bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns of Adjuvant Chemotherapy Use in a Population-Based Cohort of Patients With Resected Stage II or III Colon Cancer
Authors: Abrams Thomas A. , Brightly Rick , Mao Jianbin , Kirkner Gregory , Meyerhardt Jeffrey A. , Schrag Deborah , Fuchs Charles S. 
Published: July 2011

Purpose Previous studies have examined predictors for initiation of adjuvant chemotherapy in stages II and III colon cancer. However, little is known regarding the use of specific chemotherapy regimens or treatment duration. Patients and Methods We studied treatment records for 2,560 patients with stage II or III colon cancer who received adjuvant chemotherapy between January 2004 and April 2010 at US cancer care facilities participating in a nationwide, commercially available chemotherapy order entry system that captures patient demographics, stage, and details of chemotherapy treatment. Multivariate analyses of prospectively recorded patient and provider characteristics identified predictors of specific therapeutic approaches. Results The addition of oxaliplatin to fluoropyrimidine-based adjuvant therapy increased during the study period (P trend < .001), and this combination represented 78% and 90% of adjuvant chemotherapy in stage II or III disease, respectively, by 2007. Older patients, those with diminished performance status, and those treated in a private practice setting were significantly less likely to receive oxaliplatin. Thirty percent of patients discontinued adjuvant therapy after less than 3 months. Older age, oxaliplatin-containing therapy, and receipt of treatment from a physician with a low volume of patients were each independently associated with premature discontinuation. Six percent of patients received bevacizumab as part of their adjuvant regimen. Conclusion After 2004, oxaliplatin and fluoropyrimidine-based therapy rapidly became the predominant adjuvant treatment for both stage II and stage III colon cancer in this large US cohort. Both increasing patient age and lower volume of an oncologist's practice were associated with early termination of adjuvant therapy.
The National and the International in Public Health: Carlos Chagas and the Rockefeller Foundation in Brazil, 1917 – 1930s
Authors: Stepan Nancy Leys 
Published: July 2011

Abstract
This article examines the relationship between the Rockefeller Foundation (RF) and Brazil in the era of Dr. Carlos Chagas, from the RF’s first visit to Brazil in 1916 to the late 1920s. Chagas’s discovery in 1909 of a hitherto unknown human disease (American trypanosomiasis) made him arguably the best-known medical scientist in the country. As the federal director of public health and the director as well of the Oswaldo Cruz Institute, he appeared to be well positioned to collaborate fruitfully with RF initiatives in public health and medical education. Yet in many respects the relationship was not what was hoped for. Using RF and Brazilian sources, the article examines the political, medical, and other divisions in Brazil that complicated and to a certain extent frustrated Brazil’s relationship with the RF; only in the 1930s, under different political circumstances, did the relationship flourish. The article emphasizes the national dimensions in the success or otherwise of the RF’s agenda in international health.
Footprints on the Future: Looking Forward to the History of Health and Medicine in Latin America in the Twenty-First Century
Authors: Birn Anne-Emanuelle , López Raúl Necochea 
Published: July 2011

Abstract
This essay analyzes the current state of the field of history of health and medicine in Latin America and proposes questions and areas for further investigation. Using a variety of databases to identify relevant historiographical sources from across the Americas, the authors focus on a range of subjects that have substantially engaged contemporary historians while opening up still more research avenues. These include the health of diverse populations; new perspectives on religion and on women’s health; the historicizing of health systems, health politics, and social medicine; and the local-global nexus in Latin American health and medicine. These themes both draw from and extend beyond those addressed in pathbreaking works such as Nancy Leys Stepan’s Beginnings of Brazilian Science. Among the most stimulating developments of recent years are the incorporation of interdisciplinary perspectives on historical analysis, and the elucidation of regional patterns of and preoccupations with the interrelations among state, society, and medicine. The proliferation of historical knowledge regarding the health and medical landscape of Latin America has made this one of the most dynamic fields in historical scholarship today. The authors conclude by discussing emerging methodological and theoretical challenges, including Cold War studies and postcolonialism, and by reflecting on the shared scholarly and political responsibilities of Latin Americanists.
Beginnings of Cuban Bacteriology: Juan Santos Fernández, Medical Research, and the Search for Scientific Sovereignty, 1880 – 1920
Authors: Palmer Steven 
Published: July 2011

