bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diverting loop ileostomy after restorative proctocolectomy: predictors of poor outcome and poor quality of life
Authors: Scarpa M. , Ruffolo C. , Boetto R. , Pozza A. , Sadocchi L. , Angriman I. 
Published: April 2009

AbstractAim  Diverting loop ileostomy is used to minimize the impact of anastomotic complication after restorative proctocolectomy (RPC). However, the ileostomy itself may have complications and therefore affect quality of life (QOL). The aim of this study was to analyse the predictors of complications of the ileostomy formation and closure and of the QOL of these patients.Method  Forty‐four consecutive patients who underwent RPC were enrolled. Records of the ileostomy follow‐up were retrieved from a prospectively collected database and QOL was assessed with the Stoma‐QOL questionnaire. Ileostomy site coordinates were measured. Univariate and multivariate analysis were performed.Results  In this series, three patients experienced peristomal herniae, two ileostomy stenosis, seven ileostomy retraction and fourteen peristomal dermatitis. Emergency surgery was the only predictor of parastomal hernia (P = 0.017). Stenosis correlated with the distance from the umbilicus (τ = 0.24, P = 0.021). Use of standard rod and retraction were independent predictors of peristomal dermatitis (P = 0.049 and P = 0.001). Stoma‐QOL was directly correlated to the age of the patients and to the occurrence of parastomal hernia (P = 0.001 and P = 0.021, respectively). After stoma closure, two patients reported wound sepsis and seven suffered obstructive episodes.Conclusion  The predictors of negative outcome after construction of a diverting loop ileostomy after RPC were urgent surgery, use of standard rod, the distance of the stoma site from the umbilicus, parastomal herniae and the older age of patients.
The number of lymph nodes in colon cancer specimens: what do the numbers really mean?
Authors: McPartland S. , Hyman N. , Blaszyk H. , Osler T. 
Published: April 2009

AbstractAim  Stage‐specific survival for colon cancer is improved when more lymph nodes are identified in the surgical specimen. This association is typically attributed to staging effect, but may instead be a surrogate for tumour biology.Method  We retrospectively studied a cohort of 48 consecutively treated patients with Stage II colon cancer who underwent complete resection between January 2000 and December 2002. Archived H&E slides were reviewed for lymphocytic infiltration at the leading edge, presence and degree of sinus histiocytosis in the largest node and the presence of lymph node hyperplasia.Results  The mean number of lymph nodes identified was 14.1 ± 9.4. T stage was strongly associated with the number of nodes identified (P = 0.01) and the presence of a significant degree of sinus histiocytosis approached statistical significance (P = 0.077). No statistically significant relationship existed between number of lymph nodes in a specimen and tumour location (P = 0.44), grade (P = 0.56) or lymphovascular invasion (P = 0.64).Conclusions  T stage is highly associated with the number of nodes found in a colon cancer specimen; a significant degree of sinus histiocytosis may also be predictive. Finding more nodes may be a surrogate for tumour or host‐related factors that impact prognosis.
Economic evaluation of the treatment of grade II haemorrhoids: a comparison of stapled haemorrhoidopexy and rubber band ligation
Authors: McKenzie L. , De Verteuil R. , Cook J. , Shanmugam V. , Loudon M. , Watson A. J. M. , Vale L. 
Published: April 2009

AbstractObjectives  Haemorrhoidal disease is a common condition causing considerable distress to individuals and significant cost to healthcare services. This paper explored the cost‐effectiveness of stapled haemorrhoidopexy (SH) compared with the non‐surgical intervention, rubber band ligation (RBL), for grade II symptomatic circumferential haemorrhoids.Method  An economic evaluation alongside a randomized controlled trial conducted between October 2002 and February 2005. Adults were recruited and randomized to either SH or RBL. The same surgeon performed all procedures and investigators were blinded until analyses were completed. Primary outcomes measured at 52 weeks were cumulative costs to the NHS, clinical diagnosis of recurrence and quality adjusted life years (QALYs).Results  Sixty symptomatic men and women with confirmed clinical diagnosis of grade II symptomatic haemorrhoids were randomized. Loss to follow‐up was up to 10% at 52 weeks. The mean cost for SH was greater than RBL (mean difference: £1483, 95% CI: 1339–1676); disease recurrence was lower (OR = 0.18, 95% CI: 0.03–0.86); and there was no evidence of a statistically significant difference in QALYs (−0.014, 95% CI: –0.076 to 0.051). SH was associated with a modest incremental cost per recurrence avoided at 12 months follow‐up (£4945). Based on current data, it was considered highly unlikely to be cost‐effective in terms of incremental cost per QALY.Conclusions  There is insufficient evidence about the cost‐effectiveness of SH for grade II haemorrhoids to recommend its routine use in place of RBL. Further information is needed from larger trials with a longer‐term follow‐up to inform subsequent economic evaluation.
What is the natural history of internal rectal prolapse?
Authors: Wijffels N. A. , Collinson R. , Cunningham C. , Lindsey I. 
Published: April 2009

