bluuebunny/crossref_metadata_2025_split huggingface dataset:
RETROGRADE NAILING VERSUS FIXED‐ANGLE BLADE PLATING FOR SUPRACONDYLAR FEMORAL FRACTURES: A RANDOMIZED CONTROLLED TRIAL
Authors: Hartin Nathan L. , Harris Ian , Hazratwala Kaushik 
Published: May 2006

Background:  A variety of devices have been used in the treatment of supracondylar femoral fractures. The condylar blade plate relies on the principles of open reduction, absolute stability and interfragmentary compression to achieve union. The technique of retrograde nailing uses indirect reduction of the metaphyseal fracture component, offering relative stability and a less invasive approach. Randomized comparison of these common methods of fixation has not been reported.Methods:  Twenty‐two patients with 23 supracondylar femur fractures were recruited from two regional trauma centres over a 26‐month period and randomized to receive either a retrograde intramedullary nail fixation (IM group, 12 fractures) or a fixed‐angle blade plate fixation (BP group, 11 fractures). The groups were followed for 12–36 months. The primary outcome measures were revision surgery and general health.Results:  Three patients in the IM group required revision surgery for the removal of implant components. No reoperations occurred in the BP group. There was a trend towards greater pain in the IM group, although there was no statistically significant difference in the scores for any of the SF‐36 domains.Conclusion:  Both distal femoral nailing and blade plating give good outcomes. There is a trend for patients undergoing retrograde nailing to complain of more pain and to require revision surgery for removal of implants.
OUTCOMES OF A CONTEMPORARY AMPUTATION SERIES
Authors: Lim Tao S. , Finlayson Andrew , Thorpe James M. , Sieunarine Kishore , Mwipatayi Bibombe P. , Brady Anne , Abbas Manzoor , Angel Donna 
Published: May 2006

Background:  The aim of this study was to determine the outcomes of a contemporary amputation series.Methods:  A retrospective audit of 87 cases of major lower limb amputation from January 2000 to December 2002 from the Department of Vascular Surgery, Royal Perth Hospital, was conducted.Results:  The mean age of the study population was 70.1 ± 14.3 years; the male : female ratio was 3.35:1. Comorbid problems included diabetes (49.4%), smoking (81.6%), hypertension (77.0%), ischaemic heart disease (58.6%), stroke (25.3%), raised creatinine level (34.5%) and chronic airway limitation (25.3%). Preamputation vascular reconstructive procedures were common, 34.5% in a previous admission and 23.0% in the same admission. The main indication was critical limb ischaemia (75.9%) followed by diabetic infection (17.2%). There were 51 below‐knee (58.6%), 5 through‐knee (5.7%) and 31 above‐knee (35.6%.) amputations. The below‐knee amputation to above‐knee amputation ratio was 1.65:1. The overall wound infection rate was 26.4%; the infection rates for below‐knee (29.4%) and above‐knee (22.6%) amputation did not differ significantly (P = 0.58). Revision rates were 17.6% for below‐knee, 20% for through‐knee and none for above‐knee amputations. Twenty patients (23.0%) underwent subsequent contralateral amputation. Thirty‐nine patients (44.8%) were selected as suitable for a prosthesis by a rehabilitation physician; 31 (79.5%) used the prosthesis both indoors and outdoors and 6 (15.4%) used it indoors only within 3 months. Cumulative mortality at 30 days, 6 months, 12 months and 24 months was 10.1, 28.7, 43.1 and 51.7%, respectively.Conclusion:  This series agrees with the current published work in finding that patients undergoing major lower limb amputation are older, with a high prevalence of comorbid conditions. Successful prosthesis rehabilitation depends on patient selection and a multidisciplinary approach. Despite a low immediate mortality, the overall long‐term results of lower limb amputation remain dismal.
INCIDENCE AND OUTCOMES OF KNEE AND HIP JOINT REPLACEMENT IN VETERANS AND CIVILIANS
Authors: Wells Vanessa , Hearn Trevor , Heard Adrian , Lange Kylie , Rankin Wayne , Graves Stephen 
Published: May 2006

