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Combining process indicators to evaluate quality of care for surgical patients with colorectal cancer: are scores consistent with short-term outcome?

At the patient level, only one of the composite measures was negatively associated with morbidity for rectum carcinoma. At the hospital level, a strong negative association was found between composite measures and hospital mortality and morbidity rates for rectum carcinoma (p<0.05), and hospital morbidity rates for colon carcinoma.

Combining process indicators to evaluate quality of care for surgical patients with colorectal cancer: are scores consistent with short-term outcome?

TCC and Mount Isa Hospital, which both operate under the auspices of the Townsville Teleoncology Network (TTN).

Can APC mutation analysis contribute to therapeutic decisions in familial adenomatous polyposis?

We examined 680 unrelated FAP families for germline mutations in the APC gene. Clinical information was obtained from 1256 patients.

Can APC mutation analysis contribute to therapeutic decisions in familial adenomatous polyposis?

In this study, we have determined that the QT interval changes significantly depending on the use of oxybutynin. The QT changes increased cardiac arrhythmia in children.

Do emergency medical services professionals think they should participate in disease prevention?

The primary objective of the study was to determine emergency medical services (EMS) professionals' opinions regarding participation in disease and injury prevention programs. A secondary objective was to determine the proportion of EMS professionals who had participated in disease prevention programs.

Do emergency medical services professionals think they should participate in disease prevention?

The specific aim of this investigation was to evaluate the proficiency of health care providers and patients in the proper use of metered-dose inhalers.

Is the ability to perform transurethral resection of the prostate influenced by the surgeon's previous experience?

Sixty-seven patients undergoing transurethral resection of the prostate without the use of a video camera were randomly allocated into three groups according to the urologist's experience: a urologist having done 25 transurethral resections of the prostate (Group I - 24 patients); a urologist having done 50 transurethral resections of the prostate (Group II - 24 patients); a senior urologist with vast transurethral resection of the prostate experience (Group III - 19 patients). The following were recorded: the weight of resected tissue, the duration of the resection procedure, the volume of irrigation used, the amount of irrigation absorbed and the hemoglobin and sodium levels in the serum during the procedure.

Is the ability to perform transurethral resection of the prostate influenced by the surgeon's previous experience?

The study population included 1,023 community dwelling 80-year-old individuals from the Danish intervention study on preventive home visits. Information on preventive home visit acceptance rates was obtained from questionnaires. Socioeconomic status was measured by financial assets obtained from national registry data, and invitational procedures were identified through the municipalities. Logistic regression analyses were used, adjusted by gender.

Is there a differential in the dental health of new recruits to the British Armed Forces?

Data for 432 participants were entered into the analysis. Recruits in the Army sample had a significantly greater prevalence of dental decay and greater treatment resource need than either of the other two Services. Army recruits had a mean number of 2.59 (2.08, 3.09) decayed teeth per recruit, compared to 1.93 (1.49, 2.39 p<0.01) in Royal Navy recruits and 1.26 (0.98, 1.53 p<0.001) in Royal Air Force recruits. Among Army recruits 62.7% were from the two most deprived quintiles of the Index of Multiple Deprivation compared to 42.5% of Royal Naval recruits and 36.6% of Royal Air Force recruits.

Is there a differential in the dental health of new recruits to the British Armed Forces?

The continence score in patients after anastomotic leakage did not differ significantly from that in patients without complications. Sphincter function was similar. Maximum tolerable volume and rectal compliance were slightly but not significantly worse after leakage.

Is laparoscopic reoperation for failed antireflux surgery feasible?

Laparoscopic techniques can be used to treat patients whose antireflux surgery has failed.

Is laparoscopic reoperation for failed antireflux surgery feasible?

Although the Internet is commonly used to recruit samples in studies of human immunodeficiency virus (HIV)-related risk behaviors, it has not been used to measure patient-reported well-being. As the burden of long-term chronic HIV infection rises, the Internet may offer enormous potential for recruitment to research and interventions.

Does exercise during pregnancy prevent postnatal depression?

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.

Does exercise during pregnancy prevent postnatal depression?

This prospective case-control study consisted of 33 patients with pre-eclampsia and 32 normotensive pregnant patients as controls. All of the subjects underwent otoscopic examinations - pure tone audiometry (0.25-16 kHz) and transient evoked otoacoustic emission (1-4 kHz) tests - during their third trimester of pregnancy.

Is endometrial polyp formation associated with increased expression of vascular endothelial growth factor and transforming growth factor-beta1?

This prospective study compared VEGF and TGF-β1 expression of endometrial polyps and adjacent endometrial tissue in 70 premenopausal women. The comparison of results was separately made for endometrium specimens obtained in the proliferative and secretory phases. The results were correlated with the steroid receptors (estrogen receptor and progesterone receptor) expression.

Is endometrial polyp formation associated with increased expression of vascular endothelial growth factor and transforming growth factor-beta1?

Coronary atherosclerotic burden is excessive in diabetic patients. Diabetes mellitus (DM) is an independent predictor for both death and myocardial infarction. It is not known whether the prevalence of complex coronary lesions, such as bifurcation and ostial lesions, is different in diabetics from nondiabetics.

