bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative chylous fistula prevention and management
Authors: Crumley Roger L. , Smith James D. 
Published: September 2006

AbstractPostoperative chylous fistulas occur as a complication in 1–2 percent of all radical neck dissections. Twelve cases are reviewed herein. Chylous fistulas are more common with left neck dissections, but 25 percent occurred on the right side in this series. An intraoperative chylous fistula was recognized and treated in 75 percent of the cases which later developed a postoperative fistula.Postoperative fistulas may be divided into two groups: minor fistulas may be treated with pressure dressings and repeated aspirations; fistulas which do not respond to conservative management should be re‐explored early and the fistula ligated.
Surgical pathology of cancer of the larynx and hypopharynx
Authors: Sessions Donald G. 
Published: September 2006

AbstractA study was designed to determine the influence of certain surgical pathologic findings on tumor spread and survival in patients with cancer of the larynx and hypopharynx. All patients with primary epidermoid carcinoma of the larynx and hypopharynx, treated by either surgery or preoperative irradiation and surgery, between 1955 and 1971 were included in the study. The patient population consisted of 791 patients all of whom were eligible for three‐year follow‐up.Information from a retrospective study of the surgical pathology reports regarding resection margins, size and differentiation of the primary tumor, histopathologic characteristics of the primary tumor and neck dissection, number, position and size of positive lymph nodes and post treatment staging, was correlated with tumor spread and survival.
Arytenoidectomy revisited
Authors: Newman M. Haskell , Work Walter P. 
Published: September 2006

AbstractThe spectrum of disabilities attendant to laryngeal paralysis range from mild hoarseness to complete upper airway obstruction depending upon the static position of the paralyzed cord or cords. The most distressing disabilities are those of bilateral vocal cord paralysis in which both vocal folds are fixed in the midline resulting in severe upper airway obstruction.Clearly the most acceptable solution to the problem of persistent laryngeal paralysis is through the establishment of normal neuromuscular integrity by vagal repair or neural transfer techniques. While electromyographic evidence of reinnervation and some restoration of cord motion has been described, synchronous neuromuscular activity is, at best, unpredictable and generally unsuccessful.Successful reinnervation procedures depend in part on early repair and herein lies a disparity between experimental work and its clinical applicability. Given the realities of delays in diagnosis and the unpredictability of operative reinnervation of the paralyzed larynx, we rely on alternative methods of improving the compromised glottic airway consequent to bilateral recurrent nerve paralysis of the larynx.During the period 1962 through 1974, 23 patients with complete bilateral paralysis of the larynx have been treated by the posterior extralaryngeal approach originally described by Woodman. The following is a description of the operative technique utilized with technical modifications which we consider important in enhancing operative results.
Amyloid deposits in the trachea and esophagus — ultrastructural confirmation
Authors: Busuttil A. , More I. A. R. , Jones D. Glyn 
Published: September 2006

AbstractThe clinical details of two patients suffering from amyloid infiltration of the trachea and esophagus respectively are presented. The “amyloid tumor” in the trachea presented with dysphonia and a swelling in the lower subglottic region. Attempts at complete surgical excision of it were unsuccessful. The patient with esophageal amyloid presented acutely with dysphagia and features of dehydration and malnutrition. Systematized amyloidosis was discovered at autopsy, but no primary initiating cause for it was found. In both cases it was possible to confirm the diagnosis by electron microscopy. The current views on the composition, structure, causation and treatment of amyloid disease are reviewed.
Arterial blood gas determination in patients with anterior packing
Authors: Slocum Carl W. , Maisel Robert H. , Cantrell Robert W. 
Published: September 2006

