A randomized controlled trial of a multifaceted integrated complementary-alternative therapy for chronic herpes zoster-related pain.

Introduction: Our objective was to determine whether a three-week complementary and alternative medicine (CAM) approach integrating several therapies from Traditional Chinese Medicine (TCM) along with neural therapy (injection of 1% procaine as local anesthesia) reduces the level of unresolved pain associated with herpes zoster.

Methods: The design was a randomized controlled clinical trial in a community-based primary care clinic in Toronto, Ontario. We studied individuals 18 years of age and older with a confirmed diagnosis of herpes zoster of at least 30 days duration and with at least moderate postherpetic neuralgia pain (≥4) on a 10-point Likert scale.

Health outcomes in infancy and childhood of moderate and late preterm infants.

There has been a long-held belief that outcomes for babies born at moderate and late preterm gestations do not differ substantially from those of infants born at full term. This has recently been challenged by studies highlighting an increased risk of adverse neonatal outcomes, and of poorer cognitive, behavioural and educational outcomes in this population. Data about the effects of birth at moderate and late preterm gestations on later health outcomes are limited, but emerging evidence suggests that ongoing physical health may also be worse in those born just a few weeks before full term.

Effects of gestational age at birth on health outcomes at 3 and 5 years of age: population based cohort study.

Objective: To investigate the burden of later disease associated with moderate/late preterm (32-36 weeks) and early term (37-38 weeks) birth.

Design: Secondary analysis of data from the Millennium Cohort Study (MCS).

Setting: Longitudinal study of infants born in the United Kingdom between 2000 and 2002.

Endovascular brachytherapy and restenosis following lower limb angioplasty: Systematic review and meta-analysis of randomized clinical trials.

Background: Restenosis is a fundamental weakness of percutaneous femoropopliteal angioplasty (PTA). The potential of endovascular brachytherapy (EVBT) to reduce restenosis has been evaluated in randomized clinical trials, but no pooled analysis has been undertaken.

Methods: A systematic review was undertaken to identify randomized controlled trials in which PTA alone was compared to PTA plus EVBT.

Early term and late preterm birth are associated with poorer school performance at age 5 years: a cohort study.

Objective: To compare school performance at age 5 years in children born at full term (39-41 weeks gestation) with those born at early term (37-38 weeks gestation), late preterm (34-36 weeks gestation), moderately preterm (32-33 weeks gestation) and very preterm (<32 weeks gestation).

Design: Population-based cohort (UK Millennium Cohort Study).

Participants: Seven thousand six hundred and fifty children born in 2000-2001 and attending school in England in 2006.

Early human herpesvirus type 6 reactivation after allogeneic stem cell transplantation: a large-scale clinical study.

This study investigated the impact of human herpesvirus type 6 (HHV6) reactivation within 100 days of allogeneic stem cell transplantation (allo-SCT) on patient outcomes. HHV6 plasma loads were monitored weekly by quantitative PCR. Of 235 consecutive patients, 112 (48%) had an early positive HHV6 PCR test (group A) and 123 (52%) did not (group B).

Residents and ICU nurses get reliable static and dynamic haemodynamic assessments with aortic oesophageal Doppler.

Background: Aortic oesophageal Doppler (ODM) allows continuous non-invasive haemodynamic monitoring. We tested to confirm if residents and nurses were able to reposition oesophageal probe (OP), obtain aortic blood flow of good quality and so perform reliable static and dynamic haemodynamic assessments.

Methods: Prospective observational study assessing ODM measurements were obtained by six residents and three nurses after they have participated in training.

Effect of packaging and storage time on survival of Listeria monocytogenes on kippered beef steak and turkey tenders.

Unlabelled: The objective of our study was to determine effect of packaging method and storage time on reducing Listeria monocytogenes in shelf-stable meat snacks. Commercially available kippered beef steak strips and turkey tenders were dipped into a 5-strain L. monocytogenes cocktail, and dried at 23 °C until a water activity of 0.

Prognostic value of PINI index in patients with multiple myeloma.

