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Is vitamin D deficiency a feature of pediatric celiac disease?

To determine the vitamin D status of prepubertal children with CD.

Is vitamin D deficiency a feature of pediatric celiac disease?

Patients with a prior benign biopsy had more favorable pathologic features with more organ-confined (74% versus 64%; P<0.001) and less margin-positive (9.8% versus 18%) disease. Only 24 patients (12%) in the study group (versus 20% in control group; P = 0.01) had eventual evidence of biochemical failure. Kaplan-Meier analyses suggested that patients with prior benign biopsies have improved biochemical disease-free survival, especially for those with more aggressive disease (Gleason sum 7 or greater; P<0.01). Overall, patients in the study group had lower probability (odds ratio 0.57, P<0.001) of biochemical failure compared with those in the control group.

Is unsafe sexual behaviour increasing among HIV-infected individuals?

To evaluate whether reported unsafe sexual behaviour among HIV- infected individuals is changing over time.

Is unsafe sexual behaviour increasing among HIV-infected individuals?

The prevalence of SMI detected by myocardial SPECT was determined in 94 HIV-infected patients with a normal clinical cardiovascular examination in relation to anthropomorphic parameters, CRFs, inflammatory and HIV infection status, and treatment.

Cholestasis associated with small bowel atresia: do we always need to investigate?

With Research Ethics Board approval, patients with SBA between 1996 and 2005 were retrospectively reviewed. Demographics, location of atresia, operative findings, complications, investigations, resumption of feeding, duration of prolonged parental nutrition, and follow-up information were examined. Cholestasis was evaluated for incidence, severity, and evolution.

Cholestasis associated with small bowel atresia: do we always need to investigate?

There were 1,986 trauma presentations during the 6-year period. Patients presenting to a level III trauma center had a significantly higher risk of death than those presenting to the level I center, regardless of age, sex, ISS, or prehospital time. Peer review of deaths at the level III center identified problems in care delivery in 15 cases associated with technical errors, delay in decision making, or errors of judgement.

Are financial incentives cost-effective to support smoking cessation during pregnancy?

A total of 612 pregnant women randomized to receive usual cessation support plus or minus financial incentives of up to £400 vouchers (US $609), contingent upon smoking cessation.

Are financial incentives cost-effective to support smoking cessation during pregnancy?

To assess the results of transsphenoidal pituitary surgery in patients with Cushing's disease over a period of 18 years, and to determine if there are factors which will predict the outcome.

Can medical students contribute to quality assurance programmes in day surgery?

Students followed 621 cases, representing a sampling of 14. 1% day surgery cases. Categories of problems highlighted by students included inappropriate patient and procedure selection, inadequate pain management, discharge, communication and resource issues. Students made a number of recommendations including the development of multilingual videotapes and patient information sheets for non-English speaking patients, avoidance of bilateral surgical procedures and improved links with local medical officers. They also developed new guidelines and protocols.

Can medical students contribute to quality assurance programmes in day surgery?

In a study in France, breaching confidentiality in 48 scenarios were accepted by 144 lay people, 10 psychologists and 7 physicians. The scenarios were all possible combinations of five factors: severity of the disease (severe, lethal); time taken to discuss this with (little time, much time); intent to inform the spouse about the disease (none, one of these days, immediately); intent to adopt protective behaviours (no intent, intent); and decision to consult an expert in STDs (yes, no), 2 x 2 x 3 x 2 x 2. The importance and interactions of each factor were determined, at the group level, by performing analyses of variance and constructing graphs.

Measurement of head and neck paragangliomas: is volumetric analysis worth the effort?

Thirty tumours, including carotid body, vagal body, jugulotympanic tumours and conglomerates of multiple tumours, were measured in duplicate, using linear dimensions, manual area tracing and an automated segmentation method.

Measurement of head and neck paragangliomas: is volumetric analysis worth the effort?

There were no significant differences between the groups regarding early hemodynamic results or complication rates.

Three-dimensional ultrasound-validated large-core needle biopsy: is it a reliable method for the histological assessment of breast lesions?

A median of two core samples per lesion provided for all the lesions a sensitivity for malignancy of 96.9%, specificity of 100%, false-positive rate of 0% and false-negative rate of 3.1%, and for the excised lesions a sensitivity of 96.5%, specificity of 100%, false-positive rate of 0%, false-negative rate of 3.5% and an underestimation rate of 3.4%.

Three-dimensional ultrasound-validated large-core needle biopsy: is it a reliable method for the histological assessment of breast lesions?

To examine whether p53 tumour suppressor gene alterations can be used to predict tumour response to pre-operative chemo-radiation in locally advanced rectal cancer in terms of reduction in tumour size and local failure.

Can bone thickness and inter-radicular space affect miniscrew placement in posterior mandibular sites?

In this retrospective study, 100 individuals were selected for orthodontic treatment at a radiology clinic. Cone-beam computed tomography data were imported into 3-dimensional software. The predictor variable was the location in the mandible and insertion angle. The demographic variables collected included age, gender, and malocclusion (Angle Classes I and II). The primary outcome variables were bone thickness and inter-radicular space. The inter-radicular spaces were evaluated 5 mm from the cement-enamel junction. The bone thicknesses were taken at 45°, 60°, and 90° in relation to the alveolar ridge, simulating a miniscrew insertion. These factors were evaluated for sexual dimorphism and malocclusion (Angle Classes I and II). Sexual dimorphism and malocclusion were evaluated with t tests. To compare the inter-radicular space and the thickness of bone between areas, an analysis of variance for repeated measures was used.

