bluuebunny/crossref_metadata_2025_split huggingface dataset:
LAWN MOWER INJURIES IN CHILDREN: A 30‐YEAR EXPERIENCE
Authors: Nguyen Anh , Raymond Simon , Morgan Vanessa , Peters Julian , Macgill Kirstie , Johnstone Bruce 
Published: August 2008

Background:  Lawn mowers cause severe injuries that are particularly devastating to children. This study analyses the patterns and trends in lawn mower injuries involving children referred to Victoria’s principal children’s hospital.Methods:  A retrospective review of the patient medical records at the Royal Children’s Hospital (Melbourne) Victoria, Australia was carried out. The series included all patients admitted for lawn mower injury during the 30‐year period spanning 1975–2004.Results:  Lawn mower injuries treated at Royal Children’s Hospital were severe and included partially amputated limbs. Overall, admissions for lawn mower injury generally decreased over time from n = 26 in the 1975–1979 interval to n = 14 in the 2000–2004 interval. However, the frequency of admission for injuries caused by ride‐on mowers contradicted the overall trend and generally increased over time from n = 5 in the 1975–1979 interval to n = 11 in the 2000–2004 interval. This is of particular concern. Ride‐on lawn mowers caused significantly more severe injuries requiring longer periods of admission and more operations during admission in comparison to standard mowers. Rural location at the time of injury was a risk factor associated with requiring longer periods of admission and more operations during admission. Children injured while operating mowers were generally older than children injured as bystanders.Conclusion:  Lawn mower injuries are a significant cause of morbidity. These injuries are particularly devastating to children. The tragedy is keenly felt in the realization that these devastating injuries to children could all be prevented. Strategic preventative measures should be developed through partnership between the medical profession, the media, industry specialists and the wider community.
RETROSPECTIVE REVIEW OF STICKLER SYNDROME PATIENTS WITH CLEFT PALATE 1997‐2004
Authors: Lee Kai H. , Hayward Peter 
Published: August 2008

Background:  Stickler syndrome is a rare autosomal dominant connective tissue disorder estimated to affect approximately 1/7500 newborns. It is diagnosed clinically and, at present, there is no consensus on a minimal clinical diagnostic criterion. The aim of this series was to evaluate the outcome of a group of cleft palate children with Stickler syndrome in a large tertiary children’s hospital in New South Wales.Methods:  The International Classification of Diseases‐10 code for ‘other specified congenital malformations affecting facial appearance’ over past 8 years (1997–2004) and an internal database from the Cleft Clinic were used to search for patients. Patients were included if the diagnosis was confirmed by a clinical geneticist, an ophthalmologist and a paediatric plastic surgeon.Results:  A total of nine patients were identified. All had cleft palate. Six patients had Pierre Robin Sequence. The most common non‐craniofacial manifestation was a refractive error, followed by musculoskeletal abnormalities and hearing impairment. Seven patients had some form of myopia bilaterally. Four patients had hearing impairment. Six patients had musculoskeletal abnormality.Conclusion:  There are few data in published work that follow patients with Stickler syndrome with initial cleft presentation. These patients can have potentially disabling consequences as a result of ophthalmological, musculoskeletal, auditory and cardiac problems. Early identification is crucial to allow referral to appropriate service.
ACUTE LAPAROSCOPIC CHOLECYSTECTOMY: PREFERRED TREATMENT FOR ACUTE BILIARY DISEASE*
Authors: Zargar‐Shoshtari Kamran , Short Heather , Poole Garth H. , Hill Andrew G. 
Published: August 2008

