bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes in total elbow arthroplasty in patients with haemophilia at the University of California, San Francisco: a retrospective review
Authors: MARSHALL BROOKS M. , TOBASE P. , KARP S. , FRANCIS D. , FOGARTY P. F. 
Published: August 2010

Summary.  Severe haemophilic arthropathy of the elbow is a significant cause of morbidity among adults with haemophilia. However, previous reports of total elbow arthroplasty (TEA) in the haemophilic population have been based on small numbers of patients with relatively short‐term follow‐up. The records of seven total elbow arthroplasties in six adult men with haemophilia at the University of California, San Francisco who underwent TEA over a period of 25 years were retrospectively reviewed. Type of haemophilia, age at time of TEA, HIV infection status, pre‐ and postoperative range‐of‐motion (ROM) scores, complications (including infections), need for subsequent surgical revision and functional outcomes were recorded. Four patients had severe factor VIII deficiency and two patients had severe factor IX deficiency. None of the patients had an inhibitor. The mean age at the time of surgery was 34 years (range, 22–46 years) and the mean follow‐up period was 118 months (range, 37–176 months). One of the six patients had TEA in both elbows. Five of the six patients were infected with HIV. There were no immediate perioperative complications. At a mean of 19.2 months postoperatively, ROM had improved in five of seven TEAs: mean flexion had increased from 110.7° (SD = 15.0) to 120.1° (SD = 14.5), whereas mean preoperative extension increased from −44.3° (SD = 21.5) to −36.9° (SD = 27.0). One patient required a revision at 30 months because of ulnar component loosening. This same patient sustained a staph epidermidis infection and ultimate removal of the prosthesis 15 years postoperatively. At a mean of 118 months postoperatively, five of six patients continued to report reduced pain and preserved functionality, with ability to perform normal daily activities. TEA resulted in favourable results in six of seven procedures. Our findings support the viability of TEA for individuals with severe haemophilic arthropathy of the elbow, especially to reduce pain and preserve or restore functionality. Level of evidence. Level IV.
Prostatic pathology reporting in the UK: development of a national external quality assurance scheme
Authors: Harnden P , Coleman D , Moss S , Kodikara S , Patnick J , Melia J 
Published: August 2010

Aims:  To develop a baseline picture of prostatic pathology reporting in the UK, identify areas of particular difficulty and assess the feasibility of a national external quality assurance scheme based on prostatic biopsy specimens using the same format as the National Health Service breast pathology scheme, as recommended by the National Institute for Clinical Excellence.Methods and results:  Eight expert uropathologists and 32 randomly selected pathologists participated in four circulations each of 12 cases of prostatic biopsy specimens. A fixed text proforma was developed and responses were analysed for interobserver agreement using κ statistics. Consistency of reporting the main diagnostic categories of benign and invasive carcinoma was good (κ values 0.77 and 0.88, respectively), but only after excluding 19% of cases for which the experts did not reach 75% agreement. Areas of difficulty included the diagnosis of high‐grade prostatic intraepithelial neoplasia and small foci of cancer. Prognostic factor reporting was more variable, with lower overall κs for the assessment of Gleason grading (experts 0.55, others 0.50), perineural invasion (experts 0.64, others 0.50) and number of positive cores (experts 0.74, others 0.61).Conclusions:  Given the difficulties in diagnosis of prostatic biopsy specimens and the assessment of prognostic factors, the expansion of the scheme could deliver important educational benefits.
Renal cell carcinoma in children and young adults: analysis of clinicopathological, immunohistochemical and molecular characteristics with an emphasis on the spectrum of Xp11.2 translocation‐associated and unusual clear cell subtypes
Authors: Wu A , Kunju L P , Cheng L , Shah R B 
Published: August 2010

