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Question: Do European people with type 1 diabetes consume a high atherogenic diet?
Context: Individuals with type 1 diabetes have a high risk of developing cardiovascular diseases, and it has been reported that they consume a high atherogenic diet. We examined how nutrient intake and adherence to current European nutri... | European individuals with type 1 diabetes consume a high atherogenic diet as few patients met recommendations for dietary fibre and saturated fat. This study showed minor changes in dietary nutrients and energy intakes over a period of 7 years. Nutrition education needs particular focus on strategies to increase dietar... |
Question: Is digoxin use for cardiovascular disease associated with risk of prostate cancer?
Context: Digoxin is a commonly used medication for heart failure and cardiac arrhythmias that has recently been suggested as a novel chemotherapeutic agent. Preclinical studies of prostate cancer (PCa) have shown anti-tumor act... | These data indicate digoxin use may be associated with a reduction in risk of PCa. Given the potential mechanisms by which digoxin may exert an anti-neoplastic effect and other recent studies showing a negative association between digoxin use and PCa, further research is warranted. |
Question: Optimism and survival: does an optimistic outlook predict better survival at advanced ages?
Context: Studies examining predictors of survival among the oldest-old have primarily focused on objective measures, such as physical function and health status. Only a few studies have examined the effect of personali... | An optimistic outlook appears to be a significant predictor of survival among the oldest-old women. It may also be a significant predictor for men but the sample size is small. |
Question: Do teleoncology models of care enable safe delivery of chemotherapy in rural towns?
Context: To compare the dose intensity and toxicity profiles for patients undergoing chemotherapy at the Townsville Cancer Centre (TCC), a tertiary cancer centre in northern Queensland, with those for patients treated in Mount... | It appears safe to administer chemotherapy in rural towns under the supervision of medical oncologists from larger centres via teleoncology, provided that rural health care resources and governance arrangements are adequate. |
Question: Do nomograms designed to predict biochemical recurrence (BCR) do a better job of predicting more clinically relevant prostate cancer outcomes than BCR?
Context: To examine the ability of various postoperative nomograms to predict prostate cancer-specific mortality (PCSM) and to validate that they could predic... | Currently available nomograms used to predict BCR accurately predict PCSM and other more clinically relevant endpoints. Moreover, not only do they significantly predict PCSM, but do so with generally greater accuracy than BCR. |
Question: Necrotizing fasciitis: an indication for hyperbaric oxygenation therapy?
Context: The accepted treatment protocol for necrotizing fasciitis (NF) consists of extensive surgery and wide spectrum antibiotics. Hyperbaric oxygenation (HBO) has been recommended as adjuvant therapy for NF, improving patient mortalit... | The results of this study cast doubt on the suggested advantage of HBO in reducing patient mortality and morbidity when used as adjuvant therapy for NF. |
Question: Has the use of complementary and alternative medicine therapies by U.S. adults with chronic disease-related functional limitations changed from 2002 to 2007?
Context: This study examined changes in the use of complementary and alternative medicine (CAM) therapies by U.S. adults aged 18 years or older with chr... | Among U.S. adults with chronic disease-related functional limitations, the overall increase in CAM use from 2002 to 2007 was significant, particularly among those with changing and maintaining body position limitations. |
Question: Did Chile's traffic law reform push police enforcement?
Context: The objective of the current study is to determine to what extent the reduction of Chile's traffic fatalities and injuries during 2000-2012 was related to the police traffic enforcement increment registered after the introduction of its 2005 tra... | Findings suggest that traffic law reforms in order to have an effect on both traffic fatality and injury rates reduction require changes in police enforcement practices. Last, this case also illustrates how the diffusion of successful road safety practices globally promoted by WHO and World Bank can be an important inf... |
Question: Does the use of atypical antipsychotics as adjunctive therapy in depression result in cost savings?
Context: Several atypical antipsychotics (AAPs) are used as second-line agents for treatment resistant depression. AAPs can be expensive compared to other treatment options and can cause several side effects. T... | The results show no evidence that AAPs used as second-line treatment for depression results in overall cost savings or lower inpatient and ED visits compared to other treatment strategies. |
Question: The Omega-3 Index: a new risk factor for death from coronary heart disease?
Context: Low intakes or blood levels of eicosapentaenoic and docosahexaenoic acids (EPA + DHA) are independently associated with increased risk of death from coronary heart disease (CHD). In randomized secondary prevention trials, fis... | The Omega-3 Index may represent a novel, physiologically relevant, easily modified, independent, and graded risk factor for death from CHD that could have significant clinical utility. |
Question: The nurse cystoscopist: a feasible option?
Context: To compare the accuracy achieved by a trained urology nurse practitioner (UNP) and consultant urologist in detecting bladder tumours during flexible cystoscopy. Eighty-three patients underwent flexible cystoscopy by both the UNP and consultant urologist, eac... | A UNP can be trained to perform cystoscopy and detect suspicious lesions as accurately as can a consultant urologist. Legal and training issues in implementation are important. |
Question: Sternal fracture in growing children : A rare and often overlooked fracture?
Context: Sternal fractures in childhood are rare. The aim of the study was to investigate the accident mechanism, the detection of radiological and sonographical criteria and consideration of associated injuries. In the period from J... | Isolated sternal fractures in childhood are often due to typical age-related traumatic incidents. Ultrasonography is a useful diagnostic tool for fracture detection and radiography is the method of choice for visualization of the extent of the dislocation. |
Question: Could Adult European Pharmacoresistant Epilepsy Patients Be Treated With Higher Doses of Zonisamide?
Context: To examine the clinical effect (efficacy and tolerability) of high doses of zonisamide (ZNS) (>500 mg/d) in adult patients with pharmacoresistant epilepsy. Between 2006 and 2013, all epileptic outpati... | High doses of ZNS are effective and safe in pharmacoresistant epileptic patients. Therapeutic drug monitoring of ZNS may be considered at therapeutic failure. |
Question: Three-dimensional ultrasound-validated large-core needle biopsy: is it a reliable method for the histological assessment of breast lesions?
