FindingsAt follow-up, study participants who had received THN training reported greater overdose-related knowledge relative to those receiving basic information only [OOKS mean difference, 4.08 (95% confidence interval, 2.10-6.06; P<0.001); Cohen's d=0.74 (0.37-1.10)]. There were also more positive opioid overdose-related Bafilomycin A1 manufacturer attitudes among the trained group at follow-up [OOAS mean difference, 7.47 (3.13-11.82); P=0.001; d=0.61 (0.25-0.97)]. At the individual level 35 and 54%, respectively, of the experimental group increased their

knowledge and attitudes compared with 11 and 30% of the control group. During follow-up, 13 participants witnessed an overdose with naloxone administered on eight occasions: five among the THN-trained group and three among the controls.

ConclusionsTake-home naloxone training for family members of heroin users increases opioid overdose-related knowledge and competence and these benefits are well retained after 3 months.”
“Guttate psoriasis, known to have a better prognosis than other types of psoriasis,

shows rapid involution and longer remission, but its clinical course has barely been studied. The aim of this study was to determine the clinical course and to compare the clinical and laboratory features of guttate psoriasis. This is a retrospective study of 26 patients with guttate psoriasis. The patients were divided into two groups; the good one with complete remission and long remission for at least 1 year (group A) and the poor one with incomplete remission VX-680 mw and progression into chronic plaque psoriasis (group CAL-101 supplier B). Among 36 patients, 22 patients (61.1%) were group A and 14 patients (38.9%) were group B. In group A, most of the skin lesions disappeared within 8 months. In group B, two patients without proper treatment progressed to plaque psoriasis. The onset age was younger and more frequent upper respiratory infection and high anti-streptolysin O (ASO) titer were found in group A, but family history of psoriasis was more common

in group B. Patients had two distingushable clinical courses: rapid involuting course with long-term remission and chronic course without remission. There was a tendency toward younger age of onset with elevated ASO titer in patients with rapid involuting course.”
“Background: Pulmonary aspiration is a leading cause of nosocomial infection in the intensive care unit (ICU) and step-down unit (SDU). A key goal is to identify patients who exhibit increased aspiration risk before beginning oral alimentation. This study investigated the success of recommending specific oral diets to ICU and SDU patients based on passing a 3-oz water swallow challenge.

Methods: A referral-based sample of 401 ICU and 92 SDU patients were prospectively analyzed.

The humoral response was analyzed using enzyme-linked immunosorbent assay (for levels of IgG1, IgG2) and a serum neutralization test (SNT), and the cellular response

using an MTT assay. Significantly higher humoral and cell-mediated immune responses were seen in the P12A3C and the IL-18 coinoculated group than that in P12A3C-pcDNA alone and inactivated virus vaccine inoculated groups. Similarly, a higher population of C188-9 price CD4+, CD8+ and T-helper type 1 (Th1), and Th2 cytokine levels were seen in the former group in comparison with the other groups. P12A3C+IL-18 protected all the six animals when challenged with a homologous virus compared with five and four in an inactivated virus vaccine and the P12A3C-pcDNA groups, respectively. These results have shown that the plasmid encoding for P12A3C-pcDNA, when coinoculated with IL-18, induced

higher responses and protected the animals from a virus challenge.”
“Background: Risk factors and outcome in patients who acquire nosocomial infections due to carbapenem-resistant Acinetobacter baumannii (CRAB) are rarely investigated.

Methods: A multicenter retrospective study was conducted to analyze the clinical and microbiological data of patients with nosocomial infections due to A. baumannii in 10 hospitals around selleck chemical Taiwan from May 2004 to December 2006. Comparisons were made between patients with infections due to CRAB and patients with infections due to carbapenem-susceptible A. baumannii (CSAB).

