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61201 | Management of heart failure among very old persons living in long-term care: has the voice of trials spread? | Increasing prevalence, use of health services, and number of deaths have made congestive heart failure (CHF) a new epidemic in the United States. Yet there are no adequate data to guide treatment of the more typical and complex cases of patients who are very old and frail. Using the SAGE database, we studied the cases ... | Patients in long-term care who have CHF little resemble to those enrolled in randomized trials. This circumstance may explain, at least in part, the divergence from pharmacologic management consensus guidelines. Yet the prescription of ACE inhibitors varies significantly across facilities and depends on organizational ... | 425 |
61202 | Does hysteroscopy facilitate tumor cell dissemination? | In several case reports, distension and irrigation of the uterine cavity during fluid hysteroscopy was suspected to cause tumor cell dissemination into the abdominal cavity in patients with endometrial carcinoma. It was the aim of this study to compare the incidence of positive peritoneal cytology in patients who under... | Based on the limited extent of endometrial carcinoma in the current analysis, our data strongly suggest dissemination of endometrial carcinoma cells after fluid hysteroscopy. Determining whether a positive peritoneal cytology affects the prognoses of patients without further evidence of extrauterine disease will requir... | 411 |
61203 | Sympathetic skin response in diabetic children: do diabetic children have diabetic neuropathy? | Abnormal sympathetic skin response (SSR) has been reported in adult patients with diabetic neuropathy. In addition, other studies have revealed abnormal SSR in diabetic patients not having autonomic symptoms and autonomic dysfunctions. These findings have been only obtained from adult patients. There have been few repo... | Diabetic neuropathy may not have occurred in young patients having shorter duration of illness. Conversely, assuming that prolonged latency is abnormal, it may even have occurred in them. Follow up on these patients with prolonged latencies would be required. | 325 |
61204 | Are the newer antidepressant drugs as effective as established physical treatments? | The aim of this study was to determine, in a clinical panel sample, the extent to which patients with depression (and melancholic and non-melancholic subtypes) judged the effectiveness of previously received antidepressant treatments, particularly the comparative effectiveness of the older and newer antidepressant drug... | Despite methodological limitations intrinsic to such clinical panel data, the judged greater effectiveness of the older antidepressants (tricyclics and irreversible MAOIs) for melancholic depression is of importance. If valid, such data are of intrinsic clinical relevance but also have the potential to inform us about ... | 386 |
61205 | Does syndrome X exist in hypertensive elderly persons with impaired glycemic control? | This report focuses on the glycemic state in relation to insulin and lipid levels of a cohort of elderly hypertensive persons to estimate the prevalence of syndrome X. A cross-sectional study was performed at the University of Tennessee, Memphis, and the General Clinical Research Center (GCRC) on 95 participants in the... | Our data demonstrated that in this cohort of elderly hypertensive participants with a high prevalence of central obesity, impaired glycemic control was common, but was not associated with fasting hyperinsulinemia or peripheral insulin resistance. Furthermore, we conclude that syndrome X essentially did not occur in the... | 387 |
61206 | Fish allergy: is cross-reactivity among fish species relevant? | Allergic reactions to fish are a common cause of food allergy in many areas of the world where fish is a major source of protein. Although different species of fish may be consumed, possible cross-reactivity has received limited investigation. The aim of this study was to assess potential cross-reactivity to different ... | Our results indicate that clinically relevant cross-reactivity among various species of fish may exist. Advising fish-allergic subjects to avoid all fish species should be emphasized until a species can be proven safe to eat by provocative challenge. | 306 |
61207 | Do eosinophil counts correlate differently with asthma severity by symptoms versus peak flow rate? | Discrepancy in asthmatic assessment by symptoms and peak flow rate (PFR) is a frequent dilemma. Currently, total peripheral eosinophil count (TPEC) is under study for asthma evaluation. To explore the correlation between TPEC and asthma severity assessed by symptoms alone versus symptoms and PFR. Adults asthmatics were... | The discrepancy between symptoms and PFR is confirmed by these results. A reliable objective parameter in asthma assessment is a continuous challenge. This study advocates the possible supplementation of TPEC as another objective parameter that might help in selecting the appropriate severity level in asthmatics. | 390 |
