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[ "Does prolonged length of stay in the emergency department affect outcome for stroke patients?<||||>Conflicting data exist regarding the association between the length of stay (LOS) of critically ill patients in the emergency department (ED) and their subsequent outcome. However, such patients are an overall heterogeneous group, and we therefore sought to study the association between EDLOS and outcomes in a specific subgroup of critically ill patients, namely those with acute ischemic stroke/transient ischemic attack (AIS/TIA).", "Does prolonged length of stay in the emergency department affect outcome for stroke patients?<||||>This was a retrospective review of adult patients with a discharge diagnosis of AIS/TIA presenting to an ED between July 2009 and February 2010. We collected demographics, EDLOS, arrival stroke severity (National Institutes of Health Stroke Scale - NIHSS), intravenous tissue plasminogen activator (IV tPA) use, functional outcome at discharge, discharge destination and hospital-LOS. We analyzed relationship between EDLOS, outcomes and discharge destination after controlling for confounders.", "Does prolonged length of stay in the emergency department affect outcome for stroke patients?<||||>190 patients were included in the cohort. Median EDLOS was 332 minutes (Inter-Quartile Range -IQR: 250.3-557.8). There was a significant inverse linear association between EDLOS and hospital-LOS (p=0.049). Patients who received IV tPA had a shorter median EDLOS (238 minutes, IQR: 194-299) than patients who did not (median: 387 minutes, IQR: 285-588 minutes; p<0.0001). There was no significant association between EDLOS and poor outcome (p=0.40), discharge destination (p=0.20), or death (p=0.44). This remained true even after controlling for IV tPA use, NIHSS and hospital-LOS; and did not change even when analysis was restricted to AIS patients alone." ]

[ "Do exercise balls provide a training advantage for trunk extensor exercises?<||||>Only a few abdominal muscle exercises have been quantitatively evaluated on both a mat and exercise ball, but the benefits reported for the ball have been equivocally applied to all exercises. The purpose of this study is to evaluate differences in the biological response of muscle activation, lumbar spine posture, and loading variables for extensor exercises performed on 2 surfaces.", "Do exercise balls provide a training advantage for trunk extensor exercises?<||||>Bilateral muscle activation was recorded from 7 sites (rectus abdominis, external/internal obliques, latissimus dorsi, thoracic/lumbar erector spinae, and multifidus) on 8 subjects. Three-dimensional lumbar spine postures and upper body kinematics were recorded while the participants performed the exercises. An electromyography-driven model was used to calculate spinal loading.", "Do exercise balls provide a training advantage for trunk extensor exercises?<||||>Cocontraction of trunk flexor and extensor muscles was reduced by up to 30% for the extension exercises when performed on the ball. Peak muscle activation remained unchanged or decreased, and spinal loading (compression and anterior-posterior shear) decreased when the extension exercises were performed on the ball. The lumbar spine postures attained during the exercises did not differ between surfaces." ]

[ "Does the participation of a surgical trainee adversely impact patient outcomes?<||||>Some patients have concerns regarding the impact of surgical trainees on the quality of care that they receive in teaching hospitals. No population-based data exist that describe outcomes of surgical procedures in teaching and nonteaching hospitals; however, institutional data suggest that teaching hospitals provide high-quality care. We hypothesized that the presence of a general surgery residency program (GSRP) is associated with superior outcomes for pancreatic resection, a complex surgical procedure.", "Does the participation of a surgical trainee adversely impact patient outcomes?<||||>A retrospective, population-based, risk-adjusted analysis of 5696 patients who underwent major pancreatic resection compares the outcomes of patients treated at hospitals with a GSRP (GSRP+) and those hospitals without a GSRP (GSRP-).", "Does the participation of a surgical trainee adversely impact patient outcomes?<||||>GSRP+ hospitals had a lower operative mortality rate (8.3% vs 11.0%; P<. 001), a lower percentage of patients discharged to another acute care hospital or skilled nursing facility (6.5% vs 13.0%; P<.001), and a longer length of stay compared with GSRP- hospitals (22.1 +/- 0.4 days vs 19.6 +/- 0.3 days; P<.001). The observed difference in hospital mortality rates was not significant after an adjustment was made for patient mix and hospital volume (9.7% vs 10.0%). However, superior outcomes were found in the university teaching hospitals, as compared with the affiliated teaching and the nonteaching hospitals (5.3% [P<.001] vs 11.4% vs 11.0%; risk adjusted, 8.0% [P<.05] vs 10.9% vs 10.0%)." ]

[ "Intensive exercise: a remedy for childhood obesity?<||||>Acute exercise can affect the energy intake regulation, which is of major interest in terms of obesity intervention and weight loss.", "Intensive exercise: a remedy for childhood obesity?<||||>To test the hypothesis that intensive exercise can affect the subsequent energy intake and balance in obese adolescents.", "Intensive exercise: a remedy for childhood obesity?<||||>The study was conducted in 2009 and enrolled 12 obese pubertal adolescents ages 14.4±1.5 years old. Two exercise and one sedentary sessions were completed. The first exercise (EX(1)) and sedentary session (SED) were randomly conducted 1 week apart. The second exercise session (EX₂) was conducted following 6 weeks of diet modification and physical activity (3×90 min/week) to produce weight loss. Energy intake was recorded, subjective appetite sensation was evaluated using Visual Analogue Scales and energy expenditure was measured using ActiHerats during EX(1), EX₂ and SED.", "Intensive exercise: a remedy for childhood obesity?<||||>Total energy intake over the awakened period was significantly reduced by 31% and 18% during the EX(1) and EX(2) sessions compared with the SED session, respectively (p<0.01). Energy balance over the awakened period was negative during EX₁, neutral during EX₂ and positive during SED. There was no significant difference in terms of subjective appetite rates between sessions during the awakened hours." ]

[ "Is prostate-specific antigen surveillance necessary in men with benign prostate pathology following radical cystoprostatectomy for bladder cancer?<||||>Radical cystoprostatectomy (RCP) remains the gold standard for the treatment of muscle-invasive bladder cancer. There are limited data regarding the clinical impact and detection of PSA following complete prostatectomy or the need to monitor serum PSA in patients with benign prostate pathology at time of RCP. The purpose of our study was to analyze the postoperative PSA characteristics of men without prostate cancer who underwent a RCP for bladder cancer.", "Is prostate-specific antigen surveillance necessary in men with benign prostate pathology following radical cystoprostatectomy for bladder cancer?<||||>The demographic, clinical and pathologic data were reviewed on 138 men who underwent RCP for bladder cancer from 1994 to 2008. Patients with known or incidentally discovered prostate cancer on final pathology were excluded from this study, and postoperative serum PSA values were reviewed in the remaining men.", "Is prostate-specific antigen surveillance necessary in men with benign prostate pathology following radical cystoprostatectomy for bladder cancer?<||||>The median age of the study population was 64 years (range 40-84). At a mean follow-up of 40.7 months, 137 (99.3%) of patients had an undetectable serum PSA. The one (0.7%) case in which serum PSA was not undetectable underwent an apex-sparing prostatectomy at the time of cystectomy." ]

[ "Can the impact of gender equality on health be measured?<||||>The aim of this study was to investigate potential associations between gender equality at work and self-rated health.", "Can the impact of gender equality on health be measured?<||||>2861 employees in 21 companies were invited to participate in a survey. The mean response rate was 49.2%. The questionnaire contained 65 questions, mainly on gender equality and health. Two logistic regression analyses were conducted to assess associations between (i) self-rated health and a register-based company gender equality index (OGGI), and (ii) self-rated health and self-rated gender equality at work.", "Can the impact of gender equality on health be measured?<||||>Even though no association was found between the OGGI and health, women who rated their company as \"completely equal\" or \"quite equal\" had higher odds of reporting \"good health\" compared to women who perceived their company as \"not equal\" (OR = 2.8, 95% confidence interval = 1.4 - 5.5 and OR = 2.73, 95% CI = 1.6-4.6). Although not statistically significant, we observed the same trends in men. The results were adjusted for age, highest education level, income, full or part-time employment, and type of company based on the OGGI." ]

[ "N-acetyl-cysteine decreases the matrix-degrading capacity of macrophage-derived foam cells: new target for antioxidant therapy?<||||>Atherosclerotic plaque destabilization triggers clinical cardiovascular disease and thus represents an attractive therapeutic target. Weakening of tissue through the action of matrix-degrading enzymes, called matrix metalloproteinases (MMPs), released by resident macrophages was previously implicated in unstable vascular syndromes.", "N-acetyl-cysteine decreases the matrix-degrading capacity of macrophage-derived foam cells: new target for antioxidant therapy?<||||>We used a hypercholesterolemic rabbit model of atherosclerosis to investigate the gelatinolytic activity associated with macrophage-derived foam cells (FCs). Gelatinolytic activity and expression of MMP-9 but not of MMP-2 cosegregated with macrophage FCs in aortic lesions. Macrophage-derived gelatinases were further investigated in vitro. MMP-9 was identified as the main macrophage-derived gelatinase in cells isolated from aortic lesions and from granuloma induced in the same rabbits to increase cell yield. Importantly, detection of activated MMP-9 in the FC culture medium supports the notion that these cells can independently initiate processing of secreted MMP zymogens to active enzymes. We further examined whether FC gelatinolytic activity is dependent on the presence of reactive oxygen species (ROS). We found that treatment (1 to 5 days) with 1 to 10 mmol/L N-acetyl-L-cysteine (NAC), an ROS scavenger, decreased not only gelatinolytic activity but also gelatinase expression by FCs. Similarly, NAC treatment of explanted lesions abolished in situ gelatinolytic activity and MMP-9 expression." ]

[ "Do food and physical activity environments vary between disadvantaged urban and rural areas?<||||>The presence or absence of amenities in local neighbourhood environments can either promote or restrict access to opportunities to engage in healthy and/or less healthy behaviours. Rurality is thought to constrain access to facilities and services. This study investigated whether the presence and density of environmental amenities related to physical activity and eating behaviours differs between socioeconomically disadvantaged urban and rural areas in Victoria, Australia.", "Do food and physical activity environments vary between disadvantaged urban and rural areas?<||||>We undertook cross-sectional analysis of environmental data collected in 2007-08 as part of the Resilience for Eating and Activity Despite Inequality (READI) study. These data were sourced and analysed for 40 urban and 40 rural socioeconomically disadvantaged areas. The variables examined were the presence, raw count, count/km2, and count/'000 population of a range of environmental amenities (fast-food restaurants, all supermarkets (also separated by major chain and other supermarkets), greengrocers, playgrounds, gyms/leisure centres, public swimming pools and public open spaces).", "Do food and physical activity environments vary between disadvantaged urban and rural areas?<||||>A greater proportion of urban areas had a fast-food restaurant and gym/leisure centre present while more rural areas contained a supermarket and public swimming pool. All amenities examined (with the exception of swimming pools) were more numerous per km2 in urban areas, however rural areas had a greater number of all supermarkets, other supermarkets, playgrounds, swimming pools and public open space per '000 population." ]

[ "Intravenous regional anesthesia administered by the operating plastic surgeon: is it safe and efficient?<||||>Intravenous regional anesthesia (Bier's block) is an effective method of providing anesthesia for extremity surgery. This technique is most suitable for short-duration, less than 60-minute surgical procedures in distal extremities. Earlier studies recommended that intravenous regional anesthesia be performed by anesthesiologists who are familiar with the technique and fully trained to treat its complications. This study was conducted to demonstrate that intravenous regional anesthesia administered by the operating plastic surgeon is safe, efficient, and simple to perform.", "Intravenous regional anesthesia administered by the operating plastic surgeon: is it safe and efficient?<||||>A 5-year retrospective chart review (January of 2000 to December of 2004) was undertaken. The study included patients who underwent surgical procedures and were administered intravenous regional anesthesia by the surgeon.", "Intravenous regional anesthesia administered by the operating plastic surgeon: is it safe and efficient?<||||>Four hundred forty-eight patients were included in the study, and 479 operations of 483 scheduled were completed under intravenous regional anesthesia performed by the operating surgeon. Intravenous regional anesthesia was efficient in 478 of 479 of the cases (99.8 percent). Tourniquet-related technical problems were noted in five of 483 cases (1 percent), resulting in cancellation of four operations, with no reported consequent anesthetic toxicity. Minor complications were reported in six of 479 of the cases (1.2. percent). No major complications occurred." ]

[ "Does the Modified Fatigue Impact Scale offer a more comprehensive assessment of fatigue in MS?<||||>As a symptom of multiple sclerosis (MS), fatigue is difficult to manage because of its unknown etiology, the lack of efficacy of the drugs tested to date and the absence of consensus about which would be the ideal measure to assess fatigue.", "Does the Modified Fatigue Impact Scale offer a more comprehensive assessment of fatigue in MS?<||||>Our aim was to assess the frequency of fatigue in a sample of MS patients and healthy controls (HC) using two fatigue scales, the Fatigue Severity Scale (FSS) and the Modified Fatigue Impact Scale (MFIS) with physical, cognitive and psychosocial subscales. We also studied the relationship fatigue has with depression, disability and interferon beta.", "Does the Modified Fatigue Impact Scale offer a more comprehensive assessment of fatigue in MS?<||||>Three hundred and fifty-four individuals (231 MS patients and 123 HC) were included in this cross-sectional study. Fatigue was assessed using the FSS and MFIS. Depression was measured by the Beck Depression Inventory (BDI), and disability by the Expanded Disability Status Scale (EDSS). A status of fatigue was considered when the FSS>or =5, of non-fatigue when the FSS<or =4, and scores between 4.1 and 4.9 were considered doubtful fatigue cases.", "Does the Modified Fatigue Impact Scale offer a more comprehensive assessment of fatigue in MS?<||||>Fifty-five percent of MS patients and 13% of HC were fatigued. The global MFIS score positively correlated with the FSS in MS and HC (r =0.68 for MS and r =0.59 for HC, p<0.0001). Nonetheless, the MFIS physical subscale showed the strongest correlation score with the FSS (r =0.75, p<0.0001). In addition, a prediction analysis showed the physical MFIS subscale to be the only independent predictor of FSS score (p<0.0001), suggesting other aspects of fatigue, as cognition and psychosocial functions, may be explored by the FSS to a lesser extent. Depression also correlated with fatigue (r =0.48 for the FSS and r =0.7 for the MFIS, p<0.0001) and, although EDSS correlated with fatigue as well, the scores decreased after correcting for depression. Interferon beta showed no relationship with fatigue." ]

[ "Is it possible to define a threshold for free PSA index that is useful in the daily practice of urology?<||||>Retrospective evaluation of the use of the free PSA index before prostatic biopsies.", "Is it possible to define a threshold for free PSA index that is useful in the daily practice of urology?<||||>The authors retrospectively studied the values for total PSA, free PSA, and free PSA index (ratio of free PSA over total PSA expressed as a %) in men with a total PSA between 2 and 10 ng/ml, from a population of 391 men prior to prostatic biopsies. They also isolated a subgroup of patients in whom the free PSA index could have been used as a first-line marker to decide whether or not to perform prostatic biopsies.", "Is it possible to define a threshold for free PSA index that is useful in the daily practice of urology?<||||>The mean values for total PSA, free PSA, and free PSA index were compared as a function of the diagnosis, age, and ultrasound prostatic volume. The yields of the various cut-off values for the free PSA index for PSA between 2 and 4 ng/ml, 4 and 10 ng/ml, and 2 and 10 ng/ml with a normal digital rectal examination are reported. Between 2 to 10 ng/ml, at a cut-off value of 30%, 94.1% of cancers would have been detected (sensitivity) and 22% of biopsies would have been avoided, 10 of which would have been useless, i.e. a 30.3% economy of useless biopsies not performed (specificity). At the cut-off value of 15%, less than half of cancers would have been detected (47.1%) and 90.9% of useless biopsies would have been avoided. Biases creating difficulties of interpretation were the assay kits, the reference population, age, storage of sera, and prostatic volume." ]

[ "Significant post-transplant hypogammaglobulinemia in six heart transplant recipients: an emerging clinical phenomenon?<||||>The recent development of powerful agents such as mycophenolate mofetil and tacrolimus has altered current regimens for the prevention and treatment of allograft rejection. Questions have been raised about these newer regimens in terms of susceptibility to opportunistic infections and effects on host defenses. Severe hypogammaglobulinemia has been infrequently described in solid organ transplant recipients, but has been recently noted in six heart transplant recipients at one center, of whom five were receiving a combination of tacrolimus, mycophenolate mofetil, and prednisone.", "Significant post-transplant hypogammaglobulinemia in six heart transplant recipients: an emerging clinical phenomenon?<||||>Case summaries of six recent heart transplant recipients with total immunoglobulin G (IgG) levels of less than 310 mg/dl, five of whom had cytomegalovirus (CMV) infection and three of whom had multiple infections including Nocardia, invasive Trichophyton, and Acinetobacter bacteremia. Previous literature was reviewed with the aid of a Medline search using the search terms hypogammaglobulinemia; kidney, liver, heart, lung, and organ transplantation; mycophenolate mofetil; tacrolimus; cyclosporine; azathioprine; and nocardiosis.", "Significant post-transplant hypogammaglobulinemia in six heart transplant recipients: an emerging clinical phenomenon?<||||>We here report six cardiac transplant recipients seen over a period of one year who were found to have immunoglobulin G levels of 310 mg/dl or below (normal: 717-1400 mg/dl). The first five patients were diagnosed because of evaluation for infections; the sixth, who was asymptomatic with an IgG level of 175, was found during screening for hypogammaglobulinemia instituted as a result of these first five patients. All six patients had received steroid pulses for rejection; all received mycophenolate mofetil; and 5/6 had been switched from cyclosporine to tacrolimus because of steroid-resistant rejection. Transient neutropenia (absolute neutrophil count less than 1000) was observed in 2/6; 3/6 had received OKT3 therapy for refractory rejection. These six patients were treated with a combination of antimicrobials, immunoglobulin replacement, and decrease in immunosuppressive therapy." ]