Results: One hundred and twenty-one patients carrying CRAB (infections, n = 91) and 127 patients carrying CSAB (infections, n = 97) were recruited for analysis. Compared with patients with CSAB infections,

patients with CRAB infections had a longer duration of hospital Autophagy Compound Library stay before A. baumannii was isolated (median 48 vs. 21 days, p < 0.001) and were more likely to have had exposure to a carbapenem (adjusted odds ratio (AOR) 2.57, 95% confidence interval (95% CI) 1.43-5.35; p = 0.02) and an intensive care unit (ICU) stay (AOR 3.42, 95% CI 1.76-5.26; p = 0.008). Risk factors associated with CRAB bacteremia included duration of hospital stay before onset of bacteremia (AOR 1.009 per 1-day longer, 95% CI 1.03-1.24; p = 0.049), prior colonization with A. baumannii (AOR 3.27, 95% CI 1.99-5.93; p = 0.002), and hospitalization in the ICU (AOR 6.12, 95% CI 1.58-13.68; p = 0.009). Patients with CRAB bacteremia had a higher mortality rate than patients with CSAB bacteremia (46.0% vs. 28.3%, p = 0.04). Multivariate analysis showed that carbapenem resistance (AOR 5.31, 95% CI 1.88-13.25; p = 0.002), central venous catheterization (AOR 3.27, 95% CI 1.55-10.56; p = 0.009), and ICU stay (AOR 2.56, 95% CI 1.15-8.85; p = 0.04) were independent variables associated with mortality in patients with A. baumannii bacteremia.

Conclusions: Patients with CRAB infections have a higher mortality rate than those with CSAB infections.

Notably, at y = 7.8, only the D0(3) phase (the equilibrium phase of Fe-Ge at e/a = 1.54) was found in the ternary alloy. The theory also shows that the D0(3) instability is removed for compositions with y >= 3.9, when D0(3) becomes MLN4924 mouse the structure’s ground-state phase. Thus, the high, positive lambda(gamma,2) value for Fe-Ga at x = 28 could be the result of the high sensitivity of its metastable D0(3) structure. VC 2011 American Institute of Physics. [doi:10.1063/1.3535444]“
“Introduction: We investigated whether

primary prevention implantable cardioverter defibrillator (ICD) patients with atrial arrhythmias are at higher risk for ICD shocks and mortality compared to patients without atrial arrhythmias in a subanalysis TGF-beta inhibitor clinical trial of the PREPARE study.

Methods and Results: Details of the PREPARE study design and results have been previously reported. We now included 537 of the 700 patients enrolled in PREPARE. These patients had a dual or biventricular device and at least one device follow-up after implantation. Continuously collected device diagnostics data were used to classify

patients into two groups during follow-up: with (n = 133) or without (n = 404) atrial tachycardia/atrial fibrillation (AT/AF). The primary outcomes were ICD shocks and mortality. Subjects were followed for a mean of 333 +/- 73 (range 5-365) days. During a follow-up of 1 year, ICD shocks occurred in 44 (8%) patients. Significantly, more patients with AT/AF received a shock (13.0% vs 6.9%, P = 0.03), with inappropriate shocks selleck screening library accounting for the majority of the difference (6.9% vs 2.6%, P = 0.02). There was no difference in prevalence of shocks between patients with and without a history of AF. Mortality was similar in patients with and without AT/AF, whether detected during the study or prior to the study. In addition, the 34 subjects with high average ventricular rate (>= 110 beats per minute) during AT/AF had a higher risk of an inappropriate shock (21.0% vs 2.1%, P < 0.01).

Conclusion: Primary prevention ICD patients with AT/AF are more likely to receive

shocks, especially inappropriate shocks. Mortality was not higher in AT/AF patients. (PACE 2011; 34:1070-1079)”
“Human herpesvirus-6 (HHV-6) belongs to the herpesvirus family and is categorized into variant A and B (HHV-6A and HHV-6B). Primary HHV-6 infection in children and its related diseases are almost exclusively caused by HHV-6B and no disease caused by HHV-6A has been identified. The cellular receptor of HHV-6 has been shown to be a human CD46, and its viral ligand is an envelope glycoprotein complex, gH/gL/gQ1/gQ2 in HHV-6A. Furthermore, both cellular and viral lipid rafts play an important role in the HHV-6 entry process, suggesting that HHV-6 may enter its target cells through a lipid raft-associated mechanism.

We aimed to explore and present the issues and

means through which these women relate their symptoms, treatments and effects. We utilised the ‘cancer journey’ as a heuristic device to chart women’s experiences in the first year following diagnosis.

Method: Thirty-nine interviews were conducted over one year with a convenience sample of 10 women newly diagnosed with breast cancer recruited from a specialist oncology centre in England in 2005. Transcriptions of the interviews were analysed using a thematic narrative approach.

