Influence of SERTPR and STin2 in the serotonin transporter gene on the effect of selective serotonin reuptake inhibitors in depression: a systematic review.

Large differences in clinical response to selective serotonin reuptake inhibitors (SSRIs) are observed in depressive patients with different genotypes. Quantification of these differences is needed to decide if genetic testing prior to antidepressant treatment is useful. We conducted a systematic review of the literature on the influence of polymorphisms in the serotonin transporter gene (SERTPR (or 5-HTTLPR) and STin2) on SSRI response.

Home versus Office blood pressure MEasurements: Reduction of Unnecessary treatment Study: rationale and study design of the HOMERUS trial.

The Home versus Office MEasurements, Reduction of Unnecessary treatment Study (HOMERUS) is a multicentre prospective study, primarily designed to examine in subjects with mild to moderate hypertension whether treatment decisions based on home blood pressure measurements can lead to reduction in the use of antihypertensive drugs and the associated costs, compared to office blood pressure measurements. After inclusion, 360 patients are randomized to two groups. In one group, antihypertensive therapy is based on blood pressure measured in the outpatient clinic: the office pressure (OP) group.

The additional diagnostic value of ultrasonography in the diagnosis of breast cancer.

Background: The use of ultrasonography (US) in diagnostic breast imaging is increasing. Restricting US to subgroups of patients who benefit most would result in a more efficient and effective application. This study assessed the diagnostic value of US as an adjunct to mammography (MAM) and a clinical examination (CE) in the diagnosis of breast cancer and the feasibility of selecting subgroups of patients who benefit the most.

The role of ultrasonography as an adjunct to mammography in the detection of breast cancer. a systematic review.

The aim of this review was to summarise the diagnostic performance of ultrasonography as an adjunct to mammography in the detection of breast cancer and to identify clinical indications. A systematic review was performed of all publications in MEDLINE and EMBASE between 1990 and 2000 on the role of ultrasonography as an adjunct to mammography. 22 studies were included, showing a large variety of indications for ultrasonography and variations in the diagnostic performance of mammography and ultrasonography.

Is roxithromycin better than amoxicillin in the treatment of acute lower respiratory tract infections in primary care? A double-blind randomized controlled trial.

Objective: To assess the efficacy of roxithromycin relative to amoxicillin.

Study Design: We conducted a double-blind randomized controlled trial of oral 500 mg amoxicillin 3 times per day vs oral 300 mg roxithromycin once a day for 10 days.

Population: We included 196 adults who had presented to a general practitioner with lower respiratory tract infection (LRTI) and, in the physician's opinion, needed antibiotic treatment.

Diagnostic tests for renal artery stenosis in patients suspected of having renovascular hypertension: a meta-analysis.

Purpose: To summarize and compare the validity of computed tomography angiography, magnetic resonance angiography, ultrasonography, captopril renal scintigraphy, and the captopril test for diagnosis of renal artery stenosis in patients suspected of having renovascular hypertension.

Data Sources: For each diagnostic modality, published studies were identified by MEDLINE literature searches.

Study Selection: Original studies were selected if they met the following criteria: 1) suspicion of renovascular hypertension was the indication for the test; 2) intra-arterial x-ray angiography was used as the gold standard; 3) a cutoff point for a positive test result was explicitly defined; and 4) absolute numbers of true-positive, false-negative, true-negative, and false-positive results were available or could be derived from the presented data.

Injection therapy for subacute and chronic benign low back pain.

Study Design: The Medline and Embase databases containing randomized controlled trials of injection therapy published to 1998 were systematically reviewed.

Objectives: To evaluate the effectiveness of injection therapy with anesthetics, steroids, or both in patients with low back pain persisting longer than 1 month.

Methods: Two reviewers independently assessed the trials for the quality of their methods.

Peripheral arterial disease: meta-analysis of the diagnostic performance of MR angiography.

Purpose: To summarize the overall diagnostic performance of magnetic resonance (MR) angiography in the evaluation of peripheral arteriosclerotic occlusive disease and to identify the most important sources of variation in diagnostic accuracy between studies.

Materials And Methods: A search strategy in MEDLINE and citation tracking were used to identify relevant English-language articles published since 1991. Each article was critically appraised for examination, patient, and study design characteristics.

Injection therapy for subacute and chronic benign low back pain.

Background: Injection with anaesthetics and/or steroids is one of the treatment modalities used in patients with chronic low back pain which needs evaluation with respect to the effectiveness on short and long term pain relief.

Objectives: To evaluate the effectiveness of injection therapy in patients with low back pain lasting longer than one month. We distinguished between three injection sites: facet joint, epidural or local injections.

Three-dimensional contrast-enhanced moving-bed infusion-tracking (MoBI-track) peripheral MR angiography with flexible choice of imaging parameters for each field of view.

