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Gastroesophageal reflux in neurologically impaired children: partial or total fundoplication?
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Our results show that there is no statistical difference between the two procedures in terms of relative risk of complication and success rate. The duration of surgery and hospital stay were significantly shorter in group B. The Thal procedure can, therefore, be proposed as first choice in the management of these patients.
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"Our results show that there is no statistical difference between the two procedures in terms of relative risk of complication and success rate. The duration of surgery and hospital stay were significantly shorter in group B. The Thal procedure can, therefore, be proposed as first choice in the management of these patients."
] |
It is difficult to give guidelines when approaching gastroesophageal disease in neurologically impaired children. Indication for surgery has been increasing over recent years, but there is no consensus on the surgical technique of choice. Nothing has been written specifically comparing the results of different procedures in these patients, so far. We retrospectively compare the short- and long-term results of two different types of fundoplication in a series of children operated on for documented gastroesophageal reflux disease at our institution. One group (group A) of 27 patients, operated on between 1977 and 1993, underwent Nissen fundoplication, the other (group B), formed of 20 patients all of whom were operated on between 1993 and 1995, underwent Thai fundoplication. We compared the results in terms of positive outcome (recovery) and negative outcome (minor and major complication), computing the relative odds of group A versus group B in terms of risk of complication, and we compared the mean operative time and the length of hospital stay by means of a student's t-test analysis.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 52-words sample answer on a PubMed discussion board to the following question: Gastroesophageal reflux in neurologically impaired children: partial or total fundoplication?.
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Anxiety symptom presentations in Han Chinese and Euro-Canadian outpatients: is distress always somatized in China?
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Despite the exploratory nature of this study, the results suggest that the popular notion of 'Chinese somatization' should not be over-generalized. Our findings also imply that there may be important differences in the cultural understanding of depression and anxiety in both Chinese and 'Western' contexts. Future studies should seek to unpack potential cultural explanations for why Euro-Canadian outpatients may emphasize somatic symptoms in the presentation of anxiety to a greater degree than Chinese outpatients.
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"Despite the exploratory nature of this study, the results suggest that the popular notion of 'Chinese somatization' should not be over-generalized. Our findings also imply that there may be important differences in the cultural understanding of depression and anxiety in both Chinese and 'Western' contexts. Future studies should seek to unpack potential cultural explanations for why Euro-Canadian outpatients may emphasize somatic symptoms in the presentation of anxiety to a greater degree than Chinese outpatients."
] |
Cultural variations in the relative emphasis on somatic versus psychological symptoms of distress are a common topic in cultural psychopathology. The most well-known example involves people of Chinese heritage, who are found to emphasize somatic symptoms in presenting depression as compared with people of Western European heritage. It remains unknown whether a similar cultural difference is found for anxiety disorders. Euro-Canadian (n79) and Han Chinese (n154) psychiatric outpatients with clinically significant concerns about both depression and anxiety were selected from a larger dataset based on their responses to a structured interview. They also completed two self-report questionnaires assessing somatization of depression and anxiety. As expected, Chinese participants reported a greater tendency to emphasize somatic symptoms of depression, as compared to the Euro-Canadians. Contrary to expectations, the tendency to emphasize somatic symptoms of anxiety was higher among the Euro-Canadians as compared to the Chinese participants. Characteristics of our participants limit the generalizability of our findings. The current study is preliminary and requires replication.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 74-words sample answer on a PubMed discussion board to the following question: Anxiety symptom presentations in Han Chinese and Euro-Canadian outpatients: is distress always somatized in China?.
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Is there an association between hiatal hernia and ineffective esophageal motility in patients with gastroesophageal reflux disease?
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Despite the prevalence of esophageal dysmotility in the hiatal hernia group being higher than that in the group without hiatal hernia, the association between these variables in individuals with gastroesophageal reflux disease disappeared when controlling for age, esophagitis, altered pH-metry, and altered low esophageal sphincter, leading us to believe that in these patients, hiatal hernia is not an independent risk factor for dysmotility.
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"Despite the prevalence of esophageal dysmotility in the hiatal hernia group being higher than that in the group without hiatal hernia, the association between these variables in individuals with gastroesophageal reflux disease disappeared when controlling for age, esophagitis, altered pH-metry, and altered low esophageal sphincter, leading us to believe that in these patients, hiatal hernia is not an independent risk factor for dysmotility."
] |
The pathophysiology of gastroesophageal reflux disease is multifactorial, where esophageal motility is one of the factors implicated in its genesis. However, there is still no consensus on the existence of an association between esophageal dysmotility and hiatal hernia in patients with gastroesophageal reflux disease. The objective of this study was to establish the prevalence of esophageal dysmotility in patients with hiatal hernia and to determine if herniation is a factor related to esophageal dysmotility in patients with gastroesophageal reflux disease. The study included 356 patients with a clinical diagnosis of gastroesophageal reflux disease submitted to upper digestive endoscopy and esophageal functional diagnostics. Hiatal hernia was defined endoscopically by a distance equal to or greater than 2 cm between the diaphragmatic constriction and the squamocolumnar junction and esophageal dysmotility when the esophageal manometry identified the amplitude of the peristaltic waves in the distal esophagus as30 mmHg and/or less than 80 of effective contractions. For univariate statistical analysis, the patients were divided into two groups: with and without hiatal hernia. Poisson regression models were used to estimate crude and adjusted prevalence ratios (PR) of esophageal dysmotility according to hiatal hernia. Gastroesophageal reflux disease patients with hiatal hernia had a prevalence of esophageal dysmotility equal to 14. 8 and those without hiatal hernia, a prevalence of 7. 7 (pââ0. 041). Patients with hiatal hernia also showed a higher frequency of erosive esophagitis (47. 5 versus 24. 2, pââ0. 001), lower low esophageal sphincter pressure (10. 4 versus 13. 10; pââ0. 001), and higher frequency of individuals with abnormal pH-metry values (pââ0. 001). The crude PR for esophageal dysmotility, according to the presence of hiatal hernia, was 1. 92 (confidence interval (CI), 1. 04-3. 53; pââ0. 037), but this association did not persist when controlled for age, esophagitis, altered pH-metry, and altered low esophageal sphincter (adjusted PR, 1. 69; CI, 0. 68-4. 15; pââ0. 257).
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 63-words sample answer on a PubMed discussion board to the following question: Is there an association between hiatal hernia and ineffective esophageal motility in patients with gastroesophageal reflux disease?.
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Does the Mother or Father Determine the Offspring Sex Ratio?
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Maternal digit ratio was negatively associated with offspring sex ratio. Females with a lower digit ratio were more likely to have more male offspring compared to those with a higher digit ratio. Thus, our results suggest that the sex of offspring might be more influenced by maternal rather than paternal factors.
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"Maternal digit ratio was negatively associated with offspring sex ratio. Females with a lower digit ratio were more likely to have more male offspring compared to those with a higher digit ratio. Thus, our results suggest that the sex of offspring might be more influenced by maternal rather than paternal factors."
] |
In mammals, high parental testosterone levels present around the time of conception are thought to skew offspring sex ratio toward sons. The second to fourth digit ratio (digit ratio) is now widely accepted as a negative correlate of prenatal testosterone. Thus, we investigated the association between digit ratio and offspring sex ratio. A total of 508 Korean patients (257 males and 251 females) less than 60 years old who had one or more offspring were prospectively enrolled. The lengths of the 2nd and 4th digits of the right hand were measured by a single investigator using a digital vernier calliper. Next, the patients' lifetime offspring birth sex ratios were investigated. Maternal (rather than paternal) digit ratio was significantly associated with the number of sons (r -0. 153, p 0. 015), number of daughters (r 0. 130, p 0. 039), and offspring sex ratio (r -0. 171, p 0. 007). And, the maternal digit ratio was a significant factor for predicting offspring sex ratio (B -1. 620, p 0. 008) on multiple linear regression analysis. The female patients with a lower digit ratio (0. 95) were found to have a higher offspring sex ratio (0. 609 versus 0. 521, p 0. 046) compared to those with a higher digit ratio (â 0. 95). Furthermore, females in the low digit ratio group have a probability 1. 138 greater of having sons than females in the high digit ratio group.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 51-words sample answer on a PubMed discussion board to the following question: Does the Mother or Father Determine the Offspring Sex Ratio?.
Use the following context: In mammals, high parental testosterone levels present around the time of conception are thought to skew offspring sex ratio toward sons. The second to fourth digit ratio (digit ratio) is now widely accepted as a negative correlate of prenatal testosterone. Thus, we investigated the association between digit ratio and offspring sex ratio. A total of 508 Korean patients (257 males and 251 females) less than 60 years old who had one or more offspring were prospectively enrolled. The lengths of the 2nd and 4th digits of the right hand were measured by a single investigator using a digital vernier calliper. Next, the patients' lifetime offspring birth sex ratios were investigated. Maternal (rather than paternal) digit ratio was significantly associated with the number of sons (r -0. 153, p 0. 015), number of daughters (r 0. 130, p 0. 039), and offspring sex ratio (r -0. 171, p 0. 007). And, the maternal digit ratio was a significant factor for predicting offspring sex ratio (B -1. 620, p 0. 008) on multiple linear regression analysis. The female patients with a lower digit ratio (0. 95) were found to have a higher offspring sex ratio (0. 609 versus 0. 521, p 0. 046) compared to those with a higher digit ratio (â 0. 95). Furthermore, females in the low digit ratio group have a probability 1. 138 greater of having sons than females in the high digit ratio group.
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Are the equations for the creatinine-based estimated glomerular filtration rate applicable to the evaluation of renal function in Japanese children and adult patients receiving chemotherapy?
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Concordance between eGFR and CCr in pediatric patients with a unilateral kidney should be assessed separately from that in patients with bilateral kidneys. In restricting calculation of eGFR to pediatric patients with bilateral kidneys and adult patients without little muscle mass, eGFR may be useful regardless of whether patients are receiving chemotherapy.
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"Concordance between eGFR and CCr in pediatric patients with a unilateral kidney should be assessed separately from that in patients with bilateral kidneys. In restricting calculation of eGFR to pediatric patients with bilateral kidneys and adult patients without little muscle mass, eGFR may be useful regardless of whether patients are receiving chemotherapy."
] |
Equations for the creatinine-based estimated glomerular filtration rate (eGFR) were recently established for Japanese adults (18 years old) and children (2-11 years old), respectively, but it is unclear whether eGFR can be as useful as 24-h creatinine clearance (CCr) for assessing renal function in patients receiving chemotherapy. This study examined the degree of concordance between eGFR and CCr and the risk factors leading to the overestimation of renal function by eGFR. A total of 53 data points of 19 children and 56 data points of 16 adults who received chemotherapy were analyzed retrospectively. Body mass index, serum creatinine concentration, 24-h urinary creatinine excretion (UCr), and nephrectomy were considered as risk factors for overestimation by eGFR. In the pediatric part of the study, 7 data points from 3 patients who underwent nephrectomy were included. The eGFR in patients with bilateral kidneys overestimated renal function to a greater degree than in patients with a unilateral kidney. In 45. 7 of pediatric patients with bilateral kidneys and in 19. 6 of adult patients, eGFR overestimated renal function. The risk factor for overestimation was lower UCr in pediatric patients with bilateral kidneys and adult patients.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 52-words sample answer on a PubMed discussion board to the following question: Are the equations for the creatinine-based estimated glomerular filtration rate applicable to the evaluation of renal function in Japanese children and adult patients receiving chemotherapy?.
Use the following context: Equations for the creatinine-based estimated glomerular filtration rate (eGFR) were recently established for Japanese adults (18 years old) and children (2-11 years old), respectively, but it is unclear whether eGFR can be as useful as 24-h creatinine clearance (CCr) for assessing renal function in patients receiving chemotherapy. This study examined the degree of concordance between eGFR and CCr and the risk factors leading to the overestimation of renal function by eGFR. A total of 53 data points of 19 children and 56 data points of 16 adults who received chemotherapy were analyzed retrospectively. Body mass index, serum creatinine concentration, 24-h urinary creatinine excretion (UCr), and nephrectomy were considered as risk factors for overestimation by eGFR. In the pediatric part of the study, 7 data points from 3 patients who underwent nephrectomy were included. The eGFR in patients with bilateral kidneys overestimated renal function to a greater degree than in patients with a unilateral kidney. In 45. 7 of pediatric patients with bilateral kidneys and in 19. 6 of adult patients, eGFR overestimated renal function. The risk factor for overestimation was lower UCr in pediatric patients with bilateral kidneys and adult patients.
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A comparison of two digital mammography systems: are there any differences?
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Population breast screening is frequently criticised for identifying lesions irrelevant to long-term outcomes or life expectancy and although the two systems seem comparable in terms of invasive cancer detection, a statistically significant difference in the detection of non-invasive lesions was seen, not reported in previous studies. This is a contentious issue, as identifying more DCIS has the potential to over-diagnose screened women leading to increased morbidity, higher "cancer detection rates", longer cancer waiting times, and reduced patient psychological wellbeing. The Sectra system is able to deliver a similar invasive detection cancer delivering a much lower dose mammogram, which is important in limiting overall population radiation dose. Further study as to whether the differences in tumour detection rates are clinically significant long term are now required.
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"Population breast screening is frequently criticised for identifying lesions irrelevant to long-term outcomes or life expectancy and although the two systems seem comparable in terms of invasive cancer detection, a statistically significant difference in the detection of non-invasive lesions was seen, not reported in previous studies. This is a contentious issue, as identifying more DCIS has the potential to over-diagnose screened women leading to increased morbidity, higher \"cancer detection rates\", longer cancer waiting times, and reduced patient psychological wellbeing. The Sectra system is able to deliver a similar invasive detection cancer delivering a much lower dose mammogram, which is important in limiting overall population radiation dose.",
"Further study as to whether the differences in tumour detection rates are clinically significant long term are now required."
] |
This was a retrospective study of a prospectively collected database of 50, 000 consecutive screening episodes from 2012; clients were aged 49-88 years (mean 61. 9 years). All studies were double-blind read by two readers. All tumours identified in the two arms of the study were detailed and compared specifically with regards to type (ductal or lobular) size, grade, and whether invasive or non-invasive. Performance was analysed for any statistically significant differences. Twenty-five thousand consecutive women were screened with Hologic (recall rate 5. 9 of which 18 were cancer) and 25, 000 were screened with Sectra digital mammography (recall rate 4. 3 and 22 were cancer). Five hundred tumours were found with no significant difference in invasive cancer detection or between ductal or lobular subtypes. The Hologic system detected 267 tumours; of which 81 (30. 33) were non-invasive (3. 24 per 1000), compared to the Sectra system with 233 cancers overall including 36 non-invasive (15. 45, 1. 44 per 1000). The difference in non-invasive lesions (mainly ductal carcinoma in situ ) detection was significant (p0. 001); 38 of which were high nuclear grade (HNG) using Hologic and 50 HNG lesions using Sectra. There was no significant difference in non-invasive size between the two technologies. The mean glandular dose received using the Sectra system was significantly less (0. 7Â mGy) compared to the Hologic system (1. 6Â mGy) for a 50-60Â mm breast thickness.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 125-words sample answer on a PubMed discussion board to the following question: A comparison of two digital mammography systems: are there any differences?.
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An Observational Study on a Protocol for Withdrawal of Life-Sustaining Measures on Two Non-Academic Intensive Care Units in The Netherlands: Few Signs of Distress, No Suffering?
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The end-of-life protocol seems effective in realizing adequate patient comfort. Most patients in whom life-sustaining measures are withdrawn are well sedated and show few signs of distress. Dosages of opioids and sedatives increase significantly during treatment withdrawal but do not contribute to time until death. Dying with a minimum of distressing signs is thus practically possible and ethically feasible.
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"The end-of-life protocol seems effective in realizing adequate patient comfort. Most patients in whom life-sustaining measures are withdrawn are well sedated and show few signs of distress. Dosages of opioids and sedatives increase significantly during treatment withdrawal but do not contribute to time until death. Dying with a minimum of distressing signs is thus practically possible and ethically feasible."
] |
Because anticipation of death is common within the intensive care unit, attention must be paid to the prevention of distressing signs and symptoms, enabling the patient to die peacefully. In the relevant studies on this subject, there has been a lack of focus on measuring determinants of comfort in this population. To evaluate whether dying without distressing signs after the withdrawal of life-sustaining measures is possible using a newly introduced protocol and to analyze the potential influence of opioids and sedatives on time till death. This was a prospective observational study, in two nonacademic Dutch intensive care units after the introduction of a national protocol for end-of-life care. The study lasted two years and included adult patients in whom mechanical ventilation and/or vasoactive medication was withdrawn. Exclusion criteria included all other causes of death. During the study period, 450 patients died; of these, 305 patients were eligible, and 241 were included. Ninety percent of patients were well sedated before and after withdrawal. Severe terminal restlessness, death rattle, or stridor was seen in less than 6. Dosages of opioids and sedatives increased significantly after withdrawal, but did not contribute to a shorter time till death according the regression analysis.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 59-words sample answer on a PubMed discussion board to the following question: An Observational Study on a Protocol for Withdrawal of Life-Sustaining Measures on Two Non-Academic Intensive Care Units in The Netherlands: Few Signs of Distress, No Suffering?.
Use the following context: Because anticipation of death is common within the intensive care unit, attention must be paid to the prevention of distressing signs and symptoms, enabling the patient to die peacefully. In the relevant studies on this subject, there has been a lack of focus on measuring determinants of comfort in this population. To evaluate whether dying without distressing signs after the withdrawal of life-sustaining measures is possible using a newly introduced protocol and to analyze the potential influence of opioids and sedatives on time till death. This was a prospective observational study, in two nonacademic Dutch intensive care units after the introduction of a national protocol for end-of-life care. The study lasted two years and included adult patients in whom mechanical ventilation and/or vasoactive medication was withdrawn. Exclusion criteria included all other causes of death. During the study period, 450 patients died; of these, 305 patients were eligible, and 241 were included. Ninety percent of patients were well sedated before and after withdrawal. Severe terminal restlessness, death rattle, or stridor was seen in less than 6. Dosages of opioids and sedatives increased significantly after withdrawal, but did not contribute to a shorter time till death according the regression analysis.
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Plasma amino-terminal pro-brain natriuretic peptide levels in subjects presenting to the Emergency Department with suspected acute coronary syndrome: possible role in selecting patients for follow up?
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Although elevated NT-proBNP level detected heart failure with high sensitivity, NT-proBNP level did not assist in the diagnosis of acute myocardial ischaemia. These findings indicate that the major determinant of elevated NT-proBNP level on presentation with suspected ACS was underlying cardiac dysfunction rather than acute myocardial ischaemia. This suggests that NT-proBNP measurement in patients with a suspected cardiac reason for presentation to the Emergency Department may identify a previously unrecognized group of patients without acute ischaemia who may nevertheless benefit from further investigation of cardiac function.
