Question: Is an advance care planning model feasible in community palliative care? Answer: An advance care planning model is feasible for community palliative care services. Quality audit processes are an essential component of the Model with documentation of advance care planning discussion established as an important outcome measure.
Question: Is coeliac disease screening in risk groups justified? Answer: Long-term dietary compliance in screen-detected patients was good. Quality of life and bone mineral density were comparable with those in non-coeliac subjects and the general population. Active screening in coeliac disease risk groups seems to be reasonable rather than harmful.
Question: Does blood pressure change in treated hypertensive patients depending on whether it is measured by a physician or a nurse? Answer: Systolic BP measured by the nurse in treated hypertensive patients is significantly lower than the readings obtained by the physician, and are almost identical to ambulatory BP monitoring. Blood pressure determination by the nurse is desirable not only for diagnosis but also to evaluate the level of control
Question: Metastatic carcinoma to the cervical nodes from an unknown head and neck primary site: Is there a need for neck dissection? Answer: In our experience, definitive radiotherapy to the neck and the potential mucosal sites, whether preceded by neck dissection or not, is effective to achieve a good local control rate in the unknown primary cancer of the head and neck. The indication for neck dissection, in particular for
Question: Estimation of basal metabolic rate in Chinese: are the current prediction equations applicable? Answer: To date, the newly developed Singapore equation is the most accurate BMR prediction equation in Chinese and is applicable for use in a large BMI range including those overweight and obese.
Question: Recovery Outcome Measures: Is There a Place for Culture, Attitudes, and Faith? Answer: This paper discusses the cultural appropriateness of the RAQ in Australian settings, and identifies the need to develop rigorous, inclusive recovery outcome measures.
Question: Thoracic and thoracoabdominal aneurysm repair: is reimplantation of spinal cord arteries a waste of time? Answer: With monitoring of MEP and SSEP, sacrifice--without reimplantation--of as many as 15 intercostal and lumbar arteries during TAA/A repair is safe, resulting in acceptably low rates of immediate and delayed paraplegia. This experience suggests that routine surgical implantation of segmental vessels is not indicated, and that, with
Question: Are sports medicine journals relevant and applicable to practitioners and athletes? Answer: There is a dearth of studies addressing diagnostic and treatment interventions in the sports medicine literature. The evidence base for sports medicine must continue to increase in terms of volume and quality.
Question: Transient tachypnea of the newborn (TTN): a role for polymorphisms in the beta-adrenergic receptor (ADRB) encoding genes? Answer: We conclude that beta1Gly49 homozygosity and TACC haplotype of ADRB2 gene, both loss-of-function genetic variations, may predispose to TTN.
Question: Hepatorenal syndrome: are we missing some prognostic factors? Answer: We report for the first time ESLD etiology as a prognostic factor for survival. The renal function (expressed as serum creatinine) and urinary Na (<5 mEq/l) at the time of diagnosis were found to be associated with survival, suggesting that early treatment might increase survival.
Question: Does glomerular hyperfiltration in pregnancy damage the kidney in women with more parities? Answer: In our study, we suggest that glomerular hyperfiltration due to pregnancy does not have adverse effects on kidney in women with more parities. Pregnancy may have possible protective mechanisms for kidney against adverse effects of glomerular hyperfiltration.
Question: Is high-sensitivity C-reactive protein associated with carotid atherosclerosis in healthy Koreans? Answer: Both hsCRP levels and the carotid IMT were strongly correlated with conventional cardiovascular risk factors, but there was no independent association between hsCRP levels and carotid IMT in healthy Korean adults.
Question: Does cup-cage reconstruction with oversized cups provide initial stability in THA for osteoporotic acetabular fractures? Answer: The majority of acetabular components in this cohort were stable despite the small contact surface achieved between the component and pelvic bone. Three of 10 migrated in excess of the limits that predict later loosening in primary
Question: Are opioid dependence and methadone maintenance treatment (MMT) documented in the medical record? Answer: Among patients receiving MMT and medical care at different sites, documentation of opioid dependence and MMT in the medical record occurs for the majority, but is missing in a substantial number of patients. Most of these patients are prescribed medications that potentially interact with
Question: Do symptoms matter when considering patients for phase I clinical trials? Answer: Older adults enrolled in PICT with more symptoms may sacrifice QOL for experimental treatment.
Question: Is expert breast pathology assessment necessary for the management of ductal carcinoma in situ? Answer: Expert breast pathology assessments continue to be necessary in the management of DCIS.
Question: Is endometrial polyp formation associated with increased expression of vascular endothelial growth factor and transforming growth factor-beta1? Answer: There was increased expression of TGF-β1 and VEGF in polyps compared to adjacent normal endometrial tissue. It suggested that these cytokines might play a role in endometrial polyp formation. In addition, there was a
Question: Preparing patients at high risk of falls for discharge home after rehabilitation: Do we meet the guidelines? Answer: There was little evidence that people at high risk of falls received systematic falls risk assessment during rehabilitation. When a risk was identified, generally a strategy was implemented. However, failure to assess some risk factors might have limited fall prevention strategies offered. Failure to adequately
Question: Could the extent of lymphadenectomy be modified by neoadjuvant chemotherapy in cervical cancer? Answer: The frequency and topographic distribution of LNM are not modified by NACT, and clinical non-responders showed more involved LNs. A systemic and extensive lymphadenectomy should be performed in patients treated with NACT plus surgery regardless of the response to NACT.
