bluuebunny/crossref_metadata_2025_split huggingface dataset:
MALIGNANT PROGRESSION OF ANAL INTRA‐EPITHELIAL NEOPLASIA
Authors: Watson Angus J. M. , Smith Barnaby B. , Whitehead Martin R. , Sykes Peter H. , Frizelle Frank A. 
Published: August 2006

Background:  Anal intra‐epithelial neoplasia (AIN) is believed to be a precursor to squamous cell carcinoma of the anus. The risk of developing anal cancer in patients with AIN, although known to occur, has been thought to be relatively low. This study reviews our experience with AIN, reviewing the incidence and risk factors for development of invasive malignancy and the outcome of present management strategies.Methods:  This study examined a cohort of 72 patients identified from a prospective database with AIN from a single institution between January 1996 and December 2004. A single pathologist examined all pathological specimens.Results:  There were 72 patients (52 women) and the median age was 49 years (range, 18–81 years). We identified progression of AIN to invasive malignancy in eight patients despite undergoing surveillance. Regression following treatment or biopsy was seen in 25 patients. Four patients required stomas for incontinence following treatment.Conclusion:  This study has shown a high rate of progression to invasive malignancy (11%) with AIN despite surveillance. The patients at risk of developing squamous cell carcinoma were the immunocompromised and those with genital intra‐epithelial field change. Treatment of AIN has significant complications and despite treatment, invasive cancers do occur. Decisions made for treatment of AIN can affect treatment choices if invasive malignancy develops.
DIAGNOSTIC VALUE OF THORACOSCOPIC PLEURAL BIOPSY FOR PLEURISY UNDER LOCAL ANAESTHESIA
Authors: Sakuraba Motoki , Masuda Kimihiko , Hebisawa Akira , Sagara Yuzo , Komatsu Hikotaro 
Published: August 2006

Background:  We find pleural effusion in clinical practice frequently. However, it is difficult to make a diagnosis definitively by thoracocentesis or closed pleural biopsy. We directly examine the thoracic cavity by thoracoscopy under local anaesthesia, carry out pleural biopsy and make a definitive pathological diagnosis in pleurisy.Method:  A retrospective study of 138 patients who had been diagnosed by thoracoscopy in our hospital was carried out between January 1995 and January 2005.Results:  The patients were 114 men and 24 women, ranging in age from 21 to 85 years, with a mean of 59 years. The right side was involved in 83 patients and the left side in 55. The operations took 11–145 min, with a mean of 46 min. Thoracoscopy directly without thoracocenteses was carried out in 28 of 138 patients. Lung cancer with pleural dissemination was diagnosed in 27, malignant pleural mesothelioma in 10, tuberculous pleurisy in 32, non‐specific pleurisy in 58, other tumour in 2 and pyothorax in 9 patients. The overall diagnostic efficacy was 97.1% (134/138). The diagnostic efficacy in the cases of carcinoma was 92.6% (25/27), in malignant pleural mesothelioma it was 100% (10/10) and in tuberculosis it was 93.8% (30/32). No major complications occurred during the examination.Conclusion:  Pleural biopsy by thoracoscopy under local anaesthesia should be actively carried out in patients with pleurisy, because the technique has a high diagnostic rate and can be easily and safely carried out.
LYTIC BONE LESIONS IN AN AUSTRALIAN POPULATION: THE RESULTS OF 100 CONSECUTIVE BIOPSIES
Authors: Clayer Mark T. 
Published: August 2006

Background:  The identification of a lytic bone lesion is often perceived as a harbinger of malignancy, especially in an older patient. This study reviews the results of 100 consecutive biopsies of patients who presented with either a solitary lesion or multiple lytic bone lesions in the absence of a history of malignancy.Methods:  Following preoperative planning, including plain radiographs, bone scan and computed tomography scanning, an open biopsy was carried out.Results:  The most common site affected was the pelvis (20 patients), followed by the femur (19) and tibia (15). The lesions were solitary in 88 patients and multiple in 12. The most common diagnosis was a secondary carcinoma presenting as a bone lesion, which was found in 25 patients. The carcinomas were a widely distributed group, but the most common among them were renal cell carcinoma (seven patients), breast carcinoma (five patients) and lung carcinoma (five patients). The most common primary bone tumour was a giant cell tumour (16) followed by myeloma (10). Multiple lesions were not universally an indication of a malignant process. In 14 patients the lesion was not a tumour.Conclusion:  This study emphasizes the importance of obtaining a tissue diagnosis.
FROZEN SECTION FOR PAROTID SURGERY: SHOULD IT BECOME ROUTINE?
Authors: Arabi Mianroodi Ali A. , Sigston Elizabeth A. , Vallance Neil A. 
Published: August 2006