Is human cytomegalovirus infection associated with hypertension?

Of the participants, 54.7% had serologic evidence of HCMV infection and 17.5% had hypertension. There were ethnic differences in the prevalence of HCMV infection (P<0.001) and hypertension (P<0.001). The prevalence of both increased with age (P<0.001). Before adjustment, HCMV seropositivity was significantly associated with hypertension in women (OR=1.63, 95% CI=1.25-2.13, P=0.001) but not in men. After adjustment for race/ethnicity, the association between HCMV seropositivity and hypertension in women remained significant (OR=1.55, 95% CI=1.20-2.02, P=0.002). Further adjustment for body mass index, diabetes status and hypercholesterolemia attenuated the association (OR=1.44, 95% CI=1.10-1.90, P=0.010). However, after adjusting for age, the association was no longer significant (OR=1.24, 95% CI=0.91-1.67, P=0.162).

Is human cytomegalovirus infection associated with hypertension?

Plate clearing tendencies were positively associated with BMI and remained so after accounting for a large number of other demographic and behavioral predictors of BMI in analyses (β=0.18, 95% CIs=0.07, 0.29, P<0.001); an increased tendency to plate clear was associated with a significantly higher body weight.

Is it possible to stop treatment with nucleos(t)ide analogs in patients with e-antigen negative chronic hepatitis B?

Twelve patients showed virologic relapse (54.54%). The mean interval between discontinuation and relapse was 6.38 months (± 1.9) (75% relapsed during the first 12 months after discontinuation). Five received adefovir, 1 lamivudine and adefovir, 1 tenofovir and 5 lamivudine alone. The mean treatment duration in this group was 38.5 months (± 4.5). The sustained response group had a higher mean age and longer treatment duration than patients with virologic relapse but these differences were not statistically significant.

Is it possible to stop treatment with nucleos(t)ide analogs in patients with e-antigen negative chronic hepatitis B?

Arterial calcification is a significant cardiovascular risk factor in hemodialysis patients. A series of factors are involved in the process of arterial calcification; however, the relationship between malnutrition and arterial calcification is still unclear.

Does radiotherapy around the time of pregnancy for Hodgkin's disease modify the risk of breast cancer?

The records of 382 women treated with RT for Hodgkin's disease were reviewed and divided into those who received RT around the time of pregnancy and those who were not pregnant. Comparisons of the overall incidence, actuarial rates, and latency to breast cancer between the two groups were made. Multivariate Cox regression modeling was performed to determine possible contributing factors.

Does radiotherapy around the time of pregnancy for Hodgkin's disease modify the risk of breast cancer?

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.

Should displaced midshaft clavicular fractures be treated surgically?

This study was designed to compare clinical effectiveness of operative with nonoperative treatment for displaced midshaft clavicular fractures (DMCF).

Should displaced midshaft clavicular fractures be treated surgically?

Obesity may be associated with lower prostate specific antigen through hemodilution. We examined the relationship between body mass index and prostate specific antigen by age in men without prostate cancer in a longitudinal aging study to determine whether prostate specific antigen must be adjusted for body mass index.

Is laparoscopic cholecystectomy safe and acceptable as a day case procedure?

This study reviewed the results of performing day case laparoscopic cholecystectomy to assess the feasibility and safety of the procedure as a day case.

Is laparoscopic cholecystectomy safe and acceptable as a day case procedure?

In this study, we aimed to evaluate the potential use of a 3-phase bone scintigraphy method to determine the level of amputation on treatment cost, morbidity and mortality, reamputation rates, and the duration of hospitalization in diabetic foot.

Is etoricoxib effective in preventing heterotopic ossification after primary total hip arthroplasty?

Heterotopic ossification is a common complication after total hip arthroplasty. Non-steroidal anti-inflammatory drugs (NSAIDs) are known to prevent heterotopic ossifications effectively, however gastrointestinal complaints are reported frequently. In this study, we investigated whether etoricoxib, a selective cyclo-oxygenase-2 (COX-2) inhibitor that produces fewer gastrointestinal side effects, is an effective alternative for the prevention of heterotopic ossification.

Is etoricoxib effective in preventing heterotopic ossification after primary total hip arthroplasty?

We observed self-rated anxiety, depression, and craving during alcohol withdrawal and assessed beta E levels (RIA) in a consecutive sample of 60 alcoholics on day 1 and day 14 after onset of withdrawal, and in 30 healthy volunteers. To control for mutual interactions of beta E and the pituitary-adrenocortical hormone secretion, plasma corticotropin (ACTH) and cortisol were also determined.

Should serum pancreatic lipase replace serum amylase as a biomarker of acute pancreatitis?

Seventeen thousand five hundred and thirty-one measurements of either serum amylase and or serum pancreatic lipase were made on 10 931 patients treated at a metropolitan teaching hospital between January 2001 and May 2003. Of these, 8937 were initially treated in the Emergency Department. These results were collected in a database, which was linked by the patients' medical record number to the radiology and medical records. Patients with either an elevated lipase value or a discharge diagnosis of acute pancreatitis had their radiological diagnosis reviewed along with their biochemistry and histology record. The diagnosis of acute pancreatitis was made if there was radiological evidence of peripancreatic inflammation.

