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[ "Do junior house officers routinely test visual acuity and perform ophthalmoscopy?<||||>Our objective was to assess junior house officer (JHO) practice of visual acuity testing and ophthalmoscopy in clerking patients.", "Do junior house officers routinely test visual acuity and perform ophthalmoscopy?<||||>Cross-sectional questionnaire-based study using a standardised structured interview technique.", "Do junior house officers routinely test visual acuity and perform ophthalmoscopy?<||||>A Scottish university teaching hospital employing 65 JHOs.", "Do junior house officers routinely test visual acuity and perform ophthalmoscopy?<||||>All medical and surgical JHOs from this hospital were interviewed over a three month period.", "Do junior house officers routinely test visual acuity and perform ophthalmoscopy?<||||>Questionnaire-based data on the subjective responses studying current practice of visual acuity testing, and direct ophthalmoscopy with and without topical mydriatics.", "Do junior house officers routinely test visual acuity and perform ophthalmoscopy?<||||>18.5% and 4.6% of participants perform daily ophthalmoscopy and visual acuity testing respectively. Most do not routinely use the Snellen chart (80.0%) or topical mydriatics during ophthalmoscopy (75.4%). JHOs claimed these were not easily available in the wards." ]

[ "Does spouse participation influence quality of life reporting in patients with Parkinson's disease?<||||>To investigate whether patient-spouse co-reporting (patient reporting with assistance from their spouse) results in the same ratings of health-related quality of life (HRQoL) as patient ratings without co-reporting, and to assess whether mutuality of the marital relationship is a determinant of co-reported ratings. Patients are the best source of HRQoL; however, co-reporting is common in clinical settings, but has not been compared to independent patient reporting of HRQoL.", "Does spouse participation influence quality of life reporting in patients with Parkinson's disease?<||||>Fifty-nine Parkinson's disease (PD) patient-spouse pairs completed the Short Form Health Status Survey (SF-12), measuring mental and physical HRQoL. Initially, the patient and spouse completed the SF-12 independently (about the patient). Then, patient-spouse pairs completed the SF-12 together assessing the patient's HRQoL. Patients and spouses independently completed the Mutuality Scale rating the intimacy of their relationship.", "Does spouse participation influence quality of life reporting in patients with Parkinson's disease?<||||>Patients rated physical HRQoL higher (M = 46.6) than spouses alone (M = 43.4, p<0.01) and co-reporting (M = 44.8, p<0.05). Co-reporting rated physical HRQoL in between that of patients and spouses, (p<0.05). Spouses who reported greater mutuality showed greater concordance with the patient regarding the patient's mental HRQoL (B = -0.43, p<0.05)." ]

[ "Information technologies in Florida's rural hospitals: does system affiliation matter?<||||>The recent explosive growth of information technology in hospitals promises to improve hospital and patient outcomes. Financial barriers may cause rural hospitals to lag in adoption of information technology, however, formal studies that examine rural hospital adoption of information technology are lacking.", "Information technologies in Florida's rural hospitals: does system affiliation matter?<||||>To determine the extent to which rural Florida hospitals utilize clinical and other information technology applications, to identify related information technology issues and barriers, and to explore differences between stand-alone and system-affiliated hospitals.", "Information technologies in Florida's rural hospitals: does system affiliation matter?<||||>Chief information officers in rural Florida hospitals were surveyed from June 2003-October 2003. A comprehensive set of questions assessed hospital demographics, information technology priorities and barriers, clinical and other information technology systems, and staffing needs.", "Information technologies in Florida's rural hospitals: does system affiliation matter?<||||>In rural Florida, current information technology priorities included upgrading security on information technology systems to meet Health Insurance Portability and Accountability Act requirements (53.6%), implementing technology to reduce medical errors and to promote patient safety (50.0%), and implementing wireless systems (46.4%). With respect to current information technology adoption, system-affiliated rural hospitals were statistically more likely than their stand-alone counterparts to have laboratory information systems (93% vs 39%), pharmacy (87% vs 46%), pharmacy dispensing (53% vs 8%), chart deficiency (60% vs 15%), and order communication results (60% vs 23%). Financial barriers to successful information technology implementation were noted by 69% of stand-alone and 20% of system-affiliated rural hospitals." ]

[ "Can diagnostic ultrasound scanners be a potential vector of opportunistic bacterial infection?<||||>Ultrasound examinations are recognised as being safe. The greatest epidemiological threat during the performance of examination is the transfer of pathogenic and opportunistic microorganisms between patients and from personnel to patients. Colonization of the skin with opportunistic bacteria of immunocompromised and high risk patients may lead to infection following an ultrasound scan.AIM: To identify and evaluate the strains of bacteria occurring on ultrasound equipment subjected to unexpected control performed by a local infectious diseases control team. We assumed that transducers, gel holders and gel bottles can be contaminated with normal human skin microflora. The remaining tested parts of the ultrasound equipment could possibly be contaminated with normal human skin microflora and other pathogens.", "Can diagnostic ultrasound scanners be a potential vector of opportunistic bacterial infection?<||||>The swabs were taken from ultrasound scanners located in various hospital settings, from out-patient based radiology scanning rooms to operating theatre, and cultured.", "Can diagnostic ultrasound scanners be a potential vector of opportunistic bacterial infection?<||||>Among all isolated 23% strains were classified as environmental microflora; 8% as strains related to patient's skin contamination; and 13 % strains constituted pathogenic Gram-negative rods.. The remaining strains were classified as opportunistic flora 38%. High prevalence of opportunistic bacteria cultured in our study lead to the modification of the ultrasound cleaning procedures in both institutions and recommendation of the use of antibacterial wipes to clean all parts of ultrasound equipment in contact with patients' skin and examiners." ]

[ "Are dietary diversity scores related to the socio-economic and anthropometric status of women living in an urban area in Burkina Faso?<||||>To study dietary diversity and its relationship with socio-economic and nutritional characteristics of women in an urban Sahelian context.", "Are dietary diversity scores related to the socio-economic and anthropometric status of women living in an urban area in Burkina Faso?<||||>A qualitative dietary recall was performed over a 24-h period. Dietary diversity scores (DDS = number of food groups consumed) were calculated from a list of nine food groups (DDS-9) or from a list of 22 food groups (DDS-22) which detailed both micronutrient- and energy-dense foods more extensively. Body mass index (BMI), mid upper-arm circumference and body fat percentage were used to assess the nutritional status of the women.", "Are dietary diversity scores related to the socio-economic and anthropometric status of women living in an urban area in Burkina Faso?<||||>Five hundred and fifty-seven women randomly selected in two districts of Ouagadougou, the capital of Burkina Faso.", "Are dietary diversity scores related to the socio-economic and anthropometric status of women living in an urban area in Burkina Faso?<||||>The mean DDS-9 and DDS-22 were 4.9 +/- 1.0 and 6.5 +/- 1.8 food groups, respectively. In the high tertile of DDS-22, more women consumed fatty and sweetened foods, fresh fish, non-fatty meat and vitamin-A-rich fruits and vegetables. The DDS-9 was not associated with the women's socio-economic characteristics whereas the DDS-22 was higher when the women were younger, richer and had received at least a minimum education. Mean BMI of the women was 24.2 +/- 4.9 kg m-2 and 37% of them were overweight or obese (BMI>or = 25 kg m-2). Neither the DDS-9 nor the DDS-22 was associated with the women's anthropometric status, even though there was a trend towards fewer overweight women in the lowest tertile of DDS-22." ]

[ "Do vaginal birth after cesarean outcomes differ based on hospital setting?<||||>The objective of the study was to test the null hypothesis that outcomes of vaginal birth after cesarean (VBAC) do not differ on the basis of the hospital setting.", "Do vaginal birth after cesarean outcomes differ based on hospital setting?<||||>The study was a retrospective cohort study of women who were offered VBAC in 17 hospitals from 1996 to 2000. VBAC attempts occurring in hospitals with and without obstetrics-gynecology residency programs were compared, as were outcomes from university and community hospitals. Bivariate and multivariate logistic regression analyses assessed the association between hospital setting and VBAC outcomes.", "Do vaginal birth after cesarean outcomes differ based on hospital setting?<||||>Of 25,065 women with 1 or more prior cesareans, the VBAC attempt rate was 56.1% at hospitals with obstetrics-gynecology residencies, 51.3% at hospitals without obstetrics-gynecology residencies, 61% at university hospitals, and 50.4% at community hospitals. The occurrence of failed VBAC, blood transfusion, or composite adverse outcome did not differ by hospital setting. There was a significant increase in the uterine rupture rate at community (1.2%) vs university hospitals (0.6%), but the absolute risk remained low." ]

[ "Do radiographic parameters correlate with clinical outcomes in adolescent idiopathic scoliosis?<||||>A radiographic assessment has been developed to include coronal, sagittal, and axial parameters.", "Do radiographic parameters correlate with clinical outcomes in adolescent idiopathic scoliosis?<||||>To determine the correlation of postoperative radiographic results and percentage postoperative radiographic improvement with patient clinical self-assessment.", "Do radiographic parameters correlate with clinical outcomes in adolescent idiopathic scoliosis?<||||>With the increasing interest in outcome studies, the authors wanted to determine whether Scoliosis Research Society clinical questionnaire results would correlate with objective radiographic improvement.", "Do radiographic parameters correlate with clinical outcomes in adolescent idiopathic scoliosis?<||||>adolescent idiopathic scoliosis treated with anterior or posterior instrumentation, a solid fusion, minimum 2-year follow-up, and a completed postoperative Scoliosis Research Society questionnaire. Seventy-eight patients met the criteria. Measurements included in the radiographic score: Cobb angles of the coronal curve, C7 to the center sacral vertical line, apical translation, apical vertebral rotation, T1 rib angle, end-instrumented vertebrae angulation, angulation of the disc below the end-instrumented vertebra, and curve type. Sagittal measurements included T2-T12, T5-T12, T2-T5, T12-L2, and L1-S1.", "Do radiographic parameters correlate with clinical outcomes in adolescent idiopathic scoliosis?<||||>The preoperative radiographic score of these 78 patients was mean 60.1 +/- 9.7 (range 41-88, maximum radiographic score, 100). The 2-year postoperative radiographic score was mean 83.8 +/- 8.8 (range, 65-100). The median Scoliosis Research Society questionnaire score was 98 +/- 12.3 (range, 58-116, maximum score, 125, showing that the patient is highly satisfied and asymptomatic). The postoperative radiographic score versus the questionnaire score showed a Spearman rank correlation of 0.04 (P = 0.68, little or no correlation throughout). Percentage improvement of the radiographic score versus the questionnaire score showed a Spearman rank correlation of 0.1 (P = 0.38, little or no correlation throughout)." ]

[ "Does endothelin play a role in chemoreception during acute hypoxia in normal men?<||||>The peripheral chemoreceptors are the dominant reflex mechanism responsible for the rise in ventilation and muscle sympathetic nerve activity (MSNA) in response to hypoxia. Animal studies have suggested that endothelin (ET) plays an important role in chemosensitivity. Moreover, several human clinical conditions in which circulating ET levels are increased are accompanied by enhanced chemoreflex sensitivity. Whether ET plays a role in normal human chemosensitivity is unknown.", "Does endothelin play a role in chemoreception during acute hypoxia in normal men?<||||>We determined whether bosentan, a nonspecific ET receptor antagonist, would decrease chemoreflex sensitivity in 14 healthy subjects. We assessed the effects of bosentan on the response to isocapnic hypoxia, using a randomized, crossover, double-blinded study design.", "Does endothelin play a role in chemoreception during acute hypoxia in normal men?<||||>Bosentan increased mean (+/- SEM) plasma ET levels from 1.97 +/- 0.28 to 2.53 +/- 0.23 pg/mL (p = 0.01). Hypoxia increased mean minute ventilation from 6.7 +/- 0.3 to 8+/0.4 L/min (p<0.01), mean MSNA from 100 to 111 +/- 5% (p<0.01), mean heart rate from 67 +/- 3 to 86 +/- 3 beats/min (p<0.01), and mean systolic BP from 116 +/- 3 to 122 +/- 3 mm Hg (p<0.01). However, none of these responses differed between therapy with bosentan and therapy with placebo (p = 0.26). Bosentan did not affect the mean MSNA responses to the apneas, during normoxia (change from baseline: placebo, 259 +/- 58%; bosentan, 201 +/- 28%; p = 0.17) or during hypoxia (change from baseline: placebo, 469 +/- 139%; bosentan, 329 +/- 46%; p = 0.24). The durations of the voluntary end-expiratory apneas in normoxia and hypoxia, and the subsequent reductions in oxygen saturation, were also similar with therapy using bosentan and placebo (p = 0.42)." ]

[ "The hysterectomized woman. Is she special?<||||>To delineate the health profile of hysterectomized women and to assess whether women who have undergone hysterectomy have a different health profile even before surgery.", "The hysterectomized woman. Is she special?<||||>The WHILA project covers all women (n = 10,766) aged 50-60, living in the Lund area and are based on questionnaires and personal interviews tied to laboratory examinations.", "The hysterectomized woman. Is she special?<||||>6917 women (64.2%) had complete questionnaires and laboratory tests, 800 were hysterectomized (11.6%). Logistic regression analysis revealed that hysterectomized women had more \"dizziness\" 1.40 (1.19-1.66), \"nervous problems\" 1.29 (1.07-1.56), \"backache\" 1.37 (1.16-1.62), \"joint problems\" 1.29 (1.09-1.52), \"eye problem\" 1.20 (1.02-1.42) and \"headache\" 1.17 (1.00-1.37). For both somatic (5.22 versus 4.49 mean value, p<0.001) and psychological (4.19 versus 3.86 mean value, p = 0.002) symptoms, the number was higher in hysterectomized women. Logistic regression analysis revealed that among hysterectomized women university education was less common odds ratios 0.73 (95% confidence interval 0.58-0.91) as well as working full time 0.76 (0.62-0.93). A higher body weight at the age 25, 1.01 (1.001-1.02) as well as a weight gain of more than 5 kg during the last 5 years 1.27 (1.07-1.50), elevation of serum triglycerides 1.29 (1.16-1.44), high-density (HDL) 1.44 (1.14-1.80) and low-density lipoprotein (LDL) cholesterol 1.11 (1.02-1.21) as well as the bone density 1.08 (1.00-1.17). Hysterectomized women had a lower age at giving first birth (p<0.001), shorter interval between menstrual periods (p<or = 0.001) and less frequent amenorrhic episodes (p<0.05). The hysterectomized women used IUD to a lesser extent (p<0.05) but used hormone therapy (HT) (p<0.001) and utilized health care services (p<0.001) more often." ]

[ "Low-grade gliomas: do changes in rCBV measurements at longitudinal perfusion-weighted MR imaging predict malignant transformation?<||||>To prospectively perform longitudinal magnetic resonance (MR) perfusion imaging of conservatively treated low-grade gliomas to determine whether relative cerebral blood volume (rCBV) changes precede malignant transformation as defined by conventional MR imaging and clinical criteria.", "Low-grade gliomas: do changes in rCBV measurements at longitudinal perfusion-weighted MR imaging predict malignant transformation?<||||>All patients gave written informed consent for this institutional ethics committee-approved study. Thirteen patients (seven men, six women; age range, 29-69 years) with biopsy-proved low-grade glioma treated only with antiepileptic drugs were examined longitudinally with susceptibility-weighted perfusion, T2-weighted, fluid-attenuated inversion recovery, and high-dose contrast material-enhanced T1-weighted MR imaging at 6-month intervals to date or until malignant transformation was diagnosed. Student t tests were used to determine differences in rCBV values between \"transformers\" and \"nontransformers\" at defined time points throughout study follow-up.", "Low-grade gliomas: do changes in rCBV measurements at longitudinal perfusion-weighted MR imaging predict malignant transformation?<||||>Seven patients showed progression to high-grade tumors between 6 and 36 months (mean, 22.3 months), and disease in six patients remained stable over a period of 12-36 months (mean, 23 months). Transformers had a slightly (but not statistically significantly) higher group mean rCBV than nontransformers at the point of study entry (1.93 vs 1.31). In nontransformers, the rCBV remained relatively stable and increased to only 1.52 over a mean follow-up of 23 months. In contrast, transformers showed a continuous increase in rCBV up to the point of transformation, when contrast enhancement became apparent on T1-weighted images. The group mean rCBV was 5.36 at transformation but also showed a significant increase from the initial study at 12 months (3.14, P = .022) and at 6 months (3.65, P = .049) before transformation. Rates of rCBV change between two successive time points were also significantly higher in transformers than in nontransformers." ]

[ "Is there a difference in outcome when treating traumatic intraperitoneal bladder rupture with or without a suprapubic tube?<||||>Primary bladder repair with a suprapubic tube is considered to be effective for managing intraperitoneal bladder injury. We compared the outcomes of suprapubic tube placement and no suprapubic tube for this injury.", "Is there a difference in outcome when treating traumatic intraperitoneal bladder rupture with or without a suprapubic tube?<||||>We reviewed the charts of 31 men and 3 women with a mean age of 28.5 years who required emergency operative repair without a cystogram of traumatic bladder injury from 1992 to 1997. Patient characteristics, mechanism of injury, associated injuries, and short and long-term complications were reviewed.", "Is there a difference in outcome when treating traumatic intraperitoneal bladder rupture with or without a suprapubic tube?<||||>Penetrating and blunt trauma occurred in 28 (82%) and 5 (15%) patients, respectively, while 1 had spontaneous bladder rupture. After primary bladder repair the bladder was drained with a suprapubic tube in 18 cases (53%) and a urethral catheter only in 16 (47%). There were no significant differences between the 2 groups with respect to mechanism of injury, patient age, location of injury in the bladder, coexisting medical illnesses, stability in the field or emergency room, or the bladder repair technique. The 18 patients treated with a suprapubic tube had an associated injury that resulted in 2 deaths, while 13 of the 16 treated with urethral catheter drainage only had an associated injury and 1 died. Urological and nonurological complications in the suprapubic tube versus urethral catheter only group developed in 28 and 33 versus 19 and 19% of the cases, respectively (p<0.05). Followup ranged from 1 month to 4 years. No significant long-term morbidity was noted in either group." ]