Background:  Early laparoscopic cholecystectomy has been shown to be the treatment of choice for acute presentations of gallstone disease. However, currently this practice is not common in many centres. The aim of the study was to evaluate surgical management of patients presenting with acute symptomatic gallstone disease to Middlemore Hospital in 2005.Methods:  A retrospective case review of acute presentations of symptomatic gallstone disease was carried out between 1 January and 31 December 2005.Results:  Four hundred and two patients were included in the final analysis. Forty‐six of these patients were unfit for surgery, 26 were solely admitted to the emergency department without being referred to a surgical team and 25 declined surgery. Therefore, 305 patients (76%) were eligible for surgery at index admission (IA). Two hundred and four (67%) received surgery during IA with a median time to surgery of 3 days. From the 198th patient who did not have acute surgery at IA, 112 had delayed surgery. When comparing those with surgery at IA with those who did not receive surgery at IA, median length of stay for IA was significantly longer in acute surgical group (5 vs 3 P = 0.05); however, there was no significant difference in duration of total hospital stay (6 vs 6 P > 0.05). For those who had acute surgery the conversion rate was 3% (six) compared with 7% (seven) in delayed surgery group (P = 0.09).Conclusion:  Acute surgery remains the treatment of choice for acute biliary disease. This approach requires a committed team approach but is safe and effective.
TOWARDS ESTABLISHING A NATIONAL COLORECTAL CANCER DATABASE: LESSONS LEARNT FROM BIO21 MOLECULAR MEDICINE INFORMATICS MODEL
Authors: Kosmider Suzanne , Jones Ian , Hibbert Marienne , Hunter Andrew , McLaughlin Steve , Johns Julie , Chapman Matthew , Gibbs Peter 
Published: August 2008

Background:  Collecting data regarding treatment and outcomes of patients with cancer, for both audit and research purposes, is a common but challenging goal. Modern technology promises greater ease and sophistication for data collection, linkage and analysis, but many traditional challenges remain.Method:  Here we relate our experience of an initiative aimed at multicentre colorectal cancer data collection, that is, in collaboration with the Colorectal Surgical Society Australia and New Zealand, moving towards a national initiative.Results:  Initiated from a single site in Melbourne, using a range of data collection and linkage processes, and optimizing the use of modern technology, we have now implemented and sustained comprehensive and multidisciplinary data collection across multiple Victorian and interstate institutions. Specific challenges related to ethics and privacy, data accuracy and completeness and data ownership have been addressed and many lessons have been learnt. Multicentre audit and research queries can now be conducted with confidence that privacy, security and intellectual property issues are addressed. Research output, including many studies that were not previously possible, has informed a broad range of topics relevant to colorectal cancer.Conclusion:  Multicentre and comprehensive data collection for colorectal cancer is achievable and sustainable and promises great benefit as an audit and research tool. Similar initiatives could be established for other tumour types.
Plasma nitric oxide, endothelin‐1, arginase and superoxide dismutase in pre‐eclamptic women
Authors: Bernardi Fabiana , Constantino Larissa , Machado Roberta , Petronilho Fabricia , Dal‐Pizzol Felipe 
Published: August 2008

AbstractAim:  The aim of this study was to determine several parameters of nitric oxide metabolism in pre‐eclamptic patients.Methods:  We conducted a nested case‐control study at the Department of Obstetrics and Gynecology, São José Hospital, Brazil. Thirty‐five pre‐eclamptic and 35 normotensive pregnant women were included in the study. Pre‐eclampsia was diagnosed as an increase in diastolic blood pressure (BP) of 15 mm Hg and systolic BP of 30 mm Hg at two measurements at least 4 h apart, compared with BP obtained before 20 weeks of gestation, and proteinuria >0.3 g/24 h in the absence of urinary tract infection. Fasting peripheral venous blood samples were obtained during the antepartum period in pre‐eclamptic and control (matched for maternal age and gestational age) patients.Results:  Plasma nitrite was significantly lower and plasma endothelin levels were significantly higher in pre‐eclamptic women than in normotensive pregnant women. Superoxide dismutase activity was decreased and arginase activity was significantly increased in pre‐eclamptic patients when compared to normotensive pregnant women.Conclusions:  We suggested that in pre‐eclampsia excessive arginase and low superoxide dismutase activity leads to a decrease nitric oxide levels and oxidative stress, and this may promote microvascular oxidative damage and endothelial dysfunction.
Retiform pattern of Sertoli–Leydig cell tumor of the ovary in a 4‐year‐old girl
Authors: Kawatra Vibha , Mandal Shramana , Khurana Nita , Aggarwal Satish K. 
Published: August 2008

