bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for surgical site infection after elective resection for rectal cancer. A multivariate analysis on 2131 patients
Authors: Biondo S. , Kreisler E. , Fraccalvieri D. , Basany E. E. , Codina‐Cazador A. , Ortiz H. 
Published: September 2011

AbstractAim  Surgical site infection (SSI) is the most common cause of morbidity after colorectal surgery. The aim of this study was to analyze risk factors for SSI in patients who had undergone surgery for rectal cancer.Method  A multicentre observational study was carried out on 2131 patients operated on for rectal cancer between May 2006 and May 2009. Twenty‐nine centres were involved. SSI included wound infection and organ space infection within 30 days after the operation. Univariate and multivariate analyses were carried out to study possible risk factors for SSI.Results  Wound infection and organ space infection were diagnosed in 8.9% and 10%, respectively, of patients. The anastomotic leakage rate was 8%. Multivariate analysis showed that wound infection was related to tumour stage, a converted laparoscopic procedure and open surgery. Organ space infection was related to Stage IV tumour, a tumour < 11 cm from the anal verge, low anterior resection and Hartmann’s procedure.Conclusion  Rectal surgery for malignant disease is associated with a considerable rate of SSI. Wound infection and organ space infection are related to different factors and therefore should be evaluated separately.
Elective partial nephrectomy is equivalent to radical nephrectomy in patients with clinical T1 renal cell carcinoma: results of a retrospective, comparative, multi‐institutional study
Authors: Antonelli Alessandro , Ficarra Vincenzo , Bertini Roberto , Carini Marco , Carmignani Giorgio , Corti Serena , Longo Nicola , Martorana Giuseppe , Minervini Andrea , Mirone Vincenzo , Novara Giacomo , Serni Sergio , Simeone Claudio , Simonato Alchiede , Siracusano Salvatore , Volpe Alessandro , Zattoni Filiberto , Cunico Sergio Cosciani ,   members of the SATURN Project – LUNA Foundation
Published: September 2011

Study Type – Therapy (cohort)Level of Evidence 2bWhat's known on the subject? and What does the study add?Few studies supported the expanded indications for nephron‐sparing surgery (NSS) in selected patients with 4.1 cm renal tumours in the size range (T1b). However, all these comparative studies included both imperative and elective partial nephrectomy and patient selection for analysis was based on pathological stage (pT1) and not on clinical stage (cT1).Patients with clinically organ‐confined RCC (cT1) who are candidates for elective PN have a limited risk of clinical understaging. NSS is not associated with an increased risk of recurrence and cancer‐specific mortality both in cT1a and cT1b tumoursOBJECTIVE
To compare the oncological outcomes of patients who underwent elective partial nephrectomy (PN) or radical nephrectomy (RN) for clinically organ‐confined renal masses ≤7 cm in size (cT1).
PATIENTS AND METHODS
The records of 3480 patients with cT1N0M0 disease were extracted from a multi‐institutional database and analyzed retrospectively.
RESULTS
In patients who underwent PN, the risk of clinical understaging was 3.2% in cT1a cases and 10.6% in cT1b cases.
With regard to the cT1a patients, the 5‐ and 10‐year cancer‐specific survival (CSS) estimates were 94.7% and 90.4%, respectively, after RN and 96.1% and 94.9%, respectively, after PN (log‐rank test: P = 0.01).
With regard to cT1b patients, the 5‐year CSS probabilities were 92.6% after RN and 90% after PN, respectively (log‐rank test: P = 0.89).
Surgical treatment failed to be an independent predictor of CSS on multivariable analysis, both for cT1a and cT1b patients.
Interestingly, PN was oncologically equivalent to RN also in patients with pT3a tumours (log‐rank test: P = 0.91).
CONCLUSIONS
Elective PN is not associated with an increased risk of recurrence and cancer‐specific mortality in both cT1a and cT1b tumours.
Data from the present study strongly support the use of partial nephrectomy in patients with clinically T1 tumours, according to the current recommendations of the international guidelines.
Role of Rho‐kinase and protein kinase C during contraction of hypertrophic detrusor in mice with partial urinary bladder outlet obstruction
Authors: Boberg Lena , Poljakovic Mirjana , Rahman Awahan , Eccles Rachel , Arner Anders 
Published: September 2011