Question: Does the lipid-lowering peroxisome proliferator-activated receptors ligand bezafibrate prevent colon cancer in patients with coronary artery disease? Answer: Our data, derived from patients with coronary artery disease, support the hypothesis regarding a possible preventive effect of bezafibrate on the development of colon cancer.
Question: Does head positioning influence anterior chamber depth in pseudoexfoliation syndrome? Answer: In patients with clinically apparent unilateral pseudoexfoliation, the lens seems to be more mobile in the affected eye. This results in a shallower anterior chamber when the head is placed in a prone position. Whether this fact might potentially lead to transient pupillary block when engaging in activities
Question: Does case-mix based reimbursement stimulate the development of process-oriented care delivery? Answer: This study demonstrates that hospital management can stimulate the development of care programmes by the adoption of case-mix reimbursement within hospitals' budgeting processes. Future research is recommended to confirm this finding and to determine whether the establishment of care programmes will in time indeed
Question: Does sex influence the response to intravenous thrombolysis in ischemic stroke? Answer: Data from Safe Implementation of Treatments in Stroke-International Stroke Thrombolysis Register suggest that intravenous thrombolysis may modify the observed survival and recovery advantage for men expected in the natural course of an ischemic stroke, with a possible larger beneficial treatment effect in women when compared with
Question: 30-Day and 1-year mortality in emergency general surgery laparotomies: an area of concern and need for improvement? Answer: Emergency laparotomy carries a high rate of mortality, especially in those over the age of 70 years, and more needs to be done to improve outcomes, particularly in this group. This could involve increasing acute surgical care manpower, early recognition of patients requiring
Question: Can computerised tomography replace bone scintigraphy in detecting bone metastases from breast cancer? Answer: Our findings suggest routine BS of patients presenting with MBC is not required if CT (thorax, abdomen, and pelvis) is performed.
Question: Diffusion-weighted echo-planar MR imaging of primary parotid gland tumors: is a prediction of different histologic subtypes possible? Answer: epiDWI has the potential to differentiate pleomorphic adenoma and myoepithelial adenomas from all other examined entities. Due to an overlap not only within the group of benign and malignant lesions but also between groups, diagnoses should not be addressed on
Question: Is cholecystectomy really an indication for concomitant splenectomy in mild hereditary spherocytosis? Answer: The advice to perform a concomitant splenectomy in children with mild HS undergoing cholecystectomy for symptomatic gallstones needs revisiting. In the era of minimal access surgery, the need for splenectomy in such children should be judged on its own merits.
Question: Does menopausal transition affect the quality of life? Answer: This longitudinal study found no significant effect of menopausal transition on quality of life among Taiwanese women. The decline in the role limitations due to emotional problems was related to vasomotor symptoms.
Question: Is aneurysm repair justified for the patients aged 80 or older after aneurysmal subarachnoid hemorrhage? Answer: Better prognosis was obtained when ruptured aneurysm was repaired in the elderly than it was treated conservatively. From the results of this study, we should not hesitate to offer the definitive surgery for the elderly with aSAH.
Question: Sternal fracture in growing children : A rare and often overlooked fracture? Answer: Isolated sternal fractures in childhood are often due to typical age-related traumatic incidents. Ultrasonography is a useful diagnostic tool for fracture detection and radiography is the method of choice for visualization of the extent of the dislocation.
Question: Emergency double-balloon enteroscopy combined with real-time viewing of capsule endoscopy: a feasible combined approach in acute overt-obscure gastrointestinal bleeding? Answer: Emergency DBE is feasible, safe and effective in acute OGIB and may avoid major surgery, diagnosing and successfully treating most patients. Combined approach with RT viewing by CE is especially useful to identify recurrent bleeding vascular lesions such as
Question: Are physicians meeting the needs of family caregivers of the frail elderly? Answer: Hypotheses for this discontent are presented. Physicians may be uninterested in helping caregivers; even if they were receptive to counseling caregivers, they could be poorly remunerated for the types of counseling sessions that are usual for caregivers; and being a professional caregiver to family caregivers is demanding in itself.
Question: Pap smears with glandular cell abnormalities: Are they detected by rapid prescreening? Answer: Pap smears with glandular cell abnormalities are often flagged as abnormal by RPS, and this results in a sensitivity of 36.4% (at the AGC threshold). Most importantly, some cases of AGC are detected on
Question: Does airway surgery lower serum lipid levels in obstructive sleep apnea patients? Answer: Surgery may improve blood lipid levels in patients with OSA, especially in patients with preoperative dyslipidemia, potentially yielding a major benefit in metabolism and cardiovascular sequelae. Prospective studies should examine this potential metabolic effect of airway surgery for OSA.
Question: Is withdrawal-induced anxiety in alcoholism based on beta-endorphin deficiency? Answer: Our results give first evidence that lowered beta E during alcohol withdrawal may contribute to anxiety as a common disturbance during this state.
Question: Is there any relation between cervical cord plaques and discopathy in patients with multiple sclerosis? Answer: The study data suggests a possible correlation between cervical discopathy and cervical MS plaque.