Aims:  Recent studies suggest that paediatric renal cell carcinoma (RCC) may represent a distinct group of tumours; however, its biological behaviour and classification remain poorly understood. The aim was to analyse 13 RCCs from patients ≤23 years of age to determine their clinicopathological, immunohistochemical and molecular characteristics.Methods and results:  The histological spectrum included: Xp11.2 translocation‐associated (6/13 patients, 46%), clear cell (5/13 patients, 38%), papillary (1/13 patients) and unclassified (1/13 patients) types. The Xp11.2 translocation‐associated RCCs had a wide morphological spectrum, with high nuclear grade cells with abundant cytoplasm ranging from clear to granular and architecture ranging from solid to papillary. These tumours lacked cytokeratin expression and were confirmed by nuclear reactivity for TFE3 protein. Most of these translocation‐associated tumours presented at high stage and had an unfavourable outcome. Three clear cell RCCs had unusual features that have not been previously characterized, including solid and cystic architecture, cells with abundant eosinophilic cytoplasm yet low nuclear grade and focal cytoplasmic inclusions, resembling oncocytoma. Deletion of subtelomeric 3p25 was observed in two of these RCCs.Conclusions:  Xp11.2 translocation‐associated RCC represents a predominant and aggressive subtype in the paediatric age group. Increased awareness of this subtype is important due to its heterogeneous morphology.
Connected health care: the future of health care and the role of the pharmacist
Authors: Barr Paul J. , McElnay James C. , Hughes Carmel M. 
Published: August 2010

AbstractThe population of the world is ageing. As a result, the incidence of chronic disease is projected to increase, there are predicted shortages in health care workforce and budget restraints; implications for future health care provision are serious. The current model of health care is not equipped to deal with these changes. Connected health care, via the use of health informatics, disease management and home telehealth technologies, has been suggested as an approach to ease the projected strain on future health care. Evidence to date suggests a positive impact of the use of connected health care model; however, the majority of studies have overlooked the involvement of the community pharmacist. As the most common point of contact with primary health services for most of the population, the community pharmacist may be well placed to provide connected health care. The research to date is promising with improvements in outcomes for cardiovascular patients noted; however, further work is required to investigate the potential role the community pharmacist can play in the future of connected health care.
The evaluation of an undernutrition risk score to be used by nursing staff in a teaching hospital to identify surgical patients at risk of malnutrition on admission: a pilot study
Authors: Doyle M. P. , Barnes E. , Moloney M. 
Published: August 2010

Background The purpose of this study was to evaluate an undernutrition risk score (URS) developed by the Dietetic Department of an acute tertiary referral hospital in Dublin with the aim that the URS could be used by nursing staff, to identify surgical patients at risk of malnutrition on admission.Methods Forty surgical patients (16 males and 24 females) were recruited, within 5 days of admission. A standard objective nutritional assessment was carried out on each patient. This consisted of a 3‐day diet history, anthropometric indices including: weight, armspan, mid‐upper arm circumference, mid‐arm muscle circumference and hand grip dynamometry. A nutrition risk index (NRI) screening tool was also used by a single observer to categorize patients as having low, moderate or severe risk of malnutrition. The indices used for the NRI were serum albumin and percentage weight loss. The URS assessed patients with respect to changes in weight and appetite, gut function and disease status and was completed by nursing staff by interview for each of the patients recruited.Results The URS was successful in detecting 71.4% (n = 10) of surgical patients who were classified as being at some risk (moderate/severe) for undernutrition by the NRI. However, 11.8% (n = 4) of the patients who were categorized by the NRI as being at moderate risk for undernutrition were classified as being at low risk by the nursing staff using the URS. The URS was found to be most sensitive in the detection of those at low or severe risk for undernutrition and least sensitive for those at moderate risk.Conclusion The undernutrition risk score in this study provided an accurate and consequently useful screening tool that could be used for surgical patients who are capable of feeding themselves independently.
Continuing professional development for occupational therapy emergency department services
Authors: Cusick Anne , Johnson Lucinda , Bissett Michelle 
Published: August 2010

Aim:  To explore continuing professional development (CPD) resources and needs of Australian emergency department occupational therapists.Method:  Australian websites and occupational therapy newsletters were searched to identify CPD resources/opportunities. Occupational therapists with recent clinical experience in Australian emergency departments were surveyed on strengths, weaknesses, opportunities and threats to their service, research information needs, supervision/mentor arrangements and quality assurance activity.Results:  No Australian CPD opportunities were identified; 1.3% of the 2008 OT AUSTRALIA conference topics were emergency department specific. Forty‐one Australian hospitals employed a total of 51 occupational therapists of whom 30 responded. Half were supervised by occupational therapists; 20 had occupational therapy mentors; 23 perceived that they were very independent; seven did quality assurance projects; 25 had unmet research needs; 27 thought their service was effective; and service strengths, weaknesses, opportunities and threats to service could be identified by most occupational therapists.Conclusion:  Australian occupational therapists in emergency departments need specialised CPD opportunities. The information needs and strengths, weaknesses, opportunities and threats provide a CPD topic planning guide.
The seasonal and spatial variations of labile copper, iron, manganese, lead and zinc sediment fractions in Lake Naivasha, Kenya
Authors: Kamau Joseph Nyingi , Gachanja Anthony , Ngila Catherine , Kazungu Johnson Michael , Gatagwu Joel 
Published: August 2010

