bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional problems in adult rectal prolapse and controversies in surgical treatment
Authors: Eu K-W , Seow-Choen F 
Published: June 2006

Abstract

Background
Rectal prolapse is a condition that has fascinated surgeons for a long time. To date, no single ideal surgical treatment has been identified. The aetiology of rectal prolapse remains highly controversial, but it is recognized that associated functional problems, such as incontinence and constipation, are common. The pathophysiology, and controversies surrounding continence and constipation, remain topics of debate.

Method
All relevant papers derived from Medline and manual searching on rectal prolapse and associated functional problems were reviewed.

Results and Conclusion
The surgical management of rectal prolapse has evolved from historical encirclement procedures to current minimally invasive ones. Successful management must include adequate attention to the associated functional problems in order to eradicate the basic abnormality.
Surgical management of pancreatic necrosis presenting with locoregional complications
Authors: Chaudhary A , Dhar P , Sachdev A , Agarwal A K 
Published: June 2006

Abstract

Background
Local complications of pancreatic necrosis may occur after surgery, but when they occur spontaneously render surgical treatment more hazardous and impair prognosis.

Methods
A retrospective review was carried out of 83 patients who underwent surgery for pancreatic necrosis from 1988 to 1995, to determine the incidence, type, treatment and outcome of locoregional complications caused by pancreatic necrosis associated with acute pancreatitis.

Results
Seventeen patients (20 per cent) were identified to have intra-abdominal complications with pancreatic necrosis either before operation or at the time of surgery. The majority of patients had a delay in intervention (mean 46 days). At presentation ten of the 17 patients had one or more organ system failures. Fourteen patients had gastrointestinal tract involvement, two had involvement of the biliary tract and one patient had a splenic rupture. Six patients died.

Conclusions
In patients with pancreatic necrosis, development of locoregional complications is associated with a high mortality rate. The presence of gastrointestinal bleeding, peritonitis, jaundice or pneumoperitoneum in such patients suggests the presence of a complication of the necrotic process and should prompt early intervention. Early referral of patients with severe acute pancreatitis to specialized units may reduce the risk of locoregional complications.
Melanoma of the nose
Authors: Papadopoulos T , Rasiah K , Thompson J F , Quinn M J , Crotty K A 
Published: June 2006

Abstract

Background
Melanoma of the nose is rare and management guidelines are poorly defined. In the past, excision margins have often been much narrower than for melanoma elsewhere.

Methods
The study was a retrospective clinicopathological study of 34 patients with cutaneous melanoma of the nose treated in a single unit.

Results
Desmoplastic neurotropic melanoma and lentigo maligna melanoma were the most common histological tumour types. Local recurrence occurred in eight patients, and in six cases appeared to be a result of inadequate excision margins. Regional lymph node metastases were associated with a very poor prognosis.

Conclusion
Adequate surgical excision is the mainstay of successful treatment for melanoma of the nose. Excision margins for nasal melanoma should not be any less than for melanoma elsewhere. Careful planning is required, not only to gain local disease control and the best chance of cure, but also to achieve functionally and aesthetically acceptable results. Excision margins need not be compromised in view of the variety of local flaps that can be employed to close the primary defect.
Prospective evaluation of quality of life in patients with localized oesophageal cancer treated by multimodality therapy or surgery alone
Authors: Reynolds J V , McLaughlin R , Moore J , Rowley S , Ravi N , Byrne P J 
Published: June 2006

Abstract

Background
Health-related quality of life (HRQL) outcomes are important in assessing new approaches to the treatment of cancer. Neoadjuvant therapy is being used increasingly before surgery in patients with localized oesophageal cancer. This prospective non-randomized study evaluated HRQL in patients treated by preoperative chemotherapy and radiation therapy followed by surgery (multimodal therapy) or by surgery alone.