Background:  The role of fine‐needle aspiration (FNA) in salivary gland lesions as a preoperative diagnosis has always been under scrutiny. Several studies have shown that frozen section (FS) is accurate for pathological diagnosis and decision‐making during the surgery. This study has been carried out to assess the accuracy of FNA and FS in parotid surgeries.Methods:  All parotid lesions removed between July 1998 and June 2003 by the Department of Otolaryngology, Head and Neck unit at Monash Medical Centre were reviewed. FNA, FS and definitive pathology were collected and discrepancies were identified.Results:  Eighty‐five parotid tumours had been removed. Thirty‐three were malignant in which squamous cell carcinoma was the most common. FS was able to differentiate benign tumours from malignant with 100% accuracy (30 cases). FS was able to alter the surgical decisions in six cases. FNA had been carried out in 62 cases, with sensitivity and specificity of 77.2 and 90%, respectively.Conclusion:  Frozen section in parotid surgery is accurate, inexpensive and may add important information that alters management and improves the outcome. The use of FS routinely in parotid surgery is recommended.
DOES HYPERPARATHYROIDISM CAUSE PANCREATITIS? A SOUTH INDIAN EXPERIENCE AND A REVIEW OF PUBLISHED WORK
Authors: Jacob Jubbin J. , John Mathew , Thomas Nihal , Chacko Ashok , Cherian Rekha , Selvan Ben , Nair Aravindan , Seshadri Mandalam S. 
Published: August 2006

Background:  The association between pancreatic disease and primary hyperparathyroidism (PHPT) is controversial. We attempt to suggest a causal correlation and characterize the nature of pancreatic disease in PHPT.Methods:  This study is a retrospective review of the medical records of patients who were diagnosed with PHPT and presented with pancreatic disease between 1 May 2000 and 30 May 2005 at Christian Medical College, Vellore.Results:  During the period of 5 years, there were 1284 patients with pancreatic disease and 101 patients with PHPT admitted to our hospital, accounting for 0.42 and 0.03%, respectively, of the total hospital inpatient admissions of 302 883. Of them, 13 patients had both pancreatic disease and PHPT accounting for 1% of all admissions for pancreatic disease and 12% of admissions for PHPT. Patients admitted with PHPT have a 28‐fold increased risk of developing pancreatitis compared with patients admitted without parathyroid disease. The ages of the patients ranged from 22 to 52 years with a median age of 37 years. There were 9 male and 4 female patients. The mean calcium values among patients with PHPT and pancreatic disease were significantly higher than patients with PHPT without pancreatic involvement.Conclusion:  The data suggest a causal association between the pancreatic disease and PHPT. This may be correlated to the higher calcium values. Until more information is available, it would be prudent to check serum calcium in all patients presenting with unexplained pancreatic disease.
NATIONAL BREAST CANCER AUDIT: OVERVIEW OF INVASIVE BREAST CANCER MANAGEMENT
Authors: Cuncins‐Hearn Astrid V. , Boult Margaret , Babidge Wendy , Zorbas Helen , Villanueva Elmer , Evans Alison , Oliver David , Kollias James , Reeve Tom , Maddern Guy 
Published: August 2006