AbstractSertoli–Leydig cell tumors are rare sex cord‐stromal neoplasms that account for <0.2% of ovarian tumors. These tumors with a retiform pattern pose difficult diagnostic problems, with the majority being misinterpreted as serous papillary cystadenocarcinoma and endodermal sinus tumor. Retiform pattern Sertoli–Leydig cell tumor seen mostly in young patients is clinically malignant and has a worse prognosis, underlining the importance of recognition of this histopathologic entity. In the literature only two such cases have been described in patients under the age of 5 years; reported herein is the third case. Described here is a rare case of ovarian Sertoli–Leydig cell tumor with retiform pattern in a 4‐year‐old child without any endocrine manifestations.
Role of type I collagen C telopeptide, bone‐specific alkaline phosphatase and osteocalcin in the assessment of bone status in postmenopausal women
Authors: Trento Laura K. , Pietropolli Adalgisa , Ticconi Carlo , Gravotta Enrica , De Martino Massimo U. , Fabbri Andrea , Piccione Emilio 
Published: August 2008

AbstractAim:  To investigate the clinical role of the bone turnover markers type I collagen C telopeptide (CTX), osteocalcin (OC) and bone‐specific alkaline phosphatase (BAP) in the assessment of bone status in women with postmenopausal osteoporosis.Methods:  Serum CTX (s‐CTX), OC and BAP were measured in 200 healthy menopausal women at their initial visit and were correlated with spine and femur bone mineral density (BMD), determined on dual‐energy X‐ray absorptiometry. The relationship between biochemical markers of bone turnover and age, age at menopause, body mass index (BMI) and BMD was analyzed using linear correlation. A receiver operating characteristic (ROC) curve was constructed for each serum marker versus both femur and vertebral BMD.Results:  No correlation was found between serum levels of OC and BAP and vertebral or femur BMD. A statistically significant inverse correlation was found between s‐CTX and BMD at spine and femur. S‐CTX levels were higher in women with osteoporosis than in women with normal or moderately low (osteopenic) values of BMD. The sensitivity and specificity versus spine BMD were 73.9% and 41.6% for s‐CTX, 40.4% and 80.6% for BAP, and 68.3% and 39% for OC, respectively. The sensitivity and specificity versus femur BMD were 76.9% and 40.4% for s‐CTX, 23.8% and 88.3% for BAP, and 80.4% and 53.3% for OC, respectively.Conclusions:  Determination of s‐CTX, BAP and OC is of limited clinical value in the initial evaluation of bone status in menopausal women.
Preoperative evaluation and triage of women with suspicious adnexal masses using risk of malignancy index
Authors: Enakpene Christopher A. , Omigbodun Akinyinka O. , Goecke Tamme W. , Odukogbe Akin‐Tunde , Beckmann Mathias W. 
Published: August 2008

AbstractAims:  To test the accuracy of risk of malignancy index (RMI) in preoperative prediction of malignancy and treatment of adnexal masses.Methods:  A total of 302 women with ultrasound diagnosed adnexal masses, and serum measurement of cancer‐associated antigen CA‐125 levels, were studied. They all had surgical exploration between October 2001 and September 2005 at the Friedrich‐Alexander University Women's Hospital, Erlangen, Germany. The RMI was based on menopausal status, ultrasound morphology of adnexal masses and absolute level of serum CA‐125. A cut‐off of 250 was chosen as the threshold for determining the type of surgical operations (laparotomy versus laparoscopy) and the skill of the surgeons (gynecological oncologist versus general gynecologist). The data obtained were analyzed for baseline characteristics using χ2 test and analysis of variance (ANOVA). P < 0.05 were statistically significant. The various testing methods were evaluated for sensitivity, specificity, positive and negative predictive values.Results:  The best individual performance was found in RMI at a cut‐off of 250 with a sensitivity of 88.2%, specificity of 74.3%, positive predictive value of 71.3% and negative predictive value of 90%. When RMI was used to triage patient treatment, 81.5% of patients who had laparoscopy had histological diagnosis of benign ovarian tumor and 7.5% had malignant tumor. In contrast, 74.4% of patients who had laparotomy had histological diagnosis of malignant ovarian tumor and 16% had benign tumor.Conclusion:  Risk of malignant index is a reliable, cheap, readily available and cost‐effective method of preoperative discrimination of benign from malignant adnexal masses. It is also helpful in triaging patients to different treatment groups.
Characteristics and perinatal course of prenatally diagnosed fetal abdominal wall defects managed in a tertiary center in Japan
Authors: Hidaka Nobuhiro , Murata Masaharu , Yumoto Yasuo , Hojo Satoshi , Fujita Yasuyuki , Masumoto Kouji , Taguchi Tomoaki , Tsukimori Kiyomi , Wake Norio 
Published: August 2008

