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Are variations in the use of carotid endarterectomy explained by population Need?

standardised utilisation rates for CEA and measures of inter-district variability. Spearman's rank correlation coefficients for associations between variables.

Are variations in the use of carotid endarterectomy explained by population Need?

This study includes patients with invasive breast cancer treated between 2008 and 2013. The clinical response was assessed by correlating Ki-67 to histological examination, mammography, and ultrasonography findings.

Are there effects of intrauterine cocaine exposure on delinquency during early adolescence?

Ninety-three early adolescents (12.5-14.5 years old) participating since birth in a longitudinal study of IUCE reported delinquent acts via an audio computer-assisted self-interview. Level of IUCE and exposure to cigarettes, alcohol, and marijuana were determined by maternal report, maternal and infant urine assays, and infant meconium assays at birth. Participants reported their exposure to violence on the Violence Exposure Scale for Children-Revised at ages 8.5, 9.5, and 11 years and during early adolescence, and the strictness of supervision by their caregivers during early adolescence.

Are there effects of intrauterine cocaine exposure on delinquency during early adolescence?

The intervention was a 12 week exercise program, including aerobic and strengthening exercises, conducted between week 20 and 36 of pregnancy. One weekly group session was led by physiotherapists, and home exercises were encouraged twice a week. Control women received regular antenatal care.

Is expert breast pathology assessment necessary for the management of ductal carcinoma in situ ?

481 individuals with DCIS were referred and pathology review was performed on 350 patients (73%). Inter-observer agreement was high for the main pathologic features of DCIS. From 1996 to 2000, secondary pathology assessments lead to a change in the assessment of local recurrence risk in 100 cases (29%) and contributed to a change in treatment recommendation in 93 (43%) cases.

Is expert breast pathology assessment necessary for the management of ductal carcinoma in situ ?

We formed a cohort of 1,100 randomly sampled Saskatchewan adults in September 1995. We used the Chronic Pain Questionnaire to measure neck pain and its related disability. The SF-36 questionnaire was used to measure physical and mental HRQoL 6 months later. Multivariable linear regression was used to measure the association between graded neck pain and HRQoL while controlling for confounding. Analysis of variance and t tests were used to measure the crude association among four possible courses of neck pain and HRQoL at 6 months. The neck pain trajectories over 6 months were no or mild neck pain, improving neck pain, worsening neck pain, and persistent neck pain. Finally, analysis of variance was used to examine changes in baseline to 6-month PCS and MCS scores among the four neck pain trajectory groups.

Thoracic and thoracoabdominal aneurysm repair: is reimplantation of spinal cord arteries a waste of time?

The impact of different strategies for management of intercostal and lumbar arteries during repair of thoracic and thoracoabdominal aortic aneurysms (TAA/A) on the prevention of paraplegia remains poorly understood.

Thoracic and thoracoabdominal aneurysm repair: is reimplantation of spinal cord arteries a waste of time?

We measured hsCRP levels, the carotid IMT, and conventional cardiovascular risk factors including obesity parameters, blood pressure, lipid profiles, insulin resistance, and smoking habits in 820 volunteers (35-79 years old) in a cross-sectional study.

Is year of radical prostatectomy a predictor of outcome in prostate cancer?

RP year was a predictor of outcome on preoperative analysis (p = 0.006) but not on postoperative analysis (p = 0.130). Patient outcome steadily improved with surgery through the mid 1990s and then it appeared to level off.

Is year of radical prostatectomy a predictor of outcome in prostate cancer?

Our neonatal ICU has either a resident or an intern on-call by himself/herself at night, affording us a natural setting to compare intern vs. resident test ordering. The outcomes of interest were number of arterial blood gases, radiographs, and electrolytes ordered per infant by the on-call pediatric houseofficer, as tabulated the morning after the call night. Control variables included the severity-of-illness of the individual infant (using the Neonatal Therapeutic Intervention Scoring System), the workload of the houseofficer (number of patients, number of admissions), and supervision (rounding frequency and on-call attending). Controlling for the severity-of-illness of the infant, the workload on the call night, and supervision with multiple linear regression, we found that interns ordered significantly (p = .02) greater numbers of arterial blood gases per infant than residents, amounting to some 0.33 blood gases per infant per call night (3.22 vs. 2.89 arterial blood gases per infant per night). This increase of 0.33 blood gases per infant amounts to interns ordering $169 more arterial blood gases per call night at our institution. There was no difference between interns and residents in ordering radiographs or electrolytes.

Does health information exchange reduce redundant imaging?

ED discharge data from the State Emergency Department Databases for California and Florida for 2007-2010 were merged with Health Information Management Systems Society data that report hospital HIE participation.

Does health information exchange reduce redundant imaging?

45 general practices and five child health clinics, of which 40 (80%) responded. Eight practices were selected for refrigeration monitoring.

Is decompressive surgery effective for spinal cord sarcoidosis accompanied with compressive cervical myelopathy?

In the surgery group, enhancing lesions on magnetic resonance imaging (MRI) were mostly seen at C5-C6, coincident with the maximum compression level in all cases. Postoperative recovery rates in the surgery group at 1 week and 4 weeks were -7.4% and -1.1%, respectively. Only 5 cases had showed clinical improvement, and the condition of these 5 patients had worsened again at averaged 7.4 weeks after surgery. Postoperative oral steroid therapy was initiated at an average of 6.4 weeks and the average initial dose was 54.0 mg in the surgery group, while 51.3 mg in the nonsurgery group. The recovery rate of the Japanese Orthopedic Association score, which increased after steroid therapy, was better in the nonsurgery group (62.5%) than in the surgery group (18.6%) with significant difference (P<0.01).