Background:  This article describes the incidence of total knee and hip replacement, and compares post‐surgery health status outcomes in veterans and civilians.Methods:  The numbers of male veterans and civilians who had a knee and/or a hip replacement in South Australia (1994–2002) were obtained. Standardized morbidity ratios, and odds ratios for age group by veteran/civilian interactions, were calculated. Presurgery and 1‐year post‐surgery Medical Outcomes Short Form (36) Health Survey, Knee Society and Harris hip scores were completed. Independent samples t‐tests were used to compare presurgery scores. ancova models were used to determine any differences between veterans and civilians post‐surgery.Results:  For veterans, standardized morbidity ratios were 0.987 and 0.715 for knee and hip replacements, respectively (P < 0.0001). Veterans’ odds ratios for knee and hip replacements were significantly lower in the 65‐ to 74‐year age group (P < 0.001), similar in the 75‐ to 84‐year and above 85‐year age groups for hip replacement, but significantly higher in the above 85‐year age group for knee replacement (P < 0.001). Presurgery, veterans reported significantly lower scores (P < 0.003) for knee function. After knee replacement, veterans reported significantly lower Medical Outcomes Short Form (36) Health Survey scores for bodily pain, physical functioning, role – physical, role – emotional, social functioning and physical component summary (P < 0.033). Significantly lower physical functioning, role – physical and physical component summary scores (P < 0.02) were reported by veterans post‐surgery for hip replacement.Conclusion:  Veterans are delaying joint replacement. Presurgical knee function is worse in veterans. Post‐surgery, the veterans are worse off in a number of health status outcomes.
NON‐NEOPLASTIC CYSTIC AND CYSTIC‐LIKE LESIONS OF THE PANCREAS: MAY MIMIC PANCREATIC CYSTIC NEOPLASMS
Authors: Goh Brian K. P. , Tan Yu‐Meng , Chung Yaw‐Fui A. , Chow Pierce K. H. , Ong Hock‐Soo , Lim Dennis T. H. , Wong Wai‐Keong , Ooi London L. P. J. 
Published: May 2006

Background:  Cystic lesions of the pancreas consist of a broad range of pathological entities. With the exception of the pancreatic pseudocyst, these are usually caused by pancreatic cystic neoplasms. Non‐neoplastic pancreatic cystic and cystic‐like lesions are extremely rare. In the present article, the surgical experience with these unusual entities over a 14‐year period is reported.Methods:  Between 1991 and 2004, all patients who underwent surgical exploration for a cystic lesion of the pancreas were retrospectively reviewed. Patients with a pancreatic pseudocyst were excluded. There were 106 patients of whom 8 (7.5%) had a final pathological diagnosis consistent with a non‐neoplastic pancreatic cystic or cystic‐like lesion, including 3 patients with a benign epithelial cyst, 2 with a pancreatic abscess (one tuberculous and one foreign body), 2 with mucous retention cysts and 1 with a mucinous non‐neoplastic cyst. These eight patients are the focus of this study.Results:  There were six female and two male patients with a median age of 61.5 years (range, 41–71 years). All the patients were of Asian origin including seven Chinese and one Indian. Four of the patients were asymptomatic and their pancreatic cysts were discovered incidentally on radiological imaging for other indications. All the patients underwent preoperative radiological investigations, including ultrasonography, computed tomography or magnetic resonance imaging, which showed a cystic lesion of the pancreas. Three patients, all of whom were symptomatic, were diagnosed preoperatively with a malignant cystic neoplasm on the basis of radiological imaging. Two patients were eventually found to have a pancreatic abscess, one tuberculous and the other, secondary to foreign body perforation. The third patient was found on final histology to have chronic pancreatitis with retention cysts. The remaining five patients had a preoperative diagnosis of an indeterminate cyst; on pathological examination, they were found to have a benign epithelial (congenital) cyst (n = 3), retention cyst (n = 1) and mucinous non‐neoplastic cyst (n = 1). At a median follow up of 20 months (range, 3–34 months), none of the patients had any evidence of recurrent disease.Conclusion:  Non‐neoplastic cystic and cystic‐like lesions of the pancreas are rare causes of pancreatic cystic lesions that are generally benign and do not require surgery when asymptomatic. However, despite advances in diagnostic investigations such as endoscopic ultrasound with fluid aspirate and magnetic resonance imaging, the preoperative diagnosis remains unreliable. Hence, the challenge for all clinicians is to recognize these lesions preoperatively and to avoid ‘unnecessary' surgery.
TRIAGING REFERRAL TO A SPECIALIST BREAST CLINIC
Authors: Hung Wai‐Ka , Chan Sharon W. W. , Suen Dacita T. K. , Chan Miranda C. M. , Lau Yvonne , Yip Andrew W. C. 
Published: May 2006