AbstractAim  The nature and clinical significance of internal rectal prolapse is controversial. Its natural history is unclear. Longitudinal cohort studies show rare progression to external prolapse but lack adequate follow‐up. We aimed to study the relationship of age to various stages of internal rectal prolapse using the Oxford Rectal Prolapse Grade (ORPG) and evaluate the influence of sex and vaginal delivery on this relationship.Method  Internal rectal prolapsed (IRP) diagnosed at proctography and external rectal prolapse were graded using the ORPG. Age, sex and obstetric history were documented. Mean age of each prolapse grade (1–5) was analysed and regression analysis performed for age and prolapse. Subgroup analyses were made for males, and females with (V+) and without (V0) history of vaginal delivery.Results  Sixty males (11%) and 471 females (89%) were studied. The difference in the mean ages of each group was statistically significant (grade 1,38.6; grade 2, 52.1; grade 3, 56.0; grade 4, 60.3 and grade 5, 66.5, P < 0.0001). On average male (8.7 years) and V0‐group (8.0 years) were younger than V+ group (95% CI difference 4.5–12.9 years, P < 0.0001, and 3.8–12.2 years, P < 0.0001, respectively). Males and V0‐group had weaker correlation between age and prolapse grade (r = 0.16 and r = 0.17, respectively, vs 0.41), and a faster prolapse progression rate than the V+ group.Conclusion  These data demonstrate a strong relationship between age and prolapse grade, supporting the view of internal rectal prolapse as a precursor to external prolapse in the spectrum of rectal prolapse disease.
Single incision laparoscopic sigmoid colon resections without visible scar: a novel technique
Authors: Brunner W. , Schirnhofer J. , Waldstein‐Wartenberg N. , Frass R. , Weiss H. 
Published: April 2009

AbstractObjective  On the way to ‘no‐scar’ techniques we developed a novel method for colorectal resection utilizing three intraumbilical trocars which results in a nonvisible postoperative scar.Method  Two female patients (Age: 56a, 42a) underwent laparoscopic colorectal resection for diverticulitis and infiltrating endometriosis of the rectosigmoid colon, respectively. The entire operation was carried out transumbilically following the standardized principles of colorectal resection.Results  The operative time was 110 and 180 min, respectively. No intraoperative adverse events or significant perioperative complication was noticed. The specimen measured 22 and 18 cm in length respectively. Estimated blood loss was minimal in both cases. Oral diet was resumed on postoperative day one. Patients were discharged on postoperative day 7 and day 6, respectively. At follow‐up, patients presented with an optimal cosmetic result without apparent scarring.Conclusion  For the first time, a novel laparoscopic technique for sigmoid colon resection utilizing a single intraumbilical approach is presented. This new method allows further reduction of the surgical trauma and obviates any visible scar.
Bacterial colonization of stimulation electrode wires in patients undergoing temporary sacral nerve stimulation
Authors: Dudding T. , Vaizey C. 
Published: April 2009