Is decompressive surgery effective for spinal cord sarcoidosis accompanied with compressive cervical myelopathy?

In patients referred for periodontal treatment, the prevalence of self-reported rheumatoid arthritis was 3.95% which is significantly higher than that seen in patients not referred for periodontal treatment (0.66%) and also that reported in the general population (1%). Of those referred patients with rheumatoid arthritis, 62.5% had advanced forms of periodontal disease. These results were mirrored in the results of the self-reported prevalence of cardiovascular disease and diabetes mellitus which was consistent with the published higher prevalence in periodontal patients.

Endovenous laser ablation in the treatment of small saphenous varicose veins: does site of access influence early outcomes?

Both groups demonstrated significant improvement in VCSS, AVVQ, generic quality of life Short Form 36, and EuroQol scores (P<.05) up to 1 year. No differences were seen between AMC and BMC groups for complications (phlebitis: 2 [6%] and 1 [3.8%], P>.05; paresthesia: 2 [6%] and 5 [19%], P = .223) and recurrence (3 [9%] and 1 [3.8%], P = .623), respectively.

Endovenous laser ablation in the treatment of small saphenous varicose veins: does site of access influence early outcomes?

Reimbursement based on the total care of a patient during an acute episode of illness is believed to stimulate management and clinicians to reduce quality problems like waiting times and poor coordination of care delivery. Although many studies already show that this kind of case-mix based reimbursement leads to more efficiency, it remains unclear whether care coordination improved as well. This study aims to explore whether case-mix based reimbursement stimulates development of care coordination by the use of care programmes, and a process-oriented way of working.

Is a pressor necessary during aortic perfusion and oxygenation therapy of cardiac arrest?

Aortic pressures were higher during infusions in animals treated with epinephrine. During infusion, the mean aortic relaxation pressure increased by 58+/-5 mm Hg in animals that had received epinephrine versus 20+/-11 mm Hg in those that had received saline placebo. The coronary perfusion pressure during infusion increased by 52+/-8 mm Hg in animals that had received epinephrine versus 26+/-10 mm Hg in those that had received saline. Only 2 of 7 animals in the placebo group had return of spontaneous circulation versus 7 of 8 in the epinephrine group.

Is a pressor necessary during aortic perfusion and oxygenation therapy of cardiac arrest?

Farming in the index year was significantly associated with PSV (OR 2.3 [95% CI 1.2-4.6]), with WG (2.7 [1.2-5.8]), with MPA (6.3 [1.9-21.6]), and with perinuclear ANCA (pANCA) (4.3 [1.5-12.7]). Farming during working lifetime was associated with PSV (2.2 [1.2-3.8]) and with WG (2.7 [1.3-5.7]). Significant associations were found for high occupational silica exposure in the index year (with PSV 3.0 [1.0-8.4], with CSS 5.6 [1.3-23.5], and with ANCA 4.9 [1.3-18.6]), high occupational solvent exposure in the index year (with PSV 3.4 [0.9-12.5], with WG 4.8 [1.2-19.8], and with classic ANCA [cANCA] 3.9 [1.6-9.5]), high occupational solvent exposure during working lifetime (with PSV 2.7 [1.1-6.6], with WG 3.4 [1.3-8.9], and with cANCA 3.3 [1.0-10.8]), drug allergy (with PSV 3.6 [1.8-7.0], with WG 4.0 [1.8-8.7], and with cANCA 4.7 [1.9-11.7]), and allergy overall (with PSV 2.2 [1.2-3.9], with WG 2.7 [1.4-5.7]). No other significant associations were found.

Do people who were passive smokers during childhood have increased risk of long-term work disability?

The sample comprised 5563 Norwegian nurses' aides, not on sick leave when they completed a mailed questionnaire in 1999. Of these, 4744 (85.3%) completed a second questionnaire 15 months later. The outcome measure was the incidence proportion of long-term sick leave during the 12 months prior to the follow-up.

Do people who were passive smokers during childhood have increased risk of long-term work disability?

Microbial contamination can be a marker for faulty process and is assumed to play an important role in the collection of hematopoietic progenitor cell (HPC) and infusion procedure. We aimed to determine the microbial contamination rates and evaluate the success of hematopoietic cell transplantation (HCT) in patients who received contaminated products.PATIENTS-

Is the covering of the resection margin after distal pancreatectomy advantageous?

Main indications for pancreatic surgery were insulinoma (n=18, 24%), ductal adenocarcinoma (n=9, 12%), non-single-insulinoma-pancreatogenic-hypoglycemia-syndrome (NSIPHS) (n=8, 11%), and pancreatic cysts with pancreatitis (n=8, 11%). In 39 of 74 (53%) patients no postoperative complications were noted. In detail we found that 23/42 (55%) patients with coverage vs. 16/32 (50%) without coverage of the resection margins had no postoperative complications. The most common complications were pancreatic fistulas in eleven patients (15%), and postoperative bleeding in nine patients (12%). Pancreatic fistulas occurred in patients without coverage of the resection margins in 7/32 (22%) vs. 4/42 (1011%) with coverage are of the resection margins, yet without reaching statistical significance. Postoperative bleeding ensued with equal frequency in both groups (12% with coverage versus 13% without coverage of the resection margins). The reoperation rate was 8%. The hospital stay for patients without coverage was 13 days (5-60) vs. 17 days (8-60) for patients with coverage.

Is the covering of the resection margin after distal pancreatectomy advantageous?

Compared to control and social anxiety groups, the depression groups (both pure and comorbid with social anxiety disorder) exhibited greater difficulties removing irrelevant emotional material from working memory (i.e., greater intrusion effects). Greater intrusion effects were also associated with increased rumination.

