bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dispersal by ants inCentaurea corymbosa(Asteraceae): What is the elaiosome for?
Authors: IMBERT ERIC 
Published: June 2006

AbstractThis paper reports on different observations and experiments examining the role of ants in the seed dispersal of the rare and endemic speciesCentaurea corymbosa. Direct observations of seed manipulation by ants in natural populations showed that dispersal distances are very limited, and many ants did not disperse seeds at all. Cafeteria experiments failed to demonstrate: (i) that the elaiosome represents the attractive part of the achene; and (ii) that seeds ofEuphorbia characias,a common species occurring in the same habitat, are more attractive than achenes ofC. corymbosadespite a 10‐fold difference in elaiosome size. However, ants show a foraging behavior to collect seeds ofC. corymbosabecause seed removal is greater at the foot of a fruiting plant than further away. Experiments in controlled conditions were also carried out to investigate the secondary benefits of seed manipulation by ants. Two independent experiments showed that, in contrast to many other myrmecochorous species, elaiosome removal decreases germination rate. Finally, the effects of burial at low depth (2 cm) on seed emergence are limited; however, as ants rarely move seeds to their nest, this secondary benefit of myrmecochory is unlikely. Therefore, it can be concluded that the functional role of an elaiosome in this species is not evident. However, ants clearly contribute to seed dispersal inC. corymbosa.
ADHERENCE TO GUIDELINES FOR PREVENTION OF POSTSPLENECTOMY SEPSIS. AGE AND SEX ARE RISK FACTORS: A FIVE‐YEAR RETROSPECTIVE REVIEW
Authors: Kotsanas Despina , Al‐Souffi Mohammed H. , Waxman Bruce P. , King Richard W. F. , Polkinghorne Kevan R. , Woolley Ian J. 
Published: June 2006

Background:  Vaccination, education and use of long‐term antibiotics are recommended in expert guidelines for the prevention of infectious complications after splenectomy. However, studies outside Australia have shown poor adherence to the guidelines. The aim of this study was to determine overall adherence to the guidelines and to ascertain any independent risk factors for poor compliance with the guidelines.Method:  A retrospective review of hospital records between 1999 and 2004 was carried out.Results:  Indications for splenectomy of the 111 patients in this review included post‐trauma (32), haematological (32), cancer surgery (24), iatrogenic (12) and others (11). On multivariable analysis, age was associated with a 28% less likelihood to receive education (odds ratio (OR) 0.72; 95% confidence interval (CI) 0.56–0.92; P = 0.009) and 36% less likelihood to receive long‐term antibiotics (OR 0.64; 95% CI 0.52–0.80; P ≤ 0.001). Women were four times more likely to receive education (OR 4.03; 95% CI 1.16–14.0; P = 0.028) and patients who had undergone splenectomy in 2004 were 22 times more likely to have received education compared with those in 1999 (OR 22.53; 95% CI 3.12–162.34; P = 0.002).Conclusions:  Education for prevention of sepsis after splenectomy is poorly documented and may be incomplete. Older age and male sex are risk factors in non‐adherence to guidelines for prevention of postsplenectomy sepsis. Strategies such as alert cards and information brochures may improve adherence to guidelines particularly in older patients.
DIAPHRAGMATIC HERNIAS COMPLICATING PREGNANCY
Authors: Eglinton Timothy W. , Coulter Grant N. , Bagshaw Philip F. , Cross Lauren A. 
Published: June 2006

Background:  Diaphragmatic hernias complicating pregnancy are not a common problem but they can have catastrophic consequences. They can present to the surgeon as a life‐threatening emergency or pose a management dilemma when detected incidentally. In this paper, recommendations for the management of non‐hiatal maternal diaphragmatic hernias are made based on our experience and the available published reports.Methods:  The presentation, management and outcomes of a series of three recent cases are described. A review of all other reported cases of diaphragmatic hernias complicating pregnancy was also carried out.Results:  All three cases were emergency presentations in the third trimester of pregnancy, resulting from compression of thoracic contents. All cases required emergency laparotomy and one also required thoracotomy. Delivery was by Caesarean section at the time of emergency surgery in two cases and was delayed in the third case. There was one fetal and no maternal deaths. One mother suffered persistent pleural infection. One baby also had a diaphragmatic hernia requiring postnatal repair. Published reports showed only 36 previously reported cases of diaphragmatic hernias identified in pregnancy. There is a consensus that hernias presenting with evidence of strangulation represent a surgical emergency and mandate operative management, irrespective of fetal maturity. Elective management of asymptomatic hernias is more controversial and both conservative and operative approaches have been suggested.Conclusion:  Diaphragmatic hernias can cause life‐threatening complications in pregnancy. Consideration should be given to operative repair in the second trimester if asymptomatic hernias are identified during pregnancy. If vaginal delivery is attempted in the presence of a hernia, this should only be carried out under closely monitored conditions.
PANCREATICODUODENECTOMY: DOES PREOPERATIVE BILIARY DRAINAGE, METHOD OF PANCREATIC RECONSTRUCTION OR AGE INFLUENCE PERIOPERATIVE OUTCOME? A RETROSPECTIVE STUDY OF 104 CONSECUTIVE CASES
Authors: Barnett Stephen A. , Collier Neil A. 
Published: June 2006

