the neurological symptoms, only three odds ratios (ORs) were significantly increased; for incoordination (OR 10.6), difficulty buttoning (OR 6.2), and depression (OR 6.2). Tests of arm or hand and leg tremor in both the visible and non-visible frequencies did not show any significant differences between the two groups. Testing of postural stability showed no definitive pattern of neurologically meaningful differences between the groups. There were no significant differences between the two groups in reaction time, vocabulary score, or clinical neurological assessment." ]

[ "Outcome in a post-cardiac surgery population with acute renal failure requiring dialysis: does age make a difference?<||||>Acute renal failure (ARF), requiring dialysis (ARF-d), develops in 1-5% of patients undergoing cardiac surgery and is associated with higher in-hospital mortality. Age is one of the known risk factors for the development of ARF. As the ageing population is increasing, the nephrologist will be faced with a large population of elderly patients requiring dialysis following cardiac surgery. The aim of our study was to evaluate the influence of age on and the risk factors for in-hospital mortality.", "Outcome in a post-cardiac surgery population with acute renal failure requiring dialysis: does age make a difference?<||||>Eighty-two patients with ARF following cardiac surgery and requiring dialysis between January 1997 and October 2001 were included. Two groups of patients were studied: the younger population (<70 years, 42 patients, mean age 59+/-10) and an elderly population (>/=70 years, 40 patients, mean age 76+/-4). Severity of disease was evaluated using the SAPS (Simplified Acute Physiology Score), the Liano score and the SHARF (Stuivenberg Hospital Acute Renal Failure) score.", "Outcome in a post-cardiac surgery population with acute renal failure requiring dialysis: does age make a difference?<||||>Overall mortality in the population with ARF-d was 56.1%. No difference in mortality rate was found between the younger (61.9%) and elderly patient group (50.0%). The two groups were very similar in baseline and procedural characteristics with exception of body weight (P=0.02) and preoperative glomerular filtration rate (P=0.0001). No significant difference was found in the scoring systems between the old and the young (SAPS P=0.52; Liano P=0.96; SHARF T0 P=0.06; SHARF T48 P=0.15). Mortality in the elderly was significantly correlated with hypotension before starting renal replacement therapy (RRT) (P=0.002), mechanical ventilation (P=0.002), presence of multiorgan failure (MOF) (P=0.0001) and higher scores in the severity models (SAPS: P=0.01; Liano: P<0.0001 and", "Outcome in a post-cardiac surgery population with acute renal failure requiring dialysis: does age make a difference?<||||>P<0.0001)." ]

[ "Does pretreatment of cavities effectively promote good marginal adaptation of glass-ionomer cements?<||||>The aim of this laboratory study was to evaluate the marginal sealing ability of four glass-ionomer cements in cervical restorations (Class V) using dye penetration. Two conventional (C-GIC) and two resin-modified (RM-GIC) cements were used either with or without dentin conditioning with polyacrylic acid.", "Does pretreatment of cavities effectively promote good marginal adaptation of glass-ionomer cements?<||||>96 cervical cavities of standardized size were prepared in vitro in the vestibular and lingual portions at the cementoenamel level of 48 premolars. The coronal margins were prepared in enamel, the apical margins were localized in dentin. The 96 cavities were randomly divided into 4 groups of n = 24 each. The cavities of each group were filled with one of the test materials, and only half of the cavities received a dentin conditioning for 20 s with polyacrylic acids before filling. The fillings were finished with a set of abrasive disks 24 h after setting. The restored teeth were stored in saline for 4 weeks and subjected to dye penetration. The depth of dye penetration along the coronal and apical margin was measured on 4 longitudinal sections of each tooth with a semi-automatic image analysis system at 40x magnification.", "Does pretreatment of cavities effectively promote good marginal adaptation of glass-ionomer cements?<||||>Mean depth of dye penetration ranged from 0 (ChemFil superior without conditioner) to 0.13 mm (ChemFil superior with conditioner) at enamel sites, and from 0.02 (Fuji II LC with conditioner) to 0.74 mm (ChemFil superior with and without conditioner) at dentin sites." ]

[ "Cerebral regional oxygen saturation (crSO2): are different sensors comparable?<||||>For measurement of cerebral regional oxygen saturation (crSO2) in neonates, one of the frequently used near-infrared spectroscopy devices is the INVOS 5100 with either the neonatal or pediatric sensor. Measurements between adult and pediatric sensors use different algorithms and differ by 10%. There are no published data comparing neonatal and pediatric sensors.", "Cerebral regional oxygen saturation (crSO2): are different sensors comparable?<||||>Aim of this study was to compare the neonatal sensor with the pediatric sensor of the INVOS 5100 device in a mixed cohort of neonates to recognize possible differences and enable interpretation of data.", "Cerebral regional oxygen saturation (crSO2): are different sensors comparable?<||||>In 40 neonates, crSO2 was measured in identical positions using both the neonatal and the pediatric sensor under identical conditions. Each sensor was reapplied five times to calculate mean values and standard deviations.", "Cerebral regional oxygen saturation (crSO2): are different sensors comparable?<||||>Cerebral regional oxygen saturation measurements using the neonatal sensor (mean, 76.1 ± 7.9) and crSO2 measurements using the pediatric sensor (mean, 76.4 ± 8.1) were not different. Reproducibility was not significantly different with similar means of standard deviations (neonatal, 3.7 ± 1.6; pediatric, 3.1 ± 1.3)." ]

[ "Is complete heart block after surgical closure of ventricular septum defects still an issue?<||||>A serious complication after surgical closure of ventricular septal defect (VSD) is complete heart block. In this retrospective study, we reviewed the incidence of complete heart block after surgical closure of a VSD at Great Ormond Street Hospital from 1976 to 2001 to identify any particular anatomic features that still predisposed patients to surgically-induced complete heart block and to provide anatomic guidelines to avoid this in future.", "Is complete heart block after surgical closure of ventricular septum defects still an issue?<||||>Data were extracted from our local database for patients having (1) isolated VSD or VSD in the setting of (2) tetralogy of Fallot with pulmonary stenosis or (3) tetralogy of Fallot with pulmonary atresia; (4) absent pulmonary valve syndrome; (5 and 6) coarctation or interruption of the aortic arch; and (7) subaortic fibrous shelf. We carefully reviewed the operative notes from all patients with postoperative complete heart block to discover any predisposing anatomical reasons to explain the complication.", "Is complete heart block after surgical closure of ventricular septum defects still an issue?<||||>Two thousand seventy-nine patients had a VSD closure. Permanent complete heart block developed in 7 of 996 patients (0.7%) with an isolated defect and in 1 of 847 patients (0.1%) with tetralogy of Fallot. Four more patients had postoperative complete heart block." ]

[ "Does depression precede or follow executive dysfunction?<||||>The authors sought to test the potentially reciprocal relationships between depression and executive dysfunction in older patients over time.", "Does depression precede or follow executive dysfunction?<||||>In this prospective 2-year cohort study, the authors enrolled 709 patients age 65 years and older who presented for primary care on selected days and gave informed consent. Of these, 431 and 284 patients completed follow-up interviews at 1 year and 2 years, respectively. The main outcome measures included depression diagnosis, and measures assessing selected components of executive functions: the initiation-perseveration subscale of the Mattis Dementia Rating Scale, Trail Making tests A and B, and D Trails (Trails B time minus Trails A time).", "Does depression precede or follow executive dysfunction?<||||>No cognitive measure was significantly independently associated with depression diagnosis concurrently or in 1-year lagged outcomes. A diagnosis of depression was independently associated with concurrent poorer Trails B time and with both Trails B and D Trails times in 1-year lagged models. In path analyses testing 2-year competing dynamic models, no baseline executive function measure predicted the score on the Hamilton Depression Rating Scale (HAM-D), but HAM-D score independently predicted poorer Trails B and D Trails times. Overall medical burden also independently predicted both depressive and cognitive outcomes, but cerebrovascular risk factors only predicted Trails B time." ]

[ "Does smoking or alcohol modify the risk of Epstein-Barr virus-positive or -negative Hodgkin lymphoma?<||||>The aim was to investigate whether 2 subgroups of Hodgkin lymphoma (Epstein-Barr virus-positive and Epstein-Barr virus-negative) are associated with smoking or alcohol.", "Does smoking or alcohol modify the risk of Epstein-Barr virus-positive or -negative Hodgkin lymphoma?<||||>Patients with lymphoma diagnosed between age 16 and 69 years in geographically defined areas of England were recruited between 1998 and 2003. One control, matched to each lymphoma case on sex, date of birth, and area of residence, was randomly selected from population registers. Self-reported histories of tobacco and alcohol use were collected during face-to-face interviews with cases and controls.", "Does smoking or alcohol modify the risk of Epstein-Barr virus-positive or -negative Hodgkin lymphoma?<||||>Compared with lifelong nonsmokers, ever-smokers were at increased risk of Hodgkin lymphoma (odds ratio =1.4; 95% confidence interval = 1.1-1.9). This excess was among current smokers, defined as smoking 2 years before diagnosis (1.7; 1.2-2.3). An increasing trend was observed with rising numbers of years smoked. Risks fell as the number of years stopped smoking increased, becoming equivalent to that of a nonsmoker 10 or more years after quitting. Associations were suggested for Epstein-Barr virus-positive Hodgkin lymphoma, but less so for Epstein-Barr negative Hodgkin lymphoma. No associations between Hodgkin lymphoma and alcohol consumption were observed." ]

[ "Are adverse events of nevirapine and efavirenz related to plasma concentrations?<||||>The relationships between adverse events (AEs) and plasma concentrations of nevirapine (NVP) and efavirenz (EFV) were investigated as part of the large, international, randomized 2NN study.", "Are adverse events of nevirapine and efavirenz related to plasma concentrations?<||||>Treatment-naive, HIV-1-infected patients received NVP (once or twice daily), EFV or their combination, each in combination with lamivudine and stavudine. Blood samples were collected on day 3 and weeks 1, 2, 4, 24 and 48. Concentrations of NVP and EFV were quantitatively assessed by a validated HPLC assay. Individual Bayesian estimates of the area under the plasma concentration-time curve over 24 h (AUC24h), and minimum and maximum plasma concentrations (Cmin and Cmax) as measures for drug exposure of NVP and EFV, were generated using a previously developed population pharmacokinetic model. Pharmacokinetic parameters were compared for patients with and without central nervous system (CNS) and psychiatric AEs, hepatic events, liver enzyme elevations (LEEs) and rash. Furthermore, it was investigated whether a clear cut-off for a pharmacokinetic parameter could be identified above which the incidence of AEs was clearly increased. AEs were also related to demographic parameters and baseline characteristics.", "Are adverse events of nevirapine and efavirenz related to plasma concentrations?<||||>In total, from 1077 patients, NVP (3024 samples) and EFV (1694 samples) plasma concentrations and AE data (825 observations) were available. For all patients Cmin, Cmax and AUC24h were determined. When corrected for known covariates of gender, CD4 cell count at baseline, region, hepatitis coinfection and possible interactions between these factors, no significant associations between AEs and any tested exposure parameter of NVP was observed. Also, no target Cmin value, above which patients were at increased risk for AEs, could be established. On the other hand, geographical region, hepatitis coinfection, CD4 cell count and gender were found to be significantly related with the incidence of CNS and psychiatric AEs, hepatic events, LEEs and rash during the treatment with NVP. The occurrence of elevated liver enzymes during the first 6 weeks in the EFV-containing arm was significantly (P = 0.036) correlated to the exposure of EFV (Cmin). Only hepatitis coinfection impacted on LEEs during the first 6 weeks of treatment. With an EFV Cmin above 2.18 mg/l during the induction phase, patients were 4.4 (range 1.3-15.5) times more at risk for elevated liver enzymes. No other correlations between AEs and EFV pharmacokinetics or patient characteristics could be identified." ]

[ "Can Taekwondo footwear affect postural stability in young adults?<||||>This study aims to investigate the effect of taekwondo footwear on unilateral stance stability and use of postural control strategies and to determine whether taekwondo footwear influences the somatosensory inputs for postural stability and postural strategies in young adults.", "Can Taekwondo footwear affect postural stability in young adults?<||||>A quasi-randomized crossover trial was conducted on 33 healthy young adults at a university research laboratory. Independent variables, including shoe conditions (shoes on and shoes off) and visual conditions (eyes open and eyes closed), were taken into account. The center of gravity (COG) sway velocity in unilateral stance and the strategy scores in the sensory organization test were measured. No intervention was given to the participants.", "Can Taekwondo footwear affect postural stability in young adults?<||||>There was no significant interaction between the two factors (the shoe and visual conditions) for COG sway velocities (P = .447) and strategy scores (P = .320). The shoe condition was not significant in either COG sway velocity (P = .484) or strategy score (P = .126). The visual condition was significant for COG sway velocity (P<.001) but not for strategy score (P = .573). The mean ± SD COG sway velocity with eyes open was 0.7° ± 0.2°/sec and with eyes closed was 1.7° ± 0.6°/sec (P<.001)." ]

[ "\"Cold calling\" in psychiatric follow up studies: is it justified?<||||>The ethics of cold calling-visiting subjects at home without prior appointment agreed-in follow up research studies has received little attention although it is perceived to be quite common. We examined the ethical implications of cold calling in a study of subjects with defined neurotic disorders followed up 12 years after initial assessment carried out to determine outcome in terms of symptoms, social functioning, and contact with health services. The patients concerned were asked at original assessment if they would agree to be followed up subsequently and although they agreed no time limit was put on this.", "\"Cold calling\" in psychiatric follow up studies: is it justified?<||||>To decide if cold calling was ethically justifiable and, if so, to set guidelines for researchers.", "\"Cold calling\" in psychiatric follow up studies: is it justified?<||||>The study was a cohort study of patients with neurotic disorder treated initially for 10 weeks in a randomised controlled trial.", "\"Cold calling\" in psychiatric follow up studies: is it justified?<||||>At follow up by a research medical practitioner 18 of the 210 patients had died and of the remaining 192 patients 186 (97%) were seen or had a telephone interview. Four patients refused and two others did not have interviews but agreed to some data being obtained. However, only 104 patients (54%) responded to letters inviting them to make an appointment or to refuse contact and the remainder were followed up by cold calling, with most patients agreeing readily to the research interview. The findings illustrate the dilemma of the need to get the maximum possible data from such studies to achieve scientific validity (and thereby justify the ethics of the study) and the protection of subjects' privacy and autonomy." ]

[ "Is platelet mass a more significant indicator than platelet count of closure of patent ductus arteriosus?<||||>The purpose of this study was to evaluate whether or not platelet mass contributes to closure of patent ductus arteriosus (PDA) in premature newborns.", "Is platelet mass a more significant indicator than platelet count of closure of patent ductus arteriosus?<||||>This retrospective study included 115 preterm newborns with hemodynamically significant PDA (hPDA) and 120 newborns without PDA. The newborns' platelet count, mean platelet volume (MPV) and platelet distribution width (PDW) were noted from their files and the platelet mass (platelet count plus MPV/10(3)) was calculated. Patients with congenital abnormality, persistent pulmonary hypertension or sepsis were not included in the study.", "Is platelet mass a more significant indicator than platelet count of closure of patent ductus arteriosus?<||||>Platelet count and PDW were found to not be risk factors for closure of hPDA (p > 0.05), but both high platelet mass (OR 1.25; 95% CI 1.12-1.41) and MPV (OR 1.87; 95% CI 2.52-3.85) were determined to be independent risk factors for hPDA." ]