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"Although elevated NT-proBNP level detected heart failure with high sensitivity, NT-proBNP level did not assist in the diagnosis of acute myocardial ischaemia. These findings indicate that the major determinant of elevated NT-proBNP level on presentation with suspected ACS was underlying cardiac dysfunction rather than acute myocardial ischaemia. This suggests that NT-proBNP measurement in patients with a suspected cardiac reason for presentation to the Emergency Department may identify a previously unrecognized group of patients without acute ischaemia who may nevertheless benefit from further investigation of cardiac function."
] |
Plasma amino-terminal pro-brain natriuretic peptide (NT-proBNP) level is a sensitive and specific indicator of cardiac dysfunction. AIM: To determine whether plasma NT-proBNP level is elevated at the time of presentation with acute coronary syndrome (ACS) and whether it may assist in the diagnosis of heart failure and myocardial ischaemia in the Emergency Department. Plasma NT-proBNP levels were measured prospectively in 201 unselected presentations to the Emergency Department with suspected ACS where cardiac injury markers were requested by clinicians as part of routine assessment. NT-proBNP levels were correlated with clinical, electrocardiogram (ECG), biochemical and radiological findings. Elevated NT-proBNP level detected heart failure with high sensitivity (95-96). Among patients without heart failure, NT-proBNP levels were increased more frequently in patients with previously diagnosed ischaemic heart disease. Elevated NT-proBNP level predicted cardiomegaly and a cardiac cause of presentation. However, the NT-proBNP level was not associated with ECG or biochemical markers of myocardial ischaemia, and only one-third of patients with ACS showed an increase of 40 or more in NT-proBNP level at repeat measurement of cardiac injury markers 5 h after presentation.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 86-words sample answer on a PubMed discussion board to the following question: Plasma amino-terminal pro-brain natriuretic peptide levels in subjects presenting to the Emergency Department with suspected acute coronary syndrome: possible role in selecting patients for follow up?.
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Does a glass of red wine improve endothelial function?
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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 not increase after drinking red wine with alcohol. Flow-mediated dilatation of the brachial artery increased significantly after de-alcoholized red wine and this finding may support the hypothesis that antioxidant qualities of red wine, rather than ethanol in itself, may protect against cardiovascular disease.
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"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 not increase after drinking red wine with alcohol. Flow-mediated dilatation of the brachial artery increased significantly after de-alcoholized red wine and this finding may support the hypothesis that antioxidant qualities of red wine, rather than ethanol in itself, may protect against cardiovascular disease."
] |
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 cardiovascular risk factors. The subjects drank 250 ml of red wine with or without alcohol over 10 min according to a randomized procedure. Brachial artery dilatation was measured again 30 and 60 min after the subjects had finished drinking. The subjects were studied a second time within a week of the first study in a cross-over design. After the red wine with alcohol the resting brachial artery diameter, resting blood flow, heart rate and plasma-ethanol increased significantly. After the de-alcoholized red wine these parameters were unchanged. Flow-mediated dilatation of the brachial artery was significantly higher (P0. 05) after drinking de-alcoholized red wine (5. 6+/-3. 2) than after drinking red wine with alcohol (3. 6+/-2. 2) and before drinking (3. 9+/-2. 5).
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 90-words sample answer on a PubMed discussion board to the following question: Does a glass of red wine improve endothelial function?.
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Does salivary duct repositioning prevent complications after tumor resection or salivary gland surgery?
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Salivary duct repositioning is performed to prevent blockage of physiologic salivary discharge. Complications were more frequently associated with Wharton ducts than with Stensen ducts because of the unique physiologic and anatomic characteristics of the Wharton duct. Repositioning of the salivary duct is a suitable method for preventing complications associated with the Wharton duct.
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"Salivary duct repositioning is performed to prevent blockage of physiologic salivary discharge. Complications were more frequently associated with Wharton ducts than with Stensen ducts because of the unique physiologic and anatomic characteristics of the Wharton duct. Repositioning of the salivary duct is a suitable method for preventing complications associated with the Wharton duct."
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Tissue that is resected for the treatment of oral tumors often includes salivary gland ducts. At their institution, the authors conserve and transfer as much of the salivary duct as possible during these procedures to avoid obstructive complications. Differentiating these obstructive complications from a metastatic node can be challenging and can confound subsequent oncologic management. This study compared and examined the effectiveness of salivary duct repositioning in decreasing the incidence of obstructive complications. Cases of oromandibular disease treated with salivary duct resection at Kobe University Graduate School of Medicine from 2008 to 2013 were retrospectively analyzed. Thirty-two cases (25 patients) of Wharton duct resection and 31 cases (31 patients) of Stensen duct resection were included. The incidence of complications after salivary duct repositioning, duct ligation, and retention of the sublingual gland around the Wharton duct was compared. Wharton ducts were repositioned in 30 cases and ligated in 2 cases. Complications, including oral swelling at the Wharton duct, were observed in 5 cases of repositioning and 2 cases of ligation. Stensen ducts were repositioned in 9 cases and ligated in 22 cases. The only complication reported was a single case of salivary fistula after ligation.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 53-words sample answer on a PubMed discussion board to the following question: Does salivary duct repositioning prevent complications after tumor resection or salivary gland surgery?.
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Does lumbar spinal degeneration begin with the anterior structures?
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The observed epidemiology of lumbar spinal degeneration in the community-based population is consistent with an ordered progression beginning in the anterior structures, for the majority of individuals. However, some individuals demonstrate atypical patterns of degeneration, beginning in the posterior joints. Increased age and BMI, and female sex may be related to the occurrence of isolated posterior degeneration in these individuals.
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"The observed epidemiology of lumbar spinal degeneration in the community-based population is consistent with an ordered progression beginning in the anterior structures, for the majority of individuals. However, some individuals demonstrate atypical patterns of degeneration, beginning in the posterior joints. Increased age and BMI, and female sex may be related to the occurrence of isolated posterior degeneration in these individuals."
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Prior studies that have concluded that disk degeneration uniformly precedes facet degeneration have been based on convenience samples of individuals with low back pain. We conducted a study to examine whether the view that spinal degeneration begins with the anterior spinal structures is supported by epidemiologic observations of degeneration in a community-based population. 361 participants from the Framingham Heart Study were included in this study. The prevalences of anterior vertebral structure degeneration (disk height loss) and posterior vertebral structure degeneration (facet joint osteoarthritis) were characterized by CT imaging. The cohort was divided into the structural subgroups of participants with 1) no degeneration, 2) isolated anterior degeneration (without posterior degeneration), 3) combined anterior and posterior degeneration, and 4) isolated posterior degeneration (without anterior structure degeneration). We determined the prevalence of each degeneration pattern by age group45, 45-54, 55-64, â65. In multivariate analyses we examined the association between disk height loss and the response variable of facet joint osteoarthritis, while adjusting for age, sex, BMI, and smoking. As the prevalence of the no degeneration and isolated anterior degeneration patterns decreased with increasing age group, the prevalence of the combined anterior/posterior degeneration pattern increased. 22 of individuals demonstrated isolated posterior degeneration, without an increase in prevalence by age group. Isolated posterior degeneration was most common at the L5-S1 and L4-L5 spinal levels. In multivariate analyses, disk height loss was independently associated with facet joint osteoarthritis, as were increased age (years), female sex, and increased BMI (kg/m(2)), but not smoking.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 60-words sample answer on a PubMed discussion board to the following question: Does lumbar spinal degeneration begin with the anterior structures?.
Use the following context: Prior studies that have concluded that disk degeneration uniformly precedes facet degeneration have been based on convenience samples of individuals with low back pain. We conducted a study to examine whether the view that spinal degeneration begins with the anterior spinal structures is supported by epidemiologic observations of degeneration in a community-based population. 361 participants from the Framingham Heart Study were included in this study. The prevalences of anterior vertebral structure degeneration (disk height loss) and posterior vertebral structure degeneration (facet joint osteoarthritis) were characterized by CT imaging. The cohort was divided into the structural subgroups of participants with 1) no degeneration, 2) isolated anterior degeneration (without posterior degeneration), 3) combined anterior and posterior degeneration, and 4) isolated posterior degeneration (without anterior structure degeneration). We determined the prevalence of each degeneration pattern by age group45, 45-54, 55-64, â65. In multivariate analyses we examined the association between disk height loss and the response variable of facet joint osteoarthritis, while adjusting for age, sex, BMI, and smoking. As the prevalence of the no degeneration and isolated anterior degeneration patterns decreased with increasing age group, the prevalence of the combined anterior/posterior degeneration pattern increased. 22 of individuals demonstrated isolated posterior degeneration, without an increase in prevalence by age group. Isolated posterior degeneration was most common at the L5-S1 and L4-L5 spinal levels. In multivariate analyses, disk height loss was independently associated with facet joint osteoarthritis, as were increased age (years), female sex, and increased BMI (kg/m(2)), but not smoking.
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Is a clinical positional control for nasogastric tubes good enough?
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Clinical control of a nasoenteric tube's position suffices in most instances. Checking the position further by an experienced person adds to safety. The study's findings suggest that radiological control can be safely limited to cases in which there was a problem in positioning the tube or the clinical control was unclear.
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"Clinical control of a nasoenteric tube's position suffices in most instances. Checking the position further by an experienced person adds to safety. The study's findings suggest that radiological control can be safely limited to cases in which there was a problem in positioning the tube or the clinical control was unclear."
] |
Nasoenteric tubes are usually introduced blindly by nursing staff, i. e. without visual or radiological control. A prospective study was undertaken to determine how often such blind procedure results in potentially dangerous tube placement and how often such faulty positioning remains undetected in a standardised clinical check. 43 patients (23 men, 20 women; age 24-90 years) requiring the introduction by nursing staff of a nasoenteric tube were studied, 12 in an intensive care unit (seven intubated) and 31 in an ordinary ward. At most 24 hours after the customary check of the tube's position by the nursing staff (air injection with epigastric auscultation), specially experienced medical and nursing personnel determined and recorded the tube's placement in a standardised manner. Subsequent radiological examination documented the position. All 43 tubes lay in the gastrointestinal tract. Only one tube was in a potentially dangerous position in the lower end of the oesophagus, as had already been diagnosed by the examiners. Of four other tubes which were not optimally placed (three in the region of the cardia, one in the duodenum) three were found to be "not correctly placed" by the clinical check, and one was detected only radiologically.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 51-words sample answer on a PubMed discussion board to the following question: Is a clinical positional control for nasogastric tubes good enough?.
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Recirculation of urea and dialysis efficiency using dual-lumen dialysis catheters in various locations: may the venous lumen of the catheter be used as the arterial lumen and vice versa?
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When hemodialysis is delivered by a correct blood lines connection the measurements have shown a decrease in urea recirculation by 5 for jugular and subclavian catheters, and 5-10 for femoral catheters. However, in cases when the venous lumen of the catheter is used as an arterial lumen, and vice versa, urea recirculation is below 10 for jugular catheters; whereas in femoral catheters the percentage is higher than 20. Despite so high percentage of urea recirculation, that we obtained for such use of the catheters, urea reduction ratio in hemodialysis via jugular and subclavian catheters is60, whereas via femoral catheters, the percentage is significantly lower. Consequently, the efficiency of hemodialysis is reduced, and such use of femoral catheters should therefore be avoided.
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"When hemodialysis is delivered by a correct blood lines connection the measurements have shown a decrease in urea recirculation by 5 for jugular and subclavian catheters, and 5-10 for femoral catheters. However, in cases when the venous lumen of the catheter is used as an arterial lumen, and vice versa, urea recirculation is below 10 for jugular catheters; whereas in femoral catheters the percentage is higher than 20. Despite so high percentage of urea recirculation, that we obtained for such use of the catheters, urea reduction ratio in hemodialysis via jugular and subclavian catheters is60, whereas via femoral catheters, the percentage is significantly lower. Consequently, the efficiency of hemodialysis is reduced, and such use of femoral catheters should therefore be avoided."
] |
Percentage of urea recirculation was measured in the patients with acute and chronic renal failure who underwent hemodialysis by a temporary dual-lumen central venous catheter of different localisations (jugular n 16, subclavian n 20, femoral n 20). The measurements were done in cases when arterial line was connected to arterial lumen of the catheter, and venous line to the venous lumen of the catheter (correct connection RI), and vice versa, i. e. , when arterial line was connected to venous lumen of the catheter, and venous line was connected to arterial lumen of the catheter (reversed connection R2). The efficiency of hemodialysis was evaluated by measuring urea reduction ratio in cases with the reversed (R2) connection. Statistically significant differences were found between R1 and R2 for jugular catheters (R1 2. 38 +/- 1. 09, R2 7. 59 +/- 1. 42, n 16, p 0), for subclavian catheters (R1 3. 03 +/- 3. 15, R2 15. 8 +/- 7. 18, n 20, p 0), and for femoral catheters (R1 9 +/- 6. 56, R2 29. 2 +/- 11. 8, n 20, p 0). Statistically significant differences were also found between R1 of jugular catheters and R1 of subclavian catheters (2. 38 +/- 1. 09, n 16 and 3. 03 +/- 3. 15, n 20, p 0. 0001), further on between R1 of jugular and R1 of femoral catheters (2. 38 +/- 1. 09, n 16 and 9 +/- 6. 56, n 20, p 0), as well as between R1 of subclavian and R1 of femoral catheters (2. 38 +/- 1. 09, n 20 and 9 +/- 6. 56, n 20, p 0. 0001). Also statistically significant differences were found between R2 of jugular and subclavian catheters (7. 59 +/- 1. 42, n 16 and 15. 8 +/- 7. 18, n 20, p 0. 0003), between R2 of jugular and femoral catheters (7. 59 +/- 1. 42, n 16 and 29. 2 +/- 11. 8, n 20, p 0. 0007), and between R2 of subclavian and R2 of femoral catheters (15. 8 +/- 7. 18, n 20 and 29. 2 +/- 11. 8, n 20, p 0. 0029). The measurements of urea reduction ratio that we have done for some of the catheters under R2 conditions showed a statistically significant difference between femoral and subclavian catheters (51. 45 +/- 5. 62, n 20 and 63. 75 +/- 7. 61, n 20, p 0), and between femoral and jugular catheters (51. 45 +/- 5. 62, n 20 and 64. 3 +/- 5. 23, n 16, p 0). No statistical differences were found in urea reduction ratio between jugular and subclavian catheters (64. 3 +/- 5. 23, n 16 and 63. 75 +/- 7. 61, n 20, p 0. 8).
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 121-words sample answer on a PubMed discussion board to the following question: Recirculation of urea and dialysis efficiency using dual-lumen dialysis catheters in various locations: may the venous lumen of the catheter be used as the arterial lumen and vice versa?.
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Endoscope-assisted, minimally invasive evacuation of sub-acute/chronic epidural hematoma: Novelty or paradox of Theseus?
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Endoscope-assisted evacuation of sub-acute/chronic EDH is a novel concept, which offers quick relief from symptoms in a minimally invasive fashion and a cosmetically acceptable way. None of the standard principles of surgery are hampered. It avoids extensive dissection of the temporalis or sub-occipital muscles. However, achieving hemostasis can be difficult. Further study and better equipment will validate the procedure.
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"Endoscope-assisted evacuation of sub-acute/chronic EDH is a novel concept, which offers quick relief from symptoms in a minimally invasive fashion and a cosmetically acceptable way. None of the standard principles of surgery are hampered. It avoids extensive dissection of the temporalis or sub-occipital muscles. However, achieving hemostasis can be difficult. Further study and better equipment will validate the procedure."
] |
Sub-acute/chronic epidural hematoma (EDH) may present with nagging symptoms of headache, nausea, vomiting, lethargy, etc. We attempted to offer a minimally invasive, single burr hole, endoscope-assisted evacuation of EDHs instead of a conventional craniotomy. Seven patients with sub-acute/chronic EDH (six supratentorial and one infratentorial) presented to us 3 to 7Â days after low-velocity road traffic accidents with complaints of headache and lethargy. The EDH volumes measured between 20 to 50Â ml, and the patients were operated on using a single burr hole made through a small incision. We used 0-, 30- and 70-degree, angulated, rigid, high-definition endoscopes to identify and evacuate the organized clots in the extradural space. Flexible catheters were used for suction and irrigation. After achieving hemostasis, the dura was hitched back to the burr hole site. The wound was closed over a negative suction drain. All patients had prompt recovery from symptoms. Postoperative CT scans showed complete or near complete evacuation of the hematomas. The hospital stay and analgesic requirements were minimal. There was no infective complication or conversion to conventional open surgery. The average time for surgery was 77. 8Â min, and average blood loss was 328. 5Â ml.
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Medical Research
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Write a 59-words sample answer on a PubMed discussion board to the following question: Endoscope-assisted, minimally invasive evacuation of sub-acute/chronic epidural hematoma: Novelty or paradox of Theseus?.
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Can complete tumor resection be predicted in advanced primary epithelial ovarian cancer?
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Tumor expanding in multiple (4) abdominal quadrants was the major negative predictors for complete tumor resection in primary EOC-patients. Bowel resection and macroscopical tumor residuals were of predictive value for a higher operative major morbidity. Identifying high-risk patients for suboptimal tumor resection and operative complications may improve surgical outcome in advanced primary EOC.
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"Tumor expanding in multiple (4) abdominal quadrants was the major negative predictors for complete tumor resection in primary EOC-patients. Bowel resection and macroscopical tumor residuals were of predictive value for a higher operative major morbidity. Identifying high-risk patients for suboptimal tumor resection and operative complications may improve surgical outcome in advanced primary EOC."
] |
Postoperative tumor-residual-mass is the most important prognostic factor in epithelial ovarian cancer (EOC). Aim of our study was to define risk factors for incomplete tumor resection in advanced primary EOC. PATIENTS A validated intraoperative documentation tool ("Intraoperative-Mapping of Ovarian-Cancer" "IMO") was applied to systematically evaluate intraabdominal tumor dissemination pattern, maximal tumor load, tumor residuals and operative morbidity for all EOC-patients who underwent primary surgery in our institution during 09/2000-08/2009. Univariate- and multivariate analysis were performed to identify independent risk factors of incomplete tumor resection and operative complications. We evaluated 360 consecutive EOC-patients of FIGO-stage-III/IV. In 221(61) patients a complete tumor resection could be obtained. In 50(14) patients tumor residuals were0. 5 cm. Sixty (17) patients developed a major (14) complication. Multivariate analysis identified intestinal resection (OR:2. 0; 95CI:1. 14-3. 4; p 0. 01) and macroscopical tumor residuals (OR:0. 5; 95CI:0. 2-1. 2; p 0. 05) as independent predictors of major operative morbidity. Tumor dissemination pattern and maximal tumor load were significantly different between tumor-free and not-tumor-free operated patients, with less extrapelvic tumor involvement in the tumor-free group (p0. 001). More than 4 IMO-fields of tumor involvement (OR:3. 3; 95CI:1. 5-7. 0; p 0. 002) were identified to be of predictive significance for incomplete tumor resection. FIGO-stage, histology, age, CA125-levels, bowel resection and ascites did not affect optimal tumor resectability.
