bluuebunny/crossref_metadata_2025_split huggingface dataset:
An indigenous role in partnerships for sustainable homelands occupation in Australia
Authors: Carter J. , Claudie D. , Smith N. 
Published: December 2005

AbstractThis project investigates partnerships for environmentally sustainable development (ESD) in a remote part of Australia, from the perspective of indigenous groups, through grounded research involving priority setting, implementation trials and evaluation. By exemplifying the role of the indigenous non‐government organizations (INGOs) and local clan representatives, recommendations for partnership design that enhance equity in partner engagement are suggested. Formalized roles for indigenous groups in communication, social planning and structural systems support can advance the social and cultural dimensions of ESD. Persons in communication roles might design communication tools and awareness raising material, or demonstrate technical equipment. Persons in social planning roles might coordinate and implement plans, and advise institutions about equitable programme design solutions. Persons in structural systems support roles could facilitate action learning, articulate citizen policy solutions and funding priorities and map spatial and structural boundaries and networks for environmental decision making. A person dedicated to each language group is advocated. Copyright © 2005 John Wiley & Sons, Ltd and ERP Environment.
Treatment of Mammary Duct Fistula by Fistulectomy and Saucerization
Authors: Beechey‐Newman N. , Kothari A. , Kulkarni D. , Hamed H. , Fentiman I. S. 
Published: December 2005

AbstractThis study was designed to assess the efficacy and long‐term outcome of fistulectomy and saucerization for treatment of mammary duct fistulae. Mammary fistula is a chronic condition that represents the final step in what has been termed “mammary duct associated inflammatory disease sequence.” The treatment is primarily surgical and may include healing by secondary intention or primary closure with or without antibiotics. Reported series are small and often include variable surgical strategies applied without consistency. A consecutive series of 53 patients who had 59 mammary duct fistulae were treated by fistulectomy with saucerization. The median age was 32 years. Wounds were allowed to heal by secondary intention and antibiotics were not used. We reviewed the case records to establish the incidence of recurrent fistula and the time to complete healing. The long‐term cosmetic outcome was determined by a postal survey. After a median follow‐up of 6 years there had been no relapse in 92%. There was significant delay in healing in six cases (range: 10 to 30 weeks). Thirty‐eight patients (83%) gave a definite history of regularly smoking between 10 and 20 cigarettes a day. Two thirds of the patients were either pleased or satisfied with the final cosmetic result of the surgery, but more than 90% said that it left them with some distortion of the nipple. Fistulectomy and saucerization achieves long‐term cure in the majority of patients with mammary duct fistula, but it results in some degree of distortion of the nipple. The strong relationship between smoking and the occurrence of mammary duct fistulae is again demonstrated.
Anticipated Detection of Imminent Surgeon–Patient Barrier Breaches. A Prospective Randomized Controlled Trial Using an Indicator Underglove System
Authors: Caillot Jean‐Louis , Paparel Philippe , Arnal Eric , Schreiber Vincent , Voiglio Eric J. 
Published: December 2005

AbstractThe double gloving indicator underglove system (IUS) is based on a colored detection of the outer glove perforation. Our objective was to determine the IUS efficiency to detect outer glove perforations and to reduce the risks of blood and body fluids exposure, warning the surgeon before the breach of the surgeon–patient barrier (SPB). A series of 100 visceral surgical procedures were randomly assigned to either double (IUS) or single gloving. The noticed glove perforations (using the water test method) and the IUS efficiency were analyzed in 99 procedures. In 49 single‐gloving procedures, 19 perforations were noticed: one was immediately perceived (perceived accidental exposure, PAE); 3 were discovered as the gloves were being removed, and 15 were undetected before the water test (unperceived prolonged contact, UPC). In 50 double‐gloving procedures (IUS), 16 perforations were noticed, all of them involving only the outer glove: the IUS allowed immediate detection of 3 perforations without any blood exposure; 13 other perforations went undetected but without any UPC. In conjunction with the protective quality of double gloving, the IUS allows detection of significant breaches of the outer glove before the breach of the SPB.
Early Presumptive Therapy with Fluconazole for Occult Candida Infection after Gastrointestinal Surgery
Authors: Shan Yan‐Shen , Sy Edgar D. , Wang Shan‐Tair , Lee Jenq‐Chang , Lin Pin‐Wen 
Published: December 2005