Question: Aromatase inhibitor-related musculoskeletal symptoms: is preventing osteoporosis the key to eliminating these symptoms? Answer: Patients on AIs who develop osteoporosis are at increased risk of musculoskeletal symptoms and bone fracture. Comedication with Ca/Bis reduces the likelihood for osteoporosis and musculoskeletal symptoms. Patients who received tamoxifen before AIs were less likely to develop AI-related musculoskeletal symptoms. We recommend that patients on AIs
Question: Can D-dimer become a new diagnostic parameter for acute appendicitis? Answer: Increased D-dimer levels should not be considered as a diagnostic parameter in diagnosis of acute appendicitis.
Question: Does automatic transmission improve driving behavior in older drivers? Answer: Switching to automatic transmission may be recommended for older drivers as a means to maintain safe driving and thereby the quality of their transport mobility.
Question: Should HIV-infected patients be screened for silent myocardial ischaemia using gated myocardial perfusion SPECT? Answer: In male HIV-infected patients older than 52 years and with at least two other CRFs, screening for SMI using myocardial SPECT was about four times more likely to be positive than in the general population. This may motivate physicians to advise these patients to undergo more systematic screening for
Question: Does a preoperative medically supervised weight loss program improve bariatric surgery outcomes? Answer: MSWM does not appear to confer additional benefit as compared to the standard preoperative bariatric surgery protocol in terms of weight loss and most behavioral outcomes after LAGB in our patient population.
Question: Do Indigenous Australians age prematurely? Answer: The idea that Indigenous people age prematurely is not well supported by this study of a series of discrete conditions. The current focus and type of services provided by the aged care sector may not be the
Question: Do French lay people and health professionals find it acceptable to breach confidentiality to protect a patient's wife from a sexually transmitted disease? Answer: Most people in France are influenced by situational factors when deciding if a physician should breach confidentiality to protect the spouse of a patient infected with STD.
Question: Fragility of the esophageal mucosa: a pathognomonic endoscopic sign of primary eosinophilic esophagitis? Answer: Primary eosinophilic esophagitis is characterized by fragile esophageal mucosa that readily tears in response to minor trauma during otherwise uneventful diagnostic endoscopy. This "crêpe-paper" sign may alert endoscopists to the presence of the disease when other mucosal alterations are lacking. Dilation is effective for
Question: Are stroke patients' reports of home blood pressure readings reliable? Answer: This group of elderly stroke patients were able to record their BPs reliably at home. Any bias was small and would be unlikely to affect management. Since BP readings in a GP surgery are often a poor indication of true BP, GPs might consider using hypertensive patients'
Question: Is the first urinary albumin/creatinine ratio (ACR) in women with suspected preeclampsia a prognostic factor for maternal and neonatal adverse outcome? Answer: ACR is an independent prognostic factor for maternal and neonatal adverse outcomes in suspected preeclampsia. ACR may be useful to inform risk predictions within a prognostic model.
Question: A model of healing of Los Angeles grades C and D reflux oesophagitis: is there an optimal time of acid suppression for maximal healing? Answer: After 4 weeks' acid-suppressive therapy for LA grade C or D oesophagitis, successful healing appears to reach a threshold above which improvements are unlikely to be achieved despite an increase in number of hours with intragastric pH>4.
Question: Is the ability to perform transurethral resection of the prostate influenced by the surgeon's previous experience? Answer: The senior urologist was capable of resecting four times more tissue per time unit than the more inexperienced surgeons. Therefore, a surgeon's experience may be important to reduce the risk of secondary TURP due to recurring adenomas or adenomas that were incompletely
Question: Cervical spine fractures in geriatric blunt trauma patients with low-energy mechanism: are clinical predictors adequate? Answer: Clinical predictors appear inadequate for the evaluation of the cervical spine in geriatric trauma patients with low-energy mechanism.
Question: Can APC mutation analysis contribute to therapeutic decisions in familial adenomatous polyposis? Answer: As age at manifestation and course of the disease may be rather variable, even in carriers of identical germline mutations, therapeutic decisions should be based on colonoscopic findings in individual patients rather than on the site of mutation.
Question: Does a geriatric oncology consultation modify the cancer treatment plan for elderly patients? Answer: The geriatric oncology consultation led to a modification of the cancer treatment plan in more than one third of cases. Further studies are needed to determine whether these modifications improve the outcome of these older patients.
Question: CYP2D6*4 allele and breast cancer risk: is there any association? Answer: A possible decreased transformation of procarcinogens by CYP2D6*4 poor metabolisers could result in a protective effect against carcinogens.
Question: Does obstructive sleep apnea affect aerobic fitness? Answer: Overall, in a US Air Force population, OSA does not predict a decrease in aerobic fitness as measured by cycle ergometry. However, patients with an apnea-hypopnea index of greater than 20 have a statistically significant decrease in aerobic fitness compared
Question: Does loss of consciousness predict neuropsychological decrements after concussion? Answer: The results of this study cast doubt on the importance of LOC as a predictor of neuropsychological test performance during the acute phase of recovery from mild traumatic brain injury. Neuropsychological testing procedures have been shown to be sensitive in measuring cognitive sequelae of
Question: Does early migraine treatment shorten time to headache peak and reduce its severity? Answer: Early treatment and use of triptans may lead to shorter duration from migraine headache onset to its peak but did not alleviate headache severity at peak. This could result in decreased migraine burden by reducing total migraine headache duration.
