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[ "Residual Anatomical Disease in Diffuse Large B-Cell Lymphoma Patients With FDG-PET-Based Complete Response After First-Line R-CHOP Therapy: Does It Have Any Prognostic Value?<||||>This study aimed to determine the prognostic value of residual anatomical disease, including its size and reduction relative to baseline, in diffuse large B-cell lymphoma patients who have F-fluoro-2-deoxy-d-glucose positron emission tomography-based complete response after first-line R-CHOP therapy.", "Residual Anatomical Disease in Diffuse Large B-Cell Lymphoma Patients With FDG-PET-Based Complete Response After First-Line R-CHOP Therapy: Does It Have Any Prognostic Value?<||||>This retrospective study included 47 patients. In patients with computed tomography (CT)-based residual disease, the size of the largest residual lesion (Resmax) and the sum of the sizes of all residual lesions (Restotal) were measured, and their reductions relative to baseline (ΔResmax and ΔRestotal) were calculated.", "Residual Anatomical Disease in Diffuse Large B-Cell Lymphoma Patients With FDG-PET-Based Complete Response After First-Line R-CHOP Therapy: Does It Have Any Prognostic Value?<||||>Patients with high-risk National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) scores had significantly lower progression-free survival (PFS) and overall survival (OS) than patients with low-risk NCCN-IPI scores (P = 0.032 and P = 0.022). In contrast, patients with residual lesions at CT had no significantly lower PFS and OS than those without (P = 0.531 and P = 0.801). In the subpopulation with CT-based residual disease, patients with high Resmax, high Restotal, low ΔResmax, and low ΔRestotal had no significantly different PFS and OS than those with low Resmax, low Restotal, high ΔResmax, and high ΔRestotal (P = 0.980 and P = 0.790, P = 0.423 and P = 0.229, P = 0.923 and P = 0.893, and P = 0.923 and P = 0.893, respectively)." ]

[ "Is Hypothermia Helpful in Severe Subarachnoid Hemorrhage?<||||>Therapeutic hypothermia (TH) is an established treatment after cardiac arrest and growing evidence supports its use as neuroprotective treatment in stroke. Only few and heterogeneous studies exist on the effect of hypothermia in subarachnoid hemorrhage (SAH). A novel approach of early and prolonged TH and its influence on key complications in poor-grade SAH, vasospasm and delayed cerebral ischemia (DCI) was evaluated.", "Is Hypothermia Helpful in Severe Subarachnoid Hemorrhage?<||||>This observational matched controlled study included 36 poor-grade (Hunt and Hess Scale>3 and World Federation of Neurosurgical Societies Scale>3) SAH patients. Twelve patients received early TH (<48 h after ictus), mild (35°C), prolonged (7 ± 1 days) and were matched to 24 patients from the prospective SAH database. Vasospasm was diagnosed by angiography, macrovascular spasm serially evaluated by Doppler sonography and DCI was defined as new infarction on follow-up CT. Functional outcome was assessed at 6 months by modified Rankin Scale (mRS) and categorized as favorable (mRS score 0-2) versus unfavorable (mRS score 3-6) outcome.", "Is Hypothermia Helpful in Severe Subarachnoid Hemorrhage?<||||>Angiographic vasospasm was present in 71.0% of patients. TH neither influenced occurrence nor duration, but the degree of macrovascular spasm as well as peak spastic velocities were significantly reduced (p<0.05). Frequency of DCI was 87.5% in non-TH vs. 50% in TH-treated patients, translating into a relative risk reduction of 43% and preventive risk ratio of 0.33 (95% CI 0.14-0.77, p = 0.036). Favorable functional outcome was twice as frequent in TH-treated patients 66.7 vs. 33.3% of non-TH (p = 0.06)." ]

[ "Spacers in radiotherapy treatment of prostate cancer: is reduction of toxicity cost-effective?<||||>To compare the cost-effectiveness of treating prostate cancer patients with intensity-modulated radiation therapy and a spacer (IMRT+S) versus IMRT-only without a spacer (IMRT-O).", "Spacers in radiotherapy treatment of prostate cancer: is reduction of toxicity cost-effective?<||||>A decision-analytic Markov model was constructed to examine the effect of late rectal toxicity and compare the costs and quality-adjusted Life Years (QALYs) of IMRT-O and IMRT+S. The main assumption of this modeling study was that disease progression, genito-urinary toxicity and survival were equal for both comparators.", "Spacers in radiotherapy treatment of prostate cancer: is reduction of toxicity cost-effective?<||||>For all patients, IMRT+S revealed a lower toxicity than IMRT-O. Treatment follow-up and toxicity costs for IMRT-O and IMRT+S amounted to €1604 and €1444, respectively, thus saving €160 on the complication costs at an extra charge of €1700 for the spacer in IMRT+S. The QALYs yielded for IMRT-O and IMRT+S were 3.542 and 3.570, respectively. This results in an incremental cost-effectiveness ratio (ICER) of €55,880 per QALY gained. For a ceiling ratio of €80,000, IMRT+S had a 77% probability of being cost-effective." ]

[ "Ethical considerations of mobile phone use by patients in KwaZulu-Natal: Obstacles for mHealth?<||||>mHealth has the potential to facilitate telemedicine services, particularly in the developing world. Concern has been expressed about the confidentiality of health information that is relayed by mobile phone.AIM: We examined the habits and practices of mobile phone use by patients in KwaZulu-Natal, South Africa.", "Ethical considerations of mobile phone use by patients in KwaZulu-Natal: Obstacles for mHealth?<||||>We conducted a descriptive survey of two patient populations: 137 urban patients attending private practitioners and 139 patients in remote rural areas attending outpatient departments in Government-funded hospitals. The questionnaire covered several domains: demographics, mobile phone use, privacy and confidentiality and future use for health-related matters.", "Ethical considerations of mobile phone use by patients in KwaZulu-Natal: Obstacles for mHealth?<||||>Two hundred and seventy-six patients completed the questionnaire. We found that a third of our participants shared their mobile phone with others, 24% lent their phone to others and more than half received health-related messages for other people. Mobile phone theft was common, as was number changing. Thirty-eight percent of the people were not able to afford airtime for more than a week in the past year and 22% of rural patients were unable to keep their phone charged. Mobile phone signal coverage was significantly worse in the rural areas than in urban areas." ]

[ "Are retrospectively reconstructed blood alcohol concentrations accurate?<||||>The purpose of this study was to evaluate the relationship between blood alcohol concentration (BAC) derived from an in vivo breath test and retrospective estimates of BAC (eBAC) for the same drinking event. The relationship was expected to be lower at higher levels of BAC as a result of inaccuracies in the recall of self-report data.", "Are retrospectively reconstructed blood alcohol concentrations accurate?<||||>The sample consisted of 44 persons (64% male) who were walking away from a bar district adjacent to a university campus. After giving informed consent, participants provided a breath sample and contact information. The next day a research assistant telephoned the participants and conducted a brief interview, using the equation prescribed by the National Highway Traffic Safety Administration, to obtain the self-report data necessary to calculate the eBAC for the previous evening.", "Are retrospectively reconstructed blood alcohol concentrations accurate?<||||>The actual BACs and eBACs were not significantly different, and they were highly correlated (r = 0.84, n = 43). BAC did predict the magnitude of discrepancy between the two, and at BACs over 0.08, the relationship was nonsignificant." ]

[ "Are Low-Income Peer Health Coaches Able to Master and Utilize Evidence-Based Health Coaching?<||||>A randomized controlled trial found that patients with diabetes had lower HbA1c levels after 6 months of peer health coaching than patients who did not receive coaching. This paper explores whether the peer coaches in that trial, all low-income patients with diabetes, mastered and utilized an evidence-based health coaching training curriculum. The curriculum included 5 core features: ask-tell-ask, closing the loop, know your numbers, behavior-change action plans, and medication adherence counseling.", "Are Low-Income Peer Health Coaches Able to Master and Utilize Evidence-Based Health Coaching?<||||>This paper includes the results of exams administered to trainees, exit surveys performed with peer coaches who completed the study and those who dropped out, observations of peer coaches meeting with patients, and analysis of in-depth interviews with peer coaches who completed the study.", "Are Low-Income Peer Health Coaches Able to Master and Utilize Evidence-Based Health Coaching?<||||>Of the 32 peer coach trainees who completed the training, 71.9% lacked a college degree; 25.0% did not graduate from high school. The 26 trainees who passed the exams attended 92.7% of training sessions compared with 80.6% for the 6 trainees who did not pass. Peer coaches who completed the study wanted to continue peer coaching work and had confidence in their abilities despite their not consistently employing the coaching techniques with their patients. Quotations describe coaches' perceptions of the training." ]

[ "Secondary prevention of stroke: does dipyridamole add to aspirin?<||||>The purpose of this paper is to evaluate, in the light of all available evidence, the place of aspirin alone and of aspirin combined with dipyridamole in the secondary prevention of cerebrovascular accidents.", "Secondary prevention of stroke: does dipyridamole add to aspirin?<||||>We performed a meta-analysis of all identified double blind, controlled, studies in secondary prevention of cerebrovascular accidents for the following categories: studies comparing aspirin with placebo; studies comparing aspirin plus dipyridamole with placebo; studies comparing aspirin plus dipyridamole with aspirin alone. An indirect comparison was carried out to compare the results obtained with aspirin alone and those obtained with aspirin combined with dipyridamole.", "Secondary prevention of stroke: does dipyridamole add to aspirin?<||||>The meta-analysis of trials involving aspirin alone against placebo showed a risk reduction on strokes (17% reduction, p = 0.02), \"important vascular events\", i.e. a combination of vascular deaths, non-fatal strokes and non-fatal myocardial infarction (18% reduction, p = 0.003). Fatal vascular events (vascular deaths and fatal strokes) did not seem to be reduced at all. The overall mortality was reduced by 10%, but this reduction failed to reach statistical significance (p = 0.23). The meta-analysis of trials involving aspirin combined with dipyridamole showed more important risk reductions on every outcome whether fatal or not. Strokes were reduced by 42% (p<0.001), fatal strokes by 43% (p = 0.02) and vascular deaths by 24% (p = 0.07, not significant). The overall mortality was reduced by 30% (p = 0.004). Direct comparisons of aspirin with aspirin plus dipyridamole did not indicate differences between the two treatment regimens. However the sample sizes involved in these comparisons were far too small to be informative. Indirect comparisons yielded statistically significant results in favour of the combination in terms of \"important vascular events\" (p = 0.007), all strokes (p = 0.007) and fatal strokes (p = 0.03). The results were also in favour of the combination but not statistically significant in terms of all deaths (p = 0.10) and vascular deaths (p = 0.08)." ]

[ "Do angiotensin type 2 receptors modulate haemodynamic effects of type 1 receptors in conscious newborn lambs?<||||>It was hypothesized that in the immediate newborn period, when the renin-angiotensin system (RAS) is activated, angiotensin type 2 receptors (AT2Rs) buffer the haemodynamic effects of angiotensin type 1 receptors (AT1Rs), as occurs in adult animals when the RAS is activated.", "Do angiotensin type 2 receptors modulate haemodynamic effects of type 1 receptors in conscious newborn lambs?<||||>Arterial (systolic, diastolic, and mean) pressures (SAP, DAP, MAP), mean venous pressures (MVP) and renal blood flows (RBF) were measured in conscious, chronically instrumented lambs aged ~1 (8±2 days, N=8) and 6 weeks (41±4 days, N=11). In each animal, measurements were made before and after administration of the selective AT1R antagonist ZD 7155 (experiment one) and the selective AT2R antagonist PD123319 (experiment two) as well as both antagonists, ZD 7155 and PD 123319 (experiment three).", "Do angiotensin type 2 receptors modulate haemodynamic effects of type 1 receptors in conscious newborn lambs?<||||>Haemodynamic responses to combined inhibition of both AT1Rs and AT2Rs were similar to inhibition of AT1Rs alone: there was a significant decrease in SAP, DAP, and MAP and a significant increase in RBF within minutes of concomitant administration of ZD 7155 and PD 123319 in both age groups. These responses were similar to responses to ZD 7155 alone, whereas PD 123319 alone did not alter any of the measured variables." ]

[ "Do abnormal Starling forces cause fetal hydrops in red blood cell alloimmunization?<||||>The purpose of the current investigation was to ascertain whether derangements in umbilical venous pressure and plasma colloid osmotic pressure are involved in the pathophysiologic condition of immune hydrops fetalis.", "Do abnormal Starling forces cause fetal hydrops in red blood cell alloimmunization?<||||>Umbilical venous pressure (corrected for ambient amniotic fluid pressure) and colloid osmotic pressure were measured during intravascular transfusion. Fetal hydrops was defined as the presence of ascites by ultrasonography. The Mann-Whitney test was used for comparison of groups; a value of p<0.05 was considered statistically significant.", "Do abnormal Starling forces cause fetal hydrops in red blood cell alloimmunization?<||||>Fifteen hydropic fetuses were matched for gestational age with 15 nonhydropic fetuses also undergoing intrauterine transfusion for anemia. On comparison with their nonhydropic counterparts, hydropic fetuses had a statistically lower colloid osmotic pressure. Umbilical venous pressure was higher and the colloid osmotic pressure--umbilical venous pressure gradient was lower in association with fetal hydrops although these differences did not achieve statistical significance." ]

[ "Does active dissemination of evidence result in faster knowledge transfer than passive diffusion?<||||>This study aimed to compare knowledge transfer (KT) in the emergency department (ED) management of pediatric asthma and croup by measuring trends in corticosteroid use for both conditions in EDs.", "Does active dissemination of evidence result in faster knowledge transfer than passive diffusion?<||||>A retrospective, cross-sectional study of the National Hospital Ambulatory Medical Care Survey data between 1995 and 2009 of corticosteroid use at ED visits for asthma or croup was conducted. Odds ratios (OR) were calculated using logistic regression. Trends over time were compared using an interaction term between disease and year and were adjusted for all other covariates in the model. We included children aged 2 to 18 years with asthma who received albuterol and were triaged emergent/urgent. Children aged between 3 months to 6 years with croup were included. The main outcome measure was the administration of corticosteroids in the ED or as a prescription at the ED visit.", "Does active dissemination of evidence result in faster knowledge transfer than passive diffusion?<||||>The corticosteroid use in asthma visits increased from 44% to 67% and from 32% to 56% for croup. After adjusting for patient and hospital factors, this trend was significant both for asthma (OR, 1.07; 95% confidence interval [CI], 1.04-1.10) and croup (OR, 1.07; 95% CI, 1.03-1.12). There was no statistical difference between the 2 trends (P = 0.69). Hospital location in a metropolitan statistical area was associated with increased corticosteroid use in asthma (OR, 1.76; 95% CI, 1.10-2.82). Factors including sex, ethnicity, insurance, or region of the country were not significantly associated with corticosteroid use." ]

[ "TBI or not TBI: that is the question. Is it better to measure toe pressure than ankle pressure in diabetic patients?<||||>Measurement of ankle blood pressure is a simple method of assessing lower limb arterial blood supply. However, its use in diabetes has been questioned due to the presence of medial artery calcification. Measurement of toe blood pressure has been advocated as an alternative but it is technically more difficult. The aim of this study was to obtain information to guide clinicians as to when pressure measurements should be taken at the toe.", "TBI or not TBI: that is the question. Is it better to measure toe pressure than ankle pressure in diabetic patients?<||||>Ankle brachial index (ABI) and toe brachial index (TBI) were measured by Doppler ultrasound, or photoplethysmography on 174 subjects with diabetes and 53 control subjects. The Bland and Altman method, and the Cohen's method of measuring agreement between two tests were used to compare ABI with TBI.", "TBI or not TBI: that is the question. Is it better to measure toe pressure than ankle pressure in diabetic patients?<||||>The mean differences between ABI and TBI in control and diabetic subjects are 0.40 +/- 0.13 and 0.37 +/- 0.15, respectively. Nearly all diabetic patients with an ABI<1.3 have an ABI-TBI gradient falling within the normal range established from the non-diabetic cohort. In contrast, the majority of diabetic subjects with an ABI>or = 1.3 have ABI-TBI differences outside this range. When patients are categorized according to ABI and TBI, there is also good agreement between the tests when ABI is low or normal (84% and 78% agreement, respectively), but not when ABI is elevated." ]

[ "Interleukin 10 genotypes in irritable bowel syndrome: evidence for an inflammatory component?<||||>Inflammation may play a role in the pathogenesis of irritable bowel syndrome in some individuals, such as in those who develop symptoms following a dysenteric illness. Persisting inflammation, resulting from an imbalance of cytokines regulating the inflammatory response, is one possible mechanism. As the elaboration of cytokines is under genetic control, this study was designed to establish whether there might be a genetic predisposition to an altered pattern of anti-inflammatory cytokine production in patients with irritable bowel syndrome.", "Interleukin 10 genotypes in irritable bowel syndrome: evidence for an inflammatory component?<||||>A total of 230 unselected patients with irritable bowel syndrome and 450 healthy, ethnically matched controls were studied.", "Interleukin 10 genotypes in irritable bowel syndrome: evidence for an inflammatory component?<||||>DNA was extracted from peripheral blood leucocytes of subjects. Allele and genotype frequencies were determined for the anti-inflammatory cytokine interleukin 10 at the site (-1082) concerned with production in lymphocytes. Transforming growth factor beta(1) (codons 10 and 25) genotypes were also examined in a smaller group of subjects.", "Interleukin 10 genotypes in irritable bowel syndrome: evidence for an inflammatory component?<||||>Patients with irritable bowel syndrome had significantly reduced frequencies of the high producer genotype for interleukin 10 than controls (21% v 32%; p=0.003). There was no apparent relationship with any particular bowel habit subtype. Genotypes for transforming growth factor beta(1) were not altered." ]

[ "Can clinical parameters predict fractures in acute pediatric wrist injuries?<||||>Fractures around the wrist are common in pediatric patients presenting to the emergency department (ED). This pilot study was aimed at identifying clinical variables that are most likely to be associated with a fracture.", "Can clinical parameters predict fractures in acute pediatric wrist injuries?<||||>This was a prospective blinded case series of patients 3-18 years of age presenting with an acute (<3 days) wrist injury, without obvious deformity. A team of five investigators blinded to the eventual radiographic findings evaluated patients. Physical examination variables included range of motion (ROM), site of maximal tenderness, and functional deficit. The latter was determined objectively, by recording any difference in grip strength between the injured and noninjured hands. Diagnostic radiographs were obtained for all patients. Univariate analysis using Wilks' log likelihood ratio test was performed to identify clinical variables associated with confirmed wrist fractures. Sample size was determined based on the ability to detect a difference of 15 degrees in the ROM variables, 20% point differences in grip strength, and 30% proportion differences in categorical variables using a power of 0.8 and a two-tailed of 0.05.", "Can clinical parameters predict fractures in acute pediatric wrist injuries?<||||>The ROMs were not significantly different between the fracture (Fx) and nonfracture (NFx) group. There was significant change in the grip strength between the Fx and NFx groups (t = 3.3, p = 0.0019). Tenderness over the distal radius was also associated with a greater likelihood of a fracture (G(2) = 5.0, p = 0.02). Sensitivity of clinical prediction was found to be 79%, and specificity was 63%. The false-negative rate was 0.21 and the false-positive rate was 0.37, while the positive predictive value was found to be 0.68 and negative predictive value 0.75." ]