[ "Does previous open nephrolithotomy affect the outcome of percutaneous nephrolithotomy?<||||>To determine the effects of previous open nephrolithotomy on the results and morbidity of subsequent percutaneous nephrolithotomy (PCNL).", "Does previous open nephrolithotomy affect the outcome of percutaneous nephrolithotomy?<||||>Between March 2005 and January 2006, 89 patients underwent PCNL at our institution. We compared the patients who had had previous open surgery on the same kidney (group 1; n = 27) with those who had had no previous surgery (group 2; n = 62). The two groups did not differ significantly in age (45.4 v 44 years), stone burden (361.3 mm(2) v 482.4 mm(2) ), stone number, or laterality. Operative time, hospital stay, success rate, visual analog pain scores 8 hours after surgery, analgesic doses (diclofenac sodium), and intraoperative and postoperative complications were compared.", "Does previous open nephrolithotomy affect the outcome of percutaneous nephrolithotomy?<||||>There were no differences in operating time, postoperative analgesic doses, pain scores, intraoperative and postoperative complications, the number of accesses, or the stone-free rate." ]

[ "Should patients infected with HIV be screened for occult hepatitis B?<||||>Occult hepatitis B is defined as the presence of hepatitis B virus (HBV) DNA in the absence of detectable HBs antigen. The prevalence of occult hepatitis B among patients HIV-infected is uncertain, varying between 0% and 89%, and the clinical consequences of the coinfection are poorly known. The aim of this study was to evaluate the frequency of occult hepatitis B among HIV-infected patients and determine risk factors.", "Should patients infected with HIV be screened for occult hepatitis B?<||||>This retrospective study was conducted with plasma samples from 31HIV-infected patients untreated for HBV infection and for whom at least one sample was available. All patients were found to be carriers of isolated anti-HBc antibodies between 2000 and 2008, and HBV DNA was quantified in 51 samples (one to three per patient) by real-time PCR using the Qiagen HBV PCR kit.", "Should patients infected with HIV be screened for occult hepatitis B?<||||>HBV DNA was found in samples from seven patients (22%). Occult hepatitis B seemed to be more frequent among patients coinfected with HCV (p=0.047). The number of CD4 cells was significantly less in samples containing detectable HBV DNA than in those with no detectable HBV DNA." ]

[ "The putaminal abnormalities on 3.0T magnetic resonance imaging: can they separate parkinsonism-predominant multiple system atrophy from Parkinson's disease?<||||>The putaminal abnormalities detected on 1.5 T magnetic resonance imaging (MRI), such as putaminal atrophy, slit-like hyperintense rim, and hypointensity in the putamen on T2-weighted (T2W) imaging are important signs on differentiating multiple system atrophy with parkinsonism (MSA-P) from Parkinson's disease (PD). However, the putaminal abnormalities may have different manifestations on 3.0 T from those on 1.5 T.", "The putaminal abnormalities on 3.0T magnetic resonance imaging: can they separate parkinsonism-predominant multiple system atrophy from Parkinson's disease?<||||>To investigate the diagnostic value of putaminal abnormalities on 3.0 T MRI for differentiating MSA-P from PD.", "The putaminal abnormalities on 3.0T magnetic resonance imaging: can they separate parkinsonism-predominant multiple system atrophy from Parkinson's disease?<||||>The study included a MSA-P group (9 men, 9 women), a PD group (12 men, 14 women), and a control group (11 men, 13 women). All subjects were examined with 3.0 T MRI using the conventional protocol. Putaminal atrophy, T2-hypointensity in the dorsolateral putamenat, and a slit-like hyperintense rim on the lateral putamen were evaluated in each subject.", "The putaminal abnormalities on 3.0T magnetic resonance imaging: can they separate parkinsonism-predominant multiple system atrophy from Parkinson's disease?<||||>There were no significant differences in the slit-like hyperintense rim (P = 0.782) or T2-hypointensity in the dorsolateral putamen (P = 0.338) among the three groups. Bilateral putaminal atrophy was found in 44.4% (8 of 18) of the MSA-P patients, in only 7.7% (2 of 26) of the PD patients, and in none of the controls. The proportion of subjects with putaminal atrophy was significantly higher in the MAS-P group (P = 0.008) and control group (P < 0.001). The specificity and sensitivity of putaminal atrophy for distinguishing MSA-P from PD was 92.3% and 44.4%, respectively." ]

[ "Is premigration health screening for tuberculosis worthwhile?<||||>To determine whether premigration screening for tuberculosis is worth undertaking in visa applicants, and whether screening resources are being appropriately directed towards intending migrants at highest risk of tuberculosis.", "Is premigration health screening for tuberculosis worthwhile?<||||>A 12-month survey of all intending migrants with tuberculosis necessitating treatment detected during the premigration health assessment process, whose medical examinations were submitted to the Department of Immigration and Citizenship's Global Health Branch for assessment by a Medical Officer of the Commonwealth between 1 July 2009 and 30 June 2010.", "Is premigration health screening for tuberculosis worthwhile?<||||>Individuals diagnosed with active tuberculosis; proportions diagnosed by sputum smear and culture tests or clinically, and with susceptibility test results; distribution of visa types among people diagnosed.", "Is premigration health screening for tuberculosis worthwhile?<||||>In premigration assessments, 519 people were diagnosed with active tuberculosis (prevalence, 137 per 100,000 in examined population). The top source countries for people with tuberculosis were the Philippines (21.8%), India (16.8%), Vietnam (16.2%) and China (8.3%). Positive sputum smear test results were submitted for 67 cases (12.9%). Positive culture test results were obtained in 230 cases (44.3%), but only 95 of these (41.3%) had susceptibility test results, with 83 fully susceptible. Four people had multidrug-resistant tuberculosis (prevalence, 1.06 per 100 000 population). Five people had both active tuberculosis and HIV infection. Of all those diagnosed with tuberculosis, 162 (31.2%) were intending students, 82 (15.8%) were intending visitors, and 53 (10.2%) were applicants for humanitarian (refugee and Special Humanitarian Program) visas." ]

[ "Can the signal-to-noise ratio of choline in magnetic resonance spectroscopy reflect the aggressiveness of endometrial cancer?<||||>To differentiate endometrial cancer (ECa) from benign lesions in endometrial or in submucosa (BLs-ESm), and investigate whether the signal-to-noise ratio (SNR) of choline-containing compounds (Cho) obtained from three-dimensional (1)H magnetic resonance spectroscopy (MRS) is associated with the aggressiveness of ECa.", "Can the signal-to-noise ratio of choline in magnetic resonance spectroscopy reflect the aggressiveness of endometrial cancer?<||||>Thirty-three patients with ECa and 15 patients with BLs-ESm underwent preoperative multivoxel (1)H MRS at 3 T MR. The amplitude of Cho peak of each voxel was recorded, and the corresponding SNR of Cho peak (ChoSNR) was calculated. The maximum ChoSNR (max ChoSNR) for each lesion was identified. The max ChoSNR of ECa and BLs-ESm, as well as type I ECa and type II ECa, was compared. The relationship between max ChoSNR and pathologic characteristics of tumors, including tumor grade, stage, type, and tumor size, was analyzed.", "Can the signal-to-noise ratio of choline in magnetic resonance spectroscopy reflect the aggressiveness of endometrial cancer?<||||>The mean max ChoSNR (±standard deviation [SD]) was 30.93 ± 16.89 for ECa and 10.40 ± 3.07 for BLs-ESm (P<.001). The mean max ChoSNR for type II ECa (48.54 ± 21.46) was higher than that for type I ECa (26.19 ± 12.02, P = .001). There were no significant differences among different grades (P = .449). The Spearman coefficient between max ChoSNR and stage was 0.423 (P = .014); the difference existed only between Ia and III ECa (P = .048). The Pearson coefficient between ChoSNR and tumor size was 0.515 (P = .002)." ]

[ "Does adherence monitoring reduce controlled substance abuse in chronic pain patients?<||||>Opioids are used extensively for chronic pain management in the United States. The frequency of opioid use prior to presenting to interventional pain management settings and in interventional pain management settings has been shown to be above 90%. Given that controlled substance abuse and illicit drug use are prevalent phenomena, adherence monitoring of patients that are prescribed opioids is becoming common. Adherence monitoring is carried out by an appropriate history, periodic evaluation of appropriate intake of drugs, random drug testing, and pill counts. Crucial to adherence monitoring is an initial controlled substance agreement and repeated review of the terms of this agreement with on-going education. However, the effect of adherence monitoring on drug abuse is unclear.", "Does adherence monitoring reduce controlled substance abuse in chronic pain patients?<||||>To identify controlled substance abuse through implementation of the terms of a controlled substance agreement, including periodic review and monitoring outside the organization.", "Does adherence monitoring reduce controlled substance abuse in chronic pain patients?<||||>Prospective evaluation with historical controls.", "Does adherence monitoring reduce controlled substance abuse in chronic pain patients?<||||>Five hundred consecutive patients receiving prescription controlled substances were followed in a prospective manner. The evaluation consisted of a chart review to monitor controlled substance intake, with special attention to drugs obtained from outside the organization. Data collection for this purpose included information from records, pharmacies, referring physicians, and all the physicians involved in the treatment of the patient.", "Does adherence monitoring reduce controlled substance abuse in chronic pain patients?<||||>Results from 500 consecutive patients were evaluated. Controlled substance abuse was seen in 9% of patients; overall, 5% of patients were obtaining controlled substances from other physicians, and 4% from illegal sources." ]

[ "Does the availability of a South Asian language in practices improve reports of doctor-patient communication from South Asian patients?<||||>Ethnic minorities report poorer evaluations of primary health care compared to White British patients. Emerging evidence suggests that when a doctor and patient share ethnicity and/or language this is associated with more positive reports of patient experience. Whether this is true for adults in English general practices remains to be explored.", "Does the availability of a South Asian language in practices improve reports of doctor-patient communication from South Asian patients?<||||>We analysed data from the 2010/2011 English General Practice Patient Survey, which were linked to data from the NHS Choices website to identify languages which were available at the practice. Our analysis was restricted to single-handed practices and included 190,582 patients across 1,068 practices. Including only single-handed practices enabled us to attribute, more accurately, reported patient experience to the languages that were listed as being available. We also carried out sensitivity analyses in multi-doctor practices. We created a composite score on a 0-100 scale from seven survey items assessing doctor-patient communication. Mixed-effect linear regression models were used to examine how differences in reported experience of doctor communication between patients of different self-reported ethnicities varied according to whether a South Asian language concordant with their ethnicity was available in their practice. Models were adjusted for patient characteristics and a random effect for practice.", "Does the availability of a South Asian language in practices improve reports of doctor-patient communication from South Asian patients?<||||>Availability of a concordant language had the largest effect on communication ratings for Bangladeshis and the least for Indian respondents (p<0.01). Bangladeshi, Pakistani and Indian respondents on average reported poorer communication than White British respondents [-2.9 (95%CI -4.2, -1.6), -1.9 (95%CI -2.6, -1.2) and -1.9 (95%CI -2.5, -1.4), respectively]. However, in practices where a concordant language was offered, the experience reported by Pakistani patients was not substantially worse than that reported by White British patients (-0.2, 95%CI -1.5,+1.0), and in the case of Bangladeshi patients was potentially much better (+4.5, 95%CI -1.0,+10.1). This contrasts with a worse experience reported among Bangladeshi (-3.3, 95%CI -4.6, -2.0) and Pakistani (-2.7, 95%CI -3.6, -1.9) respondents when a concordant language was not offered." ]

[ "Inverse correlation between genetic aberrations and malignancy grade in ependymal tumors: a paradox?<||||>The goal of our study was to investigate the inverse correlation between number of genetic aberrations and malignancy grade in ependymal tumors at the ploidy level.", "Inverse correlation between genetic aberrations and malignancy grade in ependymal tumors: a paradox?<||||>we examined seven myxopapillary ependymomas (mpEs) (WHO grade I), 28 spinal and cerebral ependymomas (Es) (WHO grade II), and 18 cerebral anaplastic ependymomas (aEs) (WHO grade III) using image DNA cytometry. The ploidy status was correlated with clinicopathological characteristics and with the results obtained by comparative genomic hybridization (CGH) analysis that we performed in about half of these tumors.", "Inverse correlation between genetic aberrations and malignancy grade in ependymal tumors: a paradox?<||||>mpEs were exclusively located in the spinal cord and aEs in the cerebrum only, whereas Es were located in both the spinal cord and brain. We found aneuploidy or tetraploidy to be common in the group of mpEs (6 out of 7) and much less frequent in Es (6 out of 28) and aEs (4 out of 18). Three-year postoperative survival was 100% for mpEs, 100% for spinal Es, 92% for cerebral Es, and 33% for aEs. Our CGH results in a selection of these tumors revealed the highest number of genetic aberrations in the mpEs (average 16; n = 2), a lower number in Es (average 12; n = 11) and the lowest number in aEs (average 5; n = 6). Interestingly, in the group of Es and aEs, a high number of genetic aberrations as detected by CGH was not correlated with aneuploidy or tetraploidy. Three patients, all with mpEs had local seeding." ]

[ "Can balloon aortic valvuloplasty help determine appropriate transcatheter aortic valve size?<||||>We sought to study the potential role of balloon aortic valvuloplasty (BAV) in sizing the aortic annulus in patients before transcatheter heart valve (THV) implantation.", "Can balloon aortic valvuloplasty help determine appropriate transcatheter aortic valve size?<||||>Despite clinicians' growing experience with THV procedures, the best method of annulus sizing remains unclear.", "Can balloon aortic valvuloplasty help determine appropriate transcatheter aortic valve size?<||||>Twenty-three patients with aortic stenosis (<1.0 cm(2)) who were undergoing surgical valve replacement were enrolled. Pre-operative echocardiographic measurements of the annulus and computed tomography measurements of valve calcium were made. Intraoperatively, a valvuloplasty balloon of known size and inflatable pressure was inserted into the aortic valve and inflated. The development of intraballoon pressure in addition to the nominal inflation pressure (AIBP) reflected the apposition of balloon and valve. Surgical annulus was measured by cylindrical sizers.", "Can balloon aortic valvuloplasty help determine appropriate transcatheter aortic valve size?<||||>In patients with tricuspid valves, AIBP was generated in 11 of 12 patients when the balloon diameter was greater than the surgically measured annulus, regardless of leaflet calcification (2 of 10 patients when balloon<or = surgical annulus). In bicuspid valves, high AIBP ( approximately 1 atm) was encountered with balloons that were within 1 mm of annulus size, and leaflet dehiscence occurred with larger balloons (n = 2 patients). Annulus size was underestimated by transthoracic echocardiogram and transesophageal echocardiogram compared with surgery (p<0.001): transthoracic echocardiogram = 21.5 +/- 1.8 mm, transesophageal echocardiogram = 22.0 +/- 1.6 mm and surgical = 23.2 +/- 1.9 mm (range 20 to 27 mm, mode 22 mm)." ]

[ "Is the rate of biological aging, as measured by age at diagnosis of cancer, socioeconomically patterned?<||||>To investigate the hypothesis that biological aging, as measured by age at diagnosis of some common cancers, is socioeconomically patterned.", "Is the rate of biological aging, as measured by age at diagnosis of cancer, socioeconomically patterned?<||||>A cross sectional analysis of the association between an area based measure of material deprivation and age at diagnosis of four common cancers (breast, prostate, colorectal, and lung cancers). A further analysis, restricted to breast and colorectal cancer, adjusted for stage and grade of cancer at diagnosis.", "Is the rate of biological aging, as measured by age at diagnosis of cancer, socioeconomically patterned?<||||>The Northern and Yorkshire cancer registry and information service, Northern and Yorkshire region, UK.", "Is the rate of biological aging, as measured by age at diagnosis of cancer, socioeconomically patterned?<||||>All people living in the Northern and Yorkshire region diagnosed with breast, prostate, colorectal, or lung cancer in 1986-1995. All people living in the Northern and Yorkshire region diagnosed with breast or colorectal cancer in 1998-2000 with data on stage and grade of cancer at diagnosis.", "Is the rate of biological aging, as measured by age at diagnosis of cancer, socioeconomically patterned?<||||>There was evidence that greater material deprivation was associated with younger age at diagnosis of cancer in prostate (beta coefficient -0.073), colorectal (women: -0.042; men: -0.063), and lung cancer (women: -0.214; men: -0.161). The opposite association was found in women with breast cancer (0.149). Adjusting for stage and grade at incidence, where possible, had little effect on the magnitude of the beta coefficients." ]

[ "Inpatient treatment of adolescents with acute alcohol intoxication: the tip of the iceberg?<||||>This study assessed whether (i) adolescents treated in hospital for acute alcohol intoxication show different habitual drinking patterns from adolescents of the general population and whether (ii) predictors for repeated treatment can be identified.", "Inpatient treatment of adolescents with acute alcohol intoxication: the tip of the iceberg?<||||>A sample of adolescents who had undergone inpatient treatment for intoxication (clinical sample) comprised n=482 under 18-year-old subjects, who had additionally been surveyed within the context of the project \"Hart am Limit\" (HaLT) between 2008 and 2010 (mean age: 15.1 years, 44.4% girls). The population sample consisted of n=1 994 Bavarian students who had taken part in the European School Survey Project on Alcohol and other Drugs (ESPAD) in 2007 (mean age: 15.7 years; 54.4% girls).", "Inpatient treatment of adolescents with acute alcohol intoxication: the tip of the iceberg?<||||>Within the clinical sample, gender differences in age, level of education and motivation to get drunk were found. Adolescents of the clinical sample were on average younger and had a higher level of education than adolescents in the general population sample. Although students in the clinical sample drank alcohol less often (2.8 vs. 5.0 times within the past 30 days), they drank more alcohol per occasion (36.4 g vs. 22.3 g pure alcohol per drinking day). Assessments by a third-party show that the risk of repeated inpatient treatment due to alcohol intoxication is positively associated with perceived psychosocial stress and negatively associated with perceived family support." ]

[ "Employment Status and Participation in Cardiac Rehabilitation: DOES ENCOURAGING EARLIER ENROLLMENT IMPROVE ATTENDANCE?<||||>For patients hospitalized for a cardiac event, an earlier appointment to outpatient cardiac rehabilitation (CR) increases participation. However, it is unknown what effect hastening CR enrollment might have among employed patients planning to return to work (RTW).", "Employment Status and Participation in Cardiac Rehabilitation: DOES ENCOURAGING EARLIER ENROLLMENT IMPROVE ATTENDANCE?<||||>Using 2 complementary data sets from Henry Ford Hospital (HFH) and Mayo Clinic, we assessed when employed patients eligible for CR anticipated a RTW, the impact of an earlier appointment on CR enrollment, and the effect of employment status on the number of CR sessions attended. Patients at HFH attended CR at either 8 or 42 days (through randomization), whereas Mayo Clinic patients attended 10 days after hospital discharge per standard routines.", "Employment Status and Participation in Cardiac Rehabilitation: DOES ENCOURAGING EARLIER ENROLLMENT IMPROVE ATTENDANCE?<||||>Among 148 patients at HFH, 65 (44%) were employed and planned to RTW. Of these, 67% desired to RTW within 1 to 2 weeks, whereas 28% anticipated an RTW within 1 to 3 days. Home financial strain predicted nonparticipation in CR (P<.001) and was associated with an earlier planned RTW. Among 1030 patients at Mayo Clinic, 393 (38%) were employed. Employed (vs nonemployed) patients enrolled in CR 3.3 days sooner (P<.001), but attended 1.6 fewer CR sessions (P = .04). In employed patients from both health systems, an earlier (vs later) appointment to CR did not result in additional exercise sessions of CR." ]