Context: The use of three-dimensional (3D) ultrasound may help to determine the exact position of the needle during breast biopsy, thereby reducing the number of core sam... | 3D ultrasound validation of the postfiring needle position is an efficient adjunct to ultrasound-guided LCNB. The advantages of 3D ultrasound validation are likely to include a reduction in the number of core samples needed to achieve a reliable histological diagnosis (and a possible reduction in the risk of tumor cell... |
Question: Is portable ultrasonography accurate in the evaluation of Schanz pin placement during extremity fracture fixation in austere environments?
Context: The purpose of this study was to investigate the efficacy of ultrasonography to confirm Schanz pin placement in a cadaveric model, and the interobserver repeatabi... | Despite the statistical imparity of pin protrusion measurement via ultrasound compared to that of gross dissection, a consideration of the clinical relevance of ultrasound measurement bias during an austere operating theatre leads to the conclusion that ultrasonography is an adequate methodology for Schanz pin protrusi... |
Question: Does normothermic normokalemic simultaneous antegrade/retrograde perfusion improve myocardial oxygenation and energy metabolism for hypertrophied hearts?
Context: Beating-heart valve surgery appears to be a promising technique for protection of hypertrophied hearts. Normothermic normokalemic simultaneous ante... | Normothermic normokalemic simultaneous antegrade/retrograde perfusion did not improve, but slightly impaired myocardial oxygenation and energy metabolism of beating hypertrophied hearts relative to NNAP. Therefore, NNSP for protection of beating hypertrophied hearts during valve surgery should be used with extra cautio... |
Question: Endovenous laser ablation in the treatment of small saphenous varicose veins: does site of access influence early outcomes?
Context: The study was performed to evaluate the clinical and technical efficacy of endovenous laser ablation (EVLA) of small saphenous varicosities, particularly in relation to the site... | The site of access in our study does not appear to influence complications specifically neural injury or recurrence rates. |
Question: Can gingival crevicular blood be relied upon for assessment of blood glucose level?
Context: Diabetes mellitus (DM) is undiagnosed in approximately half of the patients actually suffering from the disease. In addition, the prevalence of DM is more than twice as high as in patients with periodontitis when comp... | The data from this study has shown that GCB collected during diagnostic periodontal examination can be an excellent source of blood for glucometric analysis. |
Question: Is a specialised training of phonological awareness indicated in every preschool child?
Context: In a prospective study 218 preschool children were enrolled (stratified in 2 training programs, one specialized for phonologic awareness in order to prevent dyslexia, the other consisting in training of general pe... | A specialized training program to improve phonologic awareness as a basis for reading and writing in every kindergarten and preschool child seems to be unnecessary. However, children with temporary hearing deficits benefit from such a program. For all other children general perception training may be sufficient. |
Question: Does early migraine treatment shorten time to headache peak and reduce its severity?
Context: To explore whether early treatment would shorten the duration of headache from headache onset to its peak and reduce headache severity at peak. Prior clinical studies almost exclusively focused on headache relief aft... | Early treatment and use of triptans may lead to shorter duration from migraine headache onset to its peak but did not alleviate headache severity at peak. This could result in decreased migraine burden by reducing total migraine headache duration. |
Question: Department of Transportation vs self-reported data on motor vehicle collisions and driving convictions for stroke survivors: do they agree?
Context: Research on stroke survivors' driving safety has typically used either self-reports or government records, but the extent to which the 2 may differ is not known.... | In our population of stroke survivors, self-reports of motor vehicle collisions and driving convictions differed from government records. In future studies, the use of both government and self-reported data would ensure a more accurate picture of driving safety post-stroke. |
Question: Is amoxapine an atypical antipsychotic?
Context: All currently available atypical antipsychotics have, at clinically relevant doses: i) high serotonin (5-HT)2 occupancy; ii) greater 5-HT2 than dopamine (D)2 occupancy; and iii) a higher incidence of extrapyramidal side effects when their D2 occupancy exceeds 8... | PET data show that amoxapine's profile is very similar to that of the established atypical antipsychotics. These data, together with amoxapine's in vitro pharmacologic profile, effectiveness in animal models, and efficacy in psychotic depression raise the possibility of amoxapine as an "atypical" antipsychotic agent in... |
Question: Should all patients be optimized to the same preoperative hemoglobin level to avoid transfusion in primary knee arthroplasty?
Context: Optimization of the preoperative hemoglobin (Hb) level is an effective way to reduce allogeneic transfusion in total knee arthroplasty (TKA) though the procedure is expensive,... | Not all the patients undergoing TKA who receive tranexamic acid need the same preoperative Hb optimization target. Two easily available factors, such as the ASA score and the Hb level, can help individualize the Hb optimization target. |
Question: Can CT predict the level of CSF block in tuberculous hydrocephalus?
Context: Treatment of obstructive hydrocephalus in children with tuberculous meningitis (TBM) depends on the level of the cerebrospinal fluid (CSF) block. Air-encephalography is regarded as the gold standard for differentiating communicating ... | CT is therefore not useful in determining the level of CSF block in TBM. Air-encephalography remains the most reliable way of determining the level of CSF obstruction. |
Question: Prescriptions as a proxy for asthma in children: a good choice?
Context: Stock et al. (Eur Respir J 25:47-53, 2005) recently estimated asthma prevalence in Germany using claims data on prescriptions and hospital diagnoses and found high prevalence peaks in infants. Our objective was to critically assess and d... | When additional validation studies were taken into account, asthma medications were found to be prescribed not only for asthma but also for other respiratory diseases. In addition, not all children with current asthma had prescriptions. We therefore conclude that asthma medications are therefore not a good proxy for th... |
Question: Do approved doctors and medical referees in the UK agree when assessing a seafarer's fitness?