[ "Does time of day or physician experience affect outcome of acute ischemic stroke patients treated with thrombolysis?<||||>Maintaining a steady thrombolysis service for treatment of acute ischemic stroke 24 h/7 days is challenging. Diurnal and seasonal variability of stroke onset affects the clinical outcome of these patients.", "Does time of day or physician experience affect outcome of acute ischemic stroke patients treated with thrombolysis?<||||>We state that a 24 h/7 days availability of stroke-trained physicians ameliorates weekend effects and other seasonal, weekday, or non-office-hour-related influences on outcome of ischemic stroke patients treated with intravenous thrombolysis.", "Does time of day or physician experience affect outcome of acute ischemic stroke patients treated with thrombolysis?<||||>All consecutive ischemic stroke patients treated with thrombolysis at the Helsinki University Central Hospital were prospectively registered (n = 1581). Patients with basilar artery occlusion (n = 154) were excluded. Door-to-needle time, three-month clinical outcome as measured by the modified Rankin Scale dichotomized at 0 to 2 vs. 3 to 6, and symptomatic intracerebral hemorrhage were analyzed with logistic regression models adjusting for baseline variables. The treating physician was defined as experienced after 18 decisions made to give thrombolysis treatment.", "Does time of day or physician experience affect outcome of acute ischemic stroke patients treated with thrombolysis?<||||>Door-to-needle time or clinical outcome did not differ with regard to time of day or season of presentation. Higher rates of symptomatic intracerebral hemorrhage occurred in spring (odds ratio 2·06, 95% confidence interval 1·03-4·11) and fall (odds ratio 2·08, 95% confidence interval 1·03-4·18). Physician experience reduced the door-to-needle time (odds ratio 0·40, 95% confidence interval 0·32-0·50) but was not associated with patient outcome (modified Rankin scale 3 to 6, odds ratio 1·22, 95% confidence interval 0·95-1·59) or symptomatic intracerebral hemorrhage (odds ratio 0·80, 95% confidence interval 0·51-1·27) rates." ]

[ "Remission in rheumatoid arthritis: wishful thinking or clinical reality?<||||>To review the concept of remission in rheumatoid arthritis (RA), as defined by the Food and Drug Administration (FDA), the American College of Rheumatology (ACR), and the European League Against Rheumatism (EULAR). To delineate differences between significant clinical improvements, very low disease activity, and the achievement of true remission. To evaluate the prevalence of these outcomes with biologic therapy and traditional disease-modifying antirheumatic drugs (DMARD) regimens.", "Remission in rheumatoid arthritis: wishful thinking or clinical reality?<||||>The MEDLINE database was searched for the key words \"remission\" and \"rheumatoid arthritis.\" Efficacy data of RA clinical trials from 1985 to 2004 are based on a literature review of medical journals and abstracts from rheumatology meetings. We review 3 well-defined sets of criteria established by the ACR, EULAR, and the FDA for measuring remission.", "Remission in rheumatoid arthritis: wishful thinking or clinical reality?<||||>Defining remissions in clinical trials and clinical practice requires appropriate standardized and objective outcome measures, such as the ACR and EULAR remission criteria. Traditional DMARDs often provide symptom relief, improvements in physical function, and the slowing of radiographic progression in patients with RA, but rarely lead to the complete cessation of RA activity. Remission, as defined by the ACR criteria, has been observed in 7 to 22% of patients treated with traditional DMARD monotherapy (ie, gold, penicillamine, methotrexate [MTX], cyclosporine A, or sulfasalazine), but these remissions have often been short-lived. Treatments with DMARD combinations, biologic monotherapy, and biologic combination therapy with MTX offer greater hope and may facilitate the higher rates of remission. Clinical trial results have shown that newer DMARDs such as leflunomide or the combination of multiple DMARDs can generally elicit greater EULAR remission rates (ranging from 13 to 42%) than monotherapies. Biologic combinations with MTX have also been shown to induce significant remission (as defined by the EULAR criteria) in RA patients, with a 31% rate observed with infliximab plus MTX at 54 weeks, a 50% rate observed for adalimumab plus MTX after 2 years of therapy, and a 41% rate observed for etanercept plus MTX after 2 years of therapy." ]

[ "Is the hair nicotine level a more accurate biomarker of environmental tobacco smoke exposure than urine cotinine?<||||>The aim of this study was to compare the two biomarkers of exposure to environmental tobacco smoke (ETS); urine cotinine and hair nicotine, using questionnaires as the standard.", "Is the hair nicotine level a more accurate biomarker of environmental tobacco smoke exposure than urine cotinine?<||||>A cross sectional study of children consecutively admitted to hospital for lower respiratory illnesses during the period of the study.", "Is the hair nicotine level a more accurate biomarker of environmental tobacco smoke exposure than urine cotinine?<||||>Three regional hospitals in the larger Wellington area, New Zealand.", "Is the hair nicotine level a more accurate biomarker of environmental tobacco smoke exposure than urine cotinine?<||||>Children aged 3-27 months and admitted to the above hospitals during August 1997 to October 1998. A total of 322 children provided 297 hair samples and 158 urine samples.", "Is the hair nicotine level a more accurate biomarker of environmental tobacco smoke exposure than urine cotinine?<||||>Hair nicotine levels were better able to discriminate the groups of children according to their household's smoking habits at home (no smokers, smoke only outside the home, smoke inside the house) than urine cotinine (Kruskall-Wallis; chi(2)=142.14, and chi(2)=49.5, respectively (p<0.0001)). Furthermore, hair nicotine levels were more strongly correlated with number of smokers in the house, and the number of cigarettes smoked by parents and other members of the child's households. Hair nicotine was better related to the questionnaire variables of smoking in a multivariate regression model (r(2)=0.55) than urine cotinine (r(2)=0.31)." ]

[ "Are some septal deformities inherited?<||||>There has been little research into inherited septal deformities. While, Pejić carried out a study some 50 years ago, and Grymer more recently suggested that some posterior septal deformities could be inherited, both studies lack a precise definition of the types of septal deformities which were investigated. The aim of this paper is to investigate the hypothetic influence of heredity on the onset of particular types of septal deformities. The authors investigated a very particular and well defined type of septal deformity: type 6 after Mladina's classification.", "Are some septal deformities inherited?<||||>The authors studied a group of 22 children among 779 children aged 7-14, selected at random, suffering from type 6 septal deformity and their 44 parents. They were examined by means of anterior rhinoscopy by two the same ENT specialists in rhinology. The control group consisted of 24 children with a straight nasal septum of the same age and sex distribution and their 48 parents. The results were compared using Fisher's exact probability test.", "Are some septal deformities inherited?<||||>In the studied group type 6 septal deformity was found in 21 out of 22 both fathers and mothers of these children. Type 6 was not found in any of 48 parents of children with no septal deformity." ]

[ "Is adolescent varicocele a progressive disease process?<||||>We determined whether there was evidence of progression in either varicocele grade or testicular volume differentials over time in our adolescent varicocele population.", "Is adolescent varicocele a progressive disease process?<||||>A total of 41 boys 7.3 to 19 years old (mean age 13.7, SD 2.5) were seen at sequential visits. At each visit varicocele grade was determined by the attending urologist and ultrasound calculated testicular volume differential was determined by an attending ultrasonographer. A senior staff statistician performed statistical analysis of the sequential data.", "Is adolescent varicocele a progressive disease process?<||||>The varicocele grade data were analyzed using the nonparametric Wilcoxon test and no significant evidence of progression on sequential visits was demonstrated. Similarly, the serial volume differential data were assessed using the paired t test and no significant evidence for progression of testicular volume differentials was demonstrated." ]

[ "Cone-beam computed tomography evaluation of mini-implants after placement: Is root proximity a major risk factor for failure?<||||>The purposes of this study were to determine factors favoring successful mini-implant placement and to evaluate root proximity as a possible risk factor for failure of osseointegration-based mini-implants during orthodontic treatment.", "Cone-beam computed tomography evaluation of mini-implants after placement: Is root proximity a major risk factor for failure?<||||>Three-dimensional cone-beam computed tomography images were used to examine 50 sandblasted, large-grit, and acid-etched surface-treated mini-implants (C-implant, Seoul, Korea) placed in 25 patients. The images were analyzed for 3-dimensional position of the mini-implant (placement angle and depth) and any contact with root surfaces or maxillary sinuses.", "Cone-beam computed tomography evaluation of mini-implants after placement: Is root proximity a major risk factor for failure?<||||>There were no remarkable differences in horizontal placement angles in the axial plane and placement depths of the mini-implants, but the vertical placement angle was significantly higher on the left side (24.5 degrees +/- 11.0 degrees ) compared with the right side (11.8 degrees +/- 11.6 degrees ). The horizontal mini-implant placement angle had a greater inclination tendency toward the maxillary first molar, and 11 mini-implants with root proximity showed mesiobuccal contact with the maxillary first molar root. Only 1 failure in 15 mini-implants with root proximity and 1 failure in 35 without root proximity were observed on the images." ]

[ "Do fathers' attitudes support breastfeeding?<||||>The views of fathers have been shown to be important determinants of infant feeding decisions, but men's attitudes toward breastfeeding and formula feeding have rarely been explored.", "Do fathers' attitudes support breastfeeding?<||||>To explore the relationship between maternal and paternal infant feeding attitudes and their impact on the duration of exclusive breastfeeding.", "Do fathers' attitudes support breastfeeding?<||||>Prospective questionnaire-based cross-sectional study conducted in a tertiary care public hospital.", "Do fathers' attitudes support breastfeeding?<||||>From May 2009 to September 2010, a convenience sample of 238 parents of infants (>6 months to<1 year of age) were included. Each parent's attitude toward infant feeding was measured by the Iowa Infant Feeding Attitude Scale (IIFAS).", "Do fathers' attitudes support breastfeeding?<||||>Pearson's correlation test, independent samples t-test, and one-way analysis of variance were carried out for statistical significance.", "Do fathers' attitudes support breastfeeding?<||||>Only 83 (34.9%) mothers had exclusively breastfed their babies for 4-6 months. A mother's \"total\" infant feeding attitude score was significantly correlated with her husband's score (r=0.43, P<0.01). The couples shared similar \"individual\" infant feeding attitudes to all but four of the 17 items. These 13 \"individual\" attitudes favorable toward breastfeeding were related to its optimal nutritional value, convenience of administration, ease of digestibility, unique role in mother-infant bonding, acceptability of breastfeeding in public places, and long-term health benefits to babies. Only maternal attitudes played an influential role in achieving an exclusive breastfeeding period of 4-6 months." ]

[ "Is prevalence of retinopathy related to the age of onset of diabetes?<||||>This is a population-based study for which 1,414 diabetics were recruited. The fundi were photographed using 45-degree 4-field stereoscopic digital photography. The diagnosis of DR was based on Klein's classification of the Early Treatment Diabetic Retinopathy Study scales.", "Is prevalence of retinopathy related to the age of onset of diabetes?<||||>The prevalence of DR was 33.3% (95% confidence interval, CI: 26.6-39.9) in known onset of diabetes (≤ 40 years) compared to 15.6% (95% CI: 13.6-17.6) in those with late onset (>40 years; p<0.0001). In the group with age of known onset of diabetes ≤ 40 years, the risk factors, associated with any DR, were poor glycemic control (odds ratio, OR: 1.36 for every g% increase in glycosylated hemoglobin), insulin use (OR: 4.21), increasing known duration of diabetes (OR: 1.10 for increase of every year in known duration of diabetes) and presence of macroalbuminuria (OR: 13.39). In the late onset of diabetes group, besides the above-mentioned risk factors, the presence of microalbuminuria (OR: 2.08), male gender (OR: 1.67), presence of anemia (OR: 1.89) and increased systolic blood pressure (OR: 1.01) were the risk factors for DR." ]

[ "Is it possible to differentiate gastric GISTs from gastric leiomyomas by EUS?<||||>We evaluated the endoscopic EUS features in 53 patients with gastric mesenchymal tumors confirmed by histopathologic diagnosis. The GISTs were classified into benign and malignant groups according to the histological risk classification.", "Is it possible to differentiate gastric GISTs from gastric leiomyomas by EUS?<||||>Immunohistochemical analyses demonstrated 7 leiomyomas and 46 GISTs. Inhomogenicity, hyperechogenic spots, a marginal halo and higher echogenicity as compared with the surrounding muscle layer appeared more frequently in the GISTs than in the leiomyomas (P<0.05). The presence of at least two of these four features had a sensitivity of 89.1% and a specificity of 85.7% for predicting GISTs. Except for tumor size and irregularity of the border, most of the EUS features were not helpful for predicting the malignant potential of GISTs. On multivariate analysis, only the maximal diameter of the GISTs was an independent predictor. The optimal size for predicting malignant GISTs was 35 mm. The sensitivity and specificity using this value were 92.3% and 78.8%, respectively." ]

[ "General Surgery Resident Case Logs: Do They Accurately Reflect Resident Experience?<||||>Operative experience during residency lays the foundation for independent practice and additional specialty training following general surgery residency. The aim of this study was to examine operative experience of general surgery residents and detail the results of an intervention aimed at improving resident record keeping in the Accreditation Council for Graduate Medical Education (ACGME) case log system to better reflect their experience.", "General Surgery Resident Case Logs: Do They Accurately Reflect Resident Experience?<||||>Residents were asked to characterize variances in recorded operative experience identified through an audit of operative logs. Based on the results of the audit, an intervention was designed to prompt timely record keeping by residents. The intervention included education and discussion of survey audit results, weekly presentation of graphs detailing operative experience, and possible missed cases in the ACGME logs and addition of a first assistant column in morbidity and mortality (M&M) logs.", "General Surgery Resident Case Logs: Do They Accurately Reflect Resident Experience?<||||>The audit of case logs identified discrepancies in 24.2% of the 636 cases examined. Chief residents were significantly more accurate (95.9%) in recording operative experience in ACGME case logs, whereas 50.3% of junior resident case logs contained variances. Residents characterized discrepancies as \"forgot to log\" (9.6%), \"staff did the case\" (5.2%), \"another resident did more of the case\" (3.6%), \"other\" (3.6%), a \"more advanced resident was present for the case\" (1.6%), \"not present for case\" (0.6%), and \"left for consult\" (0.3%). Over the 4-week intervention period, residents logged between 72.7% and 94.0% of cases. A month following the intervention period, we observed a 13.3% increase in recorded cases compared with the intervention period. Review of first assistant case logging following inclusion of a \"first assistant\" column in M&M logs demonstrated a 70.5% increase in first assistant cases logged into the ACGME system compared with the same time period a year ago." ]

[ "Does avoidance of cardiopulmonary bypass confer any benefits in octogenarians undergoing coronary surgery?<||||>There remain concerns about hospital outcomes in octogenarians being referred for coronary artery bypass grafting (CABG). Avoiding the use of cardiopulmonary bypass (CPB) may be an attractive option to improve early outcomes in this group of patients.", "Does avoidance of cardiopulmonary bypass confer any benefits in octogenarians undergoing coronary surgery?<||||>Between April 1997 and March 2010, 343 consecutive patients aged 80-89 years received isolated first time CABG. We used logistic regression to develop a propensity score for off-pump group membership and then performed a propensity matched analysis comparing off-pump (n=107) to on-pump (n=107) groups for early mortality and morbidity. All analysis was performed retrospectively.", "Does avoidance of cardiopulmonary bypass confer any benefits in octogenarians undergoing coronary surgery?<||||>Preoperative patient characteristics were comparable in both groups, with mean age 82.0 years (80.6-83.7 years) and logistic EuroSCORE 9.9 (6.1-19.5) in the on-pump group compared to 81.6 (80.7-83.2) and 8.5 (5.3-15.7) in the off-pump group (P=0.96, P=0.23, respectively). Postoperatively, in-hospital mortality was 6.5% in the on-pump group compared to 4.7% in the off-pump group (P=0.55). Postoperative complications showed no statistically significant difference between the two groups. However, off-pump was associated with a shorter mechanical ventilation and intensive care unit (ICU) stay and less use of inotropes." ]

[ "Does a change in angiotensin II formation caused by antihypertensive drugs affect the risk of stroke?<||||>Stroke prevention by antihypertensive therapy is believed to be related to the fall in blood pressure (BP). Experimental data have documented that activation of non-AT1 receptors of angiotensin II may exert anti-ischaemic mechanisms in the brain. The present meta-analysis of various randomized clinical trials attempts to relate stroke risk to angiotensin II formation during antihypertensive therapy.", "Does a change in angiotensin II formation caused by antihypertensive drugs affect the risk of stroke?<||||>Primary and secondary stroke prevention was examined in 26 prospective, randomized clinical trials including 206,632 patients without heart failure, in whom a total of 7,108 strokes occurred. The trials were selected because a difference in angiotensin II generation was expected between the two treatment arms on the basis of the drugs' pharmacodynamic effects, and allowed 36 evaluations of the relative risk of stroke.", "Does a change in angiotensin II formation caused by antihypertensive drugs affect the risk of stroke?<||||>In placebo-controlled trials, stroke risk was significantly higher with angiotensin II-decreasing than increasing drugs, but systolic BP decreased less in the former. Compared with an active therapy having a neutral effect on angiotensin II formation, stroke risk was also higher with angiotensin-decreasing drugs than with angiotensin-increasing drugs, whereas BP decrease was comparable with both drug classes. When angiotensin II-decreasing drugs were directly compared with angiotensin II-increasing drugs in the same trials, stroke risk was significantly increased. On-treatment systolic BP was minimally and significantly higher with angiotensin II-decreasing drugs, but not large enough to explain the excess in stroke risk." ]

[ "Bricker Conduit for Pediatric Urinary Diversion--Should we Still Offer It?<||||>We sought to evaluate long-term outcomes of the Bricker conduit urinary diversion in children.", "Bricker Conduit for Pediatric Urinary Diversion--Should we Still Offer It?<||||>We retrospectively reviewed the database of a single tertiary center for children who had undergone ileal conduit between 1981 and 2011. Patients followed for less than 1 year were excluded. Patient files were reviewed for demographics, diversion indication, preoperative imaging, surgical details, hospital readmissions and followup data. Renal function at baseline and last followup was assessed by estimated glomerular filtration rate, calculated using the modified Schwartz or MDRD (Modified Diet in Renal Disease) formula. Growth charts elucidated patient growth patterns, while an internally designed quality of life questionnaire demonstrated patient and family satisfaction with the procedure.", "Bricker Conduit for Pediatric Urinary Diversion--Should we Still Offer It?<||||>We evaluated 29 children who underwent Bricker conduit at a median age of 10 years (range 2 to 18) and were followed for a median of 91 months (16 to 389). Neuropathic bladder was the underlying diagnosis in 72.4% of cases. Hydronephrosis improved or remained stable in 39 of 55 studied renal units (70.9%). Although no statistically significant difference was observed between mean ± SD baseline (64.5 ± 46 ml/minute/1.73 m(2)) and last followup estimated glomerular filtration rate (54.1 ± 44.9 ml/minute/1.73 m(2)), chronic kidney disease stage had worsened in 13 patients (44.8%), end-stage kidney disease had developed in 11 patients and 9 patients had died. Six patients underwent undiversion after stabilization of renal function. Linear growth was negatively affected in 12 patients (41.4%), and 85% reported poor quality of life. A total of 19 hospital readmissions were required in 14 patients to treat diversion related complications." ]