61208 | Do immunoassays differentially detect different acidity glycoforms of FSH? | The possibility of the carbohydrate residues of glycoproteins affecting their recognition in immunoassays is an important and unresolved issue. This study looked for evidence of differential recognition of FSH glycoform preparations, of variable isoelectric point (pI) and known molarity, using three routine assays empl... | Between the assay methods investigated in this study, few differences exist in the recognition of individual pI bands of FSH when expressed relative to a common unfractionated standard. Differences were apparent in the recognition of the different acidity glycoforms within each assay method, however, these were small a... | 370 |
61209 | Is high peritoneal transport rate an independent risk factor for CAPD mortality? | Is high peritoneal transport rate an independent risk factor for CAPD mortality? Patients with high peritoneal transport display the lowest serum albumin (SAlb) and the highest peritoneal protein loss. An association between high peritoneal membrane permeability and diabetes mellitus (DM) has been suggested. As malnutr... | DM was the most important risk factor for mortality on CAPD. A high peritoneal transport rate also predicted mortality, yet its role seems to be related to the presence of DM. The role of higher SCr predicting a better survival might have been associated with a better nutritional status. Hypoalbuminemia, previously sho... | 649 |
61210 | Expression of CD44 in uterine cervical squamous neoplasia: a predictor of microinvasion? | CD44, an integral membrane glycoprotein, may have an important role in early tumorigenesis, specifically, facilitating early tumor progression. Reports of the expression of CD44 in early uterine cervical squamous carcinogenesis are conflicting. We examined the expression of CD44 in microinvasive carcinoma of the cervix... | There is a qualitative and quantitative reduction in expression of CD44 in MIC and CIN 3 compared with CIN 1. Down-regulation of CD44 variants may occur later in neoplastic progression than CD44s. This pattern may reflect their important biological function in early progression by cervical cancer cells. Patchy and hete... | 438 |
61211 | Was the decreasing trend in hospital mortality from heart failure attributable to improved hospital care? | To assess the trend in risk-adjusted hospital mortality from heart failure. Oregon hospital discharge data from 1991 through 1995 were analyzed. A total of 29,530 hospitalizations because of heart failure in elderly patients (age>or = 65 years) were identified from International Classification of Diseases, 9th Revision... | There was a decreasing trend over time in the risk-adjusted hospital mortality rates from heart failure, which was not an artifact of decreasing length of stay. Our findings raised the possibility of improved hospital care for heart failure in Oregon. | 544 |
61212 | Is a third-trimester antibody screen in Rh+ women necessary? | To determine the need for routine third-trimester antibody screening in Rh+ women. An analytic case-control study. We identified Rh+ pregnant women who had received prenatal care and retrospectively analyzed their laboratory data. Patients were grouped into those with a positive third-trimester antibody screen (cases) ... | Based on the patient and hospital records studied, a repeat third-trimester antibody screen for Rh+ patients is clinically and economically unjustified. Eliminating this laboratory test from clinical practice will not adversely affect pregnancy outcomes and will decrease the costs of prenatal care. | 379 |
61213 | Do nursing home residents make greater demands on GPs? | The number of people residing in nursing homes has increased. General practitioners (GPs) receive an increased capitation fee for elderly patients in recognition of their higher consultation rate. However, there is no distinction between elderly patients residing in nursing homes and those in the community.AIM: To dete... | Our study suggests that nursing home residents do require a greater input from general practice than people of the same age and sex who are residing in the community. While consideration may be given to greater financial reimbursement of GPs who provide medical care to nursing home residents, consideration should also ... | 436 |
61214 | Does teaching during a general practice consultation affect patient care? | General practice differs from hospital medicine in the personal nature of the doctor-patient relationship and in the need to address social and psychological issues as well as physical problems. Recent changes in undergraduate medical education have resulted in more teaching and learning taking place in general practit... | The presence of a student has a complex effect on the general practice consultation. Future developments in medical education need to be evaluated in terms of how patient care is affected as well as meeting educational aims. | 258 |