AbstractTwenty‐two healthy males ranging in age between 18 and 43 years were studied by arterial blood sample obtained before nasal surgery and again after complete bilateral nasal obstruction produced by nasal packing. Five of these patients had a third sample drawn after pack removal.The pO2 dropped from a preoperative mean of 85 mm Hg to 74 mm Hg. This difference is statistically significant; pCO2 did not change between the two measurements.This result is attributed to hypoxia caused by acute total nasal obstruction. It suggests that anterior packing alone may cause a clinically important hypoxia in patients with inadequate pulmonary reserve and that these patients merit close observation when bilateral anterior packing is placed. The early removal of anterior packing in patients where possible seems indicated. Supplemental O2 (40 percent) for patients over 40 years of age requiring nasal packing is practiced at this Center.
Palamed G compared with Palacos R with gentamicin in Charnley total hip replacement
Authors: Hallan G. , Aamodt A. , Furnes O. , Skredderstuen A. , Haugan K. , Havelin L. I. 
Published: August 2006

We performed a randomised, radiostereometric study comparing two different bone cements, one of which has been sparsely clinically documented. Randomisation of 60 total hip replacements (57 patients) into two groups of 30 was undertaken. All the patients were operated on using a cemented Charnley total hip replacement, the only difference between groups being the bone cement used to secure the femoral component. The two cements used were Palamed G and Palacos R with gentamicin. The patients were followed up with repeated clinical and radiostereometric examinations for two years to assess the micromovement of the femoral component and the clinical outcome. The mean subsidence was 0.18 mm and 0.21 mm, and the mean internal rotation was 1.7° and 2.0° at two years for the Palamed G and Palacos R with gentamicin bone cements, respectively. We found no statistically significant differences between the groups. Micromovement occurred between the femoral component and the cement, while the cement mantle was stable inside the bone. The Harris hip score improved from a mean of 38 points (14 to 54) and 36 (10 to 57) pre-operatively to a mean of 92 (77 to 100) and 91 (63 to 100) at two years in the Palamed G and Palacos R groups, respectively. No differences were found between the groups. Both bone cements provided good initial fixation of the femoral component and good clinical results at two years.
The New York City Police Department's Compstat: Dream or Nightmare?
Authors: Eterno John A. , Silverman Eli B. 
Published: September 2006

The Compstat paradigm has revolutionised the way policing is accomplished in democratic countries. Many agencies throughout the world have emulated the Compstat programme which originated in New York City in 1994. The strengths of Compstat have been widely publicised: dramatic reductions in crime, accountability of key staff members, and coordination of various units within an agency. The weaknesses of Compstat are less recognised: due process considerations, community relations, leadership issues, inadequate problemsolving. Weaknesses pose challenges and the authors present an alternative model to address these weaknesses. This model focuses on integrating community policing's essential components within the context of the Compstat paradigm. This provides a more powerful mechanism to combat crime and terrorism.
Automotive Mechatronic Systems – General Developments and Examples (Mechatronische Systeme in Kraftfahrzeugen – Allgemeine Entwicklungen und Beispiele)
Authors: Isermann Rolf 
Published: September 2006

Automobiles are showing an increasing integration of mechanics with digital electronics and information processing. This integration is between the components (hardware) and by the information-driven functions (software), resulting in integrated systems called mechatronic systems. Their development involves finding an optimal balance between the basic mechanical structure, sensor and actuator implementation, communication, automatic information processing and overall control.
This contribution summarizes some ongoing developments for mechatronic systems in automobiles, shows design approaches and examples and considers the various embedded control functions and systems integrity. Some examples of automotive mechatronic systems are shown in more detail. Great progress can be observed in braking systems (ABS, ESP), the first brake-by-wire electro-hydraulic brake system (EHB), steering systems (electrical power steering, active front steering) and active suspension systems.
Examination of the Validity of the Ionic Additivity Principle in the Determination of Single Ion Thermodynamic Properties
Authors: Bhattacharyya Ranjana , Lahiri Sujit Chandra 
Published: September 2006

Single ion thermodynamic values of hydration or solvation (or solution) cannot be experimentally determined. The values are determinable from the thermodynamics of solvation ΔX0solv or soln(MX) [X=H,GorS] based on ionic additivity and using extrathermodynamic assumptions.However, the principle of ionic additivity is not valid in the determination of single ion thermodynamic values [i.e.ΔG0solv(M+or X−) or ΔG0soln(M+or X−), ΔH0solv(M+or X−) or ΔH0soln(M+or X−)] but additivity principle appears to be valid for the determination of ΔS0solv or soln(M+or X−).Moreover, appropriation of ΔG0solvor ΔH0solv(MX) equally on the basis of equality of radii of cations and anions is also not tenable due to differences in the effective charges of the cations and anions of equal radii.
Density and Surface Tension of the System KF–K2TaF7–Ta2O5
Authors: Boča Miroslav , Ivanová Zuzana , Kucharík Marián , Cibulková Jarmila , Vasiljev Roman , Chrenková Marta 
Published: September 2006