Context: The seafaring industry remains a hazardous occupation that requires sophisticated systems of risk and fitness assessment. This study aims to investigate the extent of agreement between Approved Doctors (ADs)... | This study found that there was poor agreement between the AD's decision and the subsequent MR's decision regarding the fitness of those seafarers who decided to appeal against the AD's initial assessment. The reasons for this are considered. |
Question: Chemoradiation instead of surgery to treat mid and low rectal tumors: is it safe?
Context: The main treatment for rectal carcinoma is surgery. Preoperative chemoradiation (CRT) is advocated to reduce local recurrence and improve resection of mid and low tethered rectal tumors. Fifty-two patients with mid or l... | Exclusive CRT approach is not safe to treat patients with low infiltrative rectal carcinoma. |
Question: Does diabetes mellitus influence the efficacy of FDG-PET in the diagnosis of cervical cancer?
Context: Compared with computed tomography (CT) and magnetic resonance imaging (MRI), positron emission tomography (PET) may have additional value in the assessment of primary and recurrent cervical cancer. However, ... | In comparison with its accuracy in non-DM patients, the accuracy of PET in cervical cancer patients with mild to moderate DM was not significantly reduced. |
Question: Do microbiological factors account for poor pregnancy outcome among unmarried pregnant women in Poland?
Context: Being unmarried is a well-known risk factor for poor pregnancy outcome such as preterm delivery and intrauterine growth restriction. The aim of this prospective study was to assess the prevalence a... | The observed socioeconomic, demographic and microbiological differences between unmarried and married women could be responsible for the poor pregnancy outcome among unmarried pregnant women in Poland. Unmarried pregnant women should be covered by comprehensive medical care even before pregnancy. Further studies taking... |
Question: Does lunar position influence the time of delivery?
Context: To study the relationship between lunar position and the day of delivery; to investigate the synodic distribution of spontaneous deliveries, especially in relation to the presence of a full moon. Retrospective analysis of 1248 spontaneous full-term ... | In this paper the effect of lunar phases on the time of delivery is shown. This influence seems to be especially relevant in the case of multiparae and plurigravidae. Nevertheless, it is too weak to allow for prediction regarding the days with the highest frequency of deliveries. |
Question: Inpatient Pediatric Tonsillectomy: Does Hospital Type Affect Cost and Outcomes of Care?
Context: To ascertain whether hospital type is associated with differences in total cost and outcomes for inpatient tonsillectomy. Cross-sectional analysis of the 2006, 2009, and 2012 Kids' Inpatient Database (KID). Childr... | Significant differences in costs, outcomes, and patient factors exist for inpatient tonsillectomy based on hospital type. Although reasons for these differences are not discernable using isolated claims data, findings provide a foundation to further evaluate patient, institutional, and system-level factors that may red... |
Question: Does a colonoscopy after acute diverticulitis affect its management?
Context: Medical records of 220 patients hospitalized for acute diverticulitis between June 1, 2002 and September 1, 2009 were reviewed. Acute diverticulitis was diagnosed by clinical criteria and characteristic CT findings. Fifteen patients... | Our results suggest that colonoscopy does not affect the management of patients with acute diverticulitis nor alter the outcome. The current practice of a routine colonoscopy after acute diverticulitis, diagnosed by typical clinical symptoms and CT needs to be reevaluated. |
Question: Are increased carotid artery pulsatility and resistance indexes early signs of vascular abnormalities in young obese males?
Context: To provide insight into the factors by which obesity in itself may directly lead to early arterial damage, we aimed to determine early sonographic markers of obesity-related vas... | Our results suggest that depressed vessel compliance and increased vascular resistance are features of young, obese, normotensive subjects independently of and in addition to cardiovascular risk factors. As changes in arterial wall properties may be incipient in young obese subjects, future studies will be required to ... |
Question: Do instrumental activities of daily living predict dementia at 1- and 2-year follow-up?
Context: To investigate whether problems in instrumental activities of daily living (IADL) can add to conventionally used clinical measurements in helping to predict a diagnosis of dementia at 1- and 2-year follow-up. Mult... | IADL disability is a useful addition to the diagnostic process in a memory clinic setting, indicating who is at higher risk of developing dementia at 1- and 2-year follow-up. |
Question: Do familiar teammates request and accept more backup?
Context: The present study investigated factors that explain when and why different groups of teammates are more likely to request and accept backup from one another when needed in an environment characterized by extreme time pressure and severe consequenc... | Transactive memory theory extends to high-stress environments in which members' expertise is highly overlapping. Teammates' shared mental models about one another increase the likelihood that they will request and accept backup. |
Question: Do adjuvant aromatase inhibitors increase the cardiovascular risk in postmenopausal women with early breast cancer?
Context: Despite the advantages from using aromatase inhibitors (AIs) compared with tamoxifen for early breast cancer, an unexpectedly greater number of grade 3 and 4 cardiovascular events (CVAE... | According to the results from this meta-analysis, the risk of grade 3 and 4 CVAEs in patients who were receiving AIs was higher compared with the risk in patients who were receiving tamoxifen, and the difference reached statistical significance. However, the AD was relatively low, and from 160 to 180 patients had to be... |
Question: Can autologous platelet-rich plasma gel enhance healing after surgical extraction of mandibular third molars?
Context: This investigation assesses the effect of platelet-rich plasma (PRP) gel on postoperative pain, swelling, and trismus as well as healing and bone regeneration potential on mandibular third mo... | The PRP group recorded reduced pain, swelling, and trismus as well as enhanced and faster bone healing compared with those in the control. Hence the study showed that topical application of PRP gel has a beneficial effect in enhancing socket healing after third molar surgery. |
Question: Does growth hormone replacement therapy reduce mortality in adults with growth hormone deficiency?