Background:  The aim of this study was to determine the effectiveness of a triage system in predicting patients with malignancy among those referred to a specialist breast clinic.Methods:  A retrospective study of all referrals seen at the specialist breast clinic from January 2002 to June 2002 was conducted. The triage system allocated an urgent appointment if (i) urgent referral was requested by the referring physicians or (ii) ‘non‐urgent referral’ was made and any one of the following ‘high‐risk’ criteria were present: aged more than 50 years when presenting with breast lump, lump larger than 3 cm, bloody nipple discharge or physical signs suggestive of malignancy. Routine appointment was given if these conditions were not met. The outcomes of individual groups were assessed.Results:  Three hundred and sixty‐three referrals were analysed and 44 cancers (13.2%) were diagnosed. The mean waiting time for urgent and routine appointments was 19 and 154 days, respectively. There were 108 urgent referrals and 21 (19.4%) cancers were diagnosed. Ninety‐two patients were given an urgent appointment because of the presence of high‐risk criteria, and 21 cancers were detected (22.8%). After the two‐stage triage, breast cancer was subsequently diagnosed in only 2 out of the remaining 163 patients (1.2%) given a routine appointment.Conclusion:  Most of the patients with cancer (96%) were given an urgent appointment through the triage system. In addition to the assessment by referring physicians, certain high‐risk criteria are helpful to select patients who should be seen urgently.
PERSONAL EXPERIENCE OF PANCREAS RECONSTRUCTION FOLLOWING PANCREATICODUODENECTOMY
Authors: Kang Chang Moo , Kim Kyung Sik , Choi Jin Sub , Lee Woo Jung , Kim Byong Ro 
Published: May 2006

Background:  This study was designed to evaluate the surgical outcomes of an alternative method of pancreaticojejunostomy and pancreaticogastrostomy according to the size of the remnant pancreatic duct following pancreaticoduodenectomy.Methods:  Eighty‐four patients who underwent pancreaticoduodenectomy by the same surgeon were retrospectively reviewed from February 1997 to December 2004. Pancreaticojejunostomy for large remnant pancreatic ducts (>5 mm in diameter) and pancreaticogastrostomy for smaller remnant pancreatic ducts (<5 mm in diameter) were alternately carried out by the surgeon. Patients' perioperative data were evaluated.Results:  The size of the remnant pancreatic duct was significantly different between the pancreaticojejunostomy and pancreaticogastrostomy groups (7.2 ± 4.3 mm vs 2.9 ± 1.6 mm, P < 0.001). Pancreaticojejunostomy was carried out in 27 patients (33.3%) and pancreaticogastrostomy was carried out in 51 patients (66.7%). The mean operation time was 327 ± 67.4 min and the mean duration of the hospital stay was 25.5 ± 9.1 days. Pancreatic leakage was found in 10 patients (12.3%) without leading to mortality and was successfully treated by temporary restriction of oral intake and conservative management. None of the patients required an additional surgical procedure for pancreatic leak. Other postoperative complications were unremarkable when compared with previous results. One case of massive bleeding found in the pancreaticogastrostomy group required surgical intervention.Conclusion:  Pancreaticogastrostomy and pancreaticojejunostomy according to the size of the remnant pancreatic duct can be an alternative strategy to maintain the postoperative rate of pancreatic leak within an acceptable range without hospital mortality related to this complication.
CHILDREN OR YOUNG ADULTS? A POPULATION‐BASED STUDY ON ADOLESCENT HEAD INJURY
Authors: Mitra Biswadev , Cameron Peter A. , Butt Warwick , Rosenfeld Jeffrey V. 
Published: May 2006