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Medical Research
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Write a 53-words sample answer on a PubMed discussion board to the following question: Can complete tumor resection be predicted in advanced primary epithelial ovarian cancer?.
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Is aggressive treatment of traumatic brain injury cost-effective?
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When all the costs of severe TBI are considered, aggressive treatment is a cost-effective option, even for older patients. Comfort care for severe TBI is associated with poor outcomes and high costs, and should be reserved for situations in which aggressive approaches have failed or testing suggests such treatment is futile.
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"When all the costs of severe TBI are considered, aggressive treatment is a cost-effective option, even for older patients. Comfort care for severe TBI is associated with poor outcomes and high costs, and should be reserved for situations in which aggressive approaches have failed or testing suggests such treatment is futile."
] |
The object of this study was to determine whether aggressive treatment of severe traumatic brain injury (TBI), including invasive intracranial monitoring and decompressive craniectomy, is cost-effective. A decision-analytical model was created to compare costs, outcomes, and cost-effectiveness of 3 strategies for treating a patient with severe TBI. The aggressive-care approach is compared with "routine care, " in which Brain Trauma Foundation guidelines are not followed. A "comfort care" category, in which a single day in the ICU is followed by routine floor care, is included for comparison only. Probabilities of each treatment resulting in various Glasgow Outcome Scale (GOS) scores were obtained from the literature. The GOS scores were converted to quality-adjusted life years (QALYs), based on expected longevity and calculated quality of life associated with each GOS category. Estimated direct (acute and long-term medical care) and indirect (loss of productivity) costs were calculated from the perspective of society. Sensitivity analyses employed a 2D Monte Carlo simulation of 1000 trials, each with 1000 patients. The model was also used to estimate these values for patients 40, 60, and 80 years of age. For the average 20-year-old, aggressive care yields 11. 7 (Â 1. 6 ) QALYs, compared with routine care (10. 0 Â 1. 5 QALYs). This difference is highly significant (p0. 0001). Although the differences in effectiveness between the 2 strategies diminish with advancing age, aggressive care remains significantly better at all ages. When all costs are considered, aggressive care is also significantly less costly than routine care (1, 264, 000 Â 118, 000 vs 1, 361, 000 Â 107, 000) for the average 20-year-old. Aggressive care remains significantly less costly until age 80, at which age it costs more than routine care. However, even in the 80-year-old, aggressive care is likely the more cost-effective approach. Comfort care is associated with poorer outcomes at all ages and with higher costs for all groups except 80-year-olds.
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Medical Research
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Write a 51-words sample answer on a PubMed discussion board to the following question: Is aggressive treatment of traumatic brain injury cost-effective?.
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Symphysiotomy: Is it obsolete?
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Symphysiotomy is an alternative management in women with obstructed labor. It has a role in low-resource settings, where CS is unaffordable, unavailable or unsafe. For the vast majority of the poor population, who may not have even have one proper meal a day, it can be of benefit to have a woman's pelvis made permanently adequate so that traditional birth attendants can conduct her subsequent labors.
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"Symphysiotomy is an alternative management in women with obstructed labor. It has a role in low-resource settings, where CS is unaffordable, unavailable or unsafe. For the vast majority of the poor population, who may not have even have one proper meal a day, it can be of benefit to have a woman's pelvis made permanently adequate so that traditional birth attendants can conduct her subsequent labors."
] |
This was a prospective comparative cohort study. Symphysiotomy was performed in 25 women who presented with obstructed labor. The controls were 50 women on whom CS was performed due to obstructed labor. Maternal mortality and morbidity due to postpartum hemorrhage (PPH), sepsis, genitourinary trauma, pelvic pain and gait problems were analyzed and compared between cases and controls. Neonatal mortality and morbidity due to birth asphyxia, intracranial hemorrhage, cephalohematoma and hypoxic ischemic encephalopathy were also compared following the two procedures. Maternal mortality was similar in both the cesarean section group (CSG) and symphysiotomy group (SG), but SYM has less morbidity than CS, and also preserves the uterus from scars. Transient pelvic pain was the most common maternal morbidity following SYM, whereas PPH and wound sepsis were the most common complications after CS. Neonatal mortality and morbidity were similar in both cases and controls. Lastly, SYM is a simple, low-cost and quicker procedure than CS.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 66-words sample answer on a PubMed discussion board to the following question: Symphysiotomy: Is it obsolete?.
Use the following context: This was a prospective comparative cohort study. Symphysiotomy was performed in 25 women who presented with obstructed labor. The controls were 50 women on whom CS was performed due to obstructed labor. Maternal mortality and morbidity due to postpartum hemorrhage (PPH), sepsis, genitourinary trauma, pelvic pain and gait problems were analyzed and compared between cases and controls. Neonatal mortality and morbidity due to birth asphyxia, intracranial hemorrhage, cephalohematoma and hypoxic ischemic encephalopathy were also compared following the two procedures. Maternal mortality was similar in both the cesarean section group (CSG) and symphysiotomy group (SG), but SYM has less morbidity than CS, and also preserves the uterus from scars. Transient pelvic pain was the most common maternal morbidity following SYM, whereas PPH and wound sepsis were the most common complications after CS. Neonatal mortality and morbidity were similar in both cases and controls. Lastly, SYM is a simple, low-cost and quicker procedure than CS.
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Does roflumilast decrease exacerbations in severe COPD patients not controlled by inhaled combination therapy?
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It is hypothesized that because roflumilast (a phosphodiesterase-4 inhibitor) has a different mode of action to bronchodilators and inhaled corticosteroids, it may provide additional benefits when added to these treatments in frequent exacerbators. REACT will be important to determine the role of roflumilast in COPD management. Here, the design and rationale for this important study is described.
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"It is hypothesized that because roflumilast (a phosphodiesterase-4 inhibitor) has a different mode of action to bronchodilators and inhaled corticosteroids, it may provide additional benefits when added to these treatments in frequent exacerbators. REACT will be important to determine the role of roflumilast in COPD management. Here, the design and rationale for this important study is described."
] |
Many patients with chronic obstructive pulmonary disease (COPD) continue to suffer exacerbations, even when treated with maximum recommended therapy (eg, inhaled combinations of long-acting β2-agonist and high dose inhaled corticosteroids, with or without a long-acting anticholinergic ). Roflumilast is approved to treat severe COPD in patients with chronic bronchitis--and a history of frequent exacerbations--as an add-on to bronchodilators. The REACT (Roflumilast in the Prevention of COPD Exacerbations While Taking Appropriate Combination Treatment) study (identification number RO-2455-404-RD, clinicaltrials. gov identifier NCT01329029) will investigate whether roflumilast further reduces exacerbations when added to inhaled combination therapy in patients still suffering from frequent exacerbations. REACT is a 1-year randomized, double-blind, multicenter, phase III/IV study of roflumilast 500 μg once daily or placebo on top of a fixed long-acting β2-agonist/inhaled corticosteroid combination. A concomitant long-acting muscarinic antagonist will be allowed at stable doses. The primary outcome is the rate of moderate or severe COPD exacerbations. Using a Poisson regression model with a two-sided significance level of 5, a sample size of 967 patients per treatment group is needed for 90 power. COPD patients with severe to very severe airflow limitation, symptoms of chronic bronchitis, and at least two exacerbations in the previous year will be recruited.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 57-words sample answer on a PubMed discussion board to the following question: Does roflumilast decrease exacerbations in severe COPD patients not controlled by inhaled combination therapy?.
Use the following context: Many patients with chronic obstructive pulmonary disease (COPD) continue to suffer exacerbations, even when treated with maximum recommended therapy (eg, inhaled combinations of long-acting β2-agonist and high dose inhaled corticosteroids, with or without a long-acting anticholinergic ). Roflumilast is approved to treat severe COPD in patients with chronic bronchitis--and a history of frequent exacerbations--as an add-on to bronchodilators. The REACT (Roflumilast in the Prevention of COPD Exacerbations While Taking Appropriate Combination Treatment) study (identification number RO-2455-404-RD, clinicaltrials. gov identifier NCT01329029) will investigate whether roflumilast further reduces exacerbations when added to inhaled combination therapy in patients still suffering from frequent exacerbations. REACT is a 1-year randomized, double-blind, multicenter, phase III/IV study of roflumilast 500 μg once daily or placebo on top of a fixed long-acting β2-agonist/inhaled corticosteroid combination. A concomitant long-acting muscarinic antagonist will be allowed at stable doses. The primary outcome is the rate of moderate or severe COPD exacerbations. Using a Poisson regression model with a two-sided significance level of 5, a sample size of 967 patients per treatment group is needed for 90 power. COPD patients with severe to very severe airflow limitation, symptoms of chronic bronchitis, and at least two exacerbations in the previous year will be recruited.
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Can the clinical pulmonary infection score impact ICU antibiotic days?
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This prospective evaluation confirms that 50 of antibiotic-days in our ICU are used empirically for pneumonia when that infection is not likely to be present by either CDC or CPIS criteria. Although the CPIS has good reliability and acceptable sensitivity and specificity, PC review and CPISor6 were commonly divergent (42-47). Thus, better strategies should be developed for identification of pneumonia and empiric antibiotic administration in the ICU.
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"This prospective evaluation confirms that 50 of antibiotic-days in our ICU are used empirically for pneumonia when that infection is not likely to be present by either CDC or CPIS criteria. Although the CPIS has good reliability and acceptable sensitivity and specificity, PC review and CPISor6 were commonly divergent (42-47). Thus, better strategies should be developed for identification of pneumonia and empiric antibiotic administration in the ICU."
] |
The Clinical Pulmonary Infection Score (CPIS) has been used in the intensive care unit (ICU) as a decision tool for initiation of antibiotics in suspected pneumonia and also for discontinuing antibiotics if the CPIS score is6 on day one receiving antibiotics empirically for pneumonia. Over 11 months, we evaluated empiric antibiotics prospectively in two ICUs of a large tertiary university teaching hospital. A pneumonia committee (PC) reviewed all patients and defined pneumonia according to the guidelines of the U. S. Centers for Disease Control and Prevention (CDC). The CPIS was calculated for all patients at day one and day three of antibiotic therapy. The percentage of patients with a CPIS6 (823 antibiotic-days). In contrast, the PC determined 19 patients (23) to have pneumonia by the CDC definition (731 antibiotic-days), with eight of these patients having a CPIS6. Pneumonia committee review resulted in fewer patients believed to have pneumonia and a greater percentage with a CPIS6 (odds ratio 2. 7; 95 confidence interval 0. 86, 8. 6; p0. 05). Restriction of antibiotics to patients with a CPIS6 would have saved 1, 460 antibiotic-days at day one and 1, 053 days if treatment was delayed until day three. Clinical Pulmonary Infection Score ROC curves for the PC showed an area under the curve (AUC) of 0. 82 (95 CI 0. 72, 0. 91), whereas the AUC for the ICU group was 0. 85 (95 CI 0. 79, 0. 92). The sensitivity and specificity of a CPIS6 for the PC were 79 and 75, respectively, with correct prediction 76 of the time. The inter-observer reliability of the CPIS had a kappa value of 0. 88.
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Medical Research
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Write a 67-words sample answer on a PubMed discussion board to the following question: Can the clinical pulmonary infection score impact ICU antibiotic days?.
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Endothelin and von Willebrand factor as parameters of endothelial function in idiopathic dilated cardiomyopathy: different stimuli for release before and after heart transplantation?
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Plasma endothelin and vWF were directly correlated in both CHF and after HTX caused by idiopathic dilated cardiomyopathy. However, the production of the 2 factors appeared to be stimulated by different mechanisms and provided different information about endothelial function, as indicated by the different determinants and different response to heart transplantation.
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"Plasma endothelin and vWF were directly correlated in both CHF and after HTX caused by idiopathic dilated cardiomyopathy. However, the production of the 2 factors appeared to be stimulated by different mechanisms and provided different information about endothelial function, as indicated by the different determinants and different response to heart transplantation."
] |
Congestive heart failure (CHF) and heart transplantation (HTX) are characterized by endothelial dysfunction as indicated by elevation of markers of endothelial function, including endothelin and von Willebrand factor (vWF). However, previous studies included both patients with idiopathic dilated cardiomyopathy and ischemic heart disease; the latter condition shows endothelial dysfunction, per se. The 2 endothelial factors have different origin and may provide different information about endothelial dysfunction in CHF and after HTX caused by idiopathic dilated cardiomyopathy. We investigated plasma endothelin and vWF, the relation between these 2 factors, and determinants of endothelin and vWF plasma levels in 32 healthy controls, 25 patients with CHF, and 22 patients who had HTX; both conditions were caused by idiopathic dilated cardiomyopathy. Plasma endothelin was elevated in CHF (6. 8 +/- 3. 4 pg/mL) and after HTX (6. 1 +/- 2. 1) compared with healthy controls (4. 0 +/- 1. 0, P. 0001 for both). VWF was also elevated in CHF (1. 6 +/- 0. 6 U/mL) and after HTX (2. 6 +/- 1. 0) compared with healthy controls (1. 0 +/- 0. 5, P. 0001 for both). VWF was increased after HTX compared with CHF (P. 001), in contrast to similar endothelin levels in CHF and after HTX. Plasma endothelin and vWF correlated in both CHF (r 0. 65, P. 001) and HTX (r 0. 66, P. 001) but not in controls. In CHF, New York Heart Association functional class was an independent determinant of vWF (P. 0001) and furosemide dose of endothelin (P. 0001). In cardiac transplant recipients, plasma albumin was an independent determinant of vWF (P. 01), and plasma sodium and furosemide dose were independent determinants of endothelin (P. 01).
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Medical Research
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Write a 51-words sample answer on a PubMed discussion board to the following question: Endothelin and von Willebrand factor as parameters of endothelial function in idiopathic dilated cardiomyopathy: different stimuli for release before and after heart transplantation?.
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Are users' most recent drug purchases representative?
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Asking about the most recent purchase appears to be an economical way to learn about purchases more generally, with little evidence of substantial variation between the most recent purchase and other recent purchases reported by participants. In spite of consistent findings across our two surveys, further replication of the work reported in this paper involving other populations of users is warranted.
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"Asking about the most recent purchase appears to be an economical way to learn about purchases more generally, with little evidence of substantial variation between the most recent purchase and other recent purchases reported by participants. In spite of consistent findings across our two surveys, further replication of the work reported in this paper involving other populations of users is warranted."
] |
Various surveys now ask respondents to describe their most recent purchase of illicit drugs, as one mechanism through which market size can be estimated. This raises the question of whether issues surrounding the timing of survey administration might make a sample of most recent purchases differ from a random sample of all purchases. We investigate these issues through a series of questions which ask about the three most recent purchases, and about drug use. Data were drawn from 688 respondents in the Melbourne Injecting Drug User Cohort Study across the period 2008-2013 and 2782 respondents to the Washington Cannabis Consumption Study in 2013. Responses to questions about the most recent purchases were compared to larger subsets of all recent purchases. For heroin, methamphetamine and cannabis no differences were found between the amount spent by participants on their most recent purchase and the average amount spent on three or more recent purchases. There were also no differences concerning the locations and types of deals, and the duration between consecutive cannabis purchases was the same for first and second most recent, and second and third most recent.
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Medical Research
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Write a 61-words sample answer on a PubMed discussion board to the following question: Are users' most recent drug purchases representative?.
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Does Primary Hip Arthroscopy Result in Improved Clinical Outcomes?
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Primary hip arthroscopy for all procedures performed in aggregate had excellent clinical outcomes and patient satisfaction scores at short-term follow-up in this study. More studies must be conducted to determine the definition of a successful outcome. There was a 6. 1 minor complication rate, which was consistent with previous studies. Patients should be counseled regarding the potential progression of degenerative change leading to arthroplasty as well as the potential for revision surgery.
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"Primary hip arthroscopy for all procedures performed in aggregate had excellent clinical outcomes and patient satisfaction scores at short-term follow-up in this study. More studies must be conducted to determine the definition of a successful outcome. There was a 6. 1 minor complication rate, which was consistent with previous studies. Patients should be counseled regarding the potential progression of degenerative change leading to arthroplasty as well as the potential for revision surgery."
] |
Hip arthroscopy has gained increasing popularity over the past decade. The need to develop metrics to evaluate success and complications in primary hip arthroscopy is an important goal. To evaluate 2-year patient-related outcome (PRO) scores and patient satisfaction scores for a single surgeon at a high-volume referral center for all primary hip arthroscopy procedures performed. Case series; Level of evidence, 4. During the study period between April 2008 and October 2011, data were collected on all patients who underwent primary hip arthroscopy. All patients were assessed pre- and postoperatively with 4 PRO measures: the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Activities of Daily Living (HOS-ADL), and Hip Outcome Score-Sport-Specific Subscale (HOS-SSS). Pain was estimated on the visual analog scale (VAS), and satisfaction was measured on a scale from 0 to 10. The number of patients who underwent revision arthroscopy, total hip arthroplasty (THA), or a resurfacing procedure during the study period was also reported. A total of 595 patients were included in the study. The score improvement from preoperative to 2-year follow-up was 61. 29 to 82. 02 for mHHS, 62. 79 to 83. 05 for HOS-ADL, 40. 96 to 70. 07 for HOS-SSS, 57. 97 to 80. 41 for NAHS, and 5. 86 to 2. 97 for VAS. All scores were statistically significantly different (P. 0001). Overall patient satisfaction was 7. 86 Â 2. 3 (range, 1-10). Forty-seven (7. 7) patients underwent revision hip arthroscopy, and 54 (9. 1) patients underwent either THA or the hip resurfacing procedure during the study period. The multivariate regression analysis showed that increased age at time of surgery was a significant risk factor for conversion to THA, revision arthroscopy, and change in NAHS10 points. Acute injury, acetabuloplasty, iliopsoas release, and patient sex were significant for 2 of these 3 types of failure.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 72-words sample answer on a PubMed discussion board to the following question: Does Primary Hip Arthroscopy Result in Improved Clinical Outcomes?.
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Prevention in dangerous industries: does safety certification prevent tree-faller injuries?
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Certification did not reduce the risk of work injury among experienced tree-fallers in the province of British Columbia. Non-statistically significant increases in the observed risk of work injury in the months immediately following certification may be attributable to an intervention effect or a methodological limitation related to a lack of individual-level, time-at-risk exposure data.
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"Certification did not reduce the risk of work injury among experienced tree-fallers in the province of British Columbia. Non-statistically significant increases in the observed risk of work injury in the months immediately following certification may be attributable to an intervention effect or a methodological limitation related to a lack of individual-level, time-at-risk exposure data."
