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Does OCT morphology provide indications for prognosis of visual acuity after venous occlusion? | Even though macular edema (ME) in patients with retinal vein occlusion (RVO) is resolved after intravitreal treatment with anti-vascular endothelial growth factor (VEGF), impairment of visual acuity (VA) often persists. A qualitative and quantitative evaluation of spectral domain optical coherence tomography (SD-OCT) i... | In patients with poor VA despite resolved ME the inner retinal layers up to the ELM were significantly thinner, which could be a sign of atrophy. Qualitative differences were seen at the photoreceptor level, which could be explained by ischemia or an involvement of the outer retina during initial ME that leads to perma... | closed_qa |
Do artisanal fishers perceive declining migratory shorebird populations? | This paper discusses the results of ethno-ornithological research conducted on the local ecological knowledge (LEK) of artisanal fishers in northeast Brazil between August 2013 and October 2014. The present study analyzed the LEK of 240 artisanal fishermen in relation to Nearctic shorebirds and the factors that may be ... | Changes in the local landscape related to urbanization and tourism are most likely the primary causes underlying the reduced migratory shorebird populations as reported by local inhabitants. Thus, managing and monitoring urbanization and tourism are fundamental to increasing the success of the migration process and imp... | closed_qa |
The orientation of transcription factor binding site motifs in gene promoter regions: does it matter? | Gene expression is to large degree regulated by the specific binding of protein transcription factors to cis-regulatory transcription factor binding sites in gene promoter regions. Despite the identification of hundreds of binding site sequence motifs, the question as to whether motif orientation matters with regard to... | Our results suggest that for the motifs considered here, either no specific orientation rendering them functional across all their instances exists with orientational requirements instead depending on gene-locus specific additional factors, or that the binding orientation of transcription factors may generally not be r... | closed_qa |
Cardiomyopathy in children: Can we rely on echocardiographic tricuspid regurgitation gradient estimates of right ventricular and pulmonary arterial pressure? | Introduction Agreement between echocardiography and right heart catheterisation-derived right ventricular systolic pressure is modest in the adult heart failure population, but is unknown in the paediatric cardiomyopathy population. All patients at a single centre from 2001 to 2012 with a diagnosis of cardiomyopathy wh... | Transthoracic echocardiography estimation of right ventricular systolic pressure shows modest correlation with right heart pressures, but has limited agreement and may underestimate the degree of pulmonary hypertension in paediatric cardiomyopathy patients. | closed_qa |
Implementation of tuberculosis infection control measures in designated hospitals in Zhejiang Province, China: are we doing enough to prevent nosocomial tuberculosis infections? | Tuberculosis (TB) infection control measures are very important to prevent nosocomial transmission and protect healthcare workers (HCWs) in hospitals. The TB infection control situation in TB treatment institutions in southeastern China has not been studied previously. Therefore, the aim of this study was to investigat... | TB infection control measures were generally implemented by the TB-designated hospitals. Measures including separation of suspected patients, regular monitoring of infection control practices, and regular fit testing of respirators should be strengthened. Infection measures for sputum collection and respirator fit test... | closed_qa |
Does the duration of symptoms influence outcome in patients with sciatica undergoing micro-discectomy and decompressions? | Early surgical treatment for back and leg pain secondary to disc herniation has been associated with very good outcomes. However, there are conflicting data on the role of surgical treatment in case of prolonged radicular symptomatology. We aimed to evaluate whether the duration of symptoms at presentation affects the ... | Our study showed significant improvement in patients with symptoms beyond 1 as well as 2 years since onset, and surgery is a viable option in selected patients. | closed_qa |
Is There a Consensus when Physicians Evaluate the Relevance of Retrieved Systematic Reviews? | A significant challenge associated with practicing evidence-based medicine is to provide physicians with relevant clinical information when it is needed. At the same time it appears that the notion of relevance is subjective and its perception is affected by a number of contextual factors. To assess to what extent phys... | There is no consensus among physicians with regards to what constitutes relevant clinical evidence for a given patient case. Subsequently, this finding suggests that evidence retrieval systems should allow for deep customization with regards to physician's preferences and contextual factors, including differences in th... | closed_qa |
Are current case-finding methods under-diagnosing tuberculosis among women in Myanmar? | Although there is a large increase in investment for tuberculosis control in Myanmar, there are few operational analyses to inform policies. Only 34% of nationally reported cases are from women. In this study, we investigate sex differences in tuberculosis diagnoses in Myanmar in order to identify potential health syst... | Our study, which is the first to systematically compile and analyse routine operational data from tuberculosis diagnostic centres in Myanmar, found that substantially fewer women than men were diagnosed in all study townships. The sex ratio of newly diagnosed cases varied by age group, month of diagnosis and township o... | closed_qa |
Can the follow-up of patients with papillary thyroid carcinoma of low and intermediate risk and excellent response to initial therapy be simplified using second-generation thyroglobulin assays? | In view of the low probability of recurrence, the cost-effective follow-up of patients with papillary thyroid carcinoma (PTC) of low or intermediate risk and excellent response to initial therapy represents a challenge. This study evaluated the cases of structural recurrence among these patients. The sample comprised 5... | Our results confirm that in patients with PTC of low or intermediate risk an excellent response to initial therapy can be defined based on nonstimulated Tg ≤ 0·2 ng/ml. Follow-up consisting only of clinical examination and periodic measurement of Tg with a second-generation assay may be sufficient. | closed_qa |
Abdominal compartment syndrome in traumatic hemorrhagic shock: is there a fluid resuscitation inflection point associated with increased risk? | The volume of fluid administered during trauma resuscitation correlates with the risk of abdominal compartment syndrome (ACS). The exact volume at which this risk rises is uncertain. We established the inflection point for ACS risk during shock resuscitation. Using the Glue Grant database, patients aged ≥16 years with ... | There is a dramatic rise in ACS risk after 1,302 mL/kg of fluid is administered. This plot could serve as a guide in limiting the ACS risk during resuscitation. | closed_qa |
Could transesophageal echocardiography be useful in selected cases during liver surgery resection? | Although only limited scientific evidence exists promoting the use of transesophageal echocardiography (TEE) in non cardiac surgery, several recent studies have documented its usefulness during liver surgery. In the present case study, through the use of color Doppler TEE, compression of the inferior vena cava and the ... | TEE should be encouraged in patients undergoing liver resection, not only for hemodynamic monitoring, but also for its ability to provide information about the anatomy of the liver, its vessels, and inferior vena cava patency. | closed_qa |
Is 3-hour cyclosporine blood level superior to trough level in early post-renal transplantation period? | Cyclosporine dose is traditionally based on trough blood levels. Cyclosporine trough blood level correlates poorly with acute rejection and cyclosporine nephrotoxicity after renal transplantation. We determined whether cyclosporine blood level at any other time point is superior to cyclosporine trough blood level as a ... | Cyclosporine blood level after 3 hours in the early post-transplantation period is associated with acute rejection and cyclosporine nephrotoxicity. A cyclosporine blood level range after 3 hours of 1,100 to 1,500 microg./l. is associated with an optimal outcome. Our data suggest that cyclosporine blood level after 3 ho... | closed_qa |