Methods
Data from European Organization for Research and Treatment of Cancer quality of life questionnaires QLQ-30 and QLQ-OES24 were collected prospectively. Questionnaires were completed at diagnosis, after chemoradiotherapy where applicable, and at 3, 6 and 12 months after surgery.

Results
The study included 202 consecutive patients with oesophageal cancer considered suitable for curative (R0) resection at the time of staging. Eighty-seven patients received chemotherapy combined with external-beam radiotherapy before surgery. At baseline, 75 (86 per cent) of 87 patients in the multimodal group completed questionnaires, compared with 72 (62·6 per cent) of 115 in the surgery-alone group. There were no significant differences in baseline global HRQL scores between groups. Preoperative chemoradiotherapy significantly reduced physical (P = 0·004) and role (P = 0·007) functioning before surgery, despite a significant (P = 0·043) improvement in the dysphagia score. Oesophageal resection had a negative impact on global, functional and symptom HRQL scores at 3 months in both groups. Most variables had recovered by 6 months in the two groups, but at 12 months physical and role functioning remained impaired in the surgery-alone group, and social functioning and financial worries in the multimodal group.

Conclusion
Although the multimodal regimen had a negative impact on HRQL before surgery, postoperative quality of life in patients who had multimodal therapy was similar to that in those who had surgery alone.
Evolutionary dynamics of knowledge
Authors: Parra Carlos M. , Yano Masakazu 
Published: June 2006

AbstractThis study discusses the evolutionary nature of knowledge acquisition at micro and macro levels, and in particular when the process involves an artificial agent's interpretative devices. In order to accomplish this, we propose using an individual learning model (or inner‐world reconstruction model) that in our view overcomes neoclassic epistemological holdups and may increase the predictive power of computational economics, by letting an artificial agent's knowledge evolve by itself, irrespective of globally specified goals or individual motives of behavior; using simultaneous (or parallel) genetic algorithms (GA) to evolve a single agent's learning strategy, each GA with different general specifications, in a multiagent setting. © 2006 Wiley Periodicals, Inc. Complexity 11: 12–19, 2006
Anemia and cognitive performance in hospitalized older patients: results from the GIFA study
Authors: Zamboni Valentina , Cesari Matteo , Zuccalà Giuseppe , Onder Graziano , Woodman Richard C , Maraldi Cinzia , Ranzini Monica , Volpato Stefano , Pahor Marco , Bernabei Roberto 
Published: June 2006

AbstractBackgroundAnemia represents a major risk factor for adverse health‐related events in older persons. The aim of this study was to evaluate the association between hemoglobin levels/anemia and cognitive function in hospitalized older persons.MethodData are from the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study. Hemoglobin levels (in g/dL) were measured upon admission to hospital; anemia was defined according to the WHO criteria. Cognitive performance was assessed by the Abbreviated Mental Test (AMT) on admission; an AMT score <7 defined cognitive impairment. Logistic regressions and analyses of covariance were performed to evaluate the relationship between cognitive status and hemoglobin levels/anemia.ResultsMean age of the sample (n = 13,301) was 72.0 years. Participants with cognitive impairment presented a higher prevalence of anemia (47%) compared to those without cognitive impairment (35%, p < 0.001). Adjusted logistic regressions showed that hemoglobin levels/anemia were significantly associated with cognitive impairment (OR = 0.96, 95%CI = 0.94–0.99, p = 0.004, and OR = 1.32, 95%CI = 1.18–1.48, p < 0.001, respectively). Patients with anemia and cognitive impairment at the hospital admission presented a higher number of impaired Activities of Daily Living compared to those with only one or none of the studied conditions (p for trend < 0.001).ConclusionLow hemoglobin levels and anemia are independently associated with cognitive performance in older persons admitted to acute care units. Copyright © 2006 John Wiley & Sons, Ltd.
Abuse of vulnerable people with dementia by their carers: can we identify those most at risk?
Authors: Cooney Colm , Howard Robert , Lawlor Brian 
Published: June 2006