Can bone thickness and inter-radicular space affect miniscrew placement in posterior mandibular sites?

This was a randomized controlled exploratory trial carried out in a rural teaching institution. In all, 200 eclampsia cases, carrying ≥34 weeks, were allocated to either cesarean or vaginal delivery. Composite maternal and perinatal event rates (death and severe morbidity) were compared by intention-to-treat principle.

Do general practice selection scores predict success at MRCGP?

Selection into general practice training is undertaken using a competency based approach. The clear advantage of this approach over traditional methods has been demonstrated through evaluation of its validity and reliability. However, the relationship between selection and performance in the Royal College of General Practitioner examinations (MRCGP) has yet to be explored. The MRCGP comprises of an applied knowledge test (AKT), a clinical skills assessment (CSA) and workplace-based assessments (WPBA).AIM: To explore the predictive validity of general practice selection scores using the AKT and CSA elements of the MRCGP as a final outcome measure.

Do general practice selection scores predict success at MRCGP?

The cumulative primary patency was 60.3% at 1 year and 48.4% at 3 years. The limb salvage rate was 68.6% at 1 and at 3 years.

The Deformity Angular Ratio: Does It Correlate With High-Risk Cases for Potential Spinal Cord Monitoring Alerts in Pediatric 3-Column Thoracic Spinal Deformity Corrective Surgery?

In patients undergoing 3-column osteotomies, sagittal curve magnitude and total curve magnitude were associated with increased incidence of transcranial motor evoked potential changes. Total DAR greater than 45° per level and sagittal DAR greater than 22° per level were associated with a 75% incidence of a motor evoked potential alert, with the incidence increasing to 90% with sagittal DAR of 28° per level.

The Deformity Angular Ratio: Does It Correlate With High-Risk Cases for Potential Spinal Cord Monitoring Alerts in Pediatric 3-Column Thoracic Spinal Deformity Corrective Surgery?

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

Does age moderate the effect of personality disorder on coping style in psychiatric inpatients?

To examine age-related differences in the relationship between personality and coping strategies in an Australian population of psychiatric inpatients.

Does age moderate the effect of personality disorder on coping style in psychiatric inpatients?

Both groups were similar in baseline characteristics. There were no significant differences in gonadotropin requirement, cancellation rate, and number of embryos transferred. Ongoing pregnancy rates (40% vs. 15%) were significantly higher in the OCP/ML group. Trends toward greater number of oocytes retrieved (7.7 ± 3.4 vs. 5.9 ± 4.2) and improved implantation rates (20% vs. 12%) were also noted, but these did not reach statistical significance.

Autoxidation products of both carbohydrates and lipids are increased in uremic plasma: is there oxidative stress in uremia?

Advanced glycation end products (AGEs), formed by non-enzymatic glycation and oxidation (glycoxidation) reactions, have been implicated in the pathogenesis of several diseases, including normoglycemic uremia. AGE research in uremia has focused on the accumulation of carbohydrate-derived adducts generated by the Maillard reaction. Recent studies, however, have demonstrated that one AGE, the glycoxidation product carboxymethyllysine (CML), could be derived not only from carbohydrates but also from oxidation of polyunsaturated fatty acids in vitro, raising the possibility that both carbohydrate and lipid autoxidation might be increased in uremia.

Autoxidation products of both carbohydrates and lipids are increased in uremic plasma: is there oxidative stress in uremia?

Seventy-five patients were recruited over a period of 5 months. Overall, the weighted kappa showed relatively poor concordance between the patient and physician responses; mean kappa: 0.33 (range 0.18-0.57). The physician underestimated QoL score in 4/9 domains by a mean of 5.5% and overestimated QoL score in 5/9 domains by a mean of 6.9%. In particular, physicians underestimated the impact of LUTS on social limitations and emotions (P<0.05).

Can 'high-risk' human papillomaviruses (HPVs) be detected in human breast milk?

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.

Can 'high-risk' human papillomaviruses (HPVs) be detected in human breast milk?

Concussions are commonly diagnosed in pediatric patients presenting to the emergency department (ED). The primary objective of this study was to evaluate compliance with ED discharge instructions for concussion management.

Quaternary cytoreductive surgery in ovarian cancer: does surgical effort still matter?

We systematically evaluated all consecutive patients undergoing QC in our institution over a 12-year period (October 2000-January 2012). All relevant surgical and clinical outcome parameters were systematically assessed.

Quaternary cytoreductive surgery in ovarian cancer: does surgical effort still matter?

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.

Chemotherapy and survival in advanced non-small cell lung carcinoma: is pneumologists' skepticism justified?