Does treatment duration affect outcome after radiotherapy for prostate cancer?

Between April 1989 and November 2004, 1,796 men with prostate cancer were treated with RT alone. The nontreatment day ratio (NTDR) was defined as the number of nontreatment days divided by the total elapsed days of RT. This ratio was used to account for the relationship between treatment duration and total RT dose. Men were stratified into low risk (n = 789), intermediate risk (n = 798), and high risk (n = 209) using a single-factor model.

Does treatment duration affect outcome after radiotherapy for prostate cancer?

The purpose of this paper is to evaluate the efficacy of ultrasonographic screening for primary hepatocellular carcinoma.

Is the urinary biomarkers assessment a non-invasive approach to tubular lesions of the solitary kidney?

A cross-sectional study of 37 patients with SK included 18 patients-acquired SK (mean age 56.44 ± 12.20 years, interval from nephrectomy 10.94 ± 9.37 years), 19 patients-congenital SK (mean age 41.52 ± 10.54 years). Urinary NAG, urinary alpha-1-microglobulin, albuminuria, eGFR (CKD-EPI equation) were measured.

Is the urinary biomarkers assessment a non-invasive approach to tubular lesions of the solitary kidney?

A population based cross-sectional study of 4200 randomly selected adults registered with a General Medical Practice in North West, England. The study examined the association of chronic oro-facial pain with a variety of self-reported mechanical factors: teeth grinding, facial trauma, missing teeth and the feeling that the teeth did not fit together properly. Information was also collected on demographic factors, psychological factors and the reporting of other frequently unexplained syndromes.

Is there a role for fondaparinux in perioperative bridging?

Anticoagulation guidelines provide minimal direction on the perioperative use of fondaparinux. Fondaparinux's extended half-life of 17-21 hours complicates its use as a perioperative bridging therapy. The ideal time for discontinuation before surgery is an issue, particularly in surgeries with a high bleeding risk or in which neuraxial anesthesia is used. Guidance for perioperative bridging with fondaparinux must be derived from pharmacokinetic data, surgical prophylaxis trials, case reports, and anesthesia guidelines. Published trials used fondaparinux sodium 2.5 mg daily for venous thromboembolism prophylaxis in surgical patients, and the majority avoided its use before surgery in patients receiving neuraxial anesthesia. Three case reports cited the use of fondaparinux sodium as perioperative bridge therapy; one used a 2.5-mg dose, and the other two used a full treatment dose of 7.5 mg. Furthermore, professional anesthesia guidelines conflict in their recommendations regarding the timing of drug administration with neuraxial catheter use. For these reasons, it may be optimal to avoid fondaparinux use before surgery. In some instances, the use of low-molecular-weight heparin or inpatient use of i.v. unfractionated heparin is not possible, is contraindicated, or has limited efficacy, such as a patient with history of heparin-induced thrombocytopenia or antithrombin III deficiency. Fondaparinux may have a role in bridge therapy for these patients.

Is there a role for fondaparinux in perioperative bridging?

It is unclear whether intravenous glycoprotein IIb/IIIa inhibitors or ischemic time might modify any clinical benefits observed with aspiration thrombectomy before primary percutaneous coronary intervention (PCI) in patients with ST-segment-elevation myocardial infarction.

Motor performance in chronic low back pain: is there an influence of pain-related cognitions?

Patients were slower throughout all conditions compared to healthy subjects. With respect to the provoking condition, patients showed deteriorated performance compared to lying while healthy subjects' performance remained equal between these two conditions. Further analysis of patients' data showed that provocation was successful in 54% of the patients. Especially this group showed deteriorated performance in the provoking condition.

Motor performance in chronic low back pain: is there an influence of pain-related cognitions?

The study included 159 cases, of which 65% were elective same-day admission patients, 20% were elective previously admitted patients; and 15% were emergent. The overall rate of preoperative assessment was 67%, involvement in the decision to operate, 17%; postoperative assessment on the ward, 79%; and patient follow-up in clinic, 3%. The rate of complete in-hospital continuity of care (assessing patient pre-op and post-op) was 57%. Emergent cases were associated with a significantly higher rate of preoperative assessment (92% vs 63%, P<.05). For elective cases admitted before the day of surgery compared with same-day admission patients, the rates of preoperative assessment (78% vs 58%, P<.05) and involvement in the decision to operate (16% vs 4%, P<.05) were significantly higher.

Patient comprehension of emergency department care and instructions: are patients aware of when they do not understand?

Seventy-eight percent of patients demonstrated deficient comprehension (less than complete concordance) in at least 1 domain; 51% of patients, in 2 or more domains. Greater than a third of these deficiencies (34%) involved patients' understanding of post-ED care, whereas only 15% were for diagnosis and cause. The majority of patients with comprehension deficits failed to perceive them. Patients perceived difficulty with comprehension only 20% of the time when they demonstrated deficient comprehension.

Patient comprehension of emergency department care and instructions: are patients aware of when they do not understand?

The objective was to evaluate the efficacy of diffusion-weighted imaging (DWI) in predicting the development of vascularization in hypovascular hepatocellular lesions (HHLs).

Can mandibular depiction be improved by changing the thickness of double-oblique computed tomography images?

In the alveolar crest and the whole of the mandibular canal, the highest value was obtained with 0.9 mm-thick images; however, there was no significant difference between 0.3 mm and 0.9 mm-thick images.

Can mandibular depiction be improved by changing the thickness of double-oblique computed tomography images?