Should serum pancreatic lipase replace serum amylase as a biomarker of acute pancreatitis?

One thousand one cases of PCa and 942 controls were analyzed. The prevalence of digoxin use in controls was 2.7%, and use was positively correlated with age. In multivariate analysis adjusting for age, race, PSA screening, and family history of PCa, digoxin use was associated with a reduction in the odds ratio of PCa (OR 0.58, 95% CI: 0.30-1.10). Among those with ≥3 PSA tests over the preceding 5 years (546 cases, 380 controls), digoxin use was associated with a stronger reduction of PCa risk (OR 0.44, 95% CI: 0.20-0.98).

Rectal cancer threatening or affecting the prostatic plane: is partial prostatectomy oncologically adequate?

A multicentre, retrospective study was conducted of patients with rectal cancer threatening or affecting the prostatic plane, but not the bladder, judged by magnetic resonance imaging (MRI). The use of preoperative chemoradiotherapy and the type of urologic resection were correlated with the status of the pathological circumferential resection margin (CRM) and local recurrence.

Rectal cancer threatening or affecting the prostatic plane: is partial prostatectomy oncologically adequate?

The evaluation was guided by the philosophy of triangulation. A questionnaire was sent to 597 randomly selected employees, that is 24% of the health care staff. Four hundred ninety-eight employees answered the questionnaire, giving a response rate of 83%. Furthermore, interviews of different groups of stakeholders were conducted.

Does bone anchor fixation improve the outcome of percutaneous bladder neck suspension in female stress urinary incontinence?

To evaluate the outcome of a new modification of percutaneous needle suspension, using a bone anchor system for fixing the suture at the public bone, and to compare the results with those published previously.

Does bone anchor fixation improve the outcome of percutaneous bladder neck suspension in female stress urinary incontinence?

All LC-MS/MS users that were registered with the UKNEQAS external quality assurance scheme for testosterone were invited to take part in the study. A set of seven serum samples and serum-based calibrators were sent to all laboratories that expressed an interest. The laboratories were instructed to analyse all samples using there own calibrators and return the results and a method questionnaire for analysis.

Are intraoperative precursor events associated with postoperative major adverse events?

Precursor events are undesirable events that can lead to a subsequent adverse event and have been associated with postoperative mortality. The purpose of the present study was to determine whether precursor events are associated with a composite endpoint of major adverse cardiac events (MACE) (death, acute renal failure, stroke, infection) in a low- to medium-risk coronary artery bypass grafting, valve, and valve plus coronary artery bypass grafting population. These events might be targets for strategies aimed at quality improvement.

Are intraoperative precursor events associated with postoperative major adverse events?

To examine gout patients' knowledge of their condition, including the central role of achieving and maintaining the serum urate (SU) goal with the use of urate-lowering therapy (ULT).

Does a family meetings intervention prevent depression and anxiety in family caregivers of dementia patients?

A randomized multicenter trial was conducted among 192 primary caregivers of community dwelling dementia patients. Caregivers did not meet the diagnostic criteria for depressive or anxiety disorder at baseline. Participants were randomized to the family meetings intervention (n = 96) or usual care (n = 96) condition. The intervention consisted of two individual sessions and four family meetings which occurred once every 2 to 3 months for a year. Outcome measures after 12 months were the incidence of a clinical depressive or anxiety disorder and change in depressive and anxiety symptoms (primary outcomes), caregiver burden and quality of life (secondary outcomes). Intention-to-treat as well as per protocol analyses were performed.

Does a family meetings intervention prevent depression and anxiety in family caregivers of dementia patients?

The 5- and 8-year overall survival for the whole population was 79% and 67%, respectively. There was no statistically significant difference in the 8-year actuarial overall survival (64.8% and 67.6%, respectively, p = .64) and local relapse-free survival (75% vs 74.5%, respectively, p = .57), among patients who had biopsy versus those who had neck dissection.

HIF1A as a major vascular endothelial growth factor regulator: do its polymorphisms have an association with age-related macular degeneration?

Genotype distribution of rs1061170 (CFH), rs429608 (SKIV2L), rs2679798 (MYRIP) and both rs11549465 and rs11549467 (HIF1A) in AMD cases and healthy controls; association between genotypes and AMD subtypes.

HIF1A as a major vascular endothelial growth factor regulator: do its polymorphisms have an association with age-related macular degeneration?

All consecutive endoscopies over a period of 15 years, in which colorectal cancer was diagnosed were included. All patients who underwent more than one endoscopy and in whom ultimately cancer was diagnosed were studied separately.

Is combined therapy more effective than growth hormone or hyperbaric oxygen alone in the healing of left ischemic and non-ischemic colonic anastomoses?

Combined treatment with hyperbaric oxygen and GH increased the mean bursting pressure values in all of the groups, and a statistically significant increase was noted in the ischemic groups compared to the controls (p<0.05). This improvement was more evident in the ischemic and normal groups treated with combined therapy. In addition, a histopathological evaluation of anastomotic neovascularization and collagen deposition showed significant differences among the groups.

Is combined therapy more effective than growth hormone or hyperbaric oxygen alone in the healing of left ischemic and non-ischemic colonic anastomoses?