Background:  Whether preoperative biliary drainage (PBD) is beneficial in reducing complications after pancreaticoduodenectomy is controversial. There remains a reluctance to consider pancreaticoduodenectomy in older patients. The major source of morbidity and potential mortality after pancreaticoduodenectomy is pancreatic fistula, which is caused by difficulties associated with the pancreatic anastomosis. The purpose of this study was to examine the effect of PBD, patient age and method of pancreatico‐enteric reconstruction on postoperative morbidity and mortality.Methods:  A total of 104 consecutive patients undergoing pancreaticoduodenectomy between November 1992 and November 2004 were identified from a prospectively collected database. Multiple preoperative and intraoperative variables were examined and their relationship to postoperative outcome was analysed.Results:  Postoperative mortality was <1%. Forty‐three patients (43%) suffered a total of 85 complications. Median length of stay was 12.5 days (range, 1–88 days). The group undergoing PBD did not have higher rates of infectious complication (12 vs 19%; P = 0.34) or overall complication (41 vs 42%; P = 0.88) compared with the undrained group. Rate of anastomotic leak (18 vs 4%; P = 0.045) and anaemia requiring transfusion (41 vs 9%; P = 0.001) were significantly higher in the pancreaticojejunostomy group compared with the pancreaticogastrostomy group. Patients over the age of 70 years did not have higher rates of complication (44 vs 41%, P = 0.5) or postoperative length of stay.Conclusion:  Preoperative biliary drainage was not associated with increased postoperative complications. Pancreaticogastrostomy after pancreaticoduodenectomy is a safe and reliable method of reconstruction. Finally, pancreaticoduodenectomy can be carried out with acceptable rates of postoperative morbidity and mortality in selected patients over 70 years of age.
METASTECTOMY FOR NON‐COLORECTAL, NON‐NEUROENDOCRINE LIVER SECONDARIES
Authors: Teo Melissa C. , Tan Yu‐Meng , Chung Alex Y. , Chow Pierce K. , Cheow Peng C. , Soo Khee‐Chee C. , Hee Siew W. , Ooi London L. 
Published: June 2006

Background:  The role of metastectomy for colorectal and neuroendocrine liver secondaries is well established. Significant palliation and survival have been reported after aggressive surgical resection. However, the role of liver resection for secondaries from other primary tumours is less well defined. In this study, we aim to describe our experience, including indications and selection criteria, operative strategy and clinical outcome of liver resection, for non‐colorectal, non‐neuroendocrine liver metastases.Methods:  A review of prospectively collected operative database was conducted and patients who underwent liver resection of secondaries from non‐colorectal, non‐neuroendocrine primary tumours were studied. Eighteen patients were included in the study. There were 4 men and 14 women with a median age of 48 years (range, 37–78 years). Liver resection was carried out either for cure or for palliation of debilitating symptoms. Selection criteria included: (i) absence of extrahepatic disease and (ii) functional status of the liver and volume of remnant liver after hepatectomy. The median follow up was 24 months (range, 7–81 months) for 17 patients, excluding the one who defaulted after surgery. Cancer‐specific survival and recurrence‐free interval was calculated from the date of hepatectomy.Results:  Liver resection was considered curative in 13 patients. There was no 30‐day mortality in this cohort of patients. The median recurrence‐free survival time was 13 months (95% confidence interval (CI), 8–18 months). The median follow‐up time for the 12 patients was 23.5 months (range, 7–35 months). Only five patients died due to cancer‐specific causes and one died from acute myocardial infarction. The median cancer‐specific survival time was 30 months (95% CI, 25–35 months). The 2‐year survival rate was 77.1% (95% CI, 48.9–100%).Conclusion:  The results are encouraging and suggest that with appropriate selection criteria, there is a role for metastectomy of non‐colorectal, non‐neuroendocrine liver secondaries.
NEW ERA: PROPHYLACTIC SURGERY FOR PATIENTS WITH MULTIPLE ENDOCRINE NEOPLASIA‐2A
Authors: Gosnell Jessica E. , Sywak Mark S. , Sidhu Stan B. , Gough Ian R. , Learoyd Diana L. , Robinson Bruce G. , Delbridge Leigh W. 
Published: June 2006