[ "Are tryptophan and 5-hydroxytryptophan effective treatments for depression?<||||>To review the literature regarding the effectiveness of 5-hydroxytryptophan (5-HT) and L-tryptophan in the treatment of unipolar depression.", "Are tryptophan and 5-hydroxytryptophan effective treatments for depression?<||||>A systematic review of the literature from 1966 to 2000 using the search terms 'tryptophan', 5-hydroxytryptophan', '5-HTP', '5-HT' and 'depression'. We extracted and grouped data for meta-analysis by pooling odds ratios (OR) and relative risks where possible.", "Are tryptophan and 5-hydroxytryptophan effective treatments for depression?<||||>One hundred and eight studies were located of which only two studies, one of 5-HT and one of L-tryptophan, with a total of 64 patients met sufficient quality criteria to be included. These studies suggest 5-HT and L-tryptophan are better than placebo at alleviating depression (Peto OR = 4.1, 95% CI = 1.3-13.2). However, the small size of the studies, and the large number of inadmissible, poorly executed studies, casts doubt on the result from potential publication bias, and suggests that they are insufficiently evaluated to assess their effectiveness." ]

[ "Postoperative sepsis: reexplore or observe?<||||>To determine if postoperative diagnostic abdominal paracentesis is a useful clinical tool in the abdominal evaluation of the critically ill septic patient.", "Postoperative sepsis: reexplore or observe?<||||>Retrospective review.", "Postoperative sepsis: reexplore or observe?<||||>Surgical ICU patients in a Veterans Administration medical center.", "Postoperative sepsis: reexplore or observe?<||||>Ten patients were studied from a total of 1,053 patients admitted to the surgical ICU between September 1985 and May 1989.", "Postoperative sepsis: reexplore or observe?<||||>Diagnostic abdominal paracentesis performed by the open or closed approaches.", "Postoperative sepsis: reexplore or observe?<||||>Results are presented in three patient groups (A, B, and C): Group A (n = 4) had positive diagnostic abdominal paracentesis. Abdominal causes for the sepsis were found at reexploration. One of these four patients survived. Group B (n = 3) had negative diagnostic abdominal paracentesis. No abdominal septic source was found at reexploration; all three patients died. In group C (n = 3), diagnostic abdominal paracentesis was negative, patients were not reexplored, and all survived. Diagnostic accuracy correlated with three variables: a) the gross appearance and smell of the fluid, b) WBC count greater than 5000 or less than 500/mm3, and c) Gram stain demonstrating bacterial organisms." ]

[ "Involving users and carers in the assessment of preregistration nursing students' clinical nursing practice: a strategy for patient empowerment and quality improvement?<||||>To examine (1) nursing lecturers' and (2) preregistration nursing students' perspectives of user and carer involvement in the formal assessment of preregistration nursing students' clinical practice.", "Involving users and carers in the assessment of preregistration nursing students' clinical nursing practice: a strategy for patient empowerment and quality improvement?<||||>The involvement of service users and carers in the assessment of clinical practice in nursing education is a recent phenomenon. The Nursing and Midwifery Council Standards in the UK clearly reflect a shift in thinking from paternalistic approaches to person-centred approaches. This shift in thinking includes service user and carer involvement in student nursing assessment and there is evidence that this is being developed in several countries.", "Involving users and carers in the assessment of preregistration nursing students' clinical nursing practice: a strategy for patient empowerment and quality improvement?<||||>Located in the interpretive paradigm, data from a two-staged, multicentre qualitative study are presented.", "Involving users and carers in the assessment of preregistration nursing students' clinical nursing practice: a strategy for patient empowerment and quality improvement?<||||>Interpretive analysis of semi-structured, one to one interviews with nursing lecturers (n = 15) and focus groups with nursing students (n = 51) across 11 Higher Educational Institutions.", "Involving users and carers in the assessment of preregistration nursing students' clinical nursing practice: a strategy for patient empowerment and quality improvement?<||||>There is a strong commitment for working alongside service users and carers in the education and training of nursing students; however, involving service users and carers in formal practice assessment is identified as more challenging compared with other areas of service user/carer involvement. Service user/carers should provide feedback/review or comment, but not necessarily formal, summative 'assessment'." ]

[ "Do seizures in patients with refractory epilepsy vary between wakefulness and sleep?<||||>The video-EEG data of patients who had two or more seizures during video-EEG telemetry (n = 270) were reviewed. Fifty seven patients who had seizures both in wakefulness and sleep were identified. The video and ictal EEG data were reviewed, paying specific attention to type of seizures, duration, semiology, lateralisation and number of seizures.", "Do seizures in patients with refractory epilepsy vary between wakefulness and sleep?<||||>Three hundred and sixty two seizures were recorded; 237 seizures while awake and 125 while sleeping. Secondary generalisation occurred more often in sleep than in wakefulness (p<0.01). Overall, there was no significant effect of sleep on the duration of seizures or ictal EEG change. Sleep and awake seizures differed in only eight patients." ]

[ "Should issues of sexuality and HIV and AIDS be a rehabilitation concern?<||||>Although rehabilitation is an integral part of the lives of many young people with physical disabilities, sexuality education and HIV and AIDS prevention services are not. The purpose of this study was to record the voices of disabled young people regarding their experiences of sexuality and HIV and AIDS and to determine the role of rehabilitation professionals in this regard.", "Should issues of sexuality and HIV and AIDS be a rehabilitation concern?<||||>Sixteen young people with physical disabilities, aged 15-24 years participated in the study. Individual in-depth interviews were conducted with each participant, followed by focus group discussions comprising four to six participants. Responses were audiotaped and transcribed verbatim. Textual and contextual features of the Atlas.ti computer programme were used to support the thematic analysis of the data.", "Should issues of sexuality and HIV and AIDS be a rehabilitation concern?<||||>The results indicated that most participants had received some form of rehabilitation for their physical impairment, yet sexuality and HIV and AIDS matters were not part of the rehabilitation process. Although the majority were aware of sexuality and HIV and AIDS issues, their limited factual knowledge did not persuade them to change their sexual behaviour or take preventive measures against contracting HIV infection." ]

[ "Localization of metastasis within the sentinel lymph node biopsies: a predictor of additional axillary spread of breast cancer?<||||>To explore the relationship between morphological characteristics and histologic localization of metastasis within sentinel lymph nodes (SLN) and axillary spread in women with breast cancer.", "Localization of metastasis within the sentinel lymph node biopsies: a predictor of additional axillary spread of breast cancer?<||||>We selected 119 patients with positive SLN submitted to complete axillary lymph node dissection from July 2002 to March 2007. We retrieved the age of patients and the primary tumor size. In the primary tumor, we evaluated histologic and nuclear grade, and peritumoral vascular invasion (PVI). In SLNs we evaluated the size of metastasis, their localization in the lymph node, number of foci, number of involved lymph nodes, and extranodal extension.", "Localization of metastasis within the sentinel lymph node biopsies: a predictor of additional axillary spread of breast cancer?<||||>Fifty-one (42.8%) patients had confirmed additional metastasis in non-sentinel lymph nodes (NLSN). High histologic grade, PVI, intraparenchymatous metastasis, extranodal neoplastic extension and size of metastasis were associated with positive NLSN. SLN metastasis affecting the capsule were associated to low risk incidence of additional metastasis. After multivariate analysis, PVI and metastasis size in the SLN remained as the most important risk factors for additional metastasis." ]

[ "Is smoking linked to positive symptoms in acutely ill psychiatric patients?<||||>The self-medication hypothesis is commonly put forward to explain the high prevalence of smoking in psychiatric patients. However, studies supporting the self-medication hypothesis have most often been carried out on chronic patients stabilized by antipsychotics.AIM: Given that antipsychotics tend to erase psychiatric symptoms, the present study was undertaken on acutely ill patients usually receiving no medications, or on whom medications are ineffective.", "Is smoking linked to positive symptoms in acutely ill psychiatric patients?<||||>Participants were 492 consecutively hospitalized patients. They were evaluated the day of their hospitalization with the Brief Psychiatric Rating Scale (BPRS, 18 items). Urinary cotinine and creatinine were measured the morning following their hospitalization. The urinary cotinine/creatinine ratio and the cotinine/creatinine/number of cigarettes smoked per day ratio (nicotine extraction index) were calculated for each patient.", "Is smoking linked to positive symptoms in acutely ill psychiatric patients?<||||>The positive symptoms subscale of the BPRS significantly correlated with smoking, whereas other BPRS subscales did not. In patients with mood disorder, the nicotine extraction index correlated with the positive symptoms, activation and hostility subscales, but not with the negative symptoms subscale. Analyses of individual BPRS items using the cotinine/creatinine ratio measure showed that smoking is positively associated with \"unusual thought content\" and \"grandiosity\" items and negatively associated with \"guilt feeling\", \"depressed mood\" and \"motor retardation\". Analyses of individual BPRS items using the nicotine extraction index showed a positive association only with \"unusual thought content\" and \"grandiosity\" items. Patients with schizophrenia extract more nicotine from cigarettes than other patients." ]

[ "Treatment of metastatic colorectal cancer with or without bevacizumab: can the neutrophil/lymphocyte ratio predict the efficiency of bevacizumab?<||||>The purpose of this study was to analyze the predictive value of neutrophil/lymphocyte ratio (NLR) to better clarify which patient groups will benefit the most from particular treatments like bevacizumab.", "Treatment of metastatic colorectal cancer with or without bevacizumab: can the neutrophil/lymphocyte ratio predict the efficiency of bevacizumab?<||||>A total of 245 treatment-naive metastatic colorectal cancern (mCRC) patients were retrospectively enrolled and divided into 2 groups: 145 group A patients were treated with chemotherapy in combination with bevacizumab, and 100 group B patients were treated as above without bevacizumab.", "Treatment of metastatic colorectal cancer with or without bevacizumab: can the neutrophil/lymphocyte ratio predict the efficiency of bevacizumab?<||||>Group A patients had better median overall survival (OS) and progression-free survival (PFS) (24.0 and 9.0 months) than group B patients (20 and 6.0 months) (p=0.033; p=0.015). In patients with low NLR, OS and PFS were significantly longer in group A patients (27 vs 18 months, p=0.001; 11 vs 7 months, p=0.017)." ]

[ "Renal cell carcinoma with tumor thrombus: is cytoreductive nephrectomy for advanced disease associated with an increased complication rate?<||||>We examined whether cytoreductive nephrectomy in patients with venous tumor thrombus and metastatic disease is associated with more complications than in those with thrombus without metastatic disease.", "Renal cell carcinoma with tumor thrombus: is cytoreductive nephrectomy for advanced disease associated with an increased complication rate?<||||>Between 1989 and 2000, 74 patients with renal vein extension, 87 with inferior vena caval extension and 491 without tumor thrombus underwent nephrectomy at our institution. Metastatic and nonmetastatic renal vein extension in 51 and 23 cases, inferior vena caval extension in 54 and 33, and nontumor thrombus in 171 and 320, respectively, were compared for symptoms at presentation, surgical data, mortality and complications.", "Renal cell carcinoma with tumor thrombus: is cytoreductive nephrectomy for advanced disease associated with an increased complication rate?<||||>For nonmetastatic and metastatic inferior vena caval extension presenting symptoms, hospital stay, surgical time and the number of patients undergoing thoraco-abdominal incision, lymph node dissection, venacavotomy alone for thrombus and adrenal sparing surgery were similar. Five patients with thrombus died intraoperatively or postoperatively, including 3.1% with and 0.8% without thrombus (p = 0.03), while 3 had metastatic (2.3%) and 2 (2.6%) had nonmetastatic disease. The rate of postoperative complications was higher in thrombus cases overall but there was no difference in nonmetastatic and metastatic disease with thrombus. On multivariate analysis inferior vena caval thrombus (odds ratio 10.5), adjacent organ resection due to locally advanced tumor (odds ratio 6), partial nephrectomy (odds ratio 3.8), regional lymph node involvement (odds ratio 1.7) and lower preoperative hemoglobin (odds ratio 1.6) were independent variables predicting bleeding requiring transfusion. Inferior vena caval thrombus (odds ratio 1.7) and adjacent organ resection (odds ratio 2) were also associated with nonhemorrhagic complications. Systemic metastasis was not an independent risk factor in either analysis." ]

[ "Are both PIVKA-II and alpha-fetoprotein necessary in follow-up management after hepatic resection for hepatocellular carcinoma?<||||>The aim of this study was to clarify the need for measuring of PIVKA-II (protein induced by vitamin K absence or antagonist-II) and alpha-fetoprotein as the prognostic indicator for patients after hepatic resection for hepatocellular carcinoma, and as the monitoring modality for early detection of recurrence after hepatic resection.", "Are both PIVKA-II and alpha-fetoprotein necessary in follow-up management after hepatic resection for hepatocellular carcinoma?<||||>One hundred and thirty-one patients who underwent planned liver resections for hepatocellular carcinoma were studied.", "Are both PIVKA-II and alpha-fetoprotein necessary in follow-up management after hepatic resection for hepatocellular carcinoma?<||||>The survival rates in patients positive for preoperative tumor markers were significantly lower than in those in the negative patients. The first modality leading to the diagnosis of recurrence was measurement of alpha-fetoprotein and/or PIVKA-II in 25 cases (55.6%). Almost all patients (96.6%) with positive preoperative alpha-fetoprotein and recurrence had elevated alpha-fetoprotein again when recurrence was found." ]

[ "Can tissue adhesives and platelet-rich plasma prevent pharyngocutaneous fistula formation?<||||>One of the frequently encountered disorders of wound healing following laryngectomy is pharyngocutaneous fistula. However, although studies have been performed with the aim of prevention of pharyngocutaneous fistulae, there are very few studies with tissue adhesives and platelet-rich plasma. In this study, our aim was to investigate the histopathologic changes in wound healing caused by various tissue adhesives and platelet-rich plasma, together with their effects on prevention of pharyngocutaneous fistula.", "Can tissue adhesives and platelet-rich plasma prevent pharyngocutaneous fistula formation?<||||>40 male rats were randomly divided into five groups: control, platelet-rich plasma, fibrin tissue adhesive, protein-based albumin glutaraldehyde and synthetic tissue adhesive groups. The pharyngotomy procedure was performed and was sutured. Except the control group, tissue adhesives and platelet-rich plasma were applied. Then, the skin was sutured. On the seventh day, the rats were sacrificed. The skin was opened and pharyngotomy site was assessed in terms of fistulae. The pharyngeal suture line was evaluated histopathologically by using Ehrlich Hunt scale.", "Can tissue adhesives and platelet-rich plasma prevent pharyngocutaneous fistula formation?<||||>Inflammatory infiltration was found to be higher in \"platelet-rich plasma\" group than \"fibrin tissue adhesive\" and \"synthetic tissue adhesive\" groups. The fibroblastic activity of \"platelet-rich plasma\", \"fibrin tissue adhesive\" and \"protein-based albumin glutaraldehyde\" groups was higher than the control group. The positive changes created by platelet-rich plasma and fibrin tissue adhesive at the histopathologic level were found together with no detected fistula. Among the study groups, there was no statistical difference for pharyngeal fistula development. This result may be obtained by the small number of animal experiments." ]