Lack of diagnostic tools to prove erectile dysfunction: consequences for reimbursement? | Oral medications for treatment of erectile dysfunction may drastically increase health care expenses. Therefore, reimbursement for treatment will be limited in many countries. Proof of erectile dysfunction on an individual basis may be required. We determine whether erectile dysfunction can be proved by pharmacostimula... | Erectile dysfunction could not be defined by pharmacostimulated erections but relevant erectile dysfunction was honestly reported. New and reliable tests for clinical assessment are required to support the application for reimbursement of treatment expenses for erectile dysfunction. | closed_qa |
Should vasectomy reversal be performed in men with older female partners? | An assumption exists that men with older female partners who seek treatment of post-vasectomy infertility should undergo in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) rather than vasectomy reversal. Although several studies have reviewed ICSI success rates with advancing maternal age, to our... | Vasectomy reversal appears to be cost-effective to achieve fertility in men with ovulating partners older than 37 years. | closed_qa |
Should the age specific prostate specific antigen cutoff for prostate biopsy be higher for black than for white men older than 50 years? | Investigators who have examined age specific reference ranges recommend a higher prostate specific antigen (PSA) cutoff for biopsy for black than for white men older than 50 years. We controlled for PSA to determine whether age specific reference range cutoffs for diagnosis defined by the Walter Reed Army Medical Cente... | Black men have similar or worse prostate cancer severity and outcome than white men with similar PSA ranges. Using age specific reference ranges for the PSA test defined by the Walter Reed group, black men have worse outcome than white men after radical prostatectomy. Therefore, we recommend that the PSA cutoff for bio... | closed_qa |
Is surgery for large hepatocellular carcinoma justified? | Most hepatocellular carcinomas are still discovered at an advanced stage and are left untreated as large hepatocellular carcinomas are contraindications to liver transplantation and percutaneous ethanol injection and are usually considered as poor indications for liver resection. The aim of this study was to reassess t... | Patients with large hepatocellular carcinomas should not be abandoned and should be considered for liver resection as this treatment may be associated with an in-hospital mortality rate and a long-term survival comparable to that observed after resection of small hepatocellular carcinomas. | closed_qa |
DSM-IV substance abuse and dependence: are there really two dimensions of substance use disorders in adolescents? | Data were collected using the 1995 Minnesota Student Survey. Survey items were designed to correspond to DSM-IV diagnostic criteria for substance abuse and dependence. Public schools, alternative schools and area learning centers. Of the 78,800 students between the ages of 14 and 18 years who completed the survey, 18,8... | The study findings indicate that DSM-IV substance abuse and dependence criteria may be more optimally structured as a unidimensional construct rather than as bidimensional constructs for adolescents. | closed_qa |
Complications in the first year of laparoscopic gastric banding: is it acceptable? | From December 1997 to December 1998, 25 laparoscopic adjustable silicone gastric banding (LASGB) procedures were done without previous experience in bariatric surgery. Body mass index (BMI) ranged from 37 to 57 kg/m2 (average 45.5 kg/m2). Retrospective analysis of the 1-year experience was done. Operating time was meas... | Despite lack of experience in bariatric surgery in these laparoscopic surgeons, the complications with LASGB appear to be acceptable. Although prior bariatric surgical experience is preferable. | closed_qa |
Fingerstick Helicobacter pylori antibody test: better than laboratory serological testing? | Antibody testing is the recommended method to screen for Helicobacter pylori (H. pylori) infection. Whole-blood fingerstick antibody tests are simple, in-office tests providing rapid results, but the accuracy of first-generation tests was lower than other diagnostic tests. We assessed a new whole-blood antibody test, u... | New generation in-office, whole-blood antibody tests that can achieve a sensitivity and specificity similar to or better than those of widely used quantitative laboratory serological tests may be used as the initial screening tests of choice for H. pylori. | closed_qa |
Mortality in rheumatoid arthritis: have we made an impact in 4 decades? | To evaluate trends in survival among patients with rheumatoid arthritis (RA) over the past 4 decades. Three population based prevalence cohorts of all Rochester, Minnesota, residents age>or =35 years with RA (1987 American College of Rheumatology criteria) on January 1, 1965, January 1, 1975, and January 1, 1985; and a... | The excess mortality associated with RA has not changed in 4 decades. Moreover, people with RA have not enjoyed the same improvements in survival experienced by their non-RA peers. More attention should be paid to mortality as an outcome measure in RA. | closed_qa |
Does social integration confound the relation between alcohol consumption and mortality in the Multiple Risk Factor Intervention Trial (MRFIT)? | It has been proposed that social integration would act as a confounder in the relationship between alcohol consumption and all-cause mortality. This study tested the assumption that the J-shaped relationship between drinking and all-cause mortality may partly reflect a protective effect of social integration, to the ex... | The MRFIT data fail to confirm a confounding effect of social integration. | closed_qa |
Prostaglandin E1: a new agent for the prevention of renal dysfunction in high risk patients caused by radiocontrast media? | Acute renal failure following the administration of radiocontrast media (RCM) is a complication found especially in patients with impaired renal function. Within the limits of a pilot study, the objective was to (a) show the effectiveness and compatibility of prostaglandin E(1) (PGE(1)=Alprostadil) in preventing acute ... | Results from this pilot-study suggest that intravenous PGE(1) may be used efficaciously and safely to prevent RCM-induced renal dysfunction in patients with pre-existing impaired renal function. | closed_qa |
Can nurses screen all outpatients? | This paper outlines and evaluates a nurse based model for screening outpatients that is utilized in our free standing Surgical Day Care Centre (SDCC). For 668 outpatients presenting at our SDCC, the attending anesthesiologist completed a study survey that was designed to identify: completeness of history; important con... | The use of the nurse based model allowed for the efficient use of anesthesia and surgical day care centre resources. The model was better at 'ruling out' patients who do not need to be seen by anesthesiology ahead of the day of surgery rather than 'ruling in' patients who need to be seen by anesthesiology. | closed_qa |
Surgical management of renal trauma: is vascular control necessary? | To assess in a randomized prospective manner nephrectomy rate, transfusion rate, blood loss, and time of operation in penetrating renal trauma patients randomized to vascular control or no vascular control before opening Gerota's fascia. During a 53-month period from January of 1994 to May of 1998, 56 patients with pen... | Vascular control of the renal hilum before opening Gerota's fascia has no impact on nephrectomy rate, transfusion requirements, or blood loss. Operative time may be increased with the vascular control technique. | closed_qa |
A preliminary investigation into the use of virtual environments in memory retraining after vascular brain injury: indications for future strategy? | In a preliminary investigation of the use of Virtual Environments (VEs) in neurorehabilitation, this study compares the effects of active and passive experience of a VE on two types of memory in vascular brain injury patients and controls. Forty-eight patients with vascular brain injury and 48 non-impaired control part... | The findings are discussed in relation to their implications for memory rehabilitation strategies. | closed_qa |