We enrolled 190 patients (157 men and 33 women) with a mean (SD) age of 61.75 (10.85) years (range, 33-85 years). Of these patients, 144 received cytostatic treatment and 46 palliative treatment. The median survival was 31 weeks and was related to absence of weight loss (hazard ratio [HR], 1.73; 95% confidence interval [CI], 1.26-2.39; P=.001), cytostatic treatment (HR, 1.85; 95% CI, 1.25-2.76; P=.002), and ECOG score of 0 to 1 (HR, 2.84; 95% CI, 1.62-5.00; P=.0001). In patients with ECOG scores of 0 to 1, weight loss and treatment were significant prognostic factors. Survival in the ECOG 2 group was 15 weeks for patients undergoing cytostatic treatment and 11 weeks for patients with symptomatic treatment.

Chemotherapy and survival in advanced non-small cell lung carcinoma: is pneumologists' skepticism justified?

Nasal Polyposis (NP) is defined as a chronic inflammatory disease of sinonasal mucosa leading to diffuse formation of benign polyps. Although family histories are frequently suggested in medical literature, no specific study focused on this point has been reported. The purpose of this study is to determine whether a hereditary factor could be implied for NP in a family where several members were affected. We included 99 members of this family.

Does topical ropivacaine reduce the post-tonsillectomy morbidity in pediatric patients?

To determine whether post-operative administration of topical ropivacaine hydrochloride decreases morbidity following adenotonsillectomy.

Does topical ropivacaine reduce the post-tonsillectomy morbidity in pediatric patients?

Twenty-six ASA I-III patients scheduled for elective lower limb surgery were randomized to receive a parasacral sciatic block, using a nerve stimulator technique seeking either a tibial (n = 14) or peroneal (n = 12) motor response. After the evoked motor response was obtained, a solution of 10 mL 2% lidocaine with epinephrine and 10 mL 0.75% ropivacaine (actual final concentration of epinephrine, 1/160,000) was slowly injected through the needle. Sensory and motor blocks were assessed every 5 min for 30 min by an anesthesiologist blinded to the elicited motor response. If the block was not complete 30 min after injection of the local anesthetics, it was considered as failed, and general anesthesia was supplemented.

Is pain a clinically relevant problem in general adult psychiatry?

Using a questionnaire we investigated in a cross-sectional study the prevalence of pain, duration of pain, impairment and unfitness for work due to pain in 106 patients primarily diagnosed with a psychiatric disorder in the field of general adult psychiatry. Potential risk factors were explored.

Is pain a clinically relevant problem in general adult psychiatry?

We collected data on influenza vaccination, frequency and timing of healthcare visits, and self-reported compliance with a potential provider recommendation for vaccination during the 2009-2010 influenza season. "Missed opportunities" for seasonal influenza vaccination in office-based settings were defined as the number of unvaccinated respondents who reported at least one healthcare visit in the Fall and Winter of 2009-2010 and indicated their willingness to get vaccinated if a healthcare provider strongly recommended it. "Potential vaccine uptake" was defined as the sum of actual vaccine uptake and "missed opportunities."

Does concomitant anterior/apical repair during midurethral sling improve the overactive bladder component of mixed incontinence?

This is a retrospective cohort study of women with bothersome MUI (defined by objective stress test and validated questionnaire) undergoing MUS alone ("MUS-only") or concomitant MUS and AA repair ("MUS + AA"). Our primary outcome was the Overactive Bladder Questionnaire Symptom Severity (OAB-q SS) change score 6 weeks after surgery.

Does concomitant anterior/apical repair during midurethral sling improve the overactive bladder component of mixed incontinence?

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

Does the use of atypical antipsychotics as adjunctive therapy in depression result in cost savings?

To estimate healthcare costs and utilization of AAPs compared to other second-line agents.

Does the use of atypical antipsychotics as adjunctive therapy in depression result in cost savings?

We analysed data from the EURODIAB Prospective Complications Study, a European multicentre prospective cohort study. Standardized 3-day dietary records were employed in individuals with type 1 diabetes. One thousand one hundred and two patients (553 men, 549 women, baseline age 33 ± 10 years, duration 15 ± 9 years) had complete nutritional data available at baseline and after 7 years. We calculated mean differences in reported nutrients over time and adjusted these for age, gender, HbA1c and BMI with ANOVA models.

Can patients be anticoagulated after intracerebral hemorrhage?

For patients with prior lobar ICH, withholding anticoagulation therapy was strongly preferred, improving quality-adjusted life expectancy by 1.9 QALYs. For patients with prior deep hemispheric ICH, withholding anticoagulation resulted in a smaller gain of 0.3 QALYs. In sensitivity analyses for patients with deep ICH, anticoagulation could be preferred if the risk of thromboembolic stroke is particularly high.

Can patients be anticoagulated after intracerebral hemorrhage?

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

Diagnostic and therapeutic ureteroscopy: is dilatation of ureteral meatus always necessary?

Among the 306 ureteroscopies studied, 286 performed in 256 patients were analyzed. Median age was 50 years (16-83), 59% of patients were male, and elective ureteroscopy was performed in 183 patients (64%). Group 1: 191 ureteroscopies, Group 2: 95 ureteroscopies. Stone location: 149 in distal ureter, 60 in middle ureter, and 35 in proximal ureter. Sixty-nine percent of stones had sizes ranging from 5 and 10 mm. The overall success rate was 86.5%. There were 5 peroperative and 22 postoperative complications, with no statistically significant differences between the groups.