[ "Is there an optimal time for laparoscopic cholecystectomy in acute cholecystitis?<||||>Laparoscopic cholecystectomy (LC) is safe in acute cholecystitis, but the exact timing remains ill-defined. This study evaluated the effect of timing of LC in patients with acute cholecystitis.", "Is there an optimal time for laparoscopic cholecystectomy in acute cholecystitis?<||||>Prospective data from the hospital registry were reviewed. All patients admitted with acute cholecystitis from June 1994 to January 2004 were included in the cohort.", "Is there an optimal time for laparoscopic cholecystectomy in acute cholecystitis?<||||>Laparoscopic cholecystectomy was attempted in 1,967 patients during the study period; 80% were women, mean patient age was 44 years (range, 20-73 years). Of the 1,967 LC procedures, 1,675 were successful, and 292 were converted to an open procedure (14%). Mean operating time for LC was 1 h 44 min (SD +/- 50 min), versus 3 h 5 min (SD +/- 79 min) when converted to an open procedure. Average postoperative length of stay was 1.89 days (+/- 2.47 days) for the laparoscopic group and 4.3 days (+/- 2.2 days) for the conversion group. No clinically relevant differences regarding conversion rates, operative times, or postoperative length of stay were found between patients who were operated on within 48 h compared to those patients who were operated on post-admission days 3-7." ]

[ "Does intra-uterine environment influence fetal head-position preference?<||||>Cephalic fetuses have increasing lateralised head-position near term.AIM: Is this development affected by breech presentation?", "Does intra-uterine environment influence fetal head-position preference?<||||>Fetal head-position was studied longitudinally in 13 healthy fetuses in breech presentation and 10 healthy fetuses in cephalic presentation by means of real-time ultrasound. Recordings were obtained weekly from 33 weeks gestational age until birth.", "Does intra-uterine environment influence fetal head-position preference?<||||>As in previous research, a significant (p = 0.045) decrease in midline head-position was found for the cephalic fetuses with advancing gestational age. The development of a lateralised head-position preference was clearly less outspoken in the breech fetuses when compared to the cephalic ones, especially after 36 weeks gestational age. Furthermore, as cephalic fetuses showed a preference for a right-sided head-position, breech fetuses that did show a lateralised head-position did not have a clear preference for left or right. Our data show an association between the orientation of the fetal vertebral column and head-position predominance in the group of cephalic fetuses, which complies with Previc's left-otolithic dominance theory. No association could be detected between fetal head shape and head-position preference." ]

[ "In pursuit of certainty: can the systematic review process deliver?<||||>There has been increasing emphasis on evidence-based approaches to improve patient outcomes through rigorous, standardised and well-validated approaches. Clinical guidelines drive this process and are largely developed based on the findings of systematic reviews (SRs). This paper presents a discussion of the SR process in providing decisive information to shape and guide clinical practice, using a purpose-built review database: the Cochrane reviews; and focussing on a highly prevalent medical condition: hypertension.", "In pursuit of certainty: can the systematic review process deliver?<||||>We searched the Cochrane database and identified 25 relevant SRs incorporating 443 clinical trials. Reviews with the terms 'blood pressure' or 'hypertension' in the title were included. Once selected for inclusion, the abstracts were assessed independently by two authors for their capacity to inform and influence clinical decision-making. The inclusions were independently audited by a third author.", "In pursuit of certainty: can the systematic review process deliver?<||||>Of the 25 SRs that formed the sample, 12 provided conclusive findings to inform a particular treatment pathway. The evidence-based approaches offer the promise of assisting clinical decision-making through clarity, but in the case of management of blood pressure, half of the SRs in our sample highlight gaps in evidence and methodological limitations. Thirteen reviews were inconclusive, and eight, including four of the 12 conclusive SRs, noted the lack of adequate reporting of potential adverse effects or incidence of harm." ]

[ "Are homeschooled adolescents less likely to use alcohol, tobacco, and other drugs?<||||>Nearly two million school-aged children in US are currently homeschooled. This study seeks to examine homeschooled adolescents' attitudes toward, access to, and use of alcohol, tobacco, and other drugs (ATOD) compared to their non-homeschooled peers.", "Are homeschooled adolescents less likely to use alcohol, tobacco, and other drugs?<||||>The study uses data between 2002 and 2013 from the National Survey on Drug Use and Health (NSDUH) for school-attending respondents aged 12-17 (n=200,824). Participants were questioned regarding peer use of licit and illicit substances, ease of accessing illicit substances, and past 12-month substance use. Survey adjusted binary logistic regression analyses were systematically executed to compare non-homeschooled adolescents with homeschooled adolescents with respect to views toward, access to, and use of substances.", "Are homeschooled adolescents less likely to use alcohol, tobacco, and other drugs?<||||>Findings indicate that homeschooled adolescents were significantly more likely to strongly disapprove of their peers drinking (AOR=1.23) and trying (AOR=1.47) and routinely using (AOR=1.59) marijuana. Homeschooled adolescents were significantly less likely to report using tobacco (AOR=0.76), alcohol (AOR=0.50), cannabis (AOR=0.56) and other illicit drugs and to be diagnosed with an alcohol (AOR=0.65) or marijuana (AOR=0.60) use disorder. Finally, homeschooled adolescents were also less likely to report easier access to illicit drugs and to be approached by someone trying to sell drugs compared to non-homeschooled peers." ]

[ "Transfusion practice in massively bleeding patients: time for a change?<||||>We identified some fatal cases where massively bleeding patients received inadequate transfusion therapy. The aim of this study was to review and evaluate the transfusion practice in acutely multitransfused patients.", "Transfusion practice in massively bleeding patients: time for a change?<||||>Patients receiving>10 units of red blood cells (RBC) within 24 h of admission and 30 blood components within 7 days of admission were reviewed.", "Transfusion practice in massively bleeding patients: time for a change?<||||>Thirty-nine patients were identified, 13 of whom were inadequately transfused (IT) and had a higher mortality (12/13) than adequately transfused (AT) patients 13/26 (P = 0.013). Ten of 13 IT patients developed a microvascular bleed compared to four of 26 in the AT group (P = 0.001) and had a lower platelet count upon arrival at the intensive care unit (40 x 10(9)/l vs. 80 x 10(9)/l, P = 0.024)." ]

[ "Is Pica under-reported in children with sickle cell disease?<||||>For centuries, writers have recorded their observations on pica. Nevertheless the association of pica with sickle cell disease (SCD) was poorly documented.", "Is Pica under-reported in children with sickle cell disease?<||||>Cross-sectional evaluation performed on SCD children and caregivers attending the outpatient clinic who were invited to complete questionnaires assessing behavior of pica.", "Is Pica under-reported in children with sickle cell disease?<||||>Out of 55 sickle cell children, 31(56.4%) reported practicing pica regularly. Substances ingested by patients covered a broad spectrum. Compared with the non-pica group, subjects who reported pica were younger and had lower hemoglobin (8.3 g/dl (7.6-9.7) vs. 9.1 g/dl (7.9-10.5): P<0.01). The level of ferritin, zinc, copper, and lead was similar between the pica and non-pica groups (P>0.05). Discussion In this series, there are many substances consumed by SCD children and adolescents, and we did not find an occurrence of similar substances among this select group. Pica children were younger and more anemic than non-pica patients." ]

[ "Do generic drugs help control expenditure on hypertension?<||||>In this article we analyze the influence of generic drugs on pharmaceutical expenditure on hypertension from the payer's perspective (the public health service), by examining the most widely used drugs: angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs).", "Do generic drugs help control expenditure on hypertension?<||||>Based on billing data to the public health service from all the pharmacies in the Health Area of Malaga, we studied the utilization (containers and cost) of ACEi (generic drugs ACEi+G and brand name) and ARBs (brand name only) (subgroup C09 ATC index) from 1999 to 2002. The mean price (weighted according to sales) and the percentage of deviation of prescriptions from one group of drugs to another was also studied.", "Do generic drugs help control expenditure on hypertension?<||||>The increase in consumption of packages in subgroup C09 was 20.79%; the increase was greater for ARBs (136%) and for ACEi+G (177%). The total amount spent during the study period increased by more than 42%. Expenditure on ACEis decreased by almost 7%, despite the increase in expenditure on ACEi+G, whereas expenditure on ARBs increased by more than 154%. The mean price of this subgroup, weighted according to sales, increased by nearly 18%. The mean weighted price of the generic drugs, captopril and enalapril, and that of the brand name, trandolapril, decreased. Notable among ARBs was the increase in mean price weighted according to sales of irbesartan (9%) and valsartan (16%)." ]

[ "Is congenital pulmonary airway malformation really a rare disease?<||||>Congenital pulmonary airway malformation (CPAM) is an increasingly recognized disease with potential mortality. Owing to limited published studies, the true incidence is yet to be determined. We carried out this prospective study with the aim to estimate its true incidence on a population basis.", "Is congenital pulmonary airway malformation really a rare disease?<||||>An antenatal ultrasonography program was implemented since 2009. Fetuses with suspected intra-thoracic lesions were monitored by regular follow-ups. Antenatal course, postnatal outcomes, and other demographics were compared to those of patients with CPAM in the previous decades (1989-2008). The incidence of CPAM was calculated in different periods.", "Is congenital pulmonary airway malformation really a rare disease?<||||>66 CPAM patients were identified between 2009 and 2014 with 62 patients being detected by antenatal scan. In contrast, 45 patients were identified between 1989 and 2008 with 27 patients being detected antenatally. The incidence rate during the past and recent period was estimated as ~1 in 27,400 and ~1 in 7200 live births, respectively (p = 0.024)." ]

[ "Is the diagnosis of dementia stable over time among elderly immigrant Gujaratis in the United Kingdom (Leicester)?<||||>The single largest ethnic elder group in the United Kingdom originates from the Indian subcontinent and their numbers are increasing.", "Is the diagnosis of dementia stable over time among elderly immigrant Gujaratis in the United Kingdom (Leicester)?<||||>Elderly Gujarati subjects, with a diagnosis of dementia ascertained during an epidemiological field study in Leicester, were reexamined at a median follow-up interval of 27 months to establish stability of the original diagnosis and cognitive decline.", "Is the diagnosis of dementia stable over time among elderly immigrant Gujaratis in the United Kingdom (Leicester)?<||||>Seven of the original 11 subjects with dementia were alive at the follow-up and they were reexamined by a Gujarati psychiatrist. In six of these seven subjects the diagnosis of dementia was reconfirmed with concomitant cognitive decline on the CAMDEX dementia severity index. Informant history in three of the four original dementia subjects provided evidence of cognitive decline between the original interview and death." ]

[ "Acute coronary syndromes and diabetes: Is intensive lipid lowering beneficial?<||||>The impact of intensive lipid lowering therapy with statins in acute coronary syndrome (ACS) patients with diabetes mellitus (DM) is not well characterized.", "Acute coronary syndromes and diabetes: Is intensive lipid lowering beneficial?<||||>We explored this question in data from the Pravastatin or Atorvastatin Evaluation and Infection Therapy (PROVE IT) TIMI 22 trial, which tested standard (pravastatin 40 mg) vs. intensive (atorvastatin 80 mg) statin therapy among patients treated early in the post-ACS period. We compared outcomes between patients with DM (identified by history, fasting plasma glucose>or =126 mg/dL or haemoglobin A1C>7%; n = 978) against those without DM (n = 3184). The rate of acute cardiac events (death, myocardial infarction, and unstable angina requiring rehospitalization) was much higher in patients with DM, but was reduced with intensive vs. standard therapy similarly in diabetic (21.1 vs. 26.6%, HR = 0.75, P = 0.03) and non-diabetic patients (14.0 vs. 18.0%, HR = 0.76, P = 0.002); P-interaction = 0.97. Despite intensive therapy, the majority of diabetics (62%) did not reach the dual goal of LDL-C<70 mg/dL and high-sensitivity C-reactive protein<2 mg/L." ]

[ "Is epidural anesthesia truly the best pain management strategy after minimally invasive pectus excavatum repair?<||||>The repair of pectus excavatum with bar placement is associated with substantial postoperative pain. Optimal pain control strategy has not been addressed with level 1 or substantial level 2 evidence. Many institutions operate under the assumption that a thoracic epidural offers the best pain control for these patients. Therefore, we conducted a retrospective evaluation to examine the validity of this assumption.", "Is epidural anesthesia truly the best pain management strategy after minimally invasive pectus excavatum repair?<||||>A retrospective review of patients undergoing pectus excavatum repair with bar placement from January 2000 to February 2006 was conducted. The demographic variables collected included age, sex, weight, and Haller's index scores. Outcome variables included total operating room time, number of calls to the anesthesiologist, hours of urinary catheterization, hours until complete transition to oral pain medication, length of hospitalization, and maximum pain scores for each of the first 5 postoperative days.", "Is epidural anesthesia truly the best pain management strategy after minimally invasive pectus excavatum repair?<||||>There were a total of 203 patients, of which 188 had an epidural, compared with 15 with intravenous narcotic therapy. Of the 188 patients committed to an epidural, 65 had a failed attempt in the operating room or a dysfunctional catheter removed within 24 hours. Patients without an epidural had a shorter operating room time, less time of urinary catheterization, decreased time to complete transition to oral medication, and decreased length of hospitalization with lower maximum scores." ]

[ "Common medical terms defined by parents: are we speaking the same language?<||||>Physicians often assume that a patient understands frequently utilized medical words and patient management may be based on these assumptions. The objective of this study was to determine the public's definition of regularly used medical terminology.", "Common medical terms defined by parents: are we speaking the same language?<||||>A cross-sectional convenience survey was conducted for guardians of children presenting to an urban pediatric emergency department. The orally completed, open-ended questionnaire included parental demographic information and their definition of eleven commonly used medical terms. The words chosen represent common chief complaints given in our emergency department. Definitions were grouped, and a concordance rate of 75% was chosen to consider responses similar.", "Common medical terms defined by parents: are we speaking the same language?<||||>One hundred twenty-two guardians completed the survey (89% parents, 88% female, and 55% high school graduates). Caregivers agreed on the definitions of diarrhea, constipation, dehydration, fever, and seizure. However, diarrhea and constipation were mainly defined by either stool consistency or frequency, not both. Dehydration was appropriately defined as lack of body fluids (92%), but many parents had difficulty identifying more than one sign of dehydration. Fever was thought to be an elevated body temperature (76%), yet 69% felt that a temperature less than 100.5 degrees F was considered a fever. Most respondents did not know the definitions of meningitis (70%), lethargy (64%), and virus (40%)." ]

[ "Mother-to-infant HCV transmission. Can we influence the frequency and the course of the infection?<||||>Part I/: Blood samples were collected from 544 pregnant women and tested for anti-HCV. Part II/: Data of risk factors of HCV infection, reasons of HCV diagnostics were assessed in 281 mothers infected with HCV, not infected with HIV. 317 children born to HCV infected mothers were observed from birth until age 2.5-10 years (testing of HCV-RNA, ALT). 26 (8.%) of them were infected with HCV.", "Mother-to-infant HCV transmission. Can we influence the frequency and the course of the infection?<||||>Part I/: 22.02% of tested pregnant women were anti-HCV(+). Part II/: Presence of risk factors for HCV infection in anamnesis was the reason of HCV diagnostics in 34% of women. None of HCV-RNA(-) women transmitted HCV to their child. The rate of HCV infection in infants born to HCV-RNA(+) mothers was 14.1% and was higher in case of natural delivery (19.2%) compared to cesarean section (7.5%). Intrapartum percutaneus exposure to maternal blood increased transmission rates. All children born via elective cesarean section (in 38 Hbd) were HCV-RNA(-). None of infected children had clinical symptoms of hepatitis, however, one of them had mild changes in liver histopathology." ]