Background:  The aim was to study the epidemiology of significant adolescent head injury in a statewide population.Methods:  A retrospective review of all significant adolescent (12–19 years old) head injuries over a period of 3 years was undertaken and compared with those of children (0–11 years old) and young adults (20–29 years old).Results:  The incidence of significant adolescent head injury was 19.2 per 100 000 adolescents per year. This compared to the incidence in children of 12.9 per 100 000 and in young adult of 14.7 per 100 000. Of all significant adolescent head injuries, 63.9% are managed at adult trauma centres.Demographics, pathology, neurosurgical management, length of intensive care unit stay, ventilated hours and length of hospital stay were similar to those of young adults and significantly different from those of children. Prehospital predictors of mortality were similar across all groups. Adolescent discharge destinations were similar to those of young adults and significantly different from those of children.Conclusions:  The study emphasizes the incidence of and mortality from adolescent head injury. The pattern of adolescent head injury is different from that of children and supports current practice of treatment of a majority of adolescents in adult trauma centres. These differences have implications on planning for injury prevention and trauma management.
ANTIPLATELET THERAPY IN PERIPHERAL OCCLUSIVE ARTERIAL DISEASE
Authors: Wong Shen , Appleberg Michael , Lewis David R. 
Published: May 2006

Background:  Antiplatelet therapy (APT) in patients with peripheral occlusive arterial disease (POAD) may reduce cardiovascular (CV) morbidity and mortality by inhibiting atherothrombosis. This article reviews the current evidence for APT in patients with stable POAD and in patients undergoing revascularization procedures for POAD.Methods:  A Medline and Pubmed literature search (January 1966 to February 2003) was conducted to identify articles relating APT and POAD. Manual cross referencing was also used.Results and Conclusions:  Meta‐analyses suggest that APT (most commonly aspirin) in patients with stable POAD significantly reduces the incidence of nonfatal stroke, myocardial infarction and CV death. However, this conclusion is based on subset analysis of data predominantly involving patients with coronary and cerebrovascular atherosclerosis. There is a little direct evidence for the use of aspirin in patients with isolated POAD, but in practice, aspirin remains the most commonly used antiplatelet agent as high rates of coronary and cerebrovascular diseases are observed in this patient population. For patients with POAD without additional indicators of vascular risk, the protective effect of aspirin is unclear and dependent on the balance of risks and benefits in the individual patient. For patients undergoing peripheral revascularization, ticlopidine and aspirin in combination with dipyridamole are effective in maintaining patency after bypass procedures and following angioplasty/femoral endarterectomy. The efficacy of thienopyridines in peripheral angioplasty is uncertain, and the optimum timing and duration of APT relative to intervention are not known.
A RAT MODEL OF POLYPROPYLENE GRAFT INFECTION CAUSED BY STAPHYLOCOCCUS EPIDERMIDIS
Authors: Agalar Canan , Ozdogan Mehmet , Agalar Fatih , Saygun Oral , Aydinuraz Kuzey , Akkuş Abdullah , ÇEken Sabahat , Akturk Selcuk 
Published: May 2006

Background:  The aim of this study was to constitute a valid graft infection model with Staphylococcus epidermidis in rats.Methods:  Rats were divided into seven groups. In groups 1 and 2, 2 cm × 2 cm polypropylene grafts were incubated with 108 c.f.u./mL slime‐positive S. epidermidis at 37°C for 2 and 24 h and were then placed subfascially to the groins of rats. In the third group, naive grafts were placed and 0.5 mL of 3 × 107 c.f.u. slime‐positive S. epidermidis were injected on the inside of the wounds. Rifampicin (30 mg/kg) in group 4 and teicoplanin (20 mg/kg) in group 5 were applied i.p. to rats with 2‐h incubated grafts for prophylaxis. The same prophylactic regimens were given to groups 6 and 7 in which rats were incubated for 24 h. At eighth day, rats were killed and wounds were assessed with macroscopic evaluation and cultures.Results:  No death occurred in any of the groups. In groups 1 and 2, 100% infection rates were achieved. However, graft infection was detected in only two (20%) of the rats in group 3 (P = 0.001). Prophylactic application of teicoplanin or rifampicin decreased the infection rates significantly in the short‐incubation groups.Conclusion:  Incubation of polypropylene grafts with slime‐producing S. epidermidis for 2 and 24 h in the pre‐application period achieved the occurrence of a standardized graft infection. Prophylactic use of teicoplanin and rifampicin decreased the infection rates. We propose to use this reproducible and reliable animal model of graft infection in future studies.
CHONDROCYTE APOPTOSIS IN RESPONSE TO DISLOCATION OF THE HIP IN THE RAT MODEL
Authors: Elliott Johanna , Ng De Juan , Tham Stephen K. Y. 
Published: May 2006