AbstractLake Naivasha is a freshwater lake with no surface outlet, lying within a closed basin of the Kenyan Rift Valley. It is perceived to be a lake undergoing anthropogenic stresses. This study is intended to determine the speciation of some selected heavy metals in the sediments of Lake Naivasha, as an indicator of potential pollution of the lake. Sediment and water sampling of the lake was conducted in March and May 2003, during the dry and wet seasons, respectively. Analyses of the speciation of heavy metals in sediment samples (<63 µm faction) were performed on sediment samples collected from five sites within the lake. The study results obtained indicated that influent Malewa River was not a source of labile copper (Cu), lead (Pb) or zinc, despite the river having the highest percentage clay content during the wet season (86%). Copper was highly distributed in the residual sediment fraction (average of 90%). Among the labile sediment factions, the highest quantity of Cu was in the oxidizable phase (3.58 and 2.30 µg g−1 during the dry and wet season, respectively). Carbonate‐bound Cu was sparingly distributed during both the dry and the wet seasons, ranging between 0.74 and 1.81 µg g−1. Iron was highly distributed in the oxidizable sediment phase, exhibiting concentrations ranging between 2.0 and 6.0 (×103) µg g−1. Relative to the other heavy metals, manganese was distributed in lower proportions in the residual sediment fraction. High concentrations of Pb were observed in the oxidizable phase from most of the sampling sites along the lake shore. Zinc was distributed largely in the oxidizable phase, being highest at sampling site SS, which was located near a municipal sewage input to the lake. The sediments collected at the sampling sites located in the deep portion of the lake exhibited the highest concentrations of labile heavy metals.
Benefits of pan‐sharpened Landsat imagery for mapping small waterbodies in the Powder River Basin, Wyoming, USA
Authors: Sivanpillai Ramesh , Miller Scott N. 
Published: August 2010

AbstractPan‐sharpened Landsat imagery was used to map waterbodies of a wide variety of sizes in the Powder River Basin (PRB) in northcentral Wyoming, USA. Coal bed natural gas extraction activities have been intensive in the PRB over the past decade, with abundant co‐produced water being discharged into retention ponds and small ephemeral channels. Although land management agencies are tasked with monitoring these waterbodies, traditional field survey methods might not be feasible during rapid development. Remote‐sensing applications could be used in such cases. Although Landsat and similar medium‐resolution datasets do not have detailed spatial information at fine resolutions required to map small waterbodies, they do contain rich spectral information. Panchromatic data collected by satellites have an appropriate spatial resolution, but lack detailed spectral information. Thus, image fusion techniques were used to create a pan‐sharpened image, by merging multispectral (30‐m resolution) and panchromatic (15‐m) bands from Landsat 7 imagery. Both the original and the pan‐sharpened images were used to map waterbodies and estimate their area, being compared to photo‐interpretation results. The accuracy of mapping waterbodies with pan‐sharpened imagery was significantly higher than the original Landsat data for waterbodies ranging in size from 901 to 8100 m2. Large reservoirs (>8100 m2) were very accurately mapped, both images producing identical results (96%). Neither image was able to suitably detect very small waterbodies (<900 m2). Detailed analysis within 901–3600 m2 size category revealed that the benefits of pan‐sharpened imagery were most pronounced (25% higher accuracy) for mapping waterbodies ranging in size from 1801 to 2700 m2.
Computation of changes in the run‐off regimen of the Lake Santa Ana watershed (Zacatecas, Mexico)
Authors: Gaytán Roberto , De Anda José , Nelson Jim 
Published: August 2010