[ "Does partial cystectomy compromise oncologic outcomes for patients with bladder cancer compared to radical cystectomy?<||||>To our knowledge long-term oncologic outcomes following partial cystectomy for urothelial carcinoma remain to be defined. We evaluated patterns of recurrence and survival among matched patients treated with partial vs radical cystectomy for bladder cancer.", "Does partial cystectomy compromise oncologic outcomes for patients with bladder cancer compared to radical cystectomy?<||||>We identified 86 patients who underwent partial cystectomy for pT1-4N0-1Mx urothelial carcinoma between 1980 and 2006 at our institution. They were matched 1:2 to patients undergoing radical cystectomy based on age, gender, pathological T stage and receipt of neoadjuvant chemotherapy. Survival was estimated using Kaplan-Meier analysis and compared with the log rank test.", "Does partial cystectomy compromise oncologic outcomes for patients with bladder cancer compared to radical cystectomy?<||||>Median postoperative followup was 6.2 years (range 0 to 27). No difference was noted for 10-year distant recurrence-free survival (61% vs 66%, p = 0.63) or cancer specific survival (58% vs 63%, p = 0.67) between patients treated with partial and radical cystectomy, respectively. Interestingly, 4 of 86 patients (5%) who underwent partial cystectomy showed extravesical pelvic tumor recurrence postoperatively vs 29 of 167 (17%) who underwent radical cystectomy (p = 0.004). In addition, 33 of 86 patients (38%) were diagnosed with intravesical recurrence of tumor after partial cystectomy and 16 of 86 (19%) initially treated with partial cystectomy ultimately underwent radical cystectomy." ]

[ "Is the serotonin transporter polymorphism (5-HTTLPR) a potential marker for suicidal behavior in bipolar disorder patients?<||||>Suicide prediction is a huge challenge for mental health workers. Structured interviews based on epidemiological and clinical factors don't show effectiveness for suicide prevention. Biological markers, such as 5-HTTLPR, could help for identification of potential suicide attempters.", "Is the serotonin transporter polymorphism (5-HTTLPR) a potential marker for suicidal behavior in bipolar disorder patients?<||||>We evaluated 198 bipolar patients and 103 health controls, using a structured interview according to DSM-IV criteria. Genotyping, blind of clinical assessment for identification of S carriers and structured interviews were performed in order to describe clinical and epidemiological factors which could be associated with suicide behavior. Statistical analyses were calculated by the x(2) test and logistic regression model.", "Is the serotonin transporter polymorphism (5-HTTLPR) a potential marker for suicidal behavior in bipolar disorder patients?<||||>We found that 26.77% and 16.67% had a lifetime history of non violent suicide attempt and violent suicide attempt, respectively. The clinical factors associated with violent and non violent suicide attempt had several differences. Violent suicide attempters had an earlier illness onset and had a higher number of psychiatric comorbidities (borderline personality disorder, panic disorder and alcoholism). The frequency of S allele carriers was higher only in those patients who had made a violent suicide attempt in their lifetime (x(2)=16.969; p=0.0001). In a logistic regression model including these factors, S allele carrier (5-HTTLPR) was the only factor associated with violent suicide attempt.", "Is the serotonin transporter polymorphism (5-HTTLPR) a potential marker for suicidal behavior in bipolar disorder patients?<||||>Sample size and retrospective assessment of suicide behavior history are the limitations of this study." ]

[ "Attitudes to reducing violence towards women: punishment or prevention?<||||>A random community sample of 3000 women was surveyed by postal questionnaire as part of the Otago Women's Health Survey. Seventy three percent (n = 1663) of those under 65 replied. As well as demographic, mental health and abuse information, responses to the question \"what steps would you like to see taken to reduce the incidence of sexual and physical harm to women and children?\" were analysed.", "Attitudes to reducing violence towards women: punishment or prevention?<||||>Education was the most favoured approach to reducing violence in the community, followed by increased punishment of the offender. Women who had experienced sexual abuse, particularly as children, were more likely to advocate measures other than punishment. Rural women, those without formal qualifications and those who were not abused were more likely to advocate increased punishment, or made no comment." ]

[ "Is there a role of free oxygen radicals in primary male osteoporosis?<||||>There is not enough evidence about the relationship between free radicals and male osteoporosis. In this study we investigated the role of free oxygen radicals and antioxidants on male osteoporosis in 31 male patients with primary osteoporosis and 21 subjects as controls.", "Is there a role of free oxygen radicals in primary male osteoporosis?<||||>Bone mineral densities (BMD) of the lumbar and femoral neck region were evaluated using dual energy X-ray absorbsiometry. Serum malondialdehyde (MDA) and nitric oxide (NO) levels and superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities were measured by analytical methods. In addition, serum osteocalcine and C telopeptide levels were determined to evaluate bone turnover MDA and NO levels and SOD activity were significantly increased (p<0.05) in osteoporotic males.", "Is there a role of free oxygen radicals in primary male osteoporosis?<||||>There was a negative correlation between SOD and lumbar BMD levels (r= -0.328; p = 0.021). The same trend was observed between NO and lumbar BMD (r = -0.473; p = 0.001) and femoral neck BMD values (r = -0.540; p = 0.000). There was no significant correlation between free radical levels and bone turnover markers." ]

[ "Early-generation versus new-generation drug-eluting stents in isolated chronic total occlusion: on the road to extinction?<||||>The performance of second-generation drug-eluting stent (DES) versus first-generation DES implantation in patients with stable angina and single chronic total occlusion (CTO) has not yet been studied. Herein, we sought to investigate whether a successful percutaneous coronary intervention (PCI) for CTO using second-generation versus first-generation polymer-coated DES improved outcomes in a setting of isolated CTO.", "Early-generation versus new-generation drug-eluting stents in isolated chronic total occlusion: on the road to extinction?<||||>Among 7765 patients undergoing elective PCIs between 2006 and 2011, a total of 742 single CTOs were identified. Of these, 496 had a successful PCI and 193 were implanted with DESs. The major adverse cardiovascular event (MACE) records were extracted from the national administrative database and all patients were linked to the 2-year follow-up.", "Early-generation versus new-generation drug-eluting stents in isolated chronic total occlusion: on the road to extinction?<||||>When compared to first-generation DES implantation, second-generation implantation once significantly reduced risk of MACE, both at 1-year (hazard ratio [HR], 0.15; 95% confidence interval [CI], 0.06-0.36; P=.01) and 2-year follow-up (HR, 0.27; 95% CI, 0.13-0.56; P=.01). The symptom-driven target lesion revascularization (TLR) also occurred less frequently in patients with second-generation DES vs first-generation DES within 2 years of follow-up (HR, 0.15; 95% CI, 0.05-0.44; P=.03). The substantial 2-year benefit of second-generation DES over first-generation DES also persisted after incorporating a propensity score analysis for MACE (HR, 0.24; 95% CI, 0.08-0.72; P=.01) and TLR (HR, 0.15; 95% CI, 0.05-0.49; P=.04)." ]

[ "Extracapsular axillary node extension in patients receiving adjuvant systemic therapy: an indication for radiotherapy?<||||>This is a retrospective review into the patterns of failure of 82 patients with Stage II or III breast cancer who had extracapsular extension (ECE) of axillary nodal metastases and who received systemic chemotherapy or hormonal therapy without loco-regional radiation.", "Extracapsular axillary node extension in patients receiving adjuvant systemic therapy: an indication for radiotherapy?<||||>The clinical records of patients with axillary node positive (T1-T3, N1, 2) Stage II or III breast cancer seen at the London Regional Cancer Centre between 1980-1989 were reviewed. Patients were identified who underwent segmental mastectomy with axillary node dissection or modified radical mastectomy and received adjuvant chemotherapy or tamoxifen but did not undergo loco-regional radiation. Eighty-two patients within this group had pathologic evidence of extracapsular axillary node extension (ECE). For 45 of these patients the extension was extensive, and for the remaining 37 it was microscopic. This ECE-positive group was compared to a subgroup of 172 patients who did not have pathologic evidence of extracapsular axillary node extension but had metastatic carcinoma confined within the nodal capsule.", "Extracapsular axillary node extension in patients receiving adjuvant systemic therapy: an indication for radiotherapy?<||||>Median age of the 82 ECE-positive patients was 56 years. Twenty-five patients had had a segmental mastectomy, the remainder a modified radical mastectomy. Median actuarial survival was 60 months, with a median disease-free and loco-regional failure-free survival of 38 months. Seventy-eight percent of these patients developed a recurrence, which was loco-regional in 60% (21% local, 21% regional, 2% local and regional, and 16% loco-regional and metastatic). There was a 36% recurrence rate in intact breast, 14% the chest wall following modified radical mastectomy, 7% relapsed in the axilla, 12% in supraclavicular nodes, and 1% in the internal mammary nodes. A comparison of the 82 ECE-positive patients with a group of 172 ECE-negative patients determined that there was a statistically significant difference between the two groups in terms of survival (overall and disease-free) and loco-regional recurrence. Univariate analysis of the entire 254 node-positive patient group revealed extracapsular nodal extension (ECE) to be a prognostically significant factor for actuarial and disease-free survival as well as for loco-regional failure, but ECE did not remain an independently prognostic factor after multivariate analysis. Segmental mastectomy, positive resection margins, and ER negative status increased the risk of loco-regional recurrence within the ECE-positive group." ]

[ "Does pan diameter influence carbon monoxide levels during heating of water to boiling point with a camping stove?<||||>To determine whether pan diameter influences carbon monoxide (CO) concentration during heating of water to boiling point with a camping stove. The hypothesis was that increasing pan diameter increases CO concentration because of greater flame dispersal and a larger flame.", "Does pan diameter influence carbon monoxide levels during heating of water to boiling point with a camping stove?<||||>This was a randomized, prospective study. A Coleman Dual Fuel 533 stove was used to heat pans of water to boiling point, with CO concentration monitored every 30 seconds for 5 minutes. The stove was inside a partially ventilated 200-L cardboard box model that was inside an environmental chamber at -6 degrees C. Water temperature, water volume, and flame characteristics were all standardized. Ten trials were performed for each of 2 pan diameters (base diameters of 165 mm [small] and 220 mm [large]).", "Does pan diameter influence carbon monoxide levels during heating of water to boiling point with a camping stove?<||||>There was a significant difference (P = .002) between the pans for CO levels at each measurement interval from 60 seconds onward. These differences were markedly larger after 90 seconds, with a mean difference of 185 ppm (95% CI 115, 276 ppm) for all the results from 120 seconds onwards." ]

[ "Low cholesterol?<||||>In vitro studies suggest that reducing cholesterol inhibits HIV replication. However, this effect may not hold in vivo, where other factors, such as cholesterol's immunomodulatory properties, may interact.", "Low cholesterol?<||||>Fasting blood samples were obtained on 165 people living with HIV at baseline and after 24 weeks on highly active antiretroviral therapy (HAART). Participants were classified as hypocholesterolemic (HypoCHL;<150 mg/dl) or non-HypoCHL (>150 mg/dl) and were compared on viro-immune outcomes.", "Low cholesterol?<||||>At baseline, participants with HypoCHL (40%) exhibited lower CD4 (197 +/- 181 vs. 295 +/- 191 cells/mm3, p = 0.02) and CD8 (823 +/- 448 vs. 1194 +/- 598 cells/mm3, p = 0.001) counts and were more likely to have detectable viral loads (OR = 3.5, p = 0.01) than non-HypoCHL controls. After HAART, participants with HypoCHL were twice as likely to experience a virological failure>400 copies (95% CI 1-2.6, p = 0.05) and to exhibit<200 CD4 (95% CI 1.03-2.9, p = 0.04) compared with non-HypoCHL. Low thymic output was related to poorer CD4 cell response in HypoCHL subjects. Analyses suggest a dose-response relationship with every increase of 50 mg/dl in cholesterol related to a parallel rise of 50 CD4 cells." ]

[ "Does current versus former smoking play a role in the relationship between anxiety and mood disorders and nicotine dependence?<||||>Research suggests an association between nicotine dependence and anxiety/mood disorders. Yet, less is known about the role of current versus former smoking in the association between nicotine dependence and these psychiatric disorders. The purpose of the present study was to investigate the relations between anxiety/mood disorders and 1) nicotine dependence and 2) current versus former smoking.", "Does current versus former smoking play a role in the relationship between anxiety and mood disorders and nicotine dependence?<||||>Data were drawn from the 2001-2002 National Epidemiologic Survey of Alcohol and Related Conditions, a nationally representative sample of over 43,000 adults in the United States. Analyses examined whether dependent versus non-dependent smoking and current versus former smoking were associated with anxiety/mood disorders.", "Does current versus former smoking play a role in the relationship between anxiety and mood disorders and nicotine dependence?<||||>Current dependent, but not non-dependent, smoking was associated with significantly increased odds of anxiety/mood disorders. There was no association between anxiety/mood disorders and former dependent smoking, compared with never smoking. However, compared with never smoking, former non-dependent smoking was associated with significantly decreased odds of current anxiety/mood disorders." ]

[ "Are quadrilateral surface buttress plates comparable to traditional forms of transverse acetabular fracture fixation?<||||>Several construct options exist for transverse acetabular fracture fixation. Accepted techniques use a combination of column plates and lag screws. Quadrilateral surface buttress plates have been introduced as potential fixation options, but as a result of their novelty, biomechanical data regarding their stabilizing effects are nonexistent. Therefore, we aimed to determine if this fixation method confers similar stability to traditional forms of fixation.QUESTIONS/", "Are quadrilateral surface buttress plates comparable to traditional forms of transverse acetabular fracture fixation?<||||>We biomechanically compared two acetabular fixation plates with quadrilateral surface buttressing with traditional forms of fixation using lag screws and column plates.", "Are quadrilateral surface buttress plates comparable to traditional forms of transverse acetabular fracture fixation?<||||>Thirty-five synthetic hemipelves with a transverse transtectal acetabular fracture were allocated to one of five groups: anterior column plate+posterior column lag screw, posterior column plate+anterior column lag screw, anterior and posterior column lag screws only, infrapectineal plate+anterior column plate, and suprapectineal plate alone. Specimens were loaded for 1500 cycles up to 2.5x body weight and stiffness was calculated. Thereafter, constructs were destructively loaded and failure loads were recorded.", "Are quadrilateral surface buttress plates comparable to traditional forms of transverse acetabular fracture fixation?<||||>After 1500 cycles, final stiffness was not different with the numbers available between the infrapectineal (568±43 N/mm) and suprapectineal groups (602±87 N/mm, p=0.988). Both quadrilateral plates were significantly stiffer than the posterior column buttress plate with supplemental lag screw fixation group (311±99 N/mm, p<0.006). No difference in stiffness was identified with the numbers available between the quadrilateral surface plating groups and the lag screw group (423±219 N/mm, p>0.223). The infrapectineal group failed at the highest loads (5.4±0.6 kN) and this was significant relative to the suprapectineal (4.4±0.3 kN; p=0.023), lag screw (2.9±0.8 kN; p<0.001), and anterior buttress plate with posterior column lag screw (4.0±0.6 kN; p=0.001) groups." ]

[ "Are addiction-related memories malleable by working memory competition?<||||>Experimental research suggests that working memory (WM) taxation reduces craving momentarily. Using a modified Eye Movement Desensitization and Reprocessing (EMDR) procedure, prolonged reductions in craving and relapse rates in alcohol dependence have been demonstrated. Modified EMDR-procedures may also hold promise in smoking cessation attempts. A proof-of-concept study was conducted to narrow the gap between WM-taxation experiments and clinical EMDR studies. To this end the clinical EMDR-procedure was modified for use in a laboratory experiment.", "Are addiction-related memories malleable by working memory competition?<||||>Daily smokers (n = 47), abstaining overnight, were allocated (by minimization randomization) to one of two groups using a parallel design. In both cases a modified EMDR-procedure was used. In the experimental group (n = 24) eye movements (EM) were induced while control group participants (n = 23) fixed their gaze (not taxing WM). During 6 min trials, craving-inducing memories were recalled. Craving, vividness of target memories, and smoking behavior were assessed at several variable-specific time-points between baseline (one week pre-intervention) and one week follow-up.", "Are addiction-related memories malleable by working memory competition?<||||>The experimental group showed significant immediate reductions of craving and vividness of targeted memories. However, these effects were lost during a one-week follow-up period." ]