Two populations were used: one from administrative datasets housed at the Manitoba Centre for Health Policy and the other from representative survey samples. The administrative datasets contained data from physician billings, hospitalizations, prescription drug use, education, and social services use, and surveys included indicators on language variables and on self-rated health.

Does oxybutynin hydrochloride cause arrhythmia in children with bladder dysfunction?

In this study, we have determined that the QT interval changes significantly depending on the use of oxybutynin. The QT changes increased cardiac arrhythmia in children.

Does oxybutynin hydrochloride cause arrhythmia in children with bladder dysfunction?

The present analysis compares two palliative treatment concepts for lung cancer in terms of overall survival.

Do "America's Best Hospitals" perform better for acute myocardial infarction?

Admission to a top-ranked hospital was associated with lower adjusted 30-day mortality (odds ratio, 0.87; 95 percent confidence interval, 0.76 to 1.00; P=0.05 for top-ranked hospitals vs. the others). Among patients without contraindications to therapy, top-ranked hospitals had significantly higher rates of use of aspirin (96.2 percent, as compared with 88.6 percent for similarly equipped hospitals and 83.4 percent for non-similarly equipped hospitals; P<0.01) and beta-blockers (75.0 percent vs. 61.8 percent and 58.7 percent, P<0.01), but lower rates of reperfusion therapy (61.0 percent vs. 70.7 percent and 65.6 percent, P=0.03). The survival advantage associated with admission to top-ranked hospitals was less strong after we adjusted for factors including the use of aspirin and beta-blockers (odds ratio, 0.94; 95 percent confidence interval, 0.82 to 1.08; P=0.38).

Do "America's Best Hospitals" perform better for acute myocardial infarction?

Treatment delays in breast cancer are generally thought to affect prognosis but the impact on survival remains unclear. Indicators for breast cancer care include time to primary treatment. The purpose of this study was to evaluate whether time to primary treatment (TPT) in breast cancer impacts survival.

Does preoperative anemia adversely affect colon and rectal surgery outcomes?

Complications associated with blood transfusions have resulted in widespread acceptance of low hematocrit levels in surgical patients. However, preoperative anemia seems to be a risk factor for adverse postoperative outcomes in certain surgical patients. This study investigated the National Surgical Quality Improvement Program (NSQIP) database to determine if preoperative anemia in patients undergoing open and laparoscopic colectomies is an independent predictor for an adverse composite outcome (CO) consisting of myocardial infarction, stroke, progressive renal insufficiency or death within 30 days of operation, or for an increased hospital length of stay (LOS).

Does preoperative anemia adversely affect colon and rectal surgery outcomes?

The occurrence and severity (Brooker Grade III/IV) of HO 6 months postsurgery.

Can early second-look tympanoplasty reduce the rate of conversion to modified radical mastoidectomy?

The aims of the study were to report the rates of recurrent and residual cholesteatoma following primary CAT surgery and to report the rate of conversion to a modified radical mastoidectomy.

Can early second-look tympanoplasty reduce the rate of conversion to modified radical mastoidectomy?

Maternal and fetal vascular catheters and a maternal electromagnetic uterine artery flow probe were implanted in 10 near-term gravid ewes. After recovery, saline, 0.125% bupivacaine, 0.125% bupivacaine with 1:200,000 epinephrine, 0.125% bupivacaine with 1:400,000 epinephrine, and 0.125% bupivacaine with 1:800,000 epinephrine were infused into the maternal superior vena cava. Drugs were infused at 10 mL/h for 30 minutes and then at 20 mL/h for an additional 30 minutes. Animals also received an intravenous bolus of epinephrine 15 micrograms. Throughout all infusions, maternal heart rate, systemic and pulmonary blood pressures, uterine blood flow, cardiac output, and acid-base balance were measured, as well as fetal heart rate, blood pressure, and acid-base balance.

Is serum total bilirubin useful to differentiate cardioembolic stroke from other stroke subtypes?

Our study consisted of 628 consecutive patients with ischaemic stroke. Various clinical and laboratory variables of the patients were analysed according to serum TB quartiles and stroke subtypes.

Is serum total bilirubin useful to differentiate cardioembolic stroke from other stroke subtypes?

The mean visual acuity of the amblyopic eyes significantly increased from 0.35 ± 0.3 to 0.16 ± 0.2 logMAR after the treatment (p < 0.001). The mean initial choroidal thickness was significantly higher in the amblyopic eyes than in the fellow eyes (p = 0.019). There were no significant differences between the pre- and post-treatment mean choroidal thickness in the amblyopic eyes (p = 0.428) and in the fellow eyes (p = 0.343). The mean choroidal thickness was still higher in the amblyopic eyes than in the fellow eyes after the treatment (p = 0.006).

Delayed imaging in routine CT examinations of the abdomen and pelvis: is it worth the additional cost of radiation and time?

Forty-two patients (4.2%) had findings that were further characterized or were observed only in the delayed phase. Most were incidental findings that could have been confirmed at noninvasive follow-up imaging, such as sonography or unenhanced CT or MRI. The most common findings were liver hemangioma (n = 12), adrenal adenoma (n = 12), and parapelvic renal cysts (n = 6). The most important finding was detection of a renal mass in one patient (0.1%). The mass was seen only on the delayed phase images but was difficult to appreciate in the portal venous phase. In the other 958 patients (95.8%), delayed imaging was of no benefit. In addition, use of the delayed phase resulted in a mean 59.5% increase in effective radiation dose.