Should the patient with an interatrial defect recognized in adulthood always be operated on? | Atrial septal defect (ASD) can be recognized in adult age, mostly in asymptomatic or scarcely symptomatic patients. These patients differ from patients in "historical" clinical series, in whom diagnosis was done on the basis of clinical evidence, and their natural history is probably different. Our aim was to verify re... | In an adult population affected with asymptomatic or mildly symptomatic ASD and age at first diagnosis>or = 30 years, surgical closure of the defect did not modify morbidity and mortality at a mid-term follow-up. We suggest that, mostly in older asymptomatic patients, surgery should not be a routine choice and clinical... | closed_qa |
Parathyroid adenomas: is bilateral neck exploration necessary? | The traditional surgical treatment for primary hyperparathyroidism is bilateral neck exploration with identification of all parathyroid glands. Multiple investigators who recommend initial unilateral neck exploration based on more advanced localization studies have recently challenged this approach. We reviewed our exp... | Unilateral neck exploration based on the results of a T99mS scan can be used as an initial approach for primary hyperparathyroidism if the scan identifies a solitary lesion. The second gland on the same side of the lesion should be biopsied, and if it is normal, the opposite side of the neck may be left undisturbed. If... | closed_qa |
Does axillary dissection affect prognosis in T1 breast tumors? | The treatment of patients with breast cancer has undergone many revisions over recent decades. The current trend is toward limited resections and breast conservation. Some authors advocate the abandonment of axillary lymph node dissection (ALND) for small tumors. While it is accepted that ALND has no therapeutic effect... | ALND did not influence the ten-year survival or the recurrence rate. Tumor size was the only statistically significant and independent prognostic factor for T1 breast cancer patients. | closed_qa |
Pure stress leakage symptomatology: is it safe to discount detrusor instability? | To determine whether the combination of a urological history and urinary diary, with rigorous selection criteria, can be used to define a group of women on whom urodynamic assessment is unnecessary prior to offering surgery for urinary stress incontinence. Retrospective review of the urodynamic records of women attendi... | Genuine stress incontinence cannot be diagnosed reliably from a urological history, even when rigorous selection criteria are used in combination with a normal urinary diary. Without cystometry, incontinence secondary to detrusor instability will be missed. | closed_qa |
Is an ultrasound assessment of gestational age at the first antenatal visit of value? | To assess the efficacy of an ultrasound scan at the first antenatal visit. Randomised clinical trial. Women's and Children's tertiary level hospital, Adelaide, Australia. Six hundred and forty-eight women attending for their first antenatal visit at less than 17 weeks of gestation who had no previous ultrasound scan in... | A routine ultrasound assessment for dating offered to women at the first antenatal visit provides more precise estimates of gestational age and reduces the need to adjust the estimate of the date of delivery in mid-gestation. Women who had an ultrasound at the first visit reported more positive feelings about their pre... | closed_qa |
Does an inflatable obstetric belt facilitate spontaneous vaginal delivery in nulliparae with epidural analgesia? | To assess whether an inflatable obstetric belt, synchronised to apply uniform fundal pressure during a uterine contraction, reduces operative delivery rates when used in the second stage of labour. Randomised controlled trial. Five hundred nulliparae with a singleton cephalic pregnancy at term and with an epidural in l... | The inflatable obstetric belt did not significantly reduce operative delivery rates when used in this clinical setting in the second stage of labour. | closed_qa |
Isolated fetal echogenic intracardiac foci or golf balls: is karyotyping for Down's syndrome indicated? | To determine the prevalence of isolated echogenic intracardiac foci and the subsequent risk for Down's syndrome at 18-23 weeks in an unselected obstetric population. Prospective study. A district general hospital serving a routine obstetric population. 16,917 pregnant women who underwent a routine ultrasound screening ... | The significance of the association between isolated echogenic intracardiac foci and Down's syndrome is a matter of ongoing debate. The data of this study suggest that in an unselected obstetric population with prior, effective, routine Down's syndrome screening, the association between isolated echogenic intracardiac ... | closed_qa |
Preparation of the internal thoracic artery by vasodilator drugs: is it really necessary? | The internal thoracic artery has become the conduit of choice for coronary artery bypass grafting. To avoid spasm of the artery, and increases in its diameter and flow, various vasodilators have been used either intraluminally or by topical application by different surgeons. In order to define the best vasodilating age... | Within the limits of our study design, we suggest that preparation of the LITA by topical vasodilator drugs using a special applicator tube does not result in a significantly superior free flow than placebo. | closed_qa |
The medical review article revisited: has the science improved? | The validity of a review depends on its methodologic quality. To determine the methodologic quality of recently published review articles. Critical appraisal. All reviews of clinical topics published in six general medical journals in 1996. Explicit criteria that have been published and validated were used. Of 158 revi... | The methodologic quality of clinical review articles is highly variable, and many of these articles do not specify systematic methods. | closed_qa |
Does a glass of red wine improve endothelial function? | To examine the acute effect of red wine and de-alcoholized red wine on endothelial function. High frequency ultrasound was used to measure blood flow and percentage brachial artery dilatation after reactive hyperaemia induced by forearm cuff occlusion in 12 healthy subjects, less than 40 years of age, without known car... | After ingestion of red wine with alcohol the brachial artery dilated and the blood flow increased. These changes were not observed following the de-alcoholized red wine and were thus attributable to ethanol. These haemodynamic changes may have concealed an effect on flow-mediated brachial artery dilatation which did no... | closed_qa |
Does a completely accomplished duplex-based surveillance prevent vein-graft failure? | to assess the benefits of duplex-based vein-graft surveillance over clinical surveillance with distal pressure measurements. prospective randomised comparative trial. three hundred and forty-four patients with 362 consecutive infrainguinal vein bypasses were prospectively randomised to a follow-up regime with or withou... | intensive surveillance with duplex scanning did not improve the results of any outcome criteria examined. To demonstrate any potential benefit of duplex scanning for vein-graft surveillance a multicentre study with a large number of patients to ensure sufficient power is needed. | closed_qa |
Do prostaglandins have a salutary role in skeletal muscle ischaemia-reperfusion injury? | the effects of prostaglandins (PG) E1, E2, and the prostacyclin analogue iloprost with and without the addition of free-radical scavengers catalase and superoxide dismutase on gastrocnemius blood flow and oedema were studied in a rodent model of hindlimb ischaemia-reperfusion. male Sprague-Dawley rats underwent 6-h hin... | PGE1 and iloprost enhance muscle blood flow at 4-h reperfusion, though neither abolishes low reflow; PGE2 improved flow at 10 and 120 min but not after 240 min. This study demonstrates a potentially beneficial role for prostaglandins in improving muscle blood flow in skeletal muscle ischaemia-reperfusion injury. | closed_qa |