AbstractThis study describes the application of a water run‐off model for Lake Santa Ana, Mexico, developed through the combined application of two simulation models: the Watershed Modelling System (WMS) and the Hydrologic Modelling System (HEC‐HMS). The WMS was used to estimate the geometric parameters of the hydrographic basin from a digital elevation model and geographical information describing the location of the hydraulic infrastructure developed in the basin in recent years. The HEC‐HMS was used to estimate the run‐off hydrographs, by using historical rainfall data and calibrating the model with the observed hydrometric data. The lake bathymetry was taken into account in order to estimate the lake's water balance. Recent observations indicate that anthropogenic activities have modified the natural run‐off features of the lake basin. The magnitude of these modifications was estimated by linking the WMS and HEC‐HMS models. Application of these linked tools allowed the successful estimation of the modified basin limits and hydraulic behaviour of Lake Santa Ana.
Short‐term functional outcome following elective surgery for complicated sigmoid diverticular disease: sutured or stapled end‐to‐end anastomosis to the proximal rectum?
Authors: Sielezneff I. , Malouf A. J. , Pirro N. , Cesari J. , Brunet C. , Sastre B. 
Published: August 2010

ObjectiveThe aim of this retrospective non‐randomized study was to evaluate the short‐term functional outcome following elective resectional surgery for complicated sigmoid diverticular disease, and to compare results of patients having hand‐sewn or stapled end‐to‐end colonic anastomosis to the proximal rectum.Patients and methodsBetween 1983 and 1995, of 182 consecutive patients referred to our Institution for surgical treatment of complicated sigmoid diverticular disease, 137 underwent elective left hemicolectomy with primary colonic anastomosis to the proximal rectum, at a level above the peritoneal reflection. Twenty‐one patients were excluded from the study because of a covering stoma (n=15), or a side‐to‐end (n=5) or side‐to‐side (n=1) anastomosis. All remaining 116 patients had an end‐to‐end anastomosis without covering stoma. Two groups were compared according to the type of anastomosis performed. Group I comprised the 67 patients who had a hand‐sewn anastomosis, and group II the 49 patients whose anastomosis was stapled. Outcome was assessed at 6 months after surgery and compared in the two groups. Assessment included specific morbidity (anastomotic leakage, haemorrhage, fistulation and stenosis, pelvic sepsis), faecal incontinence, constipation, dyschesia, daily stool frequency, and stool consistency.ResultsPreoperative patient details were comparable in both groups. There was no post‐operative mortality, and the general morbidity rate was similar in both groups (P=0.85). There was no anastomotic leakage or haemorrhage, and no fistulation or pelvic sepsis in either group. One patient in group I, and two from group II, developed flatus incontinence, and a further patient from group II developed incontinence to liquid stool (P=0.17, group I vs group II). We observed better functional outcome following hand‐sewn anastomosis. Three group II patients developed anastomotic stenosis compared with none in group I (P=0.04). Constipation (9% vs 28%, P=0.005) and dyschesia (18% vs 39%, P=0.03) were more frequent in group II. Excluding constipated patients (n=20), daily stool frequency was lower (mean 1.2 ± 0.6 vs 2 ± 1.3, P=0.0002), and more frequently of normal consistency (79% vs 43%, P=0.0001) in group I. Subgroup analysis failed to show significant differences in functional outcome in both groups in relation to the specific indications for surgery.ConclusionThese retrospective data suggest for the first time in the reported literature that hand‐sewn colonic anastomosis to the proximal rectum provides a better short‐term functional outcome than stapled anastomosis following elective resectional surgery for complicated sigmoid diverticulosis.
Audit of anal‐sphincter repair
Authors: Morren G. L. , Hallböök O. , Nyström P.‐O. , Baeten C. G. M. I. , Sjödahl R. 
Published: August 2010