What's known on the subject? and What does the study add?Intracellular signaling via Rho‐kinase and protein kinase C modulate contraction of urinary bladder smooth muscle. These systems can be involved in the bladder overactivity and may constitute pharmalogical targets for treatment of OAB.This study describes the integrated action of these two cellular pathways in BOO and normal bladders, using a mouse model. It is also shown that the activation via membrane depolarization could specifically be inhibited in BOO bladders using Rho‐kinase blockers.OBJECTIVE
To study muscarinic/purinergic receptor activation and Rho‐kinase/protein kinase C (PKC) signalling during smooth muscle contraction in normal and hypertrophic mouse urinary bladders.
METHODS
Partial urinary outflow obstruction was induced in adult female (10–12 weeks) C57Bl/6 mice and comparisons were made with sham‐operated controls.
Bladder preparations were examined in vitro.
Expression of signalling proteins was examined using Western blot analysis.
RESULTS
Obstructed bladders increased more than threefold in weight and were found to have enhanced muscarinic and attenuated purinergic components during nerve‐induced contractions.
The contractile response to carbachol was shifted towards lower concentrations of carbachol for the peak response and had a markedly enhanced sustained component. The amplitude of the α,β‐methylene ATP‐induced responses was lowered. Rho‐kinase inhibitor Y27632 (10 µm) inhibited peak and sustained contractile responses to carbachol in control bladders (peak by 38%; plateau 57%) and obstructed bladders (peak 37% plateau 47%).
PKC inhibitor GF109203X (1 µm) inhibited carbachol contractions in controls (peak by 29%; plateau 29%) and obstructed bladders (peak 17%; plateau 12%). Inhibition by a similar extent was observed after nerve stimulation.
Sensitivity to Ca2+ in high‐K+ depolarized intact tissues increased in obstructed bladders. This increased receptor‐independent Ca2+‐sensitivity was abolished by Y27632.
Tissue contents of the myosin‐binding phosphatase subunit MYPT‐1 and catalytic phosphatase subunit PP1β, were decreased and the contents of RhoGDI, RhoA and CPI‐17 increased. A decrease in the Rho‐kinase isoform ROCK‐1 was observed.
CONCLUSION
Based on these results, one can speculate that Rho‐kinase inhibition would preferentially target the pathological phasic activity in the urinary bladder rather than inhibit the physiological receptor‐mediated bladder emptying.
Diffusion‐weighted magnetic resonance imaging in patients selected for radical cystectomy: detection rate of pelvic lymph node metastases
Authors: Papalia Rocco , Simone Giuseppe , Grasso Rosario , Augelli Raffaele , Faiella Eliodoro , Guaglianone Salvatore , Cazzato Roberto , Vescovo Riccardo Del , Ferriero Mariaconsiglia , Zobel Bruno , Gallucci Michele 
Published: September 2011

Study Type – Diagnostic (exploratory cohort)Level of Evidence 3aWhat's known on the subject? and What does the study add?Preoperative imaging of nodal status in patients undergoing radical cystectomy for bladder cancer lacks diagnostic accuracy. This is the first study that has investigated nodal metastates in bladder cancer using DW‐MRI. ADC derived from DW‐MRI may be used to differentiate metastatic from non‐metastatic lymph nodes.OBJECTIVE• To evaluate whether DW‐MRI improves the detection of pelvic lymph nodes metastates in patients with bladder cancer undergoing radical cystectomy.PATIENTS AND METHODS• 36 patients with CT scan negative for nodal metastates underwent DW‐MRI before surgery. Diagnostic accuracy of DW‐MRI was compared with histopathological findings.RESULTS• Mean ADC value was 0.85 × 10−3 mm3/s in the nodal metastatic group and 1 × 10−3 mm3/s in the nodal non‐metastatic group (P = 0.02).• The ADC cut‐off value, obtained by the ROC curve was 0.86 × 10−3 mm3/s.• Patient‐based sensitivity, specificity and positive and negative predictive values were 76.4%, 89.4%, 26.6%, and 71.4%, respectively.CONCLUSION• DW‐MRI may be used to differentiate metastatic from non‐metastatic lymph nodes in patients with high‐grade bladder cancer.
Information needs of men on androgen deprivation therapy
Authors: Soeyonggo Tony , Warde Padraig , Fleshner Neil , Timilshina Narhari , Alibhai Shabbir M.H. 
Published: September 2011