Occurrence of hippocampal sclerosis: is one hemisphere or gender more vulnerable? | We analyzed a large group of patients investigated for suspected seizures to test whether gender or side are important factors in the origins of hippocampal sclerosis (HS). We studied 996 consecutive patients (48% men, 52% women) by using standard hippocampal T2-relaxometry methods. HS was associated with a highly abno... | In patients with seizure disorders, hippocampal T2 relaxometry is not different in adult men and women and in the right and left hemispheres. | closed_qa |
Can interpectoral nodes be sentinel nodes? | This study was designed to determine if interpectoral nodes could be sentinel nodes for some breast cancers. Thirty-five consecutive breast cancer patients undergoing axillary node dissection had a dissection of the interpectoral nodes. These were sent to pathology as a separate specimen. Three patients were identified... | In upper quadrants or deep breast cancers the interpectoral nodes may be the earliest site of nodal metastasis. This may lead to false negative results in some sentinel node biopsies. | closed_qa |
Do subjects with asthma have greater perception of acute bronchoconstriction than smokers with airflow limitation? | Smokers who develop chronic airflow limitation (CAL) do not usually present for medical attention until their lung disease is well advanced. In contrast, asthmatic subjects experience acute symptoms and present for care early in the course of their disease. The aim of this study was to determine whether subjects with a... | In asthmatic subjects, symptoms are closely related to change in FEV1. In smokers with CAL, symptoms change little during bronchial challenge despite large changes in FEV1. The differences in perception between the two subject groups are not due to differences in acute hyperinflation during challenge. We propose that h... | closed_qa |
Is there a relationship between serum S-100beta protein and neuropsychologic dysfunction after cardiopulmonary bypass? | Over the past decade, the glial protein S-100beta has been used to detect cerebral injury in a number of clinical settings including cardiac surgery. Previous investigations suggest that S-100beta is capable of identifying patients with cerebral dysfunction after cardiopulmonary bypass. Whether detection of elevated le... | Despite using a sensitive immunoluminometric assay of S-100beta, we found no evidence to support the suggestion that early release of S-100beta may reflect long-term neurologic injury capable of producing cognitive impairment. | closed_qa |
Is herniography an effective and safe investigation? | The records of all patients undergoing herniography within one unit over a 1 year period were studied retrospectively. A follow-up postal questionnaire was sent out to all patients enquiring about outcome and any complications of herniography. From a total of 64 patients undergoing a herniogram, 36% were found to have ... | Herniography is a useful diagnostic tool for identification of clinically occult hernias, with good rates of sensitivity and specificity. In most cases it is a safe investigation but it is not without a significant complication rate. | closed_qa |
Does exchanging comments of Indian and non-Indian reviewers improve the quality of manuscript reviews? | The quality of peer reviewing in developing countries is thought to be poor. To examine whether this was so, we compared the performance of Indian and non-Indian reviewers who were sent original and review articles submitted to The National Medical Journal of India. We also tested whether informing reviewers that their... | We found that non-Indian peer reviewers were better than Indians and informing them that their views would be exchanged did not seem to affect the quality of their reviews. We suggest that Indian editors should also use non-Indian reviewers and start training programmes to improve the quality of peer reviews in India. | closed_qa |
Radiation exposure during fluoroscopy: should we be protecting our thyroids? | Recent reports on thyroid cancer among Australian orthopaedic surgeons prompted the present study which sought to evaluate the effectiveness of lead shielding in reducing radiation exposure (RE) to the thyroid region during endo-urological procedures. Radiation exposure to the thyroid region of the surgeon and scrubbed... | Although RE without thyroid shields did not exceed current standards set by radiation safety authorities, no threshold level has been set below which thyroid carcinogenesis is unlikely to occur. Because lead shields are easy to wear and can effectively reduce RE to the thyroid region to near-background levels, they sho... | closed_qa |
Gender differences in musculoskeletal injury rates: a function of symptom reporting? | This study determined gender differences in voluntary reporting of lower extremity musculoskeletal injuries among U.S, Marine Corps (USMC) recruits, and it examined the association between these differences and the higher injury rates typically found among women trainees. Subjects were 176 male and 241 female enlisted ... | Our results indicate that the higher injury rates often found in female military trainees may be explained by gender differences in symptom reporting. | closed_qa |
Minimally invasive saphenous vein harvesting: is there an improvement of the results with the endoscopic approach? | In the postoperative course after conventional open removal of the greater saphenous vein, wound healing disturbances are common and often painful. Therefore the primary goal of this investigation was to prove the safety and practicability of this new less invasive technique for saphenous vein harvesting and the effect... | Endoscopic saphenous vein harvesting as part of a less invasive concept in cardiac surgery is a safe and after the learning curve, fast alternative to harvest the saphenous graft. The cosmetic result is excellent and the complication rate seems to be lower. It must be noted however, that the cost effectiveness of the m... | closed_qa |
Endogenous mediators in emergency department patients with presumed sepsis: are levels associated with progression to severe sepsis and death? | We sought to determine whether levels of the endogenous mediators tumor necrosis factor (TNF)-alpha, interleukin (IL) 6, and nitric oxide (NO) measured in patients with presumed sepsis (systemic inflammatory response syndrome [SIRS] and infection) are different than levels in patients with presumed noninfectious SIRS, ... | ED patients admitted with presumed sepsis have elevated cytokine levels compared with patients with sepsis who are discharged and with those patients with presumed noninfectious SIRS. An association appears to exist between cytokines and subsequent septic complications in these patients. The importance of these measure... | closed_qa |
Angel trumpet: a poisonous garden plant as a new addictive drug? | Angel's trumpet (Species Brugmansia) is widely used as a garden plant because it is easily kept and the luxuriance of its flowering. Belonging to the Family Solanacea it contains a large amount of alkaloids (parasympatholytics). Because of its hallucinogenic action, its leaves and flowers are increasingly used by young... | The ingestion of even a few flowers of Angel's trumpet can cause symptoms of poisoning. Easy availability of the plant thus presents a danger. Because of the increasing incidence of deliberate ingestion by young people, poisoning by Angel's trumpet should be included in the differential diagnosis in patients with confu... | closed_qa |
Malacoplakia: a possible complication of poorly controlled diabetes mellitus? | A 47-year-old woman with poorly controlled diabetes mellitus (HbA1C 9.2%, fasting blood glucose>200 mg/dl) had complained of moderately severe stabbing pain in the left abdomen. On admission there were no abnormal findings on abdominal palpation. Abdominal ultrasound and computed tomography (CT) revealed a partly solid... | Even extensive malakoplakia can be successfully treated with ciprofloxacin. Poorly controlled diabetes together with a weak immune status (CD4/CD8<or = 1) may have favoured the occurrence of malakoplakia. | closed_qa |
Iodine deficiency in ambulatory participants at a Sydney teaching hospital: is Australia truly iodine replete? | To assess iodine status in four separate groups--pregnant women, postpartum women, patients with diabetes mellitus and volunteers. Prospective cross-sectional study at a tertiary referral hospital in Sydney. 81 pregnant women attending a "high risk" obstetric clinic; 26 of these same women who attended three months pos... | The high frequency of iodine deficiency found in our participants suggests that dietary sources of iodine in this country may no longer be sufficient. Further population studies are required. | closed_qa |