] |
The aim of this study was to evaluate if safety certification reduces the risk of work injury among experienced manual tree-fallers. This study used a retrospective cohort study design. Experienced manual tree-fallers employed in the Canadian province of British Columbia (N3251) between 2003-2008 were enumerated from a mandatory faller registry. Registry records with demographic and certification data were linked to workers' compensation claims for injury outcomes. Data were analyzed using discrete time survival analysis over a two-year period, centered on certification date with pre- and post-certification demarcated into four three-month periods. Models were adjusted for demographic, occupation/industry, previous injury, and seasonal/temporal effects. The relative risk (RR) of work injury during the post certification periods were elevated in comparison to the pre-certification reference period, but the 95 confidence intervals included "1" for all estimates by the end of follow-up, suggesting no statistically significant increased risk of injury. Results were consistent across different outcome measures of acute injury (ie, fracture or amputations) (N186), musculoskeletal injury (ie, back strain) (N137), and serious injury claims (ie, long duration, high cost and/or fatal) (N155).
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 54-words sample answer on a PubMed discussion board to the following question: Prevention in dangerous industries: does safety certification prevent tree-faller injuries?.
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Twelve-year trends of hip fracture rates in Chile. Is there a relationship between their increase and population aging?
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Fracture rates increased in the 12 years period studied, specially among women older than 75 years old. During the same period the proportion of people over 75 years old also increased, but there was only a slight increase in its mean age. Thus, the increase in fracture rates is disproportionate to population aging and could be related to changes in lifestyles.
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"Fracture rates increased in the 12 years period studied, specially among women older than 75 years old. During the same period the proportion of people over 75 years old also increased, but there was only a slight increase in its mean age. Thus, the increase in fracture rates is disproportionate to population aging and could be related to changes in lifestyles."
] |
Epidemiology of osteoporosis is assessed measuring bone density or measuring the rates of bone frailty-related fracture rates. Of these, the most important are hip fractures, that markedly increase after 65 years of age. AIM: To measure the incidence of hip fractures in Chile from 1982 to 1993. All hospital discharges that occurred in Chile from 1982 to 1993 were analyzed, looking for the diagnosis of hip fracture. National censuses in the same period were also analyzed searching for possible changes in the age structure of the population. Fracture rates were analyzed for three age groups, and changes along the years were calculated correlating the rates with the number of the year. In the twelve year period, women aged 55-64 years old had a correlation of 0. 32 (NS), women aged 65-74 years old had a correlation of 0. 58 (NS) and women aged over 75 years old had a correlation of 0. 95 (p0. 001). This age group corresponded to 2. 01 of the whole population in 1982 and to 2. 52 in 1993. The mean age of the group increased from 80. 7 to 80. 9 years in the same lapse.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 61-words sample answer on a PubMed discussion board to the following question: Twelve-year trends of hip fracture rates in Chile. Is there a relationship between their increase and population aging?.
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Are asthmatics enrolled in randomized trials representative of real-life outpatients?
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In a real-life setting, 40 of subjects with mild/moderate asthma are currently treated by protocols based on the results of RCTs for which they would not have been eligible. This proportion increases in elderly patients with comorbidities. These findings limit the generalizability of RCTs and advocate that complementary pragmatic studies be conducted. Â 2015 S. Karger AG, Basel.
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"In a real-life setting, 40 of subjects with mild/moderate asthma are currently treated by protocols based on the results of RCTs for which they would not have been eligible. This proportion increases in elderly patients with comorbidities. These findings limit the generalizability of RCTs and advocate that complementary pragmatic studies be conducted. Â 2015 S. Karger AG, Basel."
] |
This study was aimed at exploring to what extent populations enrolled in randomized controlled trials (RCTs) of inhalation combination treatment for mild/moderate asthma in adults are fully representative of 'real-life' populations. The following is a retrospective analysis of the clinical records of outpatient subjects with an ascertained diagnosis of asthma. A retrospective analysis was performed. Stable conditions, such as smoking habit and chronic diseases other than asthma, were identified as exclusion criteria for RCTs. The selected criteria were then applied to asthmatic outpatients, yielding a population that was potentially eligible for RCTs. Out of 1, 909 subjects, 824 (43. 2) met at least one of the exclusion criteria for RCTs. Cigarette smoking (occurring in 34. 3 of the entire population), lung diseases other than asthma (5. 0), anxiety and depression (3. 3), arrhythmias (2. 3), and coronary artery disease (1. 2) would have been the most frequent causes for exclusion from RCTs. The proportion of patients excluded from RCTs appears to increase with age, reaching 57. 1 in patients aged85 years.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 58-words sample answer on a PubMed discussion board to the following question: Are asthmatics enrolled in randomized trials representative of real-life outpatients?.
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Perforated left-sided diverticulitis with faecal peritonitis: is the Hinchey classification the best guide for surgical decision making?
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The status of the underlying bowel, not the degree of peritoneal soiling, is the most significant consideration in defining the role of minimally invasive surgical treatment options for perforated diverticulitis. A new classification system that remains to be validated, taking into account the degree of colonic scarring and stricture formation, is proposed as a guide for surgical decision making in patients with perforated left-sided diverticulitis with faecal peritonitis.
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[
"The status of the underlying bowel, not the degree of peritoneal soiling, is the most significant consideration in defining the role of minimally invasive surgical treatment options for perforated diverticulitis. A new classification system that remains to be validated, taking into account the degree of colonic scarring and stricture formation, is proposed as a guide for surgical decision making in patients with perforated left-sided diverticulitis with faecal peritonitis."
] |
Although the Hinchey scoring system has guided surgical decision making for perforated diverticulitis, what constitutes optimal surgical management is controversial. We report our experience of selective primary closure of the perforation without use of a transverse colostomy and the specific circumstances in which this may be safe. All cases of perforated diverticular disease of the sigmoid colon with Hinchey grade IV (faecal) peritonitis seen over a 4-year period from one surgical unit were reviewed. Primary closure without a diverting stoma was performed in six of the eight patients studied since the bowel was deemed healthy, and resection and primary end-to-end anastomosis were performed in the other two patients because there was associated scarring and stricture formation distally. In the primary closure patients, the site of the perforation was dissected and closed with attendant omentoplasty and a meticulous peritoneal toilet. In one of these cases, a diverting stoma was later fashioned after the patient developed a short-lived faecal fistula.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 68-words sample answer on a PubMed discussion board to the following question: Perforated left-sided diverticulitis with faecal peritonitis: is the Hinchey classification the best guide for surgical decision making?.
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Is There a Relationship Between Optic Canal, Foramen Rotundum, and Vidian Canal?
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As a conclusion, the paranasal sinus, OC, VC, and FR values showed relationship with each other. Before performing craniofacial and/or skull base surgeries, CT view should be taken to evaluate the localization and the course and dimensions of the OC and vidian nerve. It should be kept in mind that in the presence of more pneumatized paranasal sinuses in CT views, VC dimensions decreased.
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"As a conclusion, the paranasal sinus, OC, VC, and FR values showed relationship with each other. Before performing craniofacial and/or skull base surgeries, CT view should be taken to evaluate the localization and the course and dimensions of the OC and vidian nerve. It should be kept in mind that in the presence of more pneumatized paranasal sinuses in CT views, VC dimensions decreased."
] |
In this retrospective study, we investigated the relationship between paranasal sinus, optic canal, foramen rotundum, and vidian canal measurements. Computed tomographic (CT) images of 320 adult subjects and 640 sides (right and left) were used. Paranasal sinus dimensions, optic canal (OC), foramen rotundum (FR), vidian canal (VC), bilateral FR (FRFR), bilateral vidian canal (VCVC), VC-foramen rotundum (VCFR), and VC-optic canal (VCOC) distances were measured. Right VCFR (6. 06 mm), and right and left VCOC values (20. 34 and 20. 31 mm) of the males were significantly higher than those of the females (5. 50, 18. 91, and 18. 80 mm, respectively). Foramen rotundum, OC, and VC values were positively correlated with each other. There was also positive correlation between FR width and maxillary sinus height. Increase of OC width was related to increase in FR width and area, VCVC distance; and decrease in maxillary sinus width. There was positive correlation between FRFR, VCVC, VCFR, and VCOC distance values. There was negative correlation between VC width and area; VCVC, VCFR, and VCOC distance; and maxillary sinus, ethmoid sinus, and sphenoid sinus measurement values. As these sinuses pneumatized more, VC width and area values decreased.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 64-words sample answer on a PubMed discussion board to the following question: Is There a Relationship Between Optic Canal, Foramen Rotundum, and Vidian Canal?.
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question
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Scoliosis related information on the internet in China: can patients benefit from this information?
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The study outlines the profile of scoliosis patients who use the Internet as a source of health information. It was shown that 87. 8 of the scoliosis patients in outpatient clinics have searched for scoliosis related information on Internet. Urban patients, higher education and Internet access at home were identified as potential predictors for Internet search. However, the overall quality of online scoliosis related information was poor and confusing. Physician based websites seemed to contain more reliable information.
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"The study outlines the profile of scoliosis patients who use the Internet as a source of health information. It was shown that 87. 8 of the scoliosis patients in outpatient clinics have searched for scoliosis related information on Internet. Urban patients, higher education and Internet access at home were identified as potential predictors for Internet search. However, the overall quality of online scoliosis related information was poor and confusing. Physician based websites seemed to contain more reliable information."
] |
There has been an increasing popularity of searching health related information online in recent years. Despite that considerable amount of scoliosis patients have shown interest in obtaining scoliosis information through Internet, previous studies have demonstrated poor quality of online information. However, this conclusion may vary depending on region and culture. Since China has a restricted Internet access outside of its borders, the aim of this study is to evaluate the quality of scoliosis information available online using recognized scoring systems and to analyze the Internet as a source of health information in China. A survey-based questionnaire was distributed to 280 respondents at outpatient clinics. Information on demographics and Internet use was collected. Binary logistic analysis was performed to identify possible predictors for the use of Internet. In addition, the top 60 scoliosis related websites assessed through 4 search engines were reviewed by a surgeon and the quality of online information was evaluated using DISCERN score and JAMA benchmark. Use of the Internet as a source for scoliosis related information was confirmed in 87. 8 of the respondents. College education, Internet access at home and urban residence were identified as potential predictors for Internet use. However, the quality of online scoliosis related information was poor with an average DISCERN score of 27. 9Â11. 7 and may be misleading for scoliosis patients.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 78-words sample answer on a PubMed discussion board to the following question: Scoliosis related information on the internet in China: can patients benefit from this information?.
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Is intramuscular mivacurium an alternative to intramuscular succinylcholine?
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Although ventilatory depression preceded twitch depression, both occurred later with intramuscular mivacurium than would be expected after intravenous mivacurium or intramuscular succinylcholine. The authors speculate that the onset of intramuscular mivacurium is too slow to treat laryngospasm or to facilitate routine tracheal intubation in infants or children, despite administration of large doses.
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"Although ventilatory depression preceded twitch depression, both occurred later with intramuscular mivacurium than would be expected after intravenous mivacurium or intramuscular succinylcholine. The authors speculate that the onset of intramuscular mivacurium is too slow to treat laryngospasm or to facilitate routine tracheal intubation in infants or children, despite administration of large doses."
] |
Mivacurium's rapid onset and short duration of action in children suggests that intramuscular administration might treat laryngospasm and facilitate tracheal intubation without producing prolonged paralysis. Accordingly, the authors measured the neuromuscular effects of intramuscular mivacurium in anesthetized infants and children. Twenty unpremedicated infants and children (3 months to 5 yr of age) were anesthetized with nitrous oxide and halothane and permitted to breathe spontaneously. When anesthetic conditions were stable, mivacurium was injected into the quadriceps or deltoid muscle. Minute ventilation and adductor pollicis twitch tension were measured. The initial mivacurium dose was 250 micrograms/kg and was increased (to a maximum of 800 micrograms/kg, at which dose the trial was ended) or decreased according to the response of the previous patient, the goal being to bracket the dose producing 80-90 twitch depression within 5 min of drug administration. No patient achieved80 twitch depression within 5 min of mivacurium administration. Peak twitch depression was 90 +/- 13 (mean +/- SD) for infants and 88 +/- 15 for children at 15. 0 +/- 4. 6 min and 18. 4 +/- 6. 4 min, respectively. Ventilatory depression (a 50 decrease in minute ventilation or a 10-mmHg increase in end-tidal carbon dioxide tension) occurred at 9. 0 +/- 4. 4 min in nine infants and 13. 6 +/- 7. 5 min in 10 children; ventilatory depression did not develop in one infant given a dose of 350 micrograms/kg. Time to peak twitch depression or ventilatory depression was not faster with larger doses.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 52-words sample answer on a PubMed discussion board to the following question: Is intramuscular mivacurium an alternative to intramuscular succinylcholine?.
Use the following context: Mivacurium's rapid onset and short duration of action in children suggests that intramuscular administration might treat laryngospasm and facilitate tracheal intubation without producing prolonged paralysis. Accordingly, the authors measured the neuromuscular effects of intramuscular mivacurium in anesthetized infants and children. Twenty unpremedicated infants and children (3 months to 5 yr of age) were anesthetized with nitrous oxide and halothane and permitted to breathe spontaneously. When anesthetic conditions were stable, mivacurium was injected into the quadriceps or deltoid muscle. Minute ventilation and adductor pollicis twitch tension were measured. The initial mivacurium dose was 250 micrograms/kg and was increased (to a maximum of 800 micrograms/kg, at which dose the trial was ended) or decreased according to the response of the previous patient, the goal being to bracket the dose producing 80-90 twitch depression within 5 min of drug administration. No patient achieved80 twitch depression within 5 min of mivacurium administration. Peak twitch depression was 90 +/- 13 (mean +/- SD) for infants and 88 +/- 15 for children at 15. 0 +/- 4. 6 min and 18. 4 +/- 6. 4 min, respectively. Ventilatory depression (a 50 decrease in minute ventilation or a 10-mmHg increase in end-tidal carbon dioxide tension) occurred at 9. 0 +/- 4. 4 min in nine infants and 13. 6 +/- 7. 5 min in 10 children; ventilatory depression did not develop in one infant given a dose of 350 micrograms/kg. Time to peak twitch depression or ventilatory depression was not faster with larger doses.
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Does vitamin C prevent the effects of high dose dexmedetomidine on rat erythrocyte deformability?
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High dose dexmedetomidine may cause functional deterioration in blood flow and tissue perfusion with negative effects in erythrocyte deformability. Vitamin C supplementation seems to reverse those negative effects and variations in erythrocyte deformability. However, our preliminary results should be confirmed in wider serious of experimental and clinical trials (Fig. 1, Ref. 27).
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"High dose dexmedetomidine may cause functional deterioration in blood flow and tissue perfusion with negative effects in erythrocyte deformability. Vitamin C supplementation seems to reverse those negative effects and variations in erythrocyte deformability. However, our preliminary results should be confirmed in wider serious of experimental and clinical trials (Fig. 1, Ref. 27)."
] |
Dexmedetomidine is an anesthetic agent frequently used for sedation at the intensive care units and during general anesthesia. The purpose of our study was to investigate whether vitamin C prevents the effect of high dose dexmedetomidine on erythrocyte deformability in rats. The study was performed on 21 male rats, with 7 rats in each study groups and the control group. The rats in the study groups were treated with intraperitoneal dexmedetomidine (10 µg/kg) and intraperitoneal dexmedetomidine plus Vitamin C (ascorbic acid) (100 mg/kg ascorbic acid administered 1 hour before administration of 10 µg/kg dexmedetomidine), respectively. Intraperitoneal physiological saline was administered in the control group. Erythrocyte packs were prepared using heparinized total blood samples. Deformability measurements were done by erythrocyte suspensions in phosphate buffered saline (PBS) buffer. A constant flow filtrometer system was used to measure erythrocyte deformability and the relative resistance was calculated. Erythrocyte deformability was significantly higher in dexmedetomidine group than in control and vitamin C plus dexmedetomidine groups (p0. 003, p0. 013, respectively). Erythrocyte deformability indexes were found similar in the control group and in the vitamin C plus dexmedetomidine group (p0. 383).
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 52-words sample answer on a PubMed discussion board to the following question: Does vitamin C prevent the effects of high dose dexmedetomidine on rat erythrocyte deformability?.
Use the following context: Dexmedetomidine is an anesthetic agent frequently used for sedation at the intensive care units and during general anesthesia. The purpose of our study was to investigate whether vitamin C prevents the effect of high dose dexmedetomidine on erythrocyte deformability in rats. The study was performed on 21 male rats, with 7 rats in each study groups and the control group. The rats in the study groups were treated with intraperitoneal dexmedetomidine (10 µg/kg) and intraperitoneal dexmedetomidine plus Vitamin C (ascorbic acid) (100 mg/kg ascorbic acid administered 1 hour before administration of 10 µg/kg dexmedetomidine), respectively. Intraperitoneal physiological saline was administered in the control group. Erythrocyte packs were prepared using heparinized total blood samples. Deformability measurements were done by erythrocyte suspensions in phosphate buffered saline (PBS) buffer. A constant flow filtrometer system was used to measure erythrocyte deformability and the relative resistance was calculated. Erythrocyte deformability was significantly higher in dexmedetomidine group than in control and vitamin C plus dexmedetomidine groups (p0. 003, p0. 013, respectively). Erythrocyte deformability indexes were found similar in the control group and in the vitamin C plus dexmedetomidine group (p0. 383).
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Laparoscopic orchiopexy without division of the spermatic vessels: can it be considered the procedure of choice in cases of intraabdominal testis?
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On the basis of our experience, we believe that laparoscopic orchiopexy without division of the spermatic vessels should be the treatment of choice in the management of nonpalpable testes, because it does not affect normal testicular vascularization and is minimally invasive. A blunt dissection and a delicate manipulation of the testis without excessive traction are the best ways to avoid any kind of complication.
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"On the basis of our experience, we believe that laparoscopic orchiopexy without division of the spermatic vessels should be the treatment of choice in the management of nonpalpable testes, because it does not affect normal testicular vascularization and is minimally invasive. A blunt dissection and a delicate manipulation of the testis without excessive traction are the best ways to avoid any kind of complication."