Context: Adults with GH deficiency (GHD) have a decreased life expectancy. The effect of GH treatment on mortality remains to be established. This nationwide cohort study investigates the effect of GH treatment ... | GHD men receiving GH treatment have a mortality rate not different from the background population. In women, after exclusion of high-risk patients, mortality was not different from the background population except for CVD. Mortality due to malignancies was not elevated in adults receiving GH treatment. Next to gender, ... |
Question: Does laparoscopic cholecystectomy influence peri-sinusoidal cell activity?
Context: To investigate the influence of laparoscopic procedures on perisinusoidal cell function. In 31 patients who underwent laparoscopic cholecystectomy for symptomatic cholelithiasis, the serum levels of beta-N-acetyl hexosaminidas... | Laparoscopic procedures caused detectable damage to Kupffer and endothelial cells as reflected by elevation of post-operative HA serum levels. The damage to the liver hepatocytes and perisinusoidal cells has no clinical significance and the laparoscopic procedure itself is the probable cause of the Kupffer and endothel... |
Question: Can routinely collected ambulance data about assaults contribute to reduction in community violence?
Context: The 'law of spatiotemporal concentrations of events' introduced major preventative shifts in policing communities. 'Hotspots' are at the forefront of these developments yet somewhat understudied in em... | A hotspots approach to sharing data circumvents the problem of disclosing person-identifiable data between different agencies. Practically, at least half of ambulance hotspots are unknown to the police; if causal, it suggests that data sharing leads to both reduced community violence by way of prevention (such as throu... |
Question: Clinical identifiers for early-stage primary/idiopathic adhesive capsulitis: are we seeing the real picture?
Context: Adhesive capsulitis is often difficult to diagnose in its early stage and to differentiate from other common shoulder disorders. The aim of this study was to validate any or all of the 8 clini... | None of the clinical identifiers for early-stage adhesive capsulitis previously proposed by expert consensus have been validated in this study. Clinicians should be aware that commonly used clinical identifiers may not be applicable to this stage. |
Question: Lloyd-Davies position with Trendelenburg--a disaster waiting to happen?
Context: Lower limb compartment syndrome has been reported to occur after colorectal, urological, and gynecological procedures during which the patient's lower limbs are elevated for prolonged periods of time. We investigated lower limb p... | The use of the modified lithotomy position during pelvic surgery is not associated with lower limb ischemia. Addition of Trendelenburg position, however, causes profound ischemia of the lower limbs, and this is followed during the recovery period by hyperperfusion that is confined to the muscle compartments, which may ... |
Question: The HELPP syndrome--evidence of a possible systemic inflammatory response in pre-eclampsia?
Context: The principal causes of morbidity and mortality during pregnancy in Mexico, are preeclampsia/eclampsia, obstetric hemorrhage and puerperium complications; this is, 62% of maternal deaths in last years. HELLP s... | We found an important renal damage, low platelets, elevated liver enzymes in women with two or more pregnancies. Then we propose there are similarities between HELLP syndrome and Systemic Inflammatory Response Syndrome (SIRS) because they could have the same pathophysiology. |
Question: Does topical ropivacaine reduce the post-tonsillectomy morbidity in pediatric patients?
Context: To determine whether post-operative administration of topical ropivacaine hydrochloride decreases morbidity following adenotonsillectomy. Prospective, randomized, double-blind clinical trial. University referral c... | Locally 1.0% ropivacaine administration significantly relieves the pain of pediatric tonsillectomy and, it is a safe and effective method. High concentrations of ropivaciane may produce clinically significant pain relief. It is more effective to reduce of post-operative analgesic requirement after first hour. |
Question: Does base deficit predict mortality in patients with severe traumatic brain injury?
Context: Base Deficit (BD) is a marker of tissue hypoxia in polytrauma patients. It guides resuscitative measures, and predicts outcomes, complications and mortality. The aim of this study was to examine the presence of BD in ... | Although BD is correlated with GCS at presentation and RTS, it is not a reliable prognostic marker for outcome and mortality in patients with isolated TBI. |
Question: Does having a regular primary care clinician improve quality of preventive care for young children?
Context: This study examines whether having a regular clinician for preventive care is associated with quality of care for young children, as measured by interpersonal quality ratings and content of anticipator... | Having a regular primary care clinician is embraced in pediatrics, although team care among physicians is also widely practiced. For young children, having a regular clinician is associated with modest gains in interpersonal quality and no differences in content of anticipatory guidance. The benefit of having a regular... |
Question: Are high flow nasal cannulae noisier than bubble CPAP for preterm infants?
Context: Noise exposure in the neonatal intensive care unit is believed to be a risk factor for hearing loss in preterm neonates. Continuous positive airway pressure (CPAP) devices exceed recommended noise levels. High flow nasal cannu... | At the gas flows studied, HFNC are not noisier than BCPAP for preterm infants. |
Question: Does multi-modal cervical physical therapy improve tinnitus in patients with cervicogenic somatic tinnitus?
Context: Tinnitus can be related to many different aetiologies such as hearing loss or a noise trauma, but it can also be related to the somatosensory system of the cervical spine, called cervicogenic s... | Cervical physical therapy can have a positive effect on subjective tinnitus complaints in patients with a combination of tinnitus and neck complaints. Larger studies, using more responsive outcome measures, are however necessary to prove this effect. |
Question: Does a 4 diagram manual enable laypersons to operate the Laryngeal Mask Supreme®?
Context: Bystander resuscitation plays an important role in lifesaving cardiopulmonary resuscitation (CPR). A significant reduction in the "no-flow-time", quantitatively better chest compressions and an improved quality of venti... | In manikin laypersons could insert LMAS in the correct direction after onsite instruction by a simple manual with a high success rate. This indicates some basic procedural understanding and intellectual transfer in principle. Operating errors (n = 91) were frequently not recognized and corrected (n = 77). Improvements ... |
Question: Does SYNTAX score predict in-hospital outcomes in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention?