AbstractAims:  To identify the clinical characteristics of fetal abdominal wall defects managed at a single institution and to provide information regarding the most likely clinical course of the affected fetuses.Methods:  A retrospective review was conducted of 44 fetuses prenatally diagnosed with abdominal wall defects at Kyushu University Hospital between 1990 and 2006.Results:  A total of 11 cases of gastroschisis and 33 cases of omphalocele were found. Preterm delivery was observed in eight of 11 fetuses (72.7%) with gastroschisis and in 14 of 27 fetuses (51.9%) with omphalocele who were not artificially aborted. Intrauterine growth restriction (IUGR) was identified in four of 11 fetuses (36.4%) with gastroschisis and in 13 of 27 fetuses (48.1%) with omphalocele who were not aborted artificially. There was a high rate of associated structural anomalies with omphalocele (26/33). Karyotypic abnormalities were observed in eight of 29 tested fetuses with omphalocele (27.6%). The prognosis for a chromosomally normal fetus with omphalocele appeared to largely depend on the associated structural abnormalities and the gestational age at delivery. Despite the frequent presence of IUGR, the outcome of neonates with gastroschisis was good.Conclusions:  The possibility of preterm delivery and IUGR should be considered during the management of both omphalocele and gastroschisis. For the management of omphaloceles, chromosomal abnormalities and respiratory insufficiency after birth must also be considered. Timely prenatal diagnosis and the subsequent identification of associated anomalies will improve patient care and will enable clinicians to provide appropriate counseling about the expected course.
Required length of follow‐up after transanal advancement flap repair of high transsphincteric fistulas
Authors: Mitalas L. E. , Gosselink M. P. , Oom D. M. J. , Zimmerman D. D. E. , Schouten W. R. 
Published: August 2008

AbstractObjective  Repair of high perianal fistulas presents a major surgical challenge. Transanal advancement flap repair (TAFR) provides a useful tool in the treatment of these fistulas. Initially promising results have been reported. More recent studies indicate that TAFR fails in one out of three patients. The aim of the present study was to determine the appropriate length of follow‐up needed to assess the healing rate after TAFR of high transsphincteric fistulas.Method  Between 1992 and 2000 a consecutive series of 80 patients with a high transsphincteric fistula of cryptoglandular origin underwent TAFR. Medical records of all patients were studied. The initial healing rate and the median healing time were assessed. The initial outcome was successful in 54 patients. The medical records revealed that only one of these patients presented with a recurrent fistula after 28 months. The other 53 patients were sent a questionnaire in 2006 aimed to determine whether they had any complaints or signs of a recurrent fistula.Results  The initial healing rate was 68%. The median healing time was 3.6 months. The completed questionnaire was returned by 48 patients. None of these patients reported any complaints or signs of a recurrent fistula. Median duration of follow‐up in these patients was 92 months.Conclusion  At a median time interval of 3.6 months fistula healing was observed in 54 patients (68%). Only one patient (2%) encountered a recurrence. The length of follow‐up can be restricted to the healing time.
An interim analysis of recruitment to the COLOFOL trial
Authors: Wille‐Jørgensen P. , Laurberg S. , Påhlman L. , Carriquiry L. , Lundqvist N. , Smedh K. , Svanfeldt M. , Bengtson J. 
Published: August 2008