Cutaneous melanoma in nonwhite persons has a manifestation and a prognosis that are different than those of cutaneous melanoma in white persons.

Adjuvant radiation of stage III thymoma: is it necessary?

Case records of the Massachusetts General Hospital were retrospectively reviewed from 1972 to 2004. One hundred and seventy-nine patients underwent resection for thymoma, of which 45 had stage III disease.

Adjuvant radiation of stage III thymoma: is it necessary?

This study aims to determine whether the clinical effects of abdominal desmoids would be worse in patients with restorative proctocolectomy than in patients with ileorectal anastomosis.

Inhibin: a new circulating marker of hydatidiform mole?

Correlation of serum inhibin concentrations with trophoblastic disease.

Inhibin: a new circulating marker of hydatidiform mole?

Spatiotemporal location of calls for services to the police and the ambulance service are equally highly concentrated in a small number of geographical areas, primarily within intra-agency hotspots (33% and 53%, respectively) but across agencies' hotspots as well (25% and 15%, respectively). Datasets are statistically correlated with one another at the 0.57 and 0.34 levels, with 50% overlap when adjusted for the number of hotspots. At least one in every two police hotspots does not have an ambulance hotspot overlapping with it, suggesting half of assault spatiotemporal concentrations are unknown to the police. Data further suggest that more severely injured patients, as estimated by transfer to hospital, tend to be injured in the places with the highest number of police-recorded crimes.

Is the fibronectin-aggrecan complex present in cervical disk disease?

Single-center, prospective, consecutive case series.

Is the fibronectin-aggrecan complex present in cervical disk disease?

Twenty-eight (31.8%) of the lesions were localized in fatty breast, and the remaining 60 (68.2%) lesions were localized in dense breast. There were 34 (38.6%) benign and 54 (61.4%) malignant masses. In fatty breast, chemical shift subtraction and T1-weighted images were valuable both for the demonstration and differentiation of benign lesions (P<.05). None of the sequence was valuable for both the demonstration and differentiation of malignant lesions in fatty breasts (P>.05). In dense breasts, chemical shift subtraction and dynamic contrast subtraction images were valuable for both the demonstration and differentiation of benign and malignant lesions. Additional to these sequences, T2-weighted images was also valuable for benign lesions (P<.05).

Does peritoneal dialysis affect halitosis in patients with end-stage renal disease?

Mean serum BUN level was found to be lower (46.05 ± 13.30 vs 91.24 ± 31.28 mg/dL), salivary flow rate higher (0.34 ± 0.07 vs 0.26 ± 0.04 mL/minute), and halitosis level lower (2.39 ± 0.60 vs 3.90 ± 0.37) at the end of 3 months of PD therapy than at the beginning of PD therapy. There was no significant difference in CPI or DMFT index before and after PD therapy (p>0.05). There was statistically significant positive correlation between the presence of halitosis and BUN levels (r = 0.702, p = 0.001 before PD; r = 0.45, p = 0.002 after PD) and a negative correlation between the presence of halitosis and salivary flow rates (r = -0.69, p = 0.000 before PD; r = -0.37, p = 0.01 after PD).

Does peritoneal dialysis affect halitosis in patients with end-stage renal disease?

Consecutive patients admitted within 24 h of stroke onset to two hospitals.

Can elevated troponin I levels predict complicated clinical course and inhospital mortality in patients with acute pulmonary embolism?

The purpose of this study was to evaluate the value of elevated cardiac troponin I (cTnI) for prediction of complicated clinical course and in-hospital mortality in patients with confirmed acute pulmonary embolism (PE).

Can elevated troponin I levels predict complicated clinical course and inhospital mortality in patients with acute pulmonary embolism?

Three clinical histories are presented, describing two fish bones and one piece of fish cartilage. FB shifting was analyzed in all of them. Migration started in the esophagus in two, one going to the aorta and the other to the neck area. In the other two, migration started in the pharynx, and the FB moved towards the prevertebral fascia and the other externalized in the submandibular region. The mechanisms and the risks posed to the patient, by FB migration, and the way to diagnose them are hereby discussed.

Is transurethral catheterisation the ideal method of bladder drainage?

All patients who underwent major open abdominal surgery between October 2006 and December 2008 and required standard transurethral bladder catheterisation, were asked to participate in the study. Fifty patients were recruited.

Is transurethral catheterisation the ideal method of bladder drainage?

Metabolic syndrome was present in 32 hypertensive patients (42.7%; 18 males, 14 females). The mean number of MetS criteria was 2.6+/-1.0 in the hypertensive group. Compared to the control group, patients with or without MetS exhibited significantly increased interventricular septum and posterior wall thickness, left atrial diameter, relative wall thickness, and left ventricular mass (p<0.05). The only significant difference between the two patient groups was that MetS was associated with a greater left atrial diameter (p=0.019). Left atrial diameter was correlated with the number of MetS criteria (r=0.51; p<0.001).

The colour of pain: can patients use colour to describe osteoarthritis pain?

The aim of the present study was to explore patients' views on the acceptability and feasibility of using colour to describe osteoarthritis (OA) pain, and whether colour could be used to communicate pain to healthcare professionals.

The colour of pain: can patients use colour to describe osteoarthritis pain?

Plasma creatine concentration and urinary excretion were measured from mid to late gestation in pregnant (n = 8) and age-matched virgin female spiny mice (n = 6). At term, body composition and organ weights were assessed and tissue total creatine content determined. mRNA expression of the creatine synthesising enzymes arginine:glycine amidinotransferase (AGAT) and guanidinoacetate methyltransferase (GAMT), and the creatine transporter (CrT1) were assessed by RT-qPCR. Protein expression of AGAT and GAMT was also assessed by western blot analysis.