Background:  The National Breast Cancer Audit is an initiative of the Breast Section of the Royal Australasian College of Surgeons collecting surgical information in early breast cancer. It is managed in conjunction with the Australian Safety and Efficacy Register of New Interventional Procedures – Surgical. An overview of results for invasive breast cancer from January 1999 until December 2004 is presented to provide preliminary data for participating surgeons.Methods:  Invasive breast cancer cases were retrieved from the National Breast Cancer Audit database for the 274 participating breast surgeons in Australia and New Zealand. Data for a variety of clinical parameters were analysed to provide an overview of the diagnostic, histological, surgical and adjuvant therapy management issues.Results:  There were 25 026 cases of invasive breast cancer. Annual percentages of mammographically detected cancers from 1999 to 2004 did not differ significantly. Breast‐conserving surgery rates also remained stable at 60%. Margins were involved in 5% of patients; an additional 9% had final margins of less than 1 mm. Radiotherapy followed breast‐conserving surgery in most cases (86%). Patients undergoing mastectomy with large tumours (>5 cm) underwent radiotherapy in 71% of cases. When at least four lymph nodes were positive, radiotherapy followed mastectomy in the majority (75%) of cases. The most frequently carried out axillary procedure was a level 2 dissection. Chemotherapy was received by 78% of oestrogen receptor negative, axillary node positive, postmenopausal patients. Tamoxifen was used in the majority (83%) of oestrogen receptor positive cases.Conclusion:  Surgeons contributing their invasive breast cancer data show a high quality of treatment. Some further improvement may be possibly related to excision margins and tamoxifen prescription for oestrogen receptor negative cancers. Chemotherapy prescription might also warrant further investigation.
Phaeochromocytoma in pregnancy
Authors: Grodski S. , Jung C. , Kertes P. , Davies M. , Banting S. 
Published: August 2006

AbstractHypertension during pregnancy is a common problem, causing significant maternal and fetal morbidity and mortality. Pre‐eclampsia is by far the most common cause, affecting 5–10% of primigravid women. Phaeochromocytoma is a rare endocrine tumour causing hypersecretion of noradrenaline, adrenaline and/or dopamine. It is extremely rare during pregnancy and may be misdiagnosed with potentially catastrophic consequences. Delayed diagnosis remains a significant source of maternal and fetal morbidity and mortality. Recognition is critical, as the majority of maternal deaths have occurred when the diagnosis has been overlooked. Diagnosis of phaeochromocytoma is achieved by detecting increased catecholamines and metabolites (metanephrine and normetanephrine) on 24‐h urine collection, as these levels are unaffected by pregnancy or pre‐eclampsia. Definitive treatment of phaeochromocytoma is surgical and the laparoscopic approach has been shown to be safe and is preferred for most phaeochromocytomas. Medical preparation and treatment of hypertension is essential for safe surgery. Timing of adrenalectomy is either during the second trimester or as a staged procedure after Caesarean section delivery.
Controlled trial of multidisciplinary care teams for acutely ill medical inpatients: enhanced multidisciplinary care
Authors: Mudge A. , Laracy S. , Richter K. , Denaro C. 
Published: August 2006

AbstractBackground: Acute hospital general medicine services care for ageing complex patients, using the skills of a range of health‐care providers. Evidence suggests that comprehensive early assessment and discharge planning may improve efficiency and outcomes of care in older medical patients.Aim: To enhance assessment, communication, care and discharge planning by restructuring consistent, patient‐centred multidisciplinary teams in a general medicine service.Methods: Prospective controlled trial enrolling 1538 consecutive medical inpatients. Intervention units with additional allied health staff formed consistent multidisciplinary teams aligned with inpatient admitting units rather than wards; implemented improved communication processes for early information collection and sharing between disciplines; and specified shared explicit discharge goals. Control units continued traditional, referral‐based multidisciplinary models with existing staffing levels.Results: Access to allied health services was significantly enhanced. There was a trend to reduced index length of stay in the intervention units (7.3 days vs 7.8 days in control units, P = 0.18), with no change in 6‐month readmissions. In‐hospital mortality was reduced from 6.4 to 3.9% (P = 0.03); less patients experienced functional decline in hospital (P = 0.04) and patients’ ratings of health status improved (P = 0.02). Additional staffing costs were balanced by potential bed‐day savings.Conclusion: This model of enhanced multidisciplinary inpatient care has provided sustainable efficiency gains for the hospital and improved patient outcomes.
Cautionary tales in the interpretation of systematic reviews of therapy trials
Authors: Scott I. , Greenberg P. , Poole P. , Campbell D. 
Published: August 2006

AbstractThis is the second in a series of articles emphasizing the cautions in the interpretation of health‐care studies. Systematic reviews are presented as comprehensive, unbiased summaries of evidence and are often referred to by clinicians, guideline developers and health policy‐makers. Their strengths and limitations, and how their results can be subject to bias and misinterpretation, are discussed.
Management of paediatric thyroid carcinoma: recent experience with recombinant human thyroid stimulating hormone in preparation for radioiodine therapy
Authors: Lau W. F. E. , Zacharin M. R. , Waters K. , Wheeler G. , Johnston V. , Hicks R. J. 
Published: August 2006