Background:  The surgical management of patients with multiple endocrine neoplasia‐2A (MEN‐2A) continues to evolve with specific genotype–phenotype correlations allowing for a more tailored approach. In this study, we report the surgical management of one of the largest MEN‐2A families with a rearranged during transfection (RET) codon 804 mutation.Method:  This is a cohort study comprising all at‐risk kindred within a single known MEN‐2A family. Prophylactic total thyroidectomy with lymph node dissection was recommended to all mutation carriers aged 5 years and older.Results:  There were a total of 48 at‐risk individuals in the MEN‐2A kindred, with 22 patients undergoing thyroidectomy after appropriate preoperative evaluation. A total of 9 patients had medullary thyroid cancer including 5 with a normal preoperative calcitonin level. A total of 11 patients had C‐cell hyperplasia and 7 showed histological evidence of parathyroid disease. Only the index case had a phaeochromocytoma.Conclusion:  Genetic testing for germline mutations in the RET proto‐oncogene has allowed precise identification of affected RET carriers and provided the opportunity for prophylactic or ‘preclinical’ surgery to treat and in fact to prevent medullary thyroid cancer. This concept of prophylactic surgery based on a genetic test is likely to be applied more widely as the tools of molecular biology advance.
OUTCOMES OF PATIENTS WITH ORTHOPAEDIC TRAUMA ADMITTED TO LEVEL 1 TRAUMA CENTRES
Authors: Urquhart Donna M , Williamson Owen D , Gabbe Belinda J , Cicuttini Flavia M , Cameron Peter A , Richardson Martin D , Edwards Elton R ,   on Behalf of the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) Project Group
Published: June 2006

Background:  Although orthopaedic trauma results in significant disability and substantial financial cost, there is a paucity of large cohort studies that collectively describe the functional outcomes of a variety of these injuries. The current study aimed to investigate the outcomes of patients admitted with a range of orthopaedic injuries to adult Level 1 trauma centres.Methods:  Patients were recruited from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR), which included all patients with orthopaedic trauma admitted to the two adult Level 1 trauma centres in Victoria (Australia). Patients were categorised into three groups; isolated orthopaedic injuries, multiple orthopaedic injuries and orthopaedic and other injuries. Demographic and injury data were collected from the medical record and hospital/trauma databases, and functional outcome instruments were given at 6 months post‐injury.Results:  Of the 1303 patients recruited for VOTOR over a 12‐month period, 1181 patients were eligible for the study and a response rate of 75.6% was obtained at 6 months post‐injury. Patients reported ongoing pain (moderate‐severe: 37.2%), disability (79.5%) and inability to return to work (35.2%). Poorer outcomes were evident in patients with orthopaedic and other injuries than those with single or multiple orthopaedic injuries alone.Conclusion:  A large percentage of patients have ongoing pain and disability and a reduced capacity to return to work 6 months after orthopaedic trauma. Further research into the long‐term outcomes of patients with orthopaedic injuries is required to identify patient subgroups and specific injuries and procedures that result in high morbidity.
NO REST FOR THE WOUNDED: EARLY AMBULATION AFTER HIP SURGERY ACCELERATES RECOVERY
Authors: Oldmeadow Leonie B. , Edwards Elton R , Kimmel Lara A , Kipen Eva , Robertson Val J. , Bailey Michael J 
Published: June 2006