Delayed imaging in routine CT examinations of the abdomen and pelvis: is it worth the additional cost of radiation and time?

Ten dogs were exposed to open right nephrectomy to create a solitary kidney model (group 1). Ten dogs with both kidneys were considered group 2. All dogs underwent warm ischemia by open occlusion of the left renal artery for 90 minutes. Dogs were sacrificed at different intervals (3 days to 4 weeks). All dogs were reevaluated by renogram before sacrifice and histopathology of the investigated kidney. The proinflammatory markers CD95 and tumor necrosis factor-α were assessed using real-time polymerase chain reaction.

Suturing of the nasal septum after septoplasty, is it an effective alternative to nasal packing?

To discuss and compare the results of suturing the nasal septum after septoplasty with the results of nasal packing.

Suturing of the nasal septum after septoplasty, is it an effective alternative to nasal packing?

The concept of SLT results from the development of reduced-size transplantation. A further development of SLT, the in situ split technique, is derived from LRT, which itself marks the optimized outcome in terms of postoperative graft function and survival. The combination of SLT and LRT has abolished deaths on the waiting list, thus raising the question whether living donor liver transplantation is still necessary.

Have antiepileptic drug prescription claims changed following the FDA suicidality warning?

A longitudinal interrupted time-series design was utilized to evaluate Oklahoma Medicaid claims data from January 2006 through December 2009. The study included 9289 continuously eligible members with prevalent diagnoses of epilepsy and/or psychiatric disorder and at least one AED prescription claim. Trends, expressed as monthly changes in the log odds of AED prescription claims, were compared across three time periods: before (January 2006 to January 2008), during (February 2008 to May 2009), and after (June 2009 to December 2009) the FDA warning.

Have antiepileptic drug prescription claims changed following the FDA suicidality warning?

To study the relationship between coronary angiography and in-hospital mortality in patients undergoing emergency surgery of the aorta without a history of coronary revascularization or coronary angiography before the onset of symptoms.

Does ossification of the posterior longitudinal ligament affect the neurological outcome after traumatic cervical cord injury?

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.

Does ossification of the posterior longitudinal ligament affect the neurological outcome after traumatic cervical cord injury?

The brain-dead donor supply has become one of the criteria limiting the performance of heart transplantation. Conventional screening criteria are too limiting and exclude suitable heart donors. Echocardiography is now widely available and is a reliable tool to assess left ventricular dysfunction in brain-dead donors. Yet few data are available on the degree of left ventricular dysfunction where a transplantation is possible.

Can distal ureteral diameter predict reflux resolution after endoscopic injection?

To test the predictive value of distal ureteral diameter (UD) on reflux resolution after endoscopic injection in children with primary vesicoureteral reflux (VUR).

Can distal ureteral diameter predict reflux resolution after endoscopic injection?

The mucosal and bony structures of the middle turbinate and the angle of the septum were measured using radiological analysis before septoplasty and at least one year after septoplasty. All pre- and post-operative measurements of the middle turbinate were compared using the paired sample t-test and Wilcoxon rank sum test.

Is leptin involved in phagocytic NADPH oxidase overactivity in obesity?

Hyperleptinemia and oxidative stress play a major role in the development of cardiovascular diseases in obesity. This study aimed to investigate whether there is a relationship between plasma levels of leptin and phagocytic nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity, and its potential relevance in the vascular remodeling in obese patients.

Is leptin involved in phagocytic NADPH oxidase overactivity in obesity?

To investigate the importance of loss of consciousness (LOC) in predicting neuropsychological test performance in a large sample of patients with head injury.

Canada's Compassionate Care Benefit: is it an adequate public health response to addressing the issue of caregiver burden in end-of-life care?

Informal caregivers spoke to several of the determinants of health outlined in the PHP model that are implicated in their burden experience: gender, income and social status, working conditions, health and social services, social support network, and personal health practises and coping strategies. They recognized the need for improving the CCB to better address these determinants.

Canada's Compassionate Care Benefit: is it an adequate public health response to addressing the issue of caregiver burden in end-of-life care?

The 56 patients (34 men and 22 women; mean age, 60 ± 14 years) in this study underwent SL for assessment of extensive disease or metastases. For two patients, SL was unsuccessful because of intraabdominal adhesions. For four patients (7.1 %), SL showed unresectability because of metastases (n = 1), tumor progression (n = 1), or severe cirrhosis in the contralateral lobe (n = 2). An additional five patients did not undergo laparotomy due to disease progression detected on imaging after SL. Exploratory laparotomy for the remaining 47 patients showed 6 (13 %) additional unresectable tumors due to advanced tumor (n = 5) or nodal metastases (n = 1). Consequently, the yield of SL was 7 % (95 % confidence interval (CI), 3-17 %), and the accuracy was 27 % (95 % CI, 11-52 %). A biopsy of the contralateral liver was performed for 45 patients who underwent SL, leading to changes in management for 4 patients (17 %) with cirrhosis.