Question: Living in an urban environment and non-communicable disease risk in Thailand: Does timing matter? Answer: Urbanicity was associated with increases in behavioral and physiological risk factors. However, these associations may not translate directly into increases in biological risk factors. It is likely that these biological risk factors were results of a complex interaction between both long term accumulation of
Question: Marital status, living arrangement and mortality: does the association vary by gender? Answer: Evaluation of living arrangements is crucial for identifying and explaining gender differences in mortality risks by marital status. The impact of living alone and living with a partner seems to be different in men and women.
Question: Major depression and alcohol use disorder in adolescence: Does comorbidity lead to poorer outcomes of depression? Answer: The results of these analyses suggest that marginally higher rates of depression to age 35 amongst the comorbid MD/AUD group were explained by increased exposure to adverse childhood circumstances amongst members of the comorbid group. Adolescent MD/AUD comorbidity is likely to be a risk marker, rather than a
Question: Stretch-sensitive KCNQ1 mutation A link between genetic and environmental factors in the pathogenesis of atrial fibrillation? Answer: These data suggest that the R14C KCNQ1 mutation alone is insufficient to cause AF. Rather, we suggest a model in which a "second hit", such as an environmental factor like hypertension, which promotes atrial stretch and thereby unmasks an inherited defect in ion channel kinetics (the "first hit"),
Question: Do we need imaging to diagnose appendicitis in children? Answer: Clinical assessment is the key to diagnose appendicitis. Nevertheless, in girls older than 10 years, selected use of imaging should be implemented to avoid unnecessary appendectomies. Imaging of choice in equivocal cases should be ultrasonography.
Question: Do resident's leadership skills relate to ratings of technical skill? Answer: General surgery research residents' intraoperative leadership skills showed significant correlations to their perceptions of skill decay and task difficulty during a bowel repair. Evaluating resident's directional instructions may provide an additional individualized intraoperative assessment metric. Further evaluation relating to operative performance outcomes is warranted.
Question: Are higher rates of depression in women accounted for by differential symptom reporting? Answer: Men and women in this community sample reported similar patterns of depressive symptoms. No evidence that the presentation of depressive symptoms differs by gender was found.
Question: Hypotension in patients with coronary disease: can profound hypotensive events cause myocardial ischaemic events? Answer: In patients with ischaemic heart disease and hypotension, symptomatic and silent ischaemia occurred in a temporally causal relation with hypotension, particularly for diastolic pressures, suggesting that patients with coronary disease may be susceptible to ischaemic events incurred as a result
Question: Are laboratories reporting serum quantitative hCG results correctly? Answer: Many factors contribute to the erroneous reporting of hCG results, including (a) the complexity of hCG molecule and confusion of nomenclature on the various forms of hCG; (b) laboratory personnel's lack of awareness of the distinctions of the forms of hCG and failure to recognize the specificity of assays for their measurement; (c) lack of
Question: Antral follicle assessment as a tool for predicting outcome in IVF--is it a better predictor than age and FSH? Answer: In vitro fertilization outcome is strongly correlated with both maternal ages, basal cycle, day 3 follicle, stimulated hormone, and antral follicle assessment. Antral follicle assessment was a better predictor of in vitro fertilization outcome than were age or follicle stimulated hormone. Antral follicle assessment may provide a marker for ovarian age that is distinct from
Question: Is pain a clinically relevant problem in general adult psychiatry? Answer: We found evidence that pain can be a significant clinical problem in psychiatric patients which seems to be underestimated in psychiatry. The investigated patients in general adult psychiatry are characterized by specific risk factors
Question: Is Alveolar Macrophage Phagocytic Dysfunction in Children With Protracted Bacterial Bronchitis a Forerunner to Bronchiectasis? Answer: A reduced alveolar macrophage phagocytic host response to apoptotic cells or NTHi may contribute to neutrophilic inflammation and NTHi colonization in both PBB and bronchiectasis. Whether this mechanism also contributes to the progression of PBB to bronchiectasis remains unknown.
Question: Discharging patients earlier from Winnipeg hospitals: does it adversely affect quality of care? Answer: Improving hospital efficiency by shortening length of stay does not appear to result in increased rates of readmission or numbers of physician visits within 30 days after discharge from hospital. Research is needed to identify optimal lengths of stay and expected readmission rates.
Question: Optimism and survival: does an optimistic outlook predict better survival at advanced ages? Answer: An optimistic outlook appears to be a significant predictor of survival among the oldest-old women. It may also be a significant predictor for men but the sample size is small.
Question: Is grandmultiparity an independent risk factor for adverse perinatal outcomes? Answer: Grandmultiparous women had increased maternal and neonatal morbidity, and neonatal mortality even after controlling for confounders, suggesting a need for closer observation than regular multiparous patients during labor and delivery.
Question: Diagnostic characteristics of child bipolar I disorder: does the "Treatment of Early Age Mania (team)" sample generalize? Answer: Generalization of the RCT sample was supported, because only 7.8% of Phenomenology subjects did not fit the RCT criteria. Nevertheless, because the RCT subjects were more severely ill, it is unclear if treatment findings from the RCT will be applicable to children with less severe mania.
Question: Do provider service networks result in lower expenditures compared with HMOs or primary care case management in Florida's Medicaid program? Answer: The Medicaid Demonstration in Florida appears to result in lower PMPM expenditures. Demonstration PSNs generated slightly greater reductions in expenditures compared to Demonstration HMOs. PSNs appear to be a promising model for delivering care to Medicaid enrollees.