The density of the system KF–K2TaF7–Ta2O5 was measured by the Archimedean method and the surface tension by the maximum bubble pressure method in the composition range up to 20 mol% Ta2O5.
The density in the system KF–K2TaF7–Ta2O5 increases from KF through K2TaF7 to Ta2O5 and the surface tension increases from K2TaF7 through KF to Ta2O5. Based on the measured density values, the molar volumes of the binary and ternary melts at 860 °C, 900 °C and 950 °C were calculated as well as the partial molar volumes of particular components in different binaries. The small negative deviation from ideal behaviour in the binary system KF–K2TaF7 was identified by the calculation of the molar excess volume. The formation of complex anions [TaF8]3− is expected in this binary system.
The surface tension decreases monotonically from KF to K2TaF7 in the binary system KF–K2TaF7. In the next two binaries KF–Ta2O5 and K2TaF7–Ta2O5 decrease of the surface tension was observed with the initial addition of Ta2O5 followed by the increase of the surface tension by further addition of Ta2O5. Based on measured data it was concluded that in binaries KF–Ta2O5 and K2TaF7–Ta2O5 the surface active component is Ta2O5 and in the binary KF–K2TaF7 the surface active component is K2TaF7.
Mathematical description of the concentration dependence of the molar volume and surface tension of the measured ternary system was done by the polynomial function at 860°C, 900°C, and at 950°C.
Neonatal Screening for Cystic Fibrosis Does Not Affect Time to First Infection WithPseudomonas aeruginosa
Authors: Baussano Iacopo , Tardivo Irene , Bellezza-Fontana Rossana , Forneris Maria Pia , Lezo Antonella , Anfossi Luciano , Castello Mario , Aleksandar Veljkovic , Bignamini Elisabetta 
Published: September 2006

OBJECTIVE. Newborn screening for cystic fibrosis was introduced in the Piedmont region of Italy in the year 2000. Our aim with this study was to estimate the effect of newborn screening on the risk of Pseudomonas aeruginosa infection at the regional cystic fibrosis pediatric reference center.METHODS. The time to first infection with P aeruginosa within the historical cohort of cystic fibrosis children diagnosed between January 1, 1997, and June 30, 2004, was investigated, comparing survival functions and the adjusted hazard ratio of children diagnosed before and after newborn screening introduction. The role of pancreatic insufficiency was also concurrently investigated.RESULTS. Overall, 71 children diagnosed with cystic fibrosis were identified, 27 cases were clinically diagnosed before newborn screening introduction, and 5 of them presented with meconium ileus, whereas 44 were identified by newborn screening. Among them 35 needed pancreatic enzyme supplementation, whereas 34 children were infected with P aeruginosa. Both the nonparametric and semiparametric survival estimates failed to show any significant increase in the risk of P aeruginosa infection among screened children compared with historical controls. However, the median time from cystic fibrosis diagnosis to P aeruginosa infection among screened children was significantly shorter (183 vs 448 days). Children with impaired pancreatic function were at high risk of P aeruginosa infection.CONCLUSIONS. The results of the study suggest that health authorities should regard newborn screening for cystic fibrosis as an opportunity to improve care and outcomes among affected children and shift the focus from whether it is appropriate to screen to how to optimize biomedical and psychosocial outcomes of screening.
Pediatricians' Knowledge, Training, and Experience in the Care of Children With Fetal Alcohol Syndrome
Authors: Gahagan Sheila , Sharpe Tanya Telfair , Brimacombe Michael , Fry-Johnson Yvonne , Levine Robert , Mengel Mark , O'Connor Mary , Paley Blair , Adubato Susan , Brenneman George 
Published: September 2006