[ "Is there an evidence-based argument for embracing an antimicrobial (triclosan)-coated suture technology to reduce the risk for surgical-site infections?<||||>It has been estimated that 750,000 to 1 million surgical-site infections (SSIs) occur in the United States each year, causing substantial morbidity and mortality. Triclosan-coated sutures were developed as an adjunctive strategy for SSI risk reduction, but a recently published systematic literature review and meta-analysis suggested that no clinical benefit is associated with this technology. However, that study was hampered by poor selection of available randomized controlled trials (RCTs) and low patient numbers. The current systematic review involves 13 randomized, international RCTs, totaling 3,568 surgical patients.", "Is there an evidence-based argument for embracing an antimicrobial (triclosan)-coated suture technology to reduce the risk for surgical-site infections?<||||>A systematic literature search was performed on PubMed, Embase/Medline, Cochrane database group (Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Health Economic Evaluations Database/Database of Health Technology Assessments), and www.clinicaltrials.gov to identify RCTs of triclosan-coated sutures compared with conventional sutures and assessing the clinical effectiveness of antimicrobial sutures to decrease the risk for SSIs. A fixed- and random-effects model was developed, and pooled estimates reported as risk ratio (RR) with a corresponding 95% confidence interval (CI). Publication bias was assessed by analyzing a funnel plot of individual studies and testing the Egger regression intercept.", "Is there an evidence-based argument for embracing an antimicrobial (triclosan)-coated suture technology to reduce the risk for surgical-site infections?<||||>The meta-analysis (13 RCTs, 3,568 patients) found that use of triclosan antimicrobial-coated sutures was associated with a decrease in SSIs in selected patient populations (fixed effect: RR = 0.734; 95% CI: 0.590-0.913; P = .005; random-effect: RR = 0.693; 95% CI: 0.533-0.920; P = .011). No publication bias was detected (Egger intercept test: P = .145)." ]

[ "Feasibility of laparoscopic Nissen fundoplication after pediatric lung or heart-lung transplantation: should this be the standard?<||||>Five-year graft survival in the pediatric lung transplant (LTxp) population is less than 50%, with obliterative bronchiolitis (OB) the leading cause of death at 1, 3, and 5 years post-transplant. Bronchiolitis obliterans syndrome (BOS), defined using spirometry values, is the clinical surrogate for the histological diagnosis of obliterative bronchiolitis. Surgical correction of documented gastroesophageal reflux disease (GERD) has been proposed as a means to potentially delay the onset of BOS and prolong allograft survival in adults before or after lung transplantation but only one such study exists in children. We have examined the safety and possible benefits of laparoscopic antireflux surgery in pediatric patients following lung (LTxp) and heart-lung transplantation (HLTxp).", "Feasibility of laparoscopic Nissen fundoplication after pediatric lung or heart-lung transplantation: should this be the standard?<||||>An Institutional Review Board (IRB)-approved retrospective chart review was performed to evaluate the outcomes and complications of laparoscopic antireflux surgery in pediatric lung and heart-lung transplant patients. Spirometry data were collected for BOS staging using BOS criteria for children.", "Feasibility of laparoscopic Nissen fundoplication after pediatric lung or heart-lung transplantation: should this be the standard?<||||>Twenty-five lung and heart-lung transplants were performed between January 2003 and July 2009. Eleven transplant recipients, including six double-lung and five heart-lung (HLTxp), with a median age of 11.7 years (range 5.1-18.4 years), underwent a total of 12 laparoscopic Nissen fundoplications at a median of 427 days after transplant (range 51-2310 days). GERD was determined based upon clinical impression, pH probe study, gastric emptying study, and/or esophagram in all patients. Three patients already had a gastrostomy tube in place and two had one placed at the time of fundoplication. There were no conversions to open surgery, 30-day readmissions, or 30-day mortalities. Complications included one exploratory laparoscopy for free air 6 days after laparoscopic Nissen fundoplication for a gastric perforation that had spontaneously sealed. Another patient required a revision laparoscopic Nissen 822 days following the initial fundoplication for a paraesophageal hernia and recurrent GERD. The average length of hospital stay was 4.4 ± 1.7 days. Nine of the 12 fundoplications were performed in patients with baseline spirometry values prior to fundoplication and who could also complete spirometry reliably. One of these nine operations was associated with improvement in BOS stage 6 months after fundoplication; seven were associated with no change in BOS stage; and one was associated with a decline in BOS stage." ]

[ "Factorial validity and invariance of four psychosocial constructs of colorectal cancer screening: does screening experience matter?<||||>Few studies have examined the psychometric properties and invariance of scales measuring constructs relevant to colorectal cancer screening (CRCS). We sought to: (i) evaluate the factorial validity of four core constructs associated with CRCS (benefits, barriers, self-efficacy, and optimism); and (ii) examine measurement invariance by screening status (currently screened, overdue, never screened).", "Factorial validity and invariance of four psychosocial constructs of colorectal cancer screening: does screening experience matter?<||||>We used baseline survey data from a longitudinal behavioral intervention trial to increase CRCS among U.S. veterans. Respondents were classified as currently screened (n = 3,498), overdue (n = 418), and never screened (n = 1,277). The measurement model was developed using a random half of the sample and then validated with the second half of the sample and the full baseline sample (n = 5,193). Single- and multi-group confirmatory factor analysis was used to examine measurement invariance by screening status.", "Factorial validity and invariance of four psychosocial constructs of colorectal cancer screening: does screening experience matter?<||||>The four-factor measurement model demonstrated good fit. Factor loadings, item intercepts, and residual item variance and covariance were invariant when comparing participants never screened and overdue for CRCS, indicating strict measurement invariance. All factor loadings were invariant among the currently screened and overdue groups. Only the benefits scale was invariant across current screeners and never screeners. Non-invariant items were primarily from the barriers scale." ]

[ "Can myofascial techniques modify immunological parameters?<||||>The objective was to determine the effect of myofascial techniques on the modulation of immunological variables.", "Can myofascial techniques modify immunological parameters?<||||>Thirty-nine healthy male volunteers were randomly assigned to an experimental or control group.", "Can myofascial techniques modify immunological parameters?<||||>The experimental group underwent three manual therapy modalities: suboccipital muscle release, so-called fourth intracranial ventricle compression, and deep cervical fascia release. The control group remained in a resting position for the same time period under the same environmental conditions.", "Can myofascial techniques modify immunological parameters?<||||>Changes in counts of CD3, CD4, CD8, CD19, and natural killer (NK) cells (as immunological markers) between baseline and 20 minutes post-intervention.", "Can myofascial techniques modify immunological parameters?<||||>Repeated-measures ANOVA revealed a significant time × groups interaction (F(1,35)=9.33; p=0.004) for CD19. There were no significant time × group interaction effects on CD3, CD4, CD8, or NK cell counts. Intrasubject analyses showed a higher CD19 count in the experimental group post-intervention versus baseline (t=-4.02; p=0.001), with no changes in the control group (t=0.526; p=0.608)." ]

[ "Was breast conserving surgery underutilized for early stage breast cancer?<||||>To estimate the average survival effects of breast conserving surgery plus irradiation relative to mastectomy for marginal stage II breast cancer patients in Iowa from 1989-1994. DATA SOURCES/", "Was breast conserving surgery underutilized for early stage breast cancer?<||||>Secondary linked Iowa SEER Cancer Registry--Iowa Hospital Association discharge abstract data for women in Iowa with stage II breast cancer from 1989-1994.", "Was breast conserving surgery underutilized for early stage breast cancer?<||||>Observational instrumental variables (IV) analysis.DATA COLLECTION/", "Was breast conserving surgery underutilized for early stage breast cancer?<||||>Women with stage II breast cancer from the Iowa SEER Cancer Registry 1989-1994 who received all of their inpatient care in Iowa were linked with their respective hospital discharge abstracts.", "Was breast conserving surgery underutilized for early stage breast cancer?<||||>Breast conserving surgery plus irradiation decreased survival relative to mastectomy for marginal stage II breast cancer patients in Iowa during the early 1990s. In this study marginal patients were those whose surgery choices were affected by differences in area treatment rates and access to radiation facilities." ]

[ "Ethnic minority elders: are they neglected in published geriatric psychiatry literature?<||||>The population size of the elderly from ethnic minority groups in many developing countries is rapidly increasing. The authors perceived a paucity of publications in the geriatric psychiatry literature pertaining to ethnic minority elders.", "Ethnic minority elders: are they neglected in published geriatric psychiatry literature?<||||>A study examining the proportion of research publications pertaining to ethnic minority elders in two leading geriatric psychiatry journals, International Psychogeriatrics and International Journal of Geriatric Psychiatry, was undertaken.", "Ethnic minority elders: are they neglected in published geriatric psychiatry literature?<||||>The main findings were: (1) overall only 7.6% of the publications examined ethnic minority elders; (2) only 5.1% of publications were exclusively of ethnic minority elderly groups; and, (3) only 2.5% of publications included ethnic minority elderly groups in their overall sample." ]

[ "Occupational cancer in Canada: what do we know?<||||>To examine the reporting of cases of occupational cancer in Canada in order to determine reporting requirements, the availability of data, the characteristics of reported cancers and the completeness of reporting.", "Occupational cancer in Canada: what do we know?<||||>Descriptive epidemiologic study based on data requested from workers' compensation boards (WCBs) and cancer registries in each province and territory from 1980 to 1989.", "Occupational cancer in Canada: what do we know?<||||>The number of claims accepted and rejected by the WCBs; year of claim, cancer site, sex of claimant, age of claimant at diagnosis, occupation, industry, exposure agent and reasons for rejection of claims; and new primary cancers according to site, age and sex.", "Occupational cancer in Canada: what do we know?<||||>Reporting of occupational cancer by physicians is required in Alberta, Saskatchewan and Newfoundland. Only British Columbia, Saskatchewan and Ontario were able to provide all the requested information about the claims. Of the 1026 claims in these three provinces almost all were by men, and about two-thirds were for cancers of the respiratory tract. Asbestos was listed as the etiologic agent in more than one-third of the cases. A comparison of the proportion of incident cancers accepted as occupational by the WCBs with the estimated proportion of cancers in the general population attributable to occupation (based on population-attributable risk percentages from epidemiologic data) suggests that less than 10% of occupational cancers [corrected] are compensated. The main source of the deficit is underreporting to WCBs rather than rejection of claims." ]

[ "Can insecticide-treated netting provide protection for Equids from Culicoides biting midges in the United Kingdom?<||||>Biting midges of the genus Culicoides Latreille, 1809 (Diptera: Ceratopogonidae) cause a significant biting nuisance to equines and are responsible for the biological transmission of African horse sickness virus (AHSV). While currently restricted in distribution to sub-Saharan Africa, AHSV has a history of emergence into southern Europe and causes one of the most lethal diseases of horses and other species of Equidae. In the event of an outbreak of AHSV, the use of insecticide treated nets (ITNs) to screen equine accomodation is recommended by competent authorities including the Office International des Épizooties (OIE) in order to reduce vector-host contact.", "Can insecticide-treated netting provide protection for Equids from Culicoides biting midges in the United Kingdom?<||||>Seven commercially avaliable pyrethroid insecticides and three repellent compounds, all of which are licensed for amateur use, were assessed in modified World Health Organization (WHO) cone bioassay trials in the laboratory using a colony line of Culicoides nubeculosus (Meigen), 1830. Two field trials were subsequently conducted to test the efficiency of treated net screens in preventing entry of Culicoides.", "Can insecticide-treated netting provide protection for Equids from Culicoides biting midges in the United Kingdom?<||||>A formulation of cypermethrin (0.15 % w/w) and pyrethrins (0.2 % w/w) (Tri-Tec 14®, LS Sales (Farnham) Ltd, Bloxham, UK) applied to black polyvinyl-coated polyester insect screen (1.6 mm aperture; 1.6 mm thickness) inflicted 100 % mortality on batches of C. nubeculosus following a three minute exposure in the WHO cone bioassays at 1, 7 and 14 days post-treatment. Tri-Tec 14® outperformed all other treatments tested and was subsequently selected for use in field trials. The first trial demonstrated that treated screens placed around an ultraviolet light-suction trap entirely prevented Culicoides being collected, despite their collection in identical traps with untreated screening or no screening. The second field trial examined entry of Culicoides into stables containing horses and found that while the insecticide treated screens reduced entry substantially, there was still a small risk of exposure to biting." ]

[ "Primary angioplasty for heart attack: mismatch between expectations and reality?<||||>Primary angioplasty is recognized as the gold standard treatment for patients with ST elevation myocardial infarction, yet little is known about patients' experiences of this treatment. Recent policy change has emphasized the need for clinical practice to be more patient-centred. One way to achieve this is to understand patients' experiences of treatment better.", "Primary angioplasty for heart attack: mismatch between expectations and reality?<||||>A mixed methods exploratory study was carried out in 2006-2007 with a purposive sample of 29 patients. Data were collected 3-12 days after hospital discharge using (a) semi-structured interviews to explore participants' experiences and (b) The Illness Perception Questionnaire to evaluate illness perceptions. Interview data were analysed using the Framework approach. Questionnaire data were used to inform the qualitative findings.", "Primary angioplasty for heart attack: mismatch between expectations and reality?<||||>Participants were very positive about their treatment but experienced considerable emotional shock, which was exacerbated by the speed with which events occurred. Patients' experiences were characterized by a mismatch between their expectations and reality. Questionnaire data supported the notion that they experienced difficulty in 'making sense' of their condition in a coherent way. They tended to see their condition as 'acute' rather than 'chronic' and their treatment as curative." ]

[ "Is uptake of genetic testing for colorectal cancer influenced by knowledge of insurance implications?<||||>To assess whether knowledge of insurance implications influenced uptake of genetic testing by participants in a research study of the causes of colorectal cancer.", "Is uptake of genetic testing for colorectal cancer influenced by knowledge of insurance implications?<||||>Analysis of uptake of genetic testing by participants in the population-based Victorian Colorectal Cancer Family Study during two periods: from 1999 to 2003, when participants were not informed of any potential effect of genetic testing conducted during the study on their eligibility for new insurance policies; and from 2003 to 2006, when the protocol was changed to provide participants with information on the potential effect of genetic testing on insurance eligibility.", "Is uptake of genetic testing for colorectal cancer influenced by knowledge of insurance implications?<||||>Uptake of genetic testing for germline mutations in DNA mismatch repair (MMR) genes at a family cancer clinic.", "Is uptake of genetic testing for colorectal cancer influenced by knowledge of insurance implications?<||||>The proportion of participants who declined genetic testing among those informed of insurance implications was more than double the proportion among those without this knowledge (29/59 [49%] v 9/47 [19%]; P = 0.002). This difference could not be explained statistically by adjusting for measured putative predictors." ]

[ "Can be sphincter electromyography reference values shared between laboratories?<||||>Sphincter electromyography (EMG) is an important method in diagnosis of neuropathic sacral lesions. Quantitative EMG analysis increases utility of the test, but requires valid reference values. Although commonly employed, validity of sharing reference data between electrodiagnostic laboratories has not been confirmed. In this study, this approach was assessed by comparing the reproducibility of data sets obtained by the same and different laboratories.", "Can be sphincter electromyography reference values shared between laboratories?<||||>Confidence intervals and sensitivity of motor unit potential (MUP) parameters in the external anal sphincter (EAS) muscles were calculated using data obtained from three different control groups of women (number of women: 41, 48, and 66), examined by the same (the first two groups) and another investigator (the third group). Sensitivities to diagnose neuropathic changes in a known patient group were compared.", "Can be sphincter electromyography reference values shared between laboratories?<||||>When compared to the first reference group, the MUP parameter means of 2/7 (same investigator) versus 3/7 (different investigator) were significantly different. Similarly, 3/14 versus 4/14 MUP parameter outliers were different. Finally, 6/14 versus 7/14 sensitivities (using a combination of MUP parameter means and outliers) were different." ]

[ "Outward versus inward head thrusts with video-head impulse testing in normal subjects: does it matter?<||||>To investigate the effect of outward and inward head thrusts on the efficacy of compensatory eye movements generated during the video-Head Impulse Test (v-HIT) in healthy subjects.", "Outward versus inward head thrusts with video-head impulse testing in normal subjects: does it matter?<||||>Diagnostic. Rapid movements of the head were performed either from the midline towards the side (outward thrusts) or from the side towards the midline (inward thrusts).", "Outward versus inward head thrusts with video-head impulse testing in normal subjects: does it matter?<||||>Gain of the vestibulo-ocular reflex (VOR) as reported by two different v-HIT devices.", "Outward versus inward head thrusts with video-head impulse testing in normal subjects: does it matter?<||||>A small but statistically significant increase of the VOR gain was found for outward impulses. This small difference is likely to be attributed to increased neck strain during outward impulses, and/or hypothetically, that an effect of Alexander's law during fast, high-frequency VOR could play a role. However, the differences are minute." ]

[ "Strenuous exercise during pregnancy: is there a limit?<||||>The purpose of this study was to evaluate fetal responses to strenuous exercise in physically active and inactive women.", "Strenuous exercise during pregnancy: is there a limit?<||||>Forty-five healthy women (15 who were nonexercisers, 15 who were regularly active, 15 who were highly active) underwent a peak treadmill test at 28 weeks' gestation to 32 weeks 6 days' gestation. Fetal well-being (umbilical artery Doppler indices, fetal heart tracing/rate, biophysical profile [BPP]) was evaluated before and after exercise. Uterine artery Doppler scans were also obtained.", "Strenuous exercise during pregnancy: is there a limit?<||||>Umbilical and uterine artery Doppler indices were similar among activity groups and did not change with exercise (P>.05). BPP and fetal heart tracings were reassuring in all groups. However, subgroup analyses showed transient fetal heart rate decelerations after exercise and elevated umbilical and uterine artery Doppler indices in 5 highly active women. After this, BPP and fetal heart tracings were reassuring." ]