[ "Can placental histology establish the timing of meconium passage during labor?<||||>To evaluate the relation between duration of placental exposure to recently passed meconium in vivo and histological evidence of meconium uptake by macrophages.", "Can placental histology establish the timing of meconium passage during labor?<||||>Retrospective cohort.", "Can placental histology establish the timing of meconium passage during labor?<||||>University hospital.", "Can placental histology establish the timing of meconium passage during labor?<||||>A total of 44 term deliveries of singleton infants with moderate or thick meconium had placental examination and documented timing of meconium appearance after membrane rupture.", "Can placental histology establish the timing of meconium passage during labor?<||||>Placentas were examined to assess the extent of meconium uptake by macrophages based on location in the amniochorionic membranes, chorionic plate and umbilical cord, and the intensity of uptake, based on the number of macrophages per field. An arbitrary score of severity of uptake was also created by multiplying the intensity of meconium uptake (number of meconium-laden macrophages) by the extent in the three placental areas. Twenty cases of singleton term pregnancy with clear amniotic fluid throughout labor and at delivery were included as negative controls.", "Can placental histology establish the timing of meconium passage during labor?<||||>Relation between interval of meconium exposure in vivo and uptake by macrophages.", "Can placental histology establish the timing of meconium passage during labor?<||||>The median interval from meconium appearance to delivery was 95 minutes (range 10-510 minutes). The median score of severity of meconium uptake was significantly higher than in the negative controls. There was no correlation between the interval of meconium appearance to delivery and score of severity of meconium uptake (p=0.76). Inflammatory lesions were present in 12 (27%) of 44 cases and vascular lesions in 11 (25%) of 44." ]

[ "Is there an impact of global and local disasters on psychiatric inpatient admissions?<||||>Disasters of the magnitude of September 11, 2001 have a serious public health impact. By dominating media broadcasts, this effect is not limited to the site of the disaster. We tested the hypothesis whether such extraordinary burden results in an increase of psychiatric inpatient treatment. As such we analysed all psychiatric inpatient admissions in the Canton of Zurich/Switzerland. To test the influence of proximity to a disaster, we additionally analysed the impact of a local amok run on September 27, 2001.", "Is there an impact of global and local disasters on psychiatric inpatient admissions?<||||>Psychiatric inpatient admissions in the Canton of Zurich from September 2000 to September 2002 were analysed based on the data of the psychiatric case register. ARIMA modelling was employed to describe time-series of admissions per week over the 2-year period and to identify the impact of the incidents of 9/11 and 9/27, 2001.", "Is there an impact of global and local disasters on psychiatric inpatient admissions?<||||>Mean numbers of weekly admissions were comparable in a time span of one month before and one month after the two incidents, thus, no significant changes were detected by the ARIMA modelling." ]

[ "Do lifestyle interventions work in developing countries?<||||>To assess the effects of a comprehensive, integrated community-based lifestyle intervention on diet, physical activity and smoking in two Iranian communities.", "Do lifestyle interventions work in developing countries?<||||>Within the framework of the Isfahan Healthy Heart Program, a community trial was conducted in two intervention counties (Isfahan and Najaf-Abad) and a control area (Arak). Lifestyle interventions targeted the urban and rural populations in the intervention counties but were not implemented in Arak. In each community, a random sample of adults was selected yearly by multi-stage cluster sampling. Food consumption, physical exercise and smoking behaviours were quantified and scored as 1 (low-risk) or 0 (other) at baseline (year 2000) and annually for 4 years in the intervention areas and for 3 years in the control area. The scores for all behaviours were then added to derive an overall lifestyle score.", "Do lifestyle interventions work in developing countries?<||||>After 4 years, changes from baseline in mean dietary score differed significantly between the intervention and control areas (+2.1 points versus -1.2 points, respectively; P<0.01), as did the change in the percentage of individuals following a healthy diet (+14.9% versus -2.0%, respectively; P<0.001). Daily smoking had decreased by 0.9% in the intervention areas and by 2.6% in the control area at the end of the third year, but the difference was not significant. Analysis by gender revealed a significant decreasing trend in smoking among men (P<0.05) but not among women. Energy expenditure for total daily physical activities showed a decreasing trend in all areas, but the mean drop from baseline was significantly smaller in the intervention areas than in the control area (-68 metabolic equivalent task (MET) minutes per week versus -114 MET minutes per week, respectively; P<0.05). Leisure time devoted to physical activities showed an increasing trend in all areas. A significantly different change from baseline was found between the intervention areas and the control area in mean lifestyle score, even after controlling for age, sex and baseline values." ]

[ "The rising tide of liver Cirrhosis mortality in the UK: can its halt be predicted?<||||>Routinely available mortality data were plotted graphically to display the trends in cirrhosis mortality by birth cohort in several countries. Data for Italy, France, Portugal, USA, Canada, Scotland and England&Wales were plotted by birth cohort.", "The rising tide of liver Cirrhosis mortality in the UK: can its halt be predicted?<||||>The current increase in cirrhosis mortality in the UK countries is being driven by a birth cohort effect. Later birth cohorts have much higher death rates than preceding ones. This pattern was seen in Western European and North American countries, which had also experienced increases in liver cirrhosis mortality. However, after the increases, those countries had sudden and persistent falls in death rates. For each country, the dramatic reversal of death rates occurred at a single calendar period and in every age group simultaneously." ]

[ "High failure rate of the Pavlik harness in dislocated hips: is it bilaterality?<||||>The purpose of this study was to evaluate the efficacy of Pavlik harness treatment in patients with bilaterally dislocated Graf type IV hips and compare them to cases with unilaterally dislocated hips.", "High failure rate of the Pavlik harness in dislocated hips: is it bilaterality?<||||>Twenty-one patients (42 hips) who presented with bilaterally dislocated hips with no prior treatment were studied. The comparison group consisted of 33 patients (33 hips) with unilateral hip dislocation treated with the same protocol. Successful treatment was defined as relocation of the hips within 3 weeks of Pavlik harness application.", "High failure rate of the Pavlik harness in dislocated hips: is it bilaterality?<||||>Twelve of 21 patients (57%) in the bilateral group (6 failed bilaterally, 6 unilaterally) and 18/33 patients (54.5%) in the unilateral group failed harness treatment." ]

[ "Microlaryngoscopic repair of iatrogenic pharyngeal pouch perforations: treatment of choice?<||||>Endoscopic stapled diverticulostomy (ESD) has become the preferred technique for managing pharyngeal pouches. Iatrogenic perforation, created during stapling, is a rare but serious complication with significant morbidity and mortality. The conventional management in these instances is to convert it to an external procedure and excise the pouch.", "Microlaryngoscopic repair of iatrogenic pharyngeal pouch perforations: treatment of choice?<||||>Iatrogenic perforations were noticed after stapling in 3 cases in our series of 73 patients who underwent ESD. They were repaired using microlaryngoscopic techniques.", "Microlaryngoscopic repair of iatrogenic pharyngeal pouch perforations: treatment of choice?<||||>All patients had an unremarkable postoperative course." ]

[ "Do cardiac glycosides affect platelet function?<||||>Cardiac glycosides exert their inotropic effect by increasing intracellular calcium. Increased intracellular calcium is a key event in platelet aggregation. In aggregometer studies, digitalis has been found to augment platelet agonist responses. A prothrombotic effect of digitalis might be concealed since heart failure and atrial fibrillation per se predispose to thromboembolism. The present study investigates the effects of digitoxin on platelet function in healthy volunteers.", "Do cardiac glycosides affect platelet function?<||||>Twenty healthy, non-smoking volunteers were randomised to receive digitoxin ( n = 10, 0.6 mg day 1, 0.4 mg day 2, then 0.1 mg daily) or placebo ( n = 10) for 10 days. Platelet function was then analysed ex vivo using three-colour whole-blood-flow cytometry, both in non-stimulated mode and after agonist stimulation with 0.1 micromol/l adenosine diphosphate (ADP), 10 micromol/l ADP and 5.0 micromol/l epinephrine (final concentrations). Expression of activated fibrinogen receptor, von Willebrand's factor receptor and P-selectin, formation of platelet-platelet and platelet-leukocyte aggregates and particle size were examined.", "Do cardiac glycosides affect platelet function?<||||>No significant difference between the placebo and the digitoxin group (digitoxin levels 17-42 nmol/l) was found, neither on a global level nor for any isolated parameter." ]

[ "Does obesity affect outcomes in hip arthroscopy?<||||>Hip arthroscopy has gained popularity over the past decade, and its indications have broadened as newer techniques have been developed. However, there has been a paucity of literature evaluating the outcomes of hip arthroscopy in obese patients.", "Does obesity affect outcomes in hip arthroscopy?<||||>To compare 2-year clinical outcomes of obese patients undergoing primary hip arthroscopy with matched nonobese controls.", "Does obesity affect outcomes in hip arthroscopy?<||||>Cohort study; Level of evidence, 3.", "Does obesity affect outcomes in hip arthroscopy?<||||>From February 2008 to February 2012, data were collected prospectively on all obese patients undergoing primary hip arthroscopy. A matched-pair nonobese control group was selected at a 1:2 ratio. All patients were assessed pre- and postoperatively with 4 patient-reported outcome (PRO) measures: the modified Harris Hip Score, Non-Arthritic Hip Score, Hip Outcome Score-Activities of Daily Living, and Hip Outcome Score-Sport Specific Subscale. Pain was estimated on the visual analog scale, and satisfaction was measured on a scale from 0 to 10.", "Does obesity affect outcomes in hip arthroscopy?<||||>Sixty-two hips (62 patients) were included in the obese group and 124 hips (124 patients) in the control group. At preoperative baseline, the obese group had significantly lower PRO scores when compared with the control group. Both groups demonstrated statistically significant postoperative improvement in all scores (P<.05). Absolute scores were significantly lower in the obese group for all PRO measures, pre- and postoperatively. However, the improvement (delta) in PRO scores from pre- to postoperative time was not significantly different between groups. The rate of conversion to total hip arthroplasty, the rate of revision, and the complication rate were not significantly different between the 2 groups; however, rates of conversion to total hip arthroplasty and revision tended to be twice as high in the obese patients, but the study was not powered for these 2 outcomes." ]

[ "Can methanolic extract of Nigella sativa seed affect glyco-regulatory enzymes in experimental hepatocellular carcinoma?<||||>To investigate the possible modulating role of \"Nigella sativa\" (NS), a plant commonly used in Egyptian traditional medicine, on premalignant perturbations in three glycol-regulatory enzymes in an experimental rat model of hepatocellular carcinoma (HCC).", "Can methanolic extract of Nigella sativa seed affect glyco-regulatory enzymes in experimental hepatocellular carcinoma?<||||>Thirty-six (36) male albino rats were divided into four groups (n = 9). Group 1 served as a normal control, group 2 was treated with methanolic extract of Nigella sativa (MENS) (1 g/kg/day, orally) for 14 weeks, group 3 received a single intraperitoneal dose of diethyl nitrosamine (DENA) (200 mg/kg), followed 2 weeks later by a subcutaneous injection of carbon tetrachloride (CCl(4), 3 ml/kg/week/6 weeks) and group IV was treated with MENS for 2 weeks prior to administration of the carcinogenic combination (DENA + CCl(4), as in group 3) until the end of the experiment. The total period of the experiment was 14 weeks.", "Can methanolic extract of Nigella sativa seed affect glyco-regulatory enzymes in experimental hepatocellular carcinoma?<||||>In the DENA + CCl(4)-treated group, there was a significant increase in the relative liver weight, serum alpha fetoprotein level and the activities of hexokinase, glyceraldehyde phosphate dehydrogenase and glucose 6 phosphate dehydrogenase in both the serum and liver homogenate; this was accompanied by a subsequent decrease in body weight. Pre-treatment with MENS significantly maintained these parameters close to the normal condition." ]

[ "Late onset vitiligo and audiological abnormalities: is there any association?<||||>There is scarce published data on late onset vitiligo. All the studies showing association of audiological abnormalities have been done on younger age group of patients.AIM: To study the clinical characteristics of the patients with late onset vitiligo. Also, to investigate the audiological abnormalities seen in these patients and compare them with age and sex matched healthy volunteers.", "Late onset vitiligo and audiological abnormalities: is there any association?<||||>One hundred and ninety-seven consecutive patients developing vitiligo after the age of 40 were studied. These patients were examined for the audiological abnormalities, and compared with those seen in age and sex matched healthy volunteers.", "Late onset vitiligo and audiological abnormalities: is there any association?<||||>Vitiligo started between 40 and 50 years of age in 68.02% of our patients. Vitiligo vulgaris was the commonest clinical pattern, and most patients reported onset of their vitiligo on the upper extremities. Fifty four had diabetes mellitus, 19 patients had autoimmune thyroid diseases, and 32 showed hypoacusis on audiometric examination. Eighteen controls (age and sex matched healthy volunteers) also showed hypoacusis. The difference in frequency was not significant (22.37% vs 18%, χ2-test, P>0.05). The sensorineural type of audiologic impairment was more commonly seen both in patients as well as in controls." ]

[ "Can Lactobacillus acidophilus improve minimal hepatic encephalopathy?<||||>Minimal hepatic encephalopathy (MHE) is diagnosed when hepatic patients perform worse on psychometric tests compared to healthy controls. This study aimed to evaluate probiotics as alternative therapy in MHE.", "Can Lactobacillus acidophilus improve minimal hepatic encephalopathy?<||||>This is an open-label randomised controlled trial, performed in the Department of Tropical Medicine and Infectious Diseases, Tanta University Hospitals, from March 2010 to January 2012. A total of 90 patients with MHE were allocated by simple randomisation to three parallel equal groups. Group A received lactulose, group B a probiotic (Lactobacillus acidophilus) and group C served as the control. After informed consent, patients were tested for gut micrecology, fasting blood ammonia, liver functions and magnetic resonance spectroscopy (MRS) examination to study brain metabolites, mainly choline (Cho), myo-inositol (mI), glutamine+glutamate (Glx) and creatinin (Cre). Patients who developed overt encephalopathy were excluded from analysis. The whole battery of investigations was repeated in the same order after 4weeks.", "Can Lactobacillus acidophilus improve minimal hepatic encephalopathy?<||||>The probiotic was better tolerated than lactulose. The relative risk reduction (RRR) of developing overt encephalopathy was 60% in the case of lactulose and 80% in the case of probiotic, with a number needed to treat (NNT) of 2.4 and 2.3, respectively. The differential but not total microecology count was significantly shifted towards saccharolytic rather than proteolytic bacteria. The mI/Cre and (Cho+mI)/Glx ratios were significantly increased and the Glx/Cre ratio was significantly reduced after 1month-follow-up in the probiotic group compared to the lactulose group and in both treatment groups compared to the control group." ]

[ "The Mother and Baby Interaction Scale: a valid broadband instrument for efficient screening of postpartum interaction?<||||>The mother-infant relationship may represent a risk or a protective factor for child development. Hence, an early focus on the relationship may be a worthwhile preventive measure. A simple 10-item instrument, the Mother and Baby Interaction Scale, could be a convenient screening instrument for early bonding failure. In this pilot study, preliminary indications of the internal consistency, stability, principal components validity of the Mother and Baby Interaction Scale were investigated.", "The Mother and Baby Interaction Scale: a valid broadband instrument for efficient screening of postpartum interaction?<||||>Seventy-six postpartum women participated. The Mother and Baby Interaction Scale and Postpartum Bonding Questionnaire were completed together with the Edinburgh Postnatal Depression Scale. The internal reliability of the Mother and Baby Interaction Scale, and its correlations with the Postpartum Bonding Questionnaire and Edinburgh Postnatal Depression Scale, was examined. Principal component analysis of the Mother and Baby Interaction Scale was conducted, and the emerging subscales were compared with the Postpartum Bonding Questionnaire.", "The Mother and Baby Interaction Scale: a valid broadband instrument for efficient screening of postpartum interaction?<||||>The principal component analysis yielded four subscales: Bonding problems, Worries about caretaking, Regulation and routine and Sensitivity and separation. We found acceptable internal consistency of the Mother and Baby Interaction Scale. The total score of the Mother and Baby Interaction Scale correlated better (r=0.72) with the Postpartum Bonding Questionnaire than the four subscales. The correlation between the total scores of the Edinburgh Postnatal Depression Scale and the Mother And Baby Interaction Scale was r=0.49." ]

[ "Factors related to lymph node harvest: does a recovery of more than 12 improve the outcome of colorectal cancer?<||||>All patients diagnosed with colorectal cancer who underwent oncological resection consecutively from January 1996 to December 2011 in a single institution have been studied. Factors influencing LN retrieval were analysed. A logistic regression analysis was performed to determine the factors that predicted a recovery of more than 12 LNs. A Cox regression analysis was made to identify the predictive factors of overall and disease-free 5-year survival.", "Factors related to lymph node harvest: does a recovery of more than 12 improve the outcome of colorectal cancer?<||||>A total of 1166 patients were included in the study. The factors associated with the number of LNs harvested in surgical resections were age, colorectal surgeon, right colectomy, total colectomy, year of surgery, number of LN metastases and lymphocyte response. The factors that predicted a recovery of ≥ 12 LNs were age<60 years, right colectomy, year of surgery and expert pathologist. A recovery of ≥ 12 LNs did not show significant differences in overall and disease-free 5-year survival, but the factor of colorectal surgeon did." ]