Diagnostic and therapeutic ureteroscopy: is dilatation of ureteral meatus always necessary?

Fourteen pre-menopausal and 16 post-menopausal women who presented with abnormal bleeding with endometrial polyps.

Does managed care enable more low income persons to identify a usual source of care?

By requiring or encouraging enrollees to obtain a usual source of care, managed care programs hope to improve access to care without incurring higher costs.

Does managed care enable more low income persons to identify a usual source of care?

Of the 154 patients, 14 patients developed new-onset atrial fibrillation with a higher mean age of 67.1 years (+/-8.8 years) versus 56.4 years (+/-14.1 years) (p = 0.006). Laparoscopic (p = 0.004) and nonthoracic surgeries (p = 0.01) were associated with lower risk of atrial fibrillation. Patients with atrial fibrillation had received more fluid (6.5 +/- 2.8 liters versus 5.3 +/- 2.0 liters) and had longer operations (370 +/- 103 min versus 362 +/- 142 min), none of which were statistically significant. The average intensive care length of stay of patients was longer: 7.5 +/- 6.8 days versus 4.0 +/- 7.1 days (p = 0.004). Multivariate analysis revealed an association of atrial fibrillation with age (OR 1.08, 95% CI 1.02-1.14, p = 0.01), and laparoscopic surgery (OR 0.09, 95% CI 0.01-0.95, p = 0.04) after adjusting for surgery type.

Knee extensor strength, dynamic stability, and functional ambulation: are they related in Parkinson's disease?

Knee extensor strength positively correlated with dynamic postural stability and negatively correlated with disease severity. Further, dynamic postural stability was negatively correlated to disease severity and positively correlated with functional ambulation in this cohort of patients with PD (P<.05). The results also suggest that the Functional Reach Test may be a valuable assessment tool to examine postural stability in PD.

Knee extensor strength, dynamic stability, and functional ambulation: are they related in Parkinson's disease?

After each seminary, an evaluation form concerning participants' satisfaction with the course was filled in. Furthermore, all course participants received a questionnaire at the beginning and at the end of the course, as well as 3 months afterwards. The participants were asked to assess their own sense of security in seven different communication settings on a visual analog scale, and to specify perceived changes in their communication behavior 3 months after the course.

Is distance to provider a barrier to care for medicaid patients with breast, colorectal, or lung cancer?

Driving distances and times from patient residence to primary care provider were calculated for 3,917 breast, colorectal (CRC) and lung cancer Medicaid patients in Washington State from 1997 to 2003 using MapQuest.com. We fitted regression models of stage at diagnosis and time-to-treatment (number of days between diagnosis and surgery) to test the hypothesis that travel burden is associated with timely diagnosis and treatment of cancer.

Is distance to provider a barrier to care for medicaid patients with breast, colorectal, or lung cancer?

Higher benefits are linked to lower disability rates. Among all single elderly individuals, 30 percent have mobility limitations, and an increase of $100 per month in the maximum SSI benefit caused the rate of mobility limitations to fall by 0.46 percentage points. The findings were robust to sensitivity analyses. First, analyses limited to those most likely to receive SSI produced larger effects, but analyses limited to those least likely to receive SSI produced no measurable effect. Second, varying the disability measure did not meaningfully alter the findings. Third, excluding the institutionalized, immigrants, individuals living in states with exceptionally large benefit changes, and individuals living in states with no SSI supplements did not change the substantive conclusions. Fourth, Medicaid did not confound the effects. Finally, these results were robust for married individuals.

Can folic acid protect against congenital heart defects in Down syndrome?

Several studies have suggested a protective effect of folic acid (FA) on congenital heart anomalies. Down syndrome (DS) infants are known to have a high frequency of heart anomalies. Not all children with DS suffer from heart anomalies, which raises the question whether maternal factors might affect the risk of these anomalies. Our objectives were to investigate whether first-trimester FA use protects against heart anomalies among DS children.

Can folic acid protect against congenital heart defects in Down syndrome?

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 18-item questionnaire was successfully administered to consultant radiologists from 84 departments.

Are there mental health differences between francophone and non-francophone populations in manitoba?

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

Are there mental health differences between francophone and non-francophone populations in manitoba?

The patients involved were schizophrenic or bipolar, mostly young men with a history of addictive disorders and regular gambling prior to the prescription of aripiprazole. For each one of them, the causality of aripiprazole was considered, using an algorithm. The probability that pathological gambling is actually due to aripiprazole is "possible" in 7 cases out of 8, and "doubtful" in one.

Does type 1 diabetes mellitus affect Achilles tendon response to a 10 km run?

Participants were 7 individuals with T1DM and 10 controls. All regularly ran distances greater than 5 km and VISA-A scores indicated good tendon function (T1DM = 94 ± 11, control = 94 ± 10). There were no diabetic complications and HbA1c was 8.7 ± 2.6 mmol/mol for T1DM and 5.3 ± 0.4 mmol/mol for control groups. Baseline tendon structure was similar in T1DM and control groups - UTC echo-types (I-IV) and anterior-posterior thickness were all p > 0.05. No response to load was seen in either T1DM or control group over the 4-days post exercise.

