Research Insights

A Novel Diagnostic Target in the Hepatitis C Virus Genome

Detection and quantification of hepatitis C virus (HCV) RNA is integral to diagnostic and therapeutic regimens. All molecular assays target the viral 5'-noncoding region (5'-NCR), and all show genotype-dependent variation of sensitivities and viral load results. Non-western HCV genotypes have been under-represented in evaluation studies. An alternative diagnostic target region within the HCV genome could facilitate a new generation of assays.

Donor-Derived Brain Tumor Following Neural Stem Cell Transplantation in an Ataxia Telangiectasia Patient

Neural stem cells are currently being investigated as potential therapies for neurodegenerative diseases, stroke, and trauma. However, concerns have been raised over the safety of this experimental therapeutic approach, including, for example, whether there is the potential for tumors to develop from transplanted stem cells.

Birth Size and Breast Cancer Risk

Re-analysis of Individual Participant Data from 32 Studies

The birth size effects did not appear to be confounded or mediated by established breast cancer risk factors and were not modified by age or menopausal status.

The Relationship between Proteinuria and Coronary Risk

A Systematic Review and Meta-Analysis

There is now a strong evidence base to support global policy on TB diagnostics. Periodic updates are also needed to ensure that systematic reviews provide the most current evidence available for clinical and policy decisions.

Evidence-Based Tuberculosis Diagnosis

There is now a strong evidence base to support global policy on TB diagnostics. Periodic updates are also needed to ensure that systematic reviews provide the most current evidence available for clinical and policy decisions.

Predicting Outcome after Traumatic Brain Injury: Development and International Validation of Prognostic Scores Based on Admission Characteristics

Prognostic models using baseline characteristics provide adequate discrimination between patients with good and poor 6 mo outcomes after TBI, especially if CT and laboratory findings are considered in addition to traditional predictors.

How Well Do Clinical Pain Assessment Tools Reflect Pain in Infants?

An infant with a low pain score based on behavioural assessment tools alone may not be pain free.

Long-Term Interleukin-6 Levels and Subsequent Risk of Coronary Heart Disease - Two New Prospective Studies and a Systematic Review

Long-term IL-6 levels are associated with CHD risk about as strongly as are some major established risk factors, but causality remains uncertain. These findings highlight the potential relevance of IL-6-mediated pathways to CHD.

Professional Uncertainty and Disempowerment Responding to Ethnic Diversity in Health Care - A Qualitative Study

Interventions should help professionals acknowledge their uncertainty and its potential to create inertia in their practice. A shift away from a cultural expertise model toward a greater focus on each patient as an individual may help.

Estimating Population Cause-Specific Mortality Fractions from in-Hospital Mortality - Validation of a New Method

Where accurate International Classification of Diseases (ICD)-coded cause-of-death data are available for deaths in hospital and for VR covering a subset of the population, we demonstrated that population CSMFs can be estimated with low average error.

Lifetime Medical Costs of Obesity - Prevention No Cure for Increasing Health Expenditure

Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained.

Patient Adherence to Tuberculosis Treatment - A Systematic Review of Qualitative Research

Adherence to the long course of TB treatment is a complex, dynamic phenomenon with a wide range of factors impacting on treatment-taking behaviour. Patients' adherence to their medication regimens was influenced by the interaction of a number of these factors.

Renal Function and Risk of Coronary Heart Disease in General Populations - New Prospective Study and Systematic Review

Although there are no strong associations between lower-than-average eGFR and CHD risk in apparently healthy adults over most of the range in renal function, there may be a moderate increase in CHD risk associated with very low eGFR (i.e., renal dysfunction) in the general population.

Quantitative research - Understanding Patients' Needs and Experiences

Quantitative research strives to be objective: human beings, health, and illness are the objects of investigation. Such investigation has led to extraordinary biomedical advances yet patients often fail to reap the benefits.

Analysis of Gene Expression Using Gene Sets Discriminates Cancer Patients with and without Late Radiation Toxicity

Gene expression profiling succeeded to some extent in discriminating groups of patients with and without severe late radiotherapy toxicity. Moreover, the discriminative power was enhanced by assessment of functionally or structurally related gene sets.

A Genomic Pathway Approach to a Complex Disease - Axon Guidance and Parkinson Disease

While major inroads have been made in identifying the genetic causes of rare Mendelian disorders, little progress has been made in the discovery of common gene variations that predispose to complex diseases.

Epidemiology of Tuberculosis in a High HIV Prevalence Population Provided with Enhanced Diagnosis of Symptomatic Disease

Strategies based on prompt investigation of TB symptoms, such as DOTS, may be an effective way of controlling prevalent TB in high HIV prevalence populations.

Indigenous Health and Socioeconomic Status in India

Socioeconomic status differentials substantially account for the health inequalities between indigenous and non-indigenous groups in India.

A Comparative Analysis of Influenza Vaccination Programs

Optimal strategy depends critically on the viral transmission level (reproductive rate) of the virus: morbidity-based strategies outperform mortality-based strategies for moderately transmissible strains, while the reverse is true for highly transmissible strains.

Patient Outcomes with Teaching Versus Nonteaching Healthcare - A Systematic Review

Extensive debate exists in the healthcare community over whether outcomes of medical care at
teaching hospitals and other healthcare units are better or worse than those at the respective nonteaching ones. No differences were seen in the 14 studies fully adjusting for volume/experience, severity, and comorbidity (relative risk 1.01).

A Multicentre Study of Shigella Diarrhoea in Six Asian Countries - Disease Burden, Clinical Manifestations, and Microbiology

Shigella appears to be more ubiquitous in Asian impoverished populations than previously thought, and antibiotic-resistant strains of different species and serotypes have emerged.

Clinical outcomes of laparoscopic right hemicolectomy for colon cancer

Laparoscopic colorectal surgery, especially for rectosigmoid cancer, is becoming increasingly popular and has got decent initial results. But due to relatively complicated anatomy and much higher advanced requirements for surgery technique, laparoscopic right colectomy developed relatively slowly when compared with laparoscopic rectomy.

Cost-Effectiveness of Treating Multidrug-Resistant Tuberculosis

Treatment of MDR TB using second-line drugs is highly cost-effective in Peru. In other settings, the attractiveness of strategies using second-line drugs will depend on TB incidence, MDR burden, and the available budget, but simulation results suggest that individualized regimens would be cost-effective in a wide range of situations.

Errors in fracture diagnoses in the emergency department - Characteristics of patients and diurnal variation

A retrospective analysis of all cases during a two-year period (2002–2004) where a fracture had been overlooked or an injury had been erroneously diagnosed as a fracture, was conducted. Results showed that 1% of all visits to the ED resulted in an error in fracture diagnosis and 3.1% of all fractures were not diagnosed at the initial visit to the ED. 86% of such errors had consequences for treatment.