Fatigue in primary Sjögren's syndrome: is there a link with the fibromyalgia syndrome?

74 patients with pSS and 216 patients with lupus were assessed with a questionnaire to identify the presence of fatigue and generalised pain. From the lupus group, in a subset of 117 lupus patients (from the Bloomsbury unit) those with sSS were identified. All patients were studied for the presence of FM.

Fatigue in primary Sjögren's syndrome: is there a link with the fibromyalgia syndrome?

A total of 123 dysphonic individuals with benign vocal pathologies were recruited. They were given either genuine acupuncture (n = 40), sham acupuncture (n = 44), or no treatment (n = 39) for 6 weeks (two 30-minute sessions/wk). The genuine acupuncture group received needles puncturing nine voice-related acupoints for 30 minutes, two times a week for 6 weeks, whereas the sham acupuncture group received blunted needles stimulating the skin surface of the nine acupoints for the same frequency and duration. The no-treatment group did not receive any intervention but attended just the assessment sessions. One-hundred seventeen subjects completed the study (genuine acupuncture = 40; sham acupuncture = 43; and no treatment = 34), but only 84 of them had a complete set of vocal functions and quality of life measures (genuine acupuncture = 29; sham acupuncture = 33; and no-treatment = 22) and 42 of them with a complete set of endoscopic data (genuine acupuncture = 16; sham acupuncture = 15; and no treatment = 11).

Is laparoscopic sonography a reliable and sensitive procedure for staging colorectal cancer?

Laparoscopic colectomy has developed rapidly with the explosion of technology. In most cases, laparoscopic resection is performed for colorectal cancer. Intraoperative staging during laparoscopic procedure is limited. Laparoscopic ultrasonography (LUS) represents the only real alternative to manual palpation during laparoscopic surgery.

Is laparoscopic sonography a reliable and sensitive procedure for staging colorectal cancer?

A case-referent analysis on death records of 5498 individuals in the art glass producing part of southeastern Sweden was performed. Out of all the enrolled subjects, 888 were glass workers. According to occupational title, glassblowers, foundry workers, and unspecified workers were regarded as potentially exposed to arsenic. Persons with a diagnosis of diabetes mellitus either as an underlying or contributing cause of death were considered cases. Referents were decedents without any indication of cancer, cardiovascular disease, or diabetes.

Is alexithymia a risk factor for unexplained physical symptoms in general medical outpatients?

Alexithymia is presumed to play an important predisposing role in the pathogenesis of medically unexplained physical symptoms. However, no research on alexithymia has been done among general medical outpatients who present with medically unexplained physical symptoms as their main problem and in which anxiety and depression have been considered as possible confounding factors. This study investigated whether patients with medically unexplained physical symptoms are more alexithymic than those with explained symptoms and whether, in patients with unexplained symptoms, alexithymia is associated with subjective health experience and use of medical services.

Is alexithymia a risk factor for unexplained physical symptoms in general medical outpatients?

In the whole group only a slight difference was found between both training modalities concerning their writing abilities. However, children with a history of hearing loss, actual hearing loss or pathologic middle ear findings profited most from the specialized training program compared to the control in their reading abilities.

Alcohol consumption and acute myocardial infarction: a benefit of alcohol consumed with meals?

The apparent favorable effect of alcohol on the risk of acute myocardial infarction (MI) may be related to its hypoinsulinemic effect when consumed with meals. We studied how the timing of alcohol consumption in relation to meals might affect the risk of MI in a population with relatively high regular alcohol consumption.

Alcohol consumption and acute myocardial infarction: a benefit of alcohol consumed with meals?

Infection control rate was 31% in retention and 59% in the removal group after initial surgical treatment, and 81% and 91% at latest followup, respectively. Treatment duration was shorter in the retention group and there was no difference in number of additional surgeries and length of hospital stay. Type of treatment (retention versus removal) was the only factor associated with infection control; subgroup analysis in the retention group showed Staphylococcus aureus infection and polyethylene nonexchange as contributing factors for failure of infection control.

The clinical significance of bile duct sludge: is it different from bile duct stones?

Bile duct sludge occurred in 14% (31/228) of patients and was more common in females. After endoscopic clearance, CBD stones recurred in 17% (33/197) of the patients with CBD stones, and in 16% (5/31) of the patients with BDS (p = 0.99). Common bile duct dilation was less common in the sludge group. The other known risk factors for recurrent CBD stones (age, previous open cholecystectomy, bile duct angulation, and the presence of a peripampullary diverticulum) were not statistically different between the two groups.

The clinical significance of bile duct sludge: is it different from bile duct stones?

Our population included 3011 patients without any cancer diagnosis who were enrolled in the randomized, double blind Bezafibrate Infarction Prevention (BIP) Study. The patients received either 400 mg of bezafibrate retard (1506 patients) or placebo (1505 patients) once a day. Cancer incidence data were obtained by matching a subject's identification numbers with the National Cancer Registry. Each matched record was checked for correct identification.

Can Ambu self-inflating bag and Neopuff infant resuscitator provide adequate and safe manual inflations for infants up to 10 kg weight?