Study Type – Needs assessment surveyLevel of Evidence 2bWhat's known on the subject? and What does the study add?Although androgen deprivation therapy (ADT) is widely used to treat men with prostate cancer, little is known about the information needs of patients on ADT.We found that patients are generally very satisfied with using ADT and expressed minimal decisional regret with its use up to four years later. For men receiving ADT in the adjuvant setting, their survival estimates with the addition of ADT were quite reasonable when compared to findings in randomized trails. A key area to enhance patient education appears to be side effects, especially around hot flashes and fatigue, which were also the most bothersome treatment sequelae for patients.OBJECTIVE
To evaluate information needs of men receiving androgen deprivation therapy (ADT).
PATIENTS AND METHODS
A cross‐sectional survey was distributed to English‐speaking prostate cancer patients receiving ADT adjuvant to radical therapy or for biochemical relapse.
Three cohorts were recruited based on duration of ADT use: <6 months (cohort 1), 6–18 months (cohort 2) and 18 months to 4 years (cohort 3).
Several validated questionnaires were used, including the Control Preferences Scale (CPS), Satisfaction with Treatment Decision Scale (SWD) and Decisional Regret Scale (DRS).
Patients on adjuvant ADT were asked to estimate their overall survival with and without ADT.
RESULTS
Eighty‐five men were recruited, of whom 91.8% were receiving a gonadotrophin‐releasing hormone agonist, 4.7% were receiving anti‐androgen monotherapy and 3.5% were receiving combined androgen blockade.
Patients preferred the following decision‐making roles: 23.5% active, 50.6% collaborative, 27.0% passive.
Mean patient satisfaction for ADT use was high at 24.0/30 and decisional regret was low at 7.9/25.
There was a perceived overall survival benefit of 3.9–6.9% at 5 years, 3.6–17.8% at 10 years and 5.7–18.1% at 15 years with the addition of adjuvant ADT.
Hot flushes and fatigue were reported as the most common theoretical adverse effects as well as those experienced most commonly by patients.
CONCLUSIONS
Patients on ADT were generally satisfied with their decisions to start ADT and expressed minimal decisional regret up to 4 years later.
A key area to enhance patient education appears to be adverse effects, especially around hot flushes and fatigue.
Diabetes medication patient safety incident reports to the National Reporting and Learning Service: the care home setting
Authors: Milligan F. J. , Krentz A. J. , Sinclair A. J. 
Published: September 2011

Diabet. Med. 28, 1537–1540 (2011)AbstractAims  To analyse adverse drug events in older people with diabetes in the care home setting via incident reports obtained from the National Reporting and Learning Service.Methods  A Freedom of Information request was made to the National Reporting and Learning Service via the National Patient Safety Agency. Within the National Reporting and Learning Service, reports on diabetes within the category of ‘medication’ using the location limiter of ‘hospice or nursing home or residential home’ were searched. We requested information about the number and nature of adverse drug event reports that had been received in relation to diabetes. The data were subdivided into reports (1) relating to insulin therapy and (2) oral glucose‐lowering agents.Results  Data were collected between 1 January 2005 and 31 December 2009. There were 684 reports related to insulin and 84 incidents related to oral glucose‐lowering agents. The most common error category with both types of drug therapy was wrong or unclear dose: 173 reports for insulin, including one death, and 20 reports for oral therapy.Conclusions  Residents with diabetes in care homes are potentially at risk of harm from adverse drug events pertaining to insulin and oral glucose‐lowering agents. Because of under‐reporting, our data most likely represent only a fraction of events.
Time trends in absolute and modifiable coronary heart disease risk in patients with Type 2 diabetes in the Swedish National Diabetes Register (NDR) 2003–2008
Authors: Fhärm E. , Cederholm J. , Eliasson B. , Gudbjörnsdottir S. , Rolandsson O. 
Published: September 2011