[ "Is early internal fixation preferred to cast treatment for well-reduced unstable distal radial fractures?<||||>In the treatment of distal radial fractures, physicians often advocate internal fixation over cast treatment for potentially unstable fracture patterns, citing the difficulties of successful nonoperative treatment and a decrease in patient tolerance for functional deficiencies. This study was performed to evaluate whether early internal fixation or nonoperative treatment would be preferred for displaced, potentially unstable distal radial fractures that initially had an adequate reduction.", "Is early internal fixation preferred to cast treatment for well-reduced unstable distal radial fractures?<||||>A decision analytic model was created to compare early internal fixation with use of a volar plate and nonoperative management of a displaced, potentially unstable distal radial fracture with an acceptable closed reduction. To identify the optimal treatment, quality-adjusted life expectancy was estimated for each management approach. Data from the literature were used to estimate rates of treatment complications (e.g., fracture redisplacement with nonoperative treatment) and of treatment outcomes. Mean health-state utilities for treatment outcomes of painless malunion, functional deficit, and painful malunion were derived by surveying fifty-one adult volunteers with use of the time trade-off method. Sensitivity analysis was used to determine which model parameters would change the treatment decision over a plausible range of values.", "Is early internal fixation preferred to cast treatment for well-reduced unstable distal radial fractures?<||||>Early internal fixation with volar plating was the preferred strategy in most scenarios over the ranges of parameters available, but the margins were small. The older patient (mean age, 57.8 years) who sustains a distal radial fracture can expect 0.08 more quality-adjusted life years (29.2 days) with internal fixation compared with nonoperative treatment. Sensitivity analysis revealed no single factor that changed the preferred option within the reported ranges in the base case. However, the group of patients sixty-five years or older, who had lower disutility for painful malunion, derived a very small benefit from operative treatment (0.01 quality-adjusted life year or 3.7 days) and would prefer cast treatment in some scenarios." ]

[ "Is mammography useful in screening for local recurrences in patients with TRAM flap breast reconstruction after mastectomy for multifocal DCIS?<||||>Skin-sparing mastectomy with immediate transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction is being used more often for the treatment of breast cancer. Mammography is not used routinely to evaluate TRAM flaps in women who have undergone mastectomy. We have identified the potential value of its use in selected patients.", "Is mammography useful in screening for local recurrences in patients with TRAM flap breast reconstruction after mastectomy for multifocal DCIS?<||||>We report on four women who manifested local recurrences in TRAM flaps after initial treatment for ductal carcinoma in situ (DCIS) or DCIS with microinvasion undergoing skin-sparing mastectomy and immediate reconstruction. All four patients presented with extensive, high-grade, multifocal DCIS that precluded breast conservation. Three of four mastectomy specimens demonstrated tumor close to the surgical margin. Three of the four recurrences were detected by physical examination; the remaining local recurrence was documented by screening mammography. The recurrences had features suggestive of malignancy on mammography." ]

[ "Internet-based treatment of headache: does telephone contact add anything?<||||>To study the contribution of therapist-initiated telephone contact in the treatment of recurrent headache via the Internet.", "Internet-based treatment of headache: does telephone contact add anything?<||||>Internet-based cognitive behavioral self-help is a promising new venue for the treatment of recurrent headache. While cost-effective, there are indications that this modality may be associated with high dropout rates.", "Internet-based treatment of headache: does telephone contact add anything?<||||>The role of therapist-initiated contact was investigated in a randomized controlled trial in which 44 self-recruited headache sufferers were randomized to either a Web-based self-help program with e-mail support or to a group receiving, in addition, weekly individual telephone calls. An additional 8 control subjects were recruited to receive similar treatment outside of the study.", "Internet-based treatment of headache: does telephone contact add anything?<||||>Dropout rates were 29% in the telephone support group and 35% in the control group, suggesting that the telephone calls did not affect dropout. Results showed significant reductions in headache-related disability, depression, maladaptive coping strategies, and perceived stress but little to indicate any superior performance in the Internet-only group and little improvement in the headache index. In short, therapist-initiated telephone calls did not influence the results." ]

[ "Can positron emission tomography be more than a diagnostic tool?<||||>An online questionnaire was developed to survey the oncologists on their use of PET, viewing protocols, contouring techniques practiced, the barriers on the use of PET and the need for training in use of PET in radiotherapy. The questionnaire was sent to about 500 oncologists and 76 completed responses were received.", "Can positron emission tomography be more than a diagnostic tool?<||||>The survey shows that radiation oncologists use PET largely to assess treatment response and staging but limitedly use it for radiotherapy treatment planning. Only manual contouring and fixed threshold based delineation techniques (e.g. 40% maximum standard uptake value [SUV max ] or SUV 2.5) are used. Cost is the major barrier in the wider use of PET, followed by limited availability of FDG radionuclide tracer. Limited or no training was available for the use of PET." ]

[ "Does Game Participation Impact Cognition and Symptoms in Elite Football Players?<||||>To measure neurocognitive functioning in college and professional football players after game participation.", "Does Game Participation Impact Cognition and Symptoms in Elite Football Players?<||||>Retrospective, cross-sectional cohort design.", "Does Game Participation Impact Cognition and Symptoms in Elite Football Players?<||||>Ninety-four male university and professional football players.", "Does Game Participation Impact Cognition and Symptoms in Elite Football Players?<||||>All participants completed Immediate Postconcussion Assessment and Cognitive Testing (ImPACT) testing at baseline, and either at postconcussion (group 1) or postgame (group 2) participation.", "Does Game Participation Impact Cognition and Symptoms in Elite Football Players?<||||>Results from the 5 ImPACT composite scores (Verbal Memory, Visual Memory, Visual Motor Speed, Reaction Time and Impulse Control) and Total Symptom Score.", "Does Game Participation Impact Cognition and Symptoms in Elite Football Players?<||||>Repeated-measures analysis of variance demonstrated a significant main effect for time (improvements) in 3 of 5 domains for the postconcussion group, but no improvements in the postgame group. The postconcussion group presented with significantly improved results on 4 of 5 ImPACT domains compared with the postgame group at the follow-up time interval." ]

[ "Prenatal assessment of the normal fetal soft palate by three-dimensional ultrasound examination: is there an objective technique?<||||>To describe a three-dimensional (3D) ultrasound technique for assessing the fetal soft palate.", "Prenatal assessment of the normal fetal soft palate by three-dimensional ultrasound examination: is there an objective technique?<||||>A prospective study conducted from April to December 2006 included 87 fetuses in a low-risk population. Fetal ultrasound scans were performed between 21 and 25 weeks of gestation to determine the normal 3D ultrasound view of the fetal soft tissues of the palate. The sonographers used a 30 degrees-inclined axial 3D view of the fetal palate. Ultrasound images obtained in this view were compared with fetopathological specimens of the same gestational age by two observers, both pediatric surgeons. Each observer indicated whether they thought that the uvula or the velum could be detected, and the differences in responses between the observers were assessed.", "Prenatal assessment of the normal fetal soft palate by three-dimensional ultrasound examination: is there an objective technique?<||||>The frequencies of detection of the uvula and velum of each observer varied between 80% and 90%. The observers showed a significant difference in judging the visualization of the uvula, but not in judging the velum." ]

[ "Open fourth ventricle prior to 20 weeks' gestation: a benign finding?<||||>To evaluate the role of the brainstem-vermis (BV) angle in the diagnosis of fetal posterior fossa abnormalities at 15-18 weeks' gestation.", "Open fourth ventricle prior to 20 weeks' gestation: a benign finding?<||||>We examined retrospectively three-dimensional (3D) ultrasound volumes acquired at 15-18 gestational weeks in fetuses with normal posterior fossa (controls) and in those with cystic posterior fossa. Whether the fourth ventricle appeared open posteriorly in axial views was noted and the BV angle was measured. A detailed follow-up was obtained in all cases.", "Open fourth ventricle prior to 20 weeks' gestation: a benign finding?<||||>Of the 139 controls, 46 cases were excluded because of inadequate quality of the 3D volumes. Of the 93 remaining normal fetuses, 84 (90.3%) had a closed fourth ventricle and a BV angle< 20°, whereas 9/93 (9.7%) had an open fourth ventricle and a BV angle between 20° and 37°. The study group of 11 fetuses included seven with Dandy-Walker malformation and four with Blake's pouch cyst. In abnormal cases as a whole, the BV angle was significantly increased compared with that in controls (P < 0.0001). However, fetuses with Blake's pouch cyst and normal fetuses with an open fourth ventricle had strikingly similar sonograms: the BV angle was between 20° and 37° and the fourth ventricle appeared open only when viewed using a more steeply angulated scanning plane than that of the standard transcerebellar plane; in fetuses with Dandy-Walker malformation the fourth ventricle was widely open posteriorly, even in the standard transcerebellar view, and the BV angle was > 45°, significantly increased compared both with that in normal fetuses (P < 0.0001) and with that in fetuses with Blake's pouch cyst (P = 0.004)." ]

[ "Are genetic variants in the platelet-derived growth factor [beta] gene associated with chronic pancreatitis?<||||>Platelet-derived growth factor [beta] (PDGF-[beta]) is a major signal in proliferation and matrix synthesis through activated pancreatic stellate cells, leading to fibrosis of the pancreas. Recurrent acute pancreatitis (RAP) seems to predispose to chronic pancreatitis (CP) in some patients but not others. We tested the hypothesis that 2 known PDGF-[beta] polymorphisms are associated with progression from RAP to CP. We also tested the hypothesis that PDGF-[beta]polymorphisms in combination with environmental risk factors such as alcohol and smoking are associated with CP.", "Are genetic variants in the platelet-derived growth factor [beta] gene associated with chronic pancreatitis?<||||>Three hundred eighty-two patients with CP (n = 176) and RAP (n = 206) and 251 controls were evaluated. Platelet-derived growth factor [beta] polymorphisms +286 A/G (rs#1800818) seen in 5'-UTR and +1135 A/C (rs#1800817) in first intron were genotyped using single-nucleotide polymorphism polymerase chain reaction approach and confirmed by DNA sequencing.", "Are genetic variants in the platelet-derived growth factor [beta] gene associated with chronic pancreatitis?<||||>The genotypic frequencies for PDGF-[beta] polymorphisms in positions +286 and +1135 were found to be similar in controls and patients with RAP and CP. There was no difference in genotypic frequencies among RAP, CP, and controls in subjects in the alcohol and smoking subgroups." ]

[ "25-Hydroxyvitamin D [25(OH)D] levels and diabetic foot ulcer: is there any relationship?<||||>In recent years, there has been an effort to understand possible roles of 25(OH)D, including its role in the immune system particularly on T cell medicated immunity, pancreatic insulin secretion and insulin action. 25(OH)D stimulates the cell differentiation and reduces cell proliferation, which is essential for cell growth and wound healing. However, data on the association between low level of plasma 25(OH)D and diabetic foot syndrome are scarce.", "25-Hydroxyvitamin D [25(OH)D] levels and diabetic foot ulcer: is there any relationship?<||||>Circulating plasma levels of 25(OH)D were measured in diabetic patients with ulcer (n=162) and without ulcer (n=162) in a prospective cohort hospital based study.", "25-Hydroxyvitamin D [25(OH)D] levels and diabetic foot ulcer: is there any relationship?<||||>Of these patients, 85.1% had type 2 diabetes. Subjects with diabetic foot ulcer showed lower median plasma level of 25(OH)D [6.3(4.2-11.1) vs 28.0(21.4-37.0)] ng/ml after adjusting the age and BMI. Regardless of the low levels of 25(OH)D in cases and controls, it was associated with neuropathy, sex (female), duration of ulcer healing, and smoking status and independent of confounding factors, including BMI (kg/m²), A1c (%), hypertension, nephropathy, foot ulcer, retinopathy, CAD, PAD, HDL-C (mg/dl) and LDL-C (mg/dl). The factors which predict the risk of developing ulcer independent of 25(OH)D status were A1c (>6.9%) [OR 4.37; RR 1.77], HDL-C (<40mg/dl) [OR 1.16; RR 1.07], LDL-C (>100mg/dl) [OR 1.07; RR 1.03], triglycerides (>200mg/dl) [OR 1.40; RR 1.19], neuropathy [OR 6.88; RR 3.12], retinopathy [OR 3.34; RR 1.91], hypertension [OR 1.64; RR 1.28], nephropathy [OR 3.12; RR 1.87] and smoking [OR 4.53; RR 2.99]using odds and risk ratios." ]

[ "Is sigmoidoscopy sufficient for evaluating inflammatory status of ulcerative colitis patients?<||||>An adequate range of colonic observations for precise evaluation of inflammation in ulcerative colitis (UC) patients has not been reported.", "Is sigmoidoscopy sufficient for evaluating inflammatory status of ulcerative colitis patients?<||||>Retrospective analysis of 545 colonoscopic examinations of UC patients was carried out. Severity of mucosal inflammation was evaluated using the Mayo score of endoscopic index at each location (rectum, sigmoid colon, descending colon, and the oral side of the splenic flexure) in each patient. The colonic site with maximum inflammation was determined for each patient.", "Is sigmoidoscopy sufficient for evaluating inflammatory status of ulcerative colitis patients?<||||>Of 545 patients, 319 (59%) had maximum inflammation in the rectum, 79 (14%) in the sigmoid colon, 70 (13%) in the descending colon, and 77 (14%) on the oral side of the splenic flexure. Severe inflammatory activity (Mayo 3) was observed more frequently in patients who had maximum activity in the descending colon or the more proximal portion than those who had this in the rectum or sigmoid colon (42% vs 25%, P<0.0001). The first-attack patients were significantly more frequently found in patients with maximum severity in the descending colon or the oral side of splenic flexure than those with maximum severity in the rectum or sigmoid colon (P=0.016). Moreover, among 134 patients with no inflammation in the rectum and sigmoid colon, 54 (40%) had inflamed mucosa in the descending colon or the more proximal portion." ]

[ "Is there a role for alpha1-blockers in treating double-J stent-related symptoms?<||||>To evaluate the effect of alfuzosin in improving symptoms in, and quality of life of, patients with indwelling double-J ureteral stents.", "Is there a role for alpha1-blockers in treating double-J stent-related symptoms?<||||>A total of 100 patients, 50 men and 50 women (mean age 54.2 years), with unilateral ureteral stone-related hydronephrosis, who had opted for conservative management with insertion of a double-J ureteral stent, were prospectively randomized into two groups. Group 1 included 50 patients who received 10 mg of alfuzosin, once daily for 4 weeks, and group 2 consisted of 50 patients who received placebo for the same period. All patients completed a validated Ureteral Stent Symptom Questionnaire (USSQ) 4 weeks after stent placement.", "Is there a role for alpha1-blockers in treating double-J stent-related symptoms?<||||>The mean urinary symptom index score was 21.6 in group 1 and 28.1 in group 2 (P<0.001). Stent-related pain was reported by 44% of patients in group 1 and 66% of patients in group 2 (P = 0.027). The mean pain index score was 14.6 in group 1 and 17.4 in group 2 (P = 0.047). The mean general health index score was statistically greater (P<0.001) in group 1 compared with in group 2 (8 versus 11.4, respectively). Among sexually active patients, the mean sexual score was 2.3 in group 1 and 2.9 in group 2 (P = 0.017)." ]