AbstractObjective To analyse the ongoing process of recruiting patients into a multicenter randomized trial on follow‐up after curative surgery for colorectal cancer. The trial is registered in Clinical Trials Registration.Method Prospective registration of all operated patients as well as inclusions (curative resection, stage II or III disease, ≤ 75 years, clean colonand exclusions of the individual patients in eight participating departments.Results Between January 2006 and September 2007, 1309 patients have been operated upon. Of these 502 (38.3 %) met the inclusion criteria, 148 (29.5%) had exclusion criteria. Of the final eligible patients 241 (68.1 %) were randomized. No specific barriers to inclusion were identified.Conclusion Of an overall population of patients operated for colorectal cancer about one in five were randomized. Bearing the rigorous inclusion and exclusion criteria in mind, this is considered satisfactory, and the investigated population may be representative of patients meeting the inclusion criteria.
The value of auditing negative lower GI investigations preceding a final diagnosis of colorectal cancer
Authors: Somasekar A. , James L. , Stephenson B. M. , Thompson I. W. , Vellacott K. D. , Allison M. C. 
Published: August 2008

AbstractObjective  To review all preceding ‘negative’ large bowel investigations in patients with a final diagnosis of colorectal cancer, and to examine whether delayed diagnosis was associated with worse outcome.Method  Details were gathered on all patients with a new diagnosis of colorectal adenocarcinoma presenting over 4.5 years. For each patient the hospital’s clinical workstation and radiology and endoscopy databases were interrogated for all flexible sigmoidoscopies, colonoscopies and barium enemas during the 5 years prior to diagnosis.Results  Among the 570 patients, 28 (5%) had undergone colonoscopy and/or flexible sigmoidoscopy that had not shown colorectal cancer during the 5 years preceding final diagnosis, and a further 28 (5%) had undergone ‘negative’ barium enemas. Polyp surveillance might have missed four lesions destined to become malignant. Correspondingly there were three patients undergoing IBD surveillance found to have CRC, having had a negative complete colonoscopy within the preceding 5 years. Among patients undergoing de novo colonoscopy for diagnosis the true miss rate was only one patient per year. At August 2007, 29 (58%) of those with delayed diagnosis were still alive, compared with 216 (42%) of those diagnosed during initial investigation (χ2 = 5.04, P < 0.05).Conclusions  Colonoscopic miss rates are in line with previous studies. The application of simple clinical ground rules will avoid most pitfalls. The methodology described herein may assist in auditing the quality assurance of lower gastrointestinal diagnostic services. Despite the delay, late diagnosis was found to be associated with improved survival and a lower likelihood of metastatic disease.
Sacral nerve stimulation for faecal incontinence: long‐term outcome
Authors: Matzel K. E. , Lux P. , Heuer S. , Besendörfer M. , Zhang W. 
Published: August 2008

AbstractAim  The efficacy of sacral nerve stimulation (SNS) to treat faecal incontinence has been demonstrated in the short‐ and mid‐term. We analysed SNS outcome in the first patients with a permanent neurostimulator in whom follow‐up ranges up to 14 years.Method  Of 12 patients who underwent SNS from 1994 to 1999, 9 were eligible for long‐term analysis (defined as a minimum of 7 years). In 3 the device had to be removed because of pain or neurological disease. Functional outcome was monitored prospectively by standardized questionnaire. For efficacy, the recorded frequency of incontinent episodes over 2‐week periods and the Wexner Score were obtained yearly after implant. Quality of life measures (FIQL scale [QoL]) were introduced in 1998. Stimulation parameter adjustments, battery longevity, and complications were documented.Results  Mean follow‐up in the nine patients was 9.8 years (range 7–14), over which time efficacy persisted. Clinical improvement was significant (baseline vs last follow‐up): median percentage of incontinent bowel movements/week 40% (range 9–100) vs 0% (0–60%; P = 0.008), median number of incontinent episodes/week, 9 (range 2–58) vs 0 (0–29; P = 0.012); median Cleveland Clinic Score, 17 (range 12–19) vs 10 (3–14; P < 0.007); QoL improved in all categories. Pulse generator exchange was required in eight of the nine patients after a mean of 7.4 years for battery fatigue (mean 2.1 V). Complications occurred in five of the original 12 and were therapy‐related, but not technique‐related, in four patients.Conclusion  Sacral nerve stimulation is an effective and safe long‐term treatment for faecal incontinence. Clinical outcome is stable over time.