Inpatient Pediatric Tonsillectomy: Does Hospital Type Affect Cost and Outcomes of Care?

To ascertain whether hospital type is associated with differences in total cost and outcomes for inpatient tonsillectomy.

Inpatient Pediatric Tonsillectomy: Does Hospital Type Affect Cost and Outcomes of Care?

Of the 601 patients with cardiogenic shock, 287 (47.8%) were admitted to hospitals without revascularization services and 314 (52.2%) were admitted to hospitals with coronary angioplasty and coronary artery bypass surgery facilities. Clinical characteristics were similar across the subgroups. Patients admitted to hospitals with revascularization services were more likely to undergo coronary revascularization during the index hospitalization and during the first month after acute myocardial infarction. After adjustment for demographic, clinical, hospital, and treatment strategies, the presence of onsite revascularization services was not associated with a significantly lower 30-day (odds ratio 0.83, 95% CI 0.47, 1.45) or 1-year mortality (odds ratio 0.91, 95% CI 0.49, 1.72).

Does anterior laxity of the uninjured knee influence clinical outcomes of ACL reconstruction?

We retrospectively reviewed 163 patients who had undergone unilateral ACL reconstruction from January 2002 to August 2009. Patients were divided into three groups according to the anterior laxity of the contralateral, normal knee in 30° of knee flexion as measured with a KT2000 arthrometer exerting a force of 134 N:<5 mm for Group 1, 5 to 7.5 mm for Group 2, and>7.5 mm for Group 3. Anterior laxity of the uninjured knee was assessed preoperatively, and anterior laxity of the reconstructed knee was assessed at twenty-four months postoperatively. Anterior stability of the knee was also assessed with use of the Lachman and pivot-shift tests. Functional outcomes were assessed with the Lysholm score and the International Knee Documentation Committee (IKDC) score.

Does anterior laxity of the uninjured knee influence clinical outcomes of ACL reconstruction?

This was a single-center, retrospective cohort study which included patients diagnosed with colorectal cancer at age ≤40 years in 1997-2013 matched 1:2 by year of diagnosis with consecutive colorectal cancer patients diagnosed at age>50 years during the same period. Patients aged 41-50 years were not included in the study, to accentuate potential age-related differences. Clinicopathological characteristics, treatment, and outcome were compared between groups.

Is the type of remission after a major depressive episode an important risk factor to relapses in a 4-year follow up?

The decreasing sample size during the follow-up and the difficulty in warranting the treatment compliance.

Is the type of remission after a major depressive episode an important risk factor to relapses in a 4-year follow up?

There have so far been few reports examining the relationship between OPLL and SCI and there is controversy regarding the deteriorating effects of OPLL-induced canal stenosis on neurologic outcomes.

Prostate-specific antigen and free prostate-specific antigen in the early detection of prostate cancer: do combination tests improve detection?

The combined use of free and total prostate-specific antigen (PSA) in early detection of prostate cancer has been controversial. This article systematically evaluates the discriminating capacity of a large number of combination tests.

Prostate-specific antigen and free prostate-specific antigen in the early detection of prostate cancer: do combination tests improve detection?

This was a retrospective study of 18 consecutive adults with a partial seizure disorder and PIPE (study group) and 36 patients with a partial seizure disorder but without PIPE (control group). These two groups were compared with respect to the likelihood of developing IPE over an 8-year follow-up period and the variables operant in the development of IPE. Statistical analyses consisted of logistic regression models to identify the variables predictive of the development of IPE. Predictors included: number and location of ictal foci, seizure type, etiology, age at seizure onset, duration of seizure disorder, MRI abnormalities, and psychiatric history prior to the index video/EEG monitoring (other than PIPE).

Can homemade alcohol (Raksi) be useful for preserving dead bodies?

Observations made at 48 and 72 hours of embalming revealed that Raksi can arrest postmortem changes in the rats up to 72 hours (3rd day) successfully in the experimental group whereas moderate to severe postmortem changes were seen in the control group. The experimental group showed mild degree of putrefactive changes, liberation of gases and liquefaction of tissues only at 96 hours (4th day) of embalming.

Can homemade alcohol (Raksi) be useful for preserving dead bodies?

Case records of the Massachusetts General Hospital were retrospectively reviewed from 1972 to 2004. One hundred and seventy-nine patients underwent resection for thymoma, of which 45 had stage III disease.

Do elderly cancer patients have different care needs compared with younger ones?

The increasingly older population confronts oncologists with an imposing challenge: older cancer patients have specific healthcare needs both independent of and associated with the diagnosis of cancer. The aim of the present study is to examine whether elderly versus younger cancer patients have different needs with respect to attendance, treatment and information.

Do elderly cancer patients have different care needs compared with younger ones?

In the Philippines, the current national control strategy for schistosomiasis is annual mass drug administration (MDA) with 40 mg/kg of praziquantel in all schistosomiasis-endemic villages with a prevalence ≥10%.

Is breast cancer survival improving?

The authors analyzed the survival experience of 834 women who developed recurrent breast cancer between November 1974 and December 2000. All patients had been treated previously with adjuvant anthracycline-based protocols. Patients were divided into five consecutive groups based on year of breast cancer recurrence, and survival was compared across the five groups. Because some prognostic variables were divided unevenly divided among the cohorts, a multivariate model was created to determine the association of year of recurrence and survival after accounting for other prognostic factors.

Is breast cancer survival improving?

The records of 282 consecutive women with recurrent endometrial cancer treated from 1986 to 2005 were retrospectively collected in 8 Italian institutions. Primary disease, clinical history, and recurrence features and data were analyzed.