Context: SYNTAX score (SxS) has been demonstrated to predict long-term outcomes in stable patients with coronary artery disease. But its prognostic value fo... | SxS is a useful tool that can predict in-hospital outcomes of patients with STEMI undergoing pPCI. |
Question: Can serum be used for analyzing the EGFR mutation status in patients with advanced non-small cell lung cancer?
Context: Epidermal growth factor receptor (EGFR) mutations as prognostic or predictive marker in patients with non-small cell lung cancer (NSCLC) have been used widely. However, it may be difficult t... | Serum sample might be alternatively used in the difficult time of getting tumor tissue for analyzing the status of EGFR mutation status in patients with advanced NSCLC. |
Question: Is scintigraphy a guideline method in determining amputation levels in diabetic foot?
Context: 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 ho... | We conclude that 3-phase bone scintigraphy prior to surgery could be a useful method to determine the amputation level in a diabetic foot. We conclude that further, comparative, more comprehensive, long-term, and controlled studies are required. |
Question: Does ossification of the posterior longitudinal ligament affect the neurological outcome after traumatic cervical cord injury?
Context: Retrospective outcome measurement study. The purpose of this study is to assess whether ossification of the posterior longitudinal ligament (OPLL) affects neurologic outcomes... | No evidence was found for OPLL to have any effect on the initial neurologic status or recovery in motor function after traumatic cervical cord injury, suggesting that the neurologic outcome is not significantly dependent on canal space. |
Question: Is breast cancer prognosis inherited?
Context: A genetic component is well established in the etiology of breast cancer. It is not well known, however, whether genetic traits also influence prognostic features of the malignant phenotype. We carried out a population-based cohort study in Sweden based on the na... | Breast cancer prognosis of a woman predicts the survival in her first-degree relatives with breast cancer. Our novel findings suggest that breast cancer prognosis might be inherited. |
Question: Does early discharge with nurse home visits affect adequacy of newborn metabolic screening?
Context: To examine the impact of early discharge on newborn metabolic screening. Metabolic screening results were obtained from the Alabama State Lab for all infants born at our hospital between 8/1/97, and 1/31/99, a... | In this well established early discharge program with nurse home visits, newborn metabolic screening is not compromised by early discharge. |
Question: Can dentists recognize manipulated digital radiographs?
Context: To determine the ability of dentists to recognize digitally manipulated radiographs. A poster was presented at the Annual Meeting of the German Society for Periodontology displaying the intra-oral radiographs of 12 different patients. Half of th... | Image manipulations which alter the diagnostic content of a radiograph are unlikely to be detected by dentists. Digital radiography requires additional measures for data protection. |
Question: Are WHO/UNAIDS/UNICEF-recommended replacement milks for infants of HIV-infected mothers appropriate in the South African context?
Context: Little is known about the nutritional adequacy and feasibility of breastmilk replacement options recommended by WHO/UNAIDS/UNICEF. The study aim was to explore suitability... | No home-prepared replacement milks in South Africa meet all estimated micronutrient and essential fatty acid requirements of infants aged<6 months. Commercial infant formula is the only replacement milk that meets all nutritional needs. Revisions of WHO/UNAIDS/UNICEF HIV and infant feeding course replacement milk optio... |
Question: Is the h-index predictive of greater NIH funding success among academic radiologists?
Context: Despite rapid adoption of the Hirsch index (h-index) as a measure of academic success, the correlations between the h-index and other metrics of productivity remain poorly understood. The aims of this study were to ... | Having obtained at least one NIH grant was associated with a higher h-index, yet multiple or large grants, such as those for program projects, were not predictive of higher h-indices. |
Question: Is it necessary to insert a nasobiliary drainage tube routinely after endoscopic clearance of the common bile duct in patients with choledocholithiasis-induced cholangitis?
Context: Little is known about whether a routinely inserted endoscopic nasobiliary drainage (ENBD) tube improves the clinical course in p... | A routinely inserted ENBD tube did not improve the clinical course, despite patients having to endure increased procedure time and discomfort, and the insertion would therefore be unnecessary. |
Question: Does radiotherapy around the time of pregnancy for Hodgkin's disease modify the risk of breast cancer?
Context: To determine whether the risk of secondary breast cancer after radiotherapy (RT) for Hodgkin's disease is greater among women who underwent RT around time of pregnancy. The records of 382 women trea... | The results of this study indicate that the risk of breast cancer after RT is greater with irradiation around the time of pregnancy. This suggests that pregnancy is a time of increased sensitivity of breast tissue to the carcinogenic effects of radiation. Because of the small sample size and limited follow-up, addition... |
Question: Can echocardiography and ECG discriminate hereditary transthyretin V30M amyloidosis from hypertrophic cardiomyopathy?
Context: Hereditary transthyretin (ATTR) amyloidosis with increased left ventricular wall thickness could easily be misdiagnosed by echocardiography as hypertrophic cardiomyopathy (HCM). Our a... | Our study proposes an easily interpretable classification method for the differentiation between HCM and increased left ventricular myocardial thickness due to ATTR amyloidosis. Our combined echocardiographic and ECG model could increase the ability to identify ATTR cardiac amyloidosis in clinical practice. |
Question: Does the sex of acute stroke patients influence the effectiveness of rt-PA?
Context: Women have been reported to show more frequent recanalization and better recovery after intravenous (IV) recombinant tissue plasminogen activator (rt-PA) treatment for acute stroke compared with men. To investigate this we st... | In our study; sex is not a significant predictor of recanalization rate, time to recanalization or 3-month outcome in stroke patients following IV rt-PA. |
Question: Does septoplasty change the dimensions of compensatory hypertrophy of the middle turbinate?