Results: The findings suggested how women related coping and meaning to their experience of relationships, return to work, and self-management of breast cancer symptoms. The overwhelming impact of breast cancer was personal to each sufferer and yet reflects Selonsertib cost commonly reported treatment effects. These included unmet need for fatigue management, the impact of

adaptation to hair loss and disfigurement, and the evident need for sexual health and relationship counselling.

Conclusion: The multi-dimensional aspects of womens’ relationships with family, friends, co-workers and care professionals impacts significantly on their coping strategies and how they GSK3235025 make sense of their breast cancer experiences, which consequently bears upon symptom experience, and experience of survival. We suggest that narrative representation bears witness to the common and differing experiences of how women newly diagnosed with breast cancer cope with symptom experience and survival over time. Narrative representation of breast cancer is a useful pedagogical resource for supportive cancer care and highlights the needs of women that need to be addressed by health care professionals. (C) 2011 Elsevier Ltd. All rights reserved.”
“By using various column selleck kinase inhibitor chromatography for purification, two new compounds of ansamitocin (1 and 2) were isolated from the extracts of fermentation broth of Actinosynnema pretiosum FIM06-0063. Their structures were established as maytansinol-9-methyl ether-3-propionate (1) and maytansinol-9-methyl

ether-3-3-methy-butyrate (2), respectively, by an extensive NMR analysis.”
“We present a detailed study of the magnetic and structural properties of L1(0)-FePt thin films. The films are prepared via molecular beam epitaxy directly onto MgO(001) substrates, i.e., without buffer layer. Despite the large lattice misfit between the in-plane lattice parameters of L1(0) FePt and MgO, highly ordered thin films are obtained with the easy magnetization c axis perpendicular to the film plane. Via high resolution transmission electron microscopy and Rutherford backscattering measurements we focus on the FePt/MgO interface to study the misfit relaxation and the defect density. Further, the influence of elevated substrate temperatures and of postgrowth high temperature annealing on the structural and magnetic properties is discussed. (C) 2009 American Institute of Physics.

Hence, we conducted an extensive literature review to identify studies focused on the following: protein and nutritional status; recommendations for dietary protein intake; the effects of protein-rich diets; and associations between dietary protein intake

and satiety, weight loss, and body composition. We found that there have been few studies on protein intake recommendations for bariatric patients. Dietary protein ingestion among this population tends to be inadequate, potentially leading to a loss find more of lean body mass, reduced metabolic rates, and physiological damage. Conversely, a protein-rich diet can lead to increased satiety, enhanced weight loss, and improved body composition. The quality and composition of protein sources are also very important, particularly with respect to the quantity of leucine, which helps to maintain muscle mass, and thus is particularly important for this patient group. Randomized studies among bariatric surgery patient populations are necessary to establish Dinaciclib manufacturer the exact quantity of protein that should be prescribed to maintain their nutritional status.”
“Objective: Advances from health research are not well applied giving rise to over- and underuse of resources and inferior care. Knowledge translation (KT), actions and processes of getting research findings used in practice, can improve research application. The KT literature is difficult to find because of nonstandardized

terminology, rapid evolution of the field, and it is spread across several domains. We created multiple search filters to retrieve KT articles from MEDLINE.

Study Design and Setting: Analytic survey using articles from 12 journals tagged as having KT content and also as describing a KT application or containing a KT theory.

Results: Of 2,594 articles, 579 were KT articles SCH727965 of which 201 were about KT applications and 152 about KT theory. Search filter sensitivity (retrieval efficiency) maximized at 83%-94% with specificity (no retrieval of irrelevant material) approximately 50%. Filter performances were enhanced with multiple terms, but these filters often had reduced

specificity. Performance was higher for KT applications and KT theory articles. These filters can select KT material although many irrelevant articles also will be retrieved.

Conclusion: KT search filters were developed and tested, with good sensitivity but suboptimal specificity. Further research must improve their performance. (C) 2012 Elsevier Inc. All rights reserved.”
“We report a patient who presented during fetal life with severe aortic stenosis, left-ventricular dysfunction, and endocardial fibroelastosis (evolving hypoplastic left heart syndrome). Management involved in utero and postnatal balloon aortic valvuloplasty for partial relief of obstruction and early postnatal hybrid stage I palliation until recovery of left-ventricular systolic function had occurred.