] |
Several surgical procedures have been described for the management of nonpalpable testis. Following a vast experience with a complete laparoscopic two-stage Fowler-Stephens procedure, we report our experience with laparoscopic orchiopexy performed without dividing the spermatic vessels. Over a 24-month period, 70 boys with nonpalpable testes (72 overall) underwent laparoscopic diagnostic exploration. Twenty patients (27. 8) of this series who showed an intraabdominal testis underwent laparoscopic orchiopexy without sectioning the spermatic vessels. In seven cases, the testis was just proximal to the internal inguinal ring; in 13, it was in the high intraabdominal position. The technique consisted in sectioning the gubernaculum (when present), opening the peritoneum laterally to the spermatic vessels, and mobilizing the testicular vessels and the vas deferens in a retroperitoneal position for 8-10 cm. The testis was then brought down into the scrotum through the internal inguinal ring (11 cases), if this was open, or through a neo-inguinal ring (nine cases) created medially to the epigastric vessels. In every case, we closed the inguinal ring at the end of the operation using one or two detached sutures. Operating time ranged between 40 and 75 min (median, 55). All the testes were successfully brought down into the scrotum. We had only one (5) intraoperative complication. In the second patient treated with this procedure, there was an iatrogenic rupture of the spermatic vessels due to excessive traction.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 64-words sample answer on a PubMed discussion board to the following question: Laparoscopic orchiopexy without division of the spermatic vessels: can it be considered the procedure of choice in cases of intraabdominal testis?.
Use the following context: Several surgical procedures have been described for the management of nonpalpable testis. Following a vast experience with a complete laparoscopic two-stage Fowler-Stephens procedure, we report our experience with laparoscopic orchiopexy performed without dividing the spermatic vessels. Over a 24-month period, 70 boys with nonpalpable testes (72 overall) underwent laparoscopic diagnostic exploration. Twenty patients (27. 8) of this series who showed an intraabdominal testis underwent laparoscopic orchiopexy without sectioning the spermatic vessels. In seven cases, the testis was just proximal to the internal inguinal ring; in 13, it was in the high intraabdominal position. The technique consisted in sectioning the gubernaculum (when present), opening the peritoneum laterally to the spermatic vessels, and mobilizing the testicular vessels and the vas deferens in a retroperitoneal position for 8-10 cm. The testis was then brought down into the scrotum through the internal inguinal ring (11 cases), if this was open, or through a neo-inguinal ring (nine cases) created medially to the epigastric vessels. In every case, we closed the inguinal ring at the end of the operation using one or two detached sutures. Operating time ranged between 40 and 75 min (median, 55). All the testes were successfully brought down into the scrotum. We had only one (5) intraoperative complication. In the second patient treated with this procedure, there was an iatrogenic rupture of the spermatic vessels due to excessive traction.
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Inguinal hernia in female infants: a cue to check the sex chromosomes?
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Most clinicians agreed that CAIS should be considered in all female infants with inguinal hernia, as this is the commonest mode of presentation in childhood. Macroscopic inspection of the internal genital structures coupled, perhaps, with gonadal biopsy is recommended. Fluorescence in situ hybridization offers a rapid and reliable method to check the sex chromosomes. Liaison between the paediatric surgeon and endocrinologist is essential in management of infants with CAIS.
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"Most clinicians agreed that CAIS should be considered in all female infants with inguinal hernia, as this is the commonest mode of presentation in childhood. Macroscopic inspection of the internal genital structures coupled, perhaps, with gonadal biopsy is recommended. Fluorescence in situ hybridization offers a rapid and reliable method to check the sex chromosomes. Liaison between the paediatric surgeon and endocrinologist is essential in management of infants with CAIS."
] |
To review the clinical presentation of complete androgen insensitivity syndrome (CAIS) and assess the current practice of considering the diagnosis of CAIS in female infants presenting with inguinal hernia. AIS arises from target tissue resistance to the actions of androgens due to molecular abnormalities in the androgen receptor. Patients with CAIS are born with normal external female genitalia, and although inguinal hernias are uncommon in female infants, they are a well-known presentation of CAIS. Such patients were identified from the Cambridge Intersex Database and details of presentation, presence and laterality of inguinal hernia and contents, and family history of CAIS, were recorded. A questionnaire detailing different indications for considering CAIS in female infants with a hernia was distributed to members of the British Association of Paediatric Surgeons and the British Society for Paediatric Endocrinology and Diabetes. More than half of patients with CAIS presented with inguinal hernia, of which half were bilateral and a third contained gonads. Completed questionnaires were returned by 87 surgeons and 64 endocrinologists, and most of the surgeons and endocrinologists would consider CAIS in all female infants with a hernia. Bilateral hernias, hernias containing gonads and a family history of CAIS would prompt clinicians to consider the diagnosis.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 69-words sample answer on a PubMed discussion board to the following question: Inguinal hernia in female infants: a cue to check the sex chromosomes?.
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question
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Can famotidine and omeprazole be combined on a once-daily basis?
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Compared with treatment with omeprazole alone, on day 1 famotidine and omeprazole in combination improved the duration of and time to reach intragastric pH4. With regard to duration with pH4, the combination therapy was superior to famotidine alone on day 8. The rapid acid control with an H2-receptor antagonist may be combined with the long-lasting antisecretory effect of a proton-pump inhibitor.
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[
"Compared with treatment with omeprazole alone, on day 1 famotidine and omeprazole in combination improved the duration of and time to reach intragastric pH4. With regard to duration with pH4, the combination therapy was superior to famotidine alone on day 8. The rapid acid control with an H2-receptor antagonist may be combined with the long-lasting antisecretory effect of a proton-pump inhibitor."
] |
Prompt and long-standing acid control following once-daily administration of antisecretory drugs is desirable. The objective of this study was to determine whether co-administration of a well-characterized H2-receptor antagonist, famotidine, can be combined with the proton-pump inhibitor omeprazole. Intragastric 24-h pH-metry was performed in healthy, Helicobacter pylori-negative volunteers on day 1 and after 8 days of daily administration of 20 mg omeprazole, 10 mg famotidine, or a combination of these in a three-way crossover design. A combination of famotidine and omeprazole raised the gastric pH level to4 in less than 1 h. The percentage of daytime with pH4 on day 1 was significantly higher with the combination of omeprazole and famotidine (median: 37) than that with omeprazole alone (22; p0. 05). On day 8, daytime intragastric pH4 following treatment with omeprazole (median: 55) or a combination of omeprazole and famotidine (61) was superior (p0. 05) to that with famotidine (21). On day 1 treatment with both famotidine and the combination (famotidine and omeprazole) showed a significantly shorter time to reach a pH of 4 (medians: 93 and 63 min, respectively) compared with treatment with omeprazole alone (173 min; p0. 05).
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 61-words sample answer on a PubMed discussion board to the following question: Can famotidine and omeprazole be combined on a once-daily basis?.
Use the following context: Prompt and long-standing acid control following once-daily administration of antisecretory drugs is desirable. The objective of this study was to determine whether co-administration of a well-characterized H2-receptor antagonist, famotidine, can be combined with the proton-pump inhibitor omeprazole. Intragastric 24-h pH-metry was performed in healthy, Helicobacter pylori-negative volunteers on day 1 and after 8 days of daily administration of 20 mg omeprazole, 10 mg famotidine, or a combination of these in a three-way crossover design. A combination of famotidine and omeprazole raised the gastric pH level to4 in less than 1 h. The percentage of daytime with pH4 on day 1 was significantly higher with the combination of omeprazole and famotidine (median: 37) than that with omeprazole alone (22; p0. 05). On day 8, daytime intragastric pH4 following treatment with omeprazole (median: 55) or a combination of omeprazole and famotidine (61) was superior (p0. 05) to that with famotidine (21). On day 1 treatment with both famotidine and the combination (famotidine and omeprazole) showed a significantly shorter time to reach a pH of 4 (medians: 93 and 63 min, respectively) compared with treatment with omeprazole alone (173 min; p0. 05).
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Recurrent pyelonephritis without vesicoureteral reflux: is there a role for an antireflux procedure?
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Recurrent acute pyelonephritis is frequently related to VUR. Intermittent reflux can be difficult to demonstrate on voiding conventional or nuclear cystograms but can be suspected in the presence of ureteral duplication, renal scarring, or abnormal ureteral orifices. Adult patients with recurrent episodes of upper urinary tract infection and normal cystograms should be considered for an endoscopic antireflux procedure in the presence of anatomic abnormalities commonly associated with reflux.
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[
"Recurrent acute pyelonephritis is frequently related to VUR. Intermittent reflux can be difficult to demonstrate on voiding conventional or nuclear cystograms but can be suspected in the presence of ureteral duplication, renal scarring, or abnormal ureteral orifices. Adult patients with recurrent episodes of upper urinary tract infection and normal cystograms should be considered for an endoscopic antireflux procedure in the presence of anatomic abnormalities commonly associated with reflux."
] |
To evaluate the results of an endoscopic antireflux procedure in women with recurrent acute pyelonephritis and no evidence of vesicoureteral reflux (VUR) on voiding cystograms. From 1989 to 1999, 603 female patients were hospitalized for acute pyelonephritis with unilateral loin pain, chills, fever, and a positive urine culture. Of these patients, 48 (8) had recurrent episodes of acute pyelonephritis and underwent a thorough diagnostic work-up including intravenous urography or renal CT scan, cystoscopy, and voiding cystourethrography (VCUG). Vesicoureteral reflux was demonstrated in 21 patients, who were then offered an antireflux procedure, either surgical or endoscopic. Another 27 patients had no reflux on VCUG; in 15 cases, the upper urinary tract was normal, and the ureteral orifices did not show any abnormality on cystoscopy. The other 12 patients in this group with a normal VCUG had one or more abnormal findings normally associated with VUR: renal scarring in five and ureteral duplication in two. Golf-hole ureteral orifices were noted in two patients. The intravesical ureter was short (5 mm) in five patients. In spite of the normal VCU, we offered these patients endoscopic treatment of VUR by submeatal injection of Teflon or microparticulate silicone (Macroplastic). The median follow-up before treatment was 4 years (range 1-15. 3 years); 0. 3 episodes of acute pyelonephritis per patient-month of follow-up were noted. The frequence of preoperative and postoperative episodes of acute pyelonephritis was compared with Wilcoxon's paired analysis. The median postoperative follow-up was 3. 9 years (range 1. 1 months-10. 2 years). There were no significant postoperative complications. One patient had two episodes of acute pyelonephritis during pregnancy. On the whole, 11 patients (91) were free of recurrent pyelonephritis after treatment. Overall, 0. 003 episodes of acute pyelonephritis per patient-month of postoperative follow-up were observed. The result was statistically significant (P0. 01).
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 68-words sample answer on a PubMed discussion board to the following question: Recurrent pyelonephritis without vesicoureteral reflux: is there a role for an antireflux procedure?.
Use the following context: To evaluate the results of an endoscopic antireflux procedure in women with recurrent acute pyelonephritis and no evidence of vesicoureteral reflux (VUR) on voiding cystograms. From 1989 to 1999, 603 female patients were hospitalized for acute pyelonephritis with unilateral loin pain, chills, fever, and a positive urine culture. Of these patients, 48 (8) had recurrent episodes of acute pyelonephritis and underwent a thorough diagnostic work-up including intravenous urography or renal CT scan, cystoscopy, and voiding cystourethrography (VCUG). Vesicoureteral reflux was demonstrated in 21 patients, who were then offered an antireflux procedure, either surgical or endoscopic. Another 27 patients had no reflux on VCUG; in 15 cases, the upper urinary tract was normal, and the ureteral orifices did not show any abnormality on cystoscopy. The other 12 patients in this group with a normal VCUG had one or more abnormal findings normally associated with VUR: renal scarring in five and ureteral duplication in two. Golf-hole ureteral orifices were noted in two patients. The intravesical ureter was short (5 mm) in five patients. In spite of the normal VCU, we offered these patients endoscopic treatment of VUR by submeatal injection of Teflon or microparticulate silicone (Macroplastic). The median follow-up before treatment was 4 years (range 1-15. 3 years); 0. 3 episodes of acute pyelonephritis per patient-month of follow-up were noted. The frequence of preoperative and postoperative episodes of acute pyelonephritis was compared with Wilcoxon's paired analysis. The median postoperative follow-up was 3. 9 years (range 1. 1 months-10. 2 years). There were no significant postoperative complications. One patient had two episodes of acute pyelonephritis during pregnancy. On the whole, 11 patients (91) were free of recurrent pyelonephritis after treatment. Overall, 0. 003 episodes of acute pyelonephritis per patient-month of postoperative follow-up were observed. The result was statistically significant (P0. 01).
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Long-term functional outcomes after radical cystectomy with ileal bladder substitute: does the definition of continence matter?
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Functional outcomes at long-term follow-up after radical cystectomy and Studer ileal bladder substitute were at best modest in this series. Better outcomes during the second half of the study period might be explained by improved patient selection and a refined surgical technique, but possibly also by longer follow-up of patients during the first half of the period resulting in a more pronounced time-dependent decline in functional outcomes.
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[
"Functional outcomes at long-term follow-up after radical cystectomy and Studer ileal bladder substitute were at best modest in this series. Better outcomes during the second half of the study period might be explained by improved patient selection and a refined surgical technique, but possibly also by longer follow-up of patients during the first half of the period resulting in a more pronounced time-dependent decline in functional outcomes."
] |
Functional outcomes after ileal bladder substitution reflect the expectations of future patients at a particular centre. The aim of this study was to use validated questionnaires and a pad-weighing test to investigate functional outcomes after neobladder reconstruction at long-term follow-up in patients at a single centre. During 2005â-â2015, 75 patients received a Studer ileal bladder substitute at the Department of Urology, MalmÃ. Forty-six of these patients were alive for follow-up and were evaluated using the pad-weighing test and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF), the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF). Five of 37 evaluable patients (14) were considered fully continent, reporting a pad-weighing test result of 0â g and an ICIQ-UI-SF score of 0. The median ICIQ-UI-SF score was 8, and seven patients (17) were continent according to the ICIQ-UI-SF score only. In the pad-weighing test, 28 out of 37 patients (76) reported 0â g day-time leakage whereas only 12 out of 37 patients (32) reported 0â g night-time leakage. At follow-up, nine out of 39 (23) of evaluable male patients were potent. The median ICIQ-UI-SF score was significantly lower during the second half of the study period. The inverse applied to the median IIEF score.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 67-words sample answer on a PubMed discussion board to the following question: Long-term functional outcomes after radical cystectomy with ileal bladder substitute: does the definition of continence matter?.
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Can community leaders' preferences be used to proxy those of the community as a whole?
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This study has shown that community leaders' views can only be used as a partial substitute for more laborious methods of data collection insofar as they have the attraction of being quicker and less costly to use. However, they should not be assumed to be identical with the views of the community as a whole.
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"This study has shown that community leaders' views can only be used as a partial substitute for more laborious methods of data collection insofar as they have the attraction of being quicker and less costly to use. However, they should not be assumed to be identical with the views of the community as a whole."
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Community-based distribution of ivermectin and other drugs requires people in the endemic communities who are capable of distributing the drug. It is essential also to collect information on local people's views concerning different financing mechanisms and approaches to distributing ivermectin. However, studies at household level are resource-intensive. Eliciting the preferences of the community by interviewing a smaller number of community leaders offers an alternative strategy. A comparison of information from community leaders and household heads on the financing and distribution of ivermectin through communities was conducted in three communities in Nigeria to determine whether rapidly collected information from key community leaders could represent broad community preferences. The preferences of community leaders and household heads were comparable in relation to the method of collecting payments, managing payments and making payments, who should set the level of payments and the drug distribution mechanisms. However, there were differences between community leaders' views and those of heads of households concerning how the scheme should be supervised.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 55-words sample answer on a PubMed discussion board to the following question: Can community leaders' preferences be used to proxy those of the community as a whole?.
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Do market fees differ from relative value scale fees?
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Surgical fees were generally consistent with those predicted by the RBRVS. However, the fees for high volume procedures were relatively lower than predicted while the fees for low volume procedures appeared more variable. The findings are consistent with the hypothesis that market forces lowered prices for procedures with higher volumes. This has implications for how health funders might determine private surgical fees, especially in mixed public-private systems.
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"Surgical fees were generally consistent with those predicted by the RBRVS. However, the fees for high volume procedures were relatively lower than predicted while the fees for low volume procedures appeared more variable. The findings are consistent with the hypothesis that market forces lowered prices for procedures with higher volumes. This has implications for how health funders might determine private surgical fees, especially in mixed public-private systems."
] |
Health funders face the challenge of determining the appropriate level of surgeon fees in fee-for-service schemes. Â A resource-based relative value scale (RBRVS) attempts to identify the fees that would exist in a competitive market. Â Private insurance providers in New Zealand do not use a RBRVS but rather rely on a market. Â We explore the extent to which private surgeon fees in New Zealand are consistent with fees that would be generated by a RBRVS. Data on 155, 290 surgical procedures from 2004-06 were provided by New Zealand's largest private health insurer. Â 314 procedure codes were matched to the Australian Ministry of Health and Ageing's RBRVS. A random effects model determined predicted surgeon reimbursements based on the RBRVS, the location and the year. Procedure volume and specialty were explored as potential sources of deviations. The RBRVS, location and year explain 79 of the variation in surgeon fees. After accounting for the RBRVS, location and year, no statistical differences were found between five out of the seven specialties, but higher volume procedures were associated with lower fees. There was some evidence that the model explained less variation in lower volume procedures.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 67-words sample answer on a PubMed discussion board to the following question: Do market fees differ from relative value scale fees?.
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Nonsteroidal anti-inflammatory drugs in schizophrenia: ready for practice or a good start?
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These results suggest that NSAID augmentation could be a potentially useful strategy to reduce symptom severity in schizophrenia. As these are the first studies on a relatively new strategy and the included sample size is modest, these results should be interpreted with caution. However, augmentation with acetylsalicylic acid may have the additional benefit of reducing cardiac and cancer mortality in schizophrenia. We therefore believe that application of NSAIDs in schizophrenia deserves further investigation as augmentation of antipsychotic treatment and reducing comorbid somatic diseases.
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"These results suggest that NSAID augmentation could be a potentially useful strategy to reduce symptom severity in schizophrenia. As these are the first studies on a relatively new strategy and the included sample size is modest, these results should be interpreted with caution. However, augmentation with acetylsalicylic acid may have the additional benefit of reducing cardiac and cancer mortality in schizophrenia. We therefore believe that application of NSAIDs in schizophrenia deserves further investigation as augmentation of antipsychotic treatment and reducing comorbid somatic diseases."