Can common carotid intima media thickness serve as an indicator of both cardiovascular phenotype and risk among black Africans?

Bilaterally, CIMT was significantly different among the three cardiovascular phenotypes (right: p < 0.001, F = 33.8; left: p < 0.001, F = 48.6). CIMT had a higher c-statistic for differentiating stroke versus normotension (c = 0.78 right; 0.82 left, p < 0.001) and hypertension versus normotension (c = 0.65 right; 0.71 left, p < 0.001) than several traditional vascular risk factors. Bilaterally, combining all subjects, CIMT was the only factor that correlated significantly (right: 0.12 ≤ r ≤ 0.41, 0.018 ≤ p < 0.0001; left: 0.18 ≤ r ≤ 0.41, 0.005 ≤ p < 0.0001) to all the traditional cardiovascular risk factors assessed.

Can common carotid intima media thickness serve as an indicator of both cardiovascular phenotype and risk among black Africans?

Depression (Beck Depression Index), mobility and social participation (Stroke Impact Scale 3.0 subscales) were assessed initially, at the end of 12 treatments (four weeks) and six weeks later.

Delayed diagnosis of anorectal malformations: are current guidelines sufficient?

Infants referred to our institution with a final diagnosis of ARM were retrospectively reviewed between 2001 and 2009. The first cohort consisted of patients that were referred between November 2001 and November 2006 with the diagnosis of an ARM that had been delayed for more than 48 h. The second cohort was those referred between December 2006 and May 2009 with whom the diagnosis of ARM had not been made within 24 h of birth.

Delayed diagnosis of anorectal malformations: are current guidelines sufficient?

To compare the adenoma detection rate (ADR) between these bowel preparations, and to identify independent predictors of bowel preparation quality and adenoma detection.

Is being small for gestational age a risk factor for retinopathy of prematurity?

A total of 345 patients were examined: 199 included in the AGA group and 146 in the SGA. Mean BW and GA in the whole cohort (345 patients) were 1,128.12 grams (+/-239.9) and 29.7 weeks (+/-1.9), respectively. The prevalence of any stage ROP and severe ROP (needing treatment) was 29.6 and 7.0%, respectively. ROP in any evolutive stage developed in 66 AGA (33.2%) and in 36 SGA (24.7%) (p = 0.111). Severe ROP occurred in 15 AGA (7.5%) and in nine SGA (6.2%) (p = 0.779). After adjusted logistic regression, weight gain from birth to sixth week of life and need for blood transfusions were found to be significant risk factors for ROP in both groups.

Is being small for gestational age a risk factor for retinopathy of prematurity?

To compare maternal and neonatal outcomes among grandmultiparous women to those of multiparous women 30 years or older.

Comparative safety of infliximab and etanercept on the risk of serious infections: does the association vary by patient characteristics?

We identified members of Kaiser Permanente Northern California who initiated infliximab (n = 793) or etanercept (n = 2692) in 1997-2007. Using a Cox model, we estimated the propensity-score-adjusted hazard ratio (HR) and 95% confidence interval (CI) of serious infections requiring hospitalization or opportunistic infections comparing infliximab initiators to etanercept initiators. We tested whether the adjusted HR differed by age, sex, race/ethnicity, body mass index, and smoking status.

Comparative safety of infliximab and etanercept on the risk of serious infections: does the association vary by patient characteristics?

During 2001-03, 1895 patients underwent primary CABG [clinical DM (CDM) in 440/1895; complete data on fB-glu for n=1375/1455]. Using pre-operative fB-glu, non-diabetics were categorized as having normal fB-glu (<5.6 mmol/L), IFG (5.6<or =fB-glu<6.1 mmol/L), or suspected DM (SDM) (>or =6.1 mmol/L). fB-glu was normal in 59%. The relative risks of 30 day and 1 year mortality compared with patients with normal fB-glu was 1.7 [95% confidence interval (CI): 0.5-5.5] and 2.9 (CI: 0.8-11.2) with IFG, 2.8 (CI: 1.1-7.2) and 1.9 (CI: 0.5-6.3) with SDM vs. 1.8 (CI: 0.8-4.0) and 1.6 (CI: 0.6-4.3) if CDM, respectively. The receiver operator characteristic area for the continuous variable fB-glu and 1 year mortality was 0.65 (P=0.002).

Fast foods - are they a risk factor for asthma?

After adjusting for lifestyle factors, including other diet and BMI variables, compared with children who never ate hamburgers, we found an independent risk of hamburger consumption on having a history of wheeze [consumption less than once a week (OR = 1.44, 95% CI: 1.06-1.96) and 1+ times a week (OR = 1.65, 95% CI: 1.07-2.52)] and on current wheeze [consumption less than once a week (OR = 1.17, 95% CI: 0.80-1.70) and 1+ times a week (OR = 1.81, 95% CI: 1.10-2.98)]. Takeaway consumption 1+ times a week was marginally significantly related to BHR (OR = 2.41, 95% CI: 0.99-5.91). There was no effect on atopy.

Fast foods - are they a risk factor for asthma?

Patients with the symptoms of GP were treated by a GES or intensive medical therapy (MED).

Can magnetic resonance-ultrasound fusion biopsy improve cancer detection in enlarged prostates?

We retrospectively analyzed the records of patients who underwent multiparametric prostate magnetic resonance imaging followed by magnetic resonance-ultrasound fusion biopsy at our institution. Whole prostate volumes were calculated using magnetic resonance imaging reconstructions. Detection rates were analyzed with respect to age, prostate specific antigen and whole prostate volumes. Multivariable logistic regression was used to assess these parameters as independent predictors of prostate cancer detection.