Background: The Prognostic Inflammatory and Nutritional Index (PINI) is a simple scoring system that aggregates two blood markers of inflammatory [C-reactive protein (CRP) and orosomucoid] and of nutritional (albumin and prealbumin) states. It is used in routine practice in geriatric medicine, especially in hospitalized elderly patients. This study was undertaken to evaluate the usefulness of PINI index in multiple myeloma (MM), a malignancy of the elderly.

Analogous nutrient limitations in unicellular diazotrophs and Prochlorococcus in the South Pacific Ocean.

Growth limitation of phytoplankton and unicellular nitrogen (N(2)) fixers (diazotrophs) were investigated in the oligotrophic Western South Pacific Ocean. Based on change in abundances of nifH or 23S rRNA gene copies during nutrient-enrichment experiments, the factors limiting net growth of the unicellular diazotrophs UCYN-A (Group A), Crocosphaera watsonii, γ-Proteobacterium 24774A11, and the non-diazotrophic picocyanobacterium Prochlorococcus, varied within the region. At the westernmost stations, numbers were enhanced by organic carbon added as simple sugars, a combination of iron and an organic chelator, or iron added with phosphate.

Towards continuous improvement of endoscopy standards: validation of a colonoscopy assessment form.

Aim: The assessment of procedural colonoscopy skills is important and topical. The aim of this study was to develop and validate a competency-based colonoscopy assessment form that would be easy to use, suitable for the assessment of junior and senior endoscopists and potentially a useful instrument to detect differences in performance standards following different training interventions.

Method: A standardized assessment form was developed incorporating a checklist with dichotomous yes/no responses and a global assessment section incorporating several different elements.

Selective and tuneable recognition of anions using C(3v)-symmetrical tripodal urea-amide receptor platforms.

The synthesis and binding investigations of first generation C(3v)-symmetrical hydrogen bonding urea-amide based tripodal receptors, 1-6, with various anions such as acetate, phosphate, sulfate and chloride in DMSO-d(6) are presented. Analysis of the (1)H NMR titrations of 1-6 showed on all occasions the selective formation of 1 : 1 stoichiometries.

Born just a few weeks early: does it matter?

Until recently, infants born at moderate preterm (32-33 weeks) and late preterm (34-36 weeks) gestations have gone largely unstudied. Since their outcomes were thought to be similar to those of infants born at 37 weeks and above, they have historically been managed in much the same way as infants born at term. However, accumulating data indicate that risks of morbidity and mortality are significantly greater in this group than previously believed.

Ongoing development of monoclonal antibodies and antibody drug-conjugates in lymphoma.

Rituximab, a monoclonal antibody (mAb) directed against CD20, has changed practices in the treatment of patients with B-cell lymphoma. The large success of rituximab has contributed to validate immunotherapy with monoclonal antibodies as a valuable strategy in lymphoma. Recently, better-engineered anti-CD20-mAbs have been designed to improve efficacy and safety.

Are Modic changes prognostic for recovery in a cohort of patients with non-specific low back pain?

Background: There is evidence for an association between Modic type 1 and pain in patients with low back pain (LBP), but little knowledge about its effect on clinical outcomes.

Purpose: (1) To assess the prevalence of Modic changes, (2) to determine if Modic changes influence the clinical course of LBP, and (3) to identify prognostic factors for recovery.

Study Design/setting: Prospective clinical cohort study, with a 1-year follow-up.

Video gaming enhances psychomotor skills but not visuospatial and perceptual abilities in surgical trainees.

Introduction: There is considerable interest in the identification and assessment of underlying aptitudes or innate abilities that could potentially predict excellence in the technical aspects of operating. However, before the assessment of innate abilities is introduced for high-stakes assessment (such as competitive selection into surgical training programs), it is essential to determine that these abilities are stable and unchanging and are not influenced by other factors, such as the use of video games. The aim of this study was to investigate whether experience playing video games will predict psychomotor performance on a laparoscopic simulator or scores on tests of visuospatial and perceptual abilities, and to examine the correlation, if any, between these innate abilities.