Co-infection with malaria and HIV in injecting drug users in Brazil: a new challenge to public health? | To describe AIDS and malaria geography in Brazil, highlighting the role of injecting drug users (IDUs) in malaria outbreaks occurring in malaria-free regions, and the potential clinical and public health implications of malaria/HIV co-infection. Review of the available literature and original analyses using geoprocessi... | New outbreaks of cases of HIV and malaria are likely to occur among Brazilian IDUs, and might conceivably contribute to the development of treatment-resistant strains of malaria in this population. Health professionals should be alert to this possibility, which could also eventually occur in IDU networks in developed c... | closed_qa |
Does the subspecialty of the surgeon performing primary colonic resection influence the outcome of patients with hepatic metastases referred for resection? | To compare resection rates and outcome of patients subsequently referred with hepatic metastases whose initial colon cancers were resected by surgeons with different specialty interests. Variation in practice among noncolorectal specialist surgeons has led to recommendations that colorectal cancers should be treated by... | Fewer patients referred by general surgeons had resectable liver disease. After surgery, recurrent tumor was more likely to develop in the GS group; their overall outcome was worse than that of the CS group. This observation is partly explained by a lower local recurrence rate in the CS group. | closed_qa |
Linked production of antibodies to mammalian DNA and to human polyomavirus large T antigen: footprints of a common molecular and cellular process? | To test whether the presence of antibodies to human polyomavirus large T antigen, a viral DNA-binding protein essential for productive polyomavirus replication, correlates with the presence of antibodies to single-stranded DNA (ssDNA), double-stranded DNA (dsDNA), or the autologous TATA-binding protein (TBP). Sera from... | A non-self DNA-binding protein such as human polyomavirus large T antigen may render DNA immunogenic upon binding to nucleosomes when expressed in vivo. This is indicated by the strong correlation between antibodies to T antigen and antibodies to DNA or TBP and is consistent with a hapten-carrier model. This model impl... | closed_qa |
Radicular pain caused by synovial cyst: an underdiagnosed entity in the elderly? | Synovial cyst is a recognized but infrequent cause of nerve root or spinal canal compression. The authors undertook a review of 839 decompressive spinal procedures performed over a 5-year period. They found seven cases in which the symptoms were caused by synovial cysts. Six of these cases were in a subgroup of 80 pati... | The authors propose that the incidence of synovial cysts may be more common than recognized in the elderly and suggest that preoperative diagnosis may help limit the extent of the surgical approach. | closed_qa |
Risk factors for the acquisition of genital warts: are condoms protective? | To characterise risk factors for the acquisition of genital warts and specifically to determine whether condoms confer protection from infection. A retrospective case-control study comparing demographic, behavioural, and sexual factors in men and women with and without newly diagnosed genital warts, who attended Sydney... | Independent risk factors for genital warts include younger age, greater number of lifetime sexual partners, and smoking. Consistent condom use significantly reduces the risk of acquiring genital warts. | closed_qa |
Cervical cytology: are national guidelines adequate for women attending genitourinary medicine clinics? | To study whether all women attending a genitourinary medicine (GUM) clinic warrant a cervical smear as part of a routine screen for infection, or whether this "at risk" population is adequately covered by the national screening programme. A cervical smear and a screen for sexually transmitted infections (STI) were take... | The national screening programme guidelines for cervical cytology should be followed in the GUM clinic. There is no benefit in performing extra smears outside the programme nor in adopting a policy of universal screening. | closed_qa |
Can children with autistic spectrum disorders perceive affect in music? | Children with autistic spectrum disorders typically show impairments in processing affective information within social and interpersonal domains. It has yet to be established whether such difficulties persist in the area of music; a domain which is characteristically rich in emotional content. Fourteen children with au... | In contrast to their performance within social and interpersonal domains, children with autistic disorders showed no deficits in processing affect in musical stimuli. | closed_qa |
Is there a role for pneumonectomy in pulmonary metastases? | Although sublobar and lobar resections are accepted operations for pulmonary metastases, pneumonectomy is viewed as a major incursion on Stage IV patients. We considered it important to ascertain the current results of pneumonectomy for pulmonary metastases since little information is available. Of the 5,206 patients w... | Pneumonectomies for pulmonary metastases, albeit infrequently performed, were associated with acceptable operative mortality and long-term survival when performed in selected patients amenable to complete resection. | closed_qa |
Cardiac surgery in octogenarians: can elderly patients benefit? | Increasing numbers of the very old are presenting for cardiac surgical procedures. There is little information about quality of life after hospital discharge in this group. From March 1995 to February 1997, 127 patients older than 80 years at operation (mean age, 83+/-2.5 years; range, 80 to 92 years) were entered into... | Octogenarians can undergo cardiac surgical procedures at a reasonable risk and show remarkable improvement in their symptoms. Elderly patients benefit from improved functional status and quality of life. | closed_qa |
Are older patients with mechanical heart valves at increased risk? | Controversy exists regarding the use of mechanical valves in older patients. Many authorities believe that the use of anticoagulants in the elderly is associated with an increased risk of warfarin-related complications. Therefore, we compared the results with mechanical valves in older patients to a cohort of younger p... | Mechanical valves perform well in selected older patients with no increased risk of bleeding or thromboembolism. | closed_qa |
Myocardial recovery after mechanical support for acute myocarditis: is sustained recovery predictable? | At present, myocardial recovery with mechanical support for acute myocarditis is a more frequently observed issue. However, predictive parameters of a sustained myocardial recovery are still under investigation. Two recent cases of mechanical support for acute lymphocytic myocarditis with two different outcomes are rep... | Long-lasting recovery after mechanical support for acute myocarditis remains unpredictable in our experience. More predictive factors are needed. | closed_qa |
Catastrophic hemorrhage on sternal reentry: still a dreaded complication? | To define the incidence of catastrophic hemorrhage (CH) during reoperations, the experience of the University of New Mexico was reviewed and compared with the practice of surgeons contacted by questionnaire. At the University of New Mexico, 610 reoperations were reviewed and 210 deemed high risk because of multiple reo... | The risk of CH could be as high as 1%. The sagittal micro oscillating saw is the safest reported to date. Presence of a conduit increases the risk by 2.5 fold. | closed_qa |
Can technetium 99m pyrophosphate be used to quantify myocardial injury in donor hearts? | There are no prospective methods available to quantify the myocyte injury in hearts prior to transplantation. The potential of the isotope labeled infarct marker 99m Technetium pyrophosphate (TcPPT) being used in this role was investigated. Brain death was induced by creating an extradural space occupying lesion in you... | TcPPT has the potential to quantify myocardial injury induced by brain death and its potential utility merits further investigation. | closed_qa |