[ "Does blood glucose monitoring increase prior to clinic visits in children with type 1 diabetes?<||||>To assess the occurrence of white coat adherence in families with children who have type 1 diabetes.", "Does blood glucose monitoring increase prior to clinic visits in children with type 1 diabetes?<||||>Blood glucose data were downloaded from meters of 72 children, aged 2-11 years, with type 1 diabetes at four consecutive clinic visits. Generalized estimating equations were used to analyze patterns of blood glucose monitoring (BGM) during the 28 days before each clinic visit.", "Does blood glucose monitoring increase prior to clinic visits in children with type 1 diabetes?<||||>More frequent BGM was associated with better glycemic control. Evidence of a white coat adherence effect, with BGM frequency increasing before a clinic visit, was found only among children with low A1C levels." ]

[ "'To have...or not to have'. Should computed tomography and ultrasonography be implemented as a routine work-up for patients with suspected acute appendicitis in a regional hospital?<||||>Appendicitis is a common diagnosis, but is by no means a simple one to establish. This retrospective study investigated the value of medical imaging (ultrasonography and/or computed tomography [CT]) for patients with suspected appendicitis. Negative appendicectomy rate and appendiceal perforation with or without medical imaging were used as end points for this investigation.", "'To have...or not to have'. Should computed tomography and ultrasonography be implemented as a routine work-up for patients with suspected acute appendicitis in a regional hospital?<||||>This study retrospectively reviewed all patients admitted in one district general hospital with suspected acute appendicitis. The patient cohort was identified from the Unit Registry and an International Classification of Diseases-based Review of medical records. The medical records were analysed, and the outcome of patients were followed up.", "'To have...or not to have'. Should computed tomography and ultrasonography be implemented as a routine work-up for patients with suspected acute appendicitis in a regional hospital?<||||>Between 12 January 2004 to 27 May 2005, 168 patients' medical records were audited. The negative appendicitis rate was 6.7% and appendiceal perforation rate was 3.2%. Among them, only 20 in-patients (12%) had medical imaging (ultrasonography and/or CT scan) after clinical assessment for suspected acute appendicitis. Medical imaging had a 70% prediction rate for acute appendicitis, 20% false-negative rate, and 10% false-positive rate. Overall, the prediction rate for appendicitis by clinical assessment supplemented by laboratory tests and medical imaging at clinician's discretion was 93.2%." ]

[ "Do negative life experiences predict the health-care-seeking of adolescents?<||||>To analyze associations among the negative life experiences and health-care-seeking of adolescents during the 12 months before the study.", "Do negative life experiences predict the health-care-seeking of adolescents?<||||>Cross-sectional questionnaire study among 10th-year students at all secondary schools in Oslo.", "Do negative life experiences predict the health-care-seeking of adolescents?<||||>In 2000 and in 2001, 7329 (88%) of Oslo's 8316 secondary-school students responded to the questionnaire. Some contacts with primary health care during the previous year were reported by 71% of respondents, and 6% had seen a mental health practitioner (psychologist or psychiatrist). Health care utilization was not correlated with the family's financial situation as reported by the student (boys = 1019; girls = 1258), or with a parent's unemployment (boys = 253; girls = 325). The 2112 boys (59% of all) and 2378 girls (64%) who reported feeling strong pressure from others to succeed, had more contacts with all primary health care services. Girls, but not boys, who reported being bullied by others reported more psychologist or psychiatrist visits than did their nonbullied peers. Exposure to physical violence was associated with a significant increase in visits to the School Health Service, family physician, and emergency medical service, and was related to more than doubling the probability of visiting a mental health practitioner. Being sexually violated during the previous year increased the likelihood of boys visiting mental health practitioner more than four times (odds ratio [OR] 4.6; 95% confidence interval [CI]1.7-12.2); and visiting School Health Service by nearly four times, (OR 3.7; 95% CI 1.0-13.5)." ]

[ "Can surface electromyography improve surgery planning?<||||>To verify the precision of surface electromyography (sEMG) in locating the innervation zone of the gracilis muscle, by comparing the location of the IZ estimated by means of sEMG with in vivo location of the nerve bundle entry point in patients before graciloplasty procedure due to fecal incontinence.", "Can surface electromyography improve surgery planning?<||||>Nine patients who qualified for the graciloplasty procedure underwent sEMG on both gracilis muscle before their operations. During surgery the nerve bundle was identified by means of electrical stimulation. The distance between the proximal attachment and the nerve entry point into the muscle's body was measured. Both measurements (sEMG and in vivo identification) were compared for each subject.", "Can surface electromyography improve surgery planning?<||||>On average, the IZ was located 65.5mm from the proximal attachment. The mean difference in location of the innervation zones in each individual was 10±9.7mm, maximal - 30mm, the difference being statistically significant (p=0.017). It was intraoperatively confirmed, that the nerve entered the muscle an average of 62mm from the proximal attachment. The largest difference between the EMG IZ estimation and nerve bundle entry point was 5mm (mean difference 2.8mm, p=0.767)." ]

[ "Cytodiagnosis of well differentiated hepatocellular carcinoma: can indeterminate diagnoses be reduced?<||||>Distinction of well differentiated hepatocellular carcinoma (HCC) from benign hepatocellular lesions is a well recognized problem in fine-needle aspiration (FNA) cytology, sometimes leading to indeterminate reports. The aim of this study was to critically examine criteria that might allow definitive diagnosis in these cases.", "Cytodiagnosis of well differentiated hepatocellular carcinoma: can indeterminate diagnoses be reduced?<||||>FNA smears and cell blocks from 65 patients with primary hepatocellular lesions were reviewed. Seventy separate samples had been obtained. The initial reports in these samples were: HCC in 34, benign findings in 27, and indeterminate findings in 9. We defined architectural and cytological features seen in the malignant cases but not seen in the benign cases, including an assessment of reticulin in cell blocks. These criteria were then applied to the indeterminate cases.", "Cytodiagnosis of well differentiated hepatocellular carcinoma: can indeterminate diagnoses be reduced?<||||>The most specific cytologic criteria of malignancy in well differentiated HCC were (i) numerous stripped atypical nuclei, (ii) macronucleoli, (iii) increased mitoses, and (iv) multinucleation. The most specific architectural criteria in smears were (i) widened trabeculae, (ii) well defined capillaries traversing tissue fragments, and (iii) solid islands of hepatocytes rimmed by endothelial cells. The most valuable architectural criteria in cell blocks were (i) trabeculae greater than two cells thick and (ii) reduced or absent reticulin framework. Using the above criteria a retrospective diagnosis of HCC was possible in eight of the nine indeterminate cases, all but one of which have subsequently been confirmed as malignant." ]

[ "Quantification of metabolic tumor activity and burden in patients with non-small-cell lung cancer: Is manual adjustment of semiautomatic gradient-based measurements necessary?<||||>Metabolic tumor burden (MTB) measurements including metabolic tumor volume and total lesion glycolysis have been shown to have prognostic value in non-small-cell lung cancer (NSCLC). The calculation of MTB typically utilizes software to semiautomatically draw volumes of interest around the tumor, which are subsequently manually adjusted by the radiologist to include the entire tumor. The manual adjustment step can be time-consuming and observer-dependent. We compared the agreement of MTB values obtained using the semiautomatic method with and without manual adjustment in NSCLC patients.", "Quantification of metabolic tumor activity and burden in patients with non-small-cell lung cancer: Is manual adjustment of semiautomatic gradient-based measurements necessary?<||||>This IRB-approved prospective study included 134 patients with histologically proven NSCLC who underwent fluorine-18 fluorodeoxyglucose PET/computed tomography. The MTB of the primary tumor was measured with a semiautomatic gradient-based method without manual adjustment (the semiautomatic gradient method) and with manual adjustment (the manually adjusted semiautomatic gradient method) by two radiologists using the MIM PETedge tool. The paired t-test, Wilcoxon signed-rank test, and concordance correlation coefficient (CCC) were calculated to evaluate the agreement between MTB measures obtained with these two methods, as well as agreement between the two radiologists for each method.", "Quantification of metabolic tumor activity and burden in patients with non-small-cell lung cancer: Is manual adjustment of semiautomatic gradient-based measurements necessary?<||||>Maximum standardized uptake value was identical between the two methods. No statistically significant difference was present for peak standardized uptake value, metabolic tumor volume, and total lesion glycolysis values between the two methods (P=0.23, 0.45, and 0.37, respectively). Excellent agreement between the two methods was found in terms of CCC (CCC>0.98 for all measures). Interobserver reliability was excellent for all measures (CCC>0.90)." ]

[ "Trainee reporting of computed tomography examinations: do they make mistakes and does it matter?<||||>Over a 6-month period a single consultant reviewed all the CT examinations reported by registrars in one radiology department. After recording a provisional registrar report each examination was jointly reviewed by the consultant and registrar. The consultant's opinion was regarded as the gold standard. Data collected included: the error rate, whether an error was significant, leading to a change in patient management, and whether the mistake was a false-negative or positive.", "Trainee reporting of computed tomography examinations: do they make mistakes and does it matter?<||||>Three hundred and thirty-one patients were included in the study. There was an overall error rate of 21.5%. A significant error leading to a change in management was made in 10% of reports, and a significant error that did not lead to a change in management was made in 9.3%; 2.1% of reports had insignificant errors; and 69% of errors were false-negatives." ]

[ "Does training sitting balance on a platform tilted 10° to the weak side improve trunk control in the acute phase after stroke?<||||>Trunk performance and sitting balance, especially lateral sitting control, are important predictors of functional outcome after stroke. However, no studies have focused only on trunk function in the frontal plane for persons with acute-phase stroke.", "Does training sitting balance on a platform tilted 10° to the weak side improve trunk control in the acute phase after stroke?<||||>To investigate the effects of lateral sitting training on a tilting platform in persons with stroke.", "Does training sitting balance on a platform tilted 10° to the weak side improve trunk control in the acute phase after stroke?<||||>An assessor-blinded, randomized, controlled trial was carried out involving inpatients at a stroke rehabilitation center. Patients were allocated to either an experimental group (n = 15) or a control group (n = 15). The experimental group sat without leg support on a platform tilted 10° to the paretic side in the frontal plane, while the controls sat on a horizontal platform. Both groups were asked to move their trunk laterally from the paretic side to the nonparetic side. In addition to conventional therapy, this training was performed 60 times/session, with 6 sessions/week. Trunk function was assessed using the Trunk Control Test (TCT), and the ability to move the trunk laterally was evaluated kinematically. Measurements were performed at baseline and after training. Two-way repeated measures analysis of variance was used to test the significance between and within treatments for each dependent variable.", "Does training sitting balance on a platform tilted 10° to the weak side improve trunk control in the acute phase after stroke?<||||>None of the demographic data differed between the groups. After training, a significant improvement was noted in the experimental group compared to the controls in the TCT and the ability for lateral trunk transference (P < 0.05, 1 - β = 0.98, effect size = 0.4)." ]

[ "Latitude in sample handling and storage for infant faecal microbiota studies: the elephant in the room?<||||>In this manuscript, we investigate the \"stones best left unturned\" of sample storage and preparation and their implications for the next-generation sequencing of infant faecal microbial communities by the 16S ribosomal ribonucleic acid (rRNA) gene. We present a number of experiments that investigate the potential effects of often overlooked methodology factors, establishing a \"normal\" degree of variation expected between replica sequenced samples. Sources of excess variation are then identified, as measured by observation of alpha diversity, taxonomic group counts and beta diversity magnitudes between microbial communities.", "Latitude in sample handling and storage for infant faecal microbiota studies: the elephant in the room?<||||>Extraction of DNA from samples on different dates, by different people and even using varied sample weights results in little significant difference in downstream sequencing data. A key assumption in many studies is the stability of samples stored long term at -80 °C prior to extraction. After 2 years, we see relatively few changes: increased abundances of lactobacilli and bacilli and a reduction in the overall OTU count. Where samples cannot be frozen, we find that storing samples at room temperature does lead to significant changes in the microbial community after 2 days. Mailing of samples during this time period (a common form of sample collection from outpatients for example) does not lead to any additional variation." ]

[ "Is PRP useful in alveolar cleft reconstruction?<||||>Cleft lip and palate is a congenital facial malformation with an established treatment protocol. Mixed dentition period is the best moment for correct maxillary bone defect with an alveoloplasty. The aim of this surgical procedure is to facilitate dental eruption, re-establish maxillary arch, close any oro-nasal communication, give support to nasal ala, and in some cases allow dental rehabilitation with osteointegrated implants.", "Is PRP useful in alveolar cleft reconstruction?<||||>Twenty cleft patients who underwent secondary alveoloplasty were included. In 10 of them autogenous bone graft were used and in other 10 autogenous bone and platelet-rich plasma (PRP) obtained from autogenous blood. Bone formation was compared by digital orthopantomography made on immediate post-operatory and 3 and 6 months after the surgery.", "Is PRP useful in alveolar cleft reconstruction?<||||>No significant differences were found between both therapeutic groups on bone regeneration." ]

[ "Wound Hygiene Practices After Total Knee Arthroplasty: Does It Matter?<||||>Current literature is limited with regard to standardized postoperative surgical site hygiene after total knee arthroplasty (TKA). With little guidance from the literature, the timing of permissible postoperative cleaning is a decision made by the individual surgeon using anecdotal evidence. A standardized wound care regimen is of particular interest to minimize the risk of infection.", "Wound Hygiene Practices After Total Knee Arthroplasty: Does It Matter?<||||>To examine what species of bacteria recolonize the surgical site postoperatively, a randomized controlled trial was performed of 16 TKA patients who were allowed to shower at 2 days postoperatively and of 16 patients who were asked to wait until 2 weeks postoperatively before showering after TKA. Culture swabs of skin adjacent to the incision were performed preoperatively, just after incision closure, at dressing removal, and at 2 weeks postoperatively. Bacteria were speciated and compared between groups. A swab of the contralateral knee was performed at 2 weeks as a control. A survey of patient's preference regarding early and late showering was also carried out.", "Wound Hygiene Practices After Total Knee Arthroplasty: Does It Matter?<||||>No difference was found between the groups in rate of colonization or bacterial type, and no patients developed infection. Patients overwhelmingly preferred early showering rather than late (P = .28-.99)." ]

[ "Are blood tests prior to ear operations in children necessary?<||||>Operations in children are often drastic events for patients and their parents. Most ENT operations are elective. Often blood tests are done even though there is no clinical evidence for coagulation disorders or anaemia in the medical history of the patient and their family. Since the joint statement of the German Societies of Oto-Rhino-Laryngology, Head and Neck surgery, of pediatrics and of anesthesiology regarding the necessity of coagulation tests prior to adenoidectomy or tonsillectomy in children we wanted to know whether blood tests have any effect for ear operations.", "Are blood tests prior to ear operations in children necessary?<||||>Data of 81 children were analysed, undergoing an ear operation during 2006/2007 at the department of Oto-Rhino-Laryngology in Bochum, retrospectively. Information on sex, age, hemoglobin concentration, platelet count, INR, thromboplastin time, prothrombin time, count of the white blood cells, Cholinesterase (CHE), Glutamat-Oxalacetat-Transaminase (GOT), Glutamat-Pyruvat-Transaminase (GPT), gamma-Glutamyltransferase (GT), Creatinkinase (CK), creatinine, c-reactive protein (CRP) and clinical history of postoperative complications (bleeding, infections) were collected.", "Are blood tests prior to ear operations in children necessary?<||||>Out of 698 registered parameters 10,5 % were differing from the reference parameters. There were no abnormal bleedings or complications which could have been predicted by blood tests." ]

[ "Is maternal renal disease a cause of elevated free beta-hCG in first trimester aneuploidy screening?<||||>To asses whether supra elevated levels of maternal serum free beta hCG in the first trimester are associated with impaired renal function.", "Is maternal renal disease a cause of elevated free beta-hCG in first trimester aneuploidy screening?<||||>A cohort of 553 women with maternal serum free beta-hCG greater than 5 multiple of median (MoM) with a single euploid fetus was matched with a control of the same maternal age (+/-1 year), ethnic origin and with a free beta-hCG within the range 0.50-1.50 MoM. Screening samples were analysed for serum creatinine and estimated glomerular filtration rate was calculated. Renal function in the two groups was compared. The database was examined to find outcomes registered as known renal disease amongst the high free beta-hCG group.", "Is maternal renal disease a cause of elevated free beta-hCG in first trimester aneuploidy screening?<||||>In the group with a supra elevated free beta-hCG MoM there was a significant reduction in estimated glomerular filtration rate (eGFR) (122.85, 95% CI 120.43-124.74 vs 118.80, 95% CI 114.90-121.59; p = 0.009) suggesting a small but increased risk of renal disease." ]

[ "The chiropractic consultation: a stressful experience?<||||>Psychosocial stress has been linked to compromised health status. Prolonged exposure to minor problems has been found to have an equal or greater impact on health status than exposure to isolated major events. Stress is, however, determined by the reaction of the individual to a stimulus; stress responses can be managed, and ill health outcomes can be minimized. This paper explores the stress level associated with the chiropractic consultation.", "The chiropractic consultation: a stressful experience?<||||>A case study using closed questions. Purposive sampling of chiropractors by the researcher and convenience sampling of patients by participating chiropractors was undertaken. Chiropractors and patients completed closed questions on the level of stress they believed patients associated with the chiropractic consultation.", "The chiropractic consultation: a stressful experience?<||||>A case study of 25 chiropractors and 137 patients found that although the chiropractic consultation was not regarded as stressful by most patients, some patients found adjustment stressful. Chiropractors assessment of perceived stress varied according to the patient. The trend was for practitioners to overestimate the stress felt by the patient." ]