Question: Is (18)F-FDG a surrogate tracer to measure tumor hypoxia? Answer: This study showed that FDG is not a good surrogate tracer for tumor hypoxia under either ambient or hypoxic conditions. Only specific hypoxia tracers should be used to measure tumor hypoxia.
Question: Do viral infections have a role in benign paroxysmal positional vertigo? Answer: BPPV is associated with positive viral serology, particularly during certain months of the year, mainly in spring and autumn. Viral infection might promote BPPV attacks due to the development of vestibulopathy or induce secondary BPPV via viral infection-related neurolabyrinthitis.
Question: Does the radiographic transition zone correlate with the level of aganglionosis on the specimen in Hirschsprung's disease? Answer: Correlation between level of radiographic transition zone on contrast enema and length of aganglionosis remains low. Systematic preoperative biopsy by coelioscopy or ombilical incision is mandatory.
Question: Characterization of the gender dimorphism after injury and hemorrhagic shock: are hormonal differences responsible? Answer: The independent protective effect of female gender on multiple organ failure and nosocomial infection rates remains significant in both premenopausal and postmenopausal women when compared with similarly aged men. This is contrary to previous experimental studies and the known physiologic sex hormone changes that occur after
Question: Ultra high risk (UHR) for psychosis criteria: are there different levels of risk for transition to psychosis? Answer: Our data suggest that UHR intake criteria predict transition over 6 months in the order of Trait alone<APS<BLIPS. The fact that BLIPS patients are at the highest risk of transition over the short term is consistent with the "early" versus "late" prodrome model. It also indicates that particular clinical attention may need to be
Question: Does angiotensin-converting enzyme-1 (ACE-1) gene polymorphism lead to chronic kidney disease among hypertensive patients? Answer: It is concluded that ACE-DD genotype may be a risk factor for the causation and development of chronic kidney failure among hypertensive patients.
Question: Is there a first night effect on sleep bruxism? Answer: The results showed no overall first night effect on severity of RMMA frequency in young and healthy patients with SB. In clinical practice, one-night sleep recording may be sufficient for moderate-high frequency SB patients. However, low RMMA frequency in the first night could be confirmed
Question: Does Residency Selection Criteria Predict Performance in Orthopaedic Surgery Residency? Answer: We found that USMLE Step 2, number of honors in medical school clerkships, and AOA membership demonstrated the strongest correlations with resident performance. Our goal in analyzing these data was to provide residency programs at large a sense of which criteria may be "high yield" in
Question: Do general practice characteristics influence uptake of an information technology (IT) innovation in primary care? Answer: The analyses show that structural characteristics of a practice are not associated with uptake of a new IT facility, but that its use may be influenced by post-graduate education in the relevant clinical condition. For this diabetes system at least, practice nurse
Question: Are high flow nasal cannulae noisier than bubble CPAP for preterm infants? Answer: At the gas flows studied, HFNC are not noisier than BCPAP for preterm infants.
Question: BCRABL transcript detection by quantitative real-time PCR : are correlated results possible from homebrew assays? Answer: These results suggest that quantitative real-time PCR assays for BCRABL detection can be comparable between laboratories despite significant differences in methodologies if the same positive control cell line and quality control gene are used. It is imperative that some level of assay standardization be adopted between laboratories, not only for
Question: Aripiprazole: a new risk factor for pathological gambling? Answer: Adverse drug reactions were confronted with other already published case reports. Dopamine partial agonist mechanism of aripiprazole could explain the occurrence of pathological gambling.
Question: Is the fibronectin-aggrecan complex present in cervical disk disease? Answer: Biochemical analysis of injured cervical intervertebral disks reveals the presence of inflammatory markers such as MCP, fragments of structural matrix proteins such as FAC, and a correlation with pH. Further evaluation of the FAC as a potential diagnostic biomarker or therapeutic
Question: Prostate bed target interfractional motion using RTOG consensus definitions and daily CT on rails : Does target motion differ between superior and inferior portions of the clinical target volume? Answer: There are no statistically apparent motion differences between SUP-CTV and INF-CTV. Current uniform planning target volume (PTV) margins are adequate to cover both portions of the CTV.
Question: Advanced epithelial ovarian carcinoma in Thai women: should we continue to offer second-look laparotomy? Answer: The second-look laparotomy doesn't have a favorable impact on overall and disease-free survival. Tumor grade is the only independent prognostic variable for survival of the patients.
Question: Dose end-tidal carbon dioxide measurement correlate with arterial carbon dioxide in extremely low birth weight infants in the first week of life? Answer: There is good correlation and agreement between end-tidal CO(2) and arterial CO(2) in ELBW infants in the EtCO(2) range 30-50 mmHg. End-tidal CO(2) monitoring can be helpful in trending or for screening abnormal PaCO(2) values in ELBW infants in first week of life.
Question: Neck pain treatment with acupuncture: does the number of needles matter? Answer: For this pathology, the number of needles, 5 or 11, seems not to be an important variable in determining the therapeutic effect when the time of stimulation is the same in the two groups.
Question: Is zero central line-associated bloodstream infection rate sustainable? Answer: High-quality training, strict compliance with evidence-based guidelines, and thorough documentation is associated with significant reductions in CLABSIs. Mindful organizing may lead to a better understanding of what goes into a unit's ability to handle peak demands and sustain extraordinary performance in the long-term.
Question: Is robotically assisted laparoscopic radical prostatectomy less invasive than retropubic radical prostatectomy? Answer: This study showed for the first time that RALP induces lower tissue trauma than RRP.