Abstract
The paper reassesses the model of scientific success on the periphery advanced in Nancy Leys Stepan’s analysis of the Oswaldo Cruz Institute in Beginnings of Brazilian Science by looking at a comparable, though ultimately less successful, bacteriological research facility in Havana Cuba in the late nineteenth and early twentieth centuries. The Instituto Histobacteriológico y de Vacunación Antirrábica de la Crónica Médico-Quirúrgica de la Habana was a private initiative sustained by wealthy Cuban ophthalmologist Juan Santos Fernández y Hernández. At the center of attempts to establish a creole scientific sovereignty during the late Spanish Empire, the institute brought together a dynamic research team and collaborated with leading international figures in microbiology. The second Cuban War of Independence interrupted the institute’s research momentum and the US occupation government created a new state laboratory facility, displacing the Instituto from its position at the apex of scientific life in the new republic and leading to its demise. No comparable facility capable of undertaking original medical research took its place. The roles of timing and political process are emphasized as key variables in achieving scientific success on the periphery.
Spondylodiscitis in children
Authors: Chandrasenan J. , Klezl Z. , Bommireddy R. , Calthorpe D. 
Published: July 2011

We retrospectively reviewed the records of 16 children treated for spondylodiscitis at our hospital between 2000 and 2007. The mean follow-up was 24 months (12 to 38). There was a mean delay in diagnosis in hospital of 25 days in the ten children aged less than 24 months. At presentation only five of the 16 children presented with localising signs and symptoms. Common presenting symptoms were a refusal to walk or sit in nine children, unexplained fever in six, irritability in five, and limping in four. Plain radiography showed changes in only seven children. The ESR was the most useful investigation when following the clinical course of the disease. Positive blood cultures were obtained in seven children with Staphylococcus aureus being isolated in five. Antibiotics were used in 14 children and spinal bracing in six. Children with spondylodiscitis often present with a confusing clinical picture leading to late diagnosis.The early use of MRI in the investigation of children with an atypical picture may avoid unnecessary delay in starting treatment and possibly prevent long-term problems. All except one of our children had made a complete clinical recovery at final follow-up. However, all six children in the > 24-month age group showed radiological evidence of degenerative changes which might cause problems in the future.
Intercalary diaphyseal endoprosthetic reconstruction for malignant tibial bone tumours
Authors: Sewell M. D. , Hanna S. A. , McGrath A. , Aston W. J. S. , Blunn G. W. , Pollock R. C. , Skinner J. A. , Cannon S. R. , Briggs T. W. R. 
Published: July 2011

The best method of reconstruction after resection of malignant tumours of the tibial diaphysis is unknown. In the absence of any long-term studies analysing the results of intercalary endoprosthetic replacement, we present a retrospective review of 18 patients who underwent limb salvage using a tibial diaphyseal endoprosthetic replacement following excision of a malignant bone tumour. There were ten men and eight women with a mean age of 42.5 years (16 to 76). Mean follow-up was 58.5 months (20 to 141) for all patients and 69.3 months (20 to 141) for the 12 patients still alive. Cumulative patient survival was 59% (95% confidence interval (CI) 32 to 84) at five years. Implant survival was 63% (95% CI 35 to 90) at ten years. Four patients required revision to a proximal tibial replacement at a mean follow-up of 29 months (10 to 54). Complications included metastases in five patients, aseptic loosening in four, peri-prosthetic fracture in two, infection in one and local recurrence in one. The mean Musculoskeletal Tumor Society score and the mean Toronto Extremity Salvage Score were 23 (17 to 28) and 74% (53 to 91), respectively. Although rates of complication and revision were high, custom-made tibial diaphyseal replacement following resection of malignant bone tumours enables early return to function and provides an attractive alternative to other surgical options, without apparent compromise of patient survival.
Cost-effectiveness of universal ultrasound screening compared with clinical examination alone in the diagnosis and treatment of neonatal hip dysplasia in Austria
Authors: Thaler M. , Biedermann R. , Lair J. , Krismer M. , Landauer F. 
Published: July 2011