[ "Is the \"10% rule\" equally valid for all subsets of sentinel-node-positive breast cancer patients?<||||>In breast cancer, a combination of radioisotope and blue dye mapping maximizes the success and accuracy of sentinel node (SLN) biopsy. When multiple radioactive nodes are present, there is no single definition of isotope success, but the popular \"10% rule\" dictates removal of all SLN with counts>10% of the most radioactive node. Here we determine how frequently a positive SLN would be missed by the 10% rule.", "Is the \"10% rule\" equally valid for all subsets of sentinel-node-positive breast cancer patients?<||||>Between 9/96 and 12/04, we performed 6,369 successful SLN biopsies using (99m)Tc sulfur colloid and isosulfan blue dye, removing as SLN all radioactive and/or blue nodes, and taking counts from each node ex vivo. Standard processing of all SLNs with a benign frozen section included hematoxylin and eosin (H&E) staining, serial sectioning, and immunohistochemistry (IHC).", "Is the \"10% rule\" equally valid for all subsets of sentinel-node-positive breast cancer patients?<||||>33% of patients (2,130/6,369) had positive SLNs. Of these patients, 1,387/2,130 (65%) had>1 SLN identified. The most radioactive SLN was benign in 29% (398/1,387), and 107/1,387 (8%) had a positive SLN that was neither blue nor the hottest. From this group 1.7% (24/1387) of patients had positive SLN with counts<10% radioactive counts of the hottest node. The 10% rule captured 98.3% of positive nodes in patients with multiple SLNs. No patient characteristics were predictive of failure of the 10% rule." ]

[ "Is Retinal Nerve Fiber Layer Thickness Change Related to Headache Lateralization in Migraine?<||||>To evaluate retinal nerve fiber layer (RNFL) thickness in migraine patients with unilateral headache.", "Is Retinal Nerve Fiber Layer Thickness Change Related to Headache Lateralization in Migraine?<||||>A total of 58 patients diagnosed with migraine headache consistently occurring on the same side and 58 age- and sex-matched healthy subjects were evaluated in this cross-sectional study. RNFL thickness was measured using spectral-domain optical coherence tomography, and the side with the headache was compared with the contralateral side as well as with the results of healthy subjects.", "Is Retinal Nerve Fiber Layer Thickness Change Related to Headache Lateralization in Migraine?<||||>The mean patient age was 33.05 ± 8.83 years, and that of the healthy subjects was 31.44 ± 8.64 years (p = 0.32). The mean duration of disease was 10.29 ± 9.03 years. The average and nasal RNFL thicknesses were significantly thinner on the side of headache and on the contralateral side compared to control eyes (p<0.05, for all). Thinning was higher on the side of the headache compared to the contralateral side; however, this difference was not statistically significant." ]

[ "Can minilaparotomy abdominal aortic aneurysm repair be performed safely and effectively without special skills?<||||>The purpose of this study was to determine whether a surgeon without special skills can perform minimal incision abdominal aortic aneurysm repair as safely and effectively as traditional retroperitoneal aneurysmectomy.", "Can minilaparotomy abdominal aortic aneurysm repair be performed safely and effectively without special skills?<||||>After informed consent, eligible patients were randomized into minilaparotomy and retroperitoneal groups. The minilaparotomy repair consisted of a short transabdominal midline incision, intraabdominal retraction of the bowel, control of back bleeding with balloon catheters, and hand-sewn anastomoses. The retroperitoneal approach was performed through a left vertical-lateral abdominal incision.", "Can minilaparotomy abdominal aortic aneurysm repair be performed safely and effectively without special skills?<||||>Twenty-six patients were randomly treated by minilaparotomy approach (n = 14) or retroperitoneal approach (n = 12) from December, 1999, to May 2001. Parameters for speed of recovery were indistinguishable and of no clinical significance. In the long-term follow-up (mean period, 27 months), no patients in the minilaparatomy group complained of discomfort from the incision, whereas 4 patients in the retroperitoneal group complained of discomfort (P<0.05)." ]

[ "Is relatively young age within a school year a risk factor for mental health problems and poor school performance?<||||>Several studies have shown that children who are relatively young within a school year are at greater risk for poorer school performance compared with their older peers. One study also reported that relative age within a school year is an independent risk factor for emotional and behavioral problems. The objective of this study was to test the hypothesis that relatively younger adolescents in the multiethnic population of Oslo have poorer school performance and more mental health problems than their relatively older classmates within the same school year.", "Is relatively young age within a school year a risk factor for mental health problems and poor school performance?<||||>This population-based cross-sectional study included all 10th-grade pupils enrolled in 2000 and 2001 in the city of Oslo. The participation rate was 88%. Of the 6,752 pupils in the study sample, 25% had a non-Norwegian background. Mental health problems were quantified using the abbreviated versions of Symptom Check List-25 (SCL-10) and the Strength and Difficulties Questionnaire (SDQ). Information on school performances and mental health problems were self-reported. We controlled for confounding factors including parental educational level, social support, gender, and ethnicity.", "Is relatively young age within a school year a risk factor for mental health problems and poor school performance?<||||>The youngest one-third of pupils had significantly lower average school grades than the middle one-third and oldest one-third of their classmates (p<0.001). Of the mental health problems identified in the questionnaires, the groups differed only on peer problems; the youngest one-third reported significantly more problems than the middle and oldest groups (p<0.05). Age within a school year and gender showed significant interactions with total SDQ score, SDQ peer problems score, SDQ pro social score, and SCL-10 score. After stratifying for gender, the peer problem scores differed significantly between age groups only among boys. The SCL-10 score was significant, but only in girls and in the opposite direction to that expected, with the oldest pupils having significantly higher scores than the other two groups (p<0.05)." ]

[ "Vascular closure devices after endovascular procedures in swine: a reliable method?<||||>To investigate the safety and feasibility of the use of a vascular closure device (VCD) after endovascular procedures in swine.", "Vascular closure devices after endovascular procedures in swine: a reliable method?<||||>In a study on endovascular therapy, VCD (StarClose, Abbott Vascular, Il, USA) was used in 20 female swines to achieve immediate hemostasis after percutaneous right femoral artery (FA) access. 10 animals were sacrificed immediately after the study and 10 animals were sacrificed 28 days after the initial study. To ensure complete hemostasis and patency of the femoral artery, a CT-angiography of the puncture site was performed on day 1 (acute and chronic group) and day 28 (chronic group). After the sacrifice, the femoral artery was explanted and examined macroscopically for signs of VCD dysfunction.", "Vascular closure devices after endovascular procedures in swine: a reliable method?<||||>Technical success rate was 100% with immediate hemostasis being achieved in all animals. No animals showed evidence of hematoma. During explantation, only small traces of coagulated blood were found in the acute group, while there were no signs of hematoma in the chronic group. CT-angiography immediately after VCD application as well as before sacrifice (chronic group) showed patency of the FA in all cases." ]

[ "Is wound drainage necessary after lumbar spinal fusion surgery?<||||>Despite a lack of any evidence to support the utilization of closed-suction drainage after spinal surgery, it is a frequently utilized procedure.MATERIAL/", "Is wound drainage necessary after lumbar spinal fusion surgery?<||||>A retrospective evaluation of eighty-five consecutive posterior lumbar fusions at a single level for degenerative disease was performed during the six-year period between March of 1996 and February 2002 by a single surgeon. No patient had a drain placed at the conclusion of the surgical procedure.", "Is wound drainage necessary after lumbar spinal fusion surgery?<||||>One patient developed a postoperative deep wound infection requiring debridements and intravenous antibiotics for six weeks. One patient developed a postoperative cellulitis that resolved with PO antibiotics. One patient who received intravenous Lovenox (Enoxaparin) for deep vein thrombosis prophylaxis in the immediate peri-operative period developed a hematoma that was surgically decompressed. No additional complications were noted. The results of this study compare favorably with similar well-matched historical controls using routine peri-operative lumbar wound drainage." ]

[ "Is administratively coded comorbidity and complication data in total joint arthroplasty valid?<||||>Administrative claims data are increasingly being used in public reporting of provider performance and health services research. However, the concordance between administrative claims data and the clinical record in lower extremity total joint arthroplasty (TJA) is unknown.QUESTIONS/", "Is administratively coded comorbidity and complication data in total joint arthroplasty valid?<||||>We evaluated the concordance between administrative claims and the clinical record for 13 commonly reported comorbidities and complications in patients undergoing TJA.", "Is administratively coded comorbidity and complication data in total joint arthroplasty valid?<||||>We compared 13 administratively coded comorbidities and complications derived from hospital billing records with clinical documentation from a consecutive series of 1350 primary and revision TJAs performed at three high-volume institutions during 2009.", "Is administratively coded comorbidity and complication data in total joint arthroplasty valid?<||||>Concordance between administrative claims and the clinical record varied across comorbidities and complications. Concordance between diabetes and postoperative myocardial infarction was reflected by a kappa value>0.80; chronic lung disease, coronary artery disease, and postoperative venous thromboembolic events by kappa values between 0.60 and 0.79; and for congestive heart failure, obesity, prior myocardial infarction, peripheral arterial disease, bleeding complications, history of venous thromboembolism, prosthetic-related complications, and postoperative renal failure by kappa values between 0.40 and 0.59. All comorbidities and complications had a high degree of specificity (>92%) but lower sensitivity (29%-100%)." ]

[ "The modified essay question: its exit from the exit examination?<||||>Exit examinations in medicine are 'high stakes' examinations and as such must satisfy a number of criteria including psychometric robustness, fairness and reliability in the face of legal or other challenges.", "The modified essay question: its exit from the exit examination?<||||>We have undertaken a critical review of the exit examination from the University of Adelaide focussing on the written components. This examination consisted of an objective structure clinical examination (OSCE), a multiple choice question (MCQ) paper and a modified essay question (MEQ) paper.", "The modified essay question: its exit from the exit examination?<||||>The two written papers were assessed for item writing flaws and taxonomic level using modified Bloom's criteria. Curriculum experts independently assessed adequacy of the examination for validity and fidelity.", "The modified essay question: its exit from the exit examination?<||||>The overall examination had good fidelity and validity. The results of the MEQ and MCQ were strongly and positively correlated and there was a weak negative correlation between these papers and the OSCE. The MEQ had a higher proportion of questions focussed on recall of knowledge and the questions were more structurally flawed compared with the MCQs. The MEQ re-marking process resulted in lower scores than were awarded by the original, discipline-based expert markers. The MEQ paper failed to achieve its primary purpose of assessing higher cognitive skills." ]

[ "Is breast MRI helpful in the evaluation of inconclusive mammographic findings?<||||>The purpose of this study was to evaluate the usefulness of MRI of the breast in cases in which mammographic or sonographic findings are inconclusive.", "Is breast MRI helpful in the evaluation of inconclusive mammographic findings?<||||>We retrospectively reviewed images from 115 MRI examinations of the breast performed from 1999 to 2005 for the indication of problem-solving for inconclusive findings on a mammogram. Forty-eight of the 115 women (41.8%) were at high risk. We discerned whether sonography or MRI was used as an adjunctive tool and correlated the findings with those in the pathology database.", "Is breast MRI helpful in the evaluation of inconclusive mammographic findings?<||||>The equivocal findings most frequently leading to MRI were asymmetry and architectural distortion. No suspicious MRI correlate was found in 100 of 115 cases (87%). These cases were found stable at follow-up mammography or MRI after a mean of 34 months. Fifteen enhancing masses (13%) that corresponded to the mammographic abnormality were seen on MR images. All masses identified at MRI were accurately localized for biopsy, and six malignant lesions were identified. Four of six malignant tumors were seen in one mammographic view only; two were seen on second-look ultrasound images. MRI had a sensitivity of 100% and compared with mammography had significantly higher specificity (91.7% vs 80.7%, p = 0.029), positive predictive value (40% vs 8.7%, p = 0.032), and overall accuracy (92.2% vs 78.3%, p = 0.0052). Eighteen incidental lesions (15.7%) were detected at MRI, and all were subsequently found benign." ]

[ "The sources of risk factor information for general practitioners: is physical activity under-recognised?<||||>To identify and compare the amount of material on physical activity and the management of smoking, hypertension and hypercholesterolaemia in medical journals and magazines frequently read by general practitioners.", "The sources of risk factor information for general practitioners: is physical activity under-recognised?<||||>Qualitative study assessing the total number of articles and advertisements to which Australian GPs are exposed in journals and medical magazines they are likely to read.", "The sources of risk factor information for general practitioners: is physical activity under-recognised?<||||>Only 6% of articles about cardiovascular disease (CVD) risk factors in the Medline search and 5% in the medical magazine search discussed exercise prescription or how to start and maintain an exercise program. Most CVD risk factor articles were on the pharmacological treatment of hypertension (42%), followed by hypercholesterolaemia (32%) and smoking cessation (20%). A review of medical magazines found similarly ranked results, and a count of advertisements indicated 67% related to hypertension, 26% to hypercholesterolaemia and 7% to smoking cessation." ]

[ "Should we question early feminizing genitoplasty for patients with congenital adrenal hyperplasia and XX karyotype?<||||>There is a wide difference of opinion between the medical-surgical community and advocacy group regarding Disorders of Sexual Development (DSD) secondary to congenital adrenal hyperplasia (CAH) being ranked in the intersex category. This rupture is even more evident when the issue of genitoplasty is brought up. For physicians it is obvious and unequivocal that a person with CAH and an XX karyotype has a female gender identity, whereas associations tend to rank persons with CAH in the intersex category and advocate holding-off on surgical management.MATERIAL/", "Should we question early feminizing genitoplasty for patients with congenital adrenal hyperplasia and XX karyotype?<||||>A retrospective case study vs. control group, spanning over 40years, included 21 patients who were treated in 3 different centers. Each patient and their parents were contacted independently and interviewed regarding interpersonal relationships, psychological impact of genitoplasty, gender identity and opinion on optimal care management for this disorder. Three couples controls (parent-child) per CAH patients were used and matched according to age, sex assigned at birth and ethnic origin.", "Should we question early feminizing genitoplasty for patients with congenital adrenal hyperplasia and XX karyotype?<||||>Sex assigned at birth seemed to concord with the gender identity perceived by the patients in 85.7% of cases. In fact, 89.7% of patients and 100% of parents felt that feminizing genitoplasty should be performed within the first year of life. There is however a significant difference compared to controls who felt that surgical management should occur later on in life. No difference was highlighted during childhood regarding parents-child relationships or social integration. However, during adolescence, the parents-child relationship tended to be significantly more painful for the CAH group. Integrating their parenting role was significantly harder for patients in the CAH-DSD group. In the population of CAH-DSD patients who had genitoplasty the level of sexual fulfillment was not lower to the one reported by the control group." ]