[ "Use of addiction treatment services by Irish youth: does place of residence matter?<||||>Substance abuse treatment centres for Irish rural youth have largely been overlooked in the scientific literature. This study examined data from a substance abuse treatment centre that treats both urban and rural attendees to investigate if there are differences in usage patterns between attendee groups.", "Use of addiction treatment services by Irish youth: does place of residence matter?<||||>A cross-sectional study was done of 436 service-users attending a treatment centre: patient characteristics, treatment referral details and substance history of the attendees from urban and rural areas were compared. Descriptive analysis of the service-user population was performed and recent substance use was investigated. Inferential tests examined for differences between urban and rural service-users.", "Use of addiction treatment services by Irish youth: does place of residence matter?<||||>The typical service-user was an Irish male aged between 16 and 17 years, who resided with his parents. A greater percentage of rural service-users were employed (33.3% vs 22.2%, p=0.015), while a significantly greater percentage of urban service-users were unemployed (10.3% vs 4.1%, p=0.015). A greater proportion of urban service-users had tried multiple substances in their lifetimes (73.7% vs 52.2%, p=0.001) and continued to use multiple substances regularly (49.3% vs 31.3%, p=0.003) compared with their rural counterparts." ]

[ "The risk of advanced histology in small-sized colonic polyps: are non-invasive colonic imaging modalities good enough?<||||>The study aims to evaluate the risk of advanced histology within small colonic polyps and assess whether this risk warrants different recommendation for surveillance and treatment of such polyps.", "The risk of advanced histology in small-sized colonic polyps: are non-invasive colonic imaging modalities good enough?<||||>A retrospective study of all patients undergoing their first ever colonoscopy and polypectomy in a tertiary hospital for one of three indications: screening, positive family history,and positive occult blood in stool. The histological reports of all resected polyps were retrieved and stratified according to the various polyps' sizes. Advanced neoplasia was defined as tubular adenoma ≥10 mm or any size polyp with advanced histology, i.e., villous or tubulovillous adenoma, high-grade dysplasia, intramucosal carcinoma, or invasive cancer.", "The risk of advanced histology in small-sized colonic polyps: are non-invasive colonic imaging modalities good enough?<||||>Seven hundred forty-one patients who had a total of1,192 resected polyps were included. Of polyps ≤5 mm in size, 1.6% harbored invasive cancer or high-grade dysplasia,and additional 4.1% contained villous component. The rate of advanced histology for polyps sized 6-9 mm was over 15%. The rate of advanced histology in polyps ≤5 mm was not significantly different when employing sensitivity analysis accounting for possible under or overestimation of polyp sizes by 1 and 2 mm. However, 4.6% of polyps sized 6-9 mm were found to harbor an invasive or high-grade dysplasia component when taken into account a 2-mm overestimation." ]

[ "Does ligation of the intersphincteric fistula tract raise the bar in fistula surgery?<||||>The ligation of the intersphincteric fistula tract procedure has been reported to have high cure rates, with minimal impairment of continence.", "Does ligation of the intersphincteric fistula tract raise the bar in fistula surgery?<||||>The aim of this study was to evaluate the success rates and functional outcome after the ligation of the intersphincteric fistula tract procedure.", "Does ligation of the intersphincteric fistula tract raise the bar in fistula surgery?<||||>This study was performed as a retrospective review.", "Does ligation of the intersphincteric fistula tract raise the bar in fistula surgery?<||||>The study was conducted at the Division of Colon and Rectal Surgery, University of Minnesota and at affiliated hospitals in Minneapolis and St. Paul, Minnesota, between March 2007 and September 2011.", "Does ligation of the intersphincteric fistula tract raise the bar in fistula surgery?<||||>Ninety-three patients with transsphincteric cryptoglandular anal fistula were included.", "Does ligation of the intersphincteric fistula tract raise the bar in fistula surgery?<||||>Ligation of the intersphincteric fistula tract procedure was performed.", "Does ligation of the intersphincteric fistula tract raise the bar in fistula surgery?<||||>Failure was defined as persistent or recurrent drainage, air leakage from a patent external opening, or intersphincteric incision or reoperation for recurrent fistula. Success was defined as healing of the external fistula opening and intersphincteric incision. Patients were followed up with a questionnaire to assess the recurrence rate and the Wexner incontinence score.", "Does ligation of the intersphincteric fistula tract raise the bar in fistula surgery?<||||>The median follow-up time for was 19 months (range, 4-55). Thirty patients (32%) had a history of previous surgery for their fistula. The success rate of fistula healing was 40% after the first ligation of the intersphincteric fistula tract procedure. When including patients with repeat ligation of the intersphincteric fistula tract and subsequent intersphincteric fistulotomy after ligation of the intersphincteric fistula tract repair, the success rates were 47% and 57%. Patients with successful fistula closure reported a mean Cleveland Clinic Florida Fecal Incontinence score of 1.0 (SD 2.3). No predictor for successful fistula closure was found.", "Does ligation of the intersphincteric fistula tract raise the bar in fistula surgery?<||||>Retrospective design, limited accuracy of diagnosing fistula failure, and lack of baseline continence were limitations of this study." ]

[ "Are insulin resistance, impaired fasting glucose and impaired glucose tolerance all equally strongly related to age?<||||>Insulin resistance (IR) has been considered an underlying cause of impaired glucose tolerance (IGT) and impaired fasting glucose (IFG). Whether IR increases with age has been debated. We investigated the age-associated deterioration in the homeostasis model assessment (HOMA) of IR and in glucose metabolism.", "Are insulin resistance, impaired fasting glucose and impaired glucose tolerance all equally strongly related to age?<||||>Ten (nine including women) European studies contributed data on 6314 men and 6393 women aged 30-88 years. The cohort- and sex-specific top 25% of HOMA of IR in non-diabetic subjects was used to define HOMA-IR.", "Are insulin resistance, impaired fasting glucose and impaired glucose tolerance all equally strongly related to age?<||||>Compared with subjects aged 50-59 years, the cohort- and body mass index-adjusted odds ratio (95% confidence interval) for HOMA-IR was 0.83 (0.64, 1.08), 0.87 (0.74, 1.03), 1.20 (1.02, 1.42) and 1.45 (1.10, 1.92) in men and 0.84 (0.62, 1.14), 0.91 (0.77, 1.09), 1.38 (1.19, 1.62) and 1.71 (1.35, 2.17) in women, respectively, aged 30-39, 40-49, 60-69 and>or = 70 years (P<0.0001 for trend test). The same increasing trend was also observed for IFG. In contrast, the corresponding odds ratios for IGT increased linearly and more strongly with age, being 0.37 (0.22, 0.63), 0.67 (0.52, 0.87), 1.55 (1.24, 1.92) and 2.96 (2.13, 4.13) in men and 0.51 (0.31, 0.85), 0.66 (0.52, 0.86), 1.92 (1.57, 2.35) and 3.85 (2.89, 5.12) in women, respectively." ]

[ "Transfusion-related acute lung injury: lack of recognition because of unawareness of this complication?<||||>Transfusion of blood components can trigger immunological reactions which may result in a transfusion-related acute lung injury (TRALI). The reported incidence is low; however, there is increasing evidence that the true incidence of this complication may be much higher. One reason for underdiagnosing TRALI could be a deficiency of knowledge about this complication. Therefore, we studied the level of knowledge concerning TRALI among clinicians working on intensive care units (ICU) of an university teaching hospital.", "Transfusion-related acute lung injury: lack of recognition because of unawareness of this complication?<||||>A total of 65 clinicians were asked to complete a confidential questionnaire designed to evaluate their knowledge about incidence, pathophysiology, clinical symptoms, therapy and outcome of TRALI. This questionnaire consisted of 13 questions which could be assessed by 'yes', 'no' or 'do not know'.", "Transfusion-related acute lung injury: lack of recognition because of unawareness of this complication?<||||>Only 42 +/- 18% (mean +/- SD) of all answers were correct, while 33 +/- 17% were wrong and 25 +/- 8% unanswered ('do not know'). The 95% confidence interval for the correct answers was 30.8-53.8% implying that there was no significant difference compared to the probability of arbitrary guessing (33.3%)." ]

[ "Can homeopathy be integrated in a university hospital?<||||>The Dr. von Hauner Children's Hospital Munich has conducted a pilot project for 4 years, aiming at the integration of homeopathic concomitant treatment into daily clinical practice. This study was carried out to clarify whether the project is successful and accepted by physicians, nurses, and parents.", "Can homeopathy be integrated in a university hospital?<||||>Questionnaires, all standardized and anonymous, were handed out to 137 physicians, 212 nurses and paramedics, and 1,048 parents of children treated at the hospital.", "Can homeopathy be integrated in a university hospital?<||||>69% of the physicians appreciated concomitant homeopathic treatments, more than 60% believed the integration of homeopathy is suggestive, 75% saw a need for clinical research in homeopathy. 25% of the staff now had a more positive view towards homeopathy. 63% of the parents appreciated concomitant treatment, but only 19% are willing to participate in double-blind studies." ]

[ "Do heart rate and velocity variability derived from umbilical artery velocity waveforms change prior to clinical pregnancy-induced hypertension?<||||>To investigate the hypothesis that alterations in heart rate variability, peak systolic velocity variability and time-averaged velocity variability in the human umbilical artery may predict early signs of dysfunctional fetal-placental coupling in pregnancies that later develop pregnancy-induced hypertension.", "Do heart rate and velocity variability derived from umbilical artery velocity waveforms change prior to clinical pregnancy-induced hypertension?<||||>Doppler flow velocity recordings from the umbilical artery were performed at 10-20 weeks of gestation in 12 nulliparous women who subsequently developed pregnancy-induced hypertension. From umbilical artery velocity waveforms of at least 12 s in duration we determined absolute values and beat-to-beat variability in fetal heart rate, peak systolic and time-averaged velocity and compared these findings with those in normal nulliparous pregnant women matched for gestational age.", "Do heart rate and velocity variability derived from umbilical artery velocity waveforms change prior to clinical pregnancy-induced hypertension?<||||>Absolute values for fetal heart rate, peak systolic and time-averaged velocity as well as beat-to-beat variability in fetal heart rate did not differ significantly between women later developing pregnancy-induced hypertension and normal controls. However, variability in peak systolic velocity and time-averaged velocity were decreased in women who subsequently developed pregnancy-induced hypertension." ]

[ "Are children with asthma overconfident that they are using their inhalers correctly?<||||>The objectives of this study were to quantify the extent to which children with asthma are overconfident that they are using their inhalers correctly and determine whether demographic and clinical characteristics are associated with children being overconfident.", "Are children with asthma overconfident that they are using their inhalers correctly?<||||>Children (n = 91) ages 7-17 with persistent asthma were recruited at two pediatric practices in North Carolina and demonstrated their inhaler technique for metered dose inhalers during an office visit. Children were dichotomized into two groups based on how confident they were that they were using their inhalers correctly: \"completely confident\" or \"not completely confident\". The mean number of inhaler steps (out of 8) children performed incorrectly was examined. We applied linear regression models for children in the \"completely confident\" group to determine whether demographic and clinical factors predicted their overconfidence, defined as the number of inhaler steps performed incorrectly.", "Are children with asthma overconfident that they are using their inhalers correctly?<||||>Children were primarily male (56%) and non-Hispanic White (60%). Sixty-eight (75%) children were \"completely confident\" that they were using their inhalers correctly. The \"completely confident\" group missed an average of 1.5 steps. In the \"completely confident\" group, males (p<0.04) missed significantly more steps than females. The two most common errors were forgetting to shake the inhaler and holding their breath for 10 s." ]

[ "Autoimmune hepatitis: a manifestation of immune reconstitution inflammatory syndrome in HIV infected patients?<||||>To describe a case series of patients presenting with autoimmune hepatitis after initiation of antiretroviral therapy.", "Autoimmune hepatitis: a manifestation of immune reconstitution inflammatory syndrome in HIV infected patients?<||||>The demographics, clinical and laboratory features, and therapeutic response of HIV-infected patients on antiretroviral therapy presenting to our Division between November 2011 and November 2014 with elevated liver enzymes, were analysed.", "Autoimmune hepatitis: a manifestation of immune reconstitution inflammatory syndrome in HIV infected patients?<||||>Nine patients with elevated liver enzymes, immunoglobulin G and autoimmune markers in keeping with autoimmune hepatitis were identified. All were anti-hepatitis C virus negative. One patient was hepatitis B surface antigen positive but his hepatitis B viral load was undetectable. All patients denied using any traditional herbal remedies. Liver histology was consistent with autoimmune hepatitis showing interface hepatitis and infiltrates of lymphocytes and plasma cells. Diagnosis was made according to the Autoimmune Hepatitis Group Scoring Systems. All patients were started on 15-20 mg of oral prednisone with clinical and biochemical improvement after 1-6 weeks." ]

[ "Metachronous gastric MALT lymphoma and early gastric cancer: is residual lymphoma a risk factor for the development of gastric carcinoma?<||||>Helicobacter pylori plays a major role in the pathogenesis of primary gastric MALT lymphoma (GML) and gastric carcinoma. The occurrence of these two diseases metachronously in a same patient is a rare event.", "Metachronous gastric MALT lymphoma and early gastric cancer: is residual lymphoma a risk factor for the development of gastric carcinoma?<||||>Gastric biopsies and gastrectomy resection specimens of four patients who developed GML and early gastric cancer (EGC) were analysed by morphology, immunohistochemistry and molecular biology.", "Metachronous gastric MALT lymphoma and early gastric cancer: is residual lymphoma a risk factor for the development of gastric carcinoma?<||||>Four patients (three males and one female; mean age 48 years) were diagnosed with GML. Helicobacter pylori infection was observed in three cases. Two patients had localized disease (stages IE and IIE, respectively) and were treated with H. pylori eradication therapy followed by an alkylating agent for one patient. Two patients had disseminated disease (stage IV), and were treated with an alkylating agent. Three cases were t(11;18) positive. All patients achieved initially complete lymphoma remission. Long-term endoscopic surveillance detected an EGC at the same location as the lymphoma in all patients at a mean time of 9.5 years (range 2.5-17 years) after lymphoma diagnosis. Gastrectomy specimens showed residual GML in all cases." ]

[ "QT dispersion in mild cognitive impairment: a possible tool for predicting the risk of progression to dementia?<||||>The aim of this research was to investigate relationships between cognitive function and non-invasive, repeatable cardiac parameters in elderly subjects suffering from mild cognitive impairment (MCI) or Alzheimer's disease (AD).", "QT dispersion in mild cognitive impairment: a possible tool for predicting the risk of progression to dementia?<||||>Two hundred and twenty-four community-living elderly subjects, 31 AD patients, 77 MCI patients, and 116 cognitively normal subjects (CNS), were evaluated for cognitive abilities (Mini Mental State Examination score (MMSE)) and for electrocardiographic [corrected heart rate QT interval dispersion (QTcD)] and echocardiographic [Left ventricular ejection fraction (LVEF)]parameters.", "QT dispersion in mild cognitive impairment: a possible tool for predicting the risk of progression to dementia?<||||>Mean values of LVEF were not significantly different between the three groups; QTcD mean values were significantly lower in CNS group than in subjects with MCI and AD. The Pearson Product Moment Correlation test, carried out in the three study groups, showed a significant inverse correlation between QTcD and MMSE score (r = -0.357; p < 0.01) in the group of MCI patients, only. In multivariable-adjusted linear regression tests, QTcD (p = 0.030) and education (p = 0.021) are associated with MMSE score in MCI group. Only the parameter of education appears to predict MMSE in CNS group; none of these parameters appear to predict MMSE in the group of patients with AD." ]

[ "Adolescent idiopathic scoliosis and exercising: is there truly a liaison?<||||>Cross-sectional observational study.", "Adolescent idiopathic scoliosis and exercising: is there truly a liaison?<||||>Evaluation and comparison of the prevalence of adolescent idiopathic scoliosis (AIS) among 2 groups of patients (athletes and nonathletes) to determine whether athletic activities are related to the development of AIS.", "Adolescent idiopathic scoliosis and exercising: is there truly a liaison?<||||>The potential association between AIS and exercising remains uncertain. The latter has often been considered as a therapeutic means and a causative factor of the former.", "Adolescent idiopathic scoliosis and exercising: is there truly a liaison?<||||>A group of 2387 adolescents (boys: 1177, girls: 1210, mean age: 13.4 years) was evaluated. All completed a questionnaire concerning personal, somatometric, and secondary sex characteristics, type, duration and character of daily-performed physical activities, and existing cases of AIS among relatives. Patients were classified into 2 groups according to their answers; \"athletes\" and \"nonathletes.\" The groups were comparable as far as age, height, weight, onset of menstruation, family history of scoliosis, and side of handedness were concerned. Children underwent physical examination by 3 orthopedic surgeons who were unaware of their level of athletic activities. Children considered, by all, to be suspicious of suffering from scoliosis, underwent further radiographic evaluation.", "Adolescent idiopathic scoliosis and exercising: is there truly a liaison?<||||>In 99 cases (athletes: 48, nonathletes: 51), AIS was radiographically confirmed (Cobb angle>10 degrees). No statistically significant difference was found between athlete and nonathlete adolescents (P = 0.842), athlete and nonathlete boys (P = 0.757), and athlete and nonathlete girls (P = 0.705), as far as the prevalence of AIS was concerned. The mean value of the Cobb angle of the main scoliotic curve was not statistically different between male athletes and nonathletes (P = 0.45) and female athletes and nonathletes (P = 0.707). With the Cobb threshold reset at 20 degrees, no statistically significant differences were detected either." ]

[ "Should patients with severe degenerative mitral regurgitation delay surgery until symptoms develop?<||||>The American College of Cardiology/American Heart Association practice guidelines recommending surgery for asymptomatic patients with severe mitral regurgitation caused by degenerative disease remain controversial. This study examined whether delaying surgery until symptoms occur causes adverse cardiac changes and jeopardizes outcome.", "Should patients with severe degenerative mitral regurgitation delay surgery until symptoms develop?<||||>From January 1985 to January 2008, 4,586 patients had primary isolated mitral valve surgery for degenerative mitral regurgitation; 4,253 (93%) underwent repair. Preoperatively, 30% were in New York Heart Association (NYHA) class I (asymptomatic), 56% in class II, 13% in class III, and 2% in class IV. Multivariable analysis and propensity matching were used to assess association of symptoms (NYHA class) with cardiac structure and function and postoperative outcomes.", "Should patients with severe degenerative mitral regurgitation delay surgery until symptoms develop?<||||>Increasing NYHA class was associated with progressive reduction in left ventricular function, left atrial enlargement, and development of atrial fibrillation and tricuspid regurgitation. These findings were evident even in class II patients (mild symptoms). Repair was accomplished in 96% of asymptomatic patients, and in progressively fewer as NYHA class increased (93%, 86%, and 85% in classes II to IV, respectively; p<0.0001). Hospital mortality was 0.37%, but was particularly high in class IV (0.29%, 0.20%, 0.67%, and 5.1% for classes I to IV, respectively; p = 0.004). Although long-term survival progressively diminished with increasing NHYA class, these differences were largely related to differences in left ventricular function and increased comorbidity." ]