Can magnetic resonance-ultrasound fusion biopsy improve cancer detection in enlarged prostates?

58 patients undergoing elective single vessel PCI in a tertiary referral interventional cardiac unit in the UK.

Does normothermic normokalemic simultaneous antegrade/retrograde perfusion improve myocardial oxygenation and energy metabolism for hypertrophied hearts?

With 100% LAD flow, both NNAP and NNSP maintained myocardial oxygenation, adenosine triphosphate, phosphocreatine, and inorganic phosphate at normal levels. When LAD flow was reduced to 50% of its control level, NNSP resulted in a small but significant decrease in myocardial oxygenation and phosphocreatine, whereas those measurements did not change significantly during NNAP. With LAD flow further reduced to 20% of its control level, both NNAP and NNSP caused a substantial decrease in myocardial oxygenation, adenosine triphosphate, and phosphocreatine with an increase in inorganic phosphate. However, the changes were significantly greater during NNSP than during NNAP.

Does normothermic normokalemic simultaneous antegrade/retrograde perfusion improve myocardial oxygenation and energy metabolism for hypertrophied hearts?

To investigate polysomnographic and anthropomorphic factors predicting need of high optimal continuous positive airway pressure (CPAP).

Are there progressive brain changes in schizophrenia?

A systematic review of longitudinal volumetric studies using region-of-interest structural magnetic resonance imaging in patients with schizophrenia and healthy control subjects. The percentage change in volume between scans for each brain region of interest was obtained, and data were combined using random effects meta-analysis.

Are there progressive brain changes in schizophrenia?

The patient is the primary unit of analysis. I use ordinary least squares regression to estimate the effect of weekend hospitalization on rates of cardiac catheterization, angioplasty, and bypass surgery (in various time periods subsequent to the initial hospitalization), 1-year expenditures and rates of adverse health outcomes in various periods following the AMI admission.

Does concept mapping enhance learning outcome of nursing students?

The results of this study showed that the mean scores for cumulative tests (both no. 1 and no. 2) was higher in the group that engaged in map construction compared to the group that only take the quizzes. In addition, there was a gradual increase in the mean scores of developed map during the eight sessions of intervention.

Does concept mapping enhance learning outcome of nursing students?

The purpose of this study is to examine whether or not well differentiated (w-d) hepatocellular carcinoma (HCC) is indeed clinically early cancer.

Is the Androgen Deficiency of Aging Men (ADAM) questionnaire useful for the screening of partial androgenic deficiency of aging men?

A total of 78 men (81.3%) were identified as possible PADAM according to the ADAM questionnaire. Total testosterone levels fell from 503.6+/-180.1 ng/dL in men aged 40 to 54 years to 382.1+/-247.3 in those>70 years; however this was not statistically significant (ANOVA, p=0.06). In the same age groups, SHBG significantly increased (31.0+/-15.0 to 47.5+/-15.0 nmol/L, p<0.001) whereas free and available testosterone significantly decreased (10.6+/-3.2 to 6.4+/-3.6 ng/dL and 266.6+/-81.2 to 152.2+/-97.6 ng/dL, respectively, p<0.0001). Overall (n=96), available testosterone confirmed PADAM diagnosis in 27 cases (28.1%). The ADAM tool rendered a 83.3% sensitivity and 19.7% specificity in the detection of PADAM. Item 1 (decreased sexual desire) was a better predictor of hypogonadism than the complete questionnaire (63.3% sensitivity and 66.7% specificity).

Is the Androgen Deficiency of Aging Men (ADAM) questionnaire useful for the screening of partial androgenic deficiency of aging men?

Bias against operating on patients with prosthetic valve endocarditis (PVE) who have multiple prostheses may preclude the use of life-saving valve replacement. We investigated the accuracy of the preoperative diagnosis of PVE in patients with both mitral and aortic prosthesis and the safety of single-valve replacement when only one valve seemed infected.

Does the Transmissible Liability Index (TLI) assessed in late childhood predict suicidal symptoms at young adulthood?

TLI was significantly associated with number and severity of lifetime suicide attempts.

Does the Transmissible Liability Index (TLI) assessed in late childhood predict suicidal symptoms at young adulthood?

SYNTAX score (SxS) has been demonstrated to predict long-term outcomes in stable patients with coronary artery disease. But its prognostic value for patients with acute coronary syndrome remains unknown.AIM: To evaluate whether SxS could predict in-hospital outcomes for patients admitted with ST elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (pPCI).

Are there gender differences in the reasons why African Americans delay in seeking medical help for symptoms of an acute myocardial infarction?

Five hospitals in the San Francisco and East Bay areas.

Are there gender differences in the reasons why African Americans delay in seeking medical help for symptoms of an acute myocardial infarction?

Between 2000 and 2009, 417 consecutive patients with diaphyseal femur fractures (AO/OTA 32A-C) were treated via IMN. Inclusion criteria for this study included complete baseline and demographic documentation as well as pre-operative films for fracture classification and post-operative CT scanogram (per institutional protocol) for version and length measurement of both the nailed and uninjured femurs. Exclusion criteria included bilateral injuries, multiple ipsilateral lower extremity fractures, previous injury, and previous deformity. Of the initial 417 subjects, 355 patients met our inclusion criteria. Other data included in our analysis were age, sex, injury mechanism, open vs. closed fracture, daytime vs. nighttime surgery, mechanism of injury, and AO and Winquist classifications. Post-operative femoral version of both lower extremities was measured on CT scanogram by an orthopaedic trauma fellowship trained surgeon. Standard univariate and multivariate analyses were performed to determine statistically significant risk factors for malrotation between the two cohorts.