Protocol for an economic evaluation alongside the University Health Network Whiplash Intervention Trial: cost-effectiveness of education and activation, a rehabilitation program, and the legislated standard of care for acute whiplash injury in Ontario.

Background: Whiplash injury affects 83% of persons in a traffic collision and leads to whiplash-associated disorders (WAD). A major challenge facing health care decision makers is identifying cost-effective interventions due to lack of economic evidence. Our objective is to compare the cost-effectiveness of: 1) physician-based education and activation, 2) a rehabilitation program developed by Aviva Canada (a group of property and casualty insurance providers), and 3) the legislated standard of care in the Canadian province of Ontario: the Pre-approved Framework Guideline for Whiplash developed by the Financial Services Commission of Ontario.

Efficacy of home-style dehydrators for reducing Salmonella on whole-muscle chicken.

Home-style dehydrators commonly used by consumers have limited relative humidity (RH) and temperature control. To evaluate the effect of dehydrator load on temperature and RH and subsequent reduction of Salmonella on whole-muscle chicken, chicken breasts were rolled and cut into samples (1 to 2 mm thick, 6 by 6 cm(2)) and inoculated with a five-strain Salmonella cocktail. The samples were allowed to air dry for 15 min and then were loaded into home-style three-tray (3T) or five-tray (5T) dehydrators, with 12 chicken pieces per tray.

Accurate reporting of expected delivery date by mothers 9 months after birth.

Objective: To measure agreement between gestational age based on maternal report of expected date of delivery (EDD) 9 months after birth and gestational age at birth in routine hospital data. Furthermore, to examine whether sociodemographic and perinatal factors influenced agreement and whether disagreement affected classification of infants in preterm groups.

Study Design And Setting: The study used data on 8,058 singleton infants from the UK Millennium Cohort Study.

The management of rectal cancer in Ireland in 2007--room for improvement?

Introduction: Effective management of rectal cancer relies on accurate pre-operative assessment, surgical technical excellence and integrated neoadjuvant and adjuvant chemo and/or radiotherapy. The aim of this study was to examine the management of rectal cancer in Ireland.

Methods: This was a retrospective chart review.

Optimising surgical training: use of feedback to reduce errors during a simulated surgical procedure.

Objective: To assess the effect of proximate or immediate feedback during an intensive training session. The authors hypothesised that provision of feedback during a training session would improve performance and learning curves.

Methods: Twenty-eight trainee surgeons participated in the study between September and December 2008.

The importance of expert feedback during endovascular simulator training.

Objectives: Complex endovascular skills are difficult to obtain in the clinical environment. Virtual reality (VR) simulator training is a valuable addition to current training curricula, but is there a benefit in the absence of expert trainers?

Methods: Eighteen endovascular novices performed a renal artery angioplasty/stenting (RAS) on the Vascular Interventional Surgical Trainer simulator. They were randomized into three groups: Group A (n = 6, control), no performance feedback; Group B (n = 6, nonexpert feedback), feedback after every procedure from a nonexpert facilitator; and Group C (n = 6, expert feedback), feedback after every procedure from a consultant vascular surgeon.

A simple and efficient method for concentration of ocean viruses by chemical flocculation.

Ocean viruses alter ecosystems through host mortality, horizontal gene transfer and by facilitating remineralization of limiting nutrients. However, the study of wild viral populations is limited by inefficient and unreliable concentration techniques. Here, we develop a new technique to recover viruses from natural waters using iron-based flocculation and large-pore-size filtration, followed by resuspension of virus-containing precipitates in a pH 6 buffer.

Prostacyclin synthase expression and epigenetic regulation in nonsmall cell lung cancer.

Background: Prostacyclin synthase (PGIS) metabolizes prostaglandin H(2), into prostacyclin. This study aimed to determine the expression profile of PGIS in nonsmall cell lung cancer (NSCLC) and examine potential mechanisms involved in PGIS regulation.

Methods: PGIS expression was examined in human NSCLC and matched controls by reverse transcriptase polymerase chain reaction (RT-PCR), Western analysis, and immunohistochemistry.