[ "Predictors of Gleason pattern 4/5 prostate cancer on prostatectomy specimens: can high grade tumor be predicted preoperatively?<||||>Radical prostatectomy provides excellent cancer control in men with clinically localized prostate carcinoma. However, to our knowledge preoperative parameters for distinguishing indolent from clinically significant cancer are not well characterized. In fact, recent evidence suggests that the percent of Gleason pattern 4/5 carcinoma in the complete radical prostatectomy specimen is one of the strongest predictors of prostate cancer progression and a valid measure of cancer severity. However, it is unclear whether preoperative parameters, including biopsy Gleason pattern 4/5 carcinoma, may predict radical prostatectomy Gleason pattern 4/5 disease and, thereby, distinguish indolent from clinically significant cancer.", "Predictors of Gleason pattern 4/5 prostate cancer on prostatectomy specimens: can high grade tumor be predicted preoperatively?<||||>We prospectively obtained 101 consecutive radical prostatectomy specimens and processed them in whole mount fashion. In addition to total tumor volume, we determined tumor volume for each Gleason pattern. Biopsy tumor area was measured in a similar fashion. Univariate and multivariate analyses were performed to identify preoperative clinical and pathology parameters for predicting Gleason pattern 4/5 carcinoma on prostatectomy specimens.", "Predictors of Gleason pattern 4/5 prostate cancer on prostatectomy specimens: can high grade tumor be predicted preoperatively?<||||>Biopsy Gleason score 7 or greater, Gleason pattern 4/5 carcinoma, perineural invasion and biopsy tumor area had statistically significant associations for identifying Gleason pattern 4/5 carcinoma on prostatectomy specimens. Logistic regression models for predicting any or greater than 10% Gleason pattern 4/5 carcinoma on prostatectomy specimens revealed that an area of pattern 4/5 disease of greater than 0.01 cm.2 on biopsy was the best single predictor with odds ratios of 15.0 (95% confidence interval 3.3 to 69.0, p = 0.0005) and 3.9 (95% confidence interval 1. 4 to 10.9, p = 0.009), respectively. For predicting any pattern 4/5 carcinoma on prostatectomy specimens a biopsy area of pattern 4/5 disease of greater than 0.01 cm.2 had only 38% sensitivity but 96% specificity. Similarly for predicting significant pattern 4/5 disease on prostatectomy specimens, defined as 10% or greater pattern 4/5, sensitivity and specificity for a biopsy area of greater than 0.01 cm.2 were 34% and 88%, respectively. Therefore, due to high false-negative rates these models had limited predictive value on an individual basis." ]

[ "Ragweed allergy in northern Italy: are patterns of sensitization changing?<||||>Previous surveys performed in this area showed that the age at onset of ragweed allergy in monosensitized subjects is about 35.", "Ragweed allergy in northern Italy: are patterns of sensitization changing?<||||>To detect whether a reduction in the mean age of ragweed sensitization in the area of Milan has taken place after the last survey.", "Ragweed allergy in northern Italy: are patterns of sensitization changing?<||||>All patients developing clinical ragweed pollen allergy in the years 2007-2010 and monosensitized to this allergen seen were included. 30 randomly selected subjects already sensitized to at least one other allergen source among grass, pellitory, or mite who developed ragweed allergy during the same period served as controls.", "Ragweed allergy in northern Italy: are patterns of sensitization changing?<||||>The 137 patients showed a median age at onset of ragweed allergy of 36-40 years in the years 2007-2010 with no tendency to reduction. About 10% of patients were<20 years old in 3 of the 4 study years. 15% of patients were>50 years old at onset, and 3 of them were>70. In the control group the mean age at onset of ragweed allergy was 31,6 years (median 32,5 years; range 10-60; p<0.001 vs patients)." ]

[ "The impact of post-procedure interpretation of ERCP X-ray films by radiologists on patient care: should it be routine or selective?<||||>Review of ERCP x-ray films by radiologists is routine, but the utility of this practice is unproven. The aim of this study was to assess whether the routine post-procedural interpretation of ERCP films by radiologists alters patient management.", "The impact of post-procedure interpretation of ERCP X-ray films by radiologists on patient care: should it be routine or selective?<||||>A retrospective analysis of 212 ERCPs followed by a prospective analysis of 112 ERCPs was performed. Comparative ductogram interpretations were categorized as: I, complete agreement; II, minor findings reported only by the radiologist; III, findings reported only by the endoscopist; and IV, major findings reported only by the radiologist that altered or should have altered management.", "The impact of post-procedure interpretation of ERCP X-ray films by radiologists on patient care: should it be routine or selective?<||||>In the retrospective analysis, 289 ductograms were identified, and interpretations were classified as: category I, 73%; category II, 16%; category III, 10.7%; and category IV, 0.3%. In the prospective study, interpretations of 167 ductograms were analyzed and classified as follows: category I, 84%; category II, 11%; category III, 5%; category IV, none." ]

[ "Are vestibular sensory cells preserved after destruction of Scarpa's ganglion?<||||>The contribution of nerve fibers to the maintenance of vestibular sensory cells is a controversial issue in previous studies using animals and has not yet been studied in humans. The authors investigated this issue by observing vestibular end organs in the temporal bone of three patients in whom the internal auditory canal was infiltrated with tumor cells, and Scarpa's ganglion cells showed complete degeneration.", "Are vestibular sensory cells preserved after destruction of Scarpa's ganglion?<||||>Retrospective case review.", "Are vestibular sensory cells preserved after destruction of Scarpa's ganglion?<||||>University Hospital, Department of Otolaryngology.", "Are vestibular sensory cells preserved after destruction of Scarpa's ganglion?<||||>Three patients with malignant metastatic temporal bone tumors.", "Are vestibular sensory cells preserved after destruction of Scarpa's ganglion?<||||>We investigated the preservative state of vestibular sensory hair cells with the Scalpa's ganglion was destructed.", "Are vestibular sensory cells preserved after destruction of Scarpa's ganglion?<||||>Maintenances of vestibular sensory hair cells.", "Are vestibular sensory cells preserved after destruction of Scarpa's ganglion?<||||>We found that sensory cells were intact despite the severe destruction of Scarpa's ganglion cells in two of the patients." ]

[ "Computed tomography analysis of the femoral tunnel position and aperture shape of transportal and outside-in ACL reconstruction: do different anatomic reconstruction techniques create similar femoral tunnels?<||||>The desire to perform independent femoral drilling in anterior cruciate ligament (ACL) reconstruction has prompted interest in both the transportal (TP) and outside-in (OI) techniques. However, there have been no in vivo studies on the differences in femoral aperture shape between the 2 techniques.", "Computed tomography analysis of the femoral tunnel position and aperture shape of transportal and outside-in ACL reconstruction: do different anatomic reconstruction techniques create similar femoral tunnels?<||||>To evaluate the femoral tunnel aperture shape and femoral tunnel position between ACL reconstruction using the TP and OI techniques.", "Computed tomography analysis of the femoral tunnel position and aperture shape of transportal and outside-in ACL reconstruction: do different anatomic reconstruction techniques create similar femoral tunnels?<||||>Randomized controlled trial; Level of evidence, 1.", "Computed tomography analysis of the femoral tunnel position and aperture shape of transportal and outside-in ACL reconstruction: do different anatomic reconstruction techniques create similar femoral tunnels?<||||>A total of 80 patients were randomized to undergo double-bundle ACL reconstruction using either the TP (n = 40) or OI (n = 40) technique. The femoral tunnel aperture shape (height/width ratio), aperture axis angle (angle between the aperture axis and femoral shaft axis), and femoral tunnel position were assessed by computed tomography.", "Computed tomography analysis of the femoral tunnel position and aperture shape of transportal and outside-in ACL reconstruction: do different anatomic reconstruction techniques create similar femoral tunnels?<||||>The mean height/width ratio of the anteromedial (AM) femoral tunnels in the TP group (1.35 ± 0.16) was significantly more ellipsoidal than that in the OI group (1.22 ± 0.16) (P = .008). There was no difference between the 2 groups in the posterolateral (PL) tunnels (TP, 1.32 ± 0.23; OI, 1.35 ± 0.29; P = .99). The mean aperture axis angle of the PL femoral tunnels in the OI group was significantly more perpendicular to the femoral shaft axis and had a more variable range than that in the TP group (P = .007). The mean PL femoral tunnel position in the OI group was significantly shallower and a little higher than that in the TP group (P = .006)." ]

[ "Can multivariable risk-benefit profiling be used to select treatment-favorable patients for thrombolysis in stroke in the 3- to 6-hour time window?<||||>The Stroke-Thrombolytic Predictive Instrument (Stroke-TPI) uses multivariate equations to predict outcomes with and without thrombolysis. We sought to examine whether such a multivariate predictive instrument might be useful in selecting patients with a favorable risk-benefit treatment profile for therapy after 3 hours.", "Can multivariable risk-benefit profiling be used to select treatment-favorable patients for thrombolysis in stroke in the 3- to 6-hour time window?<||||>We explored outcomes in patients from 5 major randomized clinical trials testing intravenous recombinant tissue plasminogen activator (rt-PA) classified by the Stroke-TPI as \"treatment-favorable\" or \"treatment-unfavorable.\" We used iterative bootstrap re-sampling to estimate how such a model would perform on independent test data.", "Can multivariable risk-benefit profiling be used to select treatment-favorable patients for thrombolysis in stroke in the 3- to 6-hour time window?<||||>Among patients treated within the 3- to 6-hour window, 67% of patients were classified by Stroke-TPI predicted outcomes as \"treatment-favorable\" and 33% were classified as \"treatment-unfavorable.\" Outcomes in the treatment-favorable group demonstrated benefit for thrombolysis (modified Rankin Scale score<or =1: 44.0% with rt-PA versus 34.2 with placebo, P=0.005), whereas harm was demonstrated in the treatment-unfavorable group (modified Rankin Scale score<or =1: 31.3% with rt-PA versus 38.3% with placebo; P=0.004). Bootstrap resampling with complete cross-validation showed that the absolute margin of benefit in the treatment-favorable group diminished on average by 36% between derivation and independent validation sets, but still represented a significant tripling of improvement in benefit compared with conventional inclusion criteria (5.2% [interquartile range, 1.7% to 8.6%] versus 1.8% [interquartile range, -0.5 to 4.1], P<0.0001)." ]

[ "Do older patients utilize excess health care resources after liver transplantation?<||||>Liver transplantation is a highly effective treatment for end-stage liver disease. However, there is debate over the practice of liver transplantation in older recipients (age ≥ 60 years) given the relative shortage of donor grafts, worse post-transplantation survival, and concern that that older patients may utilize excess resources postoperatively, thus threatening the economic feasibility of the procedure.AIM: To determine if patients ≥ 60 years of age utilize more health resources following liver transplantation compared with younger patients.", "Do older patients utilize excess health care resources after liver transplantation?<||||>Consecutive adult patients who underwent primary liver transplantation (n = 208) at a single center were studied over a 2.5-year period. Data were collected on clinico-demographic characteristics and resource utilization. Descriptive statistics, including means, standard deviations, or frequencies were obtained for baseline variables. Patients were stratified into 2 groups: age ≥ 60 years (n = 51) and<60 years (n = 157). The Chi-Square Test, Mantel-Haenszel Test, 2-sample test and odds ratios were calculated to ascertain associations between age and resource utilization parameters. Regression analyses were adjusted for model for end-stage liver disease score, location before surgery, diabetes mellitus, donor age, cold ischemia time, albumin, and diagnosis of hepatitis C.", "Do older patients utilize excess health care resources after liver transplantation?<||||>Recipients ≥ 60 years of age have similar lengths of hospitalization, re-operative rates, need for consultative services and readmission rates following liver transplantation, but have longer lengths of stay in the intensive care (hazard ratio 1.97, p = 0.03)." ]

[ "Is atrial fibrillation always a culprit of stroke in patients with atrial fibrillation plus stroke?<||||>Some ischemic strokes in patients with atrial fibrillation (AF) are caused by noncardioembolic etiologies (AF-unrelated stroke), but not AF itself (AF-related stroke). However, most clinical trials on the risk of stroke in AF have not distinguished between these. We investigated the frequency and features of AF-unrelated versus AF-related strokes in patients with AF plus ischemic stroke. We hypothesized that certain clinical factors, including chronicity of AF, treatment at the time of stroke onset and echocardiographic findings, may help to discriminate between AF-related and AF-unrelated strokes. The mechanisms and antithrombotic medications at the time of stroke recurrence in the two groups were also examined.", "Is atrial fibrillation always a culprit of stroke in patients with atrial fibrillation plus stroke?<||||>Consecutive patients with ischemic stroke within 7 days of symptom onset and with AF were included. Patients were classified according to the previously published criteria. Clinical factors including CHADS2 and CHA2DS2-VASc scores and transthoracic echocardiographic (TTE) findings were evaluated.", "Is atrial fibrillation always a culprit of stroke in patients with atrial fibrillation plus stroke?<||||>Of 522 patients, 424 (81.2%) were grouped as AF-related stroke and the remaining 90 (17.2%) were classified as AF-unrelated stroke. Among the patients with AF-unrelated stroke, 51 (9.8%) were categorized as possible large artery atherosclerosis and 38 (7.3%) as possible small artery occlusion; 1 patient (0.2%) was assigned to miscellaneous cause. The AF-related and AF-unrelated strokes had similar CHADS2 and CHA2DS2-VASc scores. However, compared to AF-unrelated stroke, AF-related stroke was independently associated with female sex (odds ratio, OR, 2.19; 95% confidence interval, CI, 1.18-4.05), sustained AF (OR, 2.09; 95% CI, 1.21-3.59), inadequate anticoagulation at stroke onset (OR, 3.21; 95% CI, 1.33-7.75) and left ventricular dysfunction on TTE (OR, 2.84; 95% CI, 1.40-5.74). We identified 26 patients who experienced 2 strokes during the study period. The initial stroke subtype was a strong predictor of the recurrent stroke mechanism (p<0.001). Among 17 events of AF-related recurrent stroke in these subpopulation, only 2 strokes (11.8%) occurred in a setting of adequate anticoagulation, whereas 4 out of 9 patients (44.4%) who had AF-unrelated strokes at recurrence were sufficiently anticoagulated at the time of admission (p = 0.138)." ]

[ "Mac-1 directly binds to the endothelial protein C-receptor: a link between the protein C anticoagulant pathway and inflammation?<||||>The endothelial protein C-receptor (EPCR) is an endothelial transmembrane protein that binds protein C and activated protein C (APC) with equal affinity, thereby facilitating APC formation. APC has anticoagulant, antiapoptotic and antiinflammatory properties. Soluble EPCR, released by the endothelium, may bind activated neutrophils, thereby modulating cell adhesion. EPCR is therefore considered as a possible link between the anticoagulant properties of protein C and the inflammatory response of neutrophils. In the present study, we aimed to provide proof of concept for a direct binding of EPCR to the β2-integrin Mac-1 on monocytic cells under static and physiological flow conditions.", "Mac-1 directly binds to the endothelial protein C-receptor: a link between the protein C anticoagulant pathway and inflammation?<||||>Under static conditions, human monocytes bind soluble EPCR in a concentration dependent manner, as demonstrated by flow cytometry. Binding can be inhibited by specific antibodies (anti-EPCR and anti-Mac-1). Specific binding was confirmed by a static adhesion assay, where a transfected Mac-1 expressing CHO cell line (Mac-1+ cells) bound significantly more recombinant EPCR compared to Mac-1+ cells blocked by anti-Mac-1-antibody and native CHO cells. Under physiological flow conditions, monocyte binding to the endothelium could be significantly blocked by both, anti-EPCR and anti-Mac-1 antibodies in a dynamic adhesion assay at physiological flow conditions. Pre-treatment of endothelial cells with APC (drotrecogin alfa) diminished monocyte adhesion significantly in a comparable extent to anti-EPCR." ]

[ "Bilateral posterior parietal polymicrogyria: a mild form of congenital bilateral perisylvian syndrome?<||||>The main features of congenital bilateral perisylvian syndrome (CBPS) are pseudobulbar palsy, cognitive deficits, epilepsy, and perisylvian abnormalities on imaging studies, however, the clinical spectrum of this syndrome is much wider than previously believed and may vary from minor speech difficulties to severely disabled patients. The objective of this study was to present the different imaging and clinical findings of 17 patients with CBPS, their genetic background, and the occurrence of prenatal injury during their pregnancies.", "Bilateral posterior parietal polymicrogyria: a mild form of congenital bilateral perisylvian syndrome?<||||>We evaluated 17 consecutive patients with CBPS and divided them into two groups according to the imaging findings: (a) diffuse polymicrogyria around the sylvian fissure and (b) posterior polymicrogyria at the posterior parietal regions. They were systematically interviewed regarding history of prenatal events during their pregnancies, family history of speech difficulties, epilepsy, or other neurologic abnormality.", "Bilateral posterior parietal polymicrogyria: a mild form of congenital bilateral perisylvian syndrome?<||||>There were seven women, ages ranging from 3 to 41 years (mean, 11.5; median, 7 years). Seven patients had bilateral posterior parietal polymicrogyria (BPPP), and 10 had diffuse bilateral perisylvian polymicrogyria. All seven patients with BPPP had only minor speech difficulties, none had epilepsy, and all but one had a family history of epilepsy or cortical dysgenesis. In contrast, 10 patients with diffuse bilateral perisylvian polymicrogyria had pseudobulbar palsy, four had epilepsy, eight had a history of a major prenatal event, and only four had a family history of epilepsy or developmental delay." ]

[ "Do agreements between adolescent and parent reports on family socioeconomic status vary with household financial stress?<||||>Many studies compared the degree of concordance between adolescents' and parents' reports on family socioeconomic status (SES). However, none of these studies analyzed whether the degree of concordance varies by different levels of household financial stress. This research examines whether the degree of concordance between adolescents' and parent reports for the three traditional SES measures (parental education, parental occupation and household income) varied with parent-reported household financial stress and relative standard of living.", "Do agreements between adolescent and parent reports on family socioeconomic status vary with household financial stress?<||||>2,593 adolescents with a mean age of 13 years, and one of their corresponding parents from the Taiwan Longitudinal Youth Project conducted in 2000 were analyzed. Consistency of adolescents' and parents' reports on parental educational attainment, parental occupation and household income were examined by parent-reported household financial stress and relative standard of living.", "Do agreements between adolescent and parent reports on family socioeconomic status vary with household financial stress?<||||>Parent-reported SES variables are closely associated with family financial stress. For all levels of household financial stress, the degree of concordance between adolescent's and parent's reports are highest for parental education (κ ranging from 0.87 to 0.71) followed by parental occupation (κ ranging from 0.50 to 0.34) and household income (κ ranging from 0.43 to 0.31). Concordance for father's education and parental occupation decreases with higher parent-reported financial stress. This phenomenon was less significant for parent-reported relative standard of living." ]