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Mounting evidence suggests that inflammation is involved in the pathogenesis of schizophrenia. This evidence implies that anti-inflammatory agents are potentially useful therapeutic strategies in schizophrenia. This article quantitatively summarizes the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) to augment antipsychotic treatment to reduce schizophrenia symptom severity. An electronic search was performed using MEDLINE, Embase, the National Institutes of Health Web site clinicaltrials. gov, Cochrane Schizophrenia Group entries in PsiTri, and the Cochrane Database of Systematic Reviews. The following basic search terms were used: schizophrenia, nonsteroidal anti-inflammatory drug, and NSAID together with the name of each specific NSAID (ibuprofen, diclofenac, naproxen sodium, and acetylsalicylic acid). We applied no year or language restrictions. Studies were selected if they met the following inclusion criteria: (1) randomized, double-blind, placebo-controlled trials regarding augmentation of antipsychotic medication with an NSAID, (2) patients included had a diagnosis of a schizophrenia spectrum disorder according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, and (3) studies reported sufficient information to compute common effect size statistics, or corresponding authors could supply these data upon request. The primary outcome measure was the mean change in total score on the Positive and Negative Syndrome Scale (PANSS). Secondary outcome measures included positive and negative symptom subscores of the PANSS. We could include 5 double-blind, randomized, placebo-controlled trials, reporting on 264 patients. Four studies applied celecoxib, and 1 used acetylsalicylic acid. We found a mean effect size of 0. 43, which was significant at P. 02 in favor of NSAIDs on total symptom severity. For positive symptom severity, the mean standardized difference was 0. 34 (P. 02). For severity of negative symptoms the mean standardized difference was 0. 26 (P. 03).
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 83-words sample answer on a PubMed discussion board to the following question: Nonsteroidal anti-inflammatory drugs in schizophrenia: ready for practice or a good start?.
Use the following context: Mounting evidence suggests that inflammation is involved in the pathogenesis of schizophrenia. This evidence implies that anti-inflammatory agents are potentially useful therapeutic strategies in schizophrenia. This article quantitatively summarizes the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) to augment antipsychotic treatment to reduce schizophrenia symptom severity. An electronic search was performed using MEDLINE, Embase, the National Institutes of Health Web site clinicaltrials. gov, Cochrane Schizophrenia Group entries in PsiTri, and the Cochrane Database of Systematic Reviews. The following basic search terms were used: schizophrenia, nonsteroidal anti-inflammatory drug, and NSAID together with the name of each specific NSAID (ibuprofen, diclofenac, naproxen sodium, and acetylsalicylic acid). We applied no year or language restrictions. Studies were selected if they met the following inclusion criteria: (1) randomized, double-blind, placebo-controlled trials regarding augmentation of antipsychotic medication with an NSAID, (2) patients included had a diagnosis of a schizophrenia spectrum disorder according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, and (3) studies reported sufficient information to compute common effect size statistics, or corresponding authors could supply these data upon request. The primary outcome measure was the mean change in total score on the Positive and Negative Syndrome Scale (PANSS). Secondary outcome measures included positive and negative symptom subscores of the PANSS. We could include 5 double-blind, randomized, placebo-controlled trials, reporting on 264 patients. Four studies applied celecoxib, and 1 used acetylsalicylic acid. We found a mean effect size of 0. 43, which was significant at P. 02 in favor of NSAIDs on total symptom severity. For positive symptom severity, the mean standardized difference was 0. 34 (P. 02). For severity of negative symptoms the mean standardized difference was 0. 26 (P. 03).
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Can RENAL and PADUA nephrometry indices predict complications of laparoscopic cryoablation for clinical stage T1 renal tumors?
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The RENAL score, and not the PADUA score, is associated with a higher risk for IOC. A noncategorized method of scoring tumor diameter showed a more significant correlation with the risk for IOC than the categorized method of the nephrometry indices. As a result a threshold diameter of 35âmm was established.
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"The RENAL score, and not the PADUA score, is associated with a higher risk for IOC. A noncategorized method of scoring tumor diameter showed a more significant correlation with the risk for IOC than the categorized method of the nephrometry indices. As a result a threshold diameter of 35âmm was established."
] |
Assessment of anatomical complexity with the RENAL (radius; exophytic/endophytic; nearness; anterior/posterior; location) and preoperative aspects and dimensions used for anatomical classification (PADUA) nephrometry indices is used to predict complications related to surgical extirpation treatment for patients with clinical T1a/b renal mass. This single center study aims to investigate the value of these indices to predict complications in a cohort of patients treated with laparoscopic cryoablation (LCA) for cT1 renal mass. Single institution data from consecutive LCA procedures were prospectively collected from December 2006 to April 2013. Renal mass anatomical complexity was categorized according to RENAL and PADUA indices. Comorbidity was assessed by the Charlson-index. Intraoperative complications (IOCs) were reviewed and categorized: blood loss100âmL, conversion, tumor fracture, and incomplete ablation. Postoperative complications (POCs) were graded using the modified Clavien-index. Univariate and multivariate logistic regression models addressed the risk for complications. Ninety-nine LCA procedures were included. The median RENAL-score was 7. 0 (standard deviation 1. 7), and the median PADUA-score was 8. 0 (SD 1. 6). IOC occurred in 19 procedures (19). The risk for IOC was significantly correlated (p0. 05) with tumor diameter (mm), surface, volume, the RENAL domains "R-size, " "N-nearness to collecting system, " "RENAL score, " and the PADUA domain "diameter. " In multivariate analysis with surgical complication as the independent variable, tumor diameter, surface, and volume were determining factors. A threshold was set for 35âmm tumor diameter, it being predictive for an increased risk for IOC performing LCA. Twenty-three POC occurred in 20 patients. On univariate analysis, the RENAL domain "nearness to collecting system, " and no PADUA domains, had a significant association with POC.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 51-words sample answer on a PubMed discussion board to the following question: Can RENAL and PADUA nephrometry indices predict complications of laparoscopic cryoablation for clinical stage T1 renal tumors?.
Use the following context: Assessment of anatomical complexity with the RENAL (radius; exophytic/endophytic; nearness; anterior/posterior; location) and preoperative aspects and dimensions used for anatomical classification (PADUA) nephrometry indices is used to predict complications related to surgical extirpation treatment for patients with clinical T1a/b renal mass. This single center study aims to investigate the value of these indices to predict complications in a cohort of patients treated with laparoscopic cryoablation (LCA) for cT1 renal mass. Single institution data from consecutive LCA procedures were prospectively collected from December 2006 to April 2013. Renal mass anatomical complexity was categorized according to RENAL and PADUA indices. Comorbidity was assessed by the Charlson-index. Intraoperative complications (IOCs) were reviewed and categorized: blood loss100âmL, conversion, tumor fracture, and incomplete ablation. Postoperative complications (POCs) were graded using the modified Clavien-index. Univariate and multivariate logistic regression models addressed the risk for complications. Ninety-nine LCA procedures were included. The median RENAL-score was 7. 0 (standard deviation 1. 7), and the median PADUA-score was 8. 0 (SD 1. 6). IOC occurred in 19 procedures (19). The risk for IOC was significantly correlated (p0. 05) with tumor diameter (mm), surface, volume, the RENAL domains "R-size, " "N-nearness to collecting system, " "RENAL score, " and the PADUA domain "diameter. " In multivariate analysis with surgical complication as the independent variable, tumor diameter, surface, and volume were determining factors. A threshold was set for 35âmm tumor diameter, it being predictive for an increased risk for IOC performing LCA. Twenty-three POC occurred in 20 patients. On univariate analysis, the RENAL domain "nearness to collecting system, " and no PADUA domains, had a significant association with POC.
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Do outcomes of acupuncture for back pain differ according to varying sociocultural contexts?
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Although multiple studies substantiate biologic mechanisms of acupuncture, there is not necessarily a fixed relationship between those mechanisms and people's experience of them. Rather, sociocultural context may interact with biologic mechanisms and mediate this experience. The theory proposed here explains why outcomes of acupuncture for back pain will potentially be more pronounced in the sociocultural context of China than in the West.
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"Although multiple studies substantiate biologic mechanisms of acupuncture, there is not necessarily a fixed relationship between those mechanisms and people's experience of them. Rather, sociocultural context may interact with biologic mechanisms and mediate this experience. The theory proposed here explains why outcomes of acupuncture for back pain will potentially be more pronounced in the sociocultural context of China than in the West."
] |
What are the outcomes of acupuncture for back pain? According to well-regarded trials, acupuncture is little better for back pain than biomedicine, and active acupuncture is no better than sham acupuncture. These trials occurred in the West. Patients are inside the clinic a miniscule amount of time in relation to the time they are outside the clinic and enmeshed in the wider sociocultural context. Nevertheless, trials have largely overlooked potential effects of sociocultural context. The main objective of this article is to draw attention to designated features of sociocultural context that, as compared with outcomes obtained in the West, may enhance outcomes of acupuncture for back pain in China. Additional objectives of the article are to reconceptualize "sociocultural context" so that it is measurable, and to measure pre-existing acquaintance with acupuncture and other forms of Traditional Chinese Medicine (TCM) within the sociocultural context of China. DESIGN/SETTING/ Back pain patients (N86) were recruited from the Acupuncture Clinic and Pain Clinic of West China Hospital (Chengdu, Sichuan Province). Patients completed questionnaires on their use of TCM before they came to the Acupuncture Clinic and their families' use of TCM. Most patients had used TCM, and those who did so likely used it repeatedly, which indicated substantial acquaintance with TCM beliefs in the cultural context. Patients whose families used TCM were also likely to use it themselves, which indicated that TCM use was anchored in the social context of the family.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 62-words sample answer on a PubMed discussion board to the following question: Do outcomes of acupuncture for back pain differ according to varying sociocultural contexts?.
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Evaluation of operative notes concerning laparoscopic cholecystectomy: are standards being met?
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Operative notes do not always fully comply with the standards set forth in the guidelines published in the Netherlands. This could influence adjuvant treatment and future patient treatment, and it may make operative notes less suitable background for other purposes. Therefore operative note writing should be taught as part of surgical training, definitions should be provided, and procedure-specific guidelines should be established to improve the quality of the operative notes and their use to improve patient safety.
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"Operative notes do not always fully comply with the standards set forth in the guidelines published in the Netherlands. This could influence adjuvant treatment and future patient treatment, and it may make operative notes less suitable background for other purposes. Therefore operative note writing should be taught as part of surgical training, definitions should be provided, and procedure-specific guidelines should be established to improve the quality of the operative notes and their use to improve patient safety."
] |
Laparoscopic cholecystectomy (LC) is the most performed minimal invasive surgical procedure and has a relatively high complication rate. As complications are often revealed postoperatively, clear, accurate, and timely written operative notes are important in order to recall the procedure and start follow-up treatment as soon as possible. In addition, the surgeon's operative notes are important to assure surgical quality and communication with other healthcare providers. The aim of the present study was to assess compliance with the Dutch guidelines for writing operative notes for LC. Nine hospitals were asked to send 20 successive LC operative notes. All notes were compared to the Dutch guideline by two reviewers and double-checked by a third reviewer. Statistical analyses on the "not described" items were performed. All hospitals participated. Most notes complied with the Dutch guideline (52-69); 19-30 of items did not comply. Negative scores for all hospitals were found, mainly for lacking a description of the patient's posture (average 69), bandage (94), blood loss (98), name of the scrub nurse (87), postoperative conclusion (65), and postoperative instructions (78). Furthermore, notes from one community hospital and two teaching hospitals complied significantly less with the guidelines.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 77-words sample answer on a PubMed discussion board to the following question: Evaluation of operative notes concerning laparoscopic cholecystectomy: are standards being met?.
Use the following context: Laparoscopic cholecystectomy (LC) is the most performed minimal invasive surgical procedure and has a relatively high complication rate. As complications are often revealed postoperatively, clear, accurate, and timely written operative notes are important in order to recall the procedure and start follow-up treatment as soon as possible. In addition, the surgeon's operative notes are important to assure surgical quality and communication with other healthcare providers. The aim of the present study was to assess compliance with the Dutch guidelines for writing operative notes for LC. Nine hospitals were asked to send 20 successive LC operative notes. All notes were compared to the Dutch guideline by two reviewers and double-checked by a third reviewer. Statistical analyses on the "not described" items were performed. All hospitals participated. Most notes complied with the Dutch guideline (52-69); 19-30 of items did not comply. Negative scores for all hospitals were found, mainly for lacking a description of the patient's posture (average 69), bandage (94), blood loss (98), name of the scrub nurse (87), postoperative conclusion (65), and postoperative instructions (78). Furthermore, notes from one community hospital and two teaching hospitals complied significantly less with the guidelines.
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Does oocyte retrieval influence the following morphological quality of embryos?
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The results show that the number of retrieved oocytes was influenced following morphological quality of transferred embryos. In IVF cycles with more retrieved oocytes there are transferred embryos of first morphological quality more frequently. These embryos have higher implantation potential. The number and quality retrieved oocytes are possibly more effective with type and dosing of hormonal stimulation, which should be suitable for every patient.
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"The results show that the number of retrieved oocytes was influenced following morphological quality of transferred embryos. In IVF cycles with more retrieved oocytes there are transferred embryos of first morphological quality more frequently. These embryos have higher implantation potential. The number and quality retrieved oocytes are possibly more effective with type and dosing of hormonal stimulation, which should be suitable for every patient."
] |
To verify that the number of retrieved oocytes influence the following morphological quality of transferred embryos and the success of IVF treatment. A retrospective study. Clinic of assisted medicine and gynecology, Zlin. By observing the collection is composed of 837 IVF cycles with embryotransfer, which were practised between June 2002 and December 2004. To observe the number of retrieved oocytes, following morfological quality of transferred embryos, (number of clinical pregnancies). We found that in cycles with more retrieved oocytes (7 oocytes and more), there were embryos of first morphological quality transferred significantly more frequently (59. 2 cycles, p0. 001) than in cycles with 1-6 retrieved oocytes. Morphologicaly abnormal embryos were found in cycles with more retrieved oocytes (7 oocytes and more) and transferred significantly less frequently (13. 1 cycles, p0. 001) than in cycles with 1-6 retrieved oocytes (34. 8 cycles). We have found that on the retrieval of 16-18 oocytes, there were embryos of first morphological quality transferred in 67. 4 cycles of treatment (p 0. 002). The number of cycles with transferred morphological abnormal embryos is decreasing in relation with increase of oocyte retrieval (p 0. 002). Most of clinical pregnancies were achieved in IVF cycles with retrieval of 16-18 oocytes (clinical pregnancies was achieved in 50. 0 cycles, p0. 001).
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 64-words sample answer on a PubMed discussion board to the following question: Does oocyte retrieval influence the following morphological quality of embryos?.
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Does racial bias influence psychiatric diagnoses assigned at first hospitalization?
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We did not observe the expected racial bias in the assignment of diagnoses of schizophrenia and affective disorders. While there was evidence that hospital clinicians had more difficulty diagnosing black patients, the low concordance between hospital and research diagnoses for both black and white patients demonstrates the need to better understand the clinical diagnostic process for all patients with psychotic disorders at their first hospitalization.
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"We did not observe the expected racial bias in the assignment of diagnoses of schizophrenia and affective disorders. While there was evidence that hospital clinicians had more difficulty diagnosing black patients, the low concordance between hospital and research diagnoses for both black and white patients demonstrates the need to better understand the clinical diagnostic process for all patients with psychotic disorders at their first hospitalization."
] |
Research on racial bias in psychiatric diagnosis has largely been limited to studies of admission diagnoses assigned to chronically ill patients. This study tests whether racial bias influences diagnoses assigned to patients at discharge from their first psychiatric hospitalization. In a county-wide sample of patients with psychosis, hospital diagnoses were compared with research diagnoses formulated using structured interviews and strict adherence to DSM-III-R. Symptom patterns were also examined. Racial differences were observed in the distribution of both hospital and research diagnoses. Using research diagnoses as the gold standard, the sensitivities and specificities of hospital diagnoses were similar by race (for blacks the sensitivity and specificity of schizophrenia was 0. 33 and 0. 91, and for whites, 0. 43 and 0. 89). The only suggestion of possible bias was that more blacks were discharged without a definitive diagnosis (38. 7 of blacks vs. 26. 3 of whites, chi(2) 5. 80, df 1, p 0. 02).
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 65-words sample answer on a PubMed discussion board to the following question: Does racial bias influence psychiatric diagnoses assigned at first hospitalization?.
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Failure to deactivate in the prefrontal cortex in schizophrenia: dysfunction of the default mode network?
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Patients with schizophrenia show both failure to activate and failure to deactivate during performance of a working memory task. The area of failure of deactivation is in the anterior prefrontal/anterior cingulate cortex and corresponds to one of the two midline components of the 'default mode network' implicated in functions related to maintaining one's sense of self.
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"Patients with schizophrenia show both failure to activate and failure to deactivate during performance of a working memory task. The area of failure of deactivation is in the anterior prefrontal/anterior cingulate cortex and corresponds to one of the two midline components of the 'default mode network' implicated in functions related to maintaining one's sense of self."
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Functional imaging studies using working memory tasks have documented both prefrontal cortex (PFC) hypo- and hyperactivation in schizophrenia. However, these studies have often failed to consider the potential role of task-related deactivation. Thirty-two patients with chronic schizophrenia and 32 age- and sex-matched normal controls underwent functional magnetic resonance imaging (fMRI) scanning while performing baseline, 1-back and 2-back versions of the n-back task. Linear models were used to obtain maps of activations and deactivations in the groups. The controls showed activation in the expected frontal regions. There were also clusters of deactivation, particularly in the anterior cingulate/ventromedial PFC and the posterior cingulate cortex/precuneus. Compared to the controls, the schizophrenic patients showed reduced activation in the right dorsolateral prefrontal cortex (DLPFC) and other frontal areas. There was also an area in the anterior cingulate/ventromedial PFC where the patients showed apparently greater activation than the controls. This represented a failure of deactivation in the schizophrenic patients. Failure to activate was a function of the patients' impaired performance on the n-back task, whereas the failure to deactivate was less performance dependent.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 56-words sample answer on a PubMed discussion board to the following question: Failure to deactivate in the prefrontal cortex in schizophrenia: dysfunction of the default mode network?.
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Does increased investment in coronary angiography and revascularisation reduce socioeconomic inequalities in utilisation?
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Early indications are that additional resources for tertiary cardiology may have reduced socioeconomic inequities in angiography, without being specifically targeted at the needier, more deprived groups. Improvement in socioeconomic equity of utilisation of revascularisation is not yet clear, although data for April 1996 to March 1998 (after a lengthier intervention period) may confirm improved equity. Should this not be so, it might be necessary to specifically target resources to the deprived to increase equity in revascularisation.
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[
"Early indications are that additional resources for tertiary cardiology may have reduced socioeconomic inequities in angiography, without being specifically targeted at the needier, more deprived groups. Improvement in socioeconomic equity of utilisation of revascularisation is not yet clear, although data for April 1996 to March 1998 (after a lengthier intervention period) may confirm improved equity. Should this not be so, it might be necessary to specifically target resources to the deprived to increase equity in revascularisation."