AbstractObjective  In patients undergoing sacral nerve stimulation (SNS), a temporary percutaneous stimulation wire is often used to assess the clinical response to therapy prior to chronic stimulation. The aim of this study was to evaluate the incidence of bacterial colonization of screening wires and risk of clinical infection in patients undergoing prolonged temporary SNS screening.Method  Data were collected prospectively on a consecutive series of patients undergoing temporary SNS for bowel dysfunction. Procedures were performed using a standardized percutaneous technique with a single shot of either co‐amoxyclav 1.2 g or cefuroxime 1.5 g given intravenously on induction. Adherent polyurethane dressings were applied to secure the wire. At the end of the screening period the wire and dressings were removed, the skin entry site was cleaned using an alcohol wipe and the wire removed via an aseptic technique. The distal tip of the wire was then cut and sent for culture.Results  Thirteen wires were removed at a median of 21 (range 16–29) days following insertion. There were no signs of local or systemic infection. Seven of the thirteen wires (54%) were found to have deep bacterial colonization. The commonest organisms isolated were staphylococcus species. There was no correlation between the length of time the lead had been implanted and the incidence of bacterial colonization.Conclusion  Bacterial colonization of the temporary stimulation wire is common but appears to be associated with a low risk of clinical infection. A single peri‐operative dose of antibiotics does not appear to prevent colonization.
Management of obstetric anal sphincter injuries – a role for the colorectal surgeon
Authors: McNicol F. J. , Bruce C. A. , Chaudhri S. , Francombe J. , Kozman E. , Taylor B. A. , Tighe M. J. 
Published: April 2009

AbstractAim  To determine if surgical repair of third and fourth degree obstetric perineal tears by an experienced colorectal surgeon produces satisfactory functional results in the short and long term.Method  Consecutive deliveries were studied prospectively over a 32‐month period. All patients with suspected third or fourth degree tears were referred to the colorectal team. Following confirmation of the injury, patients underwent surgical repair using a standard overlapped technique according to an established protocol. The patients were reviewed 2 months later. Long‐term continence was determined, by postal and telephone follow up, after a minimum of 3 years.Results  Fifty‐nine sphincter injuries were identified and repaired by the colorectal team. Two months following repair 51 (86%) of patients had normal continence, four (7%) had urgency, and five (8%) had occasional incontinence of flatus. All patients with any degree of incontinence underwent endoanal ultrasound at which no sphincter defects were noted, and all improved symptomatically following pelvic floor physiotherapy. Long‐term follow up data was obtained in 45 women. Thirty‐nine (87%) had normal continence scores, 11 (24%) described urgency, but only three (7%) were often incontinent of liquid stool. Seven (15%) were occasionally incontinent of flatus.Conclusion  Excellent short and long‐term functional results were obtained in the repair of third and fourth degree tears when performed by experienced colorectal surgeons. Since the protocol was established, obstetricians in North Cheshire have adopted the double overlapped technique, and now manage the majority of these injuries themselves.
Selecting patients with faecal incontinence for anal sphincter surgery: the influence of irritable bowel syndrome
Authors: Chaudhary B. N. , Chadwick M. , Roe A. M. 
Published: April 2009

AbstractAim  This was a prospective study to determine the prevalence of irritable bowel syndrome (IBS) in patients with faecal incontinence and to investigate the association of IBS positivity with sphincter dysfunction.Method  Patients with faecal incontinence were referred for physiological assessment and further management. Those with an acute obstetric injury, rectal prolapse or previous anorectal surgery were excluded. One hundred and seventy‐seven women were studied. Symptom questionnaires were used prospectively to identify IBS positivity using Rome 11 criteria and the Cleveland Clinic incontinence score.Results  The prevalence of IBS was 44%. IBS patients had higher incontinence scores than non‐IBS patients (11.0 vs 9.0, P < 0.01). A normal or high maximum resting anal pressure in an incontinent woman increased the chance of her having IBS by a factor of 2.6.Conclusion  The prevalence of IBS positivity in patients presenting with faecal incontinence was high. A normal or high anal resting pressure and a high incontinence score should raise the suspicion of IBS.
Mechanisms of glucose intolerance in cystic fibrosis
Authors: Mohan K. , Miller H. , Dyce P. , Grainger R. , Hughes R. , Vora J. , Ledson M. , Walshaw M. 
Published: April 2009