[ "Is gall-bladder polyp equivalent to cancer?<||||>Polyps of the gall-bladder has long been a serious diagnostic problem. Their detection in routine ultrasound is not yet satisfactory and often does not allow you to select the proper method of operating the gall-bladder. The aim of the study was to assess the accuracy of ultrasound diagnosis of polypoid lesions of the gall-bladder through its verification by histopathology in patients treated with cholecystectomy.", "Is gall-bladder polyp equivalent to cancer?<||||>In the years 2010-2013, 1196 patients underwent surgery due to diseases of the gall-bladder at the Department of General and Transplant Surgery, Medical University in Łódź. The study evaluated the sensitivity of ultrasound in detecting polyps of the gallbladder and histopathological findings of the formulations investigated.", "Is gall-bladder polyp equivalent to cancer?<||||>Preoperative ultrasound examination (USG) revealed a polypoid lesion in 64 patients; only in 29 of them (44.6%) this diagnosis was confirmed by histopathological examination. In the other cases, cholecystolithiasis or inflammatory lesions were found. The most common histopathological findings included cholesterol polyps, adenomatous polyps, and inflammatory polyps. Malignant lesions (gall-bladder cancer) were found in five patients preoperatively diagnosed with a polypoid lesion, i.e 7.8% of patients preoperatively diagnosed with a polyp and 0.4% of all patients who received surgical treatment. Patients qualified for surgery due to polyps diagnosed by means of ultrasound examination constitued 5.4% of all patients who underwent cholecystectomy. On histopathological examination, the presence of polyps was confirmed in 2.4% patients treated with excision of the gall-bladder." ]

[ "Does reperfusion injury still cause significant mortality after lung transplantation?<||||>Severe reperfusion injury after lung transplantation has mortality rates approaching 40%. The purpose of this investigation was to identify whether our improved 1-year survival after lung transplantation is related to a change in reperfusion injury.", "Does reperfusion injury still cause significant mortality after lung transplantation?<||||>We reported in March 2000 that early institution of extracorporeal membrane oxygenation can improve lung transplantation survival. The records of consecutive lung transplant recipients from 1990 to March 2000 (early era, n = 136) were compared with those of recipients from March 2000 to August 2006 (current era, n = 155). Reperfusion injury was defined by an oxygenation index of greater than 7 (where oxygenation index = [Percentage inspired oxygen] x [Mean airway pressure]/[Partial pressure of oxygen]). Risk factors for reperfusion injury, treatment of reperfusion injury, and 30-day mortality were compared between eras by using chi(2), Fisher's, or Student's t tests where appropriate.", "Does reperfusion injury still cause significant mortality after lung transplantation?<||||>Although the incidence of reperfusion injury did not change between the eras, 30-day mortality after lung transplantation improved from 11.8% in the early era to 3.9% in the current era (P = .003). In patients without reperfusion injury, mortality was low in both eras. Patients with reperfusion injury had less severe reperfusion injury (P = .01) and less mortality in the current era (11.4% vs 38.2%, P = .01). Primary pulmonary hypertension was more common in the early era (10% [14/136] vs 3.2% [5/155], P = .02). Graft ischemic time increased from 223.3 +/- 78.5 to 286.32 +/- 88.3 minutes in the current era (P = .0001). The mortality of patients with reperfusion injury requiring extracorporeal membrane oxygenation improved in the current era (80.0% [8/10] vs 25.0% [3/12], P = .01)." ]

[ "Clinical significance of frozen section analysis during resection of intraductal papillary mucinous neoplasm: should a positive pancreatic margin for adenoma or borderline lesion be resected additionally?<||||>The clinical significance of a positive intraoperative frozen section analysis of the pancreatic margin, especially for adenoma or borderline lesion, is not well understood during operations for intraductal papillary mucinous neoplasm of the pancreas.", "Clinical significance of frozen section analysis during resection of intraductal papillary mucinous neoplasm: should a positive pancreatic margin for adenoma or borderline lesion be resected additionally?<||||>Data from 130 consecutive patients who underwent intraductal papillary mucinous neoplasm resection in a single institution were retrospectively analyzed.", "Clinical significance of frozen section analysis during resection of intraductal papillary mucinous neoplasm: should a positive pancreatic margin for adenoma or borderline lesion be resected additionally?<||||>In the first intraoperative frozen section analysis, 26 patients were positive for adenoma or borderline lesion, 10 for carcinoma in situ, 2 for cancer cells floating in the duct, and 6 for invasive cancer. Twenty-nine patients underwent additional resection, and 105 patients finally achieved a negative pancreatic margin. Among 18 patients with a positive pancreatic margin for adenoma or borderline lesion, only 1 had a recurrence. All 20 patients who suffered a recurrence harbored invasive intraductal papillary mucinous carcinoma in resected specimens. In multivariate analysis, predictive factors of recurrence after intraductal papillary mucinous carcinoma resection were the presence of lymph node metastasis, serosal invasion, and a high level of serum carbohydrate antigen 19-9." ]

[ "Does laser power influence the results of endovenous laser ablation (EVLA) of incompetent saphenous veins with the 1 470-nm diode laser?<||||>Between 28 November 2007 and 15 January 2008, 40 consecutive patients (40 legs) with an incompetent GSV were treated by EVLA. The patients were randomized in two groups. In Group A (20 patients) was used a 15-W-power laser and in Group B (20 patients) a 25-W-power laser was used. All patients were re-examined after 1, 10 and 30 days clinically and by Duplex for complications and occlusion in the treated vein segment in a standardized way.", "Does laser power influence the results of endovenous laser ablation (EVLA) of incompetent saphenous veins with the 1 470-nm diode laser?<||||>There was no significant difference concerning gender, age, C of CEAP, body mass index or diameter of the treated vein. In Group A a mean of 465 mL tumescence fluid (TF) was used and in Group B TF was of 433 mL. In Group A the mean linear endovenous energy density (LEED) was 109.7 J/cm and in Group B 132.6 J/cm. The subgroup Bsub included 16 patients of Group B with a comparable mean LEED of 115.8 J/cm. In all groups occlusion of the treated veins was achieved for all patients. The diameter of the GSV reduced at 3 cm below the sapheno-femoral junction from 1.1 to 0.6 cm, 1.0 to 0.6 cm and 0.9 to 0.6 cm respectively in the three groups. The modified CEAP clinical score improved significantly in all groups. In Group A patients have been administered analgesic tablets for a shorter period. There was also a trend to less postinterventional pain and analgesic use in Group A, but it was not significant. Ecchymosis was rare in both groups (8 in Group A, 7 in Group B)." ]

[ "Do doctors know when their patients don't?<||||>a) To determine how much patients with recently diagnosed lung cancer know about their illness and its treatment, and b) to find out if doctors know what their patients know and what they don't.", "Do doctors know when their patients don't?<||||>One hundred patients with recently diagnosed lung cancer, who were undergoing radiotherapy or chemotherapy, were interviewed to determine their view of their diagnosis, the extent of the cancer, the intent of treatment, and the risks and benefits of treatment. Their attending physicians' view were elicited contemporaneously, using a self-administered questionnaire. The principle outcome measure of the study was the level of agreement between the views of the patients and the doctors about the disease, the treatment, and the prognosis. Concordance between doctors' and patients' views was expressed in terms of percentage agreement, and Kappa (kappa).", "Do doctors know when their patients don't?<||||>Ninety-nine percent of the patients knew that they had lung cancer. Sixty-four percent (64%) agreed with their doctor about the extent of the disease (kappa = 0.48). Most of those who disagreed underestimated the extent of their cancer. Seventy-two percent (72%) agreed with their doctor about the intent of treatment (kappa = 0.49). Thirty-six percent (36%) agreed with their doctors about their probability of cure, (kappa = 0.17): most of those who disagreed systematically overestimated it. Sixty-eight patients were receiving palliative treatment. Of these, 56% agreed with their doctor about the probability of symptomatic benefit (kappa = 0.42), but only 14% agreed with their doctor about the probability that the treatment would prolong life (kappa = 0.06). Doctors frequently failed to recognize their patients' misconceptions about the intent of treatment and the prognosis." ]

[ "Verification of endotracheal tube placement by prehospital providers: is a portable fiberoptic bronchoscope of value?<||||>This study was designed to examine whether a handheld, battery-operated fiberoptic bronchoscope (FOB) used to verify endotracheal tube (ETT) placement would be as sensitive and specific as other modes and whether a combination of multiple modes would further enhance the sensitivity and specificity of ETT placement verification.", "Verification of endotracheal tube placement by prehospital providers: is a portable fiberoptic bronchoscope of value?<||||>An academic hospital-based air medical program.", "Verification of endotracheal tube placement by prehospital providers: is a portable fiberoptic bronchoscope of value?<||||>This was a prospective, randomized study examining surgical patients undergoing general endotracheal anesthesia. Eighteen critical care transport (CCT) nurses, previously unfamiliar with FOB, were asked to identify intratracheal and intraesophageal ETTs by using misting, end-tidal carbon dioxide concentration (ETCO(2)), and FOB alone or with a combination of all three modes. The sensitivity and specificity of single and multimode verification were calculated and compared.", "Verification of endotracheal tube placement by prehospital providers: is a portable fiberoptic bronchoscope of value?<||||>Comparison of ETT verification by single mode alone revealed a rank order of sensitivity with ETCO(2) (0.97)>FOB (0.87)>misting (0.84), whereas all three modes had similar specificities (0.93-0.94). However, the use of the three-mode combination revealed a sensitivity and specificity of 1.0." ]

[ "Myocardial sympathetic innervation in patients with chronic coronary artery disease: is reduction in coronary flow reserve correlated with sympathetic denervation?<||||>Higher sensitivity of sympathetic nerves to ischaemia in comparison with myocytes has been observed and has been claimed to contribute to poor prognosis in patients with coronary artery disease (CAD). The aim of this study was to evaluate the dependency of myocardial sympathetic innervation on restrictions in coronary flow reserve (CFR).", "Myocardial sympathetic innervation in patients with chronic coronary artery disease: is reduction in coronary flow reserve correlated with sympathetic denervation?<||||>We analysed 27 non-diabetic patients with advanced CAD. We determined quantitative myocardial blood flow using (13)N-ammonia PET, myocardial viability with (18)F-FDG PET and cardiac innervation with (11)C-HED PET. Scarred segments were excluded from analysis. We investigated the relationship between regional HED retention, blood flow and CFR.", "Myocardial sympathetic innervation in patients with chronic coronary artery disease: is reduction in coronary flow reserve correlated with sympathetic denervation?<||||>There was no correlation between rest perfusion and HED retention within a flow range from approximately 30 to 120 ml/(100 ml x min). A slight correlation was observed between stress perfusion values and HED retention (p<0.001), and between CFR and HED retention (p<0.001)." ]

[ "Can malaria vector control accelerate the interruption of lymphatic filariasis transmission in Africa; capturing a window of opportunity?<||||>The Global Programme to Eliminate Lymphatic Filariasis (GPELF) was launched in 2000, and nearly all endemic countries in the Americas, Eastern Mediterranean and Asia-Pacific regions have now initiated the WHO recommended mass drug administration (MDA) campaign to interrupt transmission of the parasite. However, nearly 50% of the LF endemic countries in Africa are yet to implement the GPELF MDA strategy, which does not include vector control. Nevertheless, the recent scale up in insecticide treated /long lasting nets (ITNs/LLINs) and indoor residual spraying (IRS) for malaria control in Africa may significantly impact LF transmission because the parasite is transmitted mainly by Anopheles mosquitoes. This study examined the magnitude, geographical extent and potential impact of vector control in the 17 African countries that are yet to or have only recently started MDA.", "Can malaria vector control accelerate the interruption of lymphatic filariasis transmission in Africa; capturing a window of opportunity?<||||>National data on mosquito bed nets, ITNs/LLINs and IRS were obtained from published literature, national reports, surveys and datasets from public sources such as Demographic Health Surveys, Malaria Indicator Surveys, Multiple Indicator Cluster Surveys, Malaria Report, Roll Back Malaria and President's Malaria Initiative websites. The type, number and distribution of interventions were summarised and mapped at sub-national level. and compared with known or potential LF distributions, and those which may be co-endemic with Loa loa and MDA is contraindicated.", "Can malaria vector control accelerate the interruption of lymphatic filariasis transmission in Africa; capturing a window of opportunity?<||||>Analyses found that vector control activities had increased significantly since 2005, with a three-fold increase in ITN ownership and IRS coverage. However, coverage varied dramatically across the 17 countries; some regions reported>70% ITNs ownership and regular IRS activity, while others had no coverage in remote rural populations where the risk of LF was potentially high and co-endemic with high risk L.loa." ]

[ "Should Free Thyroxine Go Back into the Routine Thyroid Profile?<||||>Many clinical chemistry laboratories offer thyroid-stimulating hormone (TSH) alone as a first-line test of thyroid function, and only reflex a free thyroxine (fT4) test if the TSH result is abnormal (i. e., outside of the laboratory reference range). In secondary hypothyroidism, a low fT4 may be accompanied by a low or a normal TSH level. A testing strategy that measures baseline TSH only risks missing cases of secondary hypothyroidism in which the TSH level is normal.", "Should Free Thyroxine Go Back into the Routine Thyroid Profile?<||||>The current authors examined 26,106 consecutive thyroid function test (TFT) results in our initial analysis. If the TFT results were compatible with hypopituitarism, with fT4 below the reference range (9-20 pmol/L) and a TSH result ≤5 mU/L (reference range: 0.5-5 mU/L), the laboratory performed further tests of pituitary function. The cost of identifying pituitary insufficiency by measuring both fT4 and TSH was estimated for our population (in 2004 and 2013) and compared with 2 other relevant studies.", "Should Free Thyroxine Go Back into the Routine Thyroid Profile?<||||>A total of 121 patients had a normal TSH with a low fT4. 8 new cases of secondary hypopituitarism were identified when fT4 was combined with TSH as the front-line TFT profile. Of these, 5 were found to have pituitary adenomas, 2 of which were macroprolactinomas. The reagent cost of identifying each case by inclusion of fT4 in the TFT profile decreased from £11,568 (€16,089) in 1998 to £1451 (€2018) in 2013." ]

[ "Is there utility in the transtheoretical model?<||||>The transtheoretical model is arguably the dominant model of health behaviour change, having received unprecedented research attention, yet it has simultaneously attracted exceptional criticism. However, the criticisms have been directed almost exclusively at the stages of change, just one of fourteen components of the transtheoretical model, which may have diverted attention away from more fruitful avenues of research based on the model.", "Is there utility in the transtheoretical model?<||||>Narrative review.", "Is there utility in the transtheoretical model?<||||>The evidence would suggest some flaws in the concept of stages of change as currently articulated in the transtheoretical model. On a conceptual level, even studies incorporating the five stages of change point to a model that better fits Gollwitzer (1993) and Heckhausen's (1991) idea of a motivational phase followed by a volitional phase. Potentially the processes of change components of the transtheoretical model may actually prove the most useful, yet have been under-researched, at least experimentally. Three studies that successfully utilise the processes of change to reduce alcohol consumption, encourage smoking cessation and increase physical activity are described." ]

[ "Is energy pooling necessary in ultraviolet matrix-assisted laser desorption/ionization?<||||>Energy pooling has been suggested as the key process for generating the primary ions during ultraviolet matrix-assisted laser desorption/ionization (UV-MALDI). In previous studies, decreases in fluorescence quantum yields as laser fluence increased for 2-aminobenzoic acid, 2,5-dihydroxybenzoic acid (2,5-DHB), and 3-hydroxypicolinic acid were used as evidence of energy pooling. This work extends the research to other matrices and addresses whether energy pooling is a universal property in UV-MALDI.", "Is energy pooling necessary in ultraviolet matrix-assisted laser desorption/ionization?<||||>Energy pooling was investigated in a time-resolved fluorescence experiment by using a short laser pulse (355 nm, 20 ps pulse width) for excitation and a streak camera (1 ps time resolution) for fluorescence detection.", "Is energy pooling necessary in ultraviolet matrix-assisted laser desorption/ionization?<||||>The excited-state lifetime of 2,5-DHB decreased with increases in laser fluence. This suggests that a reaction occurs between two excited molecules, and that energy pooling may be one of the possible reactions. However, the excited-state lifetime of 2,4,6-trihydroxyacetophenone (THAP) did not change with increases in laser fluence. The upper limit of the energy pooling rate constant for THAP is estimated to be approximately 100-500 times smaller than that of 2,5-DHB." ]

[ "Does a host country capture knowledge of migrant doctors and how might it?<||||>To investigate International Medical Graduate (IMG) perspectives on opportunities to share technical knowledge and professional experience with host country professionals and mechanisms for this.", "Does a host country capture knowledge of migrant doctors and how might it?<||||>All IMGs from the UK registered with the New Zealand Medical Council who had arrived within the decade to 2014 were surveyed (n = 1357). The main outcome measures were respondent perceptions of host country receptivity to their potential knowledge contribution, and mechanisms through which knowledge might be shared.", "Does a host country capture knowledge of migrant doctors and how might it?<||||>The survey response rate was 47 % (n = 632). 82 % of respondents agreed colleagues had been receptive to their knowledge contribution; 67 % felt they had been encouraged to share professional knowledge gained abroad; 60 % agreed they had been encouraged to share knowledge of the UK or other health systems. Only 45 % believed there were clear mechanisms in place for knowledge sharing. Statistically significant differences by age and professional practice designation were found." ]

[ "Do Adolescents With Higher Knowledge of HIV Have Lower Sexual Risk Behaviors?<||||>Human immunodeficiency virus (HIV) remains a leading cause of morbidity and mortality in the United States, and adolescents account for a disproportionate number of new cases. We aimed to assess knowledge of HIV in relation to sexual risk behaviors among adolescents seeking care in our pediatric emergency department and to assess sources of HIV knowledge among this population.", "Do Adolescents With Higher Knowledge of HIV Have Lower Sexual Risk Behaviors?<||||>Adolescents aged 14 to 21 years who presented to the pediatric emergency department participated in a questionnaire assessing HIV knowledge, sexual risk behaviors, and sources of HIV knowledge. For purposes of statistical analysis, patients were divided into a high-score (greater than or equal to the median score) or low-score (less than the median score) group based on the HIV-Knowledge Questionnaire 18 portion of the survey.", "Do Adolescents With Higher Knowledge of HIV Have Lower Sexual Risk Behaviors?<||||>A total of 240 adolescents were enrolled. Of those, 112 patients scored higher than or equal to the median HIV-Knowledge Questionnaire 18 score of 11. High-scoring knowledge was independently associated with patients 18 years or older (P = 0.001), any lifetime sexual activity (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.30-3.67; P = 0.003), previous testing for HIV (OR, 2.40; 95% CI, 1.40-4.11; P = 0.002), and an \"expert\" source (school-based or medical professionals) as their primary source of knowledge (OR, 1.88; 95% CI, 1.05-3.41; P = 0.034). Age of first sexual encounter, number of partners, and condom use were not significantly associated with knowledge score." ]