[ "Do the definitions of elder mistreatment subtypes matter?<||||>Elder mistreatment (EM) is a pervasive public health issue and is associated with morbidity and premature mortality. This study aimed to examine how the prevalence of EM and its subtypes vary using different definitions among U.S. Chinese older adults.", "Do the definitions of elder mistreatment subtypes matter?<||||>The Population Study of Chinese Elderly in Chicago is a population-based epidemiological survey of 3,159 U.S. Chinese older adults in the Greater Chicago area that is guided by a community-based participatory research approach. Participants answered questions regarding psychological, physical, and sexual abuse, caregiver neglect, and financial exploitation. Definitional approaches for EM and its subtypes were constructed from least restrictive to most restrictive.", "Do the definitions of elder mistreatment subtypes matter?<||||>Using different definitional criteria, the prevalence of psychological abuse was 1.1%-9.8%, physical abuse was 1.1%, sexual abuse was 0.2%, caregiver neglect was 4.6%-11.1%, and financial exploitation was 8.8%-9.3%. Overall, EM varied from 13.9% to 25.8%, depending on the defining criteria. Regardless of the definition used, those who experienced EM were more likely to be older and have higher educational attainment, poor health status, poor quality of life, and worsened health change in the last year. However, among the different definitions of overall EM, there were no statistically significant differences across sociodemographic characteristics or self-reported health status associated with EM criteria." ]

[ "Are HLA DQB1 alleles correlated with breast cancer histopronostic parameters in Tunisia?<||||>Tumor cells express surface structures different from normal cells. These structures may be recognized by the immune system, which ensure anti-tumoral surveillance. Antigenic presentation requires HLA molecules role. Since, these molecules are encoded by a high polymorphic system, immune response can be modulated according to HLA genotype. So, HLA polymorphism could be correlated with tumor escape from anti-tumor immunosurveillance.AIM: We have aimed to search for possible associations between HLA DQB1 alleles and the histoprognostical parameters in breast cancer in the Tunisian population.", "Are HLA DQB1 alleles correlated with breast cancer histopronostic parameters in Tunisia?<||||>DQB1 alleles were determined by PCR-SSO molecular typing in 100 healthy matched and unrelated Tunisian female and 87 Tunisian women with breast cancer.", "Are HLA DQB1 alleles correlated with breast cancer histopronostic parameters in Tunisia?<||||>Allelic distribution between the two studied groups showed no significant associations between this locus and the occurrence, the EE grade and the lymph node invasion of breast cancer in the Tunisian population." ]

[ "Are Pfannenstiel scars a boon or a curse for DIEP flap breast reconstructions?<||||>Abdominal incisions and their subsequent scarring alter the vascular architecture of the abdominal pannus. This is of significance when reconstructing the breast with the deep inferior epigastric perforator (DIEP) flap. This study aimed to objectively investigate the impact of the lower abdominal Pfannenstiel scar in utilizing the DIEP flap.", "Are Pfannenstiel scars a boon or a curse for DIEP flap breast reconstructions?<||||>A retrospective study of breast reconstruction with DIEP flaps was conducted on patients who had a Pfannenstiel scar (n = 36) compared with patients who did not (n = 36). Computed tomography angiograms were analyzed for the numbers, positions, and dimensions of perforator vessels. Influence of the scar on the reconstructive outcome was assessed.", "Are Pfannenstiel scars a boon or a curse for DIEP flap breast reconstructions?<||||>The number of perforators was greater in the control group (mean, 9.14) compared with the study group (mean, 8.3) but was not significant, with marginal significance (p = 0.09). The percentage of found perforators with 4 mm or greater was significantly higher in the study group than in the control group (21.7 percent compared with 14.3 percent, respectively; p = 0.04). The position of perforators was more or less the same, and complications were also comparable in both groups." ]

[ "Phase I trial of technetium [Leu13] bombesin as cancer seeking agent: possible scintigraphic guide for surgery?<||||>Bombesin-like neuropeptides work as neurotransmitters and growth factors at the same time. Several human cancers show overexpression of three receptors for mammalian counterparts of amphibia bombesins (ABNs), ie gastrin-releasing peptide (GRP), neuromedin B (NMB) and possibly another peptide. ABNs in turn are able to bind to mammalian and human receptors in vitro, and it is therefore interesting to study radioisotope-labeled bombesin (BN) and BN-like peptides as cancer seeking agents.", "Phase I trial of technetium [Leu13] bombesin as cancer seeking agent: possible scintigraphic guide for surgery?<||||>Starting from the amino acid sequence of [Leu13] ABN, the Demokritos Institute has synthesized and labeled with technetium a new BN-like peptide that has the same biological characteristics as the amphibian peptide; changes were made only in the N-terminal part of the tetradecapeptide. After having obtained satisfactory results with 99mTc BN in a preclinical study, we started a phase I trial involving cancer patients as well as normal volunteers in Tomsk. Three normal volunteers, one patient with small cell lung cancer and one patient with primary prostate cancer were studied after iv injection of 185 MBq, corresponding to 0.7 micrograms of 99mTc BN. Dynamic images of the tumors were acquired for 20 mins, followed by SPET. Total body images were acquired in patients and normal volunteers 1 and 3 h after 99mTc BN acquisition. In addition, 99mTc sestamibi scintigraphy was performed in the patient with small cell lung carcinoma.", "Phase I trial of technetium [Leu13] bombesin as cancer seeking agent: possible scintigraphic guide for surgery?<||||>No relevant side effects were observed. Both tumors were well visualized on early 1-2 mins images with planar as well as tomographic imaging. Total body images showed radioactivity in the liver, kidneys and thyroid gland. The stomach and spleen were ever imaged. Radioactivity was found in the urinary bladder 4 mins after injection in the patient with prostate cancer. Three-hour total body scans showed radioactivity in the duodenum. In the patient in whom also 99mTc sestamibi scintigraphy was performed, thyroid uptake was much higher with sestamibi than with 99mTc BN, whereas the uptake of small cell lung carcinoma was higher with 99mTc BN than with sestamibi." ]

[ "Imagining life with an ostomy: does a video intervention improve quality-of-life predictions for a medical condition that may elicit disgust?<||||>To test a video intervention as a way to improve predictions of mood and quality-of-life with an emotionally evocative medical condition. Such predictions are typically inaccurate, which can be consequential for decision making.", "Imagining life with an ostomy: does a video intervention improve quality-of-life predictions for a medical condition that may elicit disgust?<||||>In Part 1, people presently or formerly living with ostomies predicted how watching a video depicting a person changing his ostomy pouch would affect mood and quality-of-life forecasts for life with an ostomy. In Part 2, participants from the general public read a description about life with an ostomy; half also watched a video depicting a person changing his ostomy pouch. Participants' quality-of-life and mood forecasts for life with an ostomy were assessed.", "Imagining life with an ostomy: does a video intervention improve quality-of-life predictions for a medical condition that may elicit disgust?<||||>Contrary to our expectations, and the expectations of people presently or formerly living with ostomies, the video did not reduce mood or quality-of-life estimates, even among participants high in trait disgust sensitivity. Among low-disgust participants, watching the video increased quality-of-life predictions for ostomy." ]

[ "Does low-dose droperidol administration increase the risk of drug-induced QT prolongation and torsade de pointes in the general surgical population?<||||>The US Food and Drug Administration issued a black box warning regarding the use of droperidol and the potential for torsade de pointes (TdP).", "Does low-dose droperidol administration increase the risk of drug-induced QT prolongation and torsade de pointes in the general surgical population?<||||>The primary objective of this retrospective study was to determine whether low-dose droperidol administration increased the incidence of TdP in the general surgical population during a 3-yr time period before and after the Food and Drug Administration black box warning. A random sample of 150 surgical patients during each time interval was selected to estimate the droperidol use for each time period.", "Does low-dose droperidol administration increase the risk of drug-induced QT prolongation and torsade de pointes in the general surgical population?<||||>During the time period before the black box warning (July 1, 1998 to June 30, 2001), 2,321/139,932 patients (1.66%) had QT prolongation, TdP, or death within 48 h after surgery. We could identify no patients who clearly developed TdP before the black box warning. There was one patient for whom the cause of death could not positively be ruled out as due to TdP. In the time period after the black box warning (July 1, 2002 to June 30, 2005), 2,207 patients (1.46%) had documented QT prolongation, TdP, or death within 48 h after surgery, including only two cases (<0.1%) of TdP. The incidence of droperidol exposure was approximately 12% (exact 95% confidence interval, 7.3-18.3%) before the black box warning and 0% after placement of the black box warning on droperidol. Therefore, we estimate that approximately 16,791 patients (95% confidence interval, 10,173-25,607) were exposed to droperidol, none of whom experienced documented TdP." ]

[ "Can a selective PPARγ modulator improve glycemic control in patients with type 2 diabetes with fewer side effects compared with pioglitazone?<||||>INT131 besylate is a potent, nonthiazolidinedione, selective peroxisome proliferator-activated receptor γ (PPARγ) modulator (SPPARM) designed to improve glucose metabolism while minimizing the side effects of full PPARγ agonists. This placebo-controlled study compared the efficacy and side effects of INT131 besylate versus 45 mg pioglitazone HCl in subjects with type 2 diabetes (T2D).", "Can a selective PPARγ modulator improve glycemic control in patients with type 2 diabetes with fewer side effects compared with pioglitazone?<||||>This was a 24-week randomized, double-blind, placebo- and active-controlled study of 0.5-3.0 mg INT131 versus 45 mg pioglitazone or placebo daily in 367 subjects with T2D on sulfonylurea or sulfonylurea plus metformin. The primary efficacy analysis was the comparison of change from baseline to week 24 in hemoglobin A1c (HbA1c) across treatment groups. Fluid status was assessed with a prospective scoring system for lower-extremity pitting edema.", "Can a selective PPARγ modulator improve glycemic control in patients with type 2 diabetes with fewer side effects compared with pioglitazone?<||||>INT131 had a steep dose response for efficacy as measured by changes in HbA1c. After 24 weeks' treatment, the 0.5-mg dose demonstrated minimal efficacy (HbA1c -0.3 ± 0.12%) and the 2-mg dose demonstrated near-maximal efficacy (HbA1c -1.1 ± 0.12%), which was not statistically different from the efficacy of 45 mg pioglitazone (HbA1c -0.9 ± 0.12%; P<0.01 for noninferiority). With the 1-mg dose, INT131 provided significant improvements in glycemic control (HbA1c 0.8 ± 0.12; P<0.001 vs. placebo) but with less edema, weight gain, and hemodilution than observed with 45 mg pioglitazone." ]

[ "Adjuvant Therapy in Pancreas Cancer: Does It Influence Patterns of Recurrence?<||||>Level 1 data demonstrate that adjuvant chemotherapy (ACT) improves survival after surgical resection of pancreatic ductal adenocarcinoma (PDAC), (adjuvant gemcitabine, CONKO-001 study; adjuvant 5-FU, ESPAC3 study). The role of adjuvant chemoradiation therapy (ACRT) remains controversial. What is less clear is whether adjuvant therapy influences patterns of recurrence. The purpose of this study was to perform the first multicenter study analyzing patterns of recurrence after adjuvant therapy for PDAC.", "Adjuvant Therapy in Pancreas Cancer: Does It Influence Patterns of Recurrence?<||||>Patients undergoing resection for PDAC from 8 medical centers over a 10-year period were analyzed. Demographics, tumor characteristics, operative treatment, type of adjuvant therapy, recurrence pattern, and survival were reviewed. Using Cox-proportional hazards multivariate (MV) regression, the impact of ACT and ACRT on overall survival (OS), local recurrence (LR), and distant recurrence (DR) was investigated.", "Adjuvant Therapy in Pancreas Cancer: Does It Influence Patterns of Recurrence?<||||>There were 1,130 patients who were divided into those having surgery alone (n = 392), ACT (n = 291), or ACRT (n = 447). Median follow-up was 18 months. Compared with patients undergoing surgery alone, ACT, but not ACRT, demonstrated a significant OS advantage on MV analysis. Patients receiving ACT had significantly fewer recurrences (LR and DR); those receiving ACRT had significantly less LR but not DR. On subset MV analysis, ACT and ACRT resulted in less LR in patients with lymph node (LN) positive and margin negative disease. No improvements in LR, DR, or OS were seen in margin positive patients with either ACT or ACRT." ]

[ "Is cardiovascular remodeling in patients with essential hypertension related to more than high blood pressure?<||||>Blocking the renin-aldosterone-angiotensin II system has been hypothesized to induce blood pressure-dependent as well as blood pressure-independent regression of cardiovascular hypertrophy. However, the relative influence of elevated blood pressure (BP) and various neurohormonal factors on cardiovascular remodeling in hypertension is unclear.", "Is cardiovascular remodeling in patients with essential hypertension related to more than high blood pressure?<||||>In 43 untreated patients with hypertension with electrocardiographic left ventricular hypertrophy, we measured relative wall thickness and left ventricular mass index by echocardiography and by magnetic resonance imaging (n = 32), intima-media cross-sectional area, and distensibility of the common carotid arteries by ultrasound, media/lumen ratio of isolated subcutaneous resistance arteries by myography, and median 24-hour systolic BP (n = 40), serum insulin, and plasma levels of epinephrine, norepinephrine, renin, angiotensin II, aldosterone, and endothelin.", "Is cardiovascular remodeling in patients with essential hypertension related to more than high blood pressure?<||||>In multiple regression analyses, left ventricular mass index by echocardiography (R2 = 0.14, P<.05) and by magnetic resonance imaging (R2 = 0.32, P =.001) were associated with 24-hour systolic BP, whereas relative wall thickness was associated with plasma epinephrine (R2 = 0.12, P<.05) and aldosterone (R2 = 0.10, P<.05). Intima-media cross-sectional area/height was associated with 24-hour systolic BP (beta = 0.40) and plasma epinephrine (beta = 0.43) (adjusted R2 = 0.32, P<.001), whereas carotid distensibility was associated with 24-hour systolic BP (beta = 0.40) and plasma angiotensin II (beta = -0.41) (adjusted R2 = 0.30, P<.001). Media/lumen ratio in subcutaneous resistance arteries was associated with plasma epinephrine (R2 = 0.22, P<.01)." ]

[ "Does leg predomination affect the measurement of patellofemoral joint reaction force (PFJRF) during single leg squatting?<||||>Although measuring patellofemoral joint reaction forces (PFJRF) may provide reliable evidence for conservative treatments to correct probable malalignment in subjects with patellofemoral pain syndrome (PFPS), it may be necessary to determine whether the inherent properties of the dominant leg influences the reliability of measuring PFJRF. The aim of the present study was to examine the effect of leg predomination on reliability testing of the PFJRF measurement during single leg squatting in healthy subjects.", "Does leg predomination affect the measurement of patellofemoral joint reaction force (PFJRF) during single leg squatting?<||||>Using a motion analysis system and one force plate, PFJRF of 10 healthy subjects with a right dominant leg was assessed during single leg squatting. Data was collected from superficial markers taped to selected landmarks. This procedure was performed on the both right and left legs, during three separate single leg squats from a neutral position to a depth of approximately 30° of knee flexion. Subjects were then asked to repeat the test procedure after a minimum of a week's interval. The PFJRF was calculated using a biomechanical model of the patellofemoral joint.", "Does leg predomination affect the measurement of patellofemoral joint reaction force (PFJRF) during single leg squatting?<||||>There was significant difference between the PFJRF mean values of paired test of right (mean, SD of 1887.7, 325.1 N) and left knees (mean, SD of 2022.6, 270.5 N) (p < 0.05). The CV (coefficient of variation) values during within and between session tests, revealed the high repeatability and reproducibility of PFJRF measurements on both knees. The ICC (intra class correlation coefficient) values during within and between sessions tests showed the high reliability of these measurements on both knees." ]

[ "Do concerns about more advanced pathological features increase the likelihood of neurovascular bundle resection in black men undergoing radical prostatectomy?<||||>Traditionally black men undergoing radical prostatectomy have presented with higher serum prostate specific antigen (PSA) levels, Gleason grade and pathological stage compared to white men. We evaluated men undergoing radical prostatectomy at our institutions to determine if race was an independent predictor of neurovascular bundle resection and if racial differences existed with regard to clinical and pathological outcomes in men undergoing a nerve sparing procedure.", "Do concerns about more advanced pathological features increase the likelihood of neurovascular bundle resection in black men undergoing radical prostatectomy?<||||>Between July 1995 and March 2000, 316 men underwent radical retropubic prostatectomy for clinically localized prostate cancer. Patient data were gathered prospectively and reviewed with regard to age, race, preoperative serum PSA, operative procedure, pathological findings and patient followup. Racial differences were analyzed by the chi-square test or student's t statistic. Predictors of neurovascular bundle resection were evaluated using multiple logistic regression.", "Do concerns about more advanced pathological features increase the likelihood of neurovascular bundle resection in black men undergoing radical prostatectomy?<||||>Of the 316 men who underwent a radical retropubic prostatectomy, 126 were black and 190 were white. Overall, a nerve sparing procedure was performed in 77 (40.5%) white men and 44 (34.9%) black men. When evaluating only potent men preoperatively, a nerve sparing prostatectomy was performed in 69.3% of white men and 58.6% of black men. There was no statistically significant racial difference with regard to the proportions of men undergoing a nerve sparing procedure. Predictors of neurovascular bundle resection during radical prostatectomy were preoperative erectile function, serum PSA level before prostate biopsy, biopsy Gleason score and number of cores positive for cancer. In men undergoing a nerve sparing radical prostatectomy there were no significant racial differences with regard to age, preoperative serum PSA, Gleason score, pathological stage, postoperative potency, continence or disease-free survival (mean followup 44 months)." ]

[ "Outcomes of patients with healthcare-associated pneumonia: worse disease or sicker patients?<||||>Healthcare-associated pneumonia (HCAP) is an entity distinct from community-acquired pneumonia (CAP). HCAP has a higher case-fatality rate, due either to HCAP organisms or to the health status of HCAP patients. The contribution of HCAP criteria to case-fatality rate is unknown.", "Outcomes of patients with healthcare-associated pneumonia: worse disease or sicker patients?<||||>We conducted a retrospective review of adult patients admitted with a diagnosis of pneumonia from July 2007 through November 2011 to 491 US hospitals. HCAP was defined as having at least 1 of the following: prior hospitalization within 90 days, hemodialysis, admission from a skilled nursing facility, or immune suppression. We compared characteristics of patients with CAP and patients with HCAP and explored the contribution of HCAP criteria to case-fatality rate in a hierarchical generalized linear model.", "Outcomes of patients with healthcare-associated pneumonia: worse disease or sicker patients?<||||>Of 436,483 patients hospitalized with pneumonia, 149,963 (34.4%) had HCAP. Compared to CAP patients, HCAP patients were older, had more comorbidities, and were more likely to require intensive care unit (ICU) care. In-hospital case-fatality rate was higher among patients with HCAP, compared to those with CAP (11.1% vs 5.1%, P<.001). After adjustment for demographics, comorbidities, presence of other infections, early ICU admission, chronic and acute medications, early tests and therapies, and length of stay, HCAP remained associated with increased case-fatality rate (odds ratio [OR], 1.35 [95% confidence interval (CI), 1.32-1.39]); odds of death increased for each additional HCAP criterion (OR [95% CI]: 1 criterion, 1.27 [1.23-1.31], 2 criteria, 1.55 [1.49-1.62], and 3 or more criteria, 1.88 [1.72-2.06])." ]