Epinephrine, norepinephrine, and phenylephrine showed up to 100% radioprotective efficacy at concentrations that reflected their rank-ordered affinities for the alpha(1)-adrenergic receptor.

Conclusions. Phenylephrine Ricolinostat price swish-and-spit application before radiotherapy, or multiple applications during chemotherapy, may provide a simple, cost-effective strategy for suppression of oral mucositis in patients undergoing radiotherapy, chemotherapy, or bone marrow transplant.”
“Cardiac electrophysiology is a discipline with a rich 50-year history

of experimental research coupled with integrative modeling which has enabled us to achieve a quantitative understanding of the relationships between molecular function and the integrated behavior of the cardiac myocyte in health and disease. In this paper, we review the

development of integrative computational models of the cardiac myocyte. We begin with a historical overview of key cardiac cell models that helped shape the field. We then narrow our focus to models of the cardiac ventricular myocyte and describe these models in the context of their subcellular functional systems including dynamic models of voltage-gated ion channels, mitochondrial energy production, ATP-dependent and electrogenic membrane transporters, intracellular Ca dynamics, mechanical contraction, and regulatory signal transduction pathways. We describe key advances and limitations of the models as well as point to new directions for future modeling research. (C) 2010 John Wiley & Sons, Inc. WIREs Syst Biol Med 2011 3 392-413 DOI: 10.1002/wsbm.122″
“The optimization of operating parameters for the isolation of peroxidase from AG-120 chemical structure horseradish (Armoracia rusticana) roots with ultrafiltration (UF) technology was systemically studied. The effects of UF operating conditions on the transmission

of proteins were quantified using the parameter scanning UF. These conditions included solution pH, ionic strength, stirring speed and permeate flux. Under optimized conditions, the purity of horseradish peroxidase (HRP) obtained was selleck chemicals greater than 84 % after a two-stage UF process and the recovery of HRP from the feedstock was close to 90 %. The resulting peroxidase product was then analysed by isoelectric focusing, SDS-PAGE and circular dichroism, to confirm its isoelectric point, molecular weight and molecular secondary structure. The effects of calcium ion on HRP specific activities were also experimentally determined.”
“Medullary thyroid carcinoma currently accounts for 5-8% of all thyroid cancers. The clinical course of this disease varies from extremely indolent tumors that can go unchanged for years to an extremely aggressive variant that is associated with a high mortality rate. As many as 75% of all medullary thyroid carcinomas are sporadic, with an average age at presentation reported as 60 years, and the remaining 25% are hereditary with an earlier age of presentation, ranging from 20 to 40 years.

Although several consistent genetic variants were identified the successes are limited. This review has a focus on studies published until mid 2011 and on data presented at the Osteoarthritis

Research Society International 2011 (OARS!) in San Diego and that aim to elucidate the primary molecular and cellular events commencing OA onset in humans by applying genetic study designs. (C) 2012 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.”
“BACKGROUND: The ability of the fungi Pleurotus ostreatus and Phanerochaete chrysosporium to decolourize and detoxify 11 (mono-, dis-, poly-azo, and anthraquinonic type) dyes, widely used across the textile and leather industries, was tested.

RESULTS: Different substrate specificities were revealed between

P5091 P. ostreatus and P. chrysosporium in decolourization experiments. The latter fungus provided almost complete decolourization of the tested azo dyes up to 600 ppm and dis-azo dyes up to 1000 ppm, and 80% decolourization of the tris-azo dye DBU1L38 at 1000 ppm, after 6 days. P. ostreatus provided almost total decolourization of the Cl-amidine concentration anthraquinone type dye ABU62 (1000 ppm) after just 1 day. P. ostreatus also showed the ability to decolourize the tested dis-azo and tris-azo dyes, giving the best performances against the dis-azo DBU1U1 (600 ppm) dye, which was 100% decolourized after 6 days. Laccases proved to be the main enzymatic activities acting in P. ostreatus decolourization.

CONCLUSION: The potential of the fungi P. ostreatus and P. chrysosporium as efficient bio-systems for decolourization and detoxification of several toxic industrial dyes was demonstrated. PD173074 The role of laccases in the decolourization of dis-azo dyes by P. ostreatus was demonstrated for the first time. (C) 2008 Society of Chemical Industry”
“Obesity is a worldwide epidemic and surgery

is the only proven long-term treatment. The two most commonly performed bariatric procedures are laparoscopic adjustable gastric banding (LAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGB). There are advocates of both procedures but LAGB is associated with potentially high failure rates and may require conversion to an alternative procedure.