Context: To measure the dimensions of compensatory hypertrophy of the middle turbinate in patients with nasal septal deviation, before and after septoplasty. The mucosal and bony structures of the middle turbinate and ... | The present study findings suggest that compensatory hypertrophy of the middle turbinate is not affected by septoplasty, even after one year. |
Question: Do ventricular arrhythmias in athletes subside over time?
Context: Sudden death in athletes can occur during sport activities and is presumably related to ventricular arrhythmias. To investigate the long-term follow-up ofathletes with ventricular arrhythmias during an exercise test. From a database of 56,462 ... | Athletes engaged in competitive sports are more likely to develop ventricular arrhythmias during exercise. These arrhythmias subside over time when athletes are engaged in non-competitive sports. |
Question: Is it Crohn's disease?
Context: Sulfasalazine is a widely used anti-inflammatory agent in the treatment of inflammatory bowel disease and several rheumatological disorders. Although as many as 20% of treated patients may experience reversible, dose-dependent side effects, less frequent but potentially severe,... | Granulomatous myelotoxicity and enteritis developed in a 21 year old female within 3 weeks of initiating sulfasalazine for rheumatoid arthritis. Following a short course of corticosteroids, the patient had resolution of her cholestatic hepatitis, rash, eosinophilia, and gastrointestinal symptoms with no residual manife... |
Question: Can dobutamine stress echocardiography induce cardiac troponin elevation?
Context: Elevation of cardiac troponin (cTn) is considered specific for myocardial damage. Elevated cTn and echocardiogrpahic documentation of wall motion abnormalities (WMAs) that were recorded after extreme physical effort raise the q... | Our results indicate that there is no elevation of cTn despite the occurrence of significant WMAs on DSE. We conclude that cTnI cannot be used as an additional diagnostic tool during pharmacological stress test performed to evaluate the presence and severity of ischemia. |
Question: Are there risk factors that increase the rate of staple line leakage in patients undergoing primary sleeve gastrectomy for morbid obesity?
Context: Laparoscopic sleeve gastrectomy (LSG) is currently being performed with increasing frequency worldwide. It offers an excellent weight loss and resolution of comor... | The results of the current study demonstrated that there are factors that increase the risk of a leakage which would enable surgeons to define risk groups, to more carefully select patients, and to offer a closer follow-up during the postoperative course with early recognition and adequate treatment. All future efforts... |
Question: Is eligibility for a chemotherapy protocol a good prognostic factor for invasive bladder cancer after radical cystectomy?
Context: To assess whether eligibility to an adjuvant chemotherapy protocol in itself represents a good prognostic factor after radical cystectomy for bladder cancer. Between April 1984 an... | These data suggest that being willing and fit enough for a chemotherapy protocol is a good prognostic factor for invasive bladder cancer. This eligibility bias emphasizes the need for prospective, randomized trials, and indicates that single-group studies using historical or matched controls have to be interpreted with... |
Question: Is anorectal endosonography valuable in dyschesia?
Context: Dyschesia can be provoked by inappropriate defecation movements. The aim of this prospective study was to demonstrate dysfunction of the anal sphincter and/or the musculus (m.) puborectalis in patients with dyschesia using anorectal endosonography. T... | Linear anorectal endosonography demonstrated incomplete or even absent relaxation of the anal sphincter and the m. puborectalis during a defecation movement in the majority of our patients with dyschesia. This study highlights the value of this elegant ultrasonographic technique in the diagnosis of "pelvic floor dyssyn... |
Question: Proof of concept study: does fenofibrate have a role in sleep apnoea syndrome?
Context: To investigate the effect of fenofibrate on sleep apnoea indices. Proof-of-concept study comprising a placebo run-in period (1 week, 5 weeks if fibrate washout was required) and a 4-week randomized, double-blind treatment ... | The consistent direction of change in sleep indices in this proof-of-concept study may support further investigation of fenofibrate in moderate to severe sleep apnoea syndrome. |
Question: Can clinical supervision sustain our workforce in the current healthcare landscape?
Context: Clinical supervision is widely recognised as a mechanism for providing professional support, professional development and clinical governance for healthcare workers. There have been limited studies about the effective... | The results of the study demonstrate that when clinical supervision uses best practice principles, it can provide professional support for allied health workers, even during times of rapid organisational change. |
Question: Are octogenarians at high risk for carotid endarterectomy?
Context: Several prospective randomized trials have proved carotid endarterectomy to be safe and effective for both symptomatic and asymptomatic patients younger than 80 years of age. Recently, carotid artery stenting (CAS) has been approved for use i... | Combined end points for adverse events are acceptable in the octogenarian. Carotid endarterectomy remains the gold standard for treatment of extracranial carotid disease in all age groups. Age alone should not place patients in the high-risk category for carotid endarterectomy. |
Question: Is the 7th TNM edition suitable for biological predictor in early gastric cancer?
Context: The clinical and prognostic value of the previous node classification of TNM staging in early gastric cancer (EGC) has been less definitive. The aim was to assess the suitability of the revised node staging for predicti... | Upstaging in EGC based on the revised TNM staging reflects more aggressive biological behavior of cancer. The new TNM staging system may be informative in prediction of biological behavior of EGC as well as prognosis and survival. |
Question: Does Residency Selection Criteria Predict Performance in Orthopaedic Surgery Residency?
Context: More than 1000 candidates applied for orthopaedic residency positions in 2014, and the competition is intense; approximately one-third of the candidates failed to secure a position in the match. However, the crite... | We found that USMLE Step 2, number of honors in medical school clerkships, and AOA membership demonstrated the strongest correlations with resident performance. Our goal in analyzing these data was to provide residency programs at large a sense of which criteria may be "high yield" in ranking applicants by analyzing da... |
Question: Estimation of basal metabolic rate in Chinese: are the current prediction equations applicable?