Question: Globulomaxillary cysts--do they really exist? Answer: According to the results of our study and the data from the international literature, the entity globulomaxillary cyst is no longer justified.
Question: Is the advanced age a contraindication to GERD laparoscopic surgery? Answer: Laparoscopic antireflux surgery is a safe and effective treatment for GERD even in elderly patients, warranting low morbidity and mortality rates and a significant improvement of symptoms comparable to younger patients.
Question: Does aerobic fitness influence microvascular function in healthy adults at risk of developing Type 2 diabetes? Answer: In this 'at-risk' group with skin microvascular dysfunction maximal oxygen uptake was not reduced compared with healthy controls. However, in the 'at-risk' group alone, individuals with higher levels of aerobic fitness also had better microvascular and endothelial responsiveness.
Question: Estradiol and Antagonist Pretreatment Prior to Microdose Leuprolide in in Vitro Fertilization. Does It Improve IVF Outcomes in Poor Responders as Compared to Oral Contraceptive Pill? Answer: E2+antag pretreatment does not appear to improve IVF outcomes in ML protocol when compared to the standard OCP in poor responders. Randomized trials with adequate power to study the optimal method of steroid pretreatments appear justified.
Question: Did the call for boycott by the Catholic bishops affect the polio vaccination coverage in Kenya in 2015? Answer: The call for boycott did not affect the campaign significantly. However, if the call for boycott is repeated in future it could have some significant negative implication to polio eradication. It is therefore important to ensure that
Question: Is neck pain associated with worse health-related quality of life 6 months later? Answer: We found that neck pain was negatively associated with physical but not mental HRQoL. Our analysis suggests that neck pain may be a contributor of future poor physical HRQoL in the population. Raising awareness of the possible future impact of neck
Question: Is decompressive surgery effective for spinal cord sarcoidosis accompanied with compressive cervical myelopathy? Answer: The effect of decompression for spinal cord sarcoidosis with compressive myelopathy was not evident. Early diagnosis for sarcoidosis from other organ and steroid therapy should be needed.
Question: Can bedside assessment reliably exclude aspiration following acute stroke? Answer: Bedside assessment of swallowing lacks the necessary sensitivity to be used as a screening instrument in acute stroke, but there are concerns about the use of videofluoroscopy as a gold standard. The relative importance of aspiration and bedside assessment in predicting complications and
Question: Does family practice at residency teaching sites reflect community practice? Answer: The residency training sites of the Northeastern Ohio Universities College of Medicine provide patient care opportunities similar to those found in a national survey of family and general practitioners.
Question: Is duration of psychological treatment for depression related to return into treatment? Answer: The results suggest that a longer duration of treatment may prevent return into mental health care in some groups. However, because of the design of the study, no causal inference can be drawn. Further research, preferably in a RCT, is needed to determine whether
Question: Are increased carotid artery pulsatility and resistance indexes early signs of vascular abnormalities in young obese males? Answer: Our results suggest that depressed vessel compliance and increased vascular resistance are features of young, obese, normotensive subjects independently of and in addition to cardiovascular risk factors. As changes in arterial wall properties may
Question: Can mental imagery functional magnetic resonance imaging predict recovery in patients with disorders of consciousness? Answer: The fMRI paradigm mental imagery displays a high concordance with the further clinical course of patients in a VS. All 5 patients in a VS who showed significant activation of ROIs had a favorable further course until the end of the
Question: Does the Simultaneous Use of a Neuroendoscope Influence the Incidence of Ventriculoperitoneal Shunt Infection? Answer: In the present study, the use of an endoscope during VPS procedures did not increase the risk of surgical infection.
Question: Can a Novel Surgical Approach to the Temporomandibular Joint Improve Access and Reduce Complications? Answer: The VMPA can provide direct access and favorable visibility to the TMJ region and yield good esthetic and functional results. The VMPA can be considered the approach of choice for common TMJ surgeries.
Question: Does laparoscopic cholecystectomy influence peri-sinusoidal cell activity? Answer: Laparoscopic procedures caused detectable damage to Kupffer and endothelial cells as reflected by elevation of post-operative HA serum levels. The damage to the liver hepatocytes and perisinusoidal cells has no clinical significance and the laparoscopic procedure itself is the probable cause of
Question: Do mossy fibers release GABA? Answer: We have thus provided compelling evidence that there is a mossy fiber GABAergic signal. The physiologic role of this mossy fiber GABAergic signal is uncertain, but may be of developmental importance. Other evidence suggests that this GABAergic signal is
Question: Reporting and interpreting red blood cell morphology: is there discordance between clinical pathologists and clinicians? Answer: Important differences about the clinical relevance of certain RBC-M terms exist between clinicians and CPs. Inclusion of interpretive comments on CBC reports is the clearest way to ensure that RBC-M changes are interpreted as intended by the CP. Reporting practices should be examined critically
Question: Colorectal cancer in young patients: is it a distinct clinical entity? Answer: Colorectal cancer among young patients may constitute a distinct clinical entity. Further research is needed to validate our findings and define the optimal approach in this population.