AbstractObjectiveWe wanted to explore possible associations between characteristics of carers, dementia sufferers and the caring situation and the presence of abuse that was acknowledged by carers.MethodsEighty‐two carers of dementia sufferers were interviewed in their homes about three types of abuse (verbal abuse, physical abuse and neglect) using a structured questionnaire.ResultsFifty‐two percent (n = 43) carers admitted to having carried out some form of abuse. Verbal abuse was the most common form (n = 42, 51%), while 20% (n = 16) of carers admitted to physical abuse and 4% (n = 3) to neglect abuse. Significant associations were found between verbal abuse and psychological ill health in the carer and behavioural problems in the dementia sufferer. Physical abuse was significantly associated with higher levels of self‐reported good health by the carer. High expressed emotion measured in carers was highly correlated with all types of abuse.ConclusionIt is possible to identify situations where people with dementia may be at high risk of abuse from their carers. Any effective intervention strategy should address psychological health problems in the carer, behavioural problems in the dementia sufferer and a strategy to manage high levels of expressed emotion in these situations. Copyright © 2006 John Wiley & Sons, Ltd.
Psychiatric comorbidity in older adults with bipolar disorder
Authors: Sajatovic Martha , Blow Frederic C. , Ignacio Rosalinda V. 
Published: June 2006

AbstractIntroductionComorbidity patterns and correlates among older adults with bipolar disorder (BPD) are not well understood. The aim of this analysis was to examine the prevalence of comorbid PTSD and other anxiety disorders, substance abuse and dementia in a population of 16,330 geriatric patients with BPD in a Veterans Health Administration administrative database.MethodsPatients were identified from case registry files during Federal Fiscal Year 2001(FY01). Comorbidity groups were compared on selected clinical characteristics, inpatient and outpatient health resource use, and costs of care.ResultsFour thousand six hundred and sixty‐eight geriatric veterans with BPD were comorbid for either substance abuse, PTSD and other anxiety disorder, or dementia (28.6% of all veterans with BPD age 60 or older). Mean age of all veterans in the four comorbidity groups was 70.0 years (±SD 7.2 years). Substance abuse was seen in 1,460 (8.9%) of elderly veterans with BPD, while PTSD was seen in 875 (5.4%), other anxiety disorders in 1592 (9.7%), and dementia in 741 (4.5%) of elderly veterans. Individuals with substance abuse in this elderly bipolar population are more likely to be younger, minority, unmarried and homeless compared to elderly bipolar populations with anxiety disorders or dementia. Inpatient use was greatest among geriatric veterans with BPD and dementia compared to veterans with BPD and other comorbid conditions.ConclusionClinical characteristics, health resource use and healthcare costs differ among geriatric patients with BPD and comorbid anxiety, substance abuse or dementia. Additional research is needed to better understand presentation of illness and modifiable factors that may influence outcomes. Copyright © 2006 John Wiley & Sons, Ltd.
Reliability, validity and factor structure of the GDS‐15 in Iranian elderly
Authors: Malakouti Seyed Kazem , Fatollahi Paridokht , Mirabzadeh Arash , Salavati Mojgan , Zandi Taher 
Published: June 2006