Background:  Joint dislocation is a traumatic event that can lead to osteoarthritis. The purpose of this paper is to study cartilage changes following prolonged joint dislocation for 1, 2 or 8 h.Methods:  Sprague–Dawley rats (n = 27) were used in this study. Surgical dislocation of the hip under anaesthesia was carried out on the animals. The joints remained dislocated for 1, 2 or 8 h. The joints were subsequently harvested and terminal deoxnucleotidyl transferase‐mediated dUTP nick‐end labelling testing was carried out to show chondrocyte apoptosis in the femoral head and acetabulum. Using this test, the apoptotic index, which is the proportion of apoptotic chondrocytes to total number of chondrocytes, was calculated. A comparison of apoptotic indices was made among the three groups.Results:  The mean apoptotic indices for the femoral head for the 1‐, 2‐ and 8‐h groups were 0.065 ± 0.025, 0.162 ± 0.031 and 0.201 ± 0.030, respectively. There was a significant difference (P < 0.05) in the mean apoptotic indices between each of the three groups. For the acetabulum, the mean apoptotic indices were 0.046 ± 0.012, 0.051 ± 0.023 and 0.057 ± 0.031 for the 1‐, 2‐ and 8‐h groups, respectively. There was no significant difference (P > 0.05) between each of the three groups.Conclusions:  Dislocation of a joint causes chondrocyte apoptosis. There is a progressive increase in the apoptotic index with prolonged dislocation of the rat hip.
History of immunology in Australia: events and identities*
Authors: Mackay I. R. 
Published: May 2006

AbstractImmunology originated in Europe during the latter 1900s, and applications can be discerned in colonial Australia. The actual beginnings of immunology in Australia followed Burnet's enunciation of two fundamental principles: natural immune tolerance as an acquired characteristic in 1948 and clonal selection theory in 1957. Laboratory and clinical immunology flourished at various centres from the 1950s. The Australian Society of Immunology was founded in 1971. The merger of clinical immunology with allergy in 1991 created the Australian Society of Clinical Immunology and Allergy, exemplary for the reamalgamation of these related specialties. Australian immunology over the past 50 years has become recognized nationally and abroad as a highly visible component of the academic, research and biomedical scene and is still on a rising trajectory.
Why we need a population‐based approach to clinical indicators for cancer: a case study using microscopic confirmation of lung cancer in Queensland
Authors: Coory M. , Fong K. , Bowman R. , Hall L. 
Published: May 2006

AbstractAn important function of clinical cancer registries is to provide feedback to clinicians on various performance measures. To date, most clinical cancer registries in Australia are located in tertiary academic hospitals, where adherence to guidelines is probably already high. Microscopic confirmation is an important process measure for lung cancer care. We found that the proportion of patients with lung cancer without microscopic confirmation was much higher in regional public hospitals (27.1%) than in tertiary hospitals (7.5%), and this disparity remained after adjusting for age, sex and comorbidities. The percentage was also higher in the private than in the public sector. This case study shows that we need a population‐based approach to measuring clinical indicators that includes regional public hospitals as a matter of priority and should ideally include the private sector.
Profound lymphopenia and bacteraemia
Authors: Hawkins C. A. , Collignon P. , Adams D. N. , Bowden F. J. , Cook M. C. 
Published: May 2006

AbstractBacteraemia often carries a poor prognosis despite prompt antibiotic therapy and is associated with late morbidity and mortality that is difficult to explain. Here, we describe perisistent B‐ and T‐ cell lymphopenia in a cohort of patients with Gram‐positive and Gram‐negative bacteraemia. This suggests previously unrecognized mechanisms of subversion of immunity by pathogens and might explain the comorbidity of blood stream infection with bacteria.