] |
To investigate whether additional resources for tertiary cardiology services, aimed at increasing coronary angiography and revascularisation rates, can improve socioeconomic equity of utilisation. Cross sectional ecological study, using the Super Profile classification of enumeration districts and ischaemic heart disease (IHD) standardised mortality ratios (SMR) as a proxy for need. The degree of equity before the provision of extra resources was determined using data for April 1992 to March 1994, and the corresponding picture after, using data for April 1994 to March 1996. South Humberside (United Health-Grimsby and Scunthorpe Health Authority, a district of the former Yorkshire Region, before the April 1996 boundary changes). Patients with a primary diagnosis of IHD agedor 25 years who underwent investigation by angiography, or treatment by coronary artery bypass grafting or percutaneous transluminal coronary angioplasty, as a primary procedure. In 1992/4, before concerted intervention, both investigation and revascularisation rates, although increasing, were low in Grimsby and Scunthorpe district compared with most other districts in the Yorkshire Region. Also, there was a decreasing trend across Super Profile Lifestyle groups from the Affluent Achievers to the Have-Nots despite a two-fold increase in SMRs indicating the greater need of the more deprived. After appointing a consultant general physician with an interest in cardiology in the Scunthorpe district general hospital in 1994; arranging for both the Grimsby physician and the Scunthorpe physician to undertake angiography at a neighbouring district tertiary cardiology centre in 1995; together with significant additional health authority investment in cardiac procedures in 1995/6, district rates increased considerably, (a 41 increase in investigation and a 47 increase in revascularisation rates). Also, after additional resource input began, the trend for angiographies across socioeconomic groups clearly became more equitable, although increased equity for revascularisations is less apparent.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 76-words sample answer on a PubMed discussion board to the following question: Does increased investment in coronary angiography and revascularisation reduce socioeconomic inequalities in utilisation?.
Use the following context: To investigate whether additional resources for tertiary cardiology services, aimed at increasing coronary angiography and revascularisation rates, can improve socioeconomic equity of utilisation. Cross sectional ecological study, using the Super Profile classification of enumeration districts and ischaemic heart disease (IHD) standardised mortality ratios (SMR) as a proxy for need. The degree of equity before the provision of extra resources was determined using data for April 1992 to March 1994, and the corresponding picture after, using data for April 1994 to March 1996. South Humberside (United Health-Grimsby and Scunthorpe Health Authority, a district of the former Yorkshire Region, before the April 1996 boundary changes). Patients with a primary diagnosis of IHD agedor 25 years who underwent investigation by angiography, or treatment by coronary artery bypass grafting or percutaneous transluminal coronary angioplasty, as a primary procedure. In 1992/4, before concerted intervention, both investigation and revascularisation rates, although increasing, were low in Grimsby and Scunthorpe district compared with most other districts in the Yorkshire Region. Also, there was a decreasing trend across Super Profile Lifestyle groups from the Affluent Achievers to the Have-Nots despite a two-fold increase in SMRs indicating the greater need of the more deprived. After appointing a consultant general physician with an interest in cardiology in the Scunthorpe district general hospital in 1994; arranging for both the Grimsby physician and the Scunthorpe physician to undertake angiography at a neighbouring district tertiary cardiology centre in 1995; together with significant additional health authority investment in cardiac procedures in 1995/6, district rates increased considerably, (a 41 increase in investigation and a 47 increase in revascularisation rates). Also, after additional resource input began, the trend for angiographies across socioeconomic groups clearly became more equitable, although increased equity for revascularisations is less apparent.
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Antithrombotic treatment in non-rheumatic atrial fibrillation. Do we follow the recommendations of clinical trials?
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A high range of nonrheumatic AF patients take any kind of antithrombotic preventive therapy, though a great number of patients with high embolic risk could still get benefits from anticoagulation therapy. We should considerate in the therapy assessment some other clinical characteristics as hypertension, isquemic heart disease and heart failure apart from echocardiographical findings.
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"A high range of nonrheumatic AF patients take any kind of antithrombotic preventive therapy, though a great number of patients with high embolic risk could still get benefits from anticoagulation therapy. We should considerate in the therapy assessment some other clinical characteristics as hypertension, isquemic heart disease and heart failure apart from echocardiographical findings."
] |
Several clinical trials have demonstrated that antithrombotic treatment may be effective in prevention of stroke in nonrheumatic atrial fibrillation (AF). The aim of this study was to assess if we follow clinical trial recommendations in community practice. We analyzed 225 medical records of patients diagnosed of nonrheumatic AF in CÃceres, during February and March 1998. Patients who were contraindicated to follow antiagreggation or anti-coagulation treatment were excluded. We compared patients with and without antithrombotic treatment with different demographic characteristics and embolic risk factors. 205 patients were included in the study, 149 (72. 6) had high embolic risk. 62 (30. 2) followed anticoagulation, 94 (45. 8) antiaggregation treatment, 5 (2. 4) both treatment and 49 (24) were not receiving therapy. We didn't findings differences between age, sex, presence of ischemic heart disease, hypertension and congestive heart failure in last three months compared with the patients in respect to the group of patients with anticoagulation and antiaggregation therapy or without it. We determinate as well that previous stroke and echocardiographical finds (valve disease, valve calcification, ventricular dysfunction) were more frequent in the anticoagulation and antiaggregate patients than in those without therapy.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 54-words sample answer on a PubMed discussion board to the following question: Antithrombotic treatment in non-rheumatic atrial fibrillation. Do we follow the recommendations of clinical trials?.
Use the following context: Several clinical trials have demonstrated that antithrombotic treatment may be effective in prevention of stroke in nonrheumatic atrial fibrillation (AF). The aim of this study was to assess if we follow clinical trial recommendations in community practice. We analyzed 225 medical records of patients diagnosed of nonrheumatic AF in CÃceres, during February and March 1998. Patients who were contraindicated to follow antiagreggation or anti-coagulation treatment were excluded. We compared patients with and without antithrombotic treatment with different demographic characteristics and embolic risk factors. 205 patients were included in the study, 149 (72. 6) had high embolic risk. 62 (30. 2) followed anticoagulation, 94 (45. 8) antiaggregation treatment, 5 (2. 4) both treatment and 49 (24) were not receiving therapy. We didn't findings differences between age, sex, presence of ischemic heart disease, hypertension and congestive heart failure in last three months compared with the patients in respect to the group of patients with anticoagulation and antiaggregation therapy or without it. We determinate as well that previous stroke and echocardiographical finds (valve disease, valve calcification, ventricular dysfunction) were more frequent in the anticoagulation and antiaggregate patients than in those without therapy.
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Self-management after stroke: time for some more questions?
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The body of literature on self-management programmes for people with stroke is relatively new and although research is building many issues are unknown. We have highlighted a number of potential areas of inquiry and concern. In order to further advance the research on stroke and self-management we believe a convergence of the evidence base for chronic disease self-management programmes and research which has illuminated the specific challenges and barriers of living with stroke is warranted. There is also a need to avoid the potential consequence of focusing on a "one-size" programme but rather develop interventions which can be inclusive of social aspects of self-management, and identify new methods of delivery.
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[
"The body of literature on self-management programmes for people with stroke is relatively new and although research is building many issues are unknown. We have highlighted a number of potential areas of inquiry and concern. In order to further advance the research on stroke and self-management we believe a convergence of the evidence base for chronic disease self-management programmes and research which has illuminated the specific challenges and barriers of living with stroke is warranted. There is also a need to avoid the potential consequence of focusing on a \"one-size\" programme but rather develop interventions which can be inclusive of social aspects of self-management, and identify new methods of delivery."
] |
To discuss current research and issues which contribute towards the debate on the direction of self-management programmes for individuals after stroke and make recommendations for future research. This paper includes a critical discussion on self-management specifically applied to stroke. The findings are positioned in the context of the wider stroke literature and debates on the suitability of different programmes. Three main areas of concern and potential opportunities were identified which contribute to the debate on self-management; the "individual stroke survivor"; "professional models and practice" and "organizational context".
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 110-words sample answer on a PubMed discussion board to the following question: Self-management after stroke: time for some more questions?.
Use the following context: To discuss current research and issues which contribute towards the debate on the direction of self-management programmes for individuals after stroke and make recommendations for future research. This paper includes a critical discussion on self-management specifically applied to stroke. The findings are positioned in the context of the wider stroke literature and debates on the suitability of different programmes. Three main areas of concern and potential opportunities were identified which contribute to the debate on self-management; the "individual stroke survivor"; "professional models and practice" and "organizational context".
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Can virtual reality simulation help to determine the importance of stereopsis in intraocular surgery?
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The importance of stereopsis for intraocular surgery is difficult to establish in a live theatre setting without compromising patient safety. Virtual reality simulators provide a safe alternative. This study demonstrates a statistically significant decrease in simulated intraocular surgical performance with acute loss of stereopsis in potential ophthalmic training applicants. Caution is recommend in using these results to advocate stereopsis testing as a screening tool in interviews because some participants performed well despite an absence of stereopsis.
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[
"The importance of stereopsis for intraocular surgery is difficult to establish in a live theatre setting without compromising patient safety. Virtual reality simulators provide a safe alternative. This study demonstrates a statistically significant decrease in simulated intraocular surgical performance with acute loss of stereopsis in potential ophthalmic training applicants. Caution is recommend in using these results to advocate stereopsis testing as a screening tool in interviews because some participants performed well despite an absence of stereopsis."
] |
This study was performed using the EYESi ophthalmic surgical simulator. Thirty junior doctors with no previous ophthalmic surgical experience were enrolled and distance visual acuity (Snellen), near visual acuity and stereoacuity (Frisby) were recorded. All participants completed a standard introductory programme on the forceps module to eliminate the learning curve. They then undertook four attempts of level 4 forceps module binocularly and another four monocularly to simulate an acute loss of stereopsis. Total score, odometer movement, corneal area injured, lens area injured and total time taken were recorded. Mean age was 31 years (SDÂ9). None had amblyopia, with all demonstrating distance visual acuity of 6/6 or better and N6 for near. Mean stereopsis was 35 s of arc (SDÂ18). Average total score decreased from 60 while operating binocularly to 47 monocularly (p0. 05). Average corneal area injured increased from 0. 95 mm(2) to 2. 30 mm(2) (p0. 05), average lens area injured increased from 1. 76 mm(2) to 3. 53 mm(2) (p0. 05) and average time taken increased from 69. 6 s to 77. 4 s (p0. 05).
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 76-words sample answer on a PubMed discussion board to the following question: Can virtual reality simulation help to determine the importance of stereopsis in intraocular surgery?.
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Is the quality of surgical residency applicants deteriorating?
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There is a perception that medical school policies act to discourage recruitment of quality medical students into general surgery programs, and surgery programs are going deeper into their rank lists to fill categorical positions. However, the average USMLE part I score of applicants to surgical residencies and proportion of AOA applicants has not decreased.
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[
"There is a perception that medical school policies act to discourage recruitment of quality medical students into general surgery programs, and surgery programs are going deeper into their rank lists to fill categorical positions. However, the average USMLE part I score of applicants to surgical residencies and proportion of AOA applicants has not decreased."
] |
Among directors of general surgery residencies, there is a concern that the quality of medical students applying to surgical residencies is declining. Quality of surgical applicants was assessed by several methods including subjective opinions determined by survey and by objective data including student United States Medical Licensing Examination (USMLE) scores of matched candidates. The number of applicants interviewed, total interviews granted, proportion of Alpha Omega Alpha (AOA) students, and the rank order of the candidates matched was obtained by survey. The survey included data on postgraduate year 1 (PGY-1) residents from July 1996 to July 1999. Three mailings were made to 226 US surgical residency programs. Data were obtained from 90 programs. Surgery program directors disagreed with a survey statement that overall quality of applicants had declined (P0. 01), but agreed with a statement that activities of medical schools to enroll graduating students into primary care had hurt recruitment (P0. 001). Objective data revealed no change in mean USMLE part I scores of PGY-1 residents over the 4 years (P 0. 265, power 0. 81). There was no change in proportion of matched residents who were AOA over time. The mean score of all new PGY-1 residents, the rank of the first matched resident, the rank of the last ranked resident, and proportion of AOA students was higher in programs with five or more categorical spots when compared with programs of at most four (P0. 001). Across all programs, there was a trend to go lower on the rank list to fill categorical positions over time (P0. 001).
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 54-words sample answer on a PubMed discussion board to the following question: Is the quality of surgical residency applicants deteriorating?.
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Outcome of ICSI cycles using frozen-thawed surgically obtained spermatozoa in poor responders to ovarian stimulation: cancellation or proceeding to ICSI?
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In our opinion, these data show that it is possible to achieve satisfactory fertilisation rates using frozen-thawed epididymal and testicular spermatozoa obtained from men with obstructive or non-obstructive azoospermia, but the limiting factor in reaching the stage of embryo transfer is the poor ovarian response to stimulation induction. It therefore seems preferable to cancel these cycles, in the hope that a better response might be obtained in a subsequent cycle, avoiding in this way financial and emotional implications.
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[
"In our opinion, these data show that it is possible to achieve satisfactory fertilisation rates using frozen-thawed epididymal and testicular spermatozoa obtained from men with obstructive or non-obstructive azoospermia, but the limiting factor in reaching the stage of embryo transfer is the poor ovarian response to stimulation induction. It therefore seems preferable to cancel these cycles, in the hope that a better response might be obtained in a subsequent cycle, avoiding in this way financial and emotional implications."
] |
To investigate the ICSI outcome of the patients who produced four follicles or less after ovarian stimulation using frozen-thawed surgically obtained spermatozoa. The patient cohort of this study was composed of a carefully selected group of 20 men suffering from obstructive and non-obstructive azoospermia and in whom spermatozoa had been seen in their harvested epididymal aspirates and testicular tissues and the cryopreserved specimens had been used for subsequent ICSI cycles. This group of men represent those in whom the female partners produced only four follicles or less after ovarian stimulation. For the cases of obstructive azoospermia with MESA (n6) a total of nine cycles was carried out. Four couples went through one cycle, one couple underwent two cycles, one couple accomplished three cycles. Out of the nine cycles, seven went to embryo transfer. No pregnancy occurred in the MESA-ICSI group of patients. The mean+/-S. D. number of oocytes per cycle was 2. 556+/-1. 236, the mean+/-S. D. number of embryos per transfer was 1. 444+/-1. 014. Two couples did not have an embryo replacement because of absence of fertilisation. The mean+/-S. D. number of gonadotropin ampoules was 53. 88+/-37. 30 and the mean+/-S. D. duration of ovarian stimulation was 13. 38+/-4. 534 days. For the cases of non-obstructive azoospermia with TESE (n14) a total of 16 cycles was carried out. Thirteen couples went through one cycle, one couple accomplished three cycles. Out of the 16 cycles, 11 cycles went to embryo transfer. One pregnancy occurred in the TESE-ICSI group of patients, which produced live offspring. The mean+/-S. D. number of oocytes per cycle was 3. 00+/-1. 211, the mean+/-S. D. number of embryos per transfer was 1. 313+/-1. 195. Five couples did not have an embryo replacement, four of them because of absence of fertilisation and one because of abnormal fertilisation (3 PN). The mean+/-S. D. number of gonadotropin ampoules was 81. 77+/-53. 40 and the mean+/-S. D. duration of ovarian stimulation was 16. 71+/-3. 667 days.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 78-words sample answer on a PubMed discussion board to the following question: Outcome of ICSI cycles using frozen-thawed surgically obtained spermatozoa in poor responders to ovarian stimulation: cancellation or proceeding to ICSI?.
Use the following context: To investigate the ICSI outcome of the patients who produced four follicles or less after ovarian stimulation using frozen-thawed surgically obtained spermatozoa. The patient cohort of this study was composed of a carefully selected group of 20 men suffering from obstructive and non-obstructive azoospermia and in whom spermatozoa had been seen in their harvested epididymal aspirates and testicular tissues and the cryopreserved specimens had been used for subsequent ICSI cycles. This group of men represent those in whom the female partners produced only four follicles or less after ovarian stimulation. For the cases of obstructive azoospermia with MESA (n6) a total of nine cycles was carried out. Four couples went through one cycle, one couple underwent two cycles, one couple accomplished three cycles. Out of the nine cycles, seven went to embryo transfer. No pregnancy occurred in the MESA-ICSI group of patients. The mean+/-S. D. number of oocytes per cycle was 2. 556+/-1. 236, the mean+/-S. D. number of embryos per transfer was 1. 444+/-1. 014. Two couples did not have an embryo replacement because of absence of fertilisation. The mean+/-S. D. number of gonadotropin ampoules was 53. 88+/-37. 30 and the mean+/-S. D. duration of ovarian stimulation was 13. 38+/-4. 534 days. For the cases of non-obstructive azoospermia with TESE (n14) a total of 16 cycles was carried out. Thirteen couples went through one cycle, one couple accomplished three cycles. Out of the 16 cycles, 11 cycles went to embryo transfer. One pregnancy occurred in the TESE-ICSI group of patients, which produced live offspring. The mean+/-S. D. number of oocytes per cycle was 3. 00+/-1. 211, the mean+/-S. D. number of embryos per transfer was 1. 313+/-1. 195. Five couples did not have an embryo replacement, four of them because of absence of fertilisation and one because of abnormal fertilisation (3 PN). The mean+/-S. D. number of gonadotropin ampoules was 81. 77+/-53. 40 and the mean+/-S. D. duration of ovarian stimulation was 16. 71+/-3. 667 days.
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Is premeiotic genome elimination an exclusive mechanism for hemiclonal reproduction in hybrid males of the genus Pelophylax?
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Some P. esculentus males have no genome elimination from the germ line prior to meiosis. Considering previous cytological and experimental evidence for a formation of both ridibundus and lessonae sperm within a single P. esculentus individual, we propose a hypothesis that genome elimination from the germline can either be postponed to the meiotic stages or absent altogether in these hybrids.
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[
"Some P. esculentus males have no genome elimination from the germ line prior to meiosis. Considering previous cytological and experimental evidence for a formation of both ridibundus and lessonae sperm within a single P. esculentus individual, we propose a hypothesis that genome elimination from the germline can either be postponed to the meiotic stages or absent altogether in these hybrids."
] |
The ability to eliminate a parental genome from a eukaryotic germ cell is a phenomenon observed mostly in hybrid organisms displaying an alternative propagation to sexual reproduction. For most taxa, the underlying cellular pathways and timing of the elimination process is only poorly understood. In the water frog hybrid Pelophylax esculentus (parental taxa are P. ridibundus and P. lessonae) the only described mechanism assumes that one parental genome is excluded from the germline during metamorphosis and prior to meiosis, while only second genome enters meiosis after endoreduplication. Our study of hybrids from a P. ridibundus-P. esculentus-male populations known for its production of more types of gametes shows that hybridogenetic mechanism of genome elimination is not uniform. Using comparative genomic hybridization (CGH) on mitotic and meiotic cell stages, we identified at least two pathways of meiotic mechanisms. One type of Pelophylax esculentus males provides supporting evidence of a premeiotic elimination of one parental genome. In several other males we record the presence of both parental genomes in the late phases of meiotic prophase I (diplotene) and metaphase I.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 60-words sample answer on a PubMed discussion board to the following question: Is premeiotic genome elimination an exclusive mechanism for hemiclonal reproduction in hybrid males of the genus Pelophylax?.