Does type 1 diabetes mellitus affect Achilles tendon response to a 10 km run?

Seroma is the most frequent complication in abdominoplasty. Some patients are more prone to develop this complication. Ultrasound is a well-known method with which to diagnose seroma in the abdominal wall. The purpose of this study was to verify the efficacy of the use of quilting suture to prevent seroma.

Fragility of the esophageal mucosa: a pathognomonic endoscopic sign of primary eosinophilic esophagitis?

Five men underwent endoscopy because of dysphagia confirmed (clinically, endoscopically, and histologically) to be caused by primary eosinophilic esophagitis and were treated by bouginage.

Fragility of the esophageal mucosa: a pathognomonic endoscopic sign of primary eosinophilic esophagitis?

Observational study. We analyzed data from the Spanish National Health Surveys conducted in 2001 (n=21,058), 2003 (n=21,650), 2006 (n=29,478) and 2009 (n=22,188). We included responses from adults aged 65 years and older.

Does cup-cage reconstruction with oversized cups provide initial stability in THA for osteoporotic acetabular fractures?

At 1 year the median proximal migration was 0.83 mm (range, 0.09-5.13 mm) and sagittal rotation was 1.3° (range, 0.1°-7.4°). Three of the 10 components had migration above the suggested limits for primary THA at 1 year postoperatively. The contact surface achieved at surgery between the acetabular component and pelvis ranged from 11 to 17 cm(2) (15%-27% of each component).

Does cup-cage reconstruction with oversized cups provide initial stability in THA for osteoporotic acetabular fractures?

We performed a cross-sectional study among elderly out-patients (≥60 years) in Buenos Aires, Argentina randomly recruited from a government funded health clinic. The correct endorsement of intention to call 911 was assessed with the Stroke Action Test and the cut-off point was set at ≥75%. Knowledge of stroke and clinical and socio-demographic indicators were also collected and evaluated as predictors of correct endorsement using logistic regression.

Pulmonary valve replacement in adults late after repair of tetralogy of fallot: are we operating too late?

We studied 25 consecutive adult patients who underwent PVR for significant PR late after repair of TOF. Radionuclide angiography was performed in all at a mean of 8.2 months (+/- 8 months) before PVR and repeated at a mean of 28.0 months (+/- 22.8 months) after the operation. Right ventricular (RV) end-systolic volume (RVESV), RV end-diastolic volume (RVEDV) and RV ejection fraction (RVEF) were measured.

Pulmonary valve replacement in adults late after repair of tetralogy of fallot: are we operating too late?

The identification of the most suspect enhancing part of a lesion is regarded as a major diagnostic criterion in dynamic magnetic resonance mammography. Computer-aided diagnosis (CAD) software allows the semi-automatic analysis of the kinetic characteristics of complete enhancing lesions, providing additional information about lesion vasculature. The diagnostic value of this information has not yet been quantified.

Xanthogranulomatous cholecystitis: a premalignant condition?

Xanthogranulomatous cholecystitis (XGC) is an uncommon variant of chronic cholecystitis, characterized by marked thickening of the gallbladder wall and dense local adhesions. It often mimics a gallbladder carcinoma (GBC), and may coexist with GBC, leading to a diagnostic dilemma. Furthermore, the premalignant nature of this entity is not known. This study was undertaken to assess the p53, PCNA and beta-catenin expression in XGC in comparison to GBC and chronic inflammation.

Xanthogranulomatous cholecystitis: a premalignant condition?

Epidemiologic studies investigating the relationship between appendectomy and infertility or ectopic pregnancy were identified by searching the MEDLINE database from 1966 to 1997. Appropriate citations were also extracted from a manual search of the bibliographies of selected papers.

Does TDP-43 type confer a distinct pattern of atrophy in frontotemporal lobar degeneration?

In this case-control study, we identified all subjects with a pathologic diagnosis of FTLD with TDP-43 immunoreactive inclusions (FTLD-TDP) and at least one volumetric head MRI scan (n = 42). In each case we applied published criteria for subclassification of FTLD-TDP into FTLD-TDP types 1-3. Voxel-based morphometry was used to compare subjects with each of the different FTLD-TDP types to age- and gender-matched normal controls (n = 30). We also assessed different pathologic and genetic variants within, and across, the different types.

Does TDP-43 type confer a distinct pattern of atrophy in frontotemporal lobar degeneration?

Twenty patients had occult or obscure gastrointestinal bleeding. The source of bleeding was identified in 15/20 (75%): multiple angiodysplasias in four, arterial-venous malformation beyond the ligament of Treitz in two that could be treated with injection successfully. Other diagnoses included: duodenal adenocarcinoma, jejunal tuberculosis, erosions and ulcer of the jejunum. Of 24 patients with other indications, the diagnosis could be achieved in 18 of them (75%), including: two lymphomas, plasmocytoma, Gardner's syndrome, Peutz-Jeghers' syndrome, familial adenomatous polyposis, Behçet's disease, jejunal submucosal lesion, lymphangiectasia due to blastomycosis and unspecific chronic jejunitis. Of three cases with Roux-en-Y reconstruction, two underwent DBE in order to perform biopsies of the excluded duodenum. Additionally, two patients underwent DBE to exclude Crohn's disease and lymphoma of the small bowel. The mean length of small bowel examination was 240 +/- 50 cm during a single approach. The diagnostic yield was 75% (33/44 cases) and therapeutic yield was 63.6%. No major complications were observed, only minor complication such as sore throat in 4/44 (9.1%).