ObjectiveStructural damage of the anterior part of the anal sphincter is a major cause of faecal incontinence. Sphincter repair is the standard surgical treatment. This study was designed to analyse the results of anal sphincter repair, to identify possible predictors of outcome and to investigate the presence of bowel symptoms other than leakage at follow up.Patients and methodsFifty‐five women (median age 39 years, range 24–73 years) who underwent anal sphincter repair between 1986 and 1997 at the University Hospital of Linköping answered a postal questionnaire. Current bowel function, degree of continence and the patients’ functional result as worse, unchanged, some improvement, good or excellent were assessed. Good or excellent function was regarded as a successful result, the rest as failure. Age, duration of symptoms, type of surgery, morbidity and length of follow up were analysed in relation to outcome. Results of pre‐ and post‐operative anal manometry, endoanal ultrasound, anal sphincter electromyography and pudendal nerve function were also analysed.ResultsAfter a median (range) follow‐up period of 40 months (5–137) months, 31 (56%) patients rated the result as either excellent (n=10) or good (n=21). Twenty‐one (38%) patients rated the result as some improvement (n=14), unchanged (n=6) or worse (n=1). In three (5%) patients a colostomy was fashioned because of failure. Patients >50 years at surgery (n=18) had a worse outcome (P=0.001). Successful outcome was correlated to increased squeeze pressures post‐operatively. The presence of post‐operative urgency (P=0.01) and loose stools (P=0.02) was more common in patients with poor outcome. Eight patients became continent to formed and liquid stool.
Predictors of disease‐free survival in rectal cancer patients undergoing curative proctectomy
Authors: Stewart D. , Yan Y. , Mutch M. , Kodner I. , Hunt S. , Lowney J. , Birnbaum E. , Read T. , Fleshman J. , Dietz D. 
Published: August 2010

AbstractObjective  To identify the factors that affect the disease‐free survival (DFS) of rectal cancer patients.Method  Patients from an IRB approved rectal cancer database were reviewed (1990–2000). All patients underwent either abdominoperineal resection or low anterior resection using total mesorectal excision with curative intent. Univariate and multivariate analyses were performed to analyse the factors that influenced DFS.Results  A total of 304 patients were reviewed (mean age 64, 52% male). Seventy‐seven per cent of patients received neoadjuvant therapy (28.6% short‐course radiation therapy (RT), 35.5% long‐course RT, 12.5% chemo‐RT). The radial margin was involved with tumour in 5.2% of patients (final pathology). The overall survival rate was 85.2% with a mean follow‐up time of 33 ± 26 months. The mean time to death was 34.8 ± 26.8 months. Local recurrence (± distant recurrence) occurred in 4%. Anastomotic leaks occurred in 3.6% of patients. Overall pathologic stage, pathologic T stage, nodal status, the use of adjuvant chemotherapy, tumour fixation, involvement of the radial margin, the presence of mucin, and lymphatic and perineural invasion (PNI) were predictors of DFS by univariate analysis. Of note, anastomotic leaks and obstructing cancers did not influence DFS. Using multivariate analysis with backward elimination, overall pathologic stage, radial margin status, adjuvant chemotherapy, and PNI predicted the DFS.Conclusion  Major predictors of DFS in rectal cancer are the overall pathologic stage, adjuvant chemotherapy, radial margin status and PNI. Radial margin status may be a marker of tumour aggressiveness and should be considered in deciding on adjuvant chemotherapy.
Linkage disequilibrium in maps of SNPs and other markers
Authors: Collins Andrew 
Published: August 2010

AbstractOne strategy for detection of disease genes is to exploit linkage disequilibrium in the hope that in candidate regions there will be detectable association between disease and marker alleles. Maps of single nucleotide polymorphisms (SNPs) will be used for this purpose but a recent simulation suggests that a useful level of linkage disequilibrium is unlikely to extend beyond an average distance of 3 Kb in the general population. This implies that very high marker densities will be required to detect disease: SNP associations. The evidence from published data comprising 877 SNP pairs is presented. For comparison, associations between other pairs of markers, principally microsatellites, are examined in a large sample of haplotypes from the fragile X (FRAX) region in Xq27–28.Association ρ is estimated from haplotype frequencies and the decline in linkage disequilibrium with distance is described using the model originally described by Malecot. The evidence from SNP pairs suggest that linkage disequilibrium extends to at least 263 Kb in random haplotypes, but with a considerable amount of variation particularly at small distances. For microsatellites in the FRAX region disequilibrium extends to at least 435 Kb. This suggests that a genome scan with markers spaced every 100 Kb would be powerful (30 000 markers per genome). Higher densities might be required in some genomic regions and presumably will be required to determine causal SNPs.