[ "Can combination of Day 3 and Day 5 embryo morphology be useful to predict pregnancy in in-vitro fertilization cycles?<||||>To determine whether embryos having all top qualified both on Day 3 and Day 5 have higher pregnancy rates than the oth- ers.", "Can combination of Day 3 and Day 5 embryo morphology be useful to predict pregnancy in in-vitro fertilization cycles?<||||>The study included 143 consecutive cycles were recruited in which Day 5 embryo transfer was available. Cleavage stage embryos were graded according to 1 to 4 scoring system, based on fragmentation, cell symmetry, and blastomere num- ber. Among cleavage stage embryos, Grade 1 and Grade 2a/2b were further stratified as 'top quality' embryos to be transferred, others were defined as control group. Blastocyst stage embryos were graded from 1 to 6 according to intracellular mass (ICM) and trophec- toderm (TE). Day 5 fresh embryo transfer was performed in all cases using soft catheter. Positive pregnancy test was accepted when serum beta-human chorionic gonadotrophin (1-hCG) exceeded 20 mIU/ml.", "Can combination of Day 3 and Day 5 embryo morphology be useful to predict pregnancy in in-vitro fertilization cycles?<||||>On the cleavage stage, top quality embryo was available in 47 of 143(32.9%) cases. Of the 47 embryos, the number of cases reaching any Grade 4, 3 quality, and early blastocyst on Day 5 were 22 (46.8%), 15 (31.9%), and 10 (21.3%). The respective figures on the control group (n = 96) were 33 (34.4%), 37 (38.5%), and 26 (27.1%) (p>0.05). The pregnancy rates were also similar." ]

[ "Dying cancer patients' own opinions on euthanasia: an expression of autonomy?<||||>Deliberations on euthanasia are mostly theoretical, and often lack first-hand perspectives of the affected persons.", "Dying cancer patients' own opinions on euthanasia: an expression of autonomy?<||||>Sixty-six patients suffering from cancer in a palliative phase were interviewed about their perspectives of euthanasia in relation to autonomy. The interviews were transcribed verbatim and analysed using qualitative content analysis with no predetermined categories.", "Dying cancer patients' own opinions on euthanasia: an expression of autonomy?<||||>The informants expressed different positions on euthanasia, ranging from support to opposition, but the majority were undecided due to the complexity of the problem. The informants' perspectives on euthanasia in relation to autonomy focused on decision making, being affected by (1) power and (2) trust. Legalization of euthanasia was perceived as either (a) increasing patient autonomy by patient empowerment, or (b) decreasing patient autonomy by increasing the medical power of the health care staff, which could be frightening. The informants experienced dependence on others, and expressed various levels of trust in others' intentions, ranging from full trust to complete mistrust." ]

[ "Are routine arrhythmia inductions necessary in patients with pectoral implantable cardioverter defibrillators?<||||>The value of ventricular arrhythmia inductions as part of routine implantable cardioverter defibrillator (ICD) follow-up in new-generation pectoral ICDs is unknown.", "Are routine arrhythmia inductions necessary in patients with pectoral implantable cardioverter defibrillators?<||||>We performed a retrospective analysis of a prospectively collected database analyzing data from 153 patients with pectoral ICDs who had routine arrhythmia inductions at predismissal, and 3 months and 1 year after implantation. Routine predismissal ventricular fibrillation (VF) induction yielded important findings in 8.8% of patients, all in patients with implantation defibrillation threshold (DFT)>or = 15 J or with concomitant pacemaker systems. At 3 months and 1 year, routine VF induction yielded important findings in 5.9% and 3.8% of tested patients, respectively, all in patients who had high DFT on prior testing. Ventricular tachycardia (VT) induction at predismissal, and 3 months and 1 year after implantation resulted in programming change in 37.4%, 28.1%, and 13.8% of tested patients, almost all in patients with inducible VT on baseline electrophysiologic study and clinical episodes since implantation." ]

[ "Tracheal and tracheostomal hypergranulation and related stenosis in long-term cannulated patients: does the tracheostomy procedure make a difference?<||||>Long-term cannulated patients are at risk of developing tracheal and tracheostomal hypergranulation. This study evaluated the incidence of hypergranulation and related tracheal stenosis in long-term cannulated patients. The relation between hypergranulation, specific tracheostomy techniques, and the duration of cannulation was investigated.", "Tracheal and tracheostomal hypergranulation and related stenosis in long-term cannulated patients: does the tracheostomy procedure make a difference?<||||>A prospective observational study was conducted to analyze tracheostomal and tracheal hypergranulation in long-term cannulated patients. We compared complication rates in 344 postacute patients. Tracheas and tracheostomas were inspected visually and endoscopically at admission and at regular tube changes every 2 weeks until decannulation or discharge.", "Tracheal and tracheostomal hypergranulation and related stenosis in long-term cannulated patients: does the tracheostomy procedure make a difference?<||||>Hypergranulation appeared 3 times as often in the tracheostoma (n=338) as in the trachea (n = 109). There was no influence of the tracheostomy procedure on the frequency (p = 0.931), location (tracheostoma, p = 0.947; trachea, p = 0.918), or severity (stenoses grade I, p = 0.910; grade II, p = 0.649; grade III, p = 0.304) of the hypergranulation. The main factors to account for hypergranulation were the duration of cannulation (p<0.001) and age (p = 0.033)." ]

[ "Is meconium stained amniotic fluid related to occult myocardial injury in term low risk pregnancies?<||||>Case-control study", "Is meconium stained amniotic fluid related to occult myocardial injury in term low risk pregnancies?<||||>Thirty-five women who had delivery complicated by MSAF between 37 and 41weeks of gestation were defined as the study group and women with healthy uncomplicated pregnancies with clear amniotic fluid who were matched for age, parity, and gestational age were defined as the control group.", "Is meconium stained amniotic fluid related to occult myocardial injury in term low risk pregnancies?<||||>Cord blood Tp T level, gas analysis and neonatal outcomes were compared between groups.", "Is meconium stained amniotic fluid related to occult myocardial injury in term low risk pregnancies?<||||>Tp T levels of the study and control groups were 0.026±0.013ng/ml and 0.031±0.016ng/ml, respectively. The difference was not statistically significant (p=0.132). On the other hand, the study group had a statistically lower HCO(3) level (21.80 vs 23.60mmol/l ) and higher rate of base deficit (4.85 vs 3.25mmol/l) than the control group." ]

[ "Comparison Between Two Different Isolated Craniosynostosis Techniques: Does It Affect Cranial Bone Growth?<||||>Craniosynostosis is a premature closure of a cranial suture. Cranioplasty is indicated to correct skull deformity, relieve increased intracranial pressure, and promote homogenous cranial growth. Different techniques have been adopted to achieve optimal outcomes. Although surgical benefits are widely accepted, this intervention might also affect cranial skeletal growth.", "Comparison Between Two Different Isolated Craniosynostosis Techniques: Does It Affect Cranial Bone Growth?<||||>The authors conducted a retrospective case-control study including patients operated for isolated metopic or sagittal synostosis. These patients had undergone a computed tomography (CT) scan before surgery and/or at 3 years of age postoperatively. These were operated between 2002 and 2012. Intracranial volume was measured using a MATLAB application. The control group was age and sex-matched individuals who had CT scans for trauma or neurological indications. All results with P value<0.05 were considered statistically significant.", "Comparison Between Two Different Isolated Craniosynostosis Techniques: Does It Affect Cranial Bone Growth?<||||>A total of 185 patients were included in the study with a preoperative CT scan (143 sagittal synostosis and 42 metopic synostosis). Postoperatively 160 patients were identified including 103 sagittal synostosis and 57 metopic synostosis. These patients were compared to 414 controls. There was a statistically significant reduction in intracranial volume (ICV) in patients operated for metopic synostosis with both techniques. It also demonstrated a statistically significant difference in ICV in patients with sagittal synostosis operated with Pi-plasty and a nonsignificant difference in ICV in patients operated with strip craniotomy and springs." ]

[ "Do antidepressants influence the disease course in inflammatory bowel disease?<||||>Depression, like adverse events and psychological stress, can trigger relapse in inflammatory bowel disease (IBD); however, the effects of psychoactive drugs on disease course are unclear.", "Do antidepressants influence the disease course in inflammatory bowel disease?<||||>Using retrospective electronic case note review, after exclusion of five patients on low-dose tricyclic antidepressants we compared the course of IBD in 29 patients (14 ulcerative colitis and 15 Crohn's disease), during the years before (year 1) and after (year 2) they were started on an antidepressant for a concomitant mood disorder to that of controls matched for age, sex, disease type, medication at baseline, and relapse rate in year 1.", "Do antidepressants influence the disease course in inflammatory bowel disease?<||||>Patients had fewer relapses and courses of steroids in the year after starting an antidepressant than in the year before (1 [0-4] (median [range]) vs. 0 [0-4], P = 0.002; 1 [0-3]vs. 0 [0-4], P<0.001, respectively); the controls showed no changes between years 1 and 2 in relapses (1 [0-4] vs. 1 [0-3], respectively) or courses of steroids (1 [0-2] vs. 0 [0-3]). Although there were no differences in the use of other relapse-related medications, outpatient attendances, or hospital admissions, the number of endoscopies fell significantly in the antidepressant group in year 2 compared with year 1 (P<0.01). No such changes were seen in the controls." ]

[ "Could maternal pre-pregnancy body mass index affect Apgar score?<||||>Obesity is one of global health problems and maternal obesity may be associated with increase in risk of pregnancy complications and neonatal death. The purpose of this study was to evaluate the effect of maternal pre-pregnancy body mass index (BMI) on neonate Apgar score at minute 5.", "Could maternal pre-pregnancy body mass index affect Apgar score?<||||>In a retrospective cohort study, Apgar score at minute 5 of all singleton term babies of nulliparous women whom were delivered in Shahid Sadoughi Hospital, Yazd, Iran, from 2007 to 2009 were evaluated. Body mass index (BMI: weight in kg/height in m(2)) of the mothers were calculated and BMI less than 18.5, 18.5-24.9, 25-29.9 and more than 30 were considered underweight, normal, overweight and obesity, respectively. Neonatal Apgar score of 3-7 and less than three was considered as low and very low Apgar score, respectively.", "Could maternal pre-pregnancy body mass index affect Apgar score?<||||>Eighty-eight (2.8 %) women were underweight, 1,401 (44.9 %) normal weight, 1,389 (44.5 %) overweight and 242 (7.8 %) were obese. 477 (15.3 %) and 31(0.7 %) neonates had low and very low Apgar score, respectively at minute 5. Logistic regression analysis showed maternal overweight [in odd ratio of 3.7, 95 % CI 2.4-4.6] and obesity [in odd ratio of 13.4, 95 % CI 9.7-14.1]were risk factors of neonatal low Apgar score, but they had not any statistically significant effect on neonatal very low Apgar score." ]

[ "Brain-type and liver-type fatty acid-binding proteins: new tumor markers for renal cancer?<||||>Renal cell carcinoma (RCC) is the most common renal neoplasm. Cancer tissue is often characterized by altered energy regulation. Fatty acid-binding proteins (FABP) are involved in the intracellular transport of fatty acids (FA). We examined the level of brain-type (B) and liver-type (L) FABP mRNA and the protein expression profiles of both FABPs in renal cell carcinoma.", "Brain-type and liver-type fatty acid-binding proteins: new tumor markers for renal cancer?<||||>Paired tissue samples of cancerous and noncancerous kidney parts were investigated. Quantitative RT-PCR, immunohistochemistry and western blotting were used to determine B- and L-FABP in tumor and normal tissues. The tissue microarray (TMA) contained 272 clinico-pathologically characterized renal cell carcinomas of the clear cell, papillary and chromophobe subtype. SPSS 17.0 was used to apply crosstables (chi2-test), correlations and survival analyses.", "Brain-type and liver-type fatty acid-binding proteins: new tumor markers for renal cancer?<||||>B-FABP mRNA was significantly up-regulated in renal cell carcinoma. In normal tissue B-FABP mRNA was very low or often not detectable. RCC with a high tumor grading (G3 + G4) showed significantly lower B-FABP mRNA compared with those with a low grading (G1 + G2). Western blotting analysis detected B-FABP in 78% of the cases with a very strong band but in the corresponding normal tissue it was weak or not detectable. L-FABP showed an inverse relationship for mRNA quantification and western blotting. A strong B-FABP staining was present in 52% of the tumor tissues contained in the TMA. In normal renal tissue, L-FABP showed a moderate to strong immunoreactivity in proximal tubuli. L-FABP was expressed at lower rates compared with the normal tissues in 30.5% of all tumors. There was no correlation between patient survival times and the staining intensity of both FABPs." ]

[ "Surgical technique: does mini-invasive medial collateral ligament and posterior oblique ligament repair restore knee stability in combined chronic medial and ACL injuries?<||||>Residual laxity remains after ACL reconstruction in patients with combined chronic ACL and medial instability. The question arises whether to correct medial capsular and ligament injuries when Grade II and III medial laxity is present.", "Surgical technique: does mini-invasive medial collateral ligament and posterior oblique ligament repair restore knee stability in combined chronic medial and ACL injuries?<||||>We developed a mini-invasive medial ligament plasty to repair the medial collateral ligament to correct residual medial valgus and rotatory laxity after ACL reconstruction.", "Surgical technique: does mini-invasive medial collateral ligament and posterior oblique ligament repair restore knee stability in combined chronic medial and ACL injuries?<||||>We prospectively followed 36 patients with an ACL deficiency combined with chronic Grade II or III valgus and rotatory medial instability. The mean age was 37 years (range, 15-70 years). For all patients, we obtained preoperative and postoperative Knee Injury and Osteoarthritis Outcome, International Knee Documentation Committee, Lysholm, and Tegner Activity Level Scores. The minimum followup was 2 years (median, 3 years; range, 2-7 years).", "Surgical technique: does mini-invasive medial collateral ligament and posterior oblique ligament repair restore knee stability in combined chronic medial and ACL injuries?<||||>The mean subjective International Knee Documentation Committee score improved from 36 preoperatively to 94 at the last followup. While all patients had an International Knee Documentation Committee score of Grade C or D preoperatively, no patient did postoperatively. The mean Knee Injury and Osteoarthritis Outcome Score improved from 45 preoperatively to 93 postoperatively. Valgus and external rotatory tests were negative in all patients. The mean Tegner activity level decreased from 7 preinjury to 6 postoperatively, and the mean Lysholm score improved from 40 preoperatively to 93 at last followup." ]

[ "MR imaging of patients with lateral epicondylitis of the elbow: is the common extensor tendon an isolated lesion?<||||>To investigate whether an injury of the common extensor tendon (CET) is associated with other abnormalities in the elbow joint and find the potential relationships between these imaging features by using a high-resolution magnetic resonance imaging (MRI).", "MR imaging of patients with lateral epicondylitis of the elbow: is the common extensor tendon an isolated lesion?<||||>Twenty-three patients were examined with 3.0 T MR. Two reviewers were recruited for MR images evaluation. Image features were recorded in terms of (1) the injury degree of CET; (2) associated injuries in the elbow joint. Spearman's rank correlation analysis was performed to analyze the relationships between the injury degree of CET and associated abnormalities of the elbow joint, correlations were considered significant at p<0.05.", "MR imaging of patients with lateral epicondylitis of the elbow: is the common extensor tendon an isolated lesion?<||||>Total 24 elbows in 23 patients were included. Various degrees of injuries were found in total 24 CETs (10 mild, 7 moderate and 7 severe). Associated abnormalities were detected in accompaniments of the elbow joints including ligaments, tendons, saccussynovialis and muscles. A significantly positive correlation (r = 0.877,p<0.01) was found in injuries of CET and lateral ulnar collateral ligament (LUCL)." ]

[ "Secondary pancreatic infections: are they distinct clinical entities?<||||>Infected pseudocysts, pancreatic abscesses, and infected pancreatic necroses have been proposed as distinct clinical entities in terms of treatment and outcome. To evaluate this classification, we reviewed the clinical course and bacteriologic findings of pancreatic infections.", "Secondary pancreatic infections: are they distinct clinical entities?<||||>Of 1299 patients with pancreatitis or a related complication admitted over a 7-year period, 64 (4.9%) with culture-documented secondary pancreatic infections were reviewed with regard to cause, clinical course, bacteriologic findings, and outcomes.", "Secondary pancreatic infections: are they distinct clinical entities?<||||>Group I consisted of 23 patients with infected pseudocysts; group II, 20 patients with pancreatic abscesses; and group III, 21 patients with infected pancreatic necrosis. The causes were alcohol in 36%, biliary tract disease in 30%, and postoperative in 16%, with no significant difference between groups. Patients in group I had abdominal pain or a mass without accompanying signs of sepsis, whereas patients in groups II and III had sepsis. In group I, 15 patients were treated with internal drainage, four with percutaneous drainage, and four with external drainage. In group II, three had percutaneous drainage, 15 operative drainage, and two open packing. In group III, 19 patients had operative drainage and two had open packing. Morbidity occurred in 26% of patients in group I, 40% in group II, and 90% in group III (p less than 0.001). Mortality rates were 9% in group I, 25% in group II, and 48% in group III (p less than 0.01). Enteric organisms were present in 66% of isolates, with no difference between groups, suggesting a common mode of infection." ]