Between 1978 and 1997 all newborns in the Austrian province of Tyrol were reviewed regarding hip dysplasia and related surgery. This involved a mean of 8257 births per year (7766 to 8858). Two observation periods were determined: 1978 to 1982 (clinical examination alone) and 1993 to 1997 (clinical examination and universal ultrasound screening). A retrospective analysis compared the number and cost of interventions due to hip dysplasia in three patient age groups: A, 0 to < 1.5 years; B, ≥ 1.5 to < 15 years; and C, ≥ 15 to < 35 years. In group A, there was a decrease in hip reductions from a mean of 25.2 (sd 2.8) to 7.0 (sd 1.4) cases per year. In group B, operative procedures decreased from a mean of 17.8 (sd 3.5) to 2.6 (sd 1.3) per year. There was a 75.9% decrease in the total number of interventions for groups A and B. An increase of €57 000 in the overall cost per year for the second period (1993 to 1997) was seen, mainly due to the screening programme. However, there was a marked reduction in costs of all surgical and non-surgical treatments for dysplastic hips from €410 000 (1978 to 1982) to €117 000 (1993 to 1997). We believe the small proportional increase in costs of the universal ultrasound screening programme is justifiable as it was associated with a reduction in the number of non-surgical and surgical interventions. We therefore recommend universal hip ultrasound screening for neonates.
Preliminary results after reconstruction of bony defects of the proximal humerus with an allograft-resurfacing composite
Authors: Ruggieri P. , Mavrogenis A. F. , Guerra G. , Mercuri M. 
Published: July 2011

We retrospectively studied 14 patients with proximal and diaphyseal tumours and disappearing bone (Gorham’s) disease of the humerus treated with wide resection and reconstruction using an allograft-resurfacing composite (ARC). There were ten women and four men, with a mean age of 35 years (8 to 69). At a mean follow-up of 25 months (10 to 89), two patients had a fracture of the allograft. In one of these it was revised with a similar ARC and in the other with an intercalary prosthesis. A further patient had an infection and a fracture of the allograft that was revised with a megaprosthesis. In all patients with an ARC, healing of the ARC-host bone interface was observed. One patient had failure of the locking mechanism of the total elbow replacement. The mean post-operative Musculoskeletal Tumor Society score for the upper extremity was 77% (46.7% to 86.7%), which represents good and excellent results; one patient had a poor result (46.7%). In the short term ARC effectively relieves pain and restores shoulder function in patients with wide resection of the proximal humerus. Fracture and infection remain significant complications.
Accelerating failure rate of the ASR total hip replacement
Authors: Langton D. J. , Jameson S. S. , Joyce T. J. , Gandhi J. N. , Sidaginamale R. , Mereddy P. , Lord J. , Nargol A. V. F. 
Published: July 2011

There is widespread concern regarding the incidence of adverse soft-tissue reactions after metal-on-metal (MoM) hip replacement. Recent National Joint Registry data have shown clear differences in the rates of failure of different designs of hip resurfacing. Our aim was to update the failure rates related to metal debris for the Articular Surface Replacement (ASR). A total of 505 of these were implanted. Kaplan-Meier analysis showed a failure rate of 25% at six years for the ASR resurfacing and of 48.8% for the ASR total hip replacement (THR). Of 257 patients with a minimum follow-up of two years, 67 (26.1%) had a serum cobalt concentration which was greater than 7 μg/l. Co-ordinate measuring machine analysis of revised components showed that all patients suffering adverse tissue reactions in the resurfacing group had abnormal wear of the bearing surfaces. Six THR patients had relatively low rates of articular wear, but were found to have considerable damage at the trunion-taper interface. Our results suggest that wear at the modular junction is an important factor in the development of adverse tissue reactions after implantation of a large-diameter MoM THR.
Does chronic medial collateral ligament laxity influence the outcome of anterior cruciate ligament reconstruction?
Authors: Zaffagnini S. , Bonanzinga T. , Muccioli G. M. Marcheggiani , Giordano G. , Bruni D. , Bignozzi S. , Lopomo N. , Marcacci M. 
Published: July 2011