AbstractBackground: Thyroid carcinoma in children is rare and raises unique management issues. Although metastatic disease is more common in this age group, prognosis remains good with appropriate treatment. The aim of the study was to report recent experience in the management of differentiated thyroid carcinoma in children, especially in the use of radioiodine after recombinant human thyroid stimulating hormone (rhTSH) stimulation.Methods: Eight patients, aged 5–17  years (five were boys) presented following total thyroidectomy for thyroid carcinoma between May 2003 and June 2005. Seven had papillary carcinoma and one had follicular carcinoma. Five had known lymph node metastases and one had pulmonary metastases at presentation. Four patients had previously received therapeutic irradiation for malignancy. All eight underwent diagnostic iodine scans, seven with rhTSH stimulation. Seven went on to receive radioiodine treatment as hospital inpatients, comanaged by the paediatric and nuclear medicine units. The dosage of 131I ranged from 1.5 to 3.7 × 109 Bq. All except one were prepared by rhTSH stimulation.Results: Seven of eight patients had significant uptake in the neck on diagnostic scan and two had pulmonary abnormalities. Six of seven evaluable patients achieved complete thyroid ablation. Both patients with pulmonary abnormalities had scan resolution, although one of them only after a second radioiodine treatment. All patients had thyroxine replacement in doses to suppress TSH and all remain alive and well at time of carrying out this study.Conclusion: Optimal management of paediatric thyroid carcinoma necessitates a multidisciplinary approach. Radioiodine therapy under rhTSH is an effective and safe adjuvant treatment in this special subgroup.
Zoledronic acid prevents bone loss after allogeneic haemopoietic stem cell transplantation
Authors: D’Souza A. B. , Grigg A. P. , Szer J. , Ebeling P. R. 
Published: August 2006

AbstractAllogeneic haemopoietic stem cell transplant (alloHSCT) patients are at increased risk of osteoporosis. Zoledronic acid (ZA) is a potent i.v. bisphosphonate; however, there are few data on ZA use after alloHSCT. The aim of this study is to examine the effect of a single 4 mg ZA infusion in alloHSCT patients with either osteoporosis (T‐score < −2.5) or rapid bone loss post‐alloHSCT. An uncontrolled, prospective study of 12 consecutive patients receiving ZA, predominantly within the first year post‐HSCT. Bone mineral density (BMD) was measured by dual‐energy X‐ray absorptiometry at the spine and proximal femur pretransplant, pre‐ZA and post‐ZA. The median annualized percentage change in total hip BMD between the pretransplant scan and the scan immediately before ZA was −13% (range, −51 to +3.6%). After ZA treatment, the total hip BMD increased by a median of +3.3% (range, −20.4 to +14.8%) in 75% of patients. The median annualized percentage change in femoral neck BMD between the pretransplant scan and the scan immediately before ZA was −13.2% (range, −40 to +1.0%). Post‐ZA, femoral neck BMD increased by a median of +1.4% (range, −22.2 to +33.6%). Only one patient continued to lose bone from the femoral neck post‐ZA infusion. The median annualized percentage change in spinal BMD pretransplant was −12.5% (range, −38 to +6.9%). Post‐ZA, spinal BMD decreased by a median of −2.8% (range, −27.6 to +24.4%). Four patients continued to lose bone from the spine post‐ZA. ZA reduces bone loss in most patients after alloHSCT. Our data require confirmation in a larger prospective, randomized study.
Screening for colorectal cancer by faecal occult blood test: why people choose to refuse
Authors: Worthley D. L. , Cole S. R. , Esterman A. , Mehaffey S. , Roosa N. M. , Smith A. , Turnbull D. , Young G. P. 
Published: August 2006

AbstractTo better understand the personal barriers that limit participation in faecal occult blood test (FOBT) screening for colorectal cancer, non‐participants from a recent screening initiative were sent detailed questionnaires, defining their reasons for not participating, as well as how to make screening more attractive. The important barrier was procrastination. The type of FOBT kit offered influenced the reasons for not participating. Convenient FOBT and greater general practitioner involvement may be important for optimizing community acceptance of FOBT‐based screening.
Study of bacterial communities in Antarctic coastal waters by a combination of 16S rRNA and 16S rDNA sequencing
Authors: Gentile Gabriella , Giuliano Laura , D’Auria Giuseppe , Smedile Francesco , Azzaro Maurizio , De Domenico Maria , Yakimov Michail M. 
Published: August 2006