[ "Ultrasound prediction of follicle volume: is the mean diameter reflective?<||||>To evaluate the relationship between 2 dimensional sonographic measurement of ovarian follicles and their actual volume.", "Ultrasound prediction of follicle volume: is the mean diameter reflective?<||||>Prospective clinical study.", "Ultrasound prediction of follicle volume: is the mean diameter reflective?<||||>The in vitro fertilization (IVF) program of a University based, tertiary care hospital.", "Ultrasound prediction of follicle volume: is the mean diameter reflective?<||||>Sonographic categorization by shape, and measurement of 96 individual ovarian follicles immediately prior to aspiration for IVF. Each follicle was aspirated under direct ultrasound guidance and the volume recorded. The 96 follicles were visualized in a total of 14 patients from whom 2 to 27 oocytes were obtained.", "Ultrasound prediction of follicle volume: is the mean diameter reflective?<||||>Total volume of each follicle.", "Ultrasound prediction of follicle volume: is the mean diameter reflective?<||||>Round and polygonal follicles exhibited a highly significant relationship between sonographically measured mean diameter and total follicle volume. The volume of follicles that were categorized as ellipsoid was not predicted by measurement of the longest diameter, shortest diameter or mean diameter." ]

[ "Are general practice networks 'ready' for clinical data management?<||||>Australian general practice networks (GPN) are required to report on national performance indicators under the Australian Government Department of Health and Ageing's National Quality Performance System (NQPS).", "Are general practice networks 'ready' for clinical data management?<||||>To investigate the extent to which Victorian GPN are 'ready' to manage clinical data from general practice for reporting under the NQPS.", "Are general practice networks 'ready' for clinical data management?<||||>A qualitative study using semistructured interviews from a purposive sample of chief executive officers from urban and rural Victorian GPN included those either participating or not participating in the Australian Primary Care Collaboratives Program.", "Are general practice networks 'ready' for clinical data management?<||||>Australian Primary Care Collaborative experienced DGP have developed the range of skills and knowledge to undertake clinical data management for quality improvement and NQPS reporting. Trust by local general practices for the provision of clinical data has been developed through the demonstration of benefits to practices and improved patient health. General practice networks without Australian Primary Care Collaborative experience have a range of concerns about clinical data management for NQPS reporting, such as gaining cooperation from their practices, handling privacy issues and finding appropriately skilled staff." ]

[ "Is distortion correction necessary for digital subtraction angiography in the Gamma Knife treatment of intra-cranial arteriovenous malformations?<||||>The published literature maintains that distortion correction of digital subtraction angiography is essential for accurate definition of the arteriovenous malformation (AVM) nidus when performing Gamma Knife radiosurgery. However, as Gamma Knife treatments usually involve small volume targets, which are purposely positioned as close to the centre of the frame as possible, we postulated that the angiographic target images should be minimally distorted. Thus, the use of uncorrected images would not significantly compromise the accuracy of the treatment. We investigated this postulate.", "Is distortion correction necessary for digital subtraction angiography in the Gamma Knife treatment of intra-cranial arteriovenous malformations?<||||>Patient and phantom images with and without distortion correction were assessed. The errors measured in the angiograms were compared to those of MR and CT images of the same subjects. Any errors less than 0.5 mm in any modality were accepted as intrinsic.", "Is distortion correction necessary for digital subtraction angiography in the Gamma Knife treatment of intra-cranial arteriovenous malformations?<||||>All errors measured in the study were sub-millimetre. In the patient group, errors with distortion correction averaged 0.13 mm (range 0-0.3 mm). Without distortion correction, errors averaged 0.34 mm (range 0.1-0.6 mm). By comparison, the average error for intracranial MR imaging was 0.3 mm, with a maximum of 0.6 mm." ]

[ "Testing the children: do non-genetic health-care providers differ in their decision to advise genetic presymptomatic testing on minors?<||||>Within Europe many guidelines exist regarding the genetic testing of minors. Predictive and presymptomatic genetic testing of minors is recommended for disorders for which medical intervention/preventive measures exist, and for which early detection improves future medical health.AIM: This study, which is part of the larger 5th EU-framework \"genetic education\" (GenEd) study, aimed to evaluate the self-reported responses of nongenetic health-care providers in five different EU countries (Germany, France, Sweden, the United Kingdom, and the Netherlands) when confronted with a parent requesting presymptomatic testing on a minor child for a treatable disease.", "Testing the children: do non-genetic health-care providers differ in their decision to advise genetic presymptomatic testing on minors?<||||>A cross-sectional study design using postal, structured scenario-based questionnaires that were sent to 8129 general practitioners (GPs) and pediatricians, between July 2004 and October 2004, addressing self-reported management of a genetic case for which early medical intervention during childhood is beneficial, involving a minor.", "Testing the children: do non-genetic health-care providers differ in their decision to advise genetic presymptomatic testing on minors?<||||>Most practitioners agreed on testing the oldest child, aged 12 years (81.5% for GPs and 87.2% for pediatricians), and not testing the youngest child, aged 6 months (72.6% for GPs and 61.3% for pediatricians). After multivariate adjustment there were statistical differences between countries in recommending a genetic test for the child at the age of 8 years. Pediatricians in France (50%) and Germany (58%) would recommend a test, whereas in the United Kingdom (22%), Sweden (30%), and the Netherlands (32%) they would not." ]

[ "Is routine cavity drainage necessary in Karydakis flap operation?<||||>Different surgical techniques for pilonidal disease have been described in the literature. In this study our aim was to evaluate the influence of routine cavity drainage in the Karydakis flap technique.", "Is routine cavity drainage necessary in Karydakis flap operation?<||||>Fifty patients with pilonidal sinus who underwent the Karydakis flap operation were evaluated prospectively. The patients were assigned randomly into two groups-with and without suction drainage of the cavity-and the effects of drains were studied in terms of wound complications, hospital stay, and recurrence rate.", "Is routine cavity drainage necessary in Karydakis flap operation?<||||>There was no significant difference between groups in term of length of hospital stay. Complication rate was 20 percent and the complications were caused exclusively by fluid collections. Wound infection, dehiscence, or failure was not observed in any of the patients. There has been no recurrence in any of the patients during the follow-up period. There was a significant increase in the number of fluid collections in patents without a suction drain." ]

[ "Could a simple educational intervention modify beliefs about whiplash?<||||>Could a simple educational intervention modify beliefs about whiplash? A preliminary study among professionals working in a rehabilitation ward.", "Could a simple educational intervention modify beliefs about whiplash?<||||>Whiplash and its consequences remain an alarming clinical and social problem, and psychosocial factors could play a role. We aimed to translate and assess the effects on beliefs of an evidence-based educational booklet on whiplash-associated disorders among professionals who work in a rehabilitation ward.", "Could a simple educational intervention modify beliefs about whiplash?<||||>After translation/back-translation of the English version of The Whiplash Book, we undertook a before-and-after prospective study. The main outcome assessment was final score on the whiplash belief questionnaire (WBQ) involving nine questions assessing beliefs and attitudes about the consequences of whiplash rated on a 5-point Likert scale ranging from \"completely agree\" to \"complete disagree.\" Final scores range from 9 to 45, low scores indicating positive beliefs. Demographic, educational and professional data, as well as personal medical history of neck pain, were recorded. Acceptability of the booklet was rated on a 10-point scale and by open questions.", "Could a simple educational intervention modify beliefs about whiplash?<||||>Among the 50 professionals included in the study, 48 completed the questionnaire. Whiplash beliefs tended to be positive at first assessment (WBQ score 23.37+/-6.45). Reading the whiplash booklet significantly improved beliefs (14.27+/-4.39; P<0.05). Global evaluation of the booklet on a 10-point scale was good (8.13+/-1.05) as was acceptability (8.13+/-1.05)." ]

[ "Does the \"gateway\" sequence increase prediction of cannabis use disorder development beyond deviant socialization?<||||>This study was conducted to test whether non-normative socialization mediates the association between transmissible risk measured in childhood and cannabis use disorder manifested by young adulthood, and whether the sequence of drug use initiation (\"gateway\", i.e., consuming legal drugs before cannabis, or the reverse) increases accuracy of prediction of cannabis use disorder.", "Does the \"gateway\" sequence increase prediction of cannabis use disorder development beyond deviant socialization?<||||>Sons of fathers with or without substance use disorders (SUDs) related to illicit drugs were tracked from 10-12 to 22 years of age to model the association between transmissible risk for SUD, socialization (peer deviance), order of drug use initiation (\"gateway\" or reverse sequence), and development of cannabis use disorder. Path analysis was used to evaluate relationships among the variables.", "Does the \"gateway\" sequence increase prediction of cannabis use disorder development beyond deviant socialization?<||||>Non-normative socialization mediates the association between transmissible risk measured during childhood and cannabis use disorder manifest by young adulthood. The sequence of drug use initiation did not contribute additional explanatory information to the model." ]

[ "Outpatient general surgical follow-up: are we using this resource effectively?<||||>Raised patient expectations and the 2-week rule for the investigation of suspected malignancy have led to heightened demands on surgical outpatient clinics. In this context, the utility of benign post-operative or investigative follow-ups requires justification.", "Outpatient general surgical follow-up: are we using this resource effectively?<||||>The surgical outpatient clinic workload of four substantive general surgeons at a typical DGH was analysed over a 4-week period. All notes were examined to identify referral source, management plan and whether that clinic attendance was justified.", "Outpatient general surgical follow-up: are we using this resource effectively?<||||>Twenty three clinics (410 patients) were examined over the period of this study. Three hundred and twenty one patient episodes were examined; 52 episodes did not occur due to patient non-attendance and 37 episodes were not accounted for ('missing/incomplete data'). Thirty three percent of the patients underwent consultant review whilst 57% were reviewed by middle grade surgeons and 9% by SHO/ST2 doctors. Forty eight percent of the consultations were new referrals: 37% of these patients were added to the elective surgical waiting list. One hundred and sixty eight follow-up consultations occurred, which included cancer patients (6%), review patients (12%), patients attending for investigative results (13%) and benign post-operative follow-ups (22%). Forty six of the 69 (66%) post-operative follow-ups were deemed unnecessary as patients were being seen after benign procedures (hernia repair, anorectal surgery or laparoscopic cholecystectomy)." ]

[ "Is prednisolone as good as flutamide in hormone refractory metastatic carcinoma of the prostate?<||||>There are no generally accepted rules for the second line treatment of prostate cancer and few prospective studies have attempted to compare 2 therapeutic strategies with different modes of action.", "Is prednisolone as good as flutamide in hormone refractory metastatic carcinoma of the prostate?<||||>We describe a prospective, randomized study of 40 patients comparing the second line response of flutamide to prednisolone in patients with known hormone refractory stage M1 prostate cancer.", "Is prednisolone as good as flutamide in hormone refractory metastatic carcinoma of the prostate?<||||>The median survival of patients receiving either treatment was 32.9 weeks, with no difference between the 2 groups. In terms of biological response 11 of 20 patients (55%) receiving prednisolone and 10 of 20 (50%) receiving flutamide exhibited prostate specific antigen (PSA) suppression. Average minimum PSA was 54 and 52% of the initial PSA in patients receiving prednisolone and flutamide, respectively. There was no difference between the 2 treatment groups in terms of long-term survival, although 35% of all patients survived beyond 1 year and 3 survived beyond 2 years." ]

[ "Is the diagnostic yield of prostate needle biopsies affected by prostate volume?<||||>To determine the effect of prostate volume on the diagnostic yield of prostate biopsies.", "Is the diagnostic yield of prostate needle biopsies affected by prostate volume?<||||>155 consecutive patients underwent 12-core transrectal ultrasound guided needle biopsies. Data were collected prospectively on age, serum PSA, digital rectal examination (DRE), previous prostate biopsies, prostate volume and pathologic result. Univariate and multivariate logistic regressions were undertaken to determine the effect of prostate volume on the risk for a positive biopsy.", "Is the diagnostic yield of prostate needle biopsies affected by prostate volume?<||||>45 patients (29%) were diagnosed with cancer. The median patient age was 63 (range 48-82) years, the median PSA level was 6.7 ng/ml (0.5-156 ng/ml), and the median prostate volume was 57 ml (16-273 ml). 42 patients (27%) had an abnormal DRE and 51 (33%) had undergone previous prostate biopsies. Positive biopsy rates were 39%, 33%, and 14% for prostate volume below 46 ml, between 45 and 73 ml, and above 72 ml, respectively. Univariate analysis showed that age, serum PSA, DRE and prostate volume were all associated with a positive biopsy. Multivariate analysis adjusted for age, PSA and DRE showed a significant risk increase for a positive biopsy in smaller prostates. (OR = 5.6 95% CI 1.75-17.89; and 8.86 95% CI 2.72-28.82, for prostate volume between 45 and 72 ml and below 45 ml, respectively)." ]

[ "Could time of whole brain radiotherapy delivery impact overall survival in patients with multiple brain metastases?<||||>Whole brain radiotherapy (WBRT) is commonly used to treat brain metastases. Previous studies have explored how radiotherapy treatment time can affect response. The present study evaluated the influence of treatment time on overall survival (OS) for cancer patients receiving WBRT.", "Could time of whole brain radiotherapy delivery impact overall survival in patients with multiple brain metastases?<||||>Patients who received WBRT from 2004 to 2016 were included. Demographic information including age, performance status, primary site, dose, fraction, treatment time, and date of death were collected. Based on different percentages of treatment times falling into one time frame (i.e., 100%, ≥80%, ≥70%, or ≥60%), patients were allocated to three cohorts (8:00-11:00 AM, 11:01 AM-2:00 PM, 2:01-5:00 PM). Demographics were compared among cohorts using the Kruskal-Wallis nonparametric test and Fisher exact test. To control the multiple comparisons on select demographic variables a Bonferroni adjusted P value was considered statistically significant. Kaplan-Meier curves were created for OS. Univariate and multivariate Cox proportional hazard (PH) model were used to find predictive factors of OS in all patients, females and males.", "Could time of whole brain radiotherapy delivery impact overall survival in patients with multiple brain metastases?<||||>A total of 755 patients were included with a median age of 66 years. The actuarial median OS was 2.37 months. Treatment time was not associated with OS for all patients or males only. In elderly female patients (>65 years), a significant difference in OS was found among treatment cohorts (P=0.02). Treatment time (when ≥80% or ≥70% of treatment times were in one time frame), age, and Karnofsky performance status (KPS) were significant predictive factors of OS in univariate analysis for females. Only age and KPS remained significant in multivariate analysis." ]

[ "Are there any differences in psychiatric symptoms and eating attitudes between pregnant women with hyperemesis gravidarum and healthy pregnant women?<||||>The study sample included 48 women with HG, and the control group had 44 pregnant women. The patients were selected from women with HG hospitalized in the obstetric inpatient clinic. All of the participants were in the first trimester of pregnancy. The participants' sociodemographic and clinical characteristics were recorded in the obstetric clinic. All of the participants completed a Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Eating Attitudes Test (EAT) and Body Image Scale (BIS).", "Are there any differences in psychiatric symptoms and eating attitudes between pregnant women with hyperemesis gravidarum and healthy pregnant women?<||||>Women with HG were more likely to have had a history of HG during their previous pregnancy (P<0.05). There was no significant difference between the study and control groups regarding obstetric history. Women with HG were more influenced by food that induced nausea. There was no significant difference between the study and control groups for pre-pregnancy nausea, food craving and the initial BMI (P>0.05). Depression and anxiety scores were significantly higher in women with HG (P<0.05). However, there was no significant difference between the study and control groups for body image score and eating attitude test scores (P>0.05)." ]

[ "Height and social adjustment: are extremes a cause for concern and action?<||||>Growth hormone treatment of hormone-sufficient short youths is predicated on the belief that short stature is associated with social problems with peers. This study assessed peer relations and social adjustment as a function of height in a community sample.", "Height and social adjustment: are extremes a cause for concern and action?<||||>A cross-sectional study was conducted at 1 public school district in Western New York of students of both genders who attended grades 6 to 12 (N = 956). Target groups included participants of short stature (height<or=-1.6 standard deviation, ie,<or=5th percentile for age- and gender-adjusted population norms; n = 68) and tall stature (>or=1.6 standard deviation;>or=95th percentile; n = 58) and classmates of average height (between the 25th and 75th percentiles; n = 123) used for within-class comparisons. All remaining unclassified classmates (n = 704) also provided data. Self- and peer-rated assessment of social reputation and social acceptance was measured.", "Height and social adjustment: are extremes a cause for concern and action?<||||>Minimal effects of height on measures of social functioning were detected despite substantial statistical power. We detected no significant relationships between height and measures of friendship, popularity, or reputation with peers. Findings did not vary by gender of participant, by peer- or self-report, or by whether data from the entire sample were used or target groups were contrasted with comparison participants. Shorter students were perceived by peers to be younger than their age. This influence was restricted to lower grades and did not have an impact on measures of social acceptance or reputation with peers." ]

[ "Surgical outcome of Fontan conversion and arrhythmia surgery: Need a pacemaker?<||||>Atrial tachyarrhythmias are frequent complications in the late period after the Fontan procedure, and important risk factors for a poor prognosis. The impact of Fontan conversion and arrhythmia surgery in failed Fontan patients has been described in many reports.", "Surgical outcome of Fontan conversion and arrhythmia surgery: Need a pacemaker?<||||>We evaluated our experience with Fontan conversion procedures, concomitant arrhythmia surgery, and pacemaker implantation.", "Surgical outcome of Fontan conversion and arrhythmia surgery: Need a pacemaker?<||||>We reviewed the hospital records of 25 consecutive patients who underwent a Fontan conversion procedure from January 2004 to March 2012. Twenty-four patients had arrhythmia surgery using cryoablation and radiofrequency ablation at the time of conversion. A bilateral atrial maze procedure was performed in 6 patients, right-side maze in 15, and isthmus block in 3. Three patients with a diagnosis of corrected transposition of the great arteries underwent simultaneous pacemaker implantation electively.", "Surgical outcome of Fontan conversion and arrhythmia surgery: Need a pacemaker?<||||>There was no early death and one late death during a mean follow-up period of 21.2 months. Three tachyarrhythmia recurrences developed, and there were 4 occurrences of sinus bradycardia. Five of these patients required postoperative pacemaker implantation." ]

[ "Are these data real?<||||>To test the application of statistical methods to detect data fabrication in a clinical trial.", "Are these data real?<||||>Data from two clinical trials: a trial of a dietary intervention for cardiovascular disease and a trial of a drug intervention for the same problem.", "Are these data real?<||||>Baseline comparisons of means and variances of cardiovascular risk factors; digit preference overall and its pattern by group.", "Are these data real?<||||>In the dietary intervention trial, variances for 16 of the 22 variables available at baseline were significantly different, and 10 significant differences were seen in means for these variables. Some of these P values were extraordinarily small. Distributions of the final recorded digit were significantly different between the intervention and the control group at baseline for 14/22 variables in the dietary trial. In the drug trial, only five variables were available, and no significant differences between the groups for baseline values in means or variances or digit preference were seen." ]