OBJECTIVES. Prenatal exposure to alcohol interferes with fetal development and is the leading preventable cause of birth defects and developmental disabilities. The purpose of this study was to identify current knowledge, diagnosis, prevention, and intervention practices related to fetal alcohol syndrome and related conditions by members of the American Academy of Pediatrics.
METHODS. This study was developed collaboratively by the American Academy of Pediatrics and the Centers for Disease Control and Prevention. Questionnaires were mailed to a 3% random sample (n = 1600) of American Academy of Pediatrics members in the United States. General pediatricians, pediatric subspecialists, and pediatric residents were included.
RESULTS. Participation rate was 55% (n = 879). Respondents almost universally knew the teratology and clinical presentation of fetal alcohol spectrum disorders. However, they were less likely to report comfort with routine pediatric care of these children. Whereas 62% felt prepared to identify and 50% felt prepared to diagnose, only 34% felt prepared to manage and coordinate the treatment of children with fetal alcohol spectrum disorders. Even fewer (n = 114 [13%]) reported that they routinely counsel adolescent patients about the risks of drinking and pregnancy.
CONCLUSIONS. The survey confirms that pediatricians are knowledgeable about fetal alcohol syndrome but do not feel adequately trained to integrate the management of this diagnosis or prevention efforts into everyday practice. Furthermore, the respondents were not active in routine anticipatory guidance with adolescents for prevention of alcohol-affected pregnancies. The development, dissemination, and implementation of best practice tools for prevention, diagnosis, and referral of fetal alcohol syndrome that are specific for general and subspecialist pediatricians are recommended.
Are Encephaloceles Neural Tube Defects?
Authors: Rowland Courtney A. , Correa Adolfo , Cragan Janet D. , Alverson Clinton J. 
Published: September 2006

OBJECTIVE. Encephalocele is classified as a neural tube defect, but questions have been raised regarding whether its epidemiological characteristics are similar to those of other neural tube defects.DESIGN. We compared characteristics of temporal trends in, and the impact of folic acid grain fortification on, the prevalence of encephalocele, spina bifida, and anencephaly using data from the Metropolitan Atlanta Congenital Defects Program, a population-based birth defects surveillance system. Prevalences of encephalocele, spina bifida, and anencephaly were compared by maternal age, gender, race, birth weight, ascertainment period (1968–1981, 1982–1993, or 1994–2002), and fortification period (1994–1996 [prefortification] and 1998–2002 [postfortification]) using prevalence ratios with 95% confidence intervals. Temporal trends were assessed using Poisson and negative binomial regression models.RESULTS. Prevalence rates of encephalocele (n = 167), spina bifida (n = 650), and anencephaly (n = 431) were 1.4, 5.5, and 3.7 per 10 000 live births, respectively. Encephalocele was similar to anencephaly in showing an increased prevalence among girls and multiple gestation pregnancies and to spina bifida and anencephaly in an annual prevalence decrease between 1968 and 2002 (−1.2% for encephalocele, −4.2% for spina bifida, and −3.6% for anencephaly). With fortification, prevalence decreased for spina bifida but not significantly for encephalocele or anencephaly.CONCLUSIONS. Encephalocele shows more similarities to spina bifida or anencephaly than it shows differences with respect to characteristics, temporal trend, and impact of fortification. Additional studies should be done to explore the etiologic heterogeneity of encephalocele using better markers of folate status and a wider range of risk factors.
Maternal Depression and Violence Exposure: Double Jeopardy for Child School Functioning
Authors: Silverstein Michael , Augustyn Marilyn , Cabral Howard , Zuckerman Barry 
Published: September 2006