[ "The decision-to-delivery interval for emergency caesarean section: is 30 minutes a realistic target?<||||>To evaluate whether a 30-minute decision-to-delivery interval is a realistic target for emergency caesarean section.", "The decision-to-delivery interval for emergency caesarean section: is 30 minutes a realistic target?<||||>An audit of all emergency caesarean sections over five separate periods.", "The decision-to-delivery interval for emergency caesarean section: is 30 minutes a realistic target?<||||>A district general hospital.", "The decision-to-delivery interval for emergency caesarean section: is 30 minutes a realistic target?<||||>Five groups of women (343 women) with an indication for emergency caesarean section.", "The decision-to-delivery interval for emergency caesarean section: is 30 minutes a realistic target?<||||>Following an initial survey, a structured time sheet was introduced, followed by four other surveys to complete the audit cycle.", "The decision-to-delivery interval for emergency caesarean section: is 30 minutes a realistic target?<||||>The proportion of caesarean sections where the decision-to-delivery interval was achieved within 30 minutes. The reasons for delay.", "The decision-to-delivery interval for emergency caesarean section: is 30 minutes a realistic target?<||||>In the first survey of 73 emergency caesarean sections, the time to deliver the infant exceeded 30 minutes in 47 women (64%). The main sources of delay were transferring the women to the operating theatre and starting the anaesthetic. After the introduction of a structured time sheet, there was an improvement with each survey, but the target of 30 minutes was reached in only 71% of caesarean sections in the final survey." ]

[ "Does elective or emergent operative status influence outcomes in patients undergoing implantation of left ventricular assist devices?<||||>Acuity models to predict survival after left ventricular assist device (LVAD) implantation do not include operative status as one of the calculated variables. The effect of elective versus emergent LVAD implantation on outcomes has not been examined.", "Does elective or emergent operative status influence outcomes in patients undergoing implantation of left ventricular assist devices?<||||>Patients were stratified into 2 groups based on operative status (elective versus emergent). Variables were compared to determine whether there were differences in outcomes between elective versus emergent LVAD recipients", "Does elective or emergent operative status influence outcomes in patients undergoing implantation of left ventricular assist devices?<||||>Of the 130 patients, 59 underwent an elective procedure, whereas 71 had their LVAD implanted as an urgent/emergent operation. Patients in the urgent/emergent cohort had significantly worse preoperative hepatic and renal function and higher central venous pressures. Survival rates at 30 days, 6 months, 1 year, and 2 years were analogous for both cohorts. Patients in the emergent cohort had a higher incidence of postoperative right ventricular failure, with the requirement for short-term right ventricular support in 9.9% versus 1.7% (P = 0.054). The incidence of other LVAD-related complications, were similar in both groups. Emergency status did not predict postoperative mortality in univariate analysis." ]

[ "Decision-making in ADHD: sensitive to frequency but blind to the magnitude of penalty?<||||>Decision-making and reinforcement sensitivity were investigated in 23 children with ADHD and 20 healthy controls using a gambling paradigm.", "Decision-making in ADHD: sensitive to frequency but blind to the magnitude of penalty?<||||>Children were required to choose between three alternatives that carried (A) small rewards and small penalties (advantageous), (B) large rewards and increasing penalties and (C) small rewards and increasing penalties (both disadvantageous). Penalties increased either in frequency or magnitude in two independent conditions. Heart rate (HR) and skin conductance (SC) were measured to examine whether impaired decision-making was accompanied by autonomic abnormalities.", "Decision-making in ADHD: sensitive to frequency but blind to the magnitude of penalty?<||||>Children with ADHD showed a maladaptive response style compared to controls by demonstrating a smaller preference for the advantageous alternative, when penalties increased in magnitude. When penalties increased in frequency, children with ADHD performed like controls. Group differences in decision-making attenuated after the task was administered twice. Compared to controls, performance of children with ADHD in the magnitude condition was accompanied by increased HR acceleration following reward. In this condition, the post-selection SC of children with ADHD was larger for advantageous than for disadvantageous alternatives, in contrast to controls who showed an opposite SC pattern." ]

[ "Does the number of trauma lists provided affect care and outcome of patients with fractured neck of femur?<||||>Delay in surgery for fractured neck of femur is associated with increased mortality; it is recommended that patients with fractured neck of femur are operated within 48 h. North West hospitals provide dedicated trauma lists, as recommended by the British Orthopaedic Association, to allow rapid access to surgery. We investigated trauma list provision by each trust and its effects on the time taken to get neck of femur patients to surgery and patient survival.", "Does the number of trauma lists provided affect care and outcome of patients with fractured neck of femur?<||||>The number of trauma lists provided by 13 acute trusts was determined by telephone interview with the theatre manager. Data on operating delays, reasons for delay and 30-day mortality were obtained from the Greater Manchester and Wirral fractured neck of femur audit.", "Does the number of trauma lists provided affect care and outcome of patients with fractured neck of femur?<||||>A total of 883 patients were included in the audit (35-126 per hospital). Overall, 5-15 trauma lists were provided each week, and 80% of lists were consultant-led. Of patients, 31.8% were operated on within 24 h and 36.9% were delayed more than 48 h; 37.7% of delays were for non-medical reasons. The 30-day mortality rates varied between 5-19% (mean, 11.8%). There were no significant relationships between the number of trauma lists and these variables. When divided into hospitals with>10 lists per week (n = 6) and those with<10 lists per week (n = 7) there were no significant differences in 48-h delay, non-medical delay or mortality. However, 24-h delay showed a trend to be lower in those with>10 lists (34.6% of patients versus 28.9%; P = 0.09)." ]

[ "Is it safe to allow patients with implantable cardioverter-defibrillators to drive?<||||>Implantable cardioverter-defibrillator (ICD) implant indications have widened in recent years after the publication of the Multicenter Automatic Defibrillator Implantation Trial 2 and the Sudden Cardiac Death in Heart Failure Trial. On the contrary, guidelines on resumption of driving after ICD implant were published almost 10 years ago when the ICD implant rate was much lower and candidates were generally older.", "Is it safe to allow patients with implantable cardioverter-defibrillators to drive?<||||>The overall objective of our study was to evaluate whether patients implanted with ICDs have higher risk than the general driving population. The specific aim of the study was to verify the rate of car accidents in patients implanted with an ICD, both for primary and secondary indication, and compare this with the rate of accidents in the general population. The primary end point of the study was the annual car accident rate; the secondary end point was to determine if there were subgroups of patients with a higher risk of car accidents.", "Is it safe to allow patients with implantable cardioverter-defibrillators to drive?<||||>All patients (612) followed up in our outpatient clinic were sent a questionnaire in which they were asked five questions regarding their driving habits before and after ICD implant and, specifically, whether they had been involved in a car accident after the implant.", "Is it safe to allow patients with implantable cardioverter-defibrillators to drive?<||||>Two hundred eighty-six patients (47%) responded to the questionnaire. Seventy-one patients had never driven; two patients were forbidden to drive for professional reasons (one bus and one truck driver). Two hundred thirteen (74.5% of all responding) patients (201 men, mean age 62 +/- 11 years) continued to drive after ICD implant. During the follow-up (1430 +/- 920 days) 11 patients had been involved in car accidents and, importantly 10 out of 11 were innocent bystanders. Thus, in 996 patient-years, 11 events happened, yielding an annual event rate of 1.1% per patient-years (and only 0.1% in which the driver could had been responsible)." ]

[ "Can clinically relevant prognostic subsets of breast cancer patients with four or more involved axillary lymph nodes be identified through immunohistochemical biomarkers?<||||>Primary breast cancer involving four or more axillary lymph nodes carries a poor prognosis. We hypothesized that use of an immunohistochemical biomarker scoring system could allow for identification of variable risk subgroups.", "Can clinically relevant prognostic subsets of breast cancer patients with four or more involved axillary lymph nodes be identified through immunohistochemical biomarkers?<||||>Patients with four or more positive axillary nodes were identified from a clinically annotated tissue microarray of formalin-fixed paraffin-embedded primary breast cancers and randomized into a 'test set' and a 'validation set'. A prospectively defined prognostic scoring model was developed in the test set and was further assessed in the validation set combining expression for eight biomarkers by immunohistochemistry, including estrogen receptor, human epidermal growth factor receptors 1 and 2, carbonic anhydrase IX, cytokeratin 5/6, progesterone receptor, p53 and Ki-67. Survival outcomes were analyzed by the Kaplan-Meier method, log rank tests and Cox proportional-hazards models.", "Can clinically relevant prognostic subsets of breast cancer patients with four or more involved axillary lymph nodes be identified through immunohistochemical biomarkers?<||||>A total of 313 eligible patients were identified in the test set for whom 10-year relapse-free survival was 38.3% (SEM 2.9%), with complete immunohistochemical data available for 227. Tumor size, percentage of positive axillary nodes and expression status for the progesterone receptor, Ki-67 and carbonic anhydrase IX demonstrated independent prognostic significance with respect to relapse-free survival. Our combined biomarker scoring system defined three subgroups in the test set with mean 10-year relapse-free survivals of 75.4% (SEM 7.0%), 35.3% (SEM 4.1%) and 19.3% (SEM 7.0%). In the validation set, differences in relapse-free survival for these subgroups remained statistically significant but less marked." ]

[ "Does Staphylococcus aureus nasal carriage require eradication prior to elective ambulatory surgery in children?<||||>Rates of community-associated Staphylococcus aureus, and particularly of methicillin-resistant Staphylococcus aureus (MRSA) in children, have increased in recent years. We investigated rates of nasal colonization of S. aureus, and a possible correlation between nasal carriage and wound infection.", "Does Staphylococcus aureus nasal carriage require eradication prior to elective ambulatory surgery in children?<||||>A prospective study of children scheduled for elective day-care surgical procedures between January 2008 and December 2012 at one medical center. Nasal swabs were taken before surgery, and follow-up was performed 1-2 weeks following surgery.", "Does Staphylococcus aureus nasal carriage require eradication prior to elective ambulatory surgery in children?<||||>Of 1,127 children (median age 2 years, 70.6% males), positive nasal swabs were detected in 228 (20.2%). Rates of S. aureus nasal carriage were lowest for ages 6 months to 2 years and highest for ages 4-11 years. Child's sex did not associate with the risk for positive nasal swabs. Positive nasal swabs for MRSA were detected in five boys (0.62% of the population). Five children (0.44%) had wound infection. None of them was a nasal carrier." ]

[ "Cervical cancer in young women: a poorer prognosis?<||||>The existence of an aggressive form of cervical carcinoma affecting young women is studied by survival analysis of a large patient population.", "Cervical cancer in young women: a poorer prognosis?<||||>Between 1969 and 1986, 1577 cases of cervical cancer were treated according to well-defined policies at the University Department of Obstetrics and Gynaecology in Debrecen, Hungary. Patients' records were reviewed to obtain data for survival analysis. Kaplan-Meier survival curves were generated for each stage and stratified for age. The log-rank test was used to compare the survival of younger and older patients at each stage. Multivariate analysis was performed to control for stage and treatment type when 5-year survival trends across four different age groups were examined.", "Cervical cancer in young women: a poorer prognosis?<||||>Comparison of survival of patients under 35 and over 35 years of age, and also those under 40 and over 40 years of age revealed no significant differences. Five-year survival across the<30, 30-39, 40-49 and>or = 50 years age groups showed no significant trend. No differences in survival were revealed when the comparison was controlled for stage of disease and treatment type." ]

[ "Lumbar hernia in South Korea: different from that in foreign literature?<||||>This study aimed to analyze the clinical features of lumbar hernia reported in South Korea and compare these features with those reported in foreign literature.", "Lumbar hernia in South Korea: different from that in foreign literature?<||||>From January 1968 through December 2013, 13 cases reported in South Korea were included in the study. The variables compared were age, sex, main symptoms at hospital visit, etiology, location, herniated contents, lateralization, defect size, diagnostic methods, surgical methods, surgical opinions, and recurrence.", "Lumbar hernia in South Korea: different from that in foreign literature?<||||>In the South Korean cases, women outnumbered men (3.3:1) and no significant differences were found in the herniated side (left:right, 1.1:1). In contrast, in the foreign cases, men outnumbered women (3:1) and left-sided hernia was dominant (2:1). Moreover, in most of the foreign cases, patients were aged 50-70 years, whereas in the South Korean cases, none of the patients were in their 50 s. However, no substantial differences were found in etiology, anatomical locations, symptoms, and herniated contents." ]

[ "Does auricular acupuncture reduce postoperative vomiting after cholecystectomy?<||||>To find the efficacy of auricular acupuncture for the prevention of postoperative nausea and vomiting after cholecystectomy.", "Does auricular acupuncture reduce postoperative vomiting after cholecystectomy?<||||>One hundred (100) female patients undergoing transabdominal cholecystectomy were randomly allocated to two groups of 50 (auricular acupuncture treatment group and nontreatment group) in order to test the effectiveness of auricular acupuncture. Statistical significance (p<0.05) was determined using an unpaired t-test for age, weight, height, and duration of anesthesia; a chi-square test was used to analyze the incidence of vomiting.", "Does auricular acupuncture reduce postoperative vomiting after cholecystectomy?<||||>There was no significant difference in age, weight, height, or duration of anesthesia among the two groups of patients. There was a significant difference between the control and auricular acupuncture treatment groups in the incidence of vomiting 24 hours after surgery (66% and 0%, respectively, p<0.01). No noteworthy side effects from treatment were observed." ]

[ "Automatic exposure control in pediatric and adult computed tomography examinations: can we estimate organ and effective dose from mean MAS reduction?<||||>: The purpose of this study was (i) to measure absorbed dose to radiosensitive organs and estimate the effective dose associated with fixed tube current and automatic exposure control (AEC)-activated standard computed tomography (CT) examinations, and (ii) to investigate the relationship between the average reduction of tube current achieved by AEC and the reduction in organ and effective dose.", "Automatic exposure control in pediatric and adult computed tomography examinations: can we estimate organ and effective dose from mean MAS reduction?<||||>: Four physical anthropomorphic phantoms that represent the average individual as neonate, 1-year-old, 5-year-old, 10-year-old child, and the Rando phantom that simulates the average adult individual were employed. The phantoms were subjected to standard head and neck, thorax, and abdomen and pelvis scans using a 16-slice CT system. The scans were performed both with fixed tube current and with AEC. Dose measurements were performed for each scan using thermoluminescent dosimeters placed at internal locations in the phantoms and on the phantoms' surface. Dose measurements were performed for all radiosensitive organs according to the 2007 recommendations of the International Commission on Radiologic Protection. Effective dose was estimated on the basis of weighted sum of measured organ absorbed doses (EDMEAS). Percent reduction of organ absorbed dose and effective dose were compared with the mean percent reduction of the tube current.", "Automatic exposure control in pediatric and adult computed tomography examinations: can we estimate organ and effective dose from mean MAS reduction?<||||>: The percent organ dose reduction achieved when AEC was activated in standard head and neck CT scans ranged from 26.6% to 42% for neonate, 8.1% to 63.8% for 1-year-old, -2.9% to 22.5% for 5-year-old, -8.7% to 44.9% for 10-year-old, and 16.3% to 50.1% for an adult. The corresponding values for thorax scans were found to range from -26.1% to 9.9% for neonate, -2.5% to 37.7% for 1-year-old, -20.8% to 15.4% for 5-year-old, -61.9% to 9.3% for 10-year-old, and 5.6% to 42.2% for an adult, whereas the corresponding values for abdomen and pelvis scans were found to range from -12.1% to 29.1% for neonate, -4.9% to 26.6% for 1-year-old, -11.7% to 38.9% for 5-year-old, -62.4% to -17.3% for 10-year-old, and 31.0% to 56.8% for an adult. In neonate, the EDMEAS values ranged from 1.18 to 3.23 mSv for fixed tube current and 1.31 to 1.73 mSv for AEC scans. In 1-year-old phantom, the EDMEAS values ranged from 1.71 to 2.82 mSv for fixed tube current and 0.99 to 2.38 mSv for AEC scans. In 5-year-old phantom, the EDMEAS values ranged from 2.03 to 3.72 mSv for fixed tube current and 1.57 to 3.35 mSv for AEC scans. In 10-year-old phantom, the EDMEAS values ranged from 1.56 to 2.88 mSv for fixed tube current and 1.63 to 3.14 mSv for AEC scans. In adult phantom, the EDMEAS values ranged from 3.39 to 8.06 mSv for fixed tube current and 2.28 to 3.83 mSv for AEC scans. Mean mAs reduction is linearly related to the EDMEAS reduction (r = 0.807, P<0.0001). The absolute percent difference between percent tube current and %EDMEAS reduction was in most cases higher than 15%." ]

[ "The natural history of postischemic T-wave inversion: a predictor of poor short-term prognosis?<||||>This study followed up the natural history of T-wave inversion and assessed the short-term prognosis associated with the condition.", "The natural history of postischemic T-wave inversion: a predictor of poor short-term prognosis?<||||>Forty patients with acute ischemic syndrome, without infarction, and with postischemic T-wave inversion (group 1) were followed during the persistence (inverted T-wave period) and after the resolution of T-wave inversion (positive T-wave period). Another 40 patients with acute ischemic syndrome, without infarction and with normal T waves (group 2), were also followed.", "The natural history of postischemic T-wave inversion: a predictor of poor short-term prognosis?<||||>Postischemic inverted T waves showed resolution within 3-21 days of presentation in 31 patients from group 1 on medical treatment alone. Further ischemic events (acute myocardial infarction, acute ischemic syndrome, angina pectoris, silent ischemia), inducible ischemia (during treadmill test), wall-motion abnormalities (demonstrated by echocardiography), all developing in the primarily ischemic myocardial area, were more frequent (P<0.02) in group 1 patients during the inverted T-wave period compared with those experienced in the positive T-wave period of group 1 patients, and compared with group 2 patients." ]