Does sensitization to contact allergens begin in infancy? | Because previous studies have found allergic contact sensitization common in children by 5 years of age, our aim was to determine the prevalence of positive epicutaneous test results in children<5 years of age and to determine whether sensitization to contact allergens was as common in infancy. We recruited 95 asymptom... | Children as young as 6 months of age may be sensitized to contact allergens. Within this pediatric population, the prevalence of sensitization is 24.5%. Sensitization to contact allergens may occur in infants. | closed_qa |
Prostate-specific antigen: A surrogate endpoint for screening new agents against prostate cancer? | An endpoint for clinical trials of prostate cancer which simplifies traditional endpoints (response of measurable lesions, progression rates, and death) is urgently needed. This is especially true for hormone-unresponsive disease, for which many new drugs are presently in a development phase. This paper presents a rati... | Relatively small PSA-based trials in patients with hormone-unresponsive prostate cancer are possible if a similar patient population is utilized. As long as surrogacy is not established, such studies cannot be considered conclusive with respect to effectiveness of treatment, but are likely to be useful as a screening t... | closed_qa |
Neuroendocrine cells during human prostate development: does neuroendocrine cell density remain constant during fetal as well as postnatal life? | Knowledge concerning differentiation of neuroendocrine (NE) cells during development of the human prostate is rather fragmentary. Using immunohistochemistry combined with a morphometric method, we investigated the distribution and density of NE cells in the developing human prostate, with special emphasis on the topogr... | In the normal prostate, NE cell density probably remains constant in acini/ducts from fetuses to young adulthood. The presence of neuroendocrine cells in well-developed glandular structures at such an early fetal age and their absence in the less differentiated budding tips possibly indicates that differentiation of NE... | closed_qa |
Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health? | The role of nutritional influences on bone health remains largely undefined because most studies have focused attention on calcium intake. We reported previously that intakes of nutrients found in abundance in fruit and vegetables are positively associated with bone health. We examined this finding further by consideri... | The BMD results confirm our previous work (but at peripheral bone mass sites), and our findings associating bone resorption with dietary factors provide further evidence of a positive link between fruit and vegetable consumption and bone health. | closed_qa |
Is there an association between duration of untreated psychosis and 24-month clinical outcome in a first-admission series? | The authors examined the duration of untreated psychosis, defined as the interval from first psychotic symptom to first psychiatric hospitalization, in a county-wide sample of first-admission inpatients who had received no previous antipsychotic medication. Differences between diagnostic groups in 24-month illness cour... | Although these findings require replication in other epidemiologically based first-admission samples, at face value they do not support the suggestion of a psychotoxic effect of prolonged exposure to untreated psychosis. | closed_qa |
Is preinfarction angina related to the presence or absence of coronary plaque rupture? | To analyse the prodrome of acute myocardial infarction in relation to the plaque morphology underlying the infarct. A retrospective investigation of the relation between rupture and erosion of coronary atheromatous plaques and the clinical characteristics of acute myocardial infarction. The coronary arteries of 100 pat... | Plaque rupture causes the sudden onset of acute myocardial infarction or unstable preinfarction angina, which may be aggravated by smoking and inflammation. | closed_qa |
Management of heart failure among very old persons living in long-term care: has the voice of trials spread? | Increasing prevalence, use of health services, and number of deaths have made congestive heart failure (CHF) a new epidemic in the United States. Yet there are no adequate data to guide treatment of the more typical and complex cases of patients who are very old and frail. Using the SAGE database, we studied the cases ... | Patients in long-term care who have CHF little resemble to those enrolled in randomized trials. This circumstance may explain, at least in part, the divergence from pharmacologic management consensus guidelines. Yet the prescription of ACE inhibitors varies significantly across facilities and depends on organizational ... | closed_qa |
Does hysteroscopy facilitate tumor cell dissemination? | In several case reports, distension and irrigation of the uterine cavity during fluid hysteroscopy was suspected to cause tumor cell dissemination into the abdominal cavity in patients with endometrial carcinoma. It was the aim of this study to compare the incidence of positive peritoneal cytology in patients who under... | Based on the limited extent of endometrial carcinoma in the current analysis, our data strongly suggest dissemination of endometrial carcinoma cells after fluid hysteroscopy. Determining whether a positive peritoneal cytology affects the prognoses of patients without further evidence of extrauterine disease will requir... | closed_qa |
Sympathetic skin response in diabetic children: do diabetic children have diabetic neuropathy? | Abnormal sympathetic skin response (SSR) has been reported in adult patients with diabetic neuropathy. In addition, other studies have revealed abnormal SSR in diabetic patients not having autonomic symptoms and autonomic dysfunctions. These findings have been only obtained from adult patients. There have been few repo... | Diabetic neuropathy may not have occurred in young patients having shorter duration of illness. Conversely, assuming that prolonged latency is abnormal, it may even have occurred in them. Follow up on these patients with prolonged latencies would be required. | closed_qa |
Are the newer antidepressant drugs as effective as established physical treatments? | The aim of this study was to determine, in a clinical panel sample, the extent to which patients with depression (and melancholic and non-melancholic subtypes) judged the effectiveness of previously received antidepressant treatments, particularly the comparative effectiveness of the older and newer antidepressant drug... | Despite methodological limitations intrinsic to such clinical panel data, the judged greater effectiveness of the older antidepressants (tricyclics and irreversible MAOIs) for melancholic depression is of importance. If valid, such data are of intrinsic clinical relevance but also have the potential to inform us about ... | closed_qa |
Does syndrome X exist in hypertensive elderly persons with impaired glycemic control? | This report focuses on the glycemic state in relation to insulin and lipid levels of a cohort of elderly hypertensive persons to estimate the prevalence of syndrome X. A cross-sectional study was performed at the University of Tennessee, Memphis, and the General Clinical Research Center (GCRC) on 95 participants in the... | Our data demonstrated that in this cohort of elderly hypertensive participants with a high prevalence of central obesity, impaired glycemic control was common, but was not associated with fasting hyperinsulinemia or peripheral insulin resistance. Furthermore, we conclude that syndrome X essentially did not occur in the... | closed_qa |
Fish allergy: is cross-reactivity among fish species relevant? | Allergic reactions to fish are a common cause of food allergy in many areas of the world where fish is a major source of protein. Although different species of fish may be consumed, possible cross-reactivity has received limited investigation. The aim of this study was to assess potential cross-reactivity to different ... | Our results indicate that clinically relevant cross-reactivity among various species of fish may exist. Advising fish-allergic subjects to avoid all fish species should be emphasized until a species can be proven safe to eat by provocative challenge. | closed_qa |