[ "Bridge to recovery for postcardiotomy failure: is there still a role for centrifugal pumps?<||||>Early implantation of centrifugal devices in patients with postcardiotomy cardiogenic shock may provide a bridge to recovery and allow subsequent long-term survival.", "Bridge to recovery for postcardiotomy failure: is there still a role for centrifugal pumps?<||||>Since January 1989, 62 patients were supported with centrifugal pumps because of failure to wean from cardiopulmonary bypass. Indications were postcardiotomy cardiogenic shock (PCCS) (n = 60), bridge to cardiac retransplantation (n = 1), and right ventricular failure (n = 1). Patients' ages ranged from 23 to 78 years; 40 were men (65%), and 22 were women (35%). Twenty-two patients (35%) had a left ventricular assist device; 9 patients (15%) had a right ventricular assist device; and 31 patients (50%) had a biventricular assist device. Length of support ranged from 1 day to 19 days.", "Bridge to recovery for postcardiotomy failure: is there still a role for centrifugal pumps?<||||>Forty-two patients (68%) were weaned successfully; 27 patients survived to discharge (44%). Complications included bleeding (n = 41, 66%), renal failure (n = 28, 45%), and respiratory failure (n = 26, 42%). Currently, 23 patients survived 10 or more years (n = 1), 6 to 10 years (n = 7), 1 to 5 years (n = 10), and less than 1 year (n = 5)." ]

[ "Is follow up by specialists routinely needed after elective surgery?<||||>To assess the benefit of planned specialist follow up appointments after elective inpatient surgery.", "Is follow up by specialists routinely needed after elective surgery?<||||>This was a controlled trial, using repeated alternate allocation of time periods to the two study groups. Group 1: Planned outpatient follow up 6-12 weeks after surgery. Group 2: No planned follow up: additional written information for patients and general practitioners.", "Is follow up by specialists routinely needed after elective surgery?<||||>A district general hospital in the north west of England.", "Is follow up by specialists routinely needed after elective surgery?<||||>264 patients listed for one of: transurethral resection of the prostate, varicose vein surgery, cholecystectomy (open or laparoscopic), inguinal herniorraphy (open or laparoscopic).", "Is follow up by specialists routinely needed after elective surgery?<||||>Health status, complications, return to normal activity, patient satisfaction, use and costs of primary and secondary care in the 12 weeks after surgery.", "Is follow up by specialists routinely needed after elective surgery?<||||>Data were available for 212 (80%) of eligible patients. Thirty eight per cent of patients in the \"no planned follow up\" group were in fact seen in outpatients after their discharge. Intention to treat analysis showed that there were no significant differences between the groups for health status, complications, or time to return to normal activity. Patients in the \"no planned follow up\" group had significantly fewer hospital visits and costs (mean difference in visits 0.51, 95% confidence intervals 0.39 to 0.69; mean difference in hospital costs 12.75 Pounds, 9.75 Pounds to 15.50 Pounds). There were fewer primary care staff contacts and costs in the \"no planned follow up\" group, although this difference was not significant (mean difference = 0.61 visits, -0.13 to 1.33 visits; primary care costs difference 8.37 Pounds, -1.31 Pounds to 18.73 Pounds). Patients in the \"no planned follow up group\" had significantly reduced patient travel costs (mean difference 4.84 Pounds, 3.44 Pounds to 6.22 Pounds). Eighty nine (42%) patients would prefer to be followed up by both their hospital doctor and GP; 53 (25%) patients would prefer to be followed up by the hospital doctor only. There were no significant differences between the two groups in their preferences for follow up. The majority of GPs agreed with the statement that a policy of no follow up at hospital outpatients for each of the six surgical procedures would increase their workload." ]

[ "Does rotational acetabular osteotomy affect subsequent total hip arthroplasty?<||||>Rotational acetabular osteotomy (RAO) has been used successfully in patients with developmental dysplasia of the hip (DDH). However, some patients are forced to undergo total hip arthroplasty (THA) because of the progression of osteoarthritis. We evaluated the effect of previous RAO on the outcome of THA performed for degenerative arthritis secondary to DDH, comparing outcomes for patients with THA and prior RAO versus outcomes for patients with THA and no prior RAO.", "Does rotational acetabular osteotomy affect subsequent total hip arthroplasty?<||||>At an average follow-up point of 8.2 years (range 7-11 years), we compared outcomes in dysplastic hips for 22 hips (group R) in patients who underwent THA after successful RAO with outcomes for a well-matched control group of 30 hips in patients who underwent primary THA (group C) during the same period.", "Does rotational acetabular osteotomy affect subsequent total hip arthroplasty?<||||>Both groups had similar midterm results. No acetabular or femoral components exhibited loosening or revision in either group. Harris hip scores (HHSs) at the most recent follow-up had not been compromised by RAO, and there were no significant differences in intraoperative blood loss and operative time between the two groups. Although there was a tendency toward superolateral placement of the acetabular component in group R, there were no significant differences in the mean steady-state linear and volumetric wear rates between the two groups. There were no infections, dislocations, intraoperative fractures, damaged nerves, or deep vein thromboses in either group." ]

[ "Is there an association between urolithiasis and Roux-en-y gastric bypass surgery?<||||>Several studies have documented high incidence of urinary lithiasis after jejunoileal by-pass. Roux-en-y gastric bypass surgery (RYGB) is currently the most common bariatric procedure. Because of its difficult for absorption, RYGB has a potential risk to increase the incidence of lithiasis. This study was conducted in order to test the hypothesis that RYGB increases the incidence urolithiasis after 50% of excessive weight loss.", "Is there an association between urolithiasis and Roux-en-y gastric bypass surgery?<||||>We performed a retrospective cohort study to evaluate 58 patients who underwent RYGB at the Obesity Service at Santa Casa de Misericordia de Sao Paulo, between 2000 and 2005, with minimum follow-up of 10 and maximum of 72 months, after the procedure.", "Is there an association between urolithiasis and Roux-en-y gastric bypass surgery?<||||>Forty-five (77.6%) patients had>or= 50% loss of weight excess. There was no difference between the frequency of urolithiasis before and after the procedure, and nephrolithiasis was observed after surgery in only one patient, however this had been detected before the procedure." ]

[ "Exposure to suicide and suicidality in Korea: differential effects across men and women?<||||>Little is known about whether exposure to suicide within close social networks is associated with the suicidality in exposed individuals, and potential gender differences regarding this association.", "Exposure to suicide and suicidality in Korea: differential effects across men and women?<||||>This study examines the effect of exposure to suicide on the suicidality in exposed individuals.", "Exposure to suicide and suicidality in Korea: differential effects across men and women?<||||>The data were drawn from the 2009 Korean General Social Survey, a nationally representative interview survey. Suicidality was measured by the suicidality module in the Mini International Neuropsychiatric Interview (MINI), with exposure to suicide being determined by asking about the experience of a failed or completed suicide attempt by a closely related person.", "Exposure to suicide and suicidality in Korea: differential effects across men and women?<||||>Exposure to the suicide of someone close was significantly associated with higher suicidality in exposed individuals. While the effect of a failed attempt became non-significant after controlling for psychological factors, that of exposure to a completed act of suicide remained significant. A subsample analysis by gender indicated a significant gender difference: with control for demographic and psychological factors, exposure to a completed suicide had a significant effect on the suicidality of females only. The effect of exposure to a failed attempt became non-significant both in males and females after controlling for other factors." ]

[ "Right precordial leads and lead aVR at exercise electrocardiography: does it change test results?<||||>A recent study on exercise testing (ET) suggested that ST-segment changes in the right precordial leads (RPL) may increase its sensitivity substantially. However, this study looked at a highly selected population of patients who all underwent thallium-201 scintigraphy and coronary angiography. The present study evaluated the clinical utility of ST-segment changes in the RPL and lead aVR in an unselected population of patients undergoing ET.", "Right precordial leads and lead aVR at exercise electrocardiography: does it change test results?<||||>A total of 906 consecutive patients who received ET were included in the study. ET was done using the Bruce Protocol with a 12-lead electrocardiogram (ECG) substituting V(4)R and V(6)R for V(1) and V(6). Leads V(1) and V(6) were selected for omission as these two leads hardly ever manifest changes in isolation. Substituting two leads would obviate the need for a more complex recording system, thus improving clinical utility.", "Right precordial leads and lead aVR at exercise electrocardiography: does it change test results?<||||>On the basis of horizontal/downsloping ST-segment depression (STD) of 1.0 mm or more (the usually accepted criterion for a positive ET), 159 (17.5%) patients had a positive ET. In those patients with a negative ET (545 patients), 4 patients (0.7%) manifested STD and 5 patients (0.9%) manifested ST-segment elevation (STE) in leads V(4)R and/or V(6)R, respectively. Of note, 44.7% of the positive ET group had STE in lead aVR." ]

[ "Detection of neuroblastoma in bone marrow by immunocytology: is a single marrow aspirate adequate?<||||>Except at diagnosis and relapse, when gross disease is present, histologic evaluation is less sensitive than immunocytology (IC) of bone marrow for detecting metastatic neuroblastoma. We examined whether the chance of a positive IC from a single marrow site was comparable to an IC of pooled marrow from multiple sites.", "Detection of neuroblastoma in bone marrow by immunocytology: is a single marrow aspirate adequate?<||||>We carried out 47 marrow examinations on 29 patients with high-risk neuroblastoma on therapy. Each examination consisted of histologic evaluation of four aspirates and two biopsies (six sites), IC of a 2.5-5-mL heparinized sample from a single site (the right posterior iliac crest; IC-RPIC), as well as IC of 8-10 mL of heparinized marrow pooled from bilateral anterior and bilateral posterior iliac crests (IC-pooled). IC was performed using a panel of monoclonal antibodies specific for ganglioside GD2.", "Detection of neuroblastoma in bone marrow by immunocytology: is a single marrow aspirate adequate?<||||>The number of GD2-positive tumor cells detected by IC-pooled had a strong linear correlation with that by IC-RPIC (R = 0.91), although IC-pooled detected an average of 3.3 times more GD2-positive cells. Of 47 examinations, 15 tested positive by histology (6 sites), 20 by IC- pooled, and 17 by IC-RPIC. Among 29 patients, the level of agreement between IC-RPIC and IC-pooled was generally good (kappa statistic>or = 0.72), giving a false negative rate of<or = 30%." ]

[ "Should we pay the student?<||||>Financial incentives are effective in moderating physician and patient behaviour, but they have not been studied in the context of medical education.AIM: This study assessed whether financial incentives can motivate students to acquire electrocardiogram (ECG) interpretation skills.", "Should we pay the student?<||||>Students enrolled for a cardio-respiratory teaching module (n = 121) were randomised to an intervention (financial incentive) or a control (book voucher raffle) condition. All students took three validated exams of ECG interpretation skills (at module entry, module exit and seven weeks later). Only the exit exam was financially incentivised in the intervention group. The primary outcome was the proportion of students who correctly identified ≥60% of clinically important diagnoses in the exit exam.", "Should we pay the student?<||||>Financial incentives more than doubled the odds of correctly identifying ≥60% of diagnoses in the exit exam (adjusted odds ratio 2.44, 95% confidence interval 1.05-5.67) and significantly increased student learning time. However, there was no significant effect on performance levels in the retention exam." ]

[ "Cardiac surgery in a high-risk group of patients: is prolonged postoperative antibiotic prophylaxis effective?<||||>In a prospective, randomized study, postoperatively prolonged antibiotic prophylaxis is evaluated in a high-risk group of patients undergoing cardiac operations. These patients had postoperative low cardiac output necessitating inotropic support and intraaortic balloon pumping.", "Cardiac surgery in a high-risk group of patients: is prolonged postoperative antibiotic prophylaxis effective?<||||>Between January 1991 and 1994, 53 patients were enrolled in the study (42 men, mean age 65 years). All patients received the usual perioperative (24 hours) cefazolin prophylaxis. In the study group (n = 28) a prolonged regimen of prophylaxis with ticarcillin/clavulanate was performed for 2 days and vancomycin was added in a low dose until removal of the intraaortic balloon pump. The control group (n = 25) did not receive a prolonged regimen of prophylaxis. Follow-up ended at hospital discharge.", "Cardiac surgery in a high-risk group of patients: is prolonged postoperative antibiotic prophylaxis effective?<||||>Early mortality was 7 of 28 patients (25%) in the prophylaxis group and 8 of 25 patients (32%) in the control group (p = 0.397). Defined infections (pneumonia, n = 22; sepsis, n = 8; deep sternal wound infection, n = 2) occurred in 50% of the study group and 68% of the control group (p = 0.265). In all patients with septicemia, only coagulase-negative staphylococci could be isolated from the bloodstream (5 patients in the prophylaxis group vs 3 in the control group). Infectious parameters were controlled daily and did not differ significantly between groups. A total of 1158 bacteriologic tests were performed (blood cultures, n = 389; intravascular catheters, n = 208; bronchial aspirates, n = 411; intraaortic balloon pumps, n = 42; wound secretions, n = 108) showing bacterial growth in 322 (28%) without a significant difference between the groups. In the prophylaxis group, 13 intravascular catheters and intraaortic balloon pumps showed bacterial growth versus 11 in the control group. No side effects were seen." ]

[ "Are hospital characteristics associated with parental views of pediatric inpatient care quality?<||||>Patient assessments of care are increasingly being considered an important dimension of quality of care. Few studies have examined the types and extent of problems identified by parents in the care of hospitalized children and whether hospital characteristics are associated with some of these problems. The objective of this study was to describe the quality of pediatric inpatient care as perceived by parents of hospitalized children and test whether hospital characteristics (academic status, market competition, freestanding children's hospital) are associated with variations in quality.", "Are hospital characteristics associated with parental views of pediatric inpatient care quality?<||||>We performed a cross-sectional analysis of surveys from 6030 parents of children who were discharged for a medical condition from 38 hospitals that used the Picker Institute's Pediatric Inpatient Survey. The Pediatric Inpatient Survey measures 7 dimensions of inpatient care quality: partnership, coordination, information to parent, information to child, physical comfort, confidence and trust, and continuity and transition. Our main outcome measures included an overall quality of care rating (1 = poor, 5 = excellent), as well as overall and dimension-specific problem scores (0 = no problems, 100 = problems with 100% of processes asked about in the survey). We used Pearson correlation to determine the strength of association between the overall quality of care rating and dimension problem scores. We tested for associations between hospital characteristics and problem scores using linear regression models, controlling for patient health status and other socioeconomic status variables.", "Are hospital characteristics associated with parental views of pediatric inpatient care quality?<||||>Parents on average rated their child's care as very good (mean: 4.2) but reported problems with 27% of the survey's hospital process measures. Information to the child (33%) and coordination of care (30%) had the highest problem rates. Parent communication problems correlated most strongly with overall quality of care ratings (r = -0.49). Parents of children who were hospitalized at academic health centers (AHCs) reported 4% more problems overall (29.8% vs 25.5%) and almost 9% more problems with coordination of care (34.1% vs 25.6%) compared with those at non-AHCs. Parents in more competitive markets reported almost 3% more problems than those in the less competitive ones (28.9% vs 26.3%). The freestanding children's hospital classification was not associated with overall problem scores. We found wide variation in problem scores by hospital, even among AHCs. Hospital and patient characteristics explained only 6% of the variance in problem scores." ]

[ "Could thrombocyte parameters be an inflammatory marker in the brucellosis?<||||>This self-controlled study included 40 patients who had positive BSTAT at least at a titer of 1/160. Platelet parameters and inflammation values (CRP, ESR) at the time of positive BSTAT at least at a titer of 1/160 (pre-treatment) were compared with control of the same parameters at the time when BSTAT became negative or when the titers reduced 4 folds (post-treatment).", "Could thrombocyte parameters be an inflammatory marker in the brucellosis?<||||>Mean platelet volume values (7.90+1.96) were significantly elevated in post treatment period when compared to pre treatment (7.58+1.96), (p= 0.023). Post treatment CRP, ESR and PC were significantly reduced when compared to pretreatment values (p=0.000, p=0.000 and p=0.025, respectively). In the pretreatment period, a direct correlation between ESR and PC values (r=0.036, p=0.025), and inverse correlations between ESR with MPV (r=-0.337, p=0.038) was found. A dependent predictive factor in multivariate logistic regression analysis for BSTAT was not found." ]

[ "Coblation adenotonsillectomy: an improvement over electrocautery technique?<||||>To compare postoperative complication rates of coblation and electrocautery adenotonsillectomies.", "Coblation adenotonsillectomy: an improvement over electrocautery technique?<||||>Retrospective chart review.", "Coblation adenotonsillectomy: an improvement over electrocautery technique?<||||>From January 2000 to June 2004, 1997 pediatric patients underwent adenotonsillectomy. 745 coblation, and 1252 electrocautery tonsillectomies were performed. Primary bleed, secondary bleed, and dehydration were seen in 3, 35, and 23 coblation, and 9, 41, and 64 electrocautery tonsillectomies, respectively. Data analysis revealed no significant difference in primary and secondary hemorrhage rate, but a higher dehydration rate in the electrocautery group (P=0.0423). A total of 602 coblation, 763 curette/cautery, and 632 electrocautery adenoidectomies were performed. Neck pain was seen in 0, 17, and 3 patients, respectively. Data analysis showed a higher incidence of neck pain with the curette/cautery technique compared with coblator and cautery techniques (P=0.0006 and P=0.0119, respectively)." ]

[ "Survey of children accessing HIV services in a high prevalence setting: time for adolescents to count?<||||>To establish the proportion of adolescents among children infected with human immunodeficiency virus (HIV) in Zimbabwe who receive HIV care and support, and what clinic staff perceives to be the main problems faced by HIV-infected children and adolescents.", "Survey of children accessing HIV services in a high prevalence setting: time for adolescents to count?<||||>In July 2008, we sent a questionnaire to all 131 facilities providing HIV care in Zimbabwe. In it we requested an age breakdown of the children (aged 0-19 years) registered for care and asked what were the two major problems faced by younger children (0-5 years) and adolescents (10-19 years).", "Survey of children accessing HIV services in a high prevalence setting: time for adolescents to count?<||||>Nationally, 115 (88%) facilities responded. In 98 (75%) that provided complete data, 196 032 patients were registered and 24 958 (13%) of them were children. Of children under HIV care, 33% were aged 0-4 years; 25%, 5-9 years; 25%, 10-14 years; and 17%, 15-19 years. Staff highlighted differences in the problems most commonly faced by younger children and adolescents. For younger children, such problems were malnutrition and lack of appropriate drugs (cited by 46% and 40% of clinics, respectively); for adolescents they concerned psychosocial issues and poor drug adherence (cited by 56% and 36%, respectively)." ]