[ "Should \"indeterminate\" diagnoses be used for thyroid fine-needle aspirates of nodules smaller than 1 cm?<||||>The Bethesda System for thyroid fine-needle aspirates does not account for the size of the lesion that is aspirated.", "Should \"indeterminate\" diagnoses be used for thyroid fine-needle aspirates of nodules smaller than 1 cm?<||||>To determine whether the size of the lesion would be helpful in order to reduce indeterminate thyroid aspirations.", "Should \"indeterminate\" diagnoses be used for thyroid fine-needle aspirates of nodules smaller than 1 cm?<||||>We correlated the results of all thyroid aspirations and surgical resection for the last 16 years at our institutions.", "Should \"indeterminate\" diagnoses be used for thyroid fine-needle aspirates of nodules smaller than 1 cm?<||||>A total of 9080 cases were aspirated and 1393 resections were performed. Of those resected, a total of 236 (17%) were classified as atypical follicular cells of undetermined significance, and 256 (18%) were classified as suspicious for a follicular/Hürthle cell neoplasm. A total of 52 incidental papillary carcinomas were identified in these indeterminate cases at resection (52 of 492; 11%). Thirty-seven (16%) atypical follicular cells of undetermined significance cases and 21 (8%) suspicious for a follicular/Hürthle cell neoplasm cases were for nodules smaller than 1 cm in diameter. When cases subtyped as atypical, a papillary carcinoma cannot be ruled out, were removed (13 cases), the remaining 24 and 21 aspirates identified 3 tumors each (13% and 14%), all papillary carcinomas. Together, the incidence of identified carcinomas was not significantly different than that of incidental carcinomas (13% versus 11%, P = .48). The rate of identified carcinomas was significantly less than for similar indeterminate cases smaller than 1 cm (excluding cases of atypical, papillary carcinoma cannot be ruled out) (88 of 330 cases; 27%; P = .05)." ]

[ "Altered monoamine system activities after prenatal and adult stress: A role for stress resilience?<||||>Prenatal stress (PNS) and stress in adulthood are risk factors for development of major depressive disorder. The present study aimed to 1) confirm previous neuroendocrine and behavioral changes induced by PNS, and 2) to characterize the effect of early- and late life stress on the in vivo activity of monoamine systems.", "Altered monoamine system activities after prenatal and adult stress: A role for stress resilience?<||||>Gestational dams were restrained thrice daily under bright illumination from gestational day (GD)11-20. Behavior and neuroendocrine responses to the forced swim test (FST) were determined in adult (50-80 days) offspring, and electrophysiological single unit recordings of dorsal raphe nucleus serotonin (5-HT), ventral tegmental area dopamine (DA) and locus coeruleus norepinephrine (NE) neurons were obtained at baseline and 24h after the FST.", "Altered monoamine system activities after prenatal and adult stress: A role for stress resilience?<||||>Gestational dams did not habituate to chronic restraint stress, and PNS reduced the birth weight of offspring. In adulthood, swim stress elevated CORT levels longer in PNS animals, while it had no effect on swim behaviors. Baseline firing activity of 5-HT neurons was decreased in PNS animals, while the firing activity of NE and DA neurons was increased. Swim stress had no effect on the firing on 5-HT neurons, but normalized the firing activity of catecholamine neurons in PNS animals." ]

[ "Outcomes of minimally invasive lung transplantation in a single centre: the routine approach for the future or do we still need clamshell incision?<||||>Minimally invasive lung transplantation (MILT) via bilateral anterior thoracotomies has emerged as a novel surgical strategy with potential patient benefits when compared with transverse thoracosternotomy (clamshell incision, CS). The aim of this study is to compare MILT with CS by focusing on operative characteristics, postoperative organ function and support and mid-term clinical outcomes at Harefield Hospital.", "Outcomes of minimally invasive lung transplantation in a single centre: the routine approach for the future or do we still need clamshell incision?<||||>It was a retrospective observational study evaluating all bilateral sequential lung transplants between April 2010 and November 2013.", "Outcomes of minimally invasive lung transplantation in a single centre: the routine approach for the future or do we still need clamshell incision?<||||>CS was performed in 124 patients and MILT in 70 patients. Skin-to-skin surgical time was less in the MILT group [285 (265, 339) min] compared with CS [380 (306, 565) min]and MILT-cardiopulmonary bypass [426 (360, 478) min]. Ischaemic time was significantly longer (502 ± 116 vs 395 ± 145 min) in the MILT group compared with CS (P<0.01). Early postoperative physiological variables were similar between groups. Patients in the MILT group required less blood [2 (0, 4) vs 3 (1, 5) units, P = 0.16] and platelet transfusion [0 (0, 1) vs 1 (0, 2) units, P<0.01]. The median duration of mechanical ventilation was shorter (26 vs 44 h, P<0.01) and intensive therapy unit stay was 2 days shorter (5 vs 7) in the MILT group. While overall survival was similar, fraction of expired volume in 1 s (FEV1) and forced vital capacity (FVC) were consistently higher in the MILT group compared with CS during mid-term follow-up after transplantation. Specifically, FEV1 and FVC were, respectively, 86 ± 21 and 88 ± 18% predicted in the MILT group compared with 74 ± 21 and 74 ± 19% predicted in the CS group (P<0.01) at the 6-month follow-up." ]

[ "Can oral fluid cannabinoid testing monitor medication compliance and/or cannabis smoking during oral THC and oromucosal Sativex administration?<||||>We characterize cannabinoid disposition in oral fluid (OF) after dronabinol, synthetic oral Δ(9)-tetrahydrocannabinol (THC), and Sativex, a cannabis-extract oromucosal spray, and evaluate whether smoked cannabis relapse or Sativex compliance can be identified with OF cannabinoid monitoring.", "Can oral fluid cannabinoid testing monitor medication compliance and/or cannabis smoking during oral THC and oromucosal Sativex administration?<||||>5 and 15 mg synthetic oral THC, low (5.4 mg THC, 5.0 mg cannabidiol (CBD)) and high (16.2 mg THC, 15.0 mg CBD) dose Sativex, and placebo were administered in random order (n=14). Oral fluid specimens were collected for 10.5 h after dosing and analyzed for THC, CBD, cannabinol (CBN), and 11-nor-9-carboxy-THC (THCCOOH).", "Can oral fluid cannabinoid testing monitor medication compliance and/or cannabis smoking during oral THC and oromucosal Sativex administration?<||||>After oral THC, OF THC concentrations decreased over time from baseline, reflecting residual THC excretion from previously self-administered smoked cannabis. CBD and CBN also were rarely detected. After Sativex, THC, CBD and CBN increased greatly, peaking at 0.25-1 h. Median CBD/THC and CBN/THC ratios were 0.82-1.34 and 0.04-0.06, respectively, reflecting cannabinoids' composition in Sativex. THCCOOH/THC ratios within 4.5 h post Sativex were ≤ 1.6 pg/ng, always lower than after oral THC and placebo. THCCOOH/THC ratios increased throughout each dosing session." ]

[ "Are women more at risk of false-positive primary aldosteronism screening and unnecessary suppression testing than men?<||||>Because primary aldosteronism is not uncommon, specifically treatable and in some cases curable, and carries higher risks for cardiovascular morbidity and mortality than essential hypertension, screening hypertensive patients for its presence by measuring aldosterone to renin ratio (ARR) is increasingly common. A significantly higher false-positive ARR rate for women than men, resulting in unnecessary suppression tests has previously been reported.", "Are women more at risk of false-positive primary aldosteronism screening and unnecessary suppression testing than men?<||||>Using a new, highly accurate aldosterone assay and both of the currently widely used renin assays, ARR was measured in 19 normal, ovulating women at three time points in the menstrual cycle and compared with single measurements in 21 normal males of similar age.", "Are women more at risk of false-positive primary aldosteronism screening and unnecessary suppression testing than men?<||||>ARRs in males were possibly too well down in the current normal range. Although normotensive and normokalemic, two women had raised ARRs in the luteal phase but only when direct renin concentration (DRC) was used. Their DRC levels were low at all sampling times [despite midrange plasma renin activity levels], whereas their progesterone and aldosterone levels were highest for the group. Saline suppression testing, performed in one of them, showed normal aldosterone suppressibility." ]

[ "Does eradication of Helicobacter pylori reduce the risk of carcinogenesis in the residual stomach after gastrectomy for early gastric cancer?<||||>After partial gastrectomy, the mucosa of the residual stomach usually undergoes severe changes, and these lesions are known to be pre-cancerous. Recently, Helicobacter pylori has been highlighted as an agent that induces such mucosal alterations. In the present study, we evaluated whether eradication of H. pylori reduced the risk of carcinogenesis.", "Does eradication of Helicobacter pylori reduce the risk of carcinogenesis in the residual stomach after gastrectomy for early gastric cancer?<||||>The subjects were 12 patients who underwent distal gastrectomy with Billroth I anastomosis for early gastric cancer and were positive for H. pylori. We performed endoscopy and biopsy both before and after H. pylori eradication therapy to assess changes in the gastric mucosa.", "Does eradication of Helicobacter pylori reduce the risk of carcinogenesis in the residual stomach after gastrectomy for early gastric cancer?<||||>After eradication therapy, no mucosal edema or erythema was detected. On histological examination, mononuclear cell infiltration had decreased and there was complete absence of neutrophil infiltration. The Ki-67 labeling index and the tissue IL-8 level had also decreased significantly, compared with before eradication." ]

[ "Are incorrectly used drugs more frequently involved in adverse drug reactions?<||||>The aims of this study were to identify and evaluate the frequency of drugs involved in adverse drug reactions (ADRs) for which recommendations of the Summary of Product Characteristics (SPC) had not been respected and to compare the percentages of drugs suspected of being the cause of ADRs when correctly and incorrectly used.", "Are incorrectly used drugs more frequently involved in adverse drug reactions?<||||>All ADRs reported to the Regional Pharmacovigilance Centre of Tours (RPC) over a period of 5 months were analysed to identify drugs used \"incorrectly\" defined by drug use beyond the recommendations of the SPC, i.e. drugs used when contra-indicated and/or drugs used for an off-label indication, and/or drugs used at an inappropriate dose, and/or inappropriate duration of treatment, and/or drugs used in the presence of a potentially or definitely interacting drug.", "Are incorrectly used drugs more frequently involved in adverse drug reactions?<||||>Included in the study were 182 ADRs involving 182 patients. Of 642 drugs, 169 (26%) were incorrectly used and for 81 patients (44.5%) ADRs involved at least one \"incorrectly\" used drug. These included 10% (64 of 642) drug interactions, 7.3% (47 of 642) off-licence indications, 5% (32 of 642) inadequate dosage, 3% (20 of 642) incorrect duration of treatment and 1% (6 of 642) contraindications. \"Correctly\" used drugs appeared to be less often the cause of the ADRs than \"incorrectly\" used drugs (59.4% versus 75%, P=0.0001)." ]

[ "Can 200 IU of hCG replace recombinant FSH in the late follicular phase in a GnRH-antagonist cycle?<||||>GnRH-antagonist protocols shorten the treatment period and reduce inconvenience for IVF patients. This randomised controlled trial (RCT) further explored whether low-dose hCG can be used clinically to replace recombinant FSH (rFSH) during the late follicular phase in a GnRH-antagonist protocol.", "Can 200 IU of hCG replace recombinant FSH in the late follicular phase in a GnRH-antagonist cycle?<||||>Seventy ICSI patients undergoing controlled ovarian stimulation (COS) in a GnRH-antagonist protocol was randomized into two groups. The control group received a standard treatment with rFSH (Puregon) plus a GnRH-antagonist, daily from Day 6 of stimulation. In the study group, rFSH was discontinued when six follicles>or=12 mm were observed and estradiol levels were>600 ng/l; rFSH was subsequently replaced by low-dose hCG (200 IU/l daily).", "Can 200 IU of hCG replace recombinant FSH in the late follicular phase in a GnRH-antagonist cycle?<||||>Mean values (SD) for dose and duration of rFSH treatment in the control versus low-dose hCG group were 1617 (280) versus 1273 (260) IU rFSH [between-group difference -344, 95% confidence interval (CI) -483 to -205; P<0.001], and 8.2 (1.6) versus 6.4 (1.3) days (-1.8, -2.6 to -1.1; P<0.001), respectively. The mean number of metaphase II oocytes of 10.1 versus 8.9 (between-group difference -1.2, 95% CI -3.9 to 1.5) and the ongoing pregnancy rates of 10/35 (29%) versus 13/35 (37%) (between-group difference 8.6%; 95% CI -13.0 to 29.1%; P = 0.45) for control versus hCG, respectively, did not differ." ]

[ "Micelle-associated protein in epoetin formulations: aA risk factor for immunogenicity?<||||>An upsurge of pure red cell aplasia (PRCA) cases associated with subcutaneous treatment with epoetin alpha has been reported. A formulation change introduced in 1998 is suspected to be the reason for the induction of antibodies that also neutralize the native protein. The aim of this study was to detect the mechanism by which the new formulation may induce these antibodies.", "Micelle-associated protein in epoetin formulations: aA risk factor for immunogenicity?<||||>Formulations of epoetin were subjected to gel permeation chromatography with UV detection, and the fractions were analyzed by an immunoassay for the presence of epoetin.", "Micelle-associated protein in epoetin formulations: aA risk factor for immunogenicity?<||||>The chromatograms showed that Eprex/Erypo contained micelles of Tween 80. A minute amount of epoetin (0.008-0.033% of the total epoetin content) coeluted with the micelles, as evidenced by ELISA. When 0.03% (w/v) Tween 80, corresponding to the concentration in the formulation, was added to the elution medium, the percentage of epoetin eluting before the main peak was 0.68%." ]

[ "Is leukemic transformation of donor cells possible?<||||>Standard cytogenetics and fluorescent hybridization in situ (FISH) with a probe to the centrometic sites of X/Y chromosomes were used in examination of 2 patients with acute promyelocytic and acute non-differentiated leukemia after allogenic TBM from donors of the opposite gender. Bone marrow was studied 1, 2, 3, 6, 9, 12, 15, 17, 18 months after the transplantation.", "Is leukemic transformation of donor cells possible?<||||>One of the patient in leukemia recurrence there were 72% cells with one X chromosome with unknown origin. 28% donor cells were with genotype XX. The primary archival cytological sample of the recipient's bone marrow 68% cells did not contain Y chromosome. Thus, the clone with Y loss is the recipient's clone and leukemia after transplantation developed from the recipient's cells. The other patient had only 8% dividing cells with her karyotype XX with translocation t(10;11) while 92% metaphases were donor's ones; the interphase cells ratio was 75% of host cells and 25% donor cells. This confirms leukemia origin from the recipient's cells." ]

[ "Do maternal parenting practices predict problematic patterns of adolescent alcohol consumption?<||||>This study examines whether a mother's style of parenting at child age 5 years predicts problematic patterns of drinking in adolescence, after controlling for relevant individual, maternal and social risk factors.", "Do maternal parenting practices predict problematic patterns of adolescent alcohol consumption?<||||>Data were used from the Mater-University Study of Pregnancy, an Australian longitudinal study of mothers and their children from pregnancy to when the children were 14 years of age. Logistic regression analyses examined whether maternal parenting practices at child age 5 predicted problematic drinking patterns in adolescence, after controlling for a range of confounding covariates.", "Do maternal parenting practices predict problematic patterns of adolescent alcohol consumption?<||||>Physical punishment at child age 5 did not predict adolescent alcohol problems at follow-up. Results indicated that low maternal control at child age 5 predicted adolescent occasional drinking patterns at age 14. More frequent maternal partner change coupled with lower levels of control was the strongest predictor of more problematic patterns of drinking by adolescents." ]

[ "Is collagen fiber damage the cause of early softening in articular cartilage?<||||>Because collagen damage and cartilage softening have not yet been determined simultaneously in one study for the very early onset of osteoarthritis (OA), it remains questionable whether they are associated. The aim of the present study is therefore to evaluate whether indeed, initial collagen damage can be found when tissue softening occurs as a result of excessive mechanical loading.", "Is collagen fiber damage the cause of early softening in articular cartilage?<||||>To investigate this aim, a series of specific indentation loading protocols were designed to induce and monitor cartilage softening in osteochondral explants of bovine carpometacarpal joints. The experiment contained one control group (n = 6) in which no damage was induced and four experimental groups in which samples received either a constant load of 3 (n = 5), 6 (n = 5) or 15 N (n = 6), or an increasing load (n = 7) from 2 to 13 N in 11 steps. Moreover, to determine mechanically induced collagen damage, Col2-3/4M (cumulative collagen damage) and Col2-3/4C(short) (only enzymatic damage) staining were compared.", "Is collagen fiber damage the cause of early softening in articular cartilage?<||||>The normalized peak and equilibrium reaction forces decreased in the groups that received increasing and 15 N peak loading. However, Col2-3/4M staining was negative in all samples, while enzymatic damage (Col2-3/4C(short)) appeared similar in experiments and in unloaded control groups." ]

[ "Intraarticular corticosteroid injection: pain relief in osteoarthritis of the hip?<||||>Osteoarthritis (OA) is one of the most common causes of morbidity in the elderly population, and surgery is often preceded by years of pain and disability. Intraarticular corticosteroid injections in osteoarthritic joints may play a role in the therapeutic plan and can afford quick pain relief but do not alter the underlying disease. There is a paucity of well controlled studies that provide recommendations for the use of corticosteroids in OA of the hip.", "Intraarticular corticosteroid injection: pain relief in osteoarthritis of the hip?<||||>A prospective analysis of 80 patients with OA of the hip and pain at rest and on bearing weight for more than 4 weeks was performed. Patients were randomized into 2 groups; group 1 (n = 40) received corticosteroid (80 mg triamcinolone acetonide) and group 2 (n = 40) local anesthetic (1% mepivacaine), injected into the hip joint under fluoroscopy. Pain, functional ability, range of motion of the joint, and analgesics consumed were registered 3 weeks postinjection. The treatment was blind for the patients and the investigators performing the followup.", "Intraarticular corticosteroid injection: pain relief in osteoarthritis of the hip?<||||>Pain for all modalities decreased after corticosteroid injection, but pain at rest decreased the most. There was significant pain reduction at the 3 (and 12) week followup. Joint range of motion increased significantly for all directions. Functional ability improved significantly after injection. We found no significant pain relief or improvement of functional ability in patients treated with local anesthetics." ]