This study reports our unit results for failed LAGB converted to LRYGB and compares them to primary LRYGB patients. All patients undergoing revisional LRYGB from July 2006 to December 2011 were included in the study. Comparisons were made to patients undergoing primary LRYGB over the same time period for post-operative weight loss, complications and length of stay.

Of the patients, 722 were analysed of which 55 underwent revisional surgery. There was no statistical difference in percentage of excess weight loss at 6 months, 1 year or 2 years following surgery between the primary and revisional surgery cohorts (54.5, 63.7, 65.2 vs 51.6, 59.5, 59.4, p = NS). There was no difference in morbidity, mortality or length of stay between the two groups.

Methods: We conducted an electronic and print literature search using PubMed for articles published in the last 40 years

using the key words “”postprandial hypoglycemia,”" “”reactive hypoglycemia,”" and “”hyperinsulinemic hypoglycemia.”"All available sources were reviewed, and publications were included based on clinical relevance. Results: Over the last century, the classification, etiologies, diagnosis, and management of hypoglycemia have evolved considerably. In the contemporary literature, the evaluation of hypoglycemia is AZD6094 mw divided into well-appearing and ill-appearing patients. Symptoms of hypoglycemia in the well-appearing patient may result from insulinoma, noninsulinoma pancreatogenous hypoglycemia syndrome (NIPHS), postbariatric surgery hypoglycemia,

dumping syndrome, insulin autoimmunity, or postprandial syndrome. For each of these, the literature is lacking in randomized clinical trials investigating optimal diagnostic and treatment modalities, and this is due to the relatively recent description of some diseases and the rarity of cases. Conclusion: This review provides an overview of postprandial Protein Tyrosine Kinase inhibitor hypoglycemia and summarizes the proposed pathophysiologic mechanisms of postprandial hypoglycemia, with special attention paid to some of the more recently described syndromes, such as NIPHS and postbariatric surgery hypoglycemia. Diagnostic and management strategies are also discussed.”
“Background: Accurate monitoring of health conditions and behaviours, and health service usage in the population, using an effective and economical method is important for planning and evaluation. This study examines the reliability of questions asked in a telephone survey by conducting a test/retest analysis of a range of questions covering demographic variables, health risk factors and self-reported chronic conditions among people aged 16 years and over.

Methods: A Computer Assisted Telephone Interviewing (CATI) survey on health issues of South Australians was re-administered

to a random sub-sample of 154 respondents between 13-35 days (mean 17) after the original survey. Reliability between questions was assessed using Cohen’s kappa and intraclass correlation coefficients.

Results: Demographic questions (age, gender, number of adults and children in the household, country of birth) showed extremely high reliability this website (0.97 to 1.00). Health service use (ICC = 0.90 95% CI 0.86-0.93) and overall health status (Kappa = 0.60 95% CI 0.46-0.75) displayed moderate agreement. Questions relating to self-reported risk factors such as smoking (Kappa = 0.81 95% CI 0.72-0.89) and alcohol drinking (ICC 0.75 = 95% CI 0.63-0.83) behaviour showed good to excellent agreement, while questions relating to self-reported risk factors such as time spent walking for physical activity (ICC 0.47 = 95% CI 0.27-0.61), fruit (Kappa(w) = 0.60 95% CI 0.45-0.76) and vegetable consumption (Kappa(w) = 0.50 95% CI 0.32-0.69) showed only moderate agreement.

ResultsRegarding healthcare professionals as support source, corroborating evidence was found for associations between received support (as well as need for and satisfaction with received support) and all aspects of QOL, except for social ones. Overall, significant relations between support from healthcare personnel and QOL were observed more frequently (67% of analyzed associations), compared with support from families and friends (53% of analyzed associations). Corroborating evidence was found for the associations

compound screening assay between perceived and received support from family and friends and emotional aspects of QOL. Research investigating perceived social support from unspecified sources indicated few significant relationships (25% of analyzed associations) and only for the global QOL index.