[ "Intraoperative intra-articular injection of gentamicin: will it decrease the risk of infection in total shoulder arthroplasty?<||||>Deep infection is a debilitating complication after shoulder arthroplasty. Intra-articular injection of antibiotic can give a higher concentration compared with intravenous administration. We hypothesized that a group of patients given an intra-articular, intraoperative injection of gentamicin would report a lower infection rate than a group without local antibiotics.", "Intraoperative intra-articular injection of gentamicin: will it decrease the risk of infection in total shoulder arthroplasty?<||||>Between 2005 and 2011, the senior author performed 507 shoulder arthroplasties. We retrospectively reviewed all of those cases. All patients were administered systemic prophylactic antibiotics. Beginning in June 2007, patients were also injected with 160 mg of gentamicin in the glenohumeral joint at the end of their surgery. Patient records were examined for preexisting medical conditions, type of surgery, and presence of infection. Patients receiving surgery before 2007 were compared with those after to determine the effect of prophylactic gentamicin administration in preventing deep infection associated with surgery. All patients were observed for a minimum of 1 year.", "Intraoperative intra-articular injection of gentamicin: will it decrease the risk of infection in total shoulder arthroplasty?<||||>Of the 507 surgeries, 164 were performed before 2007 (without intra-articular injection of gentamicin; group A) and 343 were performed with addition of gentamicin (group B). In group A, 5 patients presented with infection (3.0%) compared with 1 in group B (0.29%). The gender, mean age, mean body mass index, and prevalence of comorbidities were similar between the groups." ]

[ "Tumor-infiltrating immune cells: triggers for tumor capsule disruption and tumor progression?<||||>Our previous studies of human breast and prostate cancer have shown that aberrant immune cell infiltration is associated with focal tumor capsule disruption and tumor cell budding that facilitate invasion and metastasis. Our current study attempted to determine whether aberrant immune cell infiltration would have similar impact on colorectal cancer (CRC).", "Tumor-infiltrating immune cells: triggers for tumor capsule disruption and tumor progression?<||||>Tissue sections from 100 patients with primary CRC were assessed for the frequencies of focal basement membrane (BM) disruption, muscularis mucosa (MM) fragmentation, and tumor cell dissemination in epithelial structures adjacent and distal to infiltrating lymphoid aggregates using a panel of biomarkers and quantitative digital imaging.", "Tumor-infiltrating immune cells: triggers for tumor capsule disruption and tumor progression?<||||>Our study revealed: (1) epithelial structures adjacent to lymphoid follicles or aggregates had a significantly higher (p<0.001) frequency of focally disrupted BM, dissociated epithelial cells in the stroma, disseminated epithelial cells within lymphatic ducts or blood vessels, and fragmented MM than their distal counterparts, (2) a majority of dissociated epithelial cells within the stroma or vascular structures were immediately subjacent to or physically associated with infiltrating immune cells, (3) the junctions of pre-invasive and invasive lesions were almost exclusively located at sites adjacent to lymphoid follicles or aggregates, (4) infiltrating immune cells were preferentially associated with epithelial capsules that show distinct degenerative alterations, and (5) infiltrating immune cells appeared to facilitate tumor stem cell proliferation, budding, and dissemination." ]

[ "Adipose tissue at entheses: the rheumatological implications of its distribution. A potential site of pain and stress dissipation?<||||>To describe the distribution of adipose tissue within and adjacent to entheses in order to assess its functional significance at attachment sites.", "Adipose tissue at entheses: the rheumatological implications of its distribution. A potential site of pain and stress dissipation?<||||>Entheses were removed from 29 different sites in the limbs of formalin fixed, elderly, dissecting room cadavers and the samples prepared for paraffin and/or methylmethacrylate histology. Entheses from four young volunteers with no history of significant musculoskeletal injury were examined by magnetic resonance imaging using T(1) weighted sequences.", "Adipose tissue at entheses: the rheumatological implications of its distribution. A potential site of pain and stress dissipation?<||||>Adipose tissue was present at several different sites at numerous entheses. Many tendons/ligaments lay on a bed of well vascularised, highly innervated, \"insertional angle fat\". Endotenon fat was striking between fascicles, where entheses flared out at their attachments. It was also characteristic of the epitenon, where it occurred in conjunction with lamellated and Pacinian corpuscles. Fat filled, meniscoid folds often protruded into joint cavities, immediately adjacent to attachment sites." ]

[ "Can brief workshops improve clinical instruction?<||||>The impact of faculty development activities aimed at improving the teaching skills of clinical instructors requires elucidation. Since 2003, all instructors at our school of medicine have been required to undertake a brief workshop in basic clinical instructional skills as a prerequisite for promotion and tenure. The impact of this has, so far, remained unknown.", "Can brief workshops improve clinical instruction?<||||>This study aimed to examine to what extent participation in a brief workshop can improve clinical instructors' performance in the long run, and which particular dimensions of performance are improved.", "Can brief workshops improve clinical instruction?<||||>The study included a sample of 149 faculty members who undertook a required workshop in basic instructional skills. The teaching performance of these faculty members was measured by student feedback a year after the workshop. The study used pre- and post-test design, with a comparison group of 121 faculty members.", "Can brief workshops improve clinical instruction?<||||>Student ratings for 5 dimensions of clinical instruction increased significantly, but only for the study group who had participated in a workshop. The comparison group's ratings were unchanged. The highest improvement in the instructors' performance related to availability of teachers to students." ]

[ "Does neighborhood fast-food outlet exposure amplify inequalities in diet and obesity?<||||>Greater exposures to fast-food outlets and lower levels of education are independently associated with less healthy diets and obesity. Little is known about the interplay between these environmental and individual factors.", "Does neighborhood fast-food outlet exposure amplify inequalities in diet and obesity?<||||>The purpose of this study was to test whether observed differences in fast-food consumption and obesity by fast-food outlet exposure are moderated by educational attainment.", "Does neighborhood fast-food outlet exposure amplify inequalities in diet and obesity?<||||>In a population-based cohort of 5958 adults aged 29-62 y in Cambridgeshire, United Kingdom, we used educational attainment-stratified regression models to estimate the food-frequency questionnaire-derived consumption of energy-dense \"fast foods\" (g/d) typically sold in fast-food restaurants and measured body mass index (BMI; in kg/m(2)) across geographic information system-derived home and work fast-food exposure quartiles. We used logistic regression to estimate the odds of obesity (BMI ≥30) and calculated relative excess risk due to interaction (RERI) on an additive scale. Participant data were collected during 2005-2013 and analyzed in 2015.", "Does neighborhood fast-food outlet exposure amplify inequalities in diet and obesity?<||||>Greater fast-food consumption, BMI, and odds of obesity were associated with greater fast-food outlet exposure and a lower educational level. Fast-food consumption and BMI were significantly different across education groups at all levels of fast-food outlet exposure (P<0.05). High fast-food outlet exposure amplified differences in fast-food consumption across levels of education. The relation between fast-food outlet exposure and obesity was only significant among those who were least educated (OR: 2.05; 95% CI: 1.08, 3.87; RERI = 0.88), which suggested a positive additive interaction between education and fast-food outlet exposure." ]

[ "Should the preservation of residual renal function cost volume overload and its consequence left ventricular hypertrophy in new hemodialysis patients?<||||>Left ventricular hypertrophy (LVH) is an important predictor of mortality in dialysis patients. The loss of residual renal function (RRF) appears to occur more rapidly in hemodialysis than continuous ambulatory peritoneal dialysis (CAPD). It is more likely that volume expansion in patients on CAPD may preserve RRF. The aim of this study was to investigate whether there is a cause-effect relationship between volume overload and preserving RRF in new hemodialysis patients.", "Should the preservation of residual renal function cost volume overload and its consequence left ventricular hypertrophy in new hemodialysis patients?<||||>Nineteen patients with end-stage renal disease (ESRD) starting hemodialysis therapy were included in the study. At the beginning, their elevated blood pressures (BP) were treated with antihypertensive drugs. Thereafter, until normovolemia and normal BP were obtained, strict volume control was applied. The effects of both treatment modalities on the loss of RRF and LVH were evaluated prospectively.", "Should the preservation of residual renal function cost volume overload and its consequence left ventricular hypertrophy in new hemodialysis patients?<||||>At the initial examination, all of the patients were hypertensive and had markedly increased left ventricular mass index (LVMI). The daily urine production was 1575+/-281 mL. At the end of drug treatment period lasting three months, although BP significantly decreased, daily urine production and LVMI only decreased by 12% and 6%, respectively. At the end of the period in which strict volume control was applied, the body weight significantly decreased (from 60+/-5 to 55+/-8 kg, p<0.0001). This decrease in body weight was accompanied by marked decreases in dilated cardiac chamber size and more importantly daily urine production. At the end of this period, while 7 of 19 patients had no residual urine production, residual urine production was below 200 mL/d in the remaining 12 patients. Although the period of volume control was short, there was significant reduction in the LVMI (decreased from 251+/-59 to 161+/-25 gr/m2, p<0.0001)." ]

[ "Is It possible to recognize pulmonary infarction on multisection CT images?<||||>To retrospectively determine sensitivity and specificity of four findings for distinguishing pulmonary infarction from other causes of peripheral pulmonary consolidations on multidetector computed tomographic (CT) images, with other CT and clinical findings as reference.", "Is It possible to recognize pulmonary infarction on multisection CT images?<||||>Institutional review board approved the study and waived informed consent. Three independent radiologists blindly analyzed selected multisection CT images of 50 pulmonary infarctions-not showing direct arterial signs of pulmonary embolism-and 100 peripheral consolidations of other origins. Readers analyzed four findings: triangular shape, vessel sign (defined as presence of an enlarged vessel at the apex of consolidation), central lucencies, and air bronchograms. Interobserver agreement; frequency on CT images with and without infarct; and sensitivity, specificity, and positive likelihood ratio (LR) for diagnosis of pulmonary infarction were assessed for each finding.", "Is It possible to recognize pulmonary infarction on multisection CT images?<||||>One hundred fifty peripheral consolidations were analyzed in 134 (75 men, 59 women) patients (mean age, 55.9 years+/-17.4 [standard deviation] vs 54.7+/-19.9; P=.71). Interobserver agreement was good for central lucencies and air bronchograms and poor to moderate for the other two findings (kappa<0.61). Compared with CT images without infarct, CT images with infarct had a higher frequency of vessel sign (32% [16 of 50] vs 11% [11 of 100], P=.029) and central lucencies (46% [23 of 50] vs 2% [two of 100], P<.001) and a lower frequency of air bronchograms (8% [four of 50] vs 40% [40 of 100], P=.003). Frequency of triangular shape was similar in both groups (52% [26 of 50] vs 40% [40 of 100], P=.17). Positive LR was 23.0 for central lucencies, 2.9 for vessel sign, 1.3 for triangular shape, and 0.2 for air bronchograms. Presence of central lucencies had 98% specificity and 46% sensitivity for pulmonary infarction. When the vessel sign and negative air bronchogram were combined with central lucencies, specificity increased to 99% but sensitivity decreased to 14%." ]

[ "Is malnutrition still a risk factor of postoperative complications in gastric cancer surgery?<||||>The present study aimed at retrospectively evaluating the incidence of mortality and major and minor postoperative complications in patients who underwent surgery for gastric cancer between 2000 and 2006 stratified according to the preoperative percentage weight loss, serum albumin levels and body mass index (BMI).", "Is malnutrition still a risk factor of postoperative complications in gastric cancer surgery?<||||>One hundred and ninety-six patients affected by gastric cancer admitted to the Division of Digestive Surgery of the Catholic University of Rome between January 2000 and December 2006 were considered eligible and were included in the study. According to the weight loss, patients were divided into three groups: (1) 0-5%; (2) 5.1-10%; (3)>10%. On the basis of serum albumin levels, were divided into three groups: (1)<3.0 g/dl; (2) 3.0-3.4 g/dl; (3)>3.5 g/dl. According to BMI, were divided into four groups: (1)<18.5 kg/m(2); (2) 18.5-24.9 kg/m(2); (3) 25.0-29.9 kg/m(2); (4)>30.0 kg/m(2). Postoperative complications and mortality were reported. Complications were classified by objective criteria as major or minor, and as infectious or non-infectious.", "Is malnutrition still a risk factor of postoperative complications in gastric cancer surgery?<||||>The postoperative mortality was 0%. Major infectious complications occurred in 20 patients (10.2%), major non-infectious in 18 (9.2%), minor infectious in 21 (10.7%), whereas minor non-infectious complications were absent. The rate of major infectious, major non-infectious and minor infectious postoperative complications was similar in patients with absent or light weight loss (8.8%, 8.8%, 10.6%, respectively), mild weight loss (15.3%, 11.5%, 9.6%, respectively), or severe weight loss (6.4%, 6.4%, 12.9%, respectively). Similarly, the rate of postoperative complications did not differ between patients with serum albumin<3.0 g/dl (10.8%, 8.1%, 8.1%, respectively); between 3.0 and 3.4 (8.8%, 13.3%, 17.7%, respectively) or>or =3.5 g/dl (10.5%, 7.9%, 8,7%, respectively). According to BMI, the rate of postoperative complications was: 11.7%, 5.8%, and 5.8% for BMI<18.5 kg/m(2); 9.4%, 8.2%, and 11.7% for BMI between 18.5 and 24.9 kg/m(2); 10.7%, 10.7%, and 9.2% for BMI between 25 and 29.9 kg/m(2); 10.3%, 10.3% and 13.7% for BMI>30 kg/m(2). Then, we evaluated the postoperative morbidity only in patients who underwent total gastrectomy or distal subtotal gastrectomy associated with extended lymphadenectomy. In this group of patients, the rate of postoperative complications was comparable in patients with 0-5% (8.8%, 7.7%, 10%, respectively), 5.1-10% (14.6%, 9.7%, 9.7%, respectively), and>10% (7.1%, 7.1%, 14.3%, respectively) weight loss. Also stratifying the patients according to the serum albumin levels, the rate of postoperative complications did not differ significantly (serum albumin<3.0 g/dl: 14.8%, 11.1%, 14.8%, respectively; serum albumin between 3.0 and 3.4 g/dl: 6.2%, 12.5%, 15.6%, respectively; serum albumin>or =3.5 g/dl: 10.4%, 5.8%, 7.0%, respectively). According to BMI, the rate of postoperative complications was: 7.6%, 0%, and 7.6% for BMI<18.5 kg/m(2); 9.5%, 9.5%, and 11.1% for BMI between 18.5 and 24.9 kg/m(2); 12.5%, 8.3%, and 10.4% for BMI between 25 and 29.9 kg/m(2); 9.5%, 9.5% and 9.5% for BMI>30 kg/m(2)." ]

[ "Can male circumcision have an impact on the HIV epidemic in men who have sex with men?<||||>Three trials have demonstrated the prophylactic effect of male circumcision (MC) for HIV acquisition among heterosexuals, and MC interventions are underway throughout sub-Saharan Africa. Similar efforts for men who have sex with men (MSM) are stymied by the potential for circumcised MSM to acquire HIV easily through receptive sex and transmit easily through insertive sex. Existing work suggests that MC for MSM should reach its maximum potential in settings where sexual role segregation is historically high and relatively stable across the lifecourse; HIV incidence among MSM is high; reported willingness for prophylactic circumcision is high; and pre-existing circumcision rates are low. We aim to identify the likely public health impact that MC interventions among MSM would have in one setting that fulfills these conditions-Peru-as a theoretical upper bound for their effectiveness among MSM generally.", "Can male circumcision have an impact on the HIV epidemic in men who have sex with men?<||||>We use a dynamic, stochastic sexual network model based in exponential-family random graph modeling and parameterized from multiple behavioral surveys of Peruvian MSM. We consider three enrollment criteria (insertive during 100%,>80% or>60% of UAI) and two levels of uptake (25% and 50% of eligible men); we explore sexual role proportions from two studies and different frequencies of switching among role categories. Each scenario is simulated 10 times. We estimate that efficiency could reach one case averted per 6 circumcisions. However, the population-level impact of an optimistic MSM-MC intervention in this setting would likely be at most ∼5-10% incidence and prevalence reductions over 25 years." ]

[ "Epicardial ultrasonography: a potential method for intraoperative quality assessment of coronary bypass anastomoses?<||||>Intraoperative quality assessment in coronary artery bypass surgery confirms graft patency and enables revision of failing grafts. The aim of this study was to evaluate graft quality intraoperatively by epicardial ultrasonography and to compare this technique with transit time flow measurements and intraoperative angiography, and to evaluate the ability of these methods to predict long-term patency as described by follow-up angiography.", "Epicardial ultrasonography: a potential method for intraoperative quality assessment of coronary bypass anastomoses?<||||>Thirty-nine patients with mean age of 66 years (SD 9.5) who underwent off-pump coronary artery bypass surgery with internal mammary artery graft to the left anterior descending coronary artery were included. Epicardial ultrasonography and transit time flow measurement were performed after completion of the anastomoses, and coronary angiography after closure of the chest. Follow-up angiography was carried out after 156 days (SD 50).", "Epicardial ultrasonography: a potential method for intraoperative quality assessment of coronary bypass anastomoses?<||||>Diameter measurements obtained by epicardial ultrasonography correlated poorly with the same diameter measurements obtained by angiography. Epicardial ultrasonography revealed 5 abnormal grafts (13%), transit time flow measurements none, and intraoperative angiography 9 (23%). At follow-up angiography, 4 grafts (11%) were pathologic. Epicardial ultrasonography and transit time flow measurements indicated no need for graft revision; intraoperative angiography suggested need for revision in 3 cases." ]