Five experienced clinicians delivered targeted ventilation to three lung models differing in compliance, delivery pressures and inflation rates; Preterm (0.5 mL/cmH2O, 25/5 cmH2O, 60 per minute), Term (3 mL/cmH2O, 30/5 cmH2O, 40 per minute) and Infant (9 mL/cmH2O, 35/5 cmH2O, 30 per minute). The Neopuff was examined with three gas inflow rates (5 litres per minute (LPM), 10 LPM and 15 LPM) and the Ambu with no gas inflow.

Can Ambu self-inflating bag and Neopuff infant resuscitator provide adequate and safe manual inflations for infants up to 10 kg weight?

Sixteen percent of the parturients were found to be GBS colonized. The prevalence of GBS was 13.7% in Jewish women and 19% in Arab women, P=0.038. The women were also divided into two groups according to the gestational age one group included 414 women in 24-37 weeks gestation, and the other group included 286 women in term pregnancy. No difference was found in the rate of GBS carriers between the two gestational age groups.

Are IgM-enriched immunoglobulins an effective adjuvant in septic VLBW infants?

79 neonates (40 cases) were enrolled. No difference in birth weight, gestational age or SNAP II score (disease severity score) were found. Significantly reduced short-term mortality was found in treated infants (22% vs 46%; p = 0.005) considering all microbial aetiologies and the subgroup affected by Candida spp. Secondary outcomes were not different between groups.

Are IgM-enriched immunoglobulins an effective adjuvant in septic VLBW infants?

The Spearman and Pearson coefficients of correlation between PRISM and LOS were 0.2 (p<0.001) and 0.08 (p = 0.0003), the latter being slightly higher when LOS was logarithmically transformed. Pearson's coefficient of correlation between ANN derived LOS estimate and actual LOS was 0.21 (p<0.001) (LOS logarithmically transformed: 0.34; p<0.001) in the independent validation sample.

Is resected stomach volume related to weight loss after laparoscopic sleeve gastrectomy?

Laparoscopic sleeve gastrectomy (LSG) was initially performed as the first stage of biliopancreatic diversion with duodenal switch for the treatment of super-obese or high-risk obese patients but is now most commonly performed as a standalone operation. The aim of this prospective study was to investigate outcomes after LSG according to resected stomach volume.

Is resected stomach volume related to weight loss after laparoscopic sleeve gastrectomy?

Seventeen children with ARDS and malignancy aged 10.5 +/- 5.1 years were identified. Six of the 17 children (35.3%) survived. Sepsis syndrome was present in 70.6% of all the children. Peak inspiratory pressure, positive end-expiratory pressure (PEEP), and ventilation index values could distinguish outcome by day 3. A significant relationship between respiratory data and outcome related to efficiency of oxygenation, as determined by PaO(2)/FIO(2) and P(A-a)O(2), was present from day 8 after onset of mechanical ventilation.

Resection of colorectal liver metastases after second-line chemotherapy: is it worthwhile?

Patient outcome after resection of colorectal liver metastases (CLM) following second-line preoperative chemotherapy (PCT) performed for insufficient response or toxicity of the first-line, is little known and has here been compared to the outcome following first-line.

Resection of colorectal liver metastases after second-line chemotherapy: is it worthwhile?

Bicompartmental knee arthroplasty features bone and ligament sparing as unicompartmental knee arthroplasty and is presumably better in the recovery of muscle strength and function compared to total knee arthroplasty (TKA) though not previously reported in the literature. The aim of the study was to compare isokinetic knee muscle strength and physical performance in patients who underwent either bicompartmental knee arthroplasty or TKA.

Do ART patients face higher C-section rates during their stage of delivery?

The group of fresh transferred embryos and slow freezing showed higher risks for elective and emergency C-sections (elective C-sections odds ratio 2.0, CI 95% 1.6-2.6, emergency C-sections odds ratio 1.4, CI 95% 1.1-1.9). Moreover, all groups of ART show enhanced risk of significant perinatal bleeding.

Do ART patients face higher C-section rates during their stage of delivery?

In this prospective non randomized observational cohort study we have evaluated the influence of age on outcome of laparoscopic total fundoplication for GERD.

Does a preoperative medically supervised weight loss program improve bariatric surgery outcomes?

This pilot randomized trial was conducted in a large academic urban public hospital. Patients who met NIH consensus criteria for bariatric surgery and whose insurance did not require a mandatory 6-month MSWM program were randomized to a MSWM program with monthly visits over 6 months (individual or group) or usual care for 6 months and then followed for bariatric surgery outcomes postoperatively. Demographics, weight, and patient behavior scores, including patient adherence, eating behavior, patient activation, and physical activity, were collected at baseline and at 6 months (immediately preoperatively and postoperatively).

Does a preoperative medically supervised weight loss program improve bariatric surgery outcomes?

The authors determine whether prevention influences the use of health services. Fluoridation's effect on restorative dental demand among 972 Washington state employees and spouses, aged 20 to 34 years, in two fluoridated communities and a nonfluoridated community was examined.

Is solitary kidney really more resistant to ischemia?