61215 | Are postal questionnaire surveys of reported activity valid? | Postal questionnaire surveys are commonly used in general practice and often ask about self-reported activity. The validity of this approach is unknown.AIM: To explore the criterion validity of questions asking about self-reported activity in a self-completion questionnaire. A comparison was made between (a) the self-r... | There is a variable relationship between what responders report that they do in self-completion questionnaires, and what they actually do as judged by the contents of their patients' medical records. In the absence of prior, knowledge of the validity of questions on reported activity, or of concurrent attempts to estab... | 359 |
61216 | Underestimation of the small residual damage when measuring DNA double-strand breaks (DSB): is the repair of radiation-induced DSB complete? | To overcome the underestimation of the small residual damage when measuring DNA double-strand breaks (DSB) as fraction of activity released (FAR) by pulsed-field gel electrophoresis. The techniques used to assess DNA damage (e.g. pulsed-field gel electrophoresis, neutral elution, comet assay) do not directly measure th... | The expression of repair data in terms of FAR dramatically underestimates the amount of unrepaired DNA damage. The Blöcher model that takes into account the size distribution of radiation-induced DNA fragments should therefore be used to avoid this bias. Applied to a normal human fibroblast cell line, this model shows ... | 385 |
61217 | Contracting for quality: does length matter? | To examine whether longer-term contracts for health services will shift attention away from concern for finance and activity levels and towards the achievement of better quality services. Analysis of 288 contracts from the British National Health Service (NHS) and 12 semi-structured interviews with staff from provider ... | It is optimistic to expect longer-term contracts automatically to produce a greater focus on quality and the incentives needed to ensure that improvements in quality are delivered. However, this may not matter as issues of quality are being addressed more appropriately in the British NHS through a variety of other rout... | 221 |
61218 | Is radiation therapy a preferred alternative to surgery for squamous cell carcinoma of the base of tongue? | To evaluate irradiation alone for treatment of base-of-tongue cancer. Two hundred seventeen patients with squamous cell carcinoma of the base of tongue were treated with radiation alone and had follow-up for>/= 2 years. Local control rates at 5 years were as follows: T1, 96%; T2, 91%; T3, 81%; and T4, 38%. Multivariate... | The likelihood of cure after external-beam irradiation was related to stage, overall treatment time, and addition of a planned neck dissection. The local-regional control rates and survival rates after radiation therapy were comparable to those after surgery, and the morbidity associated with irradiation was less. | 399 |
61219 | Section of the sublingual frenulum. Are the indications correct? | To see the relationship of the lingual frenum with speech and other oral functions, evaluating the surgical indications and the results of frenectomy. In 1997 we operated 72 children with sublingual frenulum, a telephone questionnaire to the mothers of these patients was done, obtaining data about: age at surgery, prof... | The presence of a nondisturbing lingual frenulum does not justify its surgical section, the frenectomy is indicated only in presence of altered oro-lingual functions caused by the tongue-tie such as: speech problems, errors of bite and deglutition, lingual dysfunction and anomalous oral habits. | 359 |
61220 | Physician education and report cards: do they make the grade? | We sought to determine whether tailored educational interventions call improve the quality of care, as measured by the provision of preventive care services recommended by the US Preventive Services Task Force, as well as lead to better patient satisfaction. We performed a randomized controlled study among 41 primary c... | A physician-targeted approach of education, peer-comparison feedback, and academic detailing has modest effects on patient satisfaction and possibly on the offering of selected preventive care services. The lack of agreement between patient reports and medical records review raises concerns about current methods of asc... | 541 |