Diabet. Med. 29, 198–206 (2012)AbstractAims  The aim was to evaluate treatment goal achievements early in the course of Type 2 diabetes, and their effect on 10‐year risk of coronary heart disease in patients receiving usual care.Methods  Assessment of risk factor control 3 years after diagnosis in patients with Type 2 diabetes with no previous coronary heart disease included from the Swedish National Diabetes Register; a total of 19 382 patients (mean age 58 years) in cross‐sectional surveys from 2003 to 2008, and a subgroup of 4293 patients followed individually from year of diagnosis to follow‐up after a mean 2.6 years. Estimation of absolute 10‐year risk of coronary heart disease using the UK Prospective Diabetes Study risk engine, and modifiable 10‐year risk defined as percentage excess risk above patients with ‘normal’ risk factor values.Results  Treatment goals for HbA1c, blood pressure, total and LDL cholesterol were achieved in 78.4, 65.5, 55.6% and 61.0%, respectively, in the cross‐sectional survey in 2008, following a trend of generally improved control. In the individually followed patients in the subgroup, mean absolute 10‐year coronary heart disease risk increased from 13.7% (men/women 16.9/9.5%) to 14.2 (men/women 17.6/9.6%) (P < 0.001) from year of diagnosis to follow‐up after 2.6 years, while mean modifiable risk decreased from 37.7% (men/women 28.6/49.9%) to 19.1% (13.2/26.9%) (P < 0.001 in all).Conclusions  A high achievement of treatment goals and a low mean modifiable 10‐year coronary heart disease risk was found at the 3‐year follow‐up, both in the cross‐sectional survey in 2008 and in patients individually followed since diagnosis. This indicates the feasibility and significance of early multifactorial risk factor treatment.
Cost–utility analysis of liraglutide compared with sulphonylurea or sitagliptin, all as add‐on to metformin monotherapy in Type 2 diabetes mellitus
Authors: Davies M. J. , Chubb B. D. , Smith I. C. , Valentine W. J. 
Published: September 2011

Diabet. Med. 29, 313–320 (2012)AbstractAim  To investigate the cost‐effectiveness of liraglutide as add‐on to metformin vs. glimepiride or sitagliptin in patients with Type 2 diabetes uncontrolled with first‐line metformin.Methods  Data were sourced from a clinical trial comparing liraglutide vs. glimepiride, both in combination with metformin, and a clinical trial comparing liraglutide vs. sitagliptin, both as add‐on to metformin. Only the subgroup of patients in whom liraglutide was added to metformin monotherapy was included in the cost–utility analysis. The CORE Diabetes Model was used to simulate outcomes and costs with liraglutide 1.2 and 1.8 mg vs. glimepiride and vs. sitagliptin over patients’ lifetimes. Treatment effects were taken directly from the trials. Costs and outcomes were discounted at 3.5% per annum and costs were accounted from a third‐party payer (UK National Health System) perspective.Results  Treatment with liraglutide 1.2 and 1.8 mg resulted, respectively, in mean increases in quality‐adjusted life expectancy of 0.32 ± 0.15 and 0.28 ± 0.14 quality‐adjusted life years vs. glimepiride, and 0.19 ± 0.15 and 0.31 ± 0.15 quality‐adjusted life years vs. sitagliptin, and was associated with higher costs of £3003 ± £678 and £4688 ± £639 vs. glimepiride, and £1842 ± £751 and £3224 ± £683 vs. sitagliptin, over a patient’s lifetime. Both liraglutide doses were cost‐effective, with incremental cost‐effectiveness ratios of £9449 and £16 501 per quality‐adjusted life year gained vs. glimepiride, and £9851 and £10 465 per quality‐adjusted life year gained vs. sitagliptin, respectively.Conclusions  Liraglutide, added to metformin monotherapy, is a cost‐effective option for the treatment of Type 2 diabetes in a UK setting.
Lightening the load? A systematic review of community pharmacy‐based weight management interventions
Authors: Gordon J. , Watson M. , Avenell A. 
Published: September 2011

SummaryThe extent to which community pharmacies can increase capacity for weight management is unknown. Thus, the objective of the present paper was to evaluate the effectiveness and cost‐effectiveness of community pharmacy weight management interventions. This paper used a design of systematic review and narrative synthesis. Electronic databases (1999–2009) were searched, including Medline, EMBASE, CINAHL and Pharm‐line. Weight management studies in community pharmacies were eligible for the inclusion criteria. All languages and study designs were considered. Outcome measures included body weight or anthropometry (at baseline and at least one follow‐up time point). Data were extracted through independent, duplicate data extraction and quality assessment. As a result, 10 studies were included, totalling 2,583 service users and 582 pharmacies from the USA, the UK, Switzerland, Spain and Denmark. One was a randomized controlled trial of a meal‐replacement versus a reduced calorie diet. A non‐randomized controlled before and after study compared community pharmacist treatment using Orlistat with usual care. Eight studies were uncontrolled. Five studies described behaviour change techniques. Long‐term (12 months) mean weight loss measured in three studies ranged from 1.1 to 4.1 kg. Four uncontrolled studies reported statistically significant weight loss. No study reported economic evaluations. Currently, there is insufficient evidence for the effectiveness and cost‐effectiveness of community pharmacy‐based weight management initiatives to support investment in their provision.
Impact of laparoscopic adjustable gastric banding on type 2 diabetes
Authors: Dixon J. B. , Murphy D. K. , Segel J. E. , Finkelstein E. A. 
Published: September 2011