Background: Level 3 evidence‐based guidelines recommend first walk after hip fracture surgery within 48 h. Early mobilization is resource and effort intensive and needs rigorous investigation to justify implementation. This study uses a prospective randomized method to investigate the effect of early ambulation (EA) after hip fracture surgery on patient and hospital outcomes.Methods: Sixty patients (41 women and 19 men; mean age 79.4 years) admitted between March 2004 through December 2004 to The Alfred Hospital, Melbourne, for surgical management of a hip fracture were studied. Randomization was either EA (first walk postoperative day 1 or 2) or delayed ambulation (DA) (first walk postoperative day 3 or 4). Functional levels on day 7 post‐surgery, acute hospital length of stay and destination at discharge were compared.Results: At 1 week post‐surgery, patients in the EA group walked further than those in the DA group (P = 0.03) and required less assistance to transfer (P = 0.009) and negotiate a step (P = 0.23). Patients in the EA group were more likely to be discharged directly home from the acute care than those in the DA group (26.3 compared with 2.4%) and less likely to need high‐level care (36.8 compared with 56%). A failed early ambulation subgroup had significantly more postoperative cardiovascular instability and worse results for all outcome measures.Conclusion: EA after hip fracture surgery accelerates functional recovery and is associated with more discharges directly home and less to high‐level care.
ASSESSING SURGEONS’ DISCLOSURE OF RISK INFORMATION BEFORE CAROTID ENDARTERECTOMY
Authors: Middleton Sandy , Gattellari Melina , Harris John P , Ward Jeanette E 
Published: June 2006

Background: To make an informed decision about treatment, patients need accurate information about the benefits and risks of treatment and ‘non‐treatment’ options. A survey was conducted to determine patients’ recall of the extent and effect of preoperative disclosure by surgeons to patients of risks about carotid endarterectomy (CEA).Methods: A self‐administered questionnaire was given to 133 patients undergoing elective CEA in New South Wales. The primary outcome measures were patient recall of preoperative discussion, self‐assessed estimates of stroke risk with and without surgery and receipt of written information before CEA.Results: A significantly higher proportion of patients recalled that their surgeon discussed the short‐term stroke risk (i.e. within 30 days) if they decided to undergo CEA (86.2%) than if they decided not to have the procedure (76.9%) (P = 0.04). Of those patients who recalled the surgeon discussing their short‐term stroke risk with CEA, only 24 (18.0%) were accurately able to quantify this risk. Patients were significantly more likely to recall their surgeon discussing their long‐term stroke risk (i.e. within 2 years) if they decided not to have CEA (72.4%) than if they decided to have the CEA (31.5%) (P < 0.0001).Conclusions: Patients recalled discussions with their surgeon about short‐term stroke risk. Only a minority, however, accurately quantified their postoperative stroke risk. In view of variable patient recall, decision aids could assist.
REGULATION OF FIBROGENESIS DURING THE EARLY PHASE OF COMMON BILE DUCT OBSTRUCTION
Authors: Engin Atilla , Dinçer Sibel , Ercan Sevim Z. , Memiş Leyla , Bukan Neslihan , Bozkurt Şükrü 
Published: June 2006

Background:  Both nitric oxide (NO) and prostaglandins have been proposed as inhibitor substances involved in collagen deposition in the hepatic parenchyma. The possible reciprocal connections between NO and eicosanoids in the development of liver fibrosis were investigated during the initial phase of common bile duct obstructions.Methods:  A total of 30 male albino guinea pigs were randomly and equally assigned to three groups. Group 1 underwent sham laparotomy. Group 2 and group 3 were subjected to permanent common bile duct ligature for 24 and 72 h , respectively. Changes in the liver prostaglandin E2 (PGE2), leukotriene C4, malondialdehyde contents and plasma nitrite plus nitrate concentrations were measured. To evaluate the extent of hepatic fibrosis, histological assessment of liver was confirmed with the equivalent hydroxyproline contents of liver.Results:  Twenty‐four hours after ligature, the amount of malondialdehyde and PGE2 and plasma nitrite plus nitrate concentrations increased significantly, whereas liver hydroxyproline contents did not change. However, 72 h after ligature (Group 3), lipid peroxidation and collagen deposition were significantly higher than that of the group 2 animals. The PGE2 : leukotriene C4 ratio peaked at 24 h and later decreased, whereas PGE2 : NO ratio remained unchanged in both group 2 and group 3 animals.Conclusions:  The initiation of collagen synthesis occurred in portal tract as early as within the first 72 h of bile duct obstruction. The optimum function of reactive oxygen species on the stellate cell activation might be determined by the interaction between NO and PGE2.
Calcium‐regulated potassium currents secure respiratory rhythm generation after loss of glycinergic inhibition
Authors: Zhao Ming‐Gao , Hülsmann Swen , Winter Stefan M. , Dutschmann Mathias , Richter Diethelm W. 
Published: June 2006