61221 | In-house referral: a primary care alternative to immediate secondary care referral? | Methods are needed to ensure that those patients referred from primary to secondary care are those most likely to benefit. In-house referral is the referral of a patient by a general practitioner to another general practitioner within the same practice for a second opinion on the need for secondary care referral. To de... | In-house referral is acceptable to patients and provides a straightforward method of addressing uncertainty over the need for referral from primary to secondary care. | 336 |
61222 | Do better quality consultations result in better health? | In theory, a positive relationship is expected between the quality of a consultation and a patient's subsequent health status. However, such a relationship has not yet been firmly established in daily practice. We aimed to study the relationship between the quality of the first consultation in a new episode of non-acut... | For the great majority of patients we found no relation between the quality of consultation and health status. However, for a very small subgroup of patients there is proof of benefit from better quality consultations. | 291 |
61223 | Development of a computer clinical instruction program. Is the game worth the candle? | Use of computers in medicine, as tools for information and education, is increasing. Many computer-assisted learning tools have been marketed. For clinician-teachers, computer-assisted learning offers interesting possibilities. Is this educational technology within the reach of family physicians? To describe developmen... | Developing a computerized learning tool is a worthwhile investment if the content has longevity; the learning process is highly interactive; there is a market for the product; and the tool is developed by a team of experienced, committed information technologists. | 235 |
61224 | Can sonographic signs predict long-term results of laparoscopic cholecystectomy? | To determine whether sonographic signs of the gallbladder can predict the long-term outcome of laparoscopic cholecystectomy (LC). All 346 patients, who underwent LC at our institution between January 1, 1993 and March 1, 1996, were interviewed using a structured questionnaire on the persistence of pre-operative abdomin... | This retrospective study showed that the sonographic sign of grit in the gallbladder is associated with a high relative risk for persistent abdominal symptoms after cholecystectomy. These findings will be re-evaluated in a prospective study to estimate the definitive clinical importance. | 490 |
61225 | Jugular phlebectasia in children: is it rare or ignored? | Phlebectasia of the jugular veins is a venous anomaly that usually presents in children as a soft cystic swelling in the neck during straining. The purpose of this report is to discuss the differential diagnosis, the methods of imaging, the mode of treatment, and to demonstrate some factors that have made us believe th... | Color Doppler sonography alone is sufficient for the diagnosis of jugular phlebectasia. The authors recommend surgical excision in asymptomatic cases for cosmetic and psychological purposes. The rarity of the lesion may be caused by a lack of knowledge among the related physicians and the tendency of reporting only sur... | 399 |
61226 | Alcoholics' selective attention to alcohol stimuli: automated processing? | This study investigated alcoholics' selective attention to alcohol words in a version of the Stroop color-naming task. Alcoholic subjects (n = 23) and nonalcoholic control subjects (n = 23) identified the color of Stroop versions of alcohol, emotional, neutral and color words. Manual reaction times (RTs), skin conducta... | These findings indicate that it is difficult for alcoholics to regulate their attention to alcohol stimuli, suggesting that alcoholics' processing of alcohol information is automated. | 382 |
61227 | Alcohol effects on movement-related potentials: a measure of impulsivity? | To assess the effects of acute alcohol intoxication on lateralized readiness potential (LRP), a central measure of movement-related brain activity, and the potential association of such effects with personality measures. Male volunteers (N = 12) alternated responding hands during a "go/no go" verbal recognition task ac... | Alcohol may result in disinhibition such that the "response execution" process is activated based on very preliminary stimulus evaluation. This alcohol-induced brain activity signaling premature motor preparation exhibited correlation trends with personality traits related to impulsivity, hyperactivity and antisocial t... | 373 |
61228 | Lower frequency of focal lip sialadenitis (focus score) in smoking patients. Can tobacco diminish the salivary gland involvement as judged by histological examination and anti-SSA/Ro and anti-SSB/La antibodies in Sjögren's syndrome? | Prospectively collected computer database information was previously assessed on a cohort of 300 patients who fulfilled the Copenhagen classification criteria for primary Sjögren's syndrome. Analysis of the clinical data showed that patients who smoked had a decreased lower lip salivary gland focus score (p<0.05). The ... | This is believed to be the first report showing that cigarette smoking is negatively associated with focal sialadenitis-focus score>1-in lower lip biopsy in patients with primary Sjögren's syndrome. Furthermore, tobacco seems to decrea | 1,027 |