Does histologic chorioamnionitis correspond to clinical chorioamnionitis?

To evaluate the degree to which histologic chorioamnionitis, a frequent finding in placentas submitted for histopathologic evaluation, correlates with clinical indicators of infection in the mother.

Does histologic chorioamnionitis correspond to clinical chorioamnionitis?

We evaluated the usefulness of a short stay or 23-hour ward in a pediatric unit of a large teaching hospital, Westmead Hospital, and an academic Children's hospital, The New Children's Hospital, to determine if they are a useful addition to the emergency service.

Are lifetime prevalence of impetigo, molluscum and herpes infection really increased in children having atopic dermatitis?

We evaluated the association of childhood AD with these infections by conducting a population-based cross-sectional study.

Are lifetime prevalence of impetigo, molluscum and herpes infection really increased in children having atopic dermatitis?

Between 05/95 and 07/98, ten patients with WD (eight males, two females) underwent cardiac surgery employing extracorporeal circulation (WD-group). Five of these patients with platelet counts below 80/nl were treated by immunoglobulins preoperatively. Each patient with WD was matched to five patients without WD (no-WD-group) using diagnosis, age, gender, ejection fraction, number of distal anastomosis and body-mass-index as matching criteria.

Does sonographic needle guidance affect the clinical outcome of intraarticular injections?

Relative to conventional palpation-guided methods, sonographic guidance resulted in 43.0% reduction in procedural pain (p<0.001), 58.5% reduction in absolute pain scores at the 2 week outcome (p<0.001), 75% reduction in significant pain (VAS pain score>or = 5 cm; p<0.001), 25.6% increase in the responder rate (reduction in VAS score>or = 50% from baseline; p<0.01), and 62.0% reduction in the nonresponder rate (reduction in VAS score<50% from baseline; p<0.01). Sonography also increased detection of effusion by 200% and volume of aspirated fluid by 337%.

Does sonographic needle guidance affect the clinical outcome of intraarticular injections?

Observational study comparing the total rates of admissions and of occupied bed days in general hospitals between populations with and without access to GP hospitals. Comparisons were also made separately for diagnoses commonly encountered in GP hospitals.

Pancreas retransplantation: a second chance for diabetic patients?

Between 1976 and 2008, 569 pancreas transplantations were performed in Lyon and Geneva, including 37 second transplantations. Second graft survival was compared with primary graft survival of the same patients and the whole population. Predictive factors of second graft survival were sought. Patient survival and impact on kidney graft function and survival were evaluated.

Pancreas retransplantation: a second chance for diabetic patients?

The etiology of hemodialysis (HD)-induced hypotension and hypertension remains speculative. There is mounting evidence that endothelin-1 (ET-1) may play a vital role in these hemodynamic changes. We examined the possible role of intradialytic changes of ET-1 in the pathogenesis of hypotension and rebound hypertension during HD.

Factors determining the survival of nasopharyngeal carcinoma with lung metastasis alone: does combined modality treatment benefit?

Nasopharyngeal carcinoma (NPC) with lung metastasis alone has been reported as a relatively favorable prognostic group, and combined modality treatment might be indicated for selected cases. However, the prognostic factors determining survival of this group and the indication of combined therapy have not been thoroughly studied.

Factors determining the survival of nasopharyngeal carcinoma with lung metastasis alone: does combined modality treatment benefit?

Retrospective cohort from a single center in 2009-2010 of singleton, term live births. CD rates were compared for women with and without US-EFW within 1 month of delivery and adjusted for potential confounders.

Do viral infections have a role in benign paroxysmal positional vertigo?

With the exception of influenza and parainfluenza, all viral serology values were higher in the BBPV group than the control group. We also observed seasonal variation. The BPPV group exhibited elevated values for HSV1 and adenovirus in March and May, for Herpes zoster, adenovirus, and influenza in April, for HSV1 in June, and for HSV1 and CMV in September, compared to the control group. In October, the BPPV group showed increased values for all of the viruses studied, compared to the control group.

Do viral infections have a role in benign paroxysmal positional vertigo?

Abdominal bloating is reported by a majority of irritable bowel syndrome (IBS) patients. Excess colonic fermentation may cause gaseous symptoms. Several foodstuffs contain oligosaccharides with an α-galactosidic linkage that is resistant to mammalian hydrolases. Assisted hydrolysis by exogenous α-galactosidase enzyme (AG) could offer a way of controlling IBS symptoms by reducing colonic fermentation and gas production. The aim of this study was to assess the effect of AG on symptom severity and quality of life in IBS patients with abdominal bloating or flatulence.

Does the enteral feeding advancement affect short-term outcomes in very low birth weight infants?

We prospectively studied the influence of center-specific enteral feeding advancement in 1430 VLBW infants recruited from 13 tertiary neonatal intensive care units in Germany on short-term outcome parameters. The centers were post hoc stratified to "rapid advancement to full enteral feeds" (median duration of advancement to full enteral feeds<or =12.5 days; 6 centers), that is, rapid advancement (RA), or "slow advancement to full enteral feeds" (median duration of advancement to full enteral feeds>12.5 days; 7 centers), that is, slow advancement (SA).

Does the enteral feeding advancement affect short-term outcomes in very low birth weight infants?

A longitudinal design was used to collect data from Danish healthcare workers at time 1 in 2005 (n = 447) and 18 months later at time 2 in 2007 (n = 274). Structural equation modelling was used to investigate the relationships between transformational leadership, self-efficacy and sleep quality at both time points independently (cross-sectionally) and longitudinally.