Question: Is discordance in TEOAE and AABR outcomes predictable in newborns? Answer: Given the available screening technologies, discordant TEOAE and AABR may be inevitable for some categories of hearing loss among apparently healthy newborns whose mothers received prenatal care. The potential limitations of perinatal morbidities as basis of targeted screening for such cases
Question: May student examiners be reasonable substitute examiners for faculty in an undergraduate OSCE on medical emergencies? Answer: It seems quite admissible and justified to encourage medical students to officiate as examiners in undergraduate emergency medicine OSCE formative testing, but not necessarily in summative assessment evaluations.
Question: Amblyopia: is visual loss permanent? Answer: Older people with a history of amblyopia who develop visual loss in the previously normal eye can experience recovery of visual function in the amblyopic eye over a period of time. This recovery in visual function occurs in the wake of visual loss
Question: Does prior benign prostate biopsy predict outcome for patients treated with radical perineal prostatectomy? Answer: A prior benign prostate biopsy may be independently associated with more favorable surgical and biochemical outcomes after prostatectomy. Additional studies are needed to confirm these findings.
Question: Does minimal access major surgery in the newborn hurt less? Answer: Minimal access surgery for the repair of esophageal atresia or congenital diaphragmatic hernia is not associated with less cumulative opioid doses.
Question: Is external palliative radiotherapy for gallbladder carcinoma effective? Answer: External radiotherapy seems to be a safe and effective method of palliative management of gallbladder carcinoma. However, further studies are necessary to determine the role of radiotherapy in palliative or adjuvant treatment of gallbladder carcinoma.
Question: The use of audit to identify maternal mortality in different settings: is it just a difference between the rich and the poor? Answer: Differences in maternal mortality are more than just differences between the rich and poor. Acknowledging the magnitude of maternal mortality and harnessing a strong political will to tackle the issues are important factors. However, there is no single, general solution to reduce maternal mortality, and identification of problems
Question: Transgastric endoscopic splenectomy: is it possible? Answer: Transgastric endoscopic splenectomy in a porcine model appears technically feasible. Additional long-term survival experiments are planned.
Question: Are environmental factors important in primary systemic vasculitis? Answer: A significant association between farming and PSV has been identified for the first time. Results also support previously reported associations with silica, solvents, and allergy.
Question: Does the central venous pressure predict fluid responsiveness? Answer: There are no data to support the widespread practice of using central venous pressure to guide fluid therapy. This approach to fluid resuscitation should be abandoned.
Question: Do preoperative statins reduce atrial fibrillation after coronary artery bypass grafting? Answer: Our study indicated that preoperative statin therapy seems to reduce AF development after CABG.
Question: Prognosis of low-tone sudden deafness - does it inevitably progress to Meniere's disease? Answer: We conclude that not all low-tone sudden deafness (SD) patients suffered from endolymphatic hydrops even if they had vertigo attack at the onset and that electrocochleography (ECochG) was a useful prognostic tool.
Question: Is primary angioplasty an acceptable alternative to thrombolysis? Answer: Reorganization of care to offer a primary angioplasty service was acceptable to patients and their carers. Satisfaction levels were high regardless of the type of care received, with the exception of discharge and aftercare.
Question: Is it necessary to insert a nasobiliary drainage tube routinely after endoscopic clearance of the common bile duct in patients with choledocholithiasis-induced cholangitis? Answer: A routinely inserted ENBD tube did not improve the clinical course, despite patients having to endure increased procedure time and discomfort, and the insertion would therefore be unnecessary.
Question: Does birth center care during a woman's first pregnancy have any impact on her future reproduction? Answer: A woman's model of care, such as birth center care, during her first pregnancy does not seem to be a sufficiently important factor to affect subsequent reproduction in Sweden.
Question: Are UK radiologists satisfied with the training and support received in suspected child abuse? Answer: The survey shows significant dissatisfaction amongst consultant radiologists with the current service, confirms a low number of paediatric radiologists taking on this work, and suggests the potential to increase numbers of radiology child abuse experts by 27% if given improved training
Question: Does preoperative anemia adversely affect colon and rectal surgery outcomes? Answer: This large multicenter database analysis suggests that the presence of severe and moderate and even mild preoperative anemia is an independent risk factor for complications and a longer hospital stay after colon surgery.
Question: Does septoplasty change the dimensions of compensatory hypertrophy of the middle turbinate? Answer: The present study findings suggest that compensatory hypertrophy of the middle turbinate is not affected by septoplasty, even after one year.
Question: Upstream solutions: does the supplemental security income program reduce disability in the elderly? Answer: Income support policy may be a significant new lever for improving population health, especially that of lower-income persons. Even though the findings are robust, further analyses are needed to confirm their reliability. Future research should examine a variety of different income support
Question: Increased neutrophil migratory activity after major trauma: a factor in the etiology of acute respiratory distress syndrome? Answer: These data indicate that major blunt trauma enhances the migratory capacity of circulating neutrophils. This is manifest within 2 hrs of admission and may be attributable to alteration in interleukin-8 receptor expression, affinity, or downstream signaling. In patients who later develop ARDS, initially elevated
Question: A patient with myelomeningocele: is untethering necessary prior to scoliosis correction? Answer: The study results suggested that spinal cord untethering may be unnecessary in patients with MM who are undergoing scoliosis corrective surgery and do not present with clinical symptoms of a tethered cord, even though tethering is radiographically demonstrated.
Question: Body perception: do parents, their children, and their children's physicians perceive body image differently? Answer: Many children underestimated their degree of overweight. Their parents and even their attending physicians shared this misperception. This study demonstrates the need to further educate physicians to recognize obesity and overweight so that they can counsel children and their families.