SummaryBariatric surgery is becoming an accepted option for obese people with type 2 diabetes. Our aim was to assess the impact of laparoscopic adjustable gastric banding (LAGB) through a systematic review of the literature. Data was sourced from Scopus, MEDLINE and EMBASE published from 2000 through May 2011, and five unpublished studies that were performed by industry for regulatory approval were also included. Studies were selected on the basis that they provide some detail of diabetes status before and after LAGB. There were 35 studies meeting the inclusion criteria. There was considerable heterogeneity in study design, sample size, length of follow‐up, attrition rates and classification of diabetes status. Weight loss was progressive over the first 2 years with a weighted average of 47% excess weight loss at 2 years. Remission or improvement in diabetes varied from 53% to 70% over different time periods. Results were broadly consistent, demonstrating clinically relevant improvements in diabetes outcomes with sustained weight loss in obese people with type 2 diabetes following LAGB surgery. However, there were significant shortcomings in the reviewed literature with few high‐quality studies, inconsistent reporting of diabetes outcomes and high attrition rates. Long‐term studies that address these limitations are needed.
Applause as an achievement‐based reward during a computerised self‐assessment test
Authors: Moridis Christos N. , Economides Anastasios A. 
Published: September 2011

AbstractAffective feedback during a self‐assessment test could help induce the learner to an optimal emotional state regarding the learning material. However, there is a lack of experimental evidence concerning the influence of affective feedback during a self‐assessment test. This paper is a step towards this direction. The effect of achievement‐based reward feedback on students' state and trait anxiety was examined. Ninety‐two students participated in an experiment. Half of these students received an applause sound after a correct answer to a question. Results highlight gender differences concerning this emotional type of feedback.
Rent‐Sharing under Different Bargaining Regimes: Evidence from Linked Employer–Employee Data
Authors: Rusinek Michael , Rycx François 
Published: September 2011

AbstractUsing Belgian linked employer–employee data, we examine how collective bargaining arrangements affect the relationship between firms' profitability and individual wages via rent‐sharing. In industries where agreements are usually renegotiated at firm‐level (‘decentralized industries’) wages and firm‐level profits are positively correlated regardless of the type of collective wage agreement by which the workers are covered (industry or firm). On the other hand, where firm‐level wage renegotiation is less common (‘centralized industries’), wages are only significantly related to firms' profitability for workers covered by a firm‐level collective agreement. Thus, industry‐wide contracts that are not complemented by a firm‐level collective agreement suppress the impact of firm profits on workers' wages in centralized industries.
Effect of Secondary School Fees on Educational Attainment*
Authors: Riphahn Regina T. 
Published: September 2011

AbstractIn this study, the heterogeneity of the fee abolition process in West German secondary schools is used to identify the effect of school fees on educational attainment and to obtain an estimate of the price elasticity of upper secondary education. The analysis is based on representative individual‐level data from three annual surveys of the German Mikrozensus. While coefficients cannot be estimated precisely, the results suggest that, on average, upper secondary school attainment increased by at least 8 percent in response to the fee abolition. The educational attainment of females appears to be more price sensitive than that of males.
Public or Private Sector Wage Leadership? An International Perspective*
Authors: Lamo Ana , Pérez Javier J. , Schuknecht Ludger 
Published: September 2011

AbstractWhether a government acts as a wage leader, placing pressure on private‐sector wages (more open to competition), or whether it plays a passive role and merely follows wage negotiations in the private sector, there are important implications for macroeconomic development, particularly in small open economies and/or countries that are members of a monetary union, such as those of the European Monetary Union. With the notable exception of the case of Sweden, opinion on this issue is still divided. In this paper, we look at public‐ and private‐sector wage interactions from an international perspective (18 OECD countries). We focus on the causal two‐way relationship between public and private wage setting, confirming that the private sector, on the whole, appears to have a stronger influence on the public sector, rather than vice versa. However, we also find evidence of feedback effects from public wage setting, which affect private‐sector wages in a number of countries. When the private sector takes the lead on wages, there are few feedback effects from the public sector, while public wage leadership is typically accompanied by private‐sector feedback effects.