61229 | Is routine procaine spirit application necessary in the care of episiotomy wound? | A randomised controlled trial to investigate the usefulness of local application of procaine spirit versus cleansing with water for care of episiotomy wound after normal vaginal delivery was conducted in 100 women. Fifty women entered the study arm and 50 entered the control arm of the study. Women in the two arms were... | It is concluded that in a woman with normal vaginal delivery, local application of procaine spirit is unnecessary in the care of a routine episiotomy wound. | 225 |
61230 | Is it necessary to biopsy the obvious? | The radiologist and oncologist are often confident that biopsy will confirm their suspicion of recurrent disease, but a biopsy is performed to confirm the histologic diagnosis before beginning or altering therapy. We have examined data to determine how often the biopsied lesion represents recurrent disease from the pri... | Of the patients for whom radiographic findings suggested recurrence, we found no patients in whom a new primary tumor would have been missed if biopsy had been avoided. Data should now be acquired prospectively to determine whether it may be prudent to make treatment decisions on the basis of imaging findings alone, wi... | 333 |
61231 | Improving the recognition and management of depression: is there a role for physician education? | Many patients who visit primary care physicians suffer from depression, but physicians may miss the diagnosis or undertreat these patients. Improving physicians' communication skills pertaining to diagnosing and managing depression may lead to better outcomes. We performed a randomized controlled trial involving 49 pri... | The Depression Education Program changed physicians' behavior and may be an important component in the efforts to improve the care of depressed patients. | 386 |
61232 | Is acculturation a risk factor for early smoking initiation among Chinese American minors? | To determine the extent to which Chinese American and white minors differ in age of smoking initiation, and to determine the effect of acculturation on smoking initiation. Cross-sectional telephone surveys. Stratified random samples of the state of California, United States. 347 Chinese American and 10 129 white adoles... | Chinese American adolescents had a lower level and a different pattern of smoking onset than white adolescents. Levels of acculturation and other known risk factors were associated with the hazards of smoking initiation among Chinese American minors and with the difference in smoking initiation between the Chinese and ... | 344 |
61233 | Decrease in asthma mortality rate in Israel from 1991-1995: is it related to increased use of inhaled corticosteroids? | Asthma mortality rates (AMRs) during the last several decades increased in many countries with developed medical services, including Israel. The reasons for this trend were never established. Recent data suggested that this trend is changing. We sought to compare the AMR in Israel during 1991-1995 with that of the prev... | We identified a trend of decreased AMRs in Israel during 1991-1995. The decline in AMRs paralleled the increase in ICS sales, whereas the sales of inhaled beta(2)-agonists did not change significantly. One may speculate that the decrease in AMR may be the result of better anti-inflammatory treatment, as reflected by th... | 599 |
61234 | A 10-year national trend study of alcohol consumption, 1984-1995: is the period of declining drinking over? | Data from the 1984, 1990, and 1995 National Alcohol Surveys were used to investigate whether declines shown previously in drinking and heavy drinking across many demographic subgroups have continued. Three alcohol consumption indicators--current drinking (vs abstaining), weekly drinking, and weekly heavy drinking (5 or... | Alcohol consumption levels, declining since the early 1980s, may reach a minimum by the 21st century. Consumption levels should be monitored carefully over the next few years in the event that long-term alcohol consumption trends may be shifting. | 242 |
61235 | Should cocaine-abusing, buprenorphine-maintained patients receive auricular acupuncture? | Buprenophrine is a synthetic opioid with micro-agonist properties currently pending Food and Drug Administration (FDA) approval as a maintenance agent for treating heroin-addicted individuals. Unlike methadone, a widely used opioid maintenance agent, buprenorphine is a kappa-receptor antagonist. Research linking the ef... | These preliminary findings are consistent with the interpretation that buprenorphine does not block auricular acupuncture, supporting the provisional recommendation that cocaine-abusing patients maintained on buprenorphine should not be excluded from receiving auricular acupuncture or from participating in clinical stu... | 363 |