Is oncoplastic surgery a contraindication for accelerated partial breast radiation using the interstitial multicatheter brachytherapy method?

At the time of data acquisition, 131 of 134 patients were alive. The median follow-up time was 39 months (range, 4-106 months). After high-dose rate treatment, 3 of 89 patients showed systemic progress after a mean follow-up of 47 months (range, 19-75 months) and 2 patients had a different quadrant in-breast tumor after 27 and 35 months. One patient died 7 months after treatment of unknown causes. After pulse dose rate treatment, 1 of 45 patients had a local recurrence after 42 months and 1 patient died because of another cause after 13 months. We observed mild fibrosis in 27 breasts, telangiectasia in 6, hyperpigmentation in 14 cases, and keloid formation in 1.

Is oncoplastic surgery a contraindication for accelerated partial breast radiation using the interstitial multicatheter brachytherapy method?

University Hospital Wales, the Royal Gwent Hospital, and East Glamorgan General Hospital. Laboratory work was conducted at the Institute of Nephrology.

Diagnostic characteristics of child bipolar I disorder: does the "Treatment of Early Age Mania (team)" sample generalize?

Subjects (N = 247) were outpatients who participated in either the National Institute of Mental Health-funded Phenomenology and Course of Pediatric Bipolar Disorders study or the Treatment of Early Age Mania (TEAM) study. Both studies required that subjects have current DSM-IV bipolar I disorder (manic or mixed phase) and a Children's Global Assessment Scale (CGAS) score<or=60. All subjects had elation and/or grandiosity. Subjects in the Phenomenology study were obtained from 1995 to 1998 by consecutive new case ascertainment from designated pediatric and psychiatric facilities. Subjects in the TEAM RCT were recruited from media and community sources between March 2003 and March 2005. Assessment instruments included the Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia, given separately to parents about their children and to children about themselves, and the CGAS. Logistic regression was used for comparisons.

Diagnostic characteristics of child bipolar I disorder: does the "Treatment of Early Age Mania (team)" sample generalize?

Both medical therapy and laparoscopic antireflux surgery have been shown to improve quality of life in gastro-oesophageal reflux disease. Although patients with poor symptom control or side effects on medical therapy might be expected to have improved quality of life after surgery, our aim was to determine, for the first time, whether patients whose symptoms are well controlled on medical therapy but who decide to undergo surgery (patient preference) would experience improved quality of life.

Estimation of basal metabolic rate in Chinese: are the current prediction equations applicable?

The equation developed from our data was: BMR (kJ/d) = 52.6 x weight (kg) + 828 x gender + 1960 (women = 0, men = 1; R(2) = 0.81). The accuracy rate (within 10 % accurate) was 78 % which compared well to Owen (70 %), Henry (67 %), Mifflin (67 %), Liu (58 %), Harris-Benedict (45 %) and Yang (37 %) for the whole range of BMI. For a BMI greater than 23, the Singapore equation reached an accuracy rate of 76 %. Cross-validation proved an accuracy rate of 80 %.

Estimation of basal metabolic rate in Chinese: are the current prediction equations applicable?

A total of 80,565 Papanicolaou (Pap) smears underwent RPS during a 25-month period. A sample was designated as "review for abnormality" (R) if any abnormal cells (at the threshold of atypical squamous cells of undetermined significance/atypical glandular cells [AGC]) were thought to be present or was designated as negative (N) if none were detected. Each sample then underwent full screening (FS) and was designated as either R or N and also given a cytologic interpretation.

Does rugby headgear prevent concussion?

To examine the attitudes of players and coaches to the use of protective headgear, particularly with respect to the prevention of concussion.

Does rugby headgear prevent concussion?

This prospective, randomized, double-blind study was designed to determine and compare the usefulness of preloading colloids (Haemaccel) 10 ml/Kg before positioning whether it can prevent hemodynamic changes during seated positioning or not.

Spinal subdural hematoma: a sequela of a ruptured intracranial aneurysm?

A case of spinal subdural hematoma (SSDH) following subarachnoid hemorrhage (SAH) because of a ruptured internal carotid aneurysm is described. Such a case has never been reported.

Spinal subdural hematoma: a sequela of a ruptured intracranial aneurysm?

Answers showed a large variety in clinical practices among breast surgeons across the country. There was little intraoperative margin analysis; only 48% of surgeons examine the margins grossly with a pathologist and even fewer used frozen sections or imprint cytology. Decisions to reexcise specific margins varied greatly. For example, 57% of surgeons would never reexcise for a positive deep margin, but 53% would always reexcise for a positive anterior margin. Most importantly, there was a large range in answers about acceptable margins with ductal carcinoma in situ and invasive carcinoma. Fifteen percent of surgeons would accept any negative margin, 28% would accept a 1-mm negative margin, 50% would accept a 2-mm negative margin, 12% would accept a 5-mm negative margin, and 3% would accept a 10-mm negative margin.