[ "Nodules in the thickened greater omentum: a good indicator of lesions?<||||>In patients with unclear ascites, a thickened greater omentum with variable nodules is usually encountered with high-frequency insonation. The purpose of our study was to assess the importance of nodules in indicating the origin of ascites.", "Nodules in the thickened greater omentum: a good indicator of lesions?<||||>In patients suggested for a biopsy of the greater omentum, if nodules were found in the omentum, sonograms of the nodules were recorded, and during the biopsy, 2 passes were made for each procedure in the nodule and the thickest region without nodules, respectively. A biopsy was considered successful if a specific benign or malignant diagnosis was made.", "Nodules in the thickened greater omentum: a good indicator of lesions?<||||>In the 258 patients undergoing sonographically guided biopsies of the greater omentum from November 2001 to November 2008, the percentage of definitive diagnoses was 94.57% (244 of 258), and sonography showed nodules in 62 patients. Nodules were found more often by a 10-MHz transducer (62 cases) than by a 3.5-MHz transducer (15 cases). The percentage of definitive diagnoses by sonographically guided biopsies was 100% (62 of 62) at the sites of the nodules and decreased to 87.1% (54 of 62) at the sites without nodules. According to the pathologic results, 48 cases were peritoneal carcinomatosis, and 14 cases were tuberculous peritonitis. The sensitivity and specificity of nodules for indicating malignant ascites were 77.42% and 75.27%, respectively." ]

[ "Is low tie ligation truly reproducible in colorectal cancer surgery?<||||>One hundred CT angiographies of healthy patients were analysed for the anatomy of the IMA and its division branches: left colic artery (LCA), sigmoid arteries trunk and superior rectal artery. Data analysed comprised angles between the IMA and the aorta, diameters of the IMA and its branches, repartition of the branches and distances between the origin of the branches and the origin of the IMA.", "Is low tie ligation truly reproducible in colorectal cancer surgery?<||||>IMA anatomy showed no variation. In contrast, its division branches showed important variability in terms of distance to the origin and repartition: in 19.9% of the patients, the IMA directly splits into three branches, and in 17.6% of the patients, the LCA originated at more than 5 cm from the origin of the IMA. These frequent variations led us to assume that the standardization of LT is very difficult in a context of neoplasm, where the quality of the lymphadenectomy is fundamental." ]

[ "Mucosal nerve deficiency in chronic childhood constipation: a postmigration defect?<||||>Idiopathic chronic childhood constipation (ICCC) includes children who are severely constipated and who are resistant to behavioral or medical treatments. These children are distinguished from those with Hirschsprung's disease (HSCR) by the presence of enteric ganglia in rectal biopsy specimens. We investigated potential autonomic dysfunction by examining nerves in rectal mucosa.", "Mucosal nerve deficiency in chronic childhood constipation: a postmigration defect?<||||>Immunostaining, confocal microscopy, and nerve analysis were performed on formalin-fixed and on Zamboni-fixed rectal biopsy specimens from children who were severely constipated. A computer-assisted neuron tracing technique was used to determine mucosal nerve density in Zamboni-fixed biopsy sections.", "Mucosal nerve deficiency in chronic childhood constipation: a postmigration defect?<||||>Nerves in Zamboni-fixed biopsy specimens were better stained than in formalin-fixed biopsy specimens. Regardless of fixation method, a deficiency of mucosal nerves was observed in ICCC when compared to children who are not constipated. Analysis of autotraced mucosal nerves confirmed the deficiency in ICCC biopsy specimens. Mucosal nerves were also severely deficient in patients with HSCR, even in transitional segments that contained ganglia." ]

[ "Intracerebral Hematoma Due to Aneurysm Rupture: Are There Risk Factors Beyond Aneurysm Location?<||||>Along with subarachnoid hemorrhage (SAH), a ruptured aneurysm may also cause an intracerebral hematoma (ICH), which negatively impacts the functional outcome of SAH.", "Intracerebral Hematoma Due to Aneurysm Rupture: Are There Risk Factors Beyond Aneurysm Location?<||||>To identify independent risk factors of aneurysmal ICH.", "Intracerebral Hematoma Due to Aneurysm Rupture: Are There Risk Factors Beyond Aneurysm Location?<||||>Six hundred thirty-two consecutive patients with aneurysmal SAH treated at our institution from January 2005 to December 2012 were eligible for this study. Demographic parameters and preexisting comorbidities of patients, as well as various clinical and radiographic characteristics of SAH were correlated with the incidence and volume of aneurysmal ICH.", "Intracerebral Hematoma Due to Aneurysm Rupture: Are There Risk Factors Beyond Aneurysm Location?<||||>One hundred fifty-five patients (25%) had ICH on initial computed tomography with a mean volume of 26.7 mL (±26.8 mL). Occurrence and volume of ICH were associated with the location (distal anterior or middle cerebral artery>proximal anterior cerebral or internal carotid artery>posterior circulation, P<.001/P<.001) and size (>12 mm, P = .026/P<.001) of the ruptured aneurysm. Vascular risk factors independently increased the risk of ICH as well (arterial hypertension: odds ratio [OR] = 1.62, P = .032; diabetes mellitus: OR = 3.06, P = .009), while the use of aspirin (P = .037) correlated with the volume of ICH. The predictors of ICH were included into a risk score (0-9 points) that strongly predicted the occurrence of ICH (P = .01). Poor functional outcome after SAH was independently associated with the occurrence of ICH (P = .003, OR = 2.77) and its volume (P = .001, OR = 1.07 per-mL-increase)." ]

[ "Is neo-adjuvant chemotherapy a better option for management of cervical cancer patients of rural India?<||||>To explore alternate modality of treatment in patients of advanced cancer cervix by neo-adjuvant chemotherapy (NACT) followed by External Beam Radiotherapy (ERT) and Brachytherapy (BT). Short- (6 months) and long- (12 months) term follow-up data from these patients were compared with the retrospective data from an urban cancer centre, where standard protocol of concurrent chemo-radiotherapy is practiced.", "Is neo-adjuvant chemotherapy a better option for management of cervical cancer patients of rural India?<||||>Two hundred patients of advanced cervical cancer, treated at our rural cancer centre between January 2007 and December 2007, were included in the study arm (Group A). These patients received three cycles of neo-adjuvant chemotherapy with Cisplatin, Bleomycin, and Vincristine before External-Beam Radiotherapy (EBT) followed by brachytherapy. Patients in the control arm (Group B) of an urban cancer centre, received EBT with weekly concomitant Cisplatin, followed by brachytherapy. Short- (6 months) and long- (12 months) term follow-up data from our patients were compared with the retrospective data from the urban cancer centre.", "Is neo-adjuvant chemotherapy a better option for management of cervical cancer patients of rural India?<||||>Complete response rate was comparatively higher among patients of Group A, also correspondingly proportion of patients showing progressive disease and stable disease was lower among them. Local treatment failure was 87.5% among patients from Group A and 94.4% in Group B patients. Concomitant chemoradiation (CRT) was associated with more GI toxicities." ]

[ "Do maternal-fetal medicine practice characteristics influence high-risk referral decisions by general obstetrician-gynecologists?<||||>To determine whether the decision of the general obstetrician-gynecologist to refer high-risk obstetric patients depends on the type of practice of the maternal-fetal medicine (MFM) specialist.", "Do maternal-fetal medicine practice characteristics influence high-risk referral decisions by general obstetrician-gynecologists?<||||>A questionnaire was mailed to 935 general obstetrician-gynecologists who were asked whether the MFM specialist's practice characteristics would influence their decision to refer their high-risk obstetric patients. Potential MFM practice components presented in the survey included: MFM, high-risk obstetrics, low-risk obstetrics or general obstetrics and gynecology.", "Do maternal-fetal medicine practice characteristics influence high-risk referral decisions by general obstetrician-gynecologists?<||||>A total of 140 (15%) general obstetrician-gynecologists responded, 110 of whom were practicing obstetrics. Of the practicing responders, 77% stated that they were more likely to refer their high-risk obstetric patients if the MFM specialist practiced only MFM and high-risk obstetrics; 69% were less likely to refer their patients when the MFM specialist, in addition to MFM, practiced general obstetrics; and 75% were less likely to refer their patients when the MFM specialist also practiced general obstetrics and gynecology. The MFM practice setting (university vs. community hospital vs. private practice), as well as the geographic location and years of practice of the respondents, did not influence the general obstetrician-gynecologists' decision to refer their high-risk obstetric patients." ]

[ "Is it necessary to perform a lumbar puncture in the evaluation of the febrile newborn infant without source?<||||>Lumbar puncture to detect bacterial meningitis is a recommended screening procedure to be performed in febrile newborn infants at admission to hospital.", "Is it necessary to perform a lumbar puncture in the evaluation of the febrile newborn infant without source?<||||>To evaluate the usefulness of this procedure performed at admission and eventually, in a second look if clinically justified.", "Is it necessary to perform a lumbar puncture in the evaluation of the febrile newborn infant without source?<||||>There were studied 1,841 febrile newborns consulting at the Emergency Department from January 1992 to December 2000 without source. All of them underwent a sepsis workup. The rate of meningitis incidence was calculated, and we analyzed the frequency of meningitis diagnosed in the initial evaluation and reappraisal.", "Is it necessary to perform a lumbar puncture in the evaluation of the febrile newborn infant without source?<||||>There were 206 febrile patients with diagnosis of meningitis for an incidence of 11.2%, which 20 were bacterial (1.1%) and 186 aseptic meningitis (10.1%). In the initial evaluation 155 patients were diagnosed with meningitis (155/ 1.774 = 8.7%) and in reappraisal (mean 39,5 +/- 25,2 hours after) there were diagnosed another 51 cases (51/ 135 = 37.8%)." ]

[ "Indeterminate CT angiography in blunt thoracic trauma: is CT angiography enough?<||||>The primary objective of our study was to determine whether catheter angiography is needed to exclude aortic and intrathoracic great vessel injury when CT angiography (CTA) findings are indeterminate (mediastinal hematoma without direct evidence of aortic or intrathoracic great vessel injury). The secondary objective was to devise a classification scheme for mediastinal hematomas.", "Indeterminate CT angiography in blunt thoracic trauma: is CT angiography enough?<||||>This study is a retrospective analysis of patients presenting with blunt trauma over 4.5 years at a level 1 trauma center. Indeterminate CTA findings in patients with blunt injury were identified through a database search of imaging reports. CTA findings and final outcomes, including catheter angiography and clinicopathologic records, were reviewed independently by blinded observers.", "Indeterminate CT angiography in blunt thoracic trauma: is CT angiography enough?<||||>One hundred seven patients (age range, 11-88 years) met the inclusion criteria. Seventy-two (age range, 15-88 years) had a reference standard of subsequent catheter angiography, and 35 subjects (age range, 11-87 years) did not undergo catheter angiography and therefore had a reference standard of clinicopathologic review. No subjects with isolated mediastinal hematoma on CTA had aortic or intrathoracic great vessel injury, for a positive predictive value of 0% (95% CI, 0-0.028). Using our proposed classification scheme, we found a direct correlation between the percentage of cases that underwent catheter angiography and hematoma severity." ]

[ "Diagnosing autoimmune hepatitis in children: is the International Autoimmune Hepatitis Group scoring system useful?<||||>In 1999, the International Autoimmune Hepatitis Group (IAIHG) modified a scoring system to differentiate adult patients with definite or probable autoimmune hepatitis (AIH) from those with other forms of chronic liver disease. We assessed the use of the scoring system in children.", "Diagnosing autoimmune hepatitis in children: is the International Autoimmune Hepatitis Group scoring system useful?<||||>Twenty-eight pediatric patients with AIH and/or sclerosing cholangitis were reviewed. Clinical, laboratory, and histologic data were collected to score patients both before and after standard treatment.", "Diagnosing autoimmune hepatitis in children: is the International Autoimmune Hepatitis Group scoring system useful?<||||>There were 8 boys and 20 girls. The median age at diagnosis was 11 years (range, 2-16 years). Twenty-one of 28 children were diagnosed with AIH, 4 as isolated primary sclerosing cholangitis (PSC), and 3 as overlap syndrome. At presentation, 18 of 21 (86%) with AIH scored as definite AIH and 3 of 21 (14%) scored as probable. No patient clinically diagnosed as AIH scored as other. Seven of 28 patients had proven PSC. All patients with isolated PSC scored as other. The 3 with overlap syndrome scored as definite AIH. When the gamma-glutamyltranspeptidase (GGT) ratio was substituted for the alkaline phosphatase (ALP) ratio, 5 patients were reclassified from definite to probable AIH. Four of these 5 had an incomplete response to therapy, and 2 of 4 have confirmed overlap syndrome." ]

[ "Is laparoscopic appendectomy an effective procedure?<||||>We retrospectively analysed the computerised data of 326 consecutive adult patients operated on for suspected appendicitis between 2001 and 2005. The series consisted of 166 men and 160 women with a mean age of 32 +/- 16 years and a mean Body Mass Index (BMI) of 24 +/- 4. There were 265 ASA I, 46 ASA II and 5 ASA III patients. According to the surgeon's preference, 176 patients had an open appendectomy (OA) and 150 a laparoscopic appendectomy (LA).", "Is laparoscopic appendectomy an effective procedure?<||||>The mean operative time and hospital stay were equivalent in the two groups : respectively 49 +/- 19 min. and 4.1 +/- 2.5 days in OA and 50 +/- 16 min. and 3.5 +/- 1.8 days in LA. However, subgroup analysis revealed that overweight (BMI>25) patients (n = 102) and patients with ectopic appendices (n = 86) had an obvious benefit from LA. In cases of OA, operative time and hospital stay were longer in overweight patients than in normal weight patients: respectively 63 +/- 20 min. and 5.3 +/- 2.9 days versus 44 +/- 16 min. (p<0.01) and 3.7 +/- 2.2 days (p<0.01). On the contrary, no difference was observed in the LA group. Operative time and hospital stay were also longer in patients with ectopic appendices submitted to OA than in patients with an appendix in the normal position: respectively 60 +/- 18 min. and 4.7 +/- 2.7 days versus 45 +/- 18 min. (p<0.01) and 3.9 +/- 2.4 days (p<0.01). Again, such a difference was not observed in cases of LA. We noted no mortality, but 24 patients (7%) developed an abdominal complication : 18 wound infections and 6 intra-abdominal abscesses. Wound infections were more common in the OA than in the LA group : 7.3% (13/176) versus 3.3% (5/150) (p = 0.1). In the LA group, 4 wound infections were observed in our early experience, at a time where no endoscopic bag was used for the removal of the appendix. The rate of intra-abdominal abscesses was similar: 1.7% (3/176) in the OA group and 2% (3/150) in the LA group." ]

[ "Is right-sided laparoendoscopic single-site donor nephrectomy feasible?<||||>To present our initial experience with right-sided laparoendoscopic single-site donor nephrectomy (LESS-RDN). Laparoendoscopic single-site (LESS) donor nephrectomy, although in its infancy, represents a potential exciting advancement over conventional laparoscopic donor nephrectomy (LDN). Almost all of the reported cases thus far have been left-sided kidneys.", "Is right-sided laparoendoscopic single-site donor nephrectomy feasible?<||||>Between August 2009 and June 2010, a total of 85 consecutive LESS DN were performed. Of these, 6 (7%) were LESS-RDN. Donor outcomes analyzed included operative time, estimated blood loss, complications, visual analog pain scores, and recovery time. Renal vein lengths were measured on preoperative computed tomography scans. Recipient outcomes analyzed included recipient creatinine at discharge and at 1 and 3 months. All data were prospectively accrued in an institutional review board-approved database.", "Is right-sided laparoendoscopic single-site donor nephrectomy feasible?<||||>Five LESS-RDN were successfully performed. One case was converted to hand-assisted laparoscopy to optimize hilar dissection. The mean (± SE) operative time until allograft extraction was 89 ± 5.1 minutes, total operative time was 146 ± 12.8 minutes, warm ischemia time was 3.9 ± 0.2 minutes, and estimated blood loss was 92 ± 27 mL. The mean renal vein length was 2.7 ± 0.3 cm. There were no perioperative complications. All allografts functioned after transplantation. When compared with a matched cohort of LESS-LDN, there was no difference in allograft function at discharge and at 1 and 3 months." ]

[ "Is Maternal Blood Procalcitonin Level a Reliable Predictor for Early Onset Neonatal Sepsis in Preterm Premature Rupture of Membranes?<||||>This study is aimed at comparing the early diagnostic accuracy of maternal blood white blood cell (WBC) count, C-reactive protein (CRP) and procalcitonin in predicting early onset neonatal sepsis (EONS) among early preterm premature rupture of membrane (PPROM) pregnancies.", "Is Maternal Blood Procalcitonin Level a Reliable Predictor for Early Onset Neonatal Sepsis in Preterm Premature Rupture of Membranes?<||||>A total of 57 consecutive pregnancies, complicated with PPROM, between 24 and 34 gestational weeks were recruited to the study at Suleymaniye Maternity Education and Research Hospital, Istanbul, Turkey between January 2012 and January 2013. All patients were hospitalized and followed up with expectant management. Maternal blood WBC count, CRP and procalcitonin levels were measured in the first 12 h of membrane rupture. EONS was diagnosed using clinical and laboratory findings, and obstetric and neonatal outcomes were noted.", "Is Maternal Blood Procalcitonin Level a Reliable Predictor for Early Onset Neonatal Sepsis in Preterm Premature Rupture of Membranes?<||||>The cutoff value for maternal blood CRP was ≥9.49 mg/dl. This value predicted EONS with 77.8% sensitivity, 80.0% specificity, 77.8% positive predictive value (PPV) and 80.0% negative predictive value (NPV). The cutoff value for maternal blood procalcitonin was 0.071 ng/ml. This value predicted EONS with 85.2% sensitivity, 86.7% specificity, 85.2% PPV and 86.7% NPV." ]

[ "Should we try to determine the specific cause of cardiac tamponade?<||||>The causes of cardiac tamponade vary and it has been suggested that underlying causes should be sought in all cases. The purpose of this study was to determine the causes of cardiac tamponade in our environment, distinguishing between specific and idiopathic causes, and analyzing the proportion and causes in the subgroup of patients with relapsing tamponade.", "Should we try to determine the specific cause of cardiac tamponade?<||||>We retrospectively studied all patients who underwent therapeutic pericardiocentesis between 1985 and 2001. The clinical and radiographic features and macroscopic characteristics of the pericardial fluid were analyzed. The final diagnosis in each patient was based on the clinical history, follow-up, pericardial fluid cytology, and pericardial biopsy, if available.", "Should we try to determine the specific cause of cardiac tamponade?<||||>Ninety-six patients were included (52 men/44 women), mean age 56.1 16.1 years. The cause of pericardial effusion was neoplasm in 50 patients (52.1%), 14 idiopathic pericarditis (14.6%), 12 renal failure (12.5%), 7 iatrogenic cases (7.3%), 4 mechanical tamponades (4.2%), 2 tuberculosis (2.1%), and 7 other causes (7.3%). Thirty-five patients had relapsing tamponade; only 2 of them had idiopathic pericarditis (5.7%). We found no significant differences in age, development time, extracted volume or fluid features between tamponade of specific or idiopathic origin." ]