[ "Does diabetes mellitus influence pathologic complete response and tumor downstaging after neoadjuvant chemoradiation for esophageal and gastroesophageal cancer?<||||>Esophageal carcinoma is an aggressive disease that is often treated with neoadjuvant therapy followed by surgical resection. Diabetes mellitus (DM) has been associated with reduced efficacy of chemoradiation (CRT) in other gastrointestinal cancers. The goal of this study was to determine if DM affects response to neoadjuvant CRT in the management of gastroesophageal carcinoma.", "Does diabetes mellitus influence pathologic complete response and tumor downstaging after neoadjuvant chemoradiation for esophageal and gastroesophageal cancer?<||||>We retrospectively reviewed the esophageal cancer patient databases and subsequently analyzed those patients who received neoadjuvant CRT followed by surgical resection at two institutions, Thomas Jefferson University (TJUH) and Fox Chase Cancer Center (FCCC). Comparative analyses of rates of pathologic complete response rate (pCR) and pathologic downstaging in DM patients versus non-DM patients was performed.", "Does diabetes mellitus influence pathologic complete response and tumor downstaging after neoadjuvant chemoradiation for esophageal and gastroesophageal cancer?<||||>Two hundred sixty patients were included in the study; 36 patients had DM and 224 were non-diabetics. The average age of the patients was 61 years (range 24-84 years). The overall pCR was 26%. The pCR rate was 19% and 27% for patients with DM and without DM, respectively (P = 0.31). Pathologic downstaging occurred in 39% of study patients, including of 33% of DM patients and 40% of non-DM patients (P = 0.42)." ]

[ "Can dosimetric parameters predict acute hematologic toxicity in rectal cancer patients treated with intensity-modulated pelvic radiotherapy?<||||>To identify dosimetric parameters associated with acute hematologic toxicity (HT) in rectal cancer patients undergoing concurrent chemotherapy and intensity-modulated pelvic radiotherapy.", "Can dosimetric parameters predict acute hematologic toxicity in rectal cancer patients treated with intensity-modulated pelvic radiotherapy?<||||>Ninety-three rectal cancer patients receiving concurrent capecitabine and pelvic intensity-modulated radiation therapy (IMRT) were analyzed. Pelvic bone marrow (PBM) was contoured for each patient and divided into three subsites: lumbosacral spine (LSS), ilium, and lower pelvis (LP). The volume of each site receiving 5-40 Gy (V 5, V10, V15, V20, V30, and V40, respectively) as well as patient baseline clinical characteristics was calculated. The endpoint for hematologic toxicity was grade ≥ 2 (HT2+) leukopenia, neutropenia, anemia or thrombocytopenia. Logistic regression was used to analyze correlation between dosimetric parameters and grade ≥ 2 hematologic toxicity.", "Can dosimetric parameters predict acute hematologic toxicity in rectal cancer patients treated with intensity-modulated pelvic radiotherapy?<||||>Twenty-four in ninety-three patients experienced grade ≥ 2 hematologic toxicity. Only the dosimetric parameter V40 of lumbosacral spine was correlated with grade ≥ 2 hematologic toxicity. Increased pelvic lumbosacral spine V40 (LSS-V40) was associated with an increased grade ≥ 2 hematologic toxicity (p = 0.041). Patients with LSS-V40 ≥ 60 % had higher rates of grade ≥ 2 hematologic toxicity than did patients with lumbosacral spine V40 <60 % (38.3 %, 18/47 vs.13 %, 6/46, p =0.005). On univariate and multivariate logistic regression analysis, lumbosacral spine V40 and gender was also the variable associated with grade ≥ 2 hematologic toxicity. Female patients were observed more likely to have grade ≥ 2 hematologic toxicity than male ones (46.9 %, 15/32 vs 14.8 %, 9/61, p =0.001)." ]

[ "Does volume of clinical experience affect performance of clinical clerks on surgery exit examinations?<||||>Controversy persists over the educational value of student clerkship clinical activities.", "Does volume of clinical experience affect performance of clinical clerks on surgery exit examinations?<||||>Students (109) from the class of 1995 recorded their clinical experiences in a logbook during their surgical clerkship at one of four affiliated teaching hospitals. The influence of clinical experience on examination scores and on correlations between prerotation and postrotation examination performance was determined.", "Does volume of clinical experience affect performance of clinical clerks on surgery exit examinations?<||||>Between sites, marked variation in clinical experience was observed but postrotation scores were similar. High-volume experience in emergency admissions and feedback was associated with better objective structured clinical examination (OSCE) performance, but high-volume outpatient clinic experience was associated with less satisfactory OSCE performance. Correlations between prerotation examination performance and the OSCE was increased by feedback on emergency and elective admissions, in a positive and negative direction, respectively." ]

[ "Emergency Medical Services: a resource for victims of domestic violence?<||||>Domestic violence (DV), also known as intimate partner violence (IPV), is one of the leading causes of serious injury among women of childbearing age. As first responders on the scene during DV calls where personal injuries have occurred, Emergency Medical Services (EMS) could routinely identify, report and assist victims of violence. Yet, little is known of the prevalence of DV calls in EMS practice, Emergency Medical Technicians' (EMT) knowledge and comfort in responding to such calls, or how they care for victims.", "Emergency Medical Services: a resource for victims of domestic violence?<||||>The objectives of this study were to assess EMTs' knowledge of and experience with providing care to victims of DV in the province of Ontario, Canada. Data were gathered through an online, short-answer survey. Survey data were analysed using basic frequency displays, and descriptive statistics are reported.", "Emergency Medical Services: a resource for victims of domestic violence?<||||>Almost 500 EMTs participated in this study, the vast majority of whom (90%) attended at least one DV call in the preceding year, with 65% attending between 10 and 20 DV calls. The majority of respondents (84.5%) wished for more education and training on the issue." ]

[ "Newly weaned nonobese diabetic mice show heightened early diabetes sensitivity to multiple low doses of streptozotocin than nondiabetes-prone CD-1 mice: initial beta-cell damage a key trigger for type 1 diabetes?<||||>We determined if newly weaned female nonobese diabetic (NOD) mice show greater diabetes sensitivity to dose-adjusted regimens of multiple low doses of streptozotocin (Stz) than nondiabetes-prone CD-1 mice.", "Newly weaned nonobese diabetic mice show heightened early diabetes sensitivity to multiple low doses of streptozotocin than nondiabetes-prone CD-1 mice: initial beta-cell damage a key trigger for type 1 diabetes?<||||>Female NOD mice received 5 daily doses of Stz from day 21 (0, 5, 10, 15, 20, 30, and 40 mg/kg body weight) and CD-1 mice 20, 30, and 40 mg.", "Newly weaned nonobese diabetic mice show heightened early diabetes sensitivity to multiple low doses of streptozotocin than nondiabetes-prone CD-1 mice: initial beta-cell damage a key trigger for type 1 diabetes?<||||>: Streptozotocin, at the 15-, 20-, 30-, and 40-mg dose, induced rapid diabetes in NOD mice. By day 100, 90% to 95% of NOD mice became diabetic after the 40- and 30-mg dose and 33% to 40% with the 15- and 20-mg dose. In comparison, only about 50% and 33% of CD-1 mice developed diabetes with the 40- and 30-mg dose, respectively, and 5.5% with the 20-mg dose. In NOD mice, the 20-mg dose also partially suppressed spontaneous diabetes. All diabetic mice displayed insulitis, variable immunostaining for insulin, and redistribution of glucagon and somatostatin cells. Glucose transporter-2 was markedly attenuated in selective beta cells." ]

[ "Is local anesthesia or oral analgesics necessary after mini-laparoscopic functional surgery in children and young adults?<||||>This prospective, randomized, single-blind trial was to determine if local anesthesia or oral analgesics reduce postoperative pain after mini-laparoscopic functional surgery.", "Is local anesthesia or oral analgesics necessary after mini-laparoscopic functional surgery in children and young adults?<||||>One hundred fifteen patients who underwent mini-laparoscopic herniorrhaphy or varicocelectomy were assigned randomly to receive wound infiltration with xylocaine, regular oral analgesics, or a placebo after the procedures. Visual analog pain scores owing to carbon-dioxide irritation and trocar wounds were recorded 2 hours, 1 day, and 1 week after surgery. Levels of pain were measured by a visual analog pain scale. Patients' age, type of procedure, pressure of gas insufflated, length of procedure, dosage of oral/parenteral analgesics, and trocar-related complications were evaluated.", "Is local anesthesia or oral analgesics necessary after mini-laparoscopic functional surgery in children and young adults?<||||>There were no significant differences between groups in the mean pain scores over trocar wounds 2 hours, 1 day, and 1 week after mini-laparoscopic procedures, respectively. There were no significant differences between groups in satisfaction of pain control regimens. Patients who received local anesthesia required fewer on demand meperidine injections than others." ]

[ "Do women grieve after terminating pregnancies because of fetal anomalies?<||||>To test the hypothesis that grief responses do not differ between women who terminate their pregnancies for fetal anomalies and women who experience spontaneous perinatal losses.", "Do women grieve after terminating pregnancies because of fetal anomalies?<||||>A case-control study was conducted. Twenty-three women who underwent terminations through the genetics service of a tertiary referral obstetric hospital from January 1991 to April 1992 were assessed psychiatrically 2 months after the termination. The grief responses of these women on the Perinatal Grief Scale and the Beck Depression Inventory were compared to a demographically similar group of women assessed 2 months after they experienced spontaneous perinatal loss. Differences between the groups were assessed through one-way analysis of covariance.", "Do women grieve after terminating pregnancies because of fetal anomalies?<||||>After matching women in the two groups, it became clear that women who terminated for fetal anomalies were significantly older than women in the comparison group, and age was inversely correlated with intensity of grief. Therefore, age was covaried in comparing the grief responses of women in the two groups. Neither statistically significant nor clinically meaningful differences were found in symptomatology between the groups. By the time of assessment, four of 23 women (17%) who terminated their pregnancies were diagnosed with a major depression, and five of 23 (22%) had sought psychiatric treatment." ]

[ "Do pure squamous cell carcinomas and urothelial carcinomas have similar prognosis after radical cystectomy?<||||>The purpose of this study was to evaluate the surgical treatment results of urothelial carcinoma (UC) and pure squamous cell carcinoma of the bladder (SCC).", "Do pure squamous cell carcinomas and urothelial carcinomas have similar prognosis after radical cystectomy?<||||>The records of 460 patients who have undergone radical cystectomy in our department between the years 1991 and 2011 were analyzed retrospectively, and 364 patients with UC and 60 patients with pure SCC were evaluated.", "Do pure squamous cell carcinomas and urothelial carcinomas have similar prognosis after radical cystectomy?<||||>Average ages of the patients with UC and SCC were 61.12 ± 8.9 and 59.38 ± 8.6 years, respectively (p = 0.902). UC group had 29 female patients, whereas SCC group had 9 female patients (p = 0.077). The mean follow-up periods were 26.09 ± 24.75 months for UC group and 22.23 ± 31.01 months for SCC group (p = 0.805). The incidence of organ-confined, extravesical, lymph node-positive diseases in UC and SCC cases was 48.9 and 32.2, 29.3 and 32.2 %, 21.8 and 35.6 %, respectively (p = 0.028). Five-year disease-specific survival (DSS) rates were 57.5 % in UC and 39.1 % in SCC group (p = 0.011). Five-year DSS rates were 81.2 % in UC and 75.0 % in SCC group in organ-confined disease (p = 0.534) and 28.2 % in UC and 40.9 % in SCC group in extravesical disease (p = 0.845). In lymph node-positive patients, DSS time was 20.9 ± 2.85 months in UC and 12.8 ± 2.07 months in SCC patients (p = 0.182). In multivariate analysis, pT stage (HR: 2.221; 95 % CI: 1.695-2.911) and lymph node involvement (HR: 2.863; 95 % CI: 1.819-4.509) were independently associated with DSS (p<0.001), but histological subtype (HR: 1.423; 95 % CI: 0.798-2.538) was not a statistically significant factor (p = 0.232)." ]

[ "Does a new videolaryngoscope (glidescope) provide better glottic exposure?<||||>The GlideScope (Saturn Biomedical Systems Inc, Burnaby, British Columbia, Canada) is a new videolaryngoscope designed as an alternative to the conventional laryngoscope. It was designed to facilitate glottic exposure during tracheal intubation. This study assessed the effectiveness of the GlideScope in providing glottic exposure.", "Does a new videolaryngoscope (glidescope) provide better glottic exposure?<||||>One hundred and three patients requiring general anesthesia for elective surgery were enrolled in this study. Under full monitoring, all patients were given fentanyl, propofol or thiopentone and muscle relaxant for induction. In each patient laryngoscopy was performed first with a Macintosh blade (size 3), then with the GlideScope. The optimal view of the larynx that could be achieved with each instrument was recorded and assessed using the grading scale of Cormack and Lehane (C&L grade). Intubation was performed with the GlideScope.", "Does a new videolaryngoscope (glidescope) provide better glottic exposure?<||||>The grading decreased in the majority (93.6%, 44/47) of patients with C&L grade>1 when using the GlideScope. Of the 22 patients who were considered as subjects of difficult intubation, 20 had an improved laryngoscopic grade with GlideScope. One hundred and one patients were intubated successfully at the first attempt." ]

[ "Can a comprehensive voucher programme prompt changes in doctors' knowledge, attitudes and practices related to sexual and reproductive health care for adolescents?<||||>To evaluate whether participation in a competitive voucher programme designed to improve access to and quality of sexual and reproductive health care (SRH-care), prompted changes in doctors' knowledge, attitudes and practices.", "Can a comprehensive voucher programme prompt changes in doctors' knowledge, attitudes and practices related to sexual and reproductive health care for adolescents?<||||>The voucher programme provided free access to SRH-care for adolescents. Doctors received training and guidelines on how to deal with adolescents, a treatment protocol, and financial incentives for each adolescent attended. To evaluate the impact of the intervention on doctors, nearly all participating doctors (n = 37) were interviewed before the intervention and 23 were interviewed after the intervention. Answers were grouped in subthemes and scores compared using nonparametric methods.", "Can a comprehensive voucher programme prompt changes in doctors' knowledge, attitudes and practices related to sexual and reproductive health care for adolescents?<||||>The initial interviews disclosed deficiencies in doctors' knowledge, attitudes and practices relating to adolescent SRH-issues. Gender and age of the doctor were not associated with the initial scores. Comparing scores from before and after the intervention revealed significant increases in doctors' knowledge of contraceptives (P = 0.003) and sexually transmittable infections (P<0.001); barriers to contraceptive use significantly diminished (P<0.001 and P = 0.003); and some attitudinal changes were observed (0 = 0.046 and P = 0.11). Doctors became more aware of the need to improve their communication skills and were positive about the programme." ]

[ "Does the Neighborhood Area of Residence Influence Non-Attendance in an Urban Mammography Screening Program?<||||>The public health impact of population-based mammography screening programs depends on high participation rates. Thus, monitoring participation rates, as well as understanding and considering the factors influencing attendance, is important. With the goal to acquire information on the appropriate level of intervention for increasing screening participation our study aimed to (1) examine whether, over and above individual factors, the neighborhood of residence influences a woman's mammography non-attendance, and (2) evaluate, whether knowing a woman's neighborhood of residence would be sufficient to predict non-attendance.", "Does the Neighborhood Area of Residence Influence Non-Attendance in an Urban Mammography Screening Program?<||||>We analyze all women invited to mammography screening in 2005-09, residing in the city of Malmö, Sweden. Information regarding mammography screening attendance was linked to data on area of residence, demographic and socioeconomic characteristics available from Statistics Sweden. The influence of individual and neighborhood factors was assessed by multilevel logistic regression analysis with 29,901 women nested within 212 neighborhoods.", "Does the Neighborhood Area of Residence Influence Non-Attendance in an Urban Mammography Screening Program?<||||>The prevalence of non-attendance among women was 18.3%. After adjusting for individual characteristics, the prevalence in the 212 neighborhoods was 3.6%. Neighborhood of residence had little influence on non-attendance. The multilevel analysis indicates that 8.4% of the total individual differences in the propensity of non-attendance were at the neighborhood level. However, when adjusting for specific individual characteristics this general contextual effect decreased to 1.8%. This minor effect was explained by the sociodemographic characteristic of the neighborhoods. The discriminatory accuracy of classifying women according to their non-attendance was 0.747 when considering only individual level variables, and 0.760 after including neighborhood level as a random effect." ]

[ "Is bone scintigraphy necessary in the initial surgical staging of chondrosarcoma of bone?<||||>To assess the value of whole-body bone scintigraphy in the initial surgical staging of chondrosarcoma of bone.", "Is bone scintigraphy necessary in the initial surgical staging of chondrosarcoma of bone?<||||>A retrospective review was conducted of the bone scintigraphy reports of a large series of patients with peripheral or central chondrosarcoma of bone treated in a specialist orthopaedic oncology unit over a 13-year period. Abnormal findings were correlated against other imaging, histological grade and the impact on surgical staging.", "Is bone scintigraphy necessary in the initial surgical staging of chondrosarcoma of bone?<||||>A total of 195 chondrosarcomas were identified in 188 patients. In 120 (63.8%) patients the reports of bone scintigraphy noted increased activity at the site of one or more chondrosarcomas. In one patient the tumour was outside the field-of-view of the scan, and in the remaining 67 (35.6%) cases, there was increased activity at the site of the chondrosarcoma and further abnormal activity in other areas of the skeleton. Causes of these additional areas of activity included degenerative joint disease, Paget's disease and in one case a previously undiagnosed melanoma metastasis. No cases of skeletal metastases from the chondrosarcoma were found in this series. Multifocal chondrosarcomas were identified in three cases. In two it was considered that all the tumours would have been adequately revealed on the initial MR imaging staging studies. In only the third multifocal case was an unsuspected, further presumed low-grade, central chondrosarcoma identified in the opposite asymptomatic femur. Although this case revealed an unexpected finding the impact on surgical staging was limited as it was decided to employ a watch-and-wait policy for this tumour." ]