Ten dogs were exposed to open right nephrectomy to create a solitary kidney model (group 1). Ten dogs with both kidneys were considered group 2. All dogs underwent warm ischemia by open occlusion of the left renal artery for 90 minutes. Dogs were sacrificed at different intervals (3 days to 4 weeks). All dogs were reevaluated by renogram before sacrifice and histopathology of the investigated kidney. The proinflammatory markers CD95 and tumor necrosis factor-α were assessed using real-time polymerase chain reaction.

Is solitary kidney really more resistant to ischemia?

The open access patients reported receiving significantly less information to help them identify the procedure (p<0.01) and less explanation concerning the nature of the procedure than the group of patients referred from the subspecialty clinic (p<0.005). There was no difference between the two groups in satisfaction scores for examinations performed under conscious sedation. For flexible sigmoidoscopy without sedation, however, the GI clinic patient group were more satisfied with their procedure. The majority of patients, regardless of access, were more likely to receive endoscopic results from a gastroenterologist than the referring physician. Furthermore, the patients in the GI clinic group who underwent colonoscopy felt significantly better at follow-up.

Neck pain treatment with acupuncture: does the number of needles matter?

Both groups, independently from the number of needles used, obtained a good therapeutic effect without clinically relevant differences.

Neck pain treatment with acupuncture: does the number of needles matter?

Subjective toxicity to the parotid glands was assessed with the help of a questionnaire at 0, 3 and 6 months and objective toxicity was assessed with parotid scintigraphy at 0 and 3 months. The mean dose to the ipsilateral parotid gland ranged from 19.5 to 52.8 Gy (mean 33.14 Gy) and the mean dose to the contralateral gland was 11.1-46.6 Gy (mean 26.85 Gy). At a median follow-up of 13 months, 9/19 patients had no symptoms of dryness of the mouth (grade I), 8/19 had mild dryness of the mouth (grade II) and only 2/19 had grade III xerostomia, although the parotid gland could only be spared on one side in most of the patients.

Does fluoridation reduce the use of dental services among adults?

The authors determine whether prevention influences the use of health services. Fluoridation's effect on restorative dental demand among 972 Washington state employees and spouses, aged 20 to 34 years, in two fluoridated communities and a nonfluoridated community was examined.

Does fluoridation reduce the use of dental services among adults?

Each patient received a smartphone with an insulin dose advisor (IDA) and with (G3 group) or without (G2 group) the telemonitoring/teleconsultation function. Patients were classified as "high users" if the proportion of "informed" meals using the IDA exceeded 67% (median) and as "low users" if not. Also analyzed was the respective impact of the IDA function and teleconsultations on the final HbA1c levels.

Pertrochanteric fractures: is there an advantage to an intramedullary nail?

Prospective computer-generated randomization of 206 patients into two study groups: those treated by sliding compression hip screw (Group 1; n = 106) and those treated by intramedullary nailing (Group 2; n = 100).

Pertrochanteric fractures: is there an advantage to an intramedullary nail?

Pterygium is a disease of unknown origin and pathogenesis that might be vision threatening. It is characterised by a wing-like conjunctival overgrowth of the cornea. Several studies have investigated human papillomavirus (HPV) as a risk factor for the development of pterygia, but the results are inconclusive.AIM: To investigate a large sample of pterygia for the presence of HPV in order to clarify the putative association between pterygia and HPV.

SPECT study with I-123-Ioflupane (DaTSCAN) in patients with essential tremor. Is there any correlation with Parkinson's disease?

Qualitative (Visual) interpretation of the SPECT data did not find any difference in the uptake of the radiopharmaceutical at the level of the S, CN and P between NV and ET patients. Reduced accumulation of the radiopharmaceutical uptake was found in the P of all PD patients. Semiquantitative analysis revealed significant differences between NV and ET patients in the striatum, reduced in the latter. There was also a significant reduction in the tracer accumulation in the left putamen of patients with right hemi-parkinsonism compared to ET and NV. Patients with left hemi-parkinsonism, demonstrated reduced radioligand uptake in the right putamen in comparison with ET and NV. Clinical follow-up of 20 patients with ET at (so many months afterwards) revealed no significant change in clinical presentation, particularly no signs of PD. Follow-up DaTSCAN performed in 10 of them (so many months afterwards) was negative in all but one. This one had an equivocal baseline study which deteriorated 12 months later.

SPECT study with I-123-Ioflupane (DaTSCAN) in patients with essential tremor. Is there any correlation with Parkinson's 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).

Are the GFRUP's recommendations for withholding or withdrawing treatments in critically ill children applicable?

Were included when limitation of treatments was expected.

Are the GFRUP's recommendations for withholding or withdrawing treatments in critically ill children applicable?

The ZEUS (Zotarolimus-Eluting Endeavor Sprint Stent in Uncertain DES Candidates) is a multinational, randomized single-blinded trial that randomized among others, in a stratified manner, 828 patients fulfilling pre-defined clinical or biochemical HBR criteria-including advanced age, indication to oral anticoagulants or other pro-hemorrhagic medications, history of bleeding and known anemia-to receive E-ZES or BMS followed by a protocol-mandated 30-day DAPT regimen. The primary endpoint of the study was the 12-month major adverse cardiovascular event rate, consisting of death, myocardial infarction, or target vessel revascularization.