61236 | Duodenojejunitis: is it idiopathic or is it Henoch-Schönlein purpura without the purpura? | Henoch-Schönlein purpura is a small-vessel vasculitic disease that most often affects the skin. Gastrointestinal manifestations have been well described, including duodenojejunal inflammation (DJI). Four children with DJI and clinical features of HSP are described, in whom the rash was either not present or appeared at... | Duodenojejunal inflammation may be the primary manifestation of HSP, even in the absence of the characteristic rash. | 301 |
61237 | Is health-related quality of life among older, chronically ill patients associated with unplanned readmission to hospital? | Assessment of health-related quality of life (HRQL) is being used increasingly to assess the impact of treatment. To determine if HRQL, assessed shortly after acute hospitalisation, is associated with readmission to hospital. In a prospective, longitudinal study, 163 chronically ill, medical and surgical patients (mean... | In this cohort of predominantly older and chronically ill patients recently discharged from acute hospital care, relatively lower SF-36 physical health component scores were independently associated with an increased risk of subsequent unplanned readmission. | 474 |
61238 | Internet-based home asthma telemonitoring: can patients handle the technology? | To evaluate the validity of spirometry self-testing during home telemonitoring and to assess the acceptance of an Internet-based home asthma telemonitoring system by asthma patients. We studied an Internet-based telemonitoring system that collected spirometry data and symptom reports from asthma patients' homes for rev... | Spirometry self-testing by asthma patients during telemonitoring is valid and comparable to those tests collected under the supervision of a trained medical professional. Internet-based home asthma telemonitoring can be successfully implemented in a group of patients with no computer background. | 409 |
61239 | Is rest or exercise hypertension a cause of a false-positive exercise test? | To determine if a history of hypertension or an exaggerated rise in exercise systolic BP is associated with a false-positive exercise ECG. Retrospective analysis of the associations between exercise-induced ST-segment depression and a history of hypertension, exercise systolic BP, and several other clinical and exercis... | In patients with normal resting ECGs, we conclude the following: (1) a history of hypertension is not a cause of a false-positive exercise test, and (2) higher exercise systolic BP is a significant but weak predictor of ST-segment depression. | 416 |
61240 | Pancreatitis during therapy of acute myeloid leukemia: cytarabine related? | Acute pancreatitis in acute myeloid leukemia (AML) has been rarely associated with cytarabine therapy. This report attempts to characterize this toxicity. Criteria for pancreatitis was prospectively defined. Seven patients with pancreatitis were identified from an AML database and a clinical study at two tertiary care ... | Pancreatitis in the setting of AML therapy may be an infrequent and self-limited toxicity of cytarabine. A schedule dependent toxicity with cytarabine was not identified. | 415 |
61241 | Pediatric residents' telephone triage experience: do parents really follow telephone advice? | A previous study showed that calls received by our continuity clinic residents were similar to those in private practice. However, that study did not address the compliance of the parents to the advice given. To determine parents' compliance to after-hours telephone advice given by pediatric residents in a continuity c... | If an after-hours line is used by caregivers, they are more likely to follow the recommendations given by pediatric residents in a tertiary center. | 398 |
61242 | Organizational and financial characteristics of health plans: are they related to primary care performance? | Primary care performance has been shown to differ under different models of health care delivery, even among various models of managed care. Pervasive changes in our nation's health care delivery systems, including the emergence of new forms of managed care, compel more current data. To compare the primary care receive... | With US employers and purchasers having largely rejected traditional indemnity insurance as unaffordable, the results suggest that the current momentum toward open-model managed care plans is consistent with goals for high-quality primary care, but that the effects of specific financial and nonfinancial incentives used... | 383 |