AbstractAims  Although cystic fibrosis‐related diabetes (CFRD), a poor prognostic factor in cystic fibrosis (CF), is characterized by insulinopenia, the role of insulin resistance is unclear. Using a prospective study design, we measured insulin resistance, pancreatic β‐cell function and correlated glycaemic status with clinical parameters.Methods  Oral glucose tolerance test was performed in 60 stable adult CF patients. Insulin sensitivity and β‐cell function were measured using the homeostatic model assessment (HOMA2), Stumvoll and oral glucose insulin sensitivity (OGIS) indices.Results  Forty‐two (70%) had normal glucose tolerance (NGT), 10 (17%) impaired glucose tolerance (IGT) and eight (13%) CFRD. There was no difference in insulin sensitivity among the three groups (HOMA2: NGT 280, IGT 250, CFRD 339, P = 0.42; Stumvoll: NGT 0.128, IGT 0.126, CFRD 0.129, P = 0.76; and OGIS: NGT 515, IGT 472, CFRD 472, P = 0.12). Pancreatic β‐cell function (CFRD 50% vs. NGT 67%; P < 0.05) and first‐phase insulin secretion were reduced in CFRD (250 vs. NGT 509; P = 0.004). First‐phase insulin secretion was inversely correlated with 1‐h (r = −0.74; P < 0.0001) and 2‐h glucose levels (r = −0.34; P < 0.05). There was no difference in body mass index or poor lung function (forced expiratory volume in 1 s: CFRD 54% vs. NGT 65%; P = 0.43). However, there were more hospital admissions in the CFRD group (three vs. NGT one per patient per year; P < 0.05).Conclusions  CFRD is characterized by qualitative and quantitative defects in insulin secretion, but not insulin resistance, and is associated with increased hospital admissions for pulmonary exacerbations.
Single nucleotide polymorphism discovery in barley using autoSNPdb
Authors: Duran Chris , Appleby Nikki , Vardy Megan , Imelfort Michael , Edwards David , Batley Jacqueline 
Published: April 2009

SummaryMolecular markers are used to provide the link between genotype and phenotype, for the production of molecular genetic maps and to assess genetic diversity within and between related species. Single nucleotide polymorphisms (SNPs) are the most abundant molecular genetic marker. SNPs can be identified in silico, but care must be taken to ensure that the identified SNPs reflect true genetic variation and are not a result of errors associated with DNA sequencing. The SNP detection method autoSNP has been developed to identify SNPs from sequence data for any species. Confidence in the predicted SNPs is based on sequence redundancy, and haplotype co‐segregation scores are calculated for a further independent measure of confidence. We have extended the autoSNP method to produce autoSNPdb, which integrates SNP and gene annotation information with a graphical viewer. We have applied this software to public barley expressed sequences, and the resulting database is available over the Internet. SNPs can be viewed and searched by sequence, functional annotation or predicted synteny with a reference genome, in this case rice. The correlation between SNPs and barley cultivar, expressed tissue type and development stage has been collated for ease of exploration. An average of one SNP per 240 bp was identified, with SNPs more prevalent in the 5′ regions and simple sequence repeat (SSR) flanking sequences. Overall, autoSNPdb can provide a wealth of genetic polymorphism information for any species for which sequence data are available.
A high‐throughput assay for rapid and simultaneous analysis of perfect markers for important quality and agronomic traits in rice using multiplexed MALDI‐TOF mass spectrometry
Authors: Masouleh Ardashir K. , Waters Daniel L. E. , Reinke Russel F. , Henry Robert J. 
Published: April 2009

SummaryThe application of single nucleotide polymorphisms (SNPs) in plant breeding involves the analysis of a large number of samples, and therefore requires rapid, inexpensive and highly automated multiplex methods to genotype the sequence variants. We have optimized a high‐throughput multiplexed SNP assay for eight polymorphisms which explain two agronomic and three grain quality traits in rice. Gene fragments coding for the agronomic traits plant height (semi‐dwarf, sd‐1) and blast disease resistance (Pi‐ta) and the quality traits amylose content (waxy), gelatinization temperature (alk) and fragrance (fgr) were amplified in a multiplex polymerase chain reaction. A single base extension reaction carried out at the polymorphism responsible for each of these phenotypes within these genes generated extension products which were quantified by a matrix‐assisted laser desorption ionization‐time of flight system. The assay detects both SNPs and indels and is co‐dominant, simultaneously detecting both homozygous and heterozygous samples in a multiplex system. This assay analyses eight functional polymorphisms in one 5 µL reaction, demonstrating the high‐throughput and cost‐effective capability of this system. At this conservative level of multiplexing, 3072 assays can be performed in a single 384‐well microtitre plate, allowing the rapid production of valuable information for selection in rice breeding.
Research Productivity in Business Economics: The Case of Marketing
Authors: Diamantopoulos Adamantios , Wagner Udo 
Published: April 2009