[ "Is routine preoperative upper GI endoscopy needed prior to gastric bypass?<||||>In Finland, upper GI endoscopy (UGI) prior to bariatric surgery is routine in all but one hospital performing bariatric surgery. However, UGI is an unpleasant investigation for the patient and requires resources. Helicobacter pylori (HP) can be tested from blood and cannot be considered as an indication for UGI. We wanted to identify the most common findings in UGI and see if the findings influenced the decision to operate or if they even canceled the operation.", "Is routine preoperative upper GI endoscopy needed prior to gastric bypass?<||||>We evaluated retrospectively the data of 412 patients undergoing preoperative UGI in Vaasa Central Hospital in the years 2006-2010.", "Is routine preoperative upper GI endoscopy needed prior to gastric bypass?<||||>UGI was considered normal in 191 (55.8 %) patients. The most common findings were hiatal hernia in 25.4 % (n = 87); gastritis, 13.7 % (n = 47); and esophagitis, 13.2 % (n = 45). Also benign polyps, 6.7 % (n = 23), and ulcers, 2.9 % (n = 10), were detected. One 0.5-cm esophageal leiomyoma was found, but no malignant lesions. Histology was found normal in 185 (54.1 %) patients. HP was found in 12.0 % (n = 41) of patients." ]

[ "Does shock wave lithotripsy of renal stones cause cardiac muscle injury?<||||>To investigate whether shock wave lithotripsy (SWL) causes cardiac muscle injury that alters the levels of troponin I plasma, a cardio-specific enzyme shown to be useful in diagnosing cardiac muscle injury because of its high specificity.", "Does shock wave lithotripsy of renal stones cause cardiac muscle injury?<||||>Patients treated by SWL for renal stones participated in the study. They had undergone a baseline 12-lead electrocardiogram (ECG) a few days earlier. One day after SWL, they were queried about any chest discomfort, blood was drawn for evaluation of troponin I and creatine kinase with isoenzymes (CK-MB), and an ECG was carried out.", "Does shock wave lithotripsy of renal stones cause cardiac muscle injury?<||||>Thirty-two patients (21 men and 11 women, mean age +/- SD 51.0 +/- 10.6 years) comprised the study group. Fourteen SWL treatments were on the right side and 18 on the left. The mean number of shock waves was 2859 +/- 202. The mean time to evaluation after SWL was 22.3 +/- 1.3 hours. None of the patients reported chest discomfort. The mean value was 6.6 +/- 9.2 mU/mL for CK-MB and 0.02 l +/- 0.04 ng/mL for troponin I. No ECG changes suggestive of myocardial injury were evident. None of the 5 patients who experienced ventricular extrasystoles during SWL had any evidence of cardiac muscle injury." ]

[ "Can a community-based 'smoke-free homes' intervention persuade families to apply smoking restrictions at homes?<||||>Children are commonly exposed to second-hand smoke (SHS). The aim of this study is to evaluate the feasibility, acceptability and outcome of Smoke-Free Homes (SFH), a community-based intervention; and assess potential evaluation methods.", "Can a community-based 'smoke-free homes' intervention persuade families to apply smoking restrictions at homes?<||||>SFH, designed to encourage families to implement smoking restrictions at home, was delivered over a period of 6 months through schools, healthcare settings and community events in Beeston, South Leeds, UK. It was evaluated using baseline and post-implementation surveys, focus group discussions and promise forms follow-up.", "Can a community-based 'smoke-free homes' intervention persuade families to apply smoking restrictions at homes?<||||>We surveyed 318 households before, and 217 households after, the intervention. The proportion of all surveyed households reporting being completely smoke free significantly increased from 35% [95% confidence interval (CI) 30, 40] at baseline to 68% (95% CI: 61, 74) 6 months post-implementation (P<0.0001). Ninety per cent of people, followed-up by telephone 3 months after signing SFH promise form, said they were still keeping their promise. Focus group discussions with children and parents conveyed acceptability of the intervention, in particular, the schools element, where children are encouraged to discuss the concept of SFH with the adults in their households." ]

[ "Is SAPS 3 better than APACHE II at predicting mortality in critically ill transplant patients?<||||>This study compared the accuracy of the Simplified Acute Physiology Score 3 with that of Acute Physiology and Chronic Health Evaluation II at predicting hospital mortality in patients from a transplant intensive care unit.", "Is SAPS 3 better than APACHE II at predicting mortality in critically ill transplant patients?<||||>A total of 501 patients were enrolled in the study (152 liver transplants, 271 kidney transplants, 54 lung transplants, 24 kidney-pancreas transplants) between May 2006 and January 2007. The Simplified Acute Physiology Score 3 was calculated using the global equation (customized for South America) and the Acute Physiology and Chronic Health Evaluation II score; the scores were calculated within 24 hours of admission. A receiver-operating characteristic curve was generated, and the area under the receiver-operating characteristic curve was calculated to identify the patients at the greatest risk of death according to Simplified Acute Physiology Score 3 and Acute Physiology and Chronic Health Evaluation II scores. The Hosmer-Lemeshow goodness-of-fit test was used for statistically significant results and indicated a difference in performance over deciles. The standardized mortality ratio was used to estimate the overall model performance.", "Is SAPS 3 better than APACHE II at predicting mortality in critically ill transplant patients?<||||>The ability of both scores to predict hospital mortality was poor in the liver and renal transplant groups and average in the lung transplant group (area under the receiver-operating characteristic curve = 0.696 for Simplified Acute Physiology Score 3 and 0.670 for Acute Physiology and Chronic Health Evaluation II). The calibration of both scores was poor, even after customizing the Simplified Acute Physiology Score 3 score for South America." ]

[ "Predictive value of the NIHSS for ADL outcome after ischemic hemispheric stroke: does timing of early assessment matter?<||||>Early prediction of future functional abilities is important for stroke management. The objective of the present study was to investigate the predictive value of the 13-item National Institutes of Health Stroke Scale (NIHSS), measured within 72 h after stroke, for the outcome in terms of activities of daily living (ADL) 6 months post stroke. The second aim was to examine if the timing of NIHSS assessment during the first days post stroke affects the accuracy of predicting ADL outcome 6 months post stroke.", "Predictive value of the NIHSS for ADL outcome after ischemic hemispheric stroke: does timing of early assessment matter?<||||>Baseline characteristics including neurological deficits were measured in 188 stroke patients, using the 13-item NIHSS, within 72 h and at 5 and 9 days after a first-ever ischemic hemispheric stroke. Outcome in terms of ADL dependency was measured with the Barthel Index (BI) at 6 months post stroke. The area under the curve (AUC) from the receiver operating characteristic (ROC) was used to determine the discriminative properties of the NIHSS at days 2, 5 and 9 for outcome of the BI. In addition, at optimal cut-off odds ratio (OR), sensitivity, specificity, positive (PPV) and negative predicted values (NPV) for the different moments of NIHSS assessment post stroke were calculated.", "Predictive value of the NIHSS for ADL outcome after ischemic hemispheric stroke: does timing of early assessment matter?<||||>One hundred and fifty-nine of the 188 patients were assessed at a mean of 2.2 (1.3), 5.4 (1.4) and 9.0 (1.8) days after stroke. Significant Spearman rank correlation coefficients were found between BI at 6 months and NIHSS scores on days 2 (r(s)=0.549, p<0.001), 5 (r(s)=0.592, p<0.001) and 9 (r(s)=0.567, p<0.001). The AUC ranged from 0.789 (95%CI, 0.715-0.864) for measurements on day 2 to 0.804 (95%CI, 0.733-0.874) and 0.808 (95%CI, 0.739-0.877) for days 5 and 9, respectively. Odds ratio's ranged from 0.143 (95%CI, 0.069-0.295) for assessment on day 2 to a maximum of 0.148 (95%CI, 0.073-0.301) for day 5. The NPV gradually increased from 0.610 (95%CI, 0.536-0.672) for assessment on day 2 to 0.679 (95%CI, 0.578-0.765) for day 9, whereas PPV declined from 0.810 (95%CI, 0.747-0.875) for assessment on day 2 to 0.767 (95%CI, 0.712-0.814) for day 9. The overall accuracy of predictions increased from 71.7% for assessment on day 2 to 73.6% for day 9." ]

[ "Is systemic right ventricular function by cardiac MRI related to the degree of tricuspid regurgitation in congenitally corrected transposition of the great arteries?<||||>Systemic right ventricular dysfunction and tricuspid regurgitation (TR) are frequently encountered in patients with congenitally corrected transposition of the great arteries (CCTGA). Studies using echocardiography have suggested a relationship between the degree of TR and systemic right ventricular dysfunction; however, assessment of systemic right ventricular function by echocardiography is limited. Cardiac MRI (CMR) is the gold standard for volumetric assessment of the systemic right ventricle. We performed a retrospective cohort study at our center evaluating all adult patients with CCTGA who underwent a CMR between 1/1999 and 1/2013 to determine the relationship between the degree of TR and systemic right ventricular function.", "Is systemic right ventricular function by cardiac MRI related to the degree of tricuspid regurgitation in congenitally corrected transposition of the great arteries?<||||>Of the 33 patients identified, 12 had ≤ mild TR (37%), 13 had moderate TR (40%), and 8 had severe TR (24%). Mean age at CMR was 38 years (23-64). Mean right ventricular ejection fraction (45% vs. 41% vs. 42%, p=0.68) and mean indexed right ventricular end diastolic volume (122 ml/m(2) vs. 136 ml/m(2) vs. 138 ml/m(2)p=0.36) were not significantly different for patients with ≤ mild TR, moderate TR or severe TR. The degree of TR was not associated with additional congenital lesions, prior procedures, presence of an intraventricular conduction delay, or decreased left ventricular function." ]

[ "Do physical activity and aerobic fitness moderate the association between birth weight and metabolic risk in youth?<||||>Lower birth weight has been associated with a greater risk of metabolic diseases. The aim of this study was examine whether physical activity and aerobic fitness may modify associations between birth weigh and metabolic risk.", "Do physical activity and aerobic fitness moderate the association between birth weight and metabolic risk in youth?<||||>The European Youth Heart Study is a population-based study of 9 and 15 year olds (n = 1,254). Birth weight was maternally reported. Skin fold measures were used to calculate body fat and fat mass index (FMI = fat mass [kilograms]/height²). Insulin was measured using fasting blood samples. Physical activity was measured using a hip-worn accelerometer (MTI Actigraph) for>600 min/day for ≥3 days and is expressed as \"average activity\" (counts per minute) and time spent in above moderate intensity activity (>2000 cpm). Aerobic fitness was assessed using a maximal cycle ergometry test (watts per kilogram fat-free mass).", "Do physical activity and aerobic fitness moderate the association between birth weight and metabolic risk in youth?<||||>Higher birth weight was associated with higher FMI (β = 0.49 [95% CI 0.21-0.80]; P = 0.001) and greater waist circumference (0.90 [0.32-1.47]; P<0.001), adjusted for sex, age-group, sexual maturity, height, and socioeconomic status. Lower birth weight was associated with higher fasting insulin only after further adjustment for adolescent waist circumference and height (-0.059 [-0.107 to -0.011]; P = 0.016). There was no evidence for any modification of the associations after adjustment for physical activity or aerobic fitness." ]

[ "Is diagnostic cystoscopy painful?<||||>To prospectively evaluate self-reported pain levels associated with diagnostic cystoscopy.", "Is diagnostic cystoscopy painful?<||||>Patients who underwent diagnostic cystoscopy and subsequently graded their pain level during the procedure were enrolled. Pain was graded on a Likert visual analog scale (VAS) of 1-10 where 0 = no pain and 10 = excruciating unbearable pain. Local lidocaine gel 2% was used as intraurethral lubricant.", "Is diagnostic cystoscopy painful?<||||>Data from 1320 consecutive cystoscopies (929 males, 391 females, age range 15-93 years) between 6/2009-1/2010 were analyzed. This was the first cystoscopy for 814 patients. The overall mean VAS was 2.74 ± 1.51 (range 0-9) for rigid cystoscopy and 2.48 ± 1.53 (range 0-10) for flexible cystoscopy (P = 0.004). The reported mean pain level for first-time cystoscopy was significantly higher than that for repeat cystoscopy (2.8 ± 1.6 vs. 2.2 ± 1.4, P<0.001), regardless of gender or type of cystoscope. Men reported significantly higher pain levels than women 2.6 ± 1.5 vs. 2.4 ± 1.4 (P<0.04). The highest mean pain level was reported by men (3.4 ± 1.6) and women (2.5 ± 1.6) for rigid cystoscopy compared to flexible cystoscopy (2.5 ± 1.4 and 1.1 ± 1.9, respectively, P<0.001). Pain levels>5 were reported in 75 (5.7%) cystoscopies." ]

[ "Is left ventricular hypertrabeculation/ noncompaction a cardiac manifestation of Fabry's disease?<||||>Some types of hypertrophic cardiomyopathy are due to cardiac Fabry's disease. Since left ventricular hypertrabeculation/noncompaction (LVHT) is regarded a subtype of hypertrophic cardiomyopathy, we looked for the alpha-galactosidase levels in blood leukocytes of LVHT patients.", "Is left ventricular hypertrabeculation/ noncompaction a cardiac manifestation of Fabry's disease?<||||>Included were male patients in whom LVHT was diagnosed between June 1995 and September 2002. Echocardiographic criteria for LVHT were 1)>3 trabeculations protruding from the left ventricular wall, apically to the papillary muscles, visible in 1 image plane, and 2) intertrabecular spaces perfused from the ventricular cavity, as visualised on colour Doppler imaging. Trabeculations were defined as structures with the same echogenicity as the myocardium and moving synchronously with the ventricular contractions. Excluded were patients with known neuromuscular disorders. All patients were asked for systemic manifestations of Fabry's disease and blood tests were taken. The alpha-galactosidase-A activity was determined by means of an established fluorometric assay in blood leukocytes.", "Is left ventricular hypertrabeculation/ noncompaction a cardiac manifestation of Fabry's disease?<||||>Forty-one patients were invited and 26 accepted the invitation. The remaining patients had died (n=5), lived abroad (n=5) or were unwilling (n=5). Among the 26 patients, aged 28-78 years, who followed the invitation, one had renal failure due to renal shrinkage and one had suffered from a stroke 3 years previously. Leukocyte alpha-galactosidase levels ranged from 70 to 188 nM/mg Prot/h (normal:>or =42 nM/mg Prot/h). In none of the patients was the alpha-galactosidase level reduced." ]

[ "Does active Crohn's disease have decreased intestinal antioxidant capacity?<||||>Oxidative stress is presumed to play an important role in Crohn's disease (CD) pathogenesis. Nevertheless, the evaluation of the intestinal antioxidant capacity through the analysis of glutathione peroxidase activity in CD remains to be determined.", "Does active Crohn's disease have decreased intestinal antioxidant capacity?<||||>20 CD outpatients and 16 volunteers going through colonic cancer screening were enrolled. Colonoscopy with biopsies was performed in all individuals. Samples from inflamed and non-inflamed mucosa were taken when there was CD endoscopic activity. Spectrophotometric assays were performed to measure tissue glutathione peroxidase (GPx) activity, and total (GSHT) and oxidized (GSSG) glutathione in all samples. Demographics and clinical characteristics were collected from clinical charts.", "Does active Crohn's disease have decreased intestinal antioxidant capacity?<||||>Inflamed CD mucosa presented reduced GPx activity compared to non-inflamed CD mucosa (42.94mU/mg protein vs 79.62mU/mg protein, P<0.05) and control mucosa (42.94mU/mg protein vs 95.08mU/mg protein, P<0.001). GSHT concentration was reduced in inflamed mucosa when compared to non-inflamed CD mucosa (0.78μmol/g vs 1.98μmol/g, P<0.01) and the control group (0.78μmol/g vs 2.11μmol/g, P<0.001). A significant correlation was detected between GPx activity and GSSG (r=-0.599), disease duration (r=0.546), and thiopurine treatment (r=-0.480) in non-inflamed CD mucosa." ]

[ "Can oral sucrose reduce the pain and distress associated with screening for retinopathy of prematurity?<||||>Infants undergoing eye exams to screen for retinopathy of prematurity (ROP) demonstrate physiologic and behavioral manifestations of pain and distress. Oral sucrose has analgesic properties that might reduce these effects.AIM: To determine the efficacy of oral sucrose in reducing the pain/distress of eye exams for ROP.", "Can oral sucrose reduce the pain and distress associated with screening for retinopathy of prematurity?<||||>A total of 32 infants about to undergo ROP screening exams received either oral sucrose [S] (N=16) or sterile water [C](N=16) in a randomized, prospective and blinded fashion. Outcome measures included HR, RR, O(2) saturation, BP, pain (premature infant pain profile) and percent of time spent crying during the eye exam.", "Can oral sucrose reduce the pain and distress associated with screening for retinopathy of prematurity?<||||>The groups were similar in GA (weeks) (28+/-1.6), BW (kg) (1.04+/-0.26), postnatal age (days) 50.8+/-20.3, and study weight (kg) 1.88+/-0.40). Both groups demonstrated significant increases in HR, BP, and pain score in response to the exam. Infants in both groups spent the majority of time actively crying during the exam ([S]53+/-35% vs [C] 63+/-31%. Infants receiving [S]showed a small but significant drop in O(2) saturation. No significant differences were seen between groups in physiologic or behavioral responses to the eye exam." ]

[ "Methicillin-resistant Staphylococcus aureus (MRSA) in municipal wastewater: an uncharted threat?<||||>(i) To cultivate methicillin-resistant Staphylococcus aureus (MRSA) from a full-scale wastewater treatment plant (WWTP), (ii) To characterize the indigenous MRSA-flora, (iii) To investigate how the treatment process affects clonal distribution and (iv) To examine the genetic relation between MRSA from wastewater and clinical MRSA.", "Methicillin-resistant Staphylococcus aureus (MRSA) in municipal wastewater: an uncharted threat?<||||>Wastewater samples were collected during 2 months at four key sites in the WWTP. MRSA isolates were characterized using spa typing, antibiograms, SSCmec typing and detection of Panton-Valentine leukocidin (PVL)." ]

[ "Bipolar radiofrequency volumetric tissue reduction of inferior turbinate: does the number of treatment sessions influence the final outcome?<||||>The aim of this study was to determine if the number of treatment sessions has an influence on the final intermediate term results of submucosal bipolar radiofrequency volumetric tissue reduction of the inferior turbinate.", "Bipolar radiofrequency volumetric tissue reduction of inferior turbinate: does the number of treatment sessions influence the final outcome?<||||>One hundred two patients were enrolled in this study prospectively. The procedure was done using the Coblation (Arthrocare Corp., Sunnyvale, CA). The assessment was done using the 10-cm visual analog scale and acoustic rhinometry. Surgical procedures and pre- and postoperative assessments were done at the Faculty of Medicine, Cairo University.", "Bipolar radiofrequency volumetric tissue reduction of inferior turbinate: does the number of treatment sessions influence the final outcome?<||||>Eighty eight percent of our study population achieved final relief of their nasal obstruction, and at least three sessions were needed to maintain the favorable outcome at 1-year follow up." ]