Context: Measurement of basal metabolic rate (BMR) is suggested as a tool to estimate energy requirements. Therefore, BMR prediction equations have been developed in multiple populations because indirect calorimetr... | To date, the newly developed Singapore equation is the most accurate BMR prediction equation in Chinese and is applicable for use in a large BMI range including those overweight and obese. |
Question: Are physicians meeting the needs of family caregivers of the frail elderly?
Context: To explore expressed needs, both formal and informal, of family caregivers of frail elderly. To evaluate roles of physicians. Questionnaire survey of members of the Montreal Jewish community providing care for frail elderly f... | Hypotheses for this discontent are presented. Physicians may be uninterested in helping caregivers; even if they were receptive to counseling caregivers, they could be poorly remunerated for the types of counseling sessions that are usual for caregivers; and being a professional caregiver to family caregivers is demand... |
Question: Screening for gestational diabetes mellitus: are the criteria proposed by the international association of the Diabetes and Pregnancy Study Groups cost-effective?
Context: The International Association of the Diabetes and Pregnancy Study Groups (IADPSG) recently recommended new criteria for diagnosing gestati... | The IADPSG recommendation for glucose screening in pregnancy is cost-effective. The model is most sensitive to the likelihood of preventing future diabetes in patients identified with GDM using postdelivery counseling and intervention. |
Question: The secular growth acceleration: does it appear during fetal life?
Context: To test if secular growth acceleration occurs during fetal life. ANOVA Kruskal-Wallis and Mann-Whitney U-test have been used for the biometric characteristics comparison of nowadays fetal population with those three decades ago and to... | Our investigation did not undoubtedly prove that significant changes of fetal biometric parameters occurred in the last three decades. It is possible that secular growth acceleration does not exist in prenatal period but also the observed time period could have been short for this phenomenon to manifest. |
Question: Predicting admission at triage: are nurses better than a simple objective score?
Context: In this single-centre prospective study, triage nurses estimated the probability of admission using a 100 mm visual analogue scale (VAS), and GAPS was generated automatically from triage data. We compared calibration usi... | GAPS, a simple clinical score, is a better predictor of admission than triage nurses, unless the nurse is sure about the outcome, in which case their clinical judgement should be respected. |
Question: Two-year follow-up survey of patients with allergic contact dermatitis from an occupational cohort: is the prognosis dependent on the omnipresence of the allergen?
Context: Skin diseases are the most frequently recognized occupational diseases in Denmark. The prognosis for occupational contact dermatitis is o... | At follow-up, patients with contact urticaria had significantly poorer prognosis than those with contact allergy, and there was a trend towards a poorer prognosis for those with contact allergy to rubber chemicals than those with allergy to epoxy. A significant positive association between job change and improvement wa... |
Question: Reporting and interpreting red blood cell morphology: is there discordance between clinical pathologists and clinicians?
Context: Clinical pathologists (CPs) report RBC morphologic (RBC-M) changes to assist clinicians in prioritizing differential diagnoses. However, reporting is subjective, semiquantitative, ... | Important differences about the clinical relevance of certain RBC-M terms exist between clinicians and CPs. Inclusion of interpretive comments on CBC reports is the clearest way to ensure that RBC-M changes are interpreted as intended by the CP. Reporting practices should be examined critically to improve communication... |
Question: Double reading of barium enemas: is it necessary?
Context: The purpose of our study was to determine the effectiveness, clinical impact, and feasibility of double reading barium enemas. Independent double readings of 1,003 consecutive barium enemas (822 double- and 181 single-contrast examinations) were prosp... | Although feasible, double reading of barium enemas does not improve sensitivity for detection of polyps and produces a higher false-positive rate. |
Question: Are pectins involved in cold acclimation and de-acclimation of winter oil-seed rape plants?
Context: The hypothesis was tested that pectin content and methylation degree participate in regulation of cell wall mechanical properties and in this way may affect tissue growth and freezing resistance over the cours... | The results show that the temperature-dependent modifications in pectin content and their methyl esterification degree correlate with changes in tensile strength of a leaf tissue, and in this way affect leaf expansion ability and its resistance to freezing and to fungus pathogens. |
Question: Does gestational age misclassification explain the difference in birthweights for Australian aborigines and whites?
Context: After 34 weeks gestation, summary measures of location for birthweight (e.g means and centiles) increase more slowly for Australian Aborigines than for whites. A similar pattern has bee... | Gestational age misclassification is an unlikely explanation for the reported divergence in average birth-weights for Aborigines and whites. The results might help with the interpretation of other between-population comparisons. |
Question: Does pediatric housestaff experience influence tests ordered for infants in the neonatal intensive care unit?
Context: To assess the relationship between the experience of pediatric housestaff and tests ordered on infants in the neonatal intensive care unit (ICU). Prospective, cohort study over one full acade... | Interns order significantly more arterial blood gases per infant than junior and senior residents on-call in the neonatal ICU. Additional study is required to see if the experience of housestaff is associated with a broader array of neonatal outcomes, such as morbidity and mortality. |
Question: Is there a correlation between androgens and sexual desire in women?
Context: For women, the correlation between circulating androgens and sexual desire is inconclusive. Substitution with androgens at physiological levels improves sexual function in women who experience decreased sexual desire and androgen de... | In the present study, FT and androstenedione were statistically significantly correlated with sexual desire in the total cohort of women. ADT-G did not correlate more strongly than circulating androgens with sexual desire and is therefore not superior to measuring circulating androgens by mass spectrometry. |
Question: Do patients with rheumatoid arthritis established on methotrexate and folic acid 5 mg daily need to continue folic acid supplements long term?
Context: It is postulated that some aspects of methotrexate toxicity may be related to its action as an anti-folate. Folic acid (FA) is often given as an adjunct to me... | It is important to continue FA supplementation over the long term in patients on methotrexate and FA in order to prevent them discontinuing treatment because of mouth ulcers or nausea and vomiting. Our data suggest that FA supplementation is also helpful in preventing neutropenia, with very little loss of efficacy of m... |
Question: Can 'high-risk' human papillomaviruses (HPVs) be detected in human breast milk?