A technique to image peripheral arteries with flexible choice of scan parameters for separate stations was developed based on moving-bed single-bolus three-dimensional gradient-recalled echo magnetic resonance angiography. A volunteer study yielded higher signal- and contrast-to-noise ratios, less venous enhancement, and better subjective interpretability compared with imaging with fixed parameters for each station. Additionally, six patients were imaged to test the feasibility of the new method in a clinical setting.

The effect of medical elastic compression stockings with different slope values on edema. Measurements underneath three different types of stockings.

Background: Medical elastic compression stockings are widely used in venous diseases. Their effects on the venous system have been shown in the past. Up to now, little is known about the slope or stiffness factor of stockings.

Value of radiological diagnosis of skull fracture in the management of mild head injury: meta-analysis.

Objectives: Head injury is a common event. Most patients sustain a mild head injury (MHI), and management depends on the risk of an intracranial haemorrhage (ICH). The value of a plain skull radiograph as a screening tool for ICH is controversial.

[Contrast-enhanced magnetic resonance angiography].

Contrast-enhanced magnetic resonance angiography (MRA) involves intravenous injection of a contrast medium that increases the signal intensity of blood by shortening its T1 value. With contrast-enhanced MRA the acquisition time is short (less than 40 s for the abdominal aorta and the iliac vessels) and the images obtained can be interpreted accurately. The contrast medium currently in use virtually never causes adverse effects and is not nephrotoxic.

The cost-effectiveness of the diagnosis of renal artery stenosis.

The objective of this study was to assess the cost effectiveness of eight strategies to diagnose renovascular hypertension (RVHT) followed by treatment with percutaneous transluminal angioplasty (PTRA) with or without stent placement. The eight diagnostic strategies were compared with a reference strategy, i.e.

Muscle strength in postpolio patients: a prospective follow-up study.

Forty-three former polio patients now complaining of new progressive muscle weakness (symptomatic patients) plus 13 former polio patients without new neuromuscular complaints were included in the study. The symptomatic patients reported high frequencies of other neuromuscular complaints and a decline in their functional level. Most frequent complaints were general fatigue, low backache, and muscle pain (97.

An addition to the controversy on sunlight exposure and melanoma risk: a meta-analytical approach.

Case control studies on the association between sunlight exposure and melanoma risk show considerable differences in design; this could be responsible for the variation in study results. In an attempt to resolve the controversy between study results, the results of 25 publications on case control studies were evaluated using meta-analytical techniques. Comparison of odds ratios between subgroups of studies revealed that the range of odds ratios was far greater for hospital-based studies than for population-based studies.

Macro EMG follow-up study in post-poliomyelitis patients.

We investigated the muscle strength and motor unit (MU) territory of five patients with postpolio syndrome (PPS), six stable patients with prior poliomyelitis, and five healthy volunteers. The MU territory was assessed by measuring amplitudes of motor unit potentials (MUPs) recorded by the macro EMG technique. The investigations were repeated after 11-20 months (mean 15.

Swimming and the risk of cutaneous melanoma.

Recreational exposure to the sun may not explain fully current trends in melanoma incidence. The hypothesis was examined whether carcinogens in water play a role in the development of cutaneous melanoma. In a case-control study, 128 melanoma patients and 168 patients with other types of malignancy completed a detailed questionnaire on aquatic leisure time activities.

Effect of intermittent exposure to sunlight on melanoma risk among indoor workers and sun-sensitive individuals.

Intermittent exposure to sunlight is considered to be an important risk factor for melanoma, but the associations reported in most case-control studies are surprisingly weak. The aim of this study was to evaluate whether the incorporation of a subject's background exposure to the sun and pigmentation characteristics (which are assumed to influence a person's susceptibility to sunlight exposure) could produce stronger associations between sunlight exposure and the risk for melanoma. A population-based case-control study was performed in the mid-eastern part of the Netherlands.

Melanoma and occupation: results of a case-control study in The Netherlands.

Several studies have reported excesses of risk of melanoma in specific industries. Data from a case-control study in The Netherlands, including 140 cases with a cutaneous melanoma and 181 controls with other types of malignancy, were used to evaluate whether the reported associations with these specific industries could be reproduced. Adjustment for characteristics of pigmentation and exposure to sunlight was made.

Bladder cancer mortality in The Netherlands, 1955-1988.

In 1955, 234 men and 116 women died from bladder cancer in the Netherlands. In 1988 the numbers were 794 and 317 respectively. After adjusting for the ageing of the Dutch population since 1955, female mortality rates per 10(5) person-years appear to be very stable: 2.

Trends in mortality from malignant cutaneous melanoma in The Netherlands, 1950-1988.

This paper presents an analysis of trends in mortality from malignant melanoma of the skin in The Netherlands, 1950-1988. Statistical analyses show that time period effects are needed to describe the mortality trends in The Netherlands. Because this contrasts with reports from other countries, in which the trends were ascribed to a cohort effect only, log-linear models including the three factors age, time period and birth cohort, were fitted to the data.