[ "Upper and lower limb functionality: are these compromised in obese children?<||||>The aim of this study was to investigate the effects of obesity on upper and lower limb functional strength and power in children, and to determine whether the ability to perform the daily activity of rising from a chair was compromised in obese children. It was hypothesised that obese children would display less upper and lower limb functionality compared to their non-obese counterparts.", "Upper and lower limb functionality: are these compromised in obese children?<||||>Upper and lower limb strength and power of 43 obese children (aged 8.4 +/- 0.5 y, BMI 24.1 +/- 2.3 kg/m(-2)) and 43 non-obese controls (aged 8.4 +/- 0.5 y, BMI 16.9 +/- 0.4 kg/m(-2)) were assessed using age-appropriate field-based tests: arm push/pull ability; basketball throw; vertical jump (VJ), and standing long jump (SLJ) performance. Functional lower limb strength was assessed for 13 obese and 13 non-obese children by quantifying their chair rising ability.", "Upper and lower limb functionality: are these compromised in obese children?<||||>Although obese children displayed significantly greater upper limb push (9.3 +/- 2.3 kg) and pull strength (9.6 +/- 3.0 kg) than their non-obese peers (push: 8.8 +/- 2.2 kg; pull: 8.8 +/- 2.3 kg; p<or = 0.05), their VJ (22.1 +/- 4.3 cm) and SLJ (94.6 +/- 12.8 cm) performance was significantly impaired relative to the non-obese children (VJ: 24.7 +/- 4.0 cm; SLJ: 101.7 +/- 14.0 cm; p<or = 0.05). Obese children spent significantly more time during all transfer phases of the chair rising task, compared to the non-obese children." ]

[ "Survival after induction chemotherapy and surgical resection for high-grade soft tissue sarcoma. Is radiation necessary?<||||>Induction chemotherapy can produce dramatic necrosis in sarcomas-raising the question of whether or not radiation is necessary. This study reviews the clinical outcome of a subset of patients with high-grade extremity soft tissue sarcomas (STS) who were treated with induction chemotherapy and surgical resection but without radiation.", "Survival after induction chemotherapy and surgical resection for high-grade soft tissue sarcoma. Is radiation necessary?<||||>Nonmetastatic, large, high-grade STS of the pelvis and extremities were treated with intra-arterial cisplatin, adriamycin, and, after 1995, ifosfamide. After induction, oncologic resection and histologic evaluation were performed. Good responders with good surgical margins were not treated with radiation.", "Survival after induction chemotherapy and surgical resection for high-grade soft tissue sarcoma. Is radiation necessary?<||||>Thirty-three patients, with a median follow-up of 5 years, were included. Limb salvage rate was 94%. Median tumor necrosis was 95%. Four patients developed metastatic disease with three subsequent deaths. Two local recurrences occurred; both patients were salvaged with reresection and adjuvant external beam radiotherapy, although one died of metastatic disease 10 years later. Relapse-free and overall survival is 80% and 88% at 5 and 10 years by Kaplan-Meier analysis." ]

[ "Backpacking in Yosemite and Kings Canyon National Parks and neighboring wilderness areas: how safe is the water to drink?<||||>The objective of this study was to determine the risk of acquiring disease from popular Sierra Nevada wilderness area lakes and streams. This study examines the relative risk factors for harmful waterborne microorganisms using coliforms as an indicator.", "Backpacking in Yosemite and Kings Canyon National Parks and neighboring wilderness areas: how safe is the water to drink?<||||>Water was collected in the backcountry Yosemite and Kings Canyon National Parks and neighboring wilderness areas. A total of 72 sites from lakes or streams were selected to statistically differentiate the risk categories: (1) natural areas rarely visited by humans or domestic animals; (2) human day use-only areas; (3) high use by backpackers; (4) high use by pack animals; and (5) cattle- and sheep-grazing tracts. Water was collected in sterile test tubes and Millipore coliform samplers during the summer of 2006. Water was analyzed at the university microbiology lab, where bacteria were harvested and then subjected to analysis using standardized techniques. Statistical analysis to compare site categories was performed using Fisher's exact test.", "Backpacking in Yosemite and Kings Canyon National Parks and neighboring wilderness areas: how safe is the water to drink?<||||>Coliforms were found in none of the 13 wild sites, none of the 12 day hike sites, and only 3 of 18 backpacker sites (17%). In contrast, 14 of 20 sites (70%) with pack animal traffic yielded coliforms, and all 9 sites (100%) below the cattle-grazing areas grew coliforms. Differences between backpacker versus cattle or pack areas were significant, p<or= 0.05. All samples grew normal aquatic bacteria. Sites below cattle grazing and pack animal use tended to have more total heterotrophic bacteria." ]

[ "Could mean platelet volume be a predictive marker for gestational diabetes mellitus?<||||>Gestational diabetes mellitus is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. Early diagnosis of this complication and appropriate treatment aimed at tight control over maternal glucose levels may positively influence the perinatal outcome. There are studies, which suggest platelets play a role in the pathogenesis of gestational diabetes mellitus.AIM: The aim of this study is to compare the platelet count and other platelet parameters in gestational diabetic and normal pregnant women and to investigate whether these parameters have a predictive significance in gestational diabetes mellitus.", "Could mean platelet volume be a predictive marker for gestational diabetes mellitus?<||||>Thirty four women with gestational diabetes mellitus and 45 normal pregnant women were enrolled into the study.", "Could mean platelet volume be a predictive marker for gestational diabetes mellitus?<||||>Women with gestational diabetes mellitus had lower platelet counts and higher mean platelet volume (MPV) values which were statistically significant (p<0.006 and p<0.0001), respectively." ]

[ "Do isolated hypertension and metabolic syndrome have equal risk of stroke in Chinese adults?<||||>To analyze whether isolated hypertension and metabolic syndrome ( Based on the 2005 IDF criteria) have equal risk on stroke in Chinese adults.", "Do isolated hypertension and metabolic syndrome have equal risk of stroke in Chinese adults?<||||>25194 subjects (25-75 years old) from Chinese National Health and Nutrition Survey in 2002 were divided into control group, isolated hypertension ( i-HTN) group, metabolic syndrome (MS) without hypertension ( non-HTN/MS) group , MS with hypertension (HTN/MS) group. The clinical features and risk for stroke ( using multiple logistic stepwise regression analysis) were compared among 4 groups.", "Do isolated hypertension and metabolic syndrome have equal risk of stroke in Chinese adults?<||||>(1) The clinic features in the i-HTN group was non-central obesity, and its plasma glucose, triglyceride 9TG), high density lipoprotein cholesterol ( HDL-C) levels were normal . (2) The prevalence of stroke in control group , i-HTN group, non-HTN/MS group and HTN/MS group was 0.14%, 1.27%, 1.19% and 2.14%, respectively. (3) After adjustment for age, sex, smoking, low density lipoprotein cholesterol level, logistic regression analysis showed that the i-HTN group, non-HTN/MS group and HTN/MS group had higher risk of stroke compared with the controls, the odd ratio (OR) were 4.18, 8.00, 8.69 (P<0.01), respectively. Compared with i-HTN group, OR in HTN/MS group was 2.05, while no difference was found between i-HTN group and non-HTN/MS group ( P>0.05). (4) Among different components of the MS, hypertension (OR 2.33), central obesity (OR 2.09), low HDL-C (OR 1.69), hyperglycemia (OR 1.66) except hypertriglyceridemia were all significantly related to stroke (P<0.01)." ]

[ "Bridging the gap in health inequalities with the help of health trainers: a realistic task in hostile environments?<||||>From a public health theoretical perspective, there is acknowledgement that synchronized policies, which address both individual and area level risks to health, are important to reduce inequalities and improve health. Despite this, much research focuses on just one of these two approaches (often pitting them against each other) and much practice tends to focus on individual level interventions. Efforts to address health inequalities between rich and poor in the UK continue to focus on individual-based interventions, with the most recent initiative being health trainers.", "Bridging the gap in health inequalities with the help of health trainers: a realistic task in hostile environments?<||||>In this debate piece, we will use health trainers as a specific example, and focusing primarily on levels of physical activity, we will argue that neither individual level interventions nor environmental change alone are likely to improve levels of activity or reduce health inequalities." ]

[ "Is circumferential minimally invasive surgery effective in the treatment of moderate adult idiopathic scoliosis?<||||>Outcomes for minimally invasive scoliosis correction surgery have been reported for mild adult scoliosis. Larger curves historically have been treated with open surgical procedures including facet resections or posterior column osteotomies, which have been associated with high-volume blood loss. Further, minimally invasive techniques have been largely reported in the setting of degenerative scoliosis.QUESTIONS/", "Is circumferential minimally invasive surgery effective in the treatment of moderate adult idiopathic scoliosis?<||||>We describe the effects of circumferential minimally invasive surgery (cMIS) for moderate to severe scoliosis in terms of (1) operative time and blood loss, (2) overall health and disease-specific patient-reported outcomes, (3) deformity correction and fusion rate, and (4) frequency and types of complications.", "Is circumferential minimally invasive surgery effective in the treatment of moderate adult idiopathic scoliosis?<||||>Between January 2007 and January 2012, we performed 50 cMIS adult idiopathic scoliosis corrections in patients with a Cobb angle of greater than 30° but less than 75° who did not have prior thoracolumbar fusion surgery; this series represented all patients we treated surgically during that time meeting those indications. Our general indications for this approach during that period were increasing back pain unresponsive to nonoperative therapy with cosmetic and radiographic worsening of curves. Surgical times and estimated blood loss were recorded. Functional clinical outcomes including VAS pain score, Oswestry Disability Index (ODI), and SF-36 were recorded preoperatively and postoperatively. Patients' deformity correction was assessed on pre- and postoperative 36-inch (91-cm) standing films and fusion was assessed on CT scan. Minimum followup was 24 months (mean, 48 months; range, 24-77 months).", "Is circumferential minimally invasive surgery effective in the treatment of moderate adult idiopathic scoliosis?<||||>Mean blood loss was 613 mL for one-stage surgery and 763 mL for two-stage surgery. Mean operative time was 351 minutes for one-stage surgery and 482 minutes for two-stage surgery. At last followup, mean VAS and ODI scores decreased from 5.7 and 44 preoperatively to 2.9 and 22 (p<0.001 and 0.03, respectively) and mean SF-36 score increased from 48 preoperatively to 74 (p = 0.026). Mean Cobb angle and sagittal vertical axis decreased from 42° and 51 mm preoperatively to 16° and 27 mm postoperatively (both p<0.001). An 88% fusion rate was confirmed on CT scan. Perioperative complications occurred in 11 of the 50 patients (22%), with delayed complications needing further surgery in 10 more patients at last followup." ]

[ "Seminoma and teratocarcinoma: synchronic unitesticular presentation as independent nodules with different histologies?<||||>To describe the ultrasound characteristics, vascularization pattern (colour Doppler ultrasound) and possible histogenesis of one case of synchronic untesticular seminoma and teratocarcinoma as independent tumor nodules, histologically different, in a 19-year-old patient with testicular mass for eight months.", "Seminoma and teratocarcinoma: synchronic unitesticular presentation as independent nodules with different histologies?<||||>Conventional ultrasound, colour Doppler ultrasound, and high resolution Doppler angiogram were performed, analyzing vascular flows. After resection of the tumor, macroscopic and histological sections were related with ultrasound images.", "Seminoma and teratocarcinoma: synchronic unitesticular presentation as independent nodules with different histologies?<||||>The patient showed three independent, well limited, tumoral nodules in the right testicle: two of them heterogeneous, 20 and 33 mm in diameter, with cystic areas and calcifications. The third nodule was solid, hypoechoic and homogeneous, 26 mm in diameter. All nodules presented an increase in vascularization with low resistance arterial flows. Histologically the first two nodules were teratocarcinomas (predominantly mature teratoma and embryonal carcinoma) and the third classic seminoma." ]

[ "Are online support groups always beneficial?<||||>Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is one of the leading concerns in healthcare. Individuals living with HIV/AIDS are often confronted with tremendous physical and psychosocial challenges. Online support groups can provide a valuable source of information, advice and support, and a medium through which individuals living with HIV/AIDS can interact with each other and share their experiences. However, very little is known about how online support group might promote empowerment and the potential disadvantages associated with online support group use among individuals living with HIV/AIDS.", "Are online support groups always beneficial?<||||>The present study explored the potential empowering and disempowering processes, and empowering outcomes of online support group use among individuals with HIV/AIDS.", "Are online support groups always beneficial?<||||>A total of 115 HIV-positive online support group members were recruited from HIV-related online support groups. They completed an online survey exploring their experiences of online support group use.", "Are online support groups always beneficial?<||||>Thematic analysis revealed six empowering processes arising from use of online support groups: exchanging information, sharing experiences, connecting to others, encountering emotional support, finding recognition and understanding, and helping others. Six empowering outcomes were identified: increased optimism, emotional well-being, social well-being, being better informed, improved disease management, and feeling confident in the relationship with physicians. Potentially disempowering processes were also identified which included: being unable to connect physically, inappropriate behaviour online, declining real life relationships, and information overload and misinformation." ]

[ "Assessing the experience in complex hepatopancreatobiliary surgery among graduating chief residents: is the operative experience enough?<||||>Resident operative autonomy and case volume is associated with posttraining confidence and practice plans. Accreditation Council for Graduate Medical Education requirements for graduating general surgery residents are four liver and three pancreas cases. We sought to evaluate trends in resident experience and autonomy for complex hepatopancreatobiliary (HPB) surgery over time.", "Assessing the experience in complex hepatopancreatobiliary surgery among graduating chief residents: is the operative experience enough?<||||>We queried the Accreditation Council for Graduate Medical Education General Surgery Case Log (2003-2012) for all cases performed by graduating chief residents (GCR) relating to liver, pancreas, and the biliary tract (HPB); simple cholecystectomy was excluded. Mean (±SD), median [10th-90th percentiles] and maximum case volumes were compared from 2003 to 2012 using R(2) for all trends.", "Assessing the experience in complex hepatopancreatobiliary surgery among graduating chief residents: is the operative experience enough?<||||>A total of 252,977 complex HPB cases (36% liver, 43% pancreas, 21% biliary) were performed by 10,288 GCR during the 10-year period examined (Mean = 24.6 per GCR). Of these, 57% were performed during the chief year, whereas 43% were performed as postgraduate year 1-4. Only 52% of liver cases were anatomic resections, whereas 71% of pancreas cases were major resections. Total number of cases increased from 22,516 (mean = 23.0) in 2003 to 27,191 (mean = 24.9) in 2012. During this same time period, the percentage of HPB cases that were performed during the chief year decreased by 7% (liver: 13%, pancreas 8%, biliary 4%). There was an increasing trend in the mean number of operations (mean ± SD) logged by GCR on the pancreas (9.1 ± 5.9 to 11.3 ± 4.3; R(2) = .85) and liver (8.0 ± 5.9 to 9.4 ± 3.4; R(2) = .91), whereas those for the biliary tract decreased (5.9 ± 2.5 to 3.8 ± 2.1; R(2) = .96). Although the median number of cases [10th:90th percentile] increased slightly for both pancreas (7.0 [4.0:15]to 8.0 [4:20]) and liver (7.0 [4:13]to 8.0 [5:14]), the maximum number of cases preformed by any given GCR remained stable for pancreas (51 to 53; R(2) = .18), but increased for liver (38 to 45; R(2) = .32). The median number of HPB cases that GCR performed as teaching assistants (TAs) remained at zero during this time period. The 90th percentile of cases performed as TA was less than two for both pancreas and liver." ]

[ "Downregulation of serum epidermal growth factor in patients with inflammatory bowel disease. Is there a link with mucosal damage?<||||>Epidermal growth factor (EGF) is a multipotent peptide which contributes to epithelial development, inhibition of gastric acid secretion, acceleration of wound healing, and promotion of angiogenesis. The aim of this study is to evaluate serum EGF concentrations in inflammatory bowel disease (IBD) patients, with regard to disease and patients' characteristics.", "Downregulation of serum epidermal growth factor in patients with inflammatory bowel disease. Is there a link with mucosal damage?<||||>EGF determination was performed by a commercially available enzyme-linked immunosorbent assay. Fifty-two patients with ulcerative colitis (UC), 59 with Crohn's disease (CD), and 55 healthy controls (HC) were included in the study.", "Downregulation of serum epidermal growth factor in patients with inflammatory bowel disease. Is there a link with mucosal damage?<||||>Mean ( ± SEM) serum EGF levels were 217.2 ( ± 30.40) pg/mL in UC patients, 324.6 ( ± 37.29) pg/mL in CD patients, and 453.1 ( ± 39.44) pg/mL in HC. Serum EGF levels were significantly lower in UC and CD patients compared to HC (P<0.0001 and P = 0.0199, respectively). Lower serum EGF levels were observed in UC compared to CD patients (P = 0.0277). Extent of the disease was found to affect serum EGF levels in UC, demonstrating significant reduction in patients with left-sided colitis and pancolitis in comparison with those with proctitis (P = 0.0190 and P = 0.0024, respectively). EGF concentration was not influenced by other characteristics of patients and disease." ]

[ "Preventive care for women. Does the sex of the physician matter?<||||>Emphasis on ensuring women's access to preventive health services has increased over the past decade. Relatively little attention has been paid to whether the sex of the physician affects the rates of cancer screening among women. We examined differences between male and female physicians in the frequency of screening mammograms and Pap smears among women patients enrolled in a large Midwestern health plan.", "Preventive care for women. Does the sex of the physician matter?<||||>We identified claims for mammography and Pap tests submitted by primary care physicians for 97,962 women, 18 to 75 years of age, who were enrolled in the health plan in 1990. The sex of the physician was manually coded, and the physician's age was obtained from the state licensing board. After identifying a principal physician for each woman, we calculated the frequency of mammography and Pap smears for each physician, using the number of women in his or her practice during 1990 as the denominator. Using unconditional logistic regression, we also calculated the odds ratio of having a Pap smear or mammogram for women patients with female physicians as compared with those with male physicians, controlling for the physician's and the patient's age.", "Preventive care for women. Does the sex of the physician matter?<||||>Crude rates for Pap smears and mammography were higher for the patients of female than male physicians in most age groups of physicians. The largest differences between female and male physicians were in the rates of Pap smears among the youngest physicians. For the subgroup of women enrolled in the health plan for a year who saw only one physician, after adjustment for the patient's age and the physician's age and specialty, the odds ratio for having a Pap smear was 1.99 (95 percent confidence interval, 1.72 to 2.30) for the patients of female physicians as compared with those of male physicians. For women 40 years old and older, the odds ratio for having a mammogram was 1.41 (95 percent confidence interval, 1.22 to 1.63). For both Pap smears and mammography, the differences between female and male physicians in screening rates were much more pronounced in internal medicine and family practice than in obstetrics and gynecology." ]