ConclusionsQuantitative

and qualitative differences in the associations between social support and QOL are PF-04929113 observed, depending on the source and type of support. Psychosocial interventions may aim at enabling provision of social support from healthcare personnel in order to promote emotional, functional, and physical QOL among lung cancer patients. Copyright (c) 2012 John Wiley & Sons, Ltd.”
“Extracorporeal membrane oxygenation (ECMO) can rescue some critical patients with circulatory collapse when intra-aortic balloon pump (IABP) and ventricular assist devices (VAD) are not suitable. A subset of these patients can use ECMO for direct bridging, or indirect double bridging via VAD to heart transplantation (HTx). For these patients, we identified risk factors for unsuccessful ECMO bridging,

with survival to receiving AR-13324 ic50 either HTx or VAD as the measure of success. The characteristics evaluated were age, sex, body mass index, pre-ECMO cardiopulmonary resuscitation (CPR), IABP use, dialysis use, sequential organ failure assessment (SOFA) score, and the etiology of cardiomyopathy. From January 1995 to August 2007, there were 70 adult ECMO patients with the intent to bridge to HTx (male: 55, age: 46 +/- 14 yr). Thirty-one patients (44%) were successful in bridging. A stepwise multivariate logistic regression analysis found that age > 50 yr (p = 0.003), pre-ECMO CPR (p = 0.001) and SOFA score > 10 at ECMO initiation (p = 0.018) were significant independent predictors of unsuccessful bridging. Direct VAD implantation, if possible, is preferable to double bridging in patients over 50 yr. Also, elective ECMO support before hemodynamic deterioration to cardiac arrest or multiple organ dysfunction would improve rates of successful ECMO bridging.”
“Experimental mouse models of asthma have broadened our understanding of the mechanisms behind allergen-induced asthma. Typically, mouse models of allergic asthma explore responses to a single allergen; however, patients with asthma are frequently exposed to, and tend to be allergic to, more than one allergen.

71, for the cervix the Kendall’s tau-b was 0.88, for the posterior fornix/vaginal cuff

the Kendall’s tau-b was 0.85.

There is substantial association between the POPQ and a simplified version of the POPQ.”
“Study Design. In all, 4 cases of the coexistence of congenital spinal deformity (CSD) and ankylosing spondylitis (AS) were reviewed.

Objective. To provide an insight into the unusual association between CSD and AS.

Summary of Background Data. CSD combined with musculoskeletal anomalies, including clubfeet, Sprengel deformity, Klippel-Feil syndrome, and developmental dysplasia of the hip, has been described in the literature. Additionally, the rare coexistence between AS and other inflammatory joint diseases, such as systemic lupus erythematosus, mixed connective

tissue disease, or Behcet disease, has also been reported. However, to the authors’ Smoothened Agonist manufacturer knowledge, the coexistence of CSD and AS has not been described in the literature.

Methods. In all, 4 patients presented with symptoms of lower back pain for at least 1 year. Among them, 3 patients (cases 1, 2, and 3) were initially diagnosed as CSD, and classified as butterfly vertebra in 2 patients (case 1, case 3), incarcerated hemivertebra in 1 patient (case 2). Furthermore, a diagnosis of coexistence of CSD and AS was proposed in these 3 cases with a delay in the diagnosis of AS for 1 to 10 years. The fourth patient sought initial medical attention in our hospital without delay in diagnosis. A-1155463 solubility dmso In case Angiogenesis inhibitor 1, polysegmental Smith-Petersen osteotomy and transpedicular fixation were performed, and drugs were administrated. Case 2, case 3, and case 4 were treated with amethopterin, folic acid, salicylazosulfapyridine, and celecoxib.

Results. At the latest follow-up, 4 patients had no back pain and were satisfied with the outcome.

Conclusion. The coexistence of CSD and AS is very rare. However, it is necessary to consider the diagnosis of AS in CSD patients who present with symptoms such as inflammatory

low back pain, morning stiffness, loss of global sagittal balance, and other clinical features can not be exclusively explained by CSD solely.”
“The treatment options available for the management of stage I seminoma consist of either a surveillance strategy or adjuvant therapy after orchidectomy. A systematic review was undertaken to identify the optimal management strategy.

The MEDLINE and EMBASE databases, in addition to the American Society of Clinical Oncology Meeting Proceedings, were searched for the period 1981 to May 2007. Studies were eligible for inclusion if they discussed at least one of survival, recurrence, second malignancy, cardiac toxicity, or quality of life for patients with stage I seminoma. A search update was carried out in June 2009.