AbstractMutant oscillator mice (Glra1spd –/–) are characterized by a developmental loss of glycinergic inhibition. These mice die during the third postnatal week presumably due to gradually increasing disturbances of breathing and motor behaviour. Some irregular rhythmic respiratory activity, however, is persevered until they die. Here we analysed cellular mechanisms that compensate for the loss of glycinergic inhibition and contribute to the maintenance of the respiratory rhythm. In a medullary slice preparation including the pre‐Bötzinger complex we performed a comparative analysis of after‐hyperpolarizations following action potentials (AP‐AHP) and burst discharges (burst‐AHP) in identified respiratory neurons from oscillator and control mice. Both AHP forms were increased in neurons from oscillator mice. These changes were combined with an augmented adaptation of firing frequency. Assuming that oscillator mice might upregulate calcium‐activated K currents (BKCa) in compensation for the loss of glycinergic inhibition, we blocked the big KCa conductances with iberiotoxin and verified that the respiratory rhythm was indeed arrested by BK channel blockade.
Ultrastructural organization of medial prefrontal inputs to the rhinal cortices
Authors: Apergis‐Schoute John , Pinto Aline , Paré Denis 
Published: June 2006

AbstractAccumulating evidence suggests that the medial prefrontal cortex (mPFC) plays a critical role in the formation, retrieval and long‐term storage of hippocampal‐dependent memories. Consistent with this, there are direct hippocampal projections to the mPFC. Moreover, the mPFC sends robust projections to the perirhinal and entorhinal cortices, two interconnected cortical fields that funnel information into and out of the hippocampus. However, the significance of the latter projection remains unclear because no data are available regarding the rhinal targets of mPFC axons. This question was examined in the present study using a combination of anterograde tracing with Phaseolus vulgaris leucoagglutinin and pre‐embedding γ‐aminobutyric acid (GABA) immunocytochemistry in guinea pigs. Following Phaseolus vulgaris leucoagglutinin injections in the mPFC, anterogradely labeled axons were seen in the perirhinal (mainly superficial layers) and lateral entorhinal (mainly deep layers) cortices. In the electron microscope, the synaptic articulation of anterogradely labeled mPFC axon terminals with perirhinal and entorhinal neurons was found to be nearly identical. In these two rhinal fields, mPFC axon terminals only formed asymmetric synapses, typically with GABA‐immunonegative spines (≈70%) but occasionally with dendritic profiles (≈30%), half of which were GABA immunopositive. In the light of earlier observations, these findings indicate that mPFC inputs exert mainly excitatory effects in the rhinal cortices, prevalently on principal neurons. Thus, these results suggest that the mPFC may affect hippocampal‐dependent memories by enhancing impulse traffic into and out of the hippocampus at the level of the rhinal cortices.
Neonatal resuscitation courses for pediatric residents: comparison between Khartoum (Sudan) and Padova (Italy)
Authors: TREVISANUTO DANIELE , IBRAHIM SALAH A. , DOGLIONI NICOLETTA , SALVADORI SABRINA , FERRARESE PAOLA , ZANARDO VINCENZO 
Published: June 2006

SummaryBackground:  The efficacy of a Neonatal Resuscitation Program (NRP) has been previously evaluated in developed countries, but there is a lack of information regarding the impact of this teaching program in developing countries. Our aim was to compare the knowledge gained by University of Khartoum (Sudan) and University of Padova (Italy) pediatric residents following participation in the NRP course.Methods:  An 80‐item questionnaire derived from the standard test contained in the American Heart Association and American Academy of Pediatrics Neonatal Resuscitation Manual was given to participants before and after the course.Results:  Twenty‐five Sudanese and 26 Italian pediatric residents answered the pre‐ and postcourse questionnaire. The percentages of correct answers significantly improved from before to immediately after the course for both Sudanese (51.9 ± 10.5% vs 84.9 ± 5.8%; P < 0.01) and Italian (64.3 ± 8.1% vs 94.0 ± 3.9%; P < 0.01) pediatric residents. During the entire study, the scores obtained by Italian pediatric residents were higher than those reached by their Sudanese colleagues (P < 0.01).Conclusions:  The trend of the knowledge attainment of both Sudanese and Italian pediatric residents was similar after NRP course participation. An NRP is effective in teaching neonatal resuscitation in developing countries.