OBJECTIVE. The goal was to determine how violence exposure affects the relationship between maternal depression, cognitive ability, and child behavior.
METHODS. A multivariate regression analysis of data for a nationally representative sample of kindergarten students was performed. Maternal depression and violence exposure were measured with standardized parent interviews. Standardized T scores were derived from direct testing of children in reading, mathematics, and general knowledge; child behavior was reported by teachers.
RESULTS. A total of 9360 children had neither maternal depression nor violence exposure, 779 violence only, 1564 depression only, and 380 both. Maternal depression alone was associated with poorer mean T scores for reading, mathematics, and general knowledge. However, this effect was attenuated by nearly 25% for reading and general knowledge with adjustment for violence. Children with concurrent exposure to depression and violence had lower mean T scores for reading, mathematics, and general knowledge, as well as more-concerning behaviors, than did those exposed to either factor alone. Across all outcome measures, boys seemed more affected than girls.
CONCLUSIONS. Violence compounds the effect of maternal depression on school functioning and behavior. Research and intervention planning for children affected by maternal depression should consider violence exposure.
Rural and Urban Children With Asthma: Are School Health Services Meeting Their Needs?
Authors: Hillemeier Marianne M. , Gusic Maryellen E. , Bai Yu 
Published: September 2006

OBJECTIVE. Children with asthma spend a large portion of their day in school, and the extent to which public schools are prepared to meet their health needs is an important issue. The objective of this study was to identify asthma policies and practices in rural and urban school settings and to compare them with current National Heart, Lung, and Blood Institute recommendations.
METHODS. A stratified random sample of school nurses who represented each of the 500 active Pennsylvania school districts were surveyed in 2004 concerning nurse staffing patterns, availability of asthma monitoring and treatment-related equipment, emergency preparedness, availability of asthma-related support and case management services, school-specific procedures including identification of children with asthma and accessibility of inhaler medication during school hours, presence and content of written asthma management plans, and perceived obstacles to asthma management in the school setting. Sampling weights were incorporated into the analyses to take the survey design into account.
RESULTS. The overall response rate was 76%, with a total of 757 surveys analyzed. In more than half of secondary schools and three quarters of elementary schools, nurses were present &lt;40 hours per week. Nearly 1 in 5 schools reported that staff who know what to do for a severe asthma attack were not always available. In 72% of rural schools, children were allowed to self-carry rescue inhalers, as compared with 47% of urban schools. Asthma management plans were on file for only 1 quarter of children with asthma, and important information often was omitted. Approximately half of the schools were equipped with peak flow meters and nebulizers, and spacers were available in 1 third of schools.
CONCLUSIONS. Improvements are needed to bring schools into compliance with current recommendations, including more consistent availability of knowledgeable staff, improved access to asthma monitoring and treatment-related equipment, more universal use of asthma management plans, and greater access to inhalers while at school, including increasing the proportion of children who are allowed to carry and self-administer inhaler medication.
Matters of Spirituality at the End of Life in the Pediatric Intensive Care Unit
Authors: Robinson Mary R. , Thiel Mary Martha , Backus Meghan M. , Meyer Elaine C. 
Published: September 2006

OBJECTIVE. Our objective with this study was to identify the nature and the role of spirituality from the parents' perspective at the end of life in the PICU and to discern clinical implications.METHODS. A qualitative study based on parental responses to open-ended questions on anonymous, self-administered questionnaires was conducted at 3 PICUs in Boston, Massachusetts. Fifty-six parents whose children had died in PICUs after the withdrawal of life-sustaining therapies participated.RESULTS. Overall, spiritual/religious themes were included in the responses of 73% (41 of 56) of parents to questions about what had been most helpful to them and what advice they would offer to others at the end of life. Four explicitly spiritual/religious themes emerged: prayer, faith, access to and care from clergy, and belief in the transcendent quality of the parent-child relationship that endures beyond death. Parents also identified several implicitly spiritual/religious themes, including insight and wisdom; reliance on values; and virtues such as hope, trust, and love.CONCLUSIONS. Many parents drew on and relied on their spirituality to guide them in end-of-life decision-making, to make meaning of the loss, and to sustain them emotionally. Despite the dominance of technology and medical discourse in the ICU, many parents experienced their child's end of life as a spiritual journey. Staff members, hospital chaplains, and community clergy are encouraged to be explicit in their hospitality to parents' spirituality and religious faith, to foster a culture of acceptance and integration of spiritual perspectives, and to work collaboratively to deliver spiritual care.