[ "Does cardiac morphology predict plasma brain natriuretic Peptide levels in adolescent athletes?<||||>The purpose of this study was to establish the relationship of plasma levels of brain natriuretic peptide (BNP) to physiologic parameters and cardiac morphologic characteristics in a population of young athletes. Our hypothesis is that physiologic and cardiac morphologic characteristics do not predict BNP levels in adolescent athletes.", "Does cardiac morphology predict plasma brain natriuretic Peptide levels in adolescent athletes?<||||>Observational study.", "Does cardiac morphology predict plasma brain natriuretic Peptide levels in adolescent athletes?<||||>Outpatient hospital.", "Does cardiac morphology predict plasma brain natriuretic Peptide levels in adolescent athletes?<||||>Thirty healthy male adolescent high school football players (16.0 +/- 1.1 years).", "Does cardiac morphology predict plasma brain natriuretic Peptide levels in adolescent athletes?<||||>Physical exam, electrocardiography, plasma BNP measurement by rapid fluorescent immunoassay, and limited echocardiography.", "Does cardiac morphology predict plasma brain natriuretic Peptide levels in adolescent athletes?<||||>Null hypothesis-physiologic parameters and cardiac morphology do not predict plasma BNP levels in healthy adolescent football players. Significance level set at P<0.05.", "Does cardiac morphology predict plasma brain natriuretic Peptide levels in adolescent athletes?<||||>Plasma BNP for this population was 11.9 +/- 10.2 pg/mL. There was no correlation between BNP and mean arterial pressure (r = -0.09, P = 0.64), body mass index (r = 0.11, P = 0.57), interventricular septal thickness (r = -0.15, P = 0.44), left ventricular (LV) wall thickness (r = 0.00, P = 0.99), relative wall thickness (r = -0.04, P = 0.84), LV mass (r = 0.05, P = 0.79), or LV mass index (r = 0.11, P = 0.55)." ]

[ "Dyspnea in patients with chronic obstructive pulmonary disease: does dyspnea worsen longitudinally in the presence of declining lung function?<||||>To determine the direction and rate of change in the symptom of dyspnea in patients with chronic obstructive pulmonary disease (COPD) whose lung function has worsened over time.", "Dyspnea in patients with chronic obstructive pulmonary disease: does dyspnea worsen longitudinally in the presence of declining lung function?<||||>Secondary analysis of a longitudinal data set.", "Dyspnea in patients with chronic obstructive pulmonary disease: does dyspnea worsen longitudinally in the presence of declining lung function?<||||>Outpatient clinic.", "Dyspnea in patients with chronic obstructive pulmonary disease: does dyspnea worsen longitudinally in the presence of declining lung function?<||||>Thirty-four medically stable male subjects with chronic obstructive pulmonary disease studied for 5.3 +/- 3.5 years, with a mean reduction in FEV1 over the period studied of 330.9 +/- 288.0 mL. Subjects were 63.3 +/- 5.5 years of age at entry into the study.", "Dyspnea in patients with chronic obstructive pulmonary disease: does dyspnea worsen longitudinally in the presence of declining lung function?<||||>Dyspnea and functional status scores were obtained using the Pulmonary Functional Status and Dyspnea Questionnaire.", "Dyspnea in patients with chronic obstructive pulmonary disease: does dyspnea worsen longitudinally in the presence of declining lung function?<||||>There was no significant difference in reports of dyspnea from the beginning to the end of the study, despite significant reductions in lung function. Of all activities studied, dyspnea when raising arms overhead was the only activity showing a relationship to the slope of change in FEV1 %." ]

[ "Small dense low-density lipoprotein in renal transplant recipients: a potential target for prevention of cardiovascular complications?<||||>Immunosuppressive therapy is frequently associated with dyslipidemia, which is involved in cardiovascular morbidity and mortality in transplant patients. Beyond classical factors, such as low-density lipoprotein (LDL) cholesterol (LDL-C), qualitative abnormalities of lipoproteins, such as presence of the atherogenic factor, small dense LDL, may be of interest for a cardiovascular risk assessment. This study was designed to explore LDL size in renal transplant recipients in relation to quantitative lipid parameters and apolipoprotein (apo) CIII polymorphism.", "Small dense low-density lipoprotein in renal transplant recipients: a potential target for prevention of cardiovascular complications?<||||>Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), LDL-C, apoA1, apoB, apoCIII, and LDL size were measured in 62 patients of mean age 45 +/- 13 years including 71% men at 2 +/- 0.5 years after renal transplantation. Thirty-two patients received cyclosporine (CsA), while 30 received tacrolimus (FK). ApoCIII Sstl genotype was determined by restriction fragment length polymorphism.", "Small dense low-density lipoprotein in renal transplant recipients: a potential target for prevention of cardiovascular complications?<||||>The CsA group exhibited higher TC (P = .001), LDL-C (P = .004), non-HDL-C (P = .009), HDL-C (P = .03), apoB (P = .008), and apoCIII (P = .002) levels than the FK group. However, LDL-C (CsA: 3.7 +/- 1.2, FK: 3.0 +/- 0.6 mmol/L) and triglyceride levels (CsA: 1.55 mmol/L, FK: 1.37 mmol/L) were near the normal range in both groups. Allelic frequency of the sparse A2 allele associated with hypertriglyceridemia was 6%, similar to the general population. LDL size, which was comparable in the CsA and FK groups (25.87 +/- 0.89 vs 25.75 +/- 0.62 nm, respectively), inversely correlated with TG/HDL ratio (P = 10(-4)). Prevalence of small dense LDL (defined as<25.5 nm) was 26% in the CsA group and 33% in the FK group." ]

[ "Does clinical exposure affect medical student examination performance?<||||>Traditionally important components of the surgical clerkship curriculum include lectures, small-group sessions, readings, clinical exposure, and testing. Time constraints require compromise among all these elements. At our institution, clinical exposure of medical students varies according to their team assignments. They differ primarily in exposure to such topics as trauma, inflammatory bowel disease (IBD), and vascular surgery.", "Does clinical exposure affect medical student examination performance?<||||>The goal of this study was to quantify the influence of clinical exposure on medical student education, testing whether it influences examination performance.", "Does clinical exposure affect medical student examination performance?<||||>At the beginning of the clerkship, students were given a written multiple-choice examination covering these three topics. They completed two 4-week blocks on surgery services in various settings. At the end of the clerkship, they were reexamined. Differences between pretest and posttest overall mean rank were analyzed using the Wilcoxon signed ranks test. Differences in improvement based on clinical exposure were analyzed using the Mann-Whitney U test.", "Does clinical exposure affect medical student examination performance?<||||>Statistically significant improvement was seen in overall examination performance, as well as in each of the subsections. However, these improvements could not be accounted for by clinical exposure. There was no statistically significant difference in mean rank in improvement based on clinical exposure to vascular, IBD, or trauma." ]

[ "Does the population living in Roma settlements differ in physical activity, smoking and alcohol consumption from the majority population in Slovakia?<||||>Several studies have revealed a high prevalence of risk factors associated with unhealthy lifestyle among individuals with lower socioeconomic status. In Slovakia, one of the most socially and health-disadvantaged groups is the Roma minority. The aim of this study is to explore differences in physical activity, smoking and alcohol consumption between the population living in Roma settlements and the majority population in Slovakia.", "Does the population living in Roma settlements differ in physical activity, smoking and alcohol consumption from the majority population in Slovakia?<||||>Data from the cross-sectional epidemiological HepaMeta study conducted in Slovakia in 2011 were used. The sample consisted of 452 Roma (mean age = 34.7; 35.2% men) and 403 non-Roma (mean age = 33.5; 45.9% men) respondents. The differences in health-related behaviour between the population living in Roma settlements and the majority population were analysed using logistic models separately for males and females.", "Does the population living in Roma settlements differ in physical activity, smoking and alcohol consumption from the majority population in Slovakia?<||||>These data show a clear difference between the population living in Roma settlements and the majority population with regard to leisure-time physical activity (only in women) and smoking, although not alcohol consumption. The prevalence of leisure-time physical activities such as walking or some other type of sport was significantly lower among Roma women than among non-Roma women. Men and women living in Roma settlements are more likely to smoke on a daily basis and they are heavier smokers in comparison with the majority population. HepaMeta study did not find differences in alcohol consumption between the Roma and non-Roma men. However, Roma women reported less frequent recent drinking and binge-drinking of 6 or more doses of alcohol on a single occasion." ]

[ "National utilization trends of partial nephrectomy for renal cell carcinoma: a case of underutilization?<||||>Partial nephrectomy is perceived to be more technically demanding than radical nephrectomy; concurrently, the increasing incidence of small renal tumors has suggested a greater role for nephron-sparing techniques. From a quality-of-care perspective, the underuse of partial nephrectomy may represent suboptimal delivery of healthcare.", "National utilization trends of partial nephrectomy for renal cell carcinoma: a case of underutilization?<||||>A total of 66,621 subjects undergoing radical and partial nephrectomy for kidney cancer between 1988 and 2002 were identified from the Nationwide Inpatient Sample, a nationally representative data set of hospital discharges. Adjusted models were developed to identify clinical factors and structural measures independently associated with the use of partial nephrectomy.", "National utilization trends of partial nephrectomy for renal cell carcinoma: a case of underutilization?<||||>Overall, 7.5% of patients treated underwent partial nephrectomy. The utilization rates for partial nephrectomy ranged from 0.21 cases per 100,000 U.S. residents in 1988 to 1.6 cases per 100,000 U.S. residents in 2002. The percentage of patients with renal cell carcinoma treated with partial nephrectomy has increased more than threefold during the study interval (3.7% in 1988 to 1990 compared with 12.3% in 2000 to 2002, P<0.0001 for trend). Patients treated at urban (odds ratio 1.1), teaching (odds ratio 1.3), and high nephrectomy volume (odds ratio 2.5) hospitals were more likely to undergo partial nephrectomy (each, P<0.01)." ]

[ "Is extended pharmacologic venous thromboembolism prophylaxis uniformly safe after radical cystectomy?<||||>To quantitate the risk of clinically significant renal function deterioration after radical cystectomy (RC), which could result in supratherapeutic levels of low-molecular-weight heparin (LMWH) and increased risk of bleeding events with the use of extended pharmacologic venous thromboembolism prophylaxis (EPVTEP) after hospital discharge.", "Is extended pharmacologic venous thromboembolism prophylaxis uniformly safe after radical cystectomy?<||||>Patients undergoing RC between 2006 and 2011 were identified from the institutional registry. Estimated glomerular filtration rate (eGFR) was calculated and categorized as preoperative, discharge, and nadir. Perioperative eGFR trends in patients who would have been candidates for EPVTEP were evaluated.", "Is extended pharmacologic venous thromboembolism prophylaxis uniformly safe after radical cystectomy?<||||>Three hundred four patients with eGFR>30 mL/min/1.73 m(2) at the time of hospital discharge were included in the analysis as potentially eligible for EPVTEP. Large portion of patients (43%) exhibited decline in eGFR after discharge. Importantly, 13.0% of patients (n = 40), who would have qualified for EPVTEP at discharge, experienced nadir GFR below the 30-mL/min/1.73 m(2) threshold value at which LMWH would have become supratherapeutic. The odds ratio for developing a GFR<30 mL/min/1.73 m(2) was 9.1 (95% confidence interval, 4.3-19.3; P<.001), comparing those with a discharge GFR ≥60 mL/min/1.73 m(2) with those with a discharge GFR<60 mL/min/1.73 m(2)." ]

[ "Does intraperitoneal chemotherapy benefit optimally debulked epithelial ovarian cancer patients after neoadjuvant chemotherapy?<||||>To compare survival of ovarian cancer patients treated with neoadjuvant chemotherapy followed by intraperitoneal (IP) versus intravenous (IV) chemotherapy after optimal interval debulking.", "Does intraperitoneal chemotherapy benefit optimally debulked epithelial ovarian cancer patients after neoadjuvant chemotherapy?<||||>Optimally debulked patients after neoadjuvant IV platinum paclitaxel based chemotherapy followed by postoperative IP chemotherapy were reviewed. A similar cohort of patients treated postoperatively with IV platinum paclitaxel based chemotherapy was chosen as control. Patient and disease-related demographics were abstracted from electronic hospital medical records. Associations between categorical variables were determined using Chi square test. Cox regression and Kaplan-Meier method estimated progression-free and overall survival.", "Does intraperitoneal chemotherapy benefit optimally debulked epithelial ovarian cancer patients after neoadjuvant chemotherapy?<||||>Fifty-four IV and 17 IP treated patients after interval debulking were studied. The majority of patients had serous histology and grade 3 tumours. There was no significant difference between the two groups with respect to age and proportion of microscopic residual disease. Patients with macroscopic residual disease had a significantly worse prognosis (HR=2.17, 95% CI=1.23-3.85, p=0.008). Clinical complete response after primary treatment was 67% and 88% in the IV and IP group, respectively (p=0.36). Estimated mean progression-free survival was 18 months in the IV group and 14.1 months in the IP group (p=0.42). IP chemotherapy was not predictive of progression-free survival in the Cox model adjusted for age and residual disease status (HR=1.22, 95% CI=0.62-2.4, p=0.56). Estimated mean survival was 68.9 months in the IV group and 37.5 months in the IP group (p=0.85)." ]

[ "Anxiety disorders, subsyndromic depressive episodes, and major depressive episodes: do they differ on their impact on the quality of life of patients with epilepsy?<||||>To compare the impact of anxiety disorders, major depressive episodes (MDEs), and subsyndromic depressive episodes (SSDEs) on the quality of life of patients with epilepsy (PWEs), and to identify the variables predictive of poor quality of life.", "Anxiety disorders, subsyndromic depressive episodes, and major depressive episodes: do they differ on their impact on the quality of life of patients with epilepsy?<||||>A psychiatric diagnosis according to DSM-IV-TR criteria was established in 188 consecutive PWEs with the MINI International Neuropsychiatric Interview. Patients also completed the Beck Depression Inventory-II (BDI-II), the Centers for Epidemiologic Studies-Depression (CES-D), and the Quality of Life in Epilepsy-89 (QOLIE-89). A diagnosis of SSDE was made in any patient with total scores of the BDI-II>12 or CES-D>16 in the absence of any DSM-IV diagnosis of mood disorder according to the MINI.", "Anxiety disorders, subsyndromic depressive episodes, and major depressive episodes: do they differ on their impact on the quality of life of patients with epilepsy?<||||>Patients with SSDEs (n = 26) had a worse quality of life than asymptomatic patients (n = 103). This finding was also observed among patients with MDEs only (n = 10), anxiety disorders only (n = 21), or mixed MDEs/anxiety disorders (n = 28). Furthermore, having mixed SSDEs/anxiety disorders yielded a worse quality of life than having only SSDEs. Independent predictors of poor quality of life included having a psychiatric disorder and persistent epileptic seizures in the last 6 months." ]

[ "Does pathologic node status affect local control in patients with carcinoma of the head and neck treated with radical surgery and postoperative radiotherapy?<||||>To evaluate the effect of pathologic lymph node status and nodal stage on local control at the primary site in patients with advanced squamous cell carcinomas of the head and neck, treated with radical surgery and postoperative irradiation.", "Does pathologic node status affect local control in patients with carcinoma of the head and neck treated with radical surgery and postoperative radiotherapy?<||||>Fifty-seven patients with advanced squamous cell carcinomas of the oral cavity, oropharynx, hypopharynx, larynx, and supraglottic larynx were analyzed. All patients underwent resection of the primary lesion, neck dissection, and postoperative radiotherapy. Minimum follow-up was 2 years. The median dose to the primary tumor bed was 60.4 Gray (range 39.7-72.0). Besides pathologic nodal status (pN0 vs. pN+) and nodal stage, the following factors were analyzed for their impact on local control: age, gender, T stage, tumor grade, resection margins, interval from surgery to irradiation, dose to the primary site, and overall treatment time.", "Does pathologic node status affect local control in patients with carcinoma of the head and neck treated with radical surgery and postoperative radiotherapy?<||||>The 3-year actuarial local control rate was 78%. When all patients were analyzed, nodal status (pN0 vs. pN+) did not affect control at the primary site (71% vs. 82%, p = 0.42). Nodal stage (pN0-N2a va. pN2b-N2c) was also not a significant factor for local control (74% vs. 82%, p = 0.57). When only patients with negative margins were analyzed, nodal status again did not impact on local control (79% vs. 90% for pN0 vs. pN+, p = 0.39). On univariate analysis, only tumor grade, margin status, and elapsed days were significant factors for local control. Local control was 85% for patients with negative margins vs. 60% for those with positive margins (p = 0.016). For patients with moderately and poorly differentiated tumors, local control was 86% as compared to 50% for patients with well-differentiated tumors (p = 0.007). When radiotherapy was completed within 50 days, local control was 93% as opposed to 63% for>50 days (p = 0.016). On multivariate analysis, only margin status (p = 0.002) and tumor grade (p = 0.007) remained significant." ]