[ "Is total arterial myocardial revascularization with composite grafts a safe and useful procedure in the elderly?<||||>The aim of the study was to evaluate the mid-term results of total arterial myocardial revascularization (TAMR) with composite grafts in patients older than 70 years when compared to standard CABG technique, since the usefulness of TAMR in the elderly has not been demonstrated yet.", "Is total arterial myocardial revascularization with composite grafts a safe and useful procedure in the elderly?<||||>A prospective randomized study was designed with the following end-points: post-operative complications, death, recurrence of angina, graft occlusion, any cardiac event and reinterventions. One hundred and eighty-eight patients older than 70 years were enrolled and assigned to Group 1(G1)=94 pts, for total arterial revascularization or Group 2(G2)=94 pts, for standard CABG (LITA on LAD plus additional saphenous veins). The groups were comparable in terms of pre-operative characteristics and Euroscore (mean: G1=8.4 vs. G2=8.2).", "Is total arterial myocardial revascularization with composite grafts a safe and useful procedure in the elderly?<||||>No differences between the groups were observed in terms of mean number of grafted vessels (G1=2.1 vs. G2=2.3), mean aortic cross-clamping time (G1=34+/-8 vs. G2=33+/-6min), mechanical ventilation time (G1=23+/-4 vs. G2=22+/-4hr), ICU stay (G1=40+/-10 vs. G2=39+/-9hr), post-operative complications and hospital mortality (G1=5.3% vs. G2=4.2%). At a mean follow-up of 12+/-4 months, cumulative incidence of angina recurrence was 2.1% in G1 vs. 11% in G2 (P=0.021). Angiographic evaluation showed 98.2% arterial patency in G1 vs. 86% saphenous vein graft patency in G2 (P<0.001). Multivariate analysis identified conventional CABG surgery as independent predictor of angina recurrence, graft occlusion and late cardiac events." ]

[ "Intra-operative parathyroid hormone monitoring in secondary hyperparathyroidism: is it useful?<||||>To assess the use of intra-operative parathyroid hormone (PTH) level monitoring as a predictor of persistent hypoparathyroidism after total parathyroidectomy in renal hyperparathyroidism.", "Intra-operative parathyroid hormone monitoring in secondary hyperparathyroidism: is it useful?<||||>University Teaching Hospital Otorhinolaryngology and Head and Neck Surgery Unit.", "Intra-operative parathyroid hormone monitoring in secondary hyperparathyroidism: is it useful?<||||>All patients with renal hyperparathyroidism undergoing parathyroidectomy between January 2004 and July 2005. Twenty-nine patients were identified.", "Intra-operative parathyroid hormone monitoring in secondary hyperparathyroidism: is it useful?<||||>Comparison is made between pre- and intra-operative PTH levels (ioPTH) in patients who at 3 months postoperatively maintained hypoparathyroidism and patients who did not. Results were analysed to see whether ioPTH predicts maintenance of the hypoparathyroid state.", "Intra-operative parathyroid hormone monitoring in secondary hyperparathyroidism: is it useful?<||||>The mean preoperative PTH level was 932 pg/L (range: 58-1808). The mean postoperative PTH level was 147 pg/L (range: 16-498). The mean 3-month PTH level was 47 pg/L (range:<1-515). The mean postoperative PTH level for patients with a persistently high PTH level at 3 months was 286 pg/L (range: 272-299), compared with 63 pg/mL (16-160) in patients remaining normparathyroid, and 159 pg/L (range: 39-498) for patients with persistent hypoparathyroidism. If the normoparathyroid state is strictly considered to be failure following total parathyroidectomy, ioPTH is not predictive of hypoparathyroidism. However, ioPTH is indicative of biochemical resolution of the hyperparathyroid state (normo- or hypoparathyroidism)." ]

[ "Can the addition of interpretative comments to laboratory reports influence outcome?<||||>There is little evidence that the addition of interpretative comments to biochemistry reports can influence outcome for patients. Interpretative comments on thyroid function test (TFT) requests were introduced in Hull in August 1999, providing the opportunity to determine whether feedback on hypothyroid patients taking thyroxine could lead to a reduction in the proportion whose thyroxine was inadequately replaced.", "Can the addition of interpretative comments to laboratory reports influence outcome?<||||>The study comprised 15 584 TFT requests, made from 1 August 1999 to 30 August 2002 by general practitioners (GPs), for 8281 patients taking thyroxine. Under-replacement of thyroxine, defined as a TSH concentration above the upper reference limit (i.e. 4.7 mU/L), was usually commented on in the biochemical report.", "Can the addition of interpretative comments to laboratory reports influence outcome?<||||>In the first, second and third years following introduction of interpretative comments, the proportions of samples with a TSH concentration of>4.7 mU/L were 21.3%, 17.6% and 16.6%, respectively (chi(2)(trend) = 43.1, P<0.0001). The proportion with a TSH concentration of<0.1 mU/L showed a more modest change, from 12.5% in year 1 to 14.0% and 14.8% in years 2 and 3, respectively (chi(2)(trend) = 22.3, P<0.0001)." ]

[ "Does screening for distress efficiently uncover meetable unmet needs in cancer patients?<||||>We evaluated screening for distress in terms of its ability to uncover unmet need for psychosocial services in cancer patients. Correlates of distress, need for services and met and unmet need for services were investigated.", "Does screening for distress efficiently uncover meetable unmet needs in cancer patients?<||||>Immediately after cancer treatment (T1) and 2 months later (T2), 302 patients completed the Hopkins Symptom Checklist-25 (HSCL-25) and a single question assessing the need for services. All distressed patients (HSCL-25≥39) and non-distressed patients endorsing a need for services were then called (n = 99) to assess their need.", "Does screening for distress efficiently uncover meetable unmet needs in cancer patients?<||||>Thirty-seven percent (T1) and 31% (T2) of patients were distressed and 31% (T1) and 18% (T2) expressed the need for services. Both time points showed higher distress in younger patients and females and lower distress in prostate cancer and patients treated by radiotherapy only. Less need for services was found in prostate cancer (T1), greater need was related to being single (T1) and younger (T2). Distress and need for services were positively related (p<0.001). The HSCL-25 showed modest sensitivity (T1: 0.59, T2: 0.65) and specificity (T1: 0.75, T2: 0.78) as an indicator of need for services. Interviews at T2 revealed that 51% of distressed patients needed no psychosocial services and 25% were already receiving services. At T2, regardless of distress level, 10% of all screened patients reported an unmet need for psychosocial services." ]

[ "Are patients with somatization disorder highly suggestible?<||||>High suggestibility is widely regarded as an important feature of patients with medically unexplained symptoms (MUS), particularly those with multiple MUS [i.e. somatization disorder (SD)], although there are few empirical data attesting to this assumption. A study was therefore conducted to compare levels of non-hypnotic suggestibility in patients with SD and medical controls.", "Are patients with somatization disorder highly suggestible?<||||>A modified version of the Barber Suggestibility Scale was administered to 19 patients with SD and 17 controls with an established organic dystonia.", "Are patients with somatization disorder highly suggestible?<||||>Patients with SD were no more suggestible than control patients. Dystonia controls were more likely to deliberately comply with suggestions than the SD patients." ]

[ "Is pulsatile perfusion necessary for renal transplantation engrafting kidneys from cardiac death donors?<||||>There has been a considerable literature describing the use of pulsatile perfusion (PP) to evaluate the efficacy of organs from deceased donors. Since 1979, we recovered 469 kidneys from deceased donors after cardiac death (DCDs), using an in situ regional cooling technique and preservation by simple cold storage. In this study, the posttransplantation outcomes as well as long-term survivals of renal grafts from DCDs were compared with PP data in the recent literature.", "Is pulsatile perfusion necessary for renal transplantation engrafting kidneys from cardiac death donors?<||||>We compared our recent data with 176 kidneys recovered between 1993-2002 using an in situ regional cooling technique. Patient and graft survivals were compared with those from the Scientific Registry of Transplant Recipients (SRTR) database.", "Is pulsatile perfusion necessary for renal transplantation engrafting kidneys from cardiac death donors?<||||>Following transplantation, 4.5% of the grafts never recovered; 10.3% of the grafts showed immediate renal function; 85.2% of the grafts had delayed graft function (DGF) with an average acute tubular necrosis (ATN) period of 13.1 days compared with 54.3% DGF from DCD using PP. Graft survival rates at 1, 3, 5, and 10 years were 90.8%, 86.5%, 77.8%, and 69.0%, respectively, compared with 89% at 1 year and 80% at 3 years reported for DCD by the SRTR in which almost 30% of the grafts underwent PP." ]

[ "Are school employees role models of healthful eating?<||||>Little is known about the dietary intake of school employees, a key target group for improving school nutrition.", "Are school employees role models of healthful eating?<||||>To investigate selected dietary variables and weight status among elementary school personnel.", "Are school employees role models of healthful eating?<||||>Cross-sectional, descriptive study.SUBJECTS/", "Are school employees role models of healthful eating?<||||>Elementary school employees (n=373) from 22 schools in a suburban parish (county) of southeastern Louisiana were randomly selected for evaluation at baseline of ACTION, a school-based worksite wellness trial.", "Are school employees role models of healthful eating?<||||>Two 24-hour dietary recalls were administered on nonconsecutive days by registered dietitians using the Nutrition Data System for Research. Height and weight were measured by trained examiners and body mass index calculated as kg/m(2).", "Are school employees role models of healthful eating?<||||>Descriptive analyses characterized energy, macronutrient, fiber, and MyPyramid food group consumption. Inferential statistics (t tests, analysis of variance, chi(2)) were used to examine differences in intake and compliance with recommendations by demographic and weight status categories.", "Are school employees role models of healthful eating?<||||>Approximately 31% and 40% of the sample were overweight and obese, respectively, with higher obesity rates than state and national estimates. Mean daily energy intake among women was 1,862+/-492 kcal and among men was 2,668+/-796 kcal. Obese employees consumed more energy (+288 kcal, P<0.001) and more energy from fat (P<0.001) than those who were normal weight. Approximately 45% of the sample exceeded dietary fat recommendations. On average, only 9% had fiber intakes at or above their Adequate Intake, which is consistent with the finding that more than 25% of employees did not eat fruit, 58% did not eat dark-green vegetables, and 45% did not eat whole grains on the recalled days. Only 7% of employees met the MyPyramid recommendations for fruits or vegetables, and 14% of the sample met those for milk and dairy foods." ]

[ "Are prophylactic antibiotics required for elective laparoscopic cholecystectomy?<||||>Some clinicians administer prophylactic antibiotics routinely before laparoscopic cholecystectomy, and the results of some of the studies in the literature support this practice. We conducted a prospective randomized trial to determine whether administration of prophylactic antibiotics is necessary during routine laparoscopic cholecystectomy in low-risk patients.", "Are prophylactic antibiotics required for elective laparoscopic cholecystectomy?<||||>Two hundred fifty patients without evidence of acute inflammation, common duct stones, or other indications for antibiotics were randomized to receive three perioperative doses of cefazolin or no prophylaxis and followed up for complications up to 30 days postoperatively. The primary end point was the occurrence of a major infectious complication, defined as that causing a systemic response, delaying discharge, or leading to readmission. Minor infectious problems were also noted, defined as those causing local symptoms only.", "Are prophylactic antibiotics required for elective laparoscopic cholecystectomy?<||||>One hundred twenty-eight patients were randomized to receive prophylactic antibiotics (PA group), 122 to receive none (NONE group; two patients in this group were actually given preoperative antibiotics). Only one major complication occurred (in a patient in the NONE group), an abscess in the presence of a bile leak, despite the administration of antibiotics when the leak was discovered several days before infectious problems arose. There were four minor problems: two lower urinary tract infections and one superficial wound infection in a NONE patient and one urinary tract infection in a PA patient (not significant); all were easily managed. The prophylactic antibiotics did not sterilize the bile, and infectious complications were not associated with weight, inflammation found at the time of operation, reported stone or bile spill-age, or conversion to open operation." ]

[ "Do the five A's work when physicians counsel about weight loss?<||||>More than two thirds of Americans are overweight or obese. Physician counseling may help patients lose weight; however, physicians perceive these discussions as somewhat futile and time-consuming. An effective and efficient tool for smoking cessation is the Five A's (Ask, Advise, Assess, Assist, and Arrange). We studied the effectiveness of the Five A's in weight-loss counseling.", "Do the five A's work when physicians counsel about weight loss?<||||>We audiorecorded primary care encounters between 40 physicians and 461 of their overweight or obese patients. All were told the study was about preventive health, not weight specifically. Encounters were coded for physician use of the Five A's. Patients' motivation and confidence were assessed before and immediately after the encounter. Three months later, we assessed patient change in dietary fat intake, exercise, and weight.", "Do the five A's work when physicians counsel about weight loss?<||||>Generalized linear models were fit adjusting for patient clustering within physician. Physicians used at least one of the Five A's often (83%). Physicians routinely Ask and Advise patients to lose weight; however, they rarely Assess, Assist, or Arrange. Assist and Arrange were related to diet improvement, whereas Advise was associated with increases in motivation and confidence to change dietary fat intake and confidence to lose weight." ]

[ "Is endodontic treatment performed under general anaesthesia technically acceptable?<||||>Undertaking endodontic treatment under general anaesthesia (GA) is often described as difficult and hazardous, but no study reports on safe and efficacious conditions for endodontic treatment under GA. This study aims to evaluate whether compromises made for the endodontic treatment of permanent teeth under GA are acceptable. It describes the quality of endodontic treatment undertaken in two series of consecutive patients treated either under GA or local anaesthesia (LA).", "Is endodontic treatment performed under general anaesthesia technically acceptable?<||||>Post-operative data sheets and periapical radiographs were collected for 255 permanent teeth treated under GA during a 4-year period (GA group, 125 patients with special needs) and for 246 permanent teeth treated under local anaesthesia over 7 months (LA group, 180 healthy patients). The radiographic criteria for quality of endodontic treatment (RCQET) were considered satisfactory when (1) the root filling was within 2 mm of the apex; (2) the filling displayed no voids or defects; and (3) all the visible canals had been obturated. The type of tooth, pulpal status and periapical status were considered independent variables for RCQET.", "Is endodontic treatment performed under general anaesthesia technically acceptable?<||||>The proportion of satisfactory RCQET reached 63% in both groups and differed by type of tooth, being significantly lower for molars than for other teeth." ]

[ "Distant past exercise in women: measures may be reliable, but are they valid?<||||>Methods to measure lifetime physical activity have been described together with evidence suggesting that they are reliable. We present study findings that challenge the validity of such measures.", "Distant past exercise in women: measures may be reliable, but are they valid?<||||>One hundred twenty-seven women aged 50-70 interviewed (31 cases, 96 controls) during a pilot case-control study about risk factors for osteoarthritis of the knee. Interviews used a life course approach with visual cues. Information obtained on past physical activity: (i) Total METs for a large range of activities within each decade between age 10 and age 50, (ii) 10-point rating scales representing level of physical activity during each decade between age 10 and age 50, and (iii) lifetime hours' participation in competitive sports.", "Distant past exercise in women: measures may be reliable, but are they valid?<||||>Any statistical correspondence between METs and activity rating scales was best in relation to women's activity when in their teens (Spearman rank correlation r = 0.40). The highest correlation thereafter related to the most recent decade (r = 0.25), which was low, but there was little or no linear association between MET values and the activity ratings when women were in their 20s or 30s. Around one fifth (20.4%) of women who reported no competitive sports participation during their teens and 18.5% who reported none during their 20s also reported total METs corresponding to the top quartile of physical activity during those periods of their lives." ]

[ "Unemployment and smoking: does psychosocial stress matter?<||||>4002 non-institutionalised, civilian adults living in the Veneto region of Italy.", "Unemployment and smoking: does psychosocial stress matter?<||||>The study was based on a computer assisted telephone interview (CATI). Linear by linear association tests were used to examine bivariate associations between unemployment, psychosocial factors, and smoking. Logistic regression models were developed to analyse the relationship between unemployment and smoking when adjusting for psychological factors.", "Unemployment and smoking: does psychosocial stress matter?<||||>The odds of smoking among the unemployed was 2.78 times (95% confidence interval (CI) 1.68 to 4.62) greater than that of higher managers and professionals controlling for demographic factors. The relationship between unemployment and smoking weakened (odds ratio 2.41, 95% CI 1.43 to 4.05) when psychosocial factors were entered into the analysis. The odds of the inability to control important things in life was 1.39 times (95% CI 1.11 to 1.75) greater, and the odds of emotional isolation was 1.45 times (95% CI 1.06 to 1.99) greater, among smokers compared to non-smokers controlling, for all other factors." ]

[ "Is chest x-ray an adequate screening tool for the diagnosis of blunt thoracic aortic injury?<||||>Blunt thoracic aortic injuries (BTAI) have a high mortality rate. For survivors, chest X-ray (CXR) findings are used to determine the need for further diagnostic testing with chest computerized tomography with angiography (CTA) or conventional angiography. We set to determine the adequacy of utilizing CXR alone as a screening tool for BTAI.", "Is chest x-ray an adequate screening tool for the diagnosis of blunt thoracic aortic injury?<||||>All patients diagnosed with BTAI at a level I trauma-center during a 7-year-period were identified. CXRs of these patients and those of a control group of blunt trauma patients with an injury severity score>15 were reviewed by four trauma surgeons blinded to the diagnosis. Based on each CXR viewed, the surgeons decided if they would have proceeded to chest CTA, angiography, or required no further studies to rule out BTAI.", "Is chest x-ray an adequate screening tool for the diagnosis of blunt thoracic aortic injury?<||||>In the 7-year-period, 83 patients had BTAI. CXRs were available in 45 patients. The four surgeons viewed 96 CXRs including those of 51 controls. Based on the CXR appearance in patients with BTAI, the surgeons chose to proceed to chest CTA in 38 patients (84.4%), conventional aortography in two patients (4.4%), and no further testing in five patients (11.2%). A widened mediastinum (75%) and loss of the aorto-pulmonary window (40%) were the most frequent CXR abnormalities. Patients with BTAI were more likely to have an abnormal CXR-40 of 45 (88.8%) patients when compared with the controls-25 of 51 (49%)patients-p<0.001." ]