AbstractObjectivesDepressive disorders are a public health problem even in developing countries. Access to valid and reliable screening instruments is needed for conducting community surveys. The main objective of this study is to provide the Iranian version of the Geriatric Depression Scale‐15 (GDS).MethodsThe GDS‐15 Farsi version was developed by translation and back translation. Two hundred and four subjects aged 59 years or older, who were chosen randomly from residents of the Ekbatan district of Tehran, the capital city of Iran, completed the GDS‐15. The Composite International Diagnostic Interview (CIDI) was used to establish a gold standard diagnosis of major depressive disorders.ResultsThe GDS was found to be an internally consistent measure. Alpha, split‐half coefficients and test–retest reliability were 0.9, 0.89 and 0.58 respectively. Two factors were extracted by using factor analysis and the principle component analysis (varimax rotation): ‘depression’ and ‘psychosocial activity’. The Depression factor (omitting items 2, 9, 10, 13), which could be considered as a short form of the scale (α = 0.92), has significant correlation with the main scale (r = 0.58). Using receiver operating curve (ROC) analysis, the optimum cutoff score for GDS‐15 is 7/8, yielding a sensitivity of 0.9 and a specificity of 0.84. The optimum cutoff score for GDS‐11 is 6, yielding a sensitivity of 0.9 and a specificity of 0.83.ConclusionThe long and short forms of the GDS have excellent properties as screening instruments for major depression in older dwellers in Iran, particularly in urban areas, as presented in our findings. Copyright © 2006 John Wiley & Sons, Ltd.
Mucoepidermoid carcinoma of salivary glands in the pediatric age group: 18 clinical cases, including 11 second malignant neoplasms
Authors: Védrine Pierre Olivier , Coffinet Laurent , Temam Stéphane , Montagne Karine , Lapeyre Michel , Oberlin Odile , Orbach Daniel , Simon Claude , Sommelet Danièle 
Published: June 2006

AbstractBackground.Salivary gland tumors represent 1% of head and neck tumors, with only 5% of these occurring in patients younger than 20 years. Mucoepidermoid carcinoma (MEC) is one of the most frequent salivary gland cancers among adults and children.Methods.This survey was conducted among 34 French pediatric oncology departments. From 1980 to 2000, 18 cases were reported.Results.Treatment included surgery or radiotherapy, or both. The 5‐year survival rate was 93.7%. Eleven patients had been previously treated by radiotherapy and/or chemotherapy for a first malignant tumor, specifically, lymphoid leukemia (n = 4), lymphoma (n = 3), brain tumor (n = 2), sarcoma (n = 1), and retinoblastoma (n = 1).Conclusions.MEC is very rare in the pediatric age group. Treatment involves surgical removal of the tumor plus radiotherapy, according to histologic staging. MEC has a good prognosis in young patients. The survival rate does not differ in the subgroup of patients with MEC as a secondary tumor. © 2006 Wiley Periodicals, Inc. Head Neck, 2006
Management and control of public hospitals—the use of performance measures in Norwegian hospitals. A case‐study
Authors: Pettersen Inger Johanne , Nyland Kari 
Published: June 2006

AbstractThis paper investigates the use of performance measures in the management control and decision‐making processes in the Norwegian hospital sector. The motivation for the study is to understand the implementation of performance‐based management systems which is an element in the international New Public Management (NPM) reforms waves now affecting the hospital sector. The theoretical framework is based on the description of hospitals as complex and decoupled organizations. The use of benchmarking is discussed, and the focus is put on the information biases that exist in such data. The main finding in the empirical study is that the ambiguous information which exists in the performance measures used at the hospital department level, maintains the decoupling between the clinical activities and the management control practices. This decoupling creates management control problems because it hampers the knowledge on the cause‐effects of actions, which is important in order to undertake strategic decisions and diagnostic action. In order to increase transparency, cost information should be decomposed as to develop practical indicators for interactive control purposes in clinical departments. Copyright © 2006 John Wiley & Sons, Ltd.
Cannabis and neurodevelopment: implications for psychiatric disorders
Authors: Sundram Suresh 
Published: June 2006