[ "Timing of endoscopic sinus surgery in children: is there an impact on outcome?<||||>Endoscopic sinus surgery in children continues to be a controversial issue. Major factors in determining when to operate are the duration of the disease and duration of medical treatment.", "Timing of endoscopic sinus surgery in children: is there an impact on outcome?<||||>Prospective study of children referred to a tertiary center.", "Timing of endoscopic sinus surgery in children: is there an impact on outcome?<||||>Eighty-three patients underwent endoscopic sinus surgery for refractory chronic sinusitis. All patients were followed prospectively to evaluate their response to surgery for a mean follow-up period of at least 1 year. A chi2 analysis and logistic regression analysis were performed to determine statistical difference between duration of symptoms and outcome.", "Timing of endoscopic sinus surgery in children: is there an impact on outcome?<||||>The overall success rate of endoscopic sinus surgery was 80%. Children who had surgery between 6 and 12 months of symptoms despite continued medical therapy had an 84% success rate, those who had surgery between 12 and 18 months had a 74% success rate, and those with more than 18 months of treatment for symptoms had an 81% success rate (P>.05)." ]

[ "Tubeless percutaneous nephrolithotomy: what about replacing the Double-J stent with a ureteral catheter?<||||>To evaluate the feasibility and safety of replacing the Double-J stent with a ureteral catheter in tubeless percutaneous nephrolithotomy (PCNL).", "Tubeless percutaneous nephrolithotomy: what about replacing the Double-J stent with a ureteral catheter?<||||>From August 1998 to February 2007, 33 patients underwent tubeless PCNL for renal calculi by the same surgeon. A retrograde 7F ureteral catheter was placed at the beginning of the surgery in all patients. A nephrostomy tube was not used in any patient. At the end of the procedure, the working tract was electrocauterized using a 26F resectoscope with a rollerball electrode; no hemostatic sealant was used. The ureteral catheter was the sole means of drainage left in place. The incidence and type of complications, the operative time, the length of hospitalization, the rate of transfusion, and the degree of pain were obtained by chart review.", "Tubeless percutaneous nephrolithotomy: what about replacing the Double-J stent with a ureteral catheter?<||||>In this group of patients, the mean stone burden was 17.25 mm. The mean operative time was 71.5 min. The mean length of hospitalization was 1.9 day (range 1 to 7 days). The mean hemoglobin decrease was 0.8 g/dL. No blood transfusions were needed. The mean visual analog pain intensity scale was 1.87. Complications developed in five (15%) patients, of whom one needed a Double-J stent placement. The complications were pyelonephritis, urinary extravasation, sustained hematuria, and renal colic. The ureteral catheter was removed by postoperative day 1 in 91% of patients." ]

[ "Is mechanical bowel preparation still necessary for gynecologic laparoscopic surgery?<||||>A number of studies have proven that mechanical bowel preparation (MBP) has no benefits in elective colorectal surgery. However, studies specifically related to gynecologic laparoscopic surgery are scant. We undertook a meta-analysis to assess the necessity of MBP before gynecologic laparoscopic surgery.", "Is mechanical bowel preparation still necessary for gynecologic laparoscopic surgery?<||||>The electronic databases MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were systematically searched to identify relevant randomized controlled trials. Two authors independently extracted data from each study. The primary outcome of interest was the quality of surgical field. Secondary outcomes of interest included postoperative pain, abdominal swelling, nausea/vomiting, and length of hospital stay.", "Is mechanical bowel preparation still necessary for gynecologic laparoscopic surgery?<||||>Three studies involving 372 participants were included in the meta-analysis. The results showed that MBP did not significantly increase the overall quality of surgical field exposure (odds ratio, 0.82; 95% confidence interval [CI], 0.46-1.49; P = 0.52). MBP also did not appear to significantly change the mean scores of postoperative pain (weighted mean difference, 0.09; 95%CI, -0.54-0.71; P = 0.79), the incidence of nausea/vomiting (odds ratio, 1.56; 95%CI, 0.80 to 3.03; P = 0.19), the mean scores of abdominal swelling (weighted mean difference, -0.26; 95%CI, -0.83-0.30; P = 0.36), and length of hospital stay (weighted mean difference, 0.05; 95%CI, -0.13-0.22; P = 0.62)." ]

[ "Merkel cell carcinoma of the head and neck: is adjuvant radiotherapy necessary?<||||>Controversy exists regarding the optimal management of patients with Merkel cell carcinoma. The primary aim of this study was to determine whether combined treatment with surgery and radiotherapy improves outcome in a multi-institutional cohort of patients with Merkel cell carcinoma of the head and neck. The secondary aims were to determine by stage, which patients derive benefit from combined therapy and to identify predictors for survival on multivariable analysis.", "Merkel cell carcinoma of the head and neck: is adjuvant radiotherapy necessary?<||||>A retrospective analysis of 110 patients with Merkel cell carcinoma of the head and neck was performed. Data were collected from 3 tertiary care institutions (Westmead Hospital, Sydney, Australia; Princess Margaret Hospital, Toronto, Canada; Royal Prince Alfred Hospital, Sydney). There were 78 males and 32 females, median age was 70 years, and mean follow-up of survivors was 2.3 years. Sixty-six patients underwent combined treatment, and 44 patients had either surgery or radiotherapy alone. Analysis by stage was performed using 2 staging systems.", "Merkel cell carcinoma of the head and neck: is adjuvant radiotherapy necessary?<||||>Local and regional control at 5 years was 84% and 69%, respectively. Combined treatment improved both local (p = .009) and regional control (p = .006). Overall and disease-specific survival at 5 years was 49% and 62%, respectively. Combined treatment was associated with significantly better disease-free survival on univariable analysis (p = .013) When analyzed by stage, patients with stage IIb (primary>1 cm, node negative) disease who underwent combined treatment had improved disease-free (p = .005) and disease-specific survival (p = .035). Predictors of survival on multivariable analysis were age>70 years (HR 6.19, p<.001), primary tumor size>1 cm (HR 7.55, p<.001), number of nodal metastases divided into none,<or= 2 and>2 (HR 3.71 per stratum, p<.001). When analyzed with age and disease stage, treatment modality trended toward significance as a predictor of disease-specific (p = .081) and overall survival (p = .076). Disease stage was the most powerful independent predictor on Cox regression (HR 5.43 per stratum, p<.001)." ]

[ "Are different measures of self-rated health comparable?<||||>Self-rated health (SRH) is widely used to compare population health across countries, but comparability is often hampered by the use of different versions of this item. This study compares the WHO recommended version (ranging from 'very good' to 'very bad') with the US version (ranging from 'excellent' to 'poor') in European countries.", "Are different measures of self-rated health comparable?<||||>Data came from the Survey of Health, Ageing and Retirement in Europe (SHARE). Both the WHO and US versions of SRH were measured in representative samples of Europeans aged 50+ (n = 11,643) in five countries. Concordance between the two SRH versions and differences in their associations with demographics, chronic diseases, functioning and depression were assessed using ordered probit regression.", "Are different measures of self-rated health comparable?<||||>The US version has a more symmetric distribution and larger variance than the WHO version. Although the WHO version discriminates better at the positive end, the US version shows better discrimination at the positive end of the scale. Sixty-nine percent of respondents provided literally concordant answers, while only about one-third provided relatively concordant answers. Overall, however, less than 10% of respondents were discordant in either sense. The two versions were strongly correlated (polychoric correlation = 0.88), had similar associations with demographics and health indicators, and showed a similar pattern of international variation." ]

[ "Does the common bile duct dilate after cholecystectomy?<||||>The purpose of this study was to determine whether the common bile duct dilates after cholecystectomy.", "Does the common bile duct dilate after cholecystectomy?<||||>All 234 patients who had cholecystectomy at our hospital between October 1985 and April 1994 were included in this study. The luminal diameter of the proximal segment of the common bile duct was measured on antero-posterior transverse sonograms 4-15 days before cholecystectomy. In all patients, the luminal diameter was measured again on sonograms obtained 7-2160 days after surgery (mean, 393 days; median, 180 days; mode, 360 days). A diameter of 6 mm or less was considered normal. This study contained 197 patients with a normal common bile duct (<or = 6 mm) and 37 patients with a dilated common bile duct (>6 mm).", "Does the common bile duct dilate after cholecystectomy?<||||>The mean diameter of the common bile duct measured on sonograms was 5.9 mm before cholecystectomy and 6.1 mm after cholecystectomy. This difference was statistically significant (p<.05). The diameter of the common bile duct increased in 110 patients, decreased in 61 patients, and stayed the same in 63 patients. Of the 234 patients, 197 (84%) had a normal preoperative diameter of the common bile duct, whereas 167 (71%) had a common bile duct with a normal diameter postoperatively." ]

[ "Applying estimated glomerular filtration rate to an ageing population: are we in danger of becoming ageist?<||||>Management of CKD is a major public health concern. The introduction of automated eGFR reporting has seen an increase in labelling of elderly patients with CKD. The prognostic significance of the CKD label in this population remains controversial.AIM: To investigate rates of specialist intervention in the over 75's to determine whether these patients may be more appropriately managed in primary care, relieving the burden of excessive outpatient visits in this population.", "Applying estimated glomerular filtration rate to an ageing population: are we in danger of becoming ageist?<||||>Retrospective review of patient notes and laboratory reports over 25 consecutive renal outpatient clinics within a single NHS trust.", "Applying estimated glomerular filtration rate to an ageing population: are we in danger of becoming ageist?<||||>546 patients were studied. The mean age of patient was 68.7 years (SD+/-14.9). The over 75's had more advanced renal disease compared to under 75's (mean eGFR 28.2 vs. 41.3 ml/min/1.73 m(2)), but there was no significant difference in eGFR stability between the older and younger cohort or in the overall rate of intervention (32.5% vs. 30.7% p=0.86). The over 75's had a lower mean haemoglobin (11.8 vs. 12.6, p=<0.001) necessitating greater EPO requirements (25.2% vs. 10.5%, p=<0.001). The greatest intervention was seen in the more advanced CKD patients (29% of CKD 3 vs. 55% of CKD 5), and in those with diagnoses requiring immunosuppression." ]

[ "Does casein phosphopeptid amorphous calcium phosphate provide remineralization on white spot lesions and inhibition of Streptococcus mutans?<||||>The aim of this study was to evaluate the remineralization effect of Casein Phosphopeptid Amorphous Calcium Phosphate (CPP-ACP) on white spot lesions (WSL) and its inhibitory effect on Streptococcus mutans colonization.", "Does casein phosphopeptid amorphous calcium phosphate provide remineralization on white spot lesions and inhibition of Streptococcus mutans?<||||>The study group consisted of 60 children exhibiting at least 1-WSL. Subjects were randomly divided into 2 groups: a test group of using CPP-ACP cream (Tooth Mousse, GC Europe N.V., Leuven, Belgium) and a control group using only fluoride containing toothpaste for a period of 3-months. Baseline WSLs were scored using DIAGNOdent device (KaVo Germany) and the saliva samples were collected to measure S. mutans counts. After the 3-month period the WSLs were again recorded and the saliva sample collection was repeated. Wilcoxon Signed Ranks Test was used for statistical analysis.", "Does casein phosphopeptid amorphous calcium phosphate provide remineralization on white spot lesions and inhibition of Streptococcus mutans?<||||>DIAGNOdent measurements were increased by time (p = 0.002) in control group and no statistically significant diference (p = 0.217) was found in test group by the 3-month period. In both groups, the mutans counts were decreased in 3-month experimental period." ]

[ "Are lumbar spine reoperation rates falling with greater use of fusion surgery and new surgical technology?<||||>A retrospective analysis of population-based hospital discharge registry from all nonfederal acute care hospitals in Washington State.", "Are lumbar spine reoperation rates falling with greater use of fusion surgery and new surgical technology?<||||>We examined the cumulative incidence of second lumbar spine operation following an initial lumbar operation for degenerative conditions. We aimed to determine if the cumulative incidence of a second lumbar spine operation decreased in the 1990s following an increase in the rate of fusion surgery and the introduction of several newer fusion technologies.", "Are lumbar spine reoperation rates falling with greater use of fusion surgery and new surgical technology?<||||>Repeat lumbar spine operations are generally undesirable, implying persistent symptoms, progression of degenerative changes, or treatment complications. Improved technology is expected to improve alignment, healing, and instability, and to reduce repeat operations.", "Are lumbar spine reoperation rates falling with greater use of fusion surgery and new surgical technology?<||||>Among the patients who had an inpatient lumbar decompression or lumbar fusion surgery for degenerative spine disorders in 1990 to 1993 (n = 24,882) or in 1997 to 2000 (n = 25,209), we examined rates of subsequent lumbar spine surgery during a 4-year follow-up. We performed a Cox proportional hazards regression to compare the probability of a reoperation between the 2 cohorts, adjusting for age, sex, primary diagnosis, type of insurance, and comorbidity.", "Are lumbar spine reoperation rates falling with greater use of fusion surgery and new surgical technology?<||||>Among patients who underwent surgery for lumbar degenerative disease, more than twice as many had a fusion procedure in the 1997 to 2000 cohort (19.1%) compared with the 1990 to 1993 cohort (9.4%). However, the 4-year cumulative incidence of reoperation was higher in the 1997 to 2000 cohort compared with the 1990 to 1993 cohort (14.0% vs. 12.4%; hazard ratio, 1.16; 95% confidence interval, 1.11-1.22, P<0.001). Among fusion patients, those in the 1997 to 2000 cohort were approximately 40% more likely to undergo a reoperation within the first year when compared with fusion patients in the 1990 to 1993 cohort. There was no difference in reoperation probability beyond 1 year." ]

[ "Do patients with traumatic brain injury learn a route in the same way in real and virtual environments?<||||>An increasing number of studies address the use of virtual environments (VE) in the cognitive assessment of spatial abilities. However, the differences between learning in a VE and a real environment (RE) remain controversial.", "Do patients with traumatic brain injury learn a route in the same way in real and virtual environments?<||||>To compare the topographical behavior and spatial representations of patients with traumatic brain injury navigating in a real environment and in a virtual reproduction of this environment.", "Do patients with traumatic brain injury learn a route in the same way in real and virtual environments?<||||>Twenty-seven subjects with moderate to severe traumatic brain injury were consecutively included and allocated to one of two groups. The subjects were taught the same route in either the virtual environment or the real environment and had to recall it twice immediately after learning the route and once after a delay. At the end of these sessions, the subjects were asked to complete three representational tests: a map test, a map recognition test recognition and a scene arrangement test.", "Do patients with traumatic brain injury learn a route in the same way in real and virtual environments?<||||>No significant difference was found between the two groups with regards to demographics, severity of brain injury or episodic memory. As a main result, the number of error rates did not significantly differ between the real and virtual environment [F (1, 25) = 0.679; p = 0.4176)]. Scores on the scene arrangement test were higher in the real environment [U = 32.5; p = 0.01]." ]