Context: Using polymerase chain reaction techniques, we evaluated the presence of HPV infection in human breast milk collected from 21 HPV-positive and 11 HPV-negative mothers. Of the 32 studied human milk specimens, no 'high-risk... | This preliminary case-control study indicates the absence of mucosal 'high-risk' HPV types in human breast milk. |
Question: Amblyopia: is visual loss permanent?
Context: The records of 465 patients with an established diagnosis of age related macular degeneration who had attended a specialist macular clinic between 1990 and 1998 were scrutinised. A full clinical examination and standardised refraction had been carried out in 189 o... | Older people with a history of amblyopia who develop visual loss in the previously normal eye can experience recovery of visual function in the amblyopic eye over a period of time. This recovery in visual function occurs in the wake of visual loss in the fellow eye and the improvement appears to be sustained. |
Question: Is the combination with 2-methoxyestradiol able to reduce the dosages of chemotherapeutices in the treatment of human ovarian cancer?
Context: The endogenous estradiol metabolite, 2-methoxyestradiol (2ME), has been shown to be a potent inhibitor of cell growth and a strong anti-angiogenic substance. We invest... | 2ME is able to enhance the antiproliferative activity of certain chemotherapeutics at pharmacological relevant concentrations. This estradiol metabolite is currently in a phase II trial in patients with refractary metastatic breast cancer and the tolerability has been shown to be very good. The combination of 2ME with ... |
Question: Is motion perception deficit in schizophrenia a consequence of eye-tracking abnormality?
Context: Studies have shown that schizophrenia patients have motion perception deficit, which was thought to cause eye-tracking abnormality in schizophrenia. However, eye movement closely interacts with motion perception.... | Speed discrimination, per se, is not impaired in schizophrenia patients. The observed abnormality appears to be a consequence of impairment in generating or integrating the feedback information from eye movements. This study introduces a novel approach to motion perception studies and highlights the importance of concu... |
Question: Is the international normalised ratio (INR) reliable?
Context: As part of an MRC funded study into primary care oral anticoagulation management, INR measurements obtained in general practice were validated against values on the same samples obtained in hospital laboratories. A prospective comparative trial wa... | No technical problems associated with INR testing within primary care were uncovered. Discrepant INR results are as problematic in hospital settings as they are in primary care. These data highlight the failings of the INR to standardise when different techniques and reagents are used, an issue which needs to be resolv... |
Question: Longer term quality of life and outcome in stroke patients: is the Barthel index alone an adequate measure of outcome?
Context: To consider whether the Barthel Index alone provides sufficient information about the long term outcome of stroke. Cross sectional follow up study with a structured interview questio... | The place of the Barthel index as the standard outcome measure for populations of stroke patients is still justified for long term follow up, and may be a proxy for different outcome measures intended for the assessment of other domains. |
Question: Does responsibility affect the public's valuation of health care interventions?
Context: Health services often spend more on safety interventions than seems cost-effective. This study investigates whether the public value safety-related health care improvements more highly than the same improvements in contex... | Our results suggest that people do not attach a simple fixed premium to "safety-related" interventions but that preferences depend more subtly on context. The use of the results of such public preference surveys to directly inform policy would therefore be premature. |
Question: Is the determination of specific IgE against components using ISAC 112 a reproducible technique?
Context: The ImmunoCAP ISAC 112 is a fluoro-immunoassay that allows detection of specific IgE to 112 molecular components from 51 allergenic sources. We studied the reliability of this technique intra- and inter- ... | The allergen microarray immunoassay, ISAC 112, is a repeatable and reproducible in vitro diagnostic tool for determination of sIgE beyond the own laboratory. |
Question: Is endometrial polyp formation associated with increased expression of vascular endothelial growth factor and transforming growth factor-beta1?
Context: Endometrial polyp is a common cause of abnormal uterine bleeding, but the etiology and pathogenesis remain unclear. Vascular endothelial growth factor (VEGF)... | There was increased expression of TGF-β1 and VEGF in polyps compared to adjacent normal endometrial tissue. It suggested that these cytokines might play a role in endometrial polyp formation. In addition, there was a significant correlation between steroid receptor expression and VEGF and TGF-β1 expression. |
Question: Does feeding tube insertion and its timing improve survival?
Context: To examine survival with and without a percutaneous endoscopic gastrostomy (PEG) feeding tube using rigorous methods to account for selection bias and to examine whether the timing of feeding tube insertion affected survival. Prospective co... | Neither insertion of PEG tubes nor timing of insertion affect survival. |
Question: Is there a role for endothelin-1 in the hemodynamic changes during hemodialysis?
Context: 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... | Altered ET-1 levels may be involved in the pathogenesis of rebound hypertension and hypotension during HD. |
Question: Do cytokine concentrations in pancreatic juice predict the presence of pancreatic diseases?
Context: Cytokine concentration in pancreatic juice of patients with pancreatic disease is unknown. Secretin stimulation allows endoscopic collection of pancreatic juice secreted into the duodenum. We aimed to evaluate... | Cytokine levels can be measured in pancreatic juice obtained from the duodenum without direct cannulation of the pancreatic duct. Interleukin-8 concentration in pancreatic juice can be used to discriminate between normal pancreas and patients with pancreatic disease. This is a relatively simple and noninvasive method t... |
Question: Are UK radiologists satisfied with the training and support received in suspected child abuse?
Context: A list of telephone numbers of UK hospitals with a radiology department was obtained from the Royal College of Radiologists. One hundred hospitals were then randomly selected for inclusion in the survey. An... | The survey shows significant dissatisfaction amongst consultant radiologists with the current service, confirms a low number of paediatric radiologists taking on this work, and suggests the potential to increase numbers of radiology child abuse experts by 27% if given improved training and support. Appropriate service ... |
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