SummaryAn ecological study on distribution of Antarctic bacterial communities was determined by 16S‐based phylogenetic analyses of clone libraries derived from RNA and DNA extracted from two different marine areas and compared between each other. Superficial seawater samples were collected from four stations in Ross Sea, three of them located in Rod Bay and one in Evans Cove; for each station two clone libraries (16S rDNA and 16S rRNA) were prepared and evident divergences between DNA and RNA libraries of each site were obtained. Of all phylotypes 93.6% were found in RNA libraries; in contrast, only 31 phylotypes (70.5%) were retrieved from total microbial community (DNA libraries). DNA and RNA sequences related to γ‐Proteobacteria and Bacteroidetes groups, typical for Antarctic sea‐ice bacterial communities, were detected in analysed sites. 16S rDNA and rRNA libraries derived from the two different areas were enriched by picophytoplanktonic 16S sequences of plastid and mitochondrion origins, reflecting that the algal blooms occurred during sampling (Antarctic summer 2003). The finding in Rod Bay libraries of high percentage of DNA clones apparently affiliated with β‐Proteobacteria typical for activated sludges and well water could be explained by the presence of a sewage depuration system at this site. Obtained results clearly demonstrate that combination of 16S rDNA and 16S rRNA gene sequencing is preferred approach to have a more reliable vision on the composition of microbial communities.
The in situ physiology of Skermania piniformis in foams in Australian activated sludge plants
Authors: Eales Kathryn L. , Nielsen Jeppe L. , Seviour Elizabeth M. , Nielsen Per H. , Seviour Robert J. 
Published: August 2006

SummaryThe in situ physiology of the filamentous bacterium Skermania piniformis frequently seen in activated sludge foams in Australia was investigated. An oligonucleotide probe, Spin1449, targeting the 16S rRNA of S. piniformis was designed for its identification by fluorescence in situ hybridization (FISH), validated with pure cultures and applied successfully to foam samples from two geographically distant Australian plants. While filaments of this bacterium appeared to be comparatively hydrophobic, the organism had no clear preference for hydrophobic or hydrophilic substrates. In both foams examined using microautoradiography (MAR), filaments selectively took up substrates under aerobic and anoxic (NO3–) but not anaerobic or anoxic (NO2–) conditions. Skermania piniformis assimilated oleic acid, palmitic acid, glycerol and glycine. Ectoenzyme activities detected suggest that S. piniformis has an ability to assimilate a greater range of substrates than might be concluded from the MAR data obtained here. Based on the substrate uptake data presented here, an anaerobic selector may work for controlling S. piniformis in activated sludge systems.
Application of a nifH oligonucleotide microarray for profiling diversity of N2‐fixing microorganisms in marine microbial mats
Authors: Moisander Pia H. , Shiue Lily , Steward Grieg F. , Jenkins Bethany D. , Bebout Brad M. , Zehr Jonathan P. 
Published: August 2006

SummaryDiazotrophic community structure in microbial mats from Guerrero Negro (GN), Baja California, Mexico, was studied using polymerase chain reaction amplification of the nifH gene and a newly developed nifH oligonucleotide microarray. Ninety‐six oligonucleotide probes designed for nifH sequences from cultivated isolates and the environment were printed on glass microarrays. Phylogenetic analysis showed that the probes represented all of the main nifH clusters. Specificity was tested by (i) evaluation of cross hybridization using individual targets, and (ii) comparison of the observed hybridization signals and those predicted from the sequences cloned from microbial mats. Signal intensity had a positive relationship with target concentration and the percentage identity between probe and target. Under moderate stringency and high target concentration, specificity of the probes varied from 77% to 100% with the individual targets tested. At the end of a 7‐month long nutrient manipulation experiment in GN microbial mats, no expression of nitrogen fixation under nitrogen loading was detected, although a diverse community of diazotrophs was detected. The diversity in diazotrophic population present was higher than in the population expressing the nifH gene, and there were taxa specific differences in response to nutrients. The nifH microarray is a powerful tool for diazotroph community analysis in the marine environment.