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Can the influence of childhood socioeconomic status on men's and women's adult body mass be explained by adult socioeconomic status or personality?
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Early social disadvantage may affect adult weight status more strongly in women owing to gender differences in the timing and nature of weight-management socialization. Personality may enhance or detract from risks incurred by childhood or adulthood SES in either gender, necessitating the consideration of dispositional differences in prevention and intervention programs.
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[
"Early social disadvantage may affect adult weight status more strongly in women owing to gender differences in the timing and nature of weight-management socialization. Personality may enhance or detract from risks incurred by childhood or adulthood SES in either gender, necessitating the consideration of dispositional differences in prevention and intervention programs."
] |
On the basis of a life-course risk-chain framework, the authors examined whether (a) residual associations between childhood socioeconomic status (SES) and adult obesity and body mass index (BMI) would be observed in women but not men after adjusting for adult SES, (b) adult Big Five personality traits would be associated with adult body mass in both genders, and (c) personality would explain unique variation in outcomes beyond child and adult SES. National survey (Midlife Development in the United States study; N 2, 922). BMI and obesity. (a) In both genders, association between childhood SES and adult obesity were accounted for entirely by adult SES, but its effect on adult BMI was observed only in women; (b) higher conscientiousness was associated with lower obesity prevalence and BMI in both genders, although more strongly in women, and in men, greater obesity prevalence was associated with higher agreeableness and neuroticism; and (c) personality explained unique outcome variation in both genders.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 51-words sample answer on a PubMed discussion board to the following question: Can the influence of childhood socioeconomic status on men's and women's adult body mass be explained by adult socioeconomic status or personality?.
Use the following context: On the basis of a life-course risk-chain framework, the authors examined whether (a) residual associations between childhood socioeconomic status (SES) and adult obesity and body mass index (BMI) would be observed in women but not men after adjusting for adult SES, (b) adult Big Five personality traits would be associated with adult body mass in both genders, and (c) personality would explain unique variation in outcomes beyond child and adult SES. National survey (Midlife Development in the United States study; N 2, 922). BMI and obesity. (a) In both genders, association between childhood SES and adult obesity were accounted for entirely by adult SES, but its effect on adult BMI was observed only in women; (b) higher conscientiousness was associated with lower obesity prevalence and BMI in both genders, although more strongly in women, and in men, greater obesity prevalence was associated with higher agreeableness and neuroticism; and (c) personality explained unique outcome variation in both genders.
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The lack of growth in use of coronary CT angiography: is it being appropriately used?
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Given that coronary CTA is a new procedure that has aroused much interest and has been shown to have very favorable results, the drop in its utilization rate in 2008 was surprising. A review of the literature indicates that there are shortcomings to the clinical diagnosis of coronary artery disease (which often includes the use of MPI), that coronary CTA can be used to stratify risk, and that it can expedite the workup of patients with acute chest pain in emergency departments. The evidence from the literature review suggests that both invasive coronary angiography and MPI may be overutilized, whereas coronary CTA is probably underutilized.
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"Given that coronary CTA is a new procedure that has aroused much interest and has been shown to have very favorable results, the drop in its utilization rate in 2008 was surprising. A review of the literature indicates that there are shortcomings to the clinical diagnosis of coronary artery disease (which often includes the use of MPI), that coronary CTA can be used to stratify risk, and that it can expedite the workup of patients with acute chest pain in emergency departments. The evidence from the literature review suggests that both invasive coronary angiography and MPI may be overutilized, whereas coronary CTA is probably underutilized."
] |
The purpose of this article is to study recent utilization trends in coronary CT angiography (CTA) and compare them with radionuclide myocardial perfusion imaging (MPI), a competing procedure. The nationwide Medicare Part B databases were used to determine utilization rates per 100, 000 beneficiaries. Rates for coronary CTA were studied from 2006 (the first year Current Procedural Terminology codes were available for this procedure) through 2008. Rates for MPI were studied from 1998 through 2008. Medicare specialty codes were used to identify examinations done by radiologists and cardiologists. The coronary CTA total utilization rate per 100, 000 rose from 99 in 2006 to 210 in 2007 (112) but then decreased to 193 in 2008 (-8). The rate for MPI increased from 4748 in 1998 to a peak of 8753 in 2006 (84), then declined to 8467 in 2008. Cardiologists performed the majority of both coronary CTA and MPI. In 2008, MPI was performed 44 times as often as coronary CTA.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 105-words sample answer on a PubMed discussion board to the following question: The lack of growth in use of coronary CT angiography: is it being appropriately used?.
Use the following context: The purpose of this article is to study recent utilization trends in coronary CT angiography (CTA) and compare them with radionuclide myocardial perfusion imaging (MPI), a competing procedure. The nationwide Medicare Part B databases were used to determine utilization rates per 100, 000 beneficiaries. Rates for coronary CTA were studied from 2006 (the first year Current Procedural Terminology codes were available for this procedure) through 2008. Rates for MPI were studied from 1998 through 2008. Medicare specialty codes were used to identify examinations done by radiologists and cardiologists. The coronary CTA total utilization rate per 100, 000 rose from 99 in 2006 to 210 in 2007 (112) but then decreased to 193 in 2008 (-8). The rate for MPI increased from 4748 in 1998 to a peak of 8753 in 2006 (84), then declined to 8467 in 2008. Cardiologists performed the majority of both coronary CTA and MPI. In 2008, MPI was performed 44 times as often as coronary CTA.
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Is there an association between coeliac disease and inflammatory bowel diseases?
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The prevalence of IBD in coeliac disease was increased 10-fold compared with that in controls (odds ratio 9. 98, 95 CI 2. 8-45. 9, p0. 0006), while the prevalence of coeliac disease in IBD was comparable with that in controls (odds ratio 1. 02, 95 CI, 0. 24-4. 29, p1. 0).
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[
"The prevalence of IBD in coeliac disease was increased 10-fold compared with that in controls (odds ratio 9. 98, 95 CI 2. 8-45. 9, p0. 0006), while the prevalence of coeliac disease in IBD was comparable with that in controls (odds ratio 1. 02, 95 CI, 0. 24-4. 29, p1. 0)."
] |
The relationship between coeliac disease and inflammatory bowel disease (IBD) is controversial. The aim of this study was to determine the prevalence of coeliac disease in IBD and the prevalence of IBD in coeliac disease. Patients were enrolled from specialist IBD and coeliac clinics. Antigliadins, endomysial, tissue transglutaminase antibody and total IgA levels were measured in IBD patients. Patients with positive antibodies were offered a duodenal biopsy. The notes on coeliac patients were reviewed for colonoscopic and biopsy findings. Controls were recruited from the local population. The study included 305 patients with coeliac disease, 354 with IBD and 601 healthy controls. The IBD group comprised 154 ulcerative colitis (UC) cases, 173 Crohn's disease, 18 indeterminate colitis and 9 cases of microscopic colitis. Forty-seven patients had positive antibodies and 3 had villous atrophy on biopsy. All three patients had positive anti-tissue transglutaminase antibodies but only two were endomysial antibody (EMA) positive. Ten coeliac patients had IBD (5 UC and 5 lymphocytic colitis). Five controls had coeliac disease and 2 had IBD (1 Crohn's disease and 1 UC). Stepwise multiple logistic regression showed only antibody positivity as being significant (p0. 0001).
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 51-words sample answer on a PubMed discussion board to the following question: Is there an association between coeliac disease and inflammatory bowel diseases?.
Use the following context: The relationship between coeliac disease and inflammatory bowel disease (IBD) is controversial. The aim of this study was to determine the prevalence of coeliac disease in IBD and the prevalence of IBD in coeliac disease. Patients were enrolled from specialist IBD and coeliac clinics. Antigliadins, endomysial, tissue transglutaminase antibody and total IgA levels were measured in IBD patients. Patients with positive antibodies were offered a duodenal biopsy. The notes on coeliac patients were reviewed for colonoscopic and biopsy findings. Controls were recruited from the local population. The study included 305 patients with coeliac disease, 354 with IBD and 601 healthy controls. The IBD group comprised 154 ulcerative colitis (UC) cases, 173 Crohn's disease, 18 indeterminate colitis and 9 cases of microscopic colitis. Forty-seven patients had positive antibodies and 3 had villous atrophy on biopsy. All three patients had positive anti-tissue transglutaminase antibodies but only two were endomysial antibody (EMA) positive. Ten coeliac patients had IBD (5 UC and 5 lymphocytic colitis). Five controls had coeliac disease and 2 had IBD (1 Crohn's disease and 1 UC). Stepwise multiple logistic regression showed only antibody positivity as being significant (p0. 0001).
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Does intentional support of degree programs in general surgery residency affect research productivity or pursuit of academic surgery?
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Our data support the utility of degree completion when economically feasible and use of dedicated research time as an effective way to significantly increase research productivity and retain graduates in academic surgery. Aggregating data from other academic surgery programs would allow us to further determine association of funding of additional degrees as a means to encourage academic productivity and retention.
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[
"Our data support the utility of degree completion when economically feasible and use of dedicated research time as an effective way to significantly increase research productivity and retain graduates in academic surgery. Aggregating data from other academic surgery programs would allow us to further determine association of funding of additional degrees as a means to encourage academic productivity and retention."
] |
Many residents supplement general surgery training with years of dedicated research, and an increasing number at our institution pursue additional degrees. We sought to determine whether it was worth the financial cost for residency programs to support degrees. We reviewed graduating chief residents (n 69) in general surgery at Vanderbilt University from 2001 to 2010 and collected the data including research time and additional degrees obtained. We then compared this information with the following parameters: (1) total papers, (2) first-author papers, (3) Journal Citation Reports impact factors of journals in which papers were published, and (4) first job after residency or fellowship training. The general surgery resident training program at Vanderbilt University is an academic program, approved to finish training 7 chief residents yearly during the time period studied. Chief residents in general surgery at Vanderbilt who finished their training 2001 through 2010. We found that completion of a degree during residency was significantly associated with more total and first-author publications as compared with those by residents with only dedicated research time (p 0. 001 and p 0. 017). Residents completing a degree also produced publications of a higher caliber and level of authorship as determined by an adjusted resident impact factor score as compared with those by residents with laboratory research time only (p 0. 005). Degree completion also was significantly correlated with a first job in academia if compared to those with dedicated research time only (p 0. 046).
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 60-words sample answer on a PubMed discussion board to the following question: Does intentional support of degree programs in general surgery residency affect research productivity or pursuit of academic surgery?.
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Does cooling Sengstaken-Blakemore tubes aid insertion?
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The current clinical practice of trainees for the insertion of SB tubes is to cool the tubes in the belief that this 'standard' practice aids tube insertion. We found no significant change in SB tube stiffness even after cooling to temperatures that would not be achieved during routine insertion. Furthermore, the rapid rise in tube temperature means that tubes approach room temperature by the time they reach the bedside. In the present era of evidence based medicine the current dogma that SB tubes should be cooled prior to insertion must be discarded.
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[
"The current clinical practice of trainees for the insertion of SB tubes is to cool the tubes in the belief that this 'standard' practice aids tube insertion. We found no significant change in SB tube stiffness even after cooling to temperatures that would not be achieved during routine insertion. Furthermore, the rapid rise in tube temperature means that tubes approach room temperature by the time they reach the bedside. In the present era of evidence based medicine the current dogma that SB tubes should be cooled prior to insertion must be discarded."
] |
To survey current clinical practice concerning the use of Sengstaken-Blakemore (SB) tubes and to determine whether cooling the tubes alters their stiffness. A telephone questionnaire was conducted of gastroenterology registrars and ITU departments in the North Thames region. The current clinical practice for insertion of SB tubes and the basis for this practice were determined in each case. The stiffness of the tubes was measured at -10 degrees C and 20 degrees C by measuring the extension (in mm) resulting from an applied load (in newtons). The time for tube warming from -30 degrees C when in stationary air and when in contact with skin was also recorded. Fifty registrars were contacted and 20 ITU departments were surveyed. All ITU departments involved the gastroenterologists in the management of acute variceal bleeds. Eight registrars had never placed an SB tube. The majority of the remainder (95) used a cooled SB tube. All of the registrars based this practice upon their clinical teaching, and 75 of these registrars thought cooling aided the insertion of the tube. There was no significant difference in the stiffness of the tubes at -10 degrees C and 20 degrees C. Upon warming, an SB tube took 30 s to rise from 0 degrees C to room temperature (20 degrees C) when in skin contact and 120 s when placed in stationary air.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 92-words sample answer on a PubMed discussion board to the following question: Does cooling Sengstaken-Blakemore tubes aid insertion?.
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Can single positive core prostate cancer at biopsy be considered a low-risk disease after radical prostatectomy?
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Single core PCa have clinically significant disease in the Radical Prostatectomy specimens, with considerable rates of overgrading for the GS, pT2c-pT3, PSMs, EPE and SVI. The treatment plan must be evaluated individually for patients with single core PCa and must take into account other prognostic factors when determining whether a patient should be managed with AS.
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[
"Single core PCa have clinically significant disease in the Radical Prostatectomy specimens, with considerable rates of overgrading for the GS, pT2c-pT3, PSMs, EPE and SVI. The treatment plan must be evaluated individually for patients with single core PCa and must take into account other prognostic factors when determining whether a patient should be managed with AS."
] |
Single positive core in a prostate biopsy is usually associated with indolent prostate cancer (PCa) and is one of the active surveillance (AS) inclusion criteria. We investigated whether single positive core PCa at biopsy could define an archetype of low-risk disease. A total of 1320 consecutive patients were enrolled. Among them, 249 patients with single positive core PCa were followed up, and the clinical and pathological parameters influencing prognosis were analyzed. Out of the 249 patients, 172 (69. 0) had pathological findings â pT2c and 87 (34. 9) had an undergraded Gleason Score (GS) based on the biopsy. Positive surgical margins (PSMs), extraprostatic extension (EPE) and seminal vesicle invasion (SVI) were found in 20. 8, 10. 0 and 6. 0 of patients, respectively. In a comparative analysis, we found that the PSA level, prostate weight and number of cores at biopsy are essential to correctly predict an indolent PCa. A total of 125 patients (67. 3) with nonpalpable tumors became high-risk tumors (pT2c-T3). Analyzing only nonpalpable tumors with a GS of 6 at biopsy (156 patients), we noted that 106 (67. 9 of cT1) progressed from cT1c to pT2c-pT3.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 56-words sample answer on a PubMed discussion board to the following question: Can single positive core prostate cancer at biopsy be considered a low-risk disease after radical prostatectomy?.
Use the following context: Single positive core in a prostate biopsy is usually associated with indolent prostate cancer (PCa) and is one of the active surveillance (AS) inclusion criteria. We investigated whether single positive core PCa at biopsy could define an archetype of low-risk disease. A total of 1320 consecutive patients were enrolled. Among them, 249 patients with single positive core PCa were followed up, and the clinical and pathological parameters influencing prognosis were analyzed. Out of the 249 patients, 172 (69. 0) had pathological findings â pT2c and 87 (34. 9) had an undergraded Gleason Score (GS) based on the biopsy. Positive surgical margins (PSMs), extraprostatic extension (EPE) and seminal vesicle invasion (SVI) were found in 20. 8, 10. 0 and 6. 0 of patients, respectively. In a comparative analysis, we found that the PSA level, prostate weight and number of cores at biopsy are essential to correctly predict an indolent PCa. A total of 125 patients (67. 3) with nonpalpable tumors became high-risk tumors (pT2c-T3). Analyzing only nonpalpable tumors with a GS of 6 at biopsy (156 patients), we noted that 106 (67. 9 of cT1) progressed from cT1c to pT2c-pT3.
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Are all 585 nm pulsed dye lasers equivalent?
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When changing from one 585 nm pulsed dye laser to another and using supposedly equivalent fluences, one cannot guarantee that clinical results will be equivalent. In an effort to achieve consistent treatments when moving between lasers manufactured by different companies, it would be prudent to place a single spot of energy onto burn paper and measure the diameter of the spot.
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"When changing from one 585 nm pulsed dye laser to another and using supposedly equivalent fluences, one cannot guarantee that clinical results will be equivalent. In an effort to achieve consistent treatments when moving between lasers manufactured by different companies, it would be prudent to place a single spot of energy onto burn paper and measure the diameter of the spot."
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Flashlamp-pumped pulsed dye lasers (585 nm) are used to treat port-wine stains and other cutaneous vascular lesions. Strikingly different tissue effects were seen after two apparently similar 585 nm pulsed dye lasers at equivalent fluences were used. We compared the photometric and histologic effects of two apparently similar 585 nm flashlamp-pumped pulsed dye laser systems. The burn pattern and beam profile analysis of two Candela SPTL-1 lasers and two Cynosure Photogenica V lasers were compared. Various fluences and spot sizes of the Cynosure laser were placed on normal skin and evaluated for histologic change. Variation between the stated area of the spot and the actual measured area of the spot was found in all lasers studied. The area of the 5 mm spot of the two Candela lasers studied was 35 and 31 larger, respectively, than the stated area. The Cynosure lasers had areas that were 8 and 4 smaller than the stated area. Neither beam profile was uniform. The Candela laser maintained a gaussian-like distribution of energy, whereas the Cynosure laser beam profile resembled a top hat with a more even distribution of energy. Histologic studies confirmed the maintenance of vascular specificity without nonspecific thermal damage.
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Medical Research
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https://github.com/pubmedqa/pubmedqa
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Write a 61-words sample answer on a PubMed discussion board to the following question: Are all 585 nm pulsed dye lasers equivalent?.
Use the following context: Flashlamp-pumped pulsed dye lasers (585 nm) are used to treat port-wine stains and other cutaneous vascular lesions. Strikingly different tissue effects were seen after two apparently similar 585 nm pulsed dye lasers at equivalent fluences were used. We compared the photometric and histologic effects of two apparently similar 585 nm flashlamp-pumped pulsed dye laser systems. The burn pattern and beam profile analysis of two Candela SPTL-1 lasers and two Cynosure Photogenica V lasers were compared. Various fluences and spot sizes of the Cynosure laser were placed on normal skin and evaluated for histologic change. Variation between the stated area of the spot and the actual measured area of the spot was found in all lasers studied. The area of the 5 mm spot of the two Candela lasers studied was 35 and 31 larger, respectively, than the stated area. The Cynosure lasers had areas that were 8 and 4 smaller than the stated area. Neither beam profile was uniform. The Candela laser maintained a gaussian-like distribution of energy, whereas the Cynosure laser beam profile resembled a top hat with a more even distribution of energy. Histologic studies confirmed the maintenance of vascular specificity without nonspecific thermal damage.
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