Can shape analysis differentiate free-floating internal carotid artery thrombus from atherosclerotic plaque in patients evaluated with CTA for stroke or transient ischemic attack?

Follow-up imaging confirmed sixteen FFT+ and seven FFT- cases. Five shape descriptors delineated FFT+ from FFT- cases. The logistic regression model produced from combining all five shape features demonstrated a sensitivity of 87.5% and a specificity of 71.4% with an area under the ROC curve = 0.85 ± 0.09. Average accuracy for each classifier ranged from 65.2%-76.4%.

Can shape analysis differentiate free-floating internal carotid artery thrombus from atherosclerotic plaque in patients evaluated with CTA for stroke or transient ischemic attack?

Tethering of the spinal cord is thought to increase the chance of neurological injury when scoliosis correction is undertaken. All patients with myelomeningocele (MM) are radiographically tethered, and untethering procedures carry significant morbidity risks including worsening neurological function and wound complications. No guidelines exist as regards untethering in patients with MM prior to scoliosis correction surgery. The authors' aim in this study was to evaluate their experience in patients with MM who were not untethered before scoliosis correction.

Dementia and aphasia in motor neuron disease: an underrecognised association?

To determine the prevalence and nature of global cognitive dysfunction and language deficits in an unselected population based cohort of patients with motor neuron disease (MND).

Dementia and aphasia in motor neuron disease: an underrecognised association?

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

Does solid culture for tuberculosis influence clinical decision making in India?

To investigate the impact of solid culture on Löwenstein-Jensen medium on clinical decision making.

Does solid culture for tuberculosis influence clinical decision making in India?

This study included 438 VPS procedures, 49 in which an endoscope was used (11.2%) and 389 in which an endoscope was not used (88.8%). The infection rates in these 2 main groups were calculated and compared. Subsequently, 4 new groups were created, composed of patients with a shunt inserted for the first time (groups 1A and 1B) and patients with a shunt reviewed or inserted for a second time (groups 2A and 2B). Groups 1A and 2A comprised patients in whom an endoscope was used simultaneously with VPS surgery, and groups 1B and 2B comprised patients in whom an endoscope was not used. These groups were compared to determine the infection rate.

Diffusion-weighted echo-planar MR imaging of primary parotid gland tumors: is a prediction of different histologic subtypes possible?

In 136 patients, a primary parotid gland tumor was confirmed by histology. Among the observers, a high correlation was calculated (0.98). ADC values of pleomorphic adenomas were significantly higher than those of all other entities, except for myoepithelial adenomas (P = .054). ADC values of Warthin tumors were different from those of myoepithelial adenomas, lipomas, and salivary duct carcinomas (P<.001, 0.013, and .037, respectively). Mucoepidermoid carcinomas, acinic cell carcinomas, and basal cell adenocarcinomas were not differentiable from Warthin tumors (P = .094, .396, and .604, respectively).

Diffusion-weighted echo-planar MR imaging of primary parotid gland tumors: is a prediction of different histologic subtypes possible?

Post hoc analysis of data from a proof-of-concept, double-blind, randomized study of 134 adult patients treated with esomeprazole (10 or 40 mg od for 4 weeks) for LA grade C or D oesophagitis. A curve was fitted to pooled 24-h intragastric pH (day 5) and endoscopically assessed healing (4 weeks) data using piecewise quadratic logistic regression.

Is there a role for endothelin-1 in the hemodynamic changes during hemodialysis?

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

Is there a role for endothelin-1 in the hemodynamic changes during hemodialysis?

Prognostic evaluation of Auer IV DNA histograms with respect to the high versus low S + G2/M fraction, obtained by image cytometry on consecutive breast cancer imprint preparations.

Do risk factors for suicidal behavior differ by affective disorder polarity?

After controlling for age of onset, there were no differences in prior suicide attempts by polarity although bipolar participants had more prior severe attempts. During follow-up, 40 cycles ended in suicide and 384 cycles contained at least one suicide attempt. Age, hopelessness and active substance abuse but not polarity predicted suicidal behavior. The effects of risk factors did not differ by polarity.

Do risk factors for suicidal behavior differ by affective disorder polarity?

The older group had more driving errors than the younger group, in both the manual and the automatic transmission car. However, and contrary to the younger drivers, automatic transmission improved the older participants' driving behavior as demonstrated by safer speed adjustment in urban areas, greater maneuvering skills, safer lane position and driving in accordance with the speed regulations.

Multidisciplinary breast cancer clinics. Do they work?

The authors found that the MDBCC increased patient satisfaction by encouraging involvement of patients' families and friends and by helping patients make treatment decisions (P<0.001). The time between diagnosis and the initiation of treatment was also significantly decreased (42.2 days vs. 29.6 days; P<0.0008).

Multidisciplinary breast cancer clinics. Do they work?

The purpose of this study was to determine whether operative volume outweighs the advantages of being treated locally by comparing the outcomes of patients with rectal cancer treated at local, low-volume centers versus far, high-volume centers.

Is the international normalised ratio (INR) reliable?