Abstract
The German Economic Review (GER) recently published a paper by Fabel, Hein and Hofmeister about research productivity in Austrian, German and Swiss universities. The authors derive the rankings of institutions and subject areas by analyzing an impressive and comprehensive dataset, which captures the research output of business administration departments. While these rankings might hold at an aggregate level, they lack face validity at a subject-specific level. This lack of validity is demonstrated in the case of marketing by analyzing the research output of the top-ranked institutions in top-ranked journals. A number of proposals to overcome these kinds of problems are provided.
Concomitant Use of Anticholinergics with Acetylcholinesterase Inhibitors in Medicaid Recipients with Dementia and Residing in Nursing Homes
Authors: Modi Ankita , Weiner Michael , Craig Bruce A. , Sands Laura P. , Rosenman Marc B. , Thomas Joseph 
Published: April 2009

OBJECTIVES: To evaluate the extent of concomitant use of anticholinergic and cholinesterase inhibitor medications in Medicaid recipients with dementia residing in nursing homes.DESIGN: Cross‐sectional survey of medical claims data.SETTING: Indiana Medicaid claims for 2004.PARTICIPANTS: Indiana Medicaid recipients continuously eligible for Medicaid in 2004 aged 65 and older with dementia who were residing in nursing homes and taking cholinesterase inhibitors.MEASUREMENTS: Rates of concomitant anticholinergic and cholinesterase inhibitor use, number of days residents experienced concomitant use, and concomitant use according to therapeutic class and level of anticholinergic activity were determined.RESULTS: A large proportion (46.7%) of 3,251 Medicaid beneficiaries living in nursing homes and taking cholinesterase inhibitors received anticholinergics concomitantly. Anticholinergics designated as Level 3, or having markedly anticholinergic adverse effects, accounted for most of the concomitant anticholinergic use. More than half (58.1%) of the individuals with concomitant anticholinergic use had 100 or more days of such use.CONCLUSION: Nearly half of Indiana Medicaid recipients with dementia residing in nursing homes who were taking cholinesterase inhibitors in 2004 were using anticholinergics concomitantly. Patterns of concomitant use in the population examined may assist practitioners in reviewing their prescribing decisions for this vulnerable population.
A Comparison of Retention Characteristics in Prefabricated and Custom‐Cast Dental Attachments
Authors: Fu Chin‐Chuan , Hsu Yung‐Tsung 
Published: April 2009

Abstract Purpose: The aim of this in vitro study was to investigate the retention characteristics of attachments fabricated by machine milling or by custom casting. In addition, the retention of reduced dimension attachments was also evaluated. Materials and Methods: Three types of ERA matrices, one prefabricated and two cast, were used. Ten specimens were made for each type, and white nylon patrices were transferred to denture bases. Tests were performed at a crosshead speed of 0.2 in/min with an Instron machine. The dislodging force at baseline, 100, 200, 300, 400, 500, and subsequently after every 500 pulls up to 2500 pulls were measured. ANOVA and Student's t‐test were used to analyze the measurements. Results: All three groups showed no difference at the baseline, but the cast groups showed greater variation within group. The prefabricated group showed higher retention after 200 pulls. Decreased‐dimension attachments have no significant difference when compared to the cast regular dimension group after 400 pulls. Conclusion: The prefabricated attachments had superior retention than the cast groups over time. Reduced dimension did not reduce the retention when compared to the cast group.
Racial Diversity, Representative Bureaucracy, and Equity in Multiracial School Districts*
Authors: Rocha Rene R. , Hawes Daniel P. 
Published: April 2009

Objective.This study examines the conditions under which minorities will face policy inequity within the educational system. It turns to the theory of representative bureaucracy as one possible explanation, and extends the literature by considering whether African‐American students benefit from the presence of Latinos on teaching faculties and vice versa. This study also tests competing theories of how racial context influences minority educational policy outcomes.Methods.This study combines original survey data with data gathered by the U.S. Census to predict levels of academic grouping in U.S. school districts as reported by the Office of Civil Rights.Results.Minority teachers lower levels of discrimination among all minority students, not just co‐ethnics. Moreover, minority teachers do so consistently and with a substantive impact that occasionally rivals that of co‐ethnic teachers. The findings also suggest that greater levels of racial/ethnic diversity within a district are associated with lower levels of discrimination.Conclusion.Theories of race relations must move beyond black‐Anglo or Latino‐Anglo relations to consider how multiple racial/ethnic groups interact, and how such interactions affect the lives of minority groups differently.