61243 | Are genetic influences on peptic ulcer dependent or independent of genetic influences for Helicobacter pylori infection? | Genetic factors play a role or roles in the etiology of peptic ulcer disease and the acquisition of Helicobacter pylori infection. To evaluate the relative importance of genetic and environmental influences as well as the importance of H. pylori on peptic ulcer disease. Cross-sectional study on monozygotic (MZ) and diz... | Genetic influences are of moderate importance for liability to peptic ulcer disease. Genetic influences for peptic ulcer are independent of genetic influences important for acquiring H. pylori infection. | 450 |
61244 | Does eradication of Helicobacter pylori alone heal duodenal ulcers? | Eradication of Helicobacter pylori infection prevents duodenal ulcer (DU) relapse, but it remains uncertain whether eradication of H. pylori alone heals duodenal ulceration.AIM: To test the hypothesis that eradication of H. pylori infection is accompanied by healing of duodenal ulcer. A total of 115 consecutive patient... | BTC is a very effective H. pylori eradication regimen. Almost all duodenal ulcers heal spontaneously after cure of H. pylori infection using a 1-week low-dose bismuth-based triple therapy. Treating duodenal ulcer with simultaneous administration of omeprazole achieves ulcer pain relief more rapidly. | 512 |
61245 | Diversion colitis in children: an iatrogenic appendix vermiformis? | Diversion colitis (DC) is a localized, relatively benign, iatrogenic condition which occurs in almost 100% of diverted colonic segments in patients who undergo ileostomy/colostomy for various reasons. The aim of this study was to establish histological features of DC in children. Twenty-three cases of DC following colo... | Histological features of DC in children are very similar to those described in adults. They should help to distinguish it from ulcerative colitis and Hirschsprung's-associated enterocolitis in order to prevent inappropriate therapy and follow-up. There are many similarities between DC and the normal appendix vermiformi... | 312 |
61246 | Raising research awareness among midwives and nurses: does it work? | The primary aim of the study was to evaluate the effectiveness of two approaches to increase research awareness among midwives and nurses. Quasi-experimental with the attitudes of staff in the two groups being measured at two points (January and October 1997). All midwives and nurses working in four clinical areas in a... | The introduction of clinical governance challenges healthcare providers to improve the care they deliver. There are huge opportunities for Trusts to invest in developing staff knowledge and use of research. However, staff will only seize these opportunities if there is an appropriate, enabling environment--an environme... | 397 |
61247 | Delivery of primary care to women. Do women's health centers do it better? | Women's health centers have been increasing in number but remain relatively unstudied. We examined patient expectations and quality of care at a hospital-based women's health center compared with those at a general medicine clinic. Cross-sectional survey. University hospital-affiliated women's health and general intern... | These results suggest that, at least in this setting, women's health centers provide care to younger women and those with fewer chronic medical conditions and may meet a market demand. While the quality of gender-specific preventive care may be modestly better in women's health centers, the quality of general preventiv... | 489 |
61248 | Analysis of failures after whole abdominal irradiation in gastrointestinal lymphomas. Is prophylactic irradiation of inguinal lymph nodes required? | To evaluate failures and to investigate the need for prophylactic inclusion of the inguinal lymph nodes in case of whole abdominal irradiation in gastrointestinal lymphoma. In October 1992 a prospective study on primary gastrointestinal lymphoma was initiated to evaluate management strategies. Treatment consisted eithe... | General prophylactic enclosure of the inguinal lymph nodes in the case of whole abdominal irradiation in gastrointestinal lymphoma seems to be unnecessary. | 325 |
61249 | Loco-regional block in ophthalmic surgery: single drug or drug combination with hyaluronidase? | The aim of this study is the comparison between the use of bupivacaine alone and a mixture of bupivacaine, mepivacaine and hyaluronidase in both retrobulbar and peribulbar blockades for eye surgery. Three hundred ninety-nine consecutive adult patients scheduled for cataract surgery with regional anaesthesia were includ... | Local anaesthetics mixture with hyaluronidase associated with peribulbar blockade presents the advantages of rapidity, duration and better quality without the risks of retrobulbar blockade side effects. | 375 |
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