We have shown in a previous study that patients with combined lesions of the anterior cruciate (ACL) and medial collateral ligaments (MCL) had similar anteroposterior (AP) but greater valgus laxity at 30° after reconstruction of the ACL when compared with patients who had undergone reconstruction of an isolated ACL injury. The present study investigated the same cohort of patients after a minimum of three years to evaluate whether the residual valgus laxity led to a poorer clinical outcome. Each patient had undergone an arthroscopic double-bundle ACL reconstruction using a semitendinosus-gracilis graft. In the combined ACL/MCL injury group, the grade II medial collateral ligament injury was not treated. At follow-up, AP laxity was measured using a KT-2000 arthrometer, while valgus laxity was evaluated with Telos valgus stress radiographs and compared with the uninjured knee. We evaluated clinical outcome scores, muscle girth and time to return to activities for the two groups. Valgus stress radiographs showed statistically significant greater mean medial joint opening in the reconstructed compared with the uninjured knees (1.7 mm (sd 0.9) versus 0.9 mm (sd 0.7), respectively, p = 0.013), while no statistically significant difference was found between the AP laxity and the other clinical parameters. Our results show that the residual valgus laxity does not affect AP laxity significantly at a minimum follow up of three years, suggesting that no additional surgical procedure is needed for the medial collateral ligament in combined lesions.
Bizarre parosteal osteochondromatous proliferation of bone
Authors: Berber O. , Dawson-Bowling S. , Jalgaonkar A. , Miles J. , Pollock R. C. , Skinner J. A. , Aston W. J. S. , Briggs T. W. R. 
Published: July 2011

We describe 22 cases of bizarre parosteal osteochondromatous proliferation, or Nora’s lesion. These are surface-based osteocartilaginous lesions typically affecting the hands and feet. All patients were identified from the records of a regional bone tumour unit and were treated between 1985 and 2009. Nine lesions involved the metacarpals, seven the metatarsals, one originated from a sesamoid bone of the foot and five from long bones (radius, ulna, tibia, and femur in two). The mean age of the patients was 31.8 years (6 to 66), with 14 men and eight women. Diagnosis was based on the radiological and histological features. The initial surgical treatment was excision in 21 cases and amputation of a toe in one. The mean follow-up was for 32 months (12 to 162). Recurrence occurred in six patients (27.3%), with a mean time to recurrence of 49 months (10 to 120). Two of the eight patients with complete resection margins developed a recurrence (25.0%), compared with four of 14 with a marginal or incomplete resection (28.6%). Given the potential surgical morbidity inherent in resection, our data suggest that there may be a role for a relatively tissue-conserving approach to the excision of these lesions.
Early to mid-term results of ceramic-on-ceramic total hip replacement
Authors: Stafford G. H. , Islam S. Ul , Witt J. D. 
Published: July 2011

Ceramic-on-ceramic bearings in hip replacement have low rates of wear and are increasingly being used in young adults. Our aim was to determine the incidence of audible phenomena or other bearing-related complications. We retrospectively analysed 250 ceramic-on-ceramic hip replacements in 224 patients which had been implanted between April 2000 and December 2007. The mean age of the patients at operation was 44 years (14 to 83) and all the operations were performed using the same surgical technique at a single centre. At a mean follow-up of 59 months (24 to 94), the mean Oxford hip score was 40.89 (11 to 48). There were six revisions, three of which were for impingement-related complications. No patient reported squeaking, but six described grinding or clicking, which was usually associated with deep flexion. No radiological evidence of osteolysis or migration of the components was observed in any hip. The early to mid-term results of contemporary ceramic-on-ceramic hip replacement show promising results with few concerns in terms of noise and squeaking. Positioning of the acetabular component remains critical in regard to the reduction of other impingement-related complications.
A randomised, controlled trial of circumpatellar electrocautery in total knee replacement without patellar resurfacing
Authors: van Jonbergen H. P. W. , Scholtes V. A. B. , van Kampen A. , Poolman R. W. 
Published: July 2011