Do eosinophil counts correlate differently with asthma severity by symptoms versus peak flow rate? | Discrepancy in asthmatic assessment by symptoms and peak flow rate (PFR) is a frequent dilemma. Currently, total peripheral eosinophil count (TPEC) is under study for asthma evaluation. To explore the correlation between TPEC and asthma severity assessed by symptoms alone versus symptoms and PFR. Adults asthmatics were... | The discrepancy between symptoms and PFR is confirmed by these results. A reliable objective parameter in asthma assessment is a continuous challenge. This study advocates the possible supplementation of TPEC as another objective parameter that might help in selecting the appropriate severity level in asthmatics. | closed_qa |
Do immunoassays differentially detect different acidity glycoforms of FSH? | The possibility of the carbohydrate residues of glycoproteins affecting their recognition in immunoassays is an important and unresolved issue. This study looked for evidence of differential recognition of FSH glycoform preparations, of variable isoelectric point (pI) and known molarity, using three routine assays empl... | Between the assay methods investigated in this study, few differences exist in the recognition of individual pI bands of FSH when expressed relative to a common unfractionated standard. Differences were apparent in the recognition of the different acidity glycoforms within each assay method, however, these were small a... | closed_qa |
Is high peritoneal transport rate an independent risk factor for CAPD mortality? | Is high peritoneal transport rate an independent risk factor for CAPD mortality? Patients with high peritoneal transport display the lowest serum albumin (SAlb) and the highest peritoneal protein loss. An association between high peritoneal membrane permeability and diabetes mellitus (DM) has been suggested. As malnutr... | DM was the most important risk factor for mortality on CAPD. A high peritoneal transport rate also predicted mortality, yet its role seems to be related to the presence of DM. The role of higher SCr predicting a better survival might have been associated with a better nutritional status. Hypoalbuminemia, previously sho... | closed_qa |
Expression of CD44 in uterine cervical squamous neoplasia: a predictor of microinvasion? | CD44, an integral membrane glycoprotein, may have an important role in early tumorigenesis, specifically, facilitating early tumor progression. Reports of the expression of CD44 in early uterine cervical squamous carcinogenesis are conflicting. We examined the expression of CD44 in microinvasive carcinoma of the cervix... | There is a qualitative and quantitative reduction in expression of CD44 in MIC and CIN 3 compared with CIN 1. Down-regulation of CD44 variants may occur later in neoplastic progression than CD44s. This pattern may reflect their important biological function in early progression by cervical cancer cells. Patchy and hete... | closed_qa |
Was the decreasing trend in hospital mortality from heart failure attributable to improved hospital care? | To assess the trend in risk-adjusted hospital mortality from heart failure. Oregon hospital discharge data from 1991 through 1995 were analyzed. A total of 29,530 hospitalizations because of heart failure in elderly patients (age>or = 65 years) were identified from International Classification of Diseases, 9th Revision... | There was a decreasing trend over time in the risk-adjusted hospital mortality rates from heart failure, which was not an artifact of decreasing length of stay. Our findings raised the possibility of improved hospital care for heart failure in Oregon. | closed_qa |
Is a third-trimester antibody screen in Rh+ women necessary? | To determine the need for routine third-trimester antibody screening in Rh+ women. An analytic case-control study. We identified Rh+ pregnant women who had received prenatal care and retrospectively analyzed their laboratory data. Patients were grouped into those with a positive third-trimester antibody screen (cases) ... | Based on the patient and hospital records studied, a repeat third-trimester antibody screen for Rh+ patients is clinically and economically unjustified. Eliminating this laboratory test from clinical practice will not adversely affect pregnancy outcomes and will decrease the costs of prenatal care. | closed_qa |
Do nursing home residents make greater demands on GPs? | The number of people residing in nursing homes has increased. General practitioners (GPs) receive an increased capitation fee for elderly patients in recognition of their higher consultation rate. However, there is no distinction between elderly patients residing in nursing homes and those in the community.AIM: To dete... | Our study suggests that nursing home residents do require a greater input from general practice than people of the same age and sex who are residing in the community. While consideration may be given to greater financial reimbursement of GPs who provide medical care to nursing home residents, consideration should also ... | closed_qa |
Does teaching during a general practice consultation affect patient care? | General practice differs from hospital medicine in the personal nature of the doctor-patient relationship and in the need to address social and psychological issues as well as physical problems. Recent changes in undergraduate medical education have resulted in more teaching and learning taking place in general practit... | The presence of a student has a complex effect on the general practice consultation. Future developments in medical education need to be evaluated in terms of how patient care is affected as well as meeting educational aims. | closed_qa |
Are postal questionnaire surveys of reported activity valid? | Postal questionnaire surveys are commonly used in general practice and often ask about self-reported activity. The validity of this approach is unknown.AIM: To explore the criterion validity of questions asking about self-reported activity in a self-completion questionnaire. A comparison was made between (a) the self-r... | There is a variable relationship between what responders report that they do in self-completion questionnaires, and what they actually do as judged by the contents of their patients' medical records. In the absence of prior, knowledge of the validity of questions on reported activity, or of concurrent attempts to estab... | closed_qa |
Underestimation of the small residual damage when measuring DNA double-strand breaks (DSB): is the repair of radiation-induced DSB complete? | To overcome the underestimation of the small residual damage when measuring DNA double-strand breaks (DSB) as fraction of activity released (FAR) by pulsed-field gel electrophoresis. The techniques used to assess DNA damage (e.g. pulsed-field gel electrophoresis, neutral elution, comet assay) do not directly measure th... | The expression of repair data in terms of FAR dramatically underestimates the amount of unrepaired DNA damage. The Blöcher model that takes into account the size distribution of radiation-induced DNA fragments should therefore be used to avoid this bias. Applied to a normal human fibroblast cell line, this model shows ... | closed_qa |
Contracting for quality: does length matter? | To examine whether longer-term contracts for health services will shift attention away from concern for finance and activity levels and towards the achievement of better quality services. Analysis of 288 contracts from the British National Health Service (NHS) and 12 semi-structured interviews with staff from provider ... | It is optimistic to expect longer-term contracts automatically to produce a greater focus on quality and the incentives needed to ensure that improvements in quality are delivered. However, this may not matter as issues of quality are being addressed more appropriately in the British NHS through a variety of other rout... | closed_qa |
Is radiation therapy a preferred alternative to surgery for squamous cell carcinoma of the base of tongue? | To evaluate irradiation alone for treatment of base-of-tongue cancer. Two hundred seventeen patients with squamous cell carcinoma of the base of tongue were treated with radiation alone and had follow-up for>/= 2 years. Local control rates at 5 years were as follows: T1, 96%; T2, 91%; T3, 81%; and T4, 38%. Multivariate... | The likelihood of cure after external-beam irradiation was related to stage, overall treatment time, and addition of a planned neck dissection. The local-regional control rates and survival rates after radiation therapy were comparable to those after surgery, and the morbidity associated with irradiation was less. | closed_qa |