AbstractThe developing brain is susceptible to the effects of exogenous cannabinoids both during the perinatal period through maternal cannabis use and in young adolescent users. Emerging data from human and animal perinatal exposure studies demonstrate a subtle rather than gross effect of cannabis upon later functioning including; specific cognitive deficits especially in visuospatial function; impulsivity, inattention and hyperactivity; depressive symptoms; and substance use disorders. From animal studies motor control systems, neuroendocrine function and nociception may additionally be affected. Fetal studies indicate that these outcomes may be through cannabinoid mediated influences on the ontogeny of, especially dopamine and opioid, neurotransmitter systems. The effect of cannabinoids in the adolescent suggest long‐term deleterious outcomes in cognition, depressive symptoms, schizophrenia and substance use disorders. Much of these data support a neurodevelopmental effect, however, predisposing genetic and/or environmental factors cannot be excluded from human studies. Gender specific differences have been observed in both human and animal studies implying sex hormone and related factors may interact with cannabinoids in neurodevelopment. Further understanding how cannabinoids influence neurodevelopment will inform public debate about the health effects of cannabis but also open avenues in discerning how modulation of the endocannabinoid system may assist in the development of therapeutic tools for a variety of neuropsychiatric disorders. Copyright © 2006 John Wiley & Sons, Ltd.
The role of the standard EEG in clinical psychiatry
Authors: O'Sullivan S. S. , Mullins G. M. , Cassidy E. M. , McNamara B. 
Published: June 2006

AbstractBackgroundThe EEG is a commonly requested test on patients attending psychiatric services, predominantly to investigate for a possible organic brain syndrome causing behavioural changes.AimsTo assess referrals for EEG from psychiatric services in comparison with those from other sources. We determine which clinical factors were associated with an abnormal EEG in patients referred from psychiatric sources.MethodsA retrospective review of EEG requests in a 1‐year period was performed. Analysis of referral reasons for psychiatric patients was undertaken, and outcome of patients referred from psychiatric services post‐EEG was reviewed.ResultsOne thousand four hundred and seventy EEGs were reviewed, of which 91 (6.2%) were referred from psychiatry. Neurology service referrals had detection rates of abnormal EEGs of 27%, with psychiatric referrals having the lowest abnormality detection rate of 17.6% (p < 0.1). In psychiatric‐referred patients the only significant predictors found of an abnormal EEG were a known history of epilepsy (p < 0.001), being on clozapine (p < 0.05), and a possible convulsive seizure (RR = 6.51). Follow‐up data of 53 patients did not reveal a significant clinical impact of EEG results on patient management.ConclusionsMany patients are referred for EEG from psychiatric sources despite a relatively low index of suspicion of an organic brain disorders, based on reasons for referral documented, with an unsurprising low clinical yield. Copyright © 2006 John Wiley & Sons, Ltd.
Junctional adhesion molecule‐A regulates cell migration and resistance to shear stress
Authors: Huang Hayden , Cruz Francisco , Bazzoni Gianfranco 
Published: June 2006

AbstractJunctional adhesion molecule‐A (JAM‐A) is an adhesive protein expressed in endothelial cells, epithelial cells, platelets, and some leukocytes. JAM‐A localizes to the tight junctions between contacting endothelial and epithelial cells, where it contributes to cell–cell adhesion and to the control of paracellular permeability. JAM‐A also regulates cell motility, even though the quantitative biophysical features have not been characterized. In this study, we evaluated the role of JAM‐A in the regulation of cell motility using JAM‐A‐expressing and JAM‐A‐deficient murine endothelial cells. We report that, in the absence of shear stress, JAM‐A absence increases cell motility by increasing directional persistence but not cell speed. In addition, in the presence of shear stress, JAM‐A absence increases protrusion extension in the direction of flow and increased downstream cellular displacement (while, conversely, decreasing upstream displacement). All these effects of JAM‐A absence are mitigated by the microtubule‐stabilizing compound taxol. A motility‐ and microtubule‐related function, integrin‐mediated adhesiveness, was only slightly reduced in JAM‐A‐deficient cells compared with JAM‐A‐expressing cells. However, overexpression of JAM‐A in the JAM‐A‐deficient cells increased integrin adhesiveness to the same levels as those observed in taxol‐treated JAM‐A‐deficient cells. Taken together, these data indicate that JAM‐A regulates cell motility by cooperating with microtubule‐stabilizing pathways. J. Cell. Physiol. 209: 122–130, 2006. © 2006 Wiley‐Liss, Inc.