405 tests were performed. Comparison between results obtained in the practices and those in the reference hospital laboratory (gold standard), which used the same method of testing for INR, showed a correlation coefficient of 0.96. Correlation coefficients comparing the results with the various standard laboratory techniques ranged from 0.86 to 0.92. It was estimated that up to 53% of tests would have resulted in clinically significant differences (change in warfarin dose) depending upon the site and method of testing. The practice derived results showed a positive bias ranging from 0.28 to 1.55, depending upon the site and method of testing.

Is the international normalised ratio (INR) reliable?

On review of the 19 moles, 53% (10/19) were diploid nonpartial moles (initially pathologically misclassified), and 37% (7/19) were triploid partial moles (initial ploidy misclassifications). One additional case (5%) was a diploid early complete mole (initially pathologically misclassified).

Are there associations of health status, disease activity and damage in SLE patients?

A total of 36 women and 2 men were included in the study (median age: 43 yrs, median disease duration: 11 yrs). Increased disease activity (total BILAG) was shown to be significantly correlated with reduced physical function. A greater damage (total SDI) correlated significantly with reduced role function due to emotional limitations. Neither age nor disease duration showed any significant correlation with health status in this study.

Are there associations of health status, disease activity and damage in SLE patients?

Comparison of the US measurements of the 2 radiologists performing the US tests did not show any interobserver difference (r = 0.981; P<.001). We therefore believe our results are objective and reproducible. We found a positive correlation between the rectal diameters and the age, height, weight, and bladder capacity. The posturination mean rectal diameter was thicker in the constipated group (3.02 ± 1.04 cm) than in the control group (1.98 ± 0.64 cm) (P<.001). The cutoff point of rectal diameter for a diagnosis of constipation was determined as 2.44 cm (71% sensitive; 76% specific; area under curve, 0.825; P<.001). The rectal anterior wall thickness and fecal load were higher in the constipated patients (P<.001). There was a significant decrease in the constipation score and fecal load after treatment for a month (P<.001), but the rectal diameter had not reached normal limits yet despite the decrease (2.71 ± 0.77 cm) (P>.05).

PSA repeatedly fluctuating levels are reassuring enough to avoid biopsy?

The study involved 211 patients who underwent at least a second biopsy after a first negative prostate biopsy. PSA Slope, PSA velocity (PSAV) and PSA doubling time (PSADT) were estimated. Flu-PSA level was defined as a PSA series with at least one PSA value lower than the one immediately preceding it.

PSA repeatedly fluctuating levels are reassuring enough to avoid biopsy?

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

Is zero central line-associated bloodstream infection rate sustainable?

Adoption and implementation of evidence-based measures for catheter care leads to reductions in central line-associated bloodstream infection (CLABSI) rates in the NICU. The purpose of this study is to evaluate whether this rate reduction is sustainable for at least 1 year and to identify key determinants of this sustainability at the NICU of the Floating Hospital for Children at Tufts Medical Center.

Is zero central line-associated bloodstream infection rate sustainable?

Current risk assessment models for surgical site occurrence (SSO) and surgical site infection (SSI) after open ventral hernia repair (VHR) have limited external validation. Our aim was to determine (1) whether existing models stratify patients into groups by risk and (2) which model best predicts the rate of SSO and SSI.

Is gastric electrical stimulation superior to standard pharmacologic therapy in improving GI symptoms, healthcare resources, and long-term health care benefits?

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

Is gastric electrical stimulation superior to standard pharmacologic therapy in improving GI symptoms, healthcare resources, and long-term health care benefits?

Of 379 patients referred to the clinic, 129 (34%) were given a non-stroke diagnosis. Of the remaining 250 patients, 149 (60%) were<or =75 years. Median time from symptom onset to clinic appointment was similar for the two groups (24 (IQR 15-42) vs 24 (IQR 14-43) days; p = 0.58). Older patients were more likely to be in atrial fibrillation (10.1% vs 22.8%, p<0.001) and have lacunar stroke (34.7% vs 22.1%; p = 0.04). CT rates were similar in the two groups (27.8% vs 80.0%, p = 0.75). Scans were performed more quickly in younger patients (p<0.01). MRI scan rates were higher in younger patients (26% vs 4%, p<0.01), as was carotid Doppler imaging (92% vs 77%, p<0.01). There were no differences in prescribed secondary preventive treatments. Older patients experienced less delay for carotid endarterectomy (49 vs 90 days, p<0.01). Younger patients were more likely to be given advice on weight reduction (30.2% vs 12.9%, p<0.01) and diet (46.3% vs 31.7%, p = 0.02) than older patients.

Should pulp chamber pulpotomy be seen as a permanent treatment?

Seventeen patients, aged 7-54 years (mean of 37.2 year), were treated by pulpotomy and filling with ProRoot MTA(®) in premolar or molar teeth with vital pulps and without clinical evidence of irreversible pulpitis. The patients were then followed up for 12 to 24 months and the teeth then assessed by clinical and radiographic examination. Statistical analysis was performed with Kaplan-Meier survival probability statistics to estimate the survival of the treated teeth.

Should pulp chamber pulpotomy be seen as a permanent treatment?

The Prospective Urban Rural Epidemiology study in the North West Province, South Africa, started in 2005 and included African volunteers (n = 1994; aged>30 years) from a sample of 6000 randomly selected households in rural and urban areas.