Section of the sublingual frenulum. Are the indications correct? | To see the relationship of the lingual frenum with speech and other oral functions, evaluating the surgical indications and the results of frenectomy. In 1997 we operated 72 children with sublingual frenulum, a telephone questionnaire to the mothers of these patients was done, obtaining data about: age at surgery, prof... | The presence of a nondisturbing lingual frenulum does not justify its surgical section, the frenectomy is indicated only in presence of altered oro-lingual functions caused by the tongue-tie such as: speech problems, errors of bite and deglutition, lingual dysfunction and anomalous oral habits. | closed_qa |
Physician education and report cards: do they make the grade? | We sought to determine whether tailored educational interventions call improve the quality of care, as measured by the provision of preventive care services recommended by the US Preventive Services Task Force, as well as lead to better patient satisfaction. We performed a randomized controlled study among 41 primary c... | A physician-targeted approach of education, peer-comparison feedback, and academic detailing has modest effects on patient satisfaction and possibly on the offering of selected preventive care services. The lack of agreement between patient reports and medical records review raises concerns about current methods of asc... | closed_qa |
In-house referral: a primary care alternative to immediate secondary care referral? | Methods are needed to ensure that those patients referred from primary to secondary care are those most likely to benefit. In-house referral is the referral of a patient by a general practitioner to another general practitioner within the same practice for a second opinion on the need for secondary care referral. To de... | In-house referral is acceptable to patients and provides a straightforward method of addressing uncertainty over the need for referral from primary to secondary care. | closed_qa |
Do better quality consultations result in better health? | In theory, a positive relationship is expected between the quality of a consultation and a patient's subsequent health status. However, such a relationship has not yet been firmly established in daily practice. We aimed to study the relationship between the quality of the first consultation in a new episode of non-acut... | For the great majority of patients we found no relation between the quality of consultation and health status. However, for a very small subgroup of patients there is proof of benefit from better quality consultations. | closed_qa |
Development of a computer clinical instruction program. Is the game worth the candle? | Use of computers in medicine, as tools for information and education, is increasing. Many computer-assisted learning tools have been marketed. For clinician-teachers, computer-assisted learning offers interesting possibilities. Is this educational technology within the reach of family physicians? To describe developmen... | Developing a computerized learning tool is a worthwhile investment if the content has longevity; the learning process is highly interactive; there is a market for the product; and the tool is developed by a team of experienced, committed information technologists. | closed_qa |
Can sonographic signs predict long-term results of laparoscopic cholecystectomy? | To determine whether sonographic signs of the gallbladder can predict the long-term outcome of laparoscopic cholecystectomy (LC). All 346 patients, who underwent LC at our institution between January 1, 1993 and March 1, 1996, were interviewed using a structured questionnaire on the persistence of pre-operative abdomin... | This retrospective study showed that the sonographic sign of grit in the gallbladder is associated with a high relative risk for persistent abdominal symptoms after cholecystectomy. These findings will be re-evaluated in a prospective study to estimate the definitive clinical importance. | closed_qa |
Jugular phlebectasia in children: is it rare or ignored? | Phlebectasia of the jugular veins is a venous anomaly that usually presents in children as a soft cystic swelling in the neck during straining. The purpose of this report is to discuss the differential diagnosis, the methods of imaging, the mode of treatment, and to demonstrate some factors that have made us believe th... | Color Doppler sonography alone is sufficient for the diagnosis of jugular phlebectasia. The authors recommend surgical excision in asymptomatic cases for cosmetic and psychological purposes. The rarity of the lesion may be caused by a lack of knowledge among the related physicians and the tendency of reporting only sur... | closed_qa |
Alcoholics' selective attention to alcohol stimuli: automated processing? | This study investigated alcoholics' selective attention to alcohol words in a version of the Stroop color-naming task. Alcoholic subjects (n = 23) and nonalcoholic control subjects (n = 23) identified the color of Stroop versions of alcohol, emotional, neutral and color words. Manual reaction times (RTs), skin conducta... | These findings indicate that it is difficult for alcoholics to regulate their attention to alcohol stimuli, suggesting that alcoholics' processing of alcohol information is automated. | closed_qa |
Alcohol effects on movement-related potentials: a measure of impulsivity? | To assess the effects of acute alcohol intoxication on lateralized readiness potential (LRP), a central measure of movement-related brain activity, and the potential association of such effects with personality measures. Male volunteers (N = 12) alternated responding hands during a "go/no go" verbal recognition task ac... | Alcohol may result in disinhibition such that the "response execution" process is activated based on very preliminary stimulus evaluation. This alcohol-induced brain activity signaling premature motor preparation exhibited correlation trends with personality traits related to impulsivity, hyperactivity and antisocial t... | closed_qa |
Lower frequency of focal lip sialadenitis (focus score) in smoking patients. Can tobacco diminish the salivary gland involvement as judged by histological examination and anti-SSA/Ro and anti-SSB/La antibodies in Sjögren's syndrome? | Prospectively collected computer database information was previously assessed on a cohort of 300 patients who fulfilled the Copenhagen classification criteria for primary Sjögren's syndrome. Analysis of the clinical data showed that patients who smoked had a decreased lower lip salivary gland focus score (p<0.05). The ... | This is believed to be the first report showing that cigarette smoking is negatively associated with focal sialadenitis-focus score>1-in lower lip biopsy in patients with primary Sjögren's syndrome. Furthermore, tobacco seems to decrea | closed_qa |
Is routine procaine spirit application necessary in the care of episiotomy wound? | A randomised controlled trial to investigate the usefulness of local application of procaine spirit versus cleansing with water for care of episiotomy wound after normal vaginal delivery was conducted in 100 women. Fifty women entered the study arm and 50 entered the control arm of the study. Women in the two arms were... | It is concluded that in a woman with normal vaginal delivery, local application of procaine spirit is unnecessary in the care of a routine episiotomy wound. | closed_qa |
Is it necessary to biopsy the obvious? | The radiologist and oncologist are often confident that biopsy will confirm their suspicion of recurrent disease, but a biopsy is performed to confirm the histologic diagnosis before beginning or altering therapy. We have examined data to determine how often the biopsied lesion represents recurrent disease from the pri... | Of the patients for whom radiographic findings suggested recurrence, we found no patients in whom a new primary tumor would have been missed if biopsy had been avoided. Data should now be acquired prospectively to determine whether it may be prudent to make treatment decisions on the basis of imaging findings alone, wi... | closed_qa |
Improving the recognition and management of depression: is there a role for physician education? | Many patients who visit primary care physicians suffer from depression, but physicians may miss the diagnosis or undertreat these patients. Improving physicians' communication skills pertaining to diagnosing and managing depression may lead to better outcomes. We performed a randomized controlled trial involving 49 pri... | The Depression Education Program changed physicians' behavior and may be an important component in the efforts to improve the care of depressed patients. | closed_qa |
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