The efficacy of circumpatellar electrocautery in reducing the incidence of post-operative anterior knee pain is unknown. We conducted a single-centre, outcome-assessor and patient-blinded, parallel-group, randomised, controlled trial to compare circumpatellar electrocautery with no electrocautery in total knee replacement in the absence of patellar resurfacing. Patients requiring knee replacement for primary osteoarthritis were randomly assigned circumpatellar electrocautery (intervention group) or no electrocautery (control group). The primary outcome measure was the incidence of anterior knee pain. A secondary measure was the standardised clinical and patient-reported outcomes determined by the American Knee Society scores and the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index. A total of 131 knees received circumpatellar electrocautery and 131 had no electrocautery. The overall incidence of anterior knee pain at follow-up at one year was 26% (20% to 31%), with 19% (12% to 26%) in the intervention group and 32% (24% to 40%) in the control group (p = 0.02). The relative risk reduction from electrocautery was 40% (9% to 61%) and the number needed to treat was 7.7 (4.3 to 41.4). The intervention group had a better mean total WOMAC score at follow-up at one year compared with the control group (16.3 (0 to 77.7) versus 21.6 (0 to 76.7), p = 0.04). The mean post-operative American Knee Society knee scores and function scores were similar in the intervention and control groups (knee score: 92.4 (55 to 100) versus 90.4 (51 to 100), respectively (p = 0.14); function score: 86.5 (15 to 100) versus 84.5 (30 to 100), respectively (p = 0.49)). Our study suggests that in the absence of patellar resurfacing electrocautery around the margin of the patella improves the outcome of total knee replacement.
Inflammation related to synovectomy during total knee replacement in patients with primary osteoarthritis
Authors: Tanavalee A. , Honsawek S. , Rojpornpradit T. , Sakdinakiattikoon M. , Ngarmukos S. 
Published: July 2011

We compared inflammation in the knee after total knee replacement (TKR) for primary osteoarthritis between two groups of patients undergoing joint replacement with and without synovectomy. A total of 67 patients who underwent unilateral TKR were randomly divided into group I, TKR without synovectomy, and group II, TKR with synovectomy. Clinical outcomes, serial serum inflammatory markers (including interleukin-6 (IL-6), CRP and ESR) and the difference in temperature of the skin of the knee, compared with the contralateral side, were sequentially evaluated until 26 weeks after surgery. Pre-operatively, there were no statistically different clinical parameters between groups I and II. At the 26-week follow-up, both groups had a similarly significantly improved American Knee Society clinical score (p < 0.001) and functional score (p < 0.001) with no differences between the groups. Similar changes in serial inflammatory markers were found in both groups, including mean peak levels of IL-6 (189 pg/ml (sd 53.4) versus 201 pg/ml (sd 49.4) for groups I and II, respectively) and CRP (91 mg/L (sd 24.1) versus 88 mg/L (sd 23.4), respectively) on the first post-operative day, returning to pre-operative values at two and six weeks, respectively. The mean peak level of ESR for the respective two groups was 46 mm/hr versus 48 mm/hr at two weeks, which had still not returned to its pre-operative mean value at 26 weeks. The elevation in the skin temperature appeared to mirror the peak elevation of the ESR, with a range of 2.5° C to 4.5° C with some reduction at 26 weeks but still exceeding the pre-operative value. We concluded that synovectomy at the time of TKR does not provide any benefit to the clinical outcome or shorten the duration of the inflammatory response after surgery.
The treatment of refractory atlanto-axial rotatory fixation using a halo vest
Authors: Tauchi R. , Imagama S. , Kanemura T. , Yoshihara H. , Sato K. , Deguchi M. , Kamiya M. , Ishiguro N. 
Published: July 2011

We reviewed seven children with torticollis due to refractory atlanto-axial rotatory fixation who were treated in a halo vest. Pre-operative three-dimensional CT and sagittal CT imaging showed deformity of the superior articular process of C2 in all patients. The mean duration of halo vest treatment was 67 days (46 to 91). The mean follow-up was 34 months (8 to 73); at the latest review six patients demonstrated remodelling of the deformed articular process. The other child, who had a more severe deformity, required C1-2 fusion. We suggest that patients with atlanto-axial rotatory fixation who do not respond to conservative treatment and who have deformity of the superior articular process of C2 should undergo manipulative reduction and halo-vest fixation for two to three months to induce remodelling of the deformed superior articular process before C1-2 fusion is considered.