Question: The insertion allele of the ACE gene I/D polymorphism. A candidate gene for insulin resistance? Answer: We conclude that increased cardiovascular risk of the DD genotype is not mediated through insulin resistance or abnormalities in fibrinolysis. Conversely, we report an increased sensitivity in NIDDM subjects with the ACE DD genotype.
Question: The clinical significance of bile duct sludge: is it different from bile duct stones? Answer: The findings indicate that the clinical significance of symptomatic BDS is similar to that of CBD stones. Bile duct sludge seems to be an early stage of choledocholithiasis.
Question: Preoperative staging of patients with liver metastases of colorectal carcinoma. Does PET/CT really add something to multidetector CT? Answer: PET/CT has a limited role in hepatic staging of LMCRC. Although PET-CT has higher sensitivity for the detection of extrahepatic disease in some anatomic locations, its results are hampered by its low PPV. PET/CT provided additional useful information in 8% of the cases but also
Question: Does the distribution of health care benefits in Kenya meet the principles of universal coverage? Answer: The principles of universal coverage require that all should benefit from health care according to need. The Kenyan health sector is clearly inequitable and benefits are not distributed on the basis of need. Deliberate efforts should be directed to restructuring the
Question: Does cognitive function predict frequency compressed speech recognition in listeners with normal hearing and normal cognition? Answer: The relationship between cognitive functioning and recognition of frequency compressed speech-in-noise was not statistically significant. The findings may have been different if the participants had been provided with training and/or time to 'acclimatize' to the frequency-compressed conditions.
Question: Preoperative platelet count in esophageal squamous cell carcinoma: is it a prognostic factor? Answer: Preoperative platelet count is a predictive factor for long-term survival in ESCC, especially in nodal-positive patients. We conclude that 205 (×10(9)/L) may be the optimum cutoff point for platelet count in predicting survival in ESCC patients.
Question: Long-term significance of postictal psychotic episodes II. Are they predictive of interictal psychotic episodes? Answer: A history of PIPE may be a risk factor for the development of IPE. Yet, the disappearance of significance on multivariate analysis indicates that it is not an independent predictor.
Question: Are Biochemical Markers of Bone Turnover Representative of Bone Histomorphometry in 370 Postmenopausal Women? Answer: Bone turnover markers were significantly but modestly associated with bone turnover parameters measured in iliac cancellous bone. The iliac crest bone may not represent perfectly the whole bone turnover.
Question: Is lumbar drainage of postoperative cerebrospinal fluid fistula after spine surgery effective? Answer: Lumbar drainage seems to be effective and safe both in preventing CSF fistula in cases of large dural tears and debilitated/irradiated patients and in treating CSF leaks.
Question: Impact of MPH programs: contributing to health system strengthening in low- and middle-income countries? Answer: There was considerable impact at many levels; graduates were perceived to be able to contribute significantly to their workplaces and often had influence at the national level. Much of the impact described was in line with public health educational aims. The qualitative method study revealed more in-depth understanding of graduates' impact as well as their career
Question: Locoregional opening of the rodent blood-brain barrier for paclitaxel using Nd:YAG laser-induced thermo therapy: a new concept of adjuvant glioma therapy? Answer: LITT induces a locoregional passage of chemotherapeutic agents into the brain tissue. This is of potential interest for the treatment of brain tumors.
Question: Do episodic migraineurs selectively attend to headache-related visual stimuli? Answer: In light of the large sample size and prior pilot testing of presented images, results suggest that episodic migraineurs do not differentially attend to headache-related facial stimuli. Given modest evidence of attentional biases among chronic headache samples, these findings
Question: Visceral adipose tissue area measurement at a single level: can it represent visceral adipose tissue volume? Answer: VAT area measurement at a single level 3 cm above the lower margin of the L3 vertebra is feasible and can reflect changes in VAT volume and body weight. Advances in knowledge: As VAT area at a CT slice 3cm above the lower
Question: Does gestational age misclassification explain the difference in birthweights for Australian aborigines and whites? Answer: Gestational age misclassification is an unlikely explanation for the reported divergence in average birth-weights for Aborigines and whites. The results might help with the interpretation of other between-population comparisons.
Question: Is there a correlation between androgens and sexual desire in women? Answer: In the present study, FT and androstenedione were statistically significantly correlated with sexual desire in the total cohort of women. ADT-G did not correlate more strongly than circulating androgens with sexual desire and is therefore not superior to measuring circulating androgens by mass spectrometry.
Question: Is there a role for fondaparinux in perioperative bridging? Answer: The role of fondaparinux in perioperative bridge therapy has not been established, and there are some important limitations to its use as a routine bridging agent.
Question: Do African American women require fewer calories to maintain weight? Answer: These results do not support the view that AA women are at greater risk for obesity because they require fewer calories to maintain weight.
Question: Is crime associated with over-the-counter pharmacy syringe sales? Answer: Our findings demonstrate that OTC pharmacy syringe sales were not associated with increases in reported crime in local communities in Los Angeles during 2006-2008.
Question: Are lower fasting plasma glucose levels at diagnosis of type 2 diabetes associated with improved outcomes? Answer: People presenting with type 2 diabetes with lower initial glycemia who may be earlier in the course of their disease had fewer adverse clinical outcomes despite similar glycemic progression. Since most such people are asymptomatic at diagnosis, active case