[ "Urinary prostate specific antigen: is the clinical use likely?<||||>Prostate specific antigen (PSA) blood test represents the standard procedure in prostate cancer (CaP) diagnosis and follow-up. However, determination of PSA in the urine, where PSA is present in much higher concentrations than in the blood, still remains in the field of research.", "Urinary prostate specific antigen: is the clinical use likely?<||||>To determine urinary concentrations of PSA (uPSA) in different groups of patients (pts.), and to estimate is it possible to differentiate benign and malignant prostate diseases and to follow-up the results of treatment.", "Urinary prostate specific antigen: is the clinical use likely?<||||>Between January 2001. and November 2003., urinary concentrations of PSA were determined at 142 pts. divided in seven groups: 1. young and healthy volunteers, 2. \"BPH-24\": pts. with benign prostatic hyperplasia (BPH) who collected the sample of 24-hour voided urine, 3. \"BPH-I\": pts. with BPH who collected the first portion of first urinary voiding, 4. \"TRUS-CaP\": pts. with CaP which gave the first portion of urine just prior to transrectal ultrasound-guided prostate biopsy (TRUS- biopsy), 5. \"TRUS-non-CaP\": pts. who gave first portion of urine prior to TRUS-biopsy, but biopsy did not prove the presence of CaP, 6. \"RRP\": pts. who underwent radical retropubic prostatectomy (RRP), 7. \"AAT\": pts. who underwent androgen deprivation therapy.", "Urinary prostate specific antigen: is the clinical use likely?<||||>Average uPSA value in the group of young and healthy volunteers, was 13.8 +/- 19.6 ng/ml, in \"BPH-24\": 38.0 +/- 44.4 ng/ml, in \"BPH-I\": 140.8 +/- 140.9 ng/ml, in \"TRUS-CaP\": 234.8 +/- 277.7 ng/ml, in TRUS-non-CaP: 113.1 +/- 148.5 ng/ml, and in the group \"RRP\": 4.4 +/- 4.7 ng/ml. There was no statistically significant difference of average uPSA values between \"BPH-I\" and \"TRUS-CaP\" groups. The significant difference was found between the group of young volunteers and \"BPH-I\". In \"TRUS-CaP\" group, there was strong correlation between tumour size and aggressivenes and uPSA concentration. Finally, PSA and uPSA decline during androgen deprivation therapy, strongly correlated (up to r = 0.95)." ]

[ "Can Patients Comprehend the Educational Materials that Hospitals Provide about Common IR Procedures?<||||>To assess the readability of online education materials offered by hospitals describing commonly performed interventional radiology (IR) procedures.", "Can Patients Comprehend the Educational Materials that Hospitals Provide about Common IR Procedures?<||||>Online patient education materials from 402 hospitals selected from the Medicare Hospital Compare database were assessed. The presence of an IR service was determined by representation in the Society of Interventional Radiology physician finder directory. Patient online education materials about (i) uterine artery embolization for fibroid tumors, (ii) liver cancer embolization, (iii) varicose vein treatment, (iv) central venous access, (v) inferior vena cava (IVC) filter placement, (vi) nephrostomy tube insertion, (vii) gastrostomy tube placement, and (viii) vertebral augmentation were targeted and assessed by using six validated readability scoring systems.", "Can Patients Comprehend the Educational Materials that Hospitals Provide about Common IR Procedures?<||||>Of 402 hospitals sampled, 156 (39%) were presumed to offer IR services. Of these, 119 (76%) offered online patient education material for one or more of the eight service lines. The average readability scores corresponding to grade varied between the ninth- and 12th-grade levels. All were higher than the recommended seventh-grade level (P<.05) except for nephrostomy and gastrostomy tube placement. Average Flesch-Kincaid Reading Ease scores ranged from 42 to 69, corresponding with fairly difficult to difficult readability for all service lines except IVC filter and gastrostomy tube placement, which corresponded with standard readability." ]

[ "Does off-pump coronary surgery reduce postoperative acute renal failure?<||||>Off-pump was compared with on-pump coronary artery bypass graft surgery to evaluate the impact of cardiopulmonary bypass on the incidence of postoperative acute renal failure (ARF).", "Does off-pump coronary surgery reduce postoperative acute renal failure?<||||>From November 1994 to December 2001, 2,943 patients having multivessel surgical disease underwent myocardial revascularization. Ninety patients were excluded because of incompleteness of data, intraoperative death, or preoperative chronic dialysis. The analysis was split: one analysis included 1,724 (862 each group) of 2,618 patients with normal preoperative creatinine (<1.5 mg/dL), and the second analysis included 160 (80 each group) of 215 patients with preoperative abnormal renal function; in both analyses matched groups were selected applying propensity score.", "Does off-pump coronary surgery reduce postoperative acute renal failure?<||||>In the group with normal preoperative creatinine, the incidence of 30-day ARF was 5.4% (2.9% off-pump versus 7.9% on-pump; p<0.001). Stepwise logistic regression confirmed that cardiopulmonary bypass was an independent variable for increased postoperative ARF incidence (odds ratio, 3.3), as well as age and reduced left ventricular ejection fraction. Receiver operating characteristic curves showed that cardiopulmonary bypass duration was a predictor of higher ARF incidence (area under the curve, 0.79) with a cutoff value of 66 minutes. In the patients with abnormal renal function preoperatively, the incidence of ARF was similar between the groups (16.3% on-pump versus 12.5% off-pump; p = 0.499). Acute renal failure had an important impact on early (odds ratio, 3.6) and late mortality (hazard ratio, 4.1)." ]

[ "Do psychiatric patients improve their competency to consent to hospitalization after admission?<||||>Competency to consent to hospitalization has important clinical and ethical implications. However, there are no follow-up studies that evaluate improvement in competency during psychiatric hospitalization. The authors sought to determine whether patients admitted to a psychiatric ward as incompetent to consent to hospitalization improve their competency during hospitalization.", "Do psychiatric patients improve their competency to consent to hospitalization after admission?<||||>A total of 160 consecutively admitted patients were administered the Competency Questionnaire (CQ), a structured scale designed to assess competency to consent to psychiatric hospitalization. The CQ was administered both upon admission and at discharge. Severity and acuity of the psychiatric disorder were assessed with the Severity of Psychiatric Illness Scale and the Acuity of Psychiatric Illness Scale.", "Do psychiatric patients improve their competency to consent to hospitalization after admission?<||||>Of the 160 assessed patients, 70 (43.8%) were rated incompetent. Forty-five of these 70 incompetent patients completed the admission-to-discharge follow-up. Twenty-one of these 45 patients (46.6%) remained incompetent at discharge. Participation in the treatment process was the only variable that predicted improvement on competency during hospitalization. Severity of psychiatric illness at admission did not predict improvement on competency." ]

[ "The relationship between preoperative and primary care blood pressure among veterans presenting from home for surgery: is there evidence for anesthesiologist-initiated blood pressure referral?<||||>American College of Cardiology/American Heart Association guidelines describe the perioperative evaluation as \"a unique opportunity to identify patients with hypertension\"; however, factors such as anticipatory stress or medication noncompliance may induce a bias toward higher blood pressure, leaving clinicians unsure about how to interpret preoperative hypertension. Information describing the relationship between preoperative intake blood pressure and primary care measurements could help anesthesiologists make primary care referrals for improved blood pressure control in an evidence-based fashion. We hypothesized that the preoperative examination provides a useful basis for initiating primary care blood pressure referral.", "The relationship between preoperative and primary care blood pressure among veterans presenting from home for surgery: is there evidence for anesthesiologist-initiated blood pressure referral?<||||>We analyzed retrospective data on 2807 patients who arrived from home for surgery and who were subsequently evaluated within 6 months after surgery in the primary care center of the same institution. After descriptive analysis, we conducted multiple linear regression analysis to identify day-of-surgery (DOS) factors associated with subsequent primary care blood pressure. We calculated the sensitivity, specificity, and positive and negative predictive value of different blood pressure referral thresholds using both a single-measurement and a 2-stage screen incorporating recent preoperative and DOS measurements for identifying patients with subsequently elevated primary care blood pressure.", "The relationship between preoperative and primary care blood pressure among veterans presenting from home for surgery: is there evidence for anesthesiologist-initiated blood pressure referral?<||||>DOS systolic blood pressure (SBP) was higher than subsequent primary care SBP by a mean bias of 5.5 mm Hg (95% limits of agreement + 43.8 to -32.8). DOS diastolic blood pressure (DBP) was higher than subsequent primary care DBP by a mean bias of 1.5 mm Hg (95% limits of agreement +13.0 to -10.0). Linear regression of DOS factors explained 19% of the variability in primary care SBP and 29% of the variability in DBP. Accounting for the observed bias, a 2-stage SBP referral screen requiring preoperative clinic SBP ≥140 mm Hg and DOS SBP ≥146 mm Hg had 95.9% estimated specificity (95% confidence interval [CI] 94.4 to 97.0) for identifying subsequent primary care SBP ≥140 mm Hg and estimated sensitivity of 26.8% (95% CI 22.0 to 32.0). A similarly high specificity using a single DOS SBP required a threshold SBP ≥160 mm Hg, for which estimated specificity was 95.2% (95% CI 94.2 to 96.1). For DBP, a presenting DOS DBP ≥92 mm Hg had 95.7% specificity (95% CI 94.8 to 96.4) for subsequent primary care DBP ≥90 mm Hg with a sensitivity of 18.8% (95% CI 14.4 to 24.0)." ]

[ "Is there an ectopic secretion of monomeric calcitonin in the human being?<||||>Persistent detectable calcitonin (CT) values can be frequently observed after treatment of medullary thyroid carcinomas (MTCs). Apart from residual C cells or incomplete tumor extirpation, ectopic CT production should be taken into account. CT determination in patients without MTC and after total thyroidectomy should reveal to what extent, apart from the C cells, other neuroendocrine cells show a relevant CT production.", "Is there an ectopic secretion of monomeric calcitonin in the human being?<||||>The objective of this study was to find out whether ectopic CT production can be detected using an assay specifically recognizing the monomeric form of CT.", "Is there an ectopic secretion of monomeric calcitonin in the human being?<||||>The CT serum values were obtained from 94 healthy individuals and 64 patients who had undergone total thyroidectomy and radioiodine therapy because of follicular or papillary carcinoma.", "Is there an ectopic secretion of monomeric calcitonin in the human being?<||||>In the group of thyroidectomized patients, the CT values were below the detection limit of the assay. In the tested patients, there was neither a physiological (C cell) nor a pathological (MTC cell) secretion of monomeric CT." ]

[ "Acute smoking induces endothelial dysfunction in healthy smokers. Is this reversible by red wine's antioxidant constituents?<||||>Acute smoking causes endothelial dysfunction through impairment of nitric oxide (NO) production, or increased oxidative stress, but the exact mechanism still needs to be elucidated. In healthy non-smokers acute endothelial dysfunction caused by smoking one cigarette was counterbalanced by red wine's antioxidants. The aim of the present study is to investigate whether red wine's antioxidant substances could counteract the acute endothelial dysfunction induced by acute cigarette smoking in healthy smokers as well.", "Acute smoking induces endothelial dysfunction in healthy smokers. Is this reversible by red wine's antioxidant constituents?<||||>Twenty healthy volunteers (12 males) participated in a double-blind, cross-over study, comprised of three study days. All subjects either smoked one cigarette, or smoked and drank 250 ml of red wine, or smoked and drank 250 ml of dealcoholized red wine in each one of the study days. Flow mediated dilatation (FMD) was measured at fast and 30, 60 and 90 minutes after each trial.", "Acute smoking induces endothelial dysfunction in healthy smokers. Is this reversible by red wine's antioxidant constituents?<||||>Smoking one cigarette induced a significant decrease in FMD (p<0.001), which remained significant 30 (p<0.001), and 60 (p = 0.003) minutes after the end of smoking. FMD remained statistically unchanged after consumption of either regular red wine, or dealcoholized red wine together with smoking." ]

[ "Do we really need plain and soft-tissue radiographies to detect radiolucent foreign bodies in the ED?<||||>The objective of this study was to compare 3 imaging techniques-plain radiography, soft-tissue radiography, and ultrasonography-in detecting nonradiopaque foreign bodies in soft tissue.", "Do we really need plain and soft-tissue radiographies to detect radiolucent foreign bodies in the ED?<||||>In this randomized, blinded, and descriptive in vitro study, 40 chicken thighs with 2 types of nonradiopaque foreign bodies (wood and rubber) and 40 chicken thighs as part of a control group were evaluated to detect soft-tissue foreign bodies with plain radiography, soft-tissue radiography, and high-frequency ultrasonography.", "Do we really need plain and soft-tissue radiographies to detect radiolucent foreign bodies in the ED?<||||>The overall sensitivity, specificity, as well as positive predictive and negative predictive values of plain radiography for both nonradiopaque foreign bodies were 5%, 90%, 33%, and 48%, respectively; those of soft-tissue radiography for both nonradiopaque foreign bodies were 5%, 90%, 33%, and 48%, respectively; and those of ultrasonography for both nonradiopaque foreign bodies were 90%, 80%, 81%, and 89%, respectively." ]

[ "Are scoop stretchers suitable for use on spine-injured patients?<||||>In the prehospital setting, spine-injured patients must be transferred to a spine board to immobilize the spine. This can be accomplished using both manual techniques and mechanical devices.", "Are scoop stretchers suitable for use on spine-injured patients?<||||>The study aimed to evaluate the effectiveness of the scoop stretcher to limit cervical spine motion as compared to 2 commonly used manual transfer techniques.", "Are scoop stretchers suitable for use on spine-injured patients?<||||>Three-dimensional angular motion generated across the C5-C6 spinal segment during execution of 2 manual transfer techniques and the application of a scoop stretcher was recorded first on cadavers with intact spines and then repeated after C5-C6 destabilization. A 3-dimensional electromagnetic tracking device was used to measure the maximum angular and linear motion produced during all test sessions.", "Are scoop stretchers suitable for use on spine-injured patients?<||||>Although not statistically significant, the execution of the log roll maneuver created more motion in all directions than either the lift-and-slide technique or with scoop stretcher application. The scoop stretcher and lift-and-slide techniques were able to restrict motion to a comparable degree." ]

[ "Hearing thresholds in sickle cell anemia patients: emerging new trends?<||||>Advances in medicine resulting in better understanding of sickle cell disease and general improvement of the well-being of the sufferers even in the developing countries have positively affected the dreadful outlook of this disease with resultant increase in the population of sickle cell disease patients reaching adulthood, and less severe complications. We therefore set out to evaluate the presence and severity of sensorineural hearing loss in sickle cell anemia (SCA) patients in the light of the overall improvement in the morbidity and mortality.", "Hearing thresholds in sickle cell anemia patients: emerging new trends?<||||>A prospective case control study of SCA patients attending our adult SCA clinic and control subjects from homozygous hemoglobin AA patients attending the staff clinic of the hospital for routine medical tests. Tympanometry and diagnostic audiometry were performed on each patient.", "Hearing thresholds in sickle cell anemia patients: emerging new trends?<||||>Forty-six SCA patients (21 males, 45.7%) aged 16-48 years with a mean age of 22.9 years +/- 6.45 and 42 controls (24 males, 57.1%) aged 15-39 years with a mean age of 23.7 years +/- 5.69 were included in this study. The average hearing thresholds of SCA patients were consistently higher than controls in all frequencies tested in both right and left ears. Of the 92 ears of SCA patients tested, 95.7% exhibited hearing thresholds within normal limits, and 4.3% had mild hearing loss. The controls had thresholds within normal limits." ]

[ "The relationship between apelin and cardiac parameters in patients on peritoneal dialysis: is there a new cardiac marker?<||||>Many markers have been proposed for CVD risk assessment in dialysis population. Apelin is a peptide that has roles in cardiovascular functions and volume regulation namely vasodilation, decreased blood pressure (BP), positive inotropic effect and inhibition of antidiuretic hormone release. The aim of this study was to examine relationship of apelin levels with echocardiographic findings and laboratory parameters related with cardiovascular function and bone mineral metabolism among peritoneal dialysis (PD) patients.", "The relationship between apelin and cardiac parameters in patients on peritoneal dialysis: is there a new cardiac marker?<||||>This is a cross-sectional study in which chronic PD patients aged between 18 and 80 without active cardiac, infectious or malignant diseases and hypervolemia have been included. Apelin-36 levels and echocardiographic findings were recorded as well as clinical and laboratory data.", "The relationship between apelin and cardiac parameters in patients on peritoneal dialysis: is there a new cardiac marker?<||||>Of the 53 patients, the mean age and female/male ratio was 52.8 ± 15.3 years and 30/23, respectively. Mean apelin level was 1.45 ± 0.37 ng/ml. Gender, drugs (renin-angiotensin-aldosteron inhibitors, statins), presence of left ventricular hypertrophy, diabetes mellitus, hypertension, hyperlipidemia and significant residual renal function did not affect apelin-36 levels. Apelin-36 was correlated negatively with age and left atrium diameter; and positively with diastolic BP, ejection fraction (EF), total cholesterol, LDL-cholesterol, HDL-cholesterol, parathyroid hormone and alkaline phosphatase (ALP) levels. Diastolic BP, LDL-cholesterol, ALP and EF were found to be the independent determinants of apelin-36 levels with linear regression analysis." ]

[ "Do we need fractionation-corrected doses in sequential two-phase treatments?<||||>For many tumour sites, external beam radiation therapy (EBRT) is delivered with a sequential two-phase treatment regime. Yet, there is a lack of consensus of how to add two different non-uniform dose distributions in order to evaluate the late radiation effect for normal tissue. The purpose of this novel investigation is to quantify the dose differences between non-corrected and fractionation-corrected combined non-uniform dose distributions.", "Do we need fractionation-corrected doses in sequential two-phase treatments?<||||>We used a model of an organ at risk (OAR) located in six different positions relative the treated volume giving 16 clinically representative two-phase treatment situations (46 Gy + 22 Gy). The linear-quadratic model was applied to correct for fractionation effects in each voxel before the doses were added. Dose differences were quantified using mean and maximum doses with corresponding fractionation-corrected doses as reference.", "Do we need fractionation-corrected doses in sequential two-phase treatments?<||||>Non-corrected doses were higher than fractionation-corrected doses in all treatment situations (mean dose: p<0.001; maximum dose: p=0.003). With the OAR outside the treated volume, non-corrected doses were 3-6 Gy higher representing 10-50% of the reference dose (10-25 Gy); with the OAR included in the treated volume, 1-6 Gy higher representing 1-15% (30-60 Gy). Mean dose differences were generally larger than maximum dose differences." ]