AbstractThe objective of this retrospective comparative study was to improve the outcome of patients with suspected occult Candida infection after gastrointestinal surgery by early presumptive therapy. It was conducted in the National Cheng Kung University Hospital in Taiwan. A total of 36 patients with prolonged ileus with fever after gastrointestinal tract surgery between January 1995 and December 2002 were examined for two time periods: those treated before and those treated after January 1999. One set of patients did not receive early presumptive therapy (EPT) until Candida infection was confirmed, and they were designated EPT(−). Another group of patients with suspected occult Candida infection received EPT and were designated EPT(+). Fluconazole, 400 mg/day, was given as EPT. Urine, wound, intraperitoneal drainage, and blood specimens were obtained from patients for fungus culture before starting treatment and weekly until symptoms subsided. The primary endpoints were the frequency of candidiasis and the persistence of candidemia; the secondary endpoint was the efficiency of EPT in the clinical outcome. There was no difference in Candida peritonitis, wound colonization, or urine colonization in the two treatment groups. Candida albicans accounted for 87.5%% of the isolated Candida species: 84.6%% in the EPT(+) group and 89.5%% in the EPT(−) group. In the EPT(+) group, the positive blood culture rate was 66.7%%. The fever subsided rapidly in 17 patients (94%%), the hospital stay and intensive care unit stay were shorter, and the mortality decreased significantly: 11%% vs. 78%%, P < 0.001. Persistent gastrointestinal ileus was the main cause of breakthrough candidemia. We concluded that EPT with fluconazole improves the prognosis of patients with occult Candida infection after gastrointestinal surgery. Surgical intervention was required in patients with breakthrough candidemia.
Technetium‐99m‐MIBI SPECT/CT in Primary Hyperparathyroidism
Authors: Krausz Yodphat , Bettman Lise , Guralnik Luda , Yosilevsky Galina , Keidar Zohar , Bar‐Shalom Rachel , Even‐Sapir Einat , Chisin Roland , Israel Ora 
Published: December 2005

AbstractThe novel trend toward focused parathyroidectomy requires precise preoperative localization of the parathyroid adenoma in patients with primary hyperparathyroidism (PHPT). The present study evaluated the impact of hybrid single photon emission computed tomography/computed tomography (SPECT/CT), using 99mTc‐sestamibi (MIBI), on the surgical management of these patients. In a retrospective study of 36 patients with PHPT, SPECT/CT was undertaken when planar 99mTc‐MIBI scintigraphy was negative or when an ill‐defined focus in the neck or an ectopic site on planar views was visualized. Imaging data were compared with intraoperative findings, and the incremental value of SPECT/CT to lesion localization and surgical procedure was assessed. Three patients with both negative planar and SPECT/CT studies subsequently underwent bilateral neck exploration, with multiglandular hyperplasia diagnosed in two patients and a parathyroid adenoma in one. Of 33 patients with a positive MIBI study, parathyroid adenoma was confined to the neck in 23 patients and to the lower neck‐mediastinum in 10. SPECT/CT facilitated the surgical exploration of all 10 ectopic parathyroid adenomas and 4 of 23 cervical parathyroid adenomas, the latter four either at reexploration or in patients with nonvisualization of the thyroid after thyroidectomy. SPECT/CT contributed to the localization of parathyroid adenomas in patients with PHPT and to planning the surgical exploration in 14 of 36 (39%) patients, predominantly those with ectopic parathyroid adenomas or who had distorted neck anatomy.
Survival of Young Patients after Gastrectomy for Gastric Cancer
Authors: Llanos Osvaldo , Butte Jean Michel , Crovari Fernando , Duarte Ignacio , Guzmán Sergio 
Published: December 2005

AbstractIt has been suggested that gastric cancer has a worse prognosis in young patients, but the data are controversial. The aim of this study was to compare the 5‐year survivals after gastrectomy for gastric cancer in two groups of patients (those ≤45 years of age and those (>45 years) and to determine some of the prognostic factors. The 5‐year survival was significantly better for patients ≤45 years of age. Survival was also better for young patients with a curative resection and also for those with lymph node metastases. However, survival was not significantly different for the two groups when the resection was not curative and when the lymph nodes were not involved. Survival was no different for the two groups when compared at each stage, although a multivariate analysis showed that age >45 years, moderate or poor degree of differentiation of the tumor, advanced tumors, the presence of lymph node involvement, and a noncurative resection were independent negative prognostic factors. Long‐term survival after gastrectomy for gastric cancer depends on the stage of the disease; the age of the patient is not a decisive factor.
Successful Repair of Iatrogenic Rectourinary Fistulas Using the Posterior Sagittal Transrectal Approach (York‐Mason): 15‐Year Experience
Authors: Moro Fabrizio Dal , Mancini Mariangela , Pinto Francesco , Zanovello Nicola , Bassi Pier Francesco , Pagano Francesco 
Published: December 2005

AbstractIntroductionRectourinary fistulas (RUFs) represent a challenging clinical problem. Most RUFs are secondary to lower urinary or intestinal tract surgery. Several surgical approaches have been proposed. The aim of this study was to review a 15‐year experience using the York‐Mason posterior sagittal transrectal approach to iatrogenic RUFs.MethodsSeven patients with RUFs secondary to urologic surgery were operated on with the York‐Mason technique at the Department of Urology, University of Padova, Italy between 1988 and 2003. The patients’ data have been collected and analyzed retrospectively.ResultsAll the patients were treated successfully (100%). In one patient with Crohn’s disease the fistula recurred 11 years after the first surgery. One patient died for metastasis of prostate cancer 1 year after surgical repair of the RUF. A temporary colostomy was performed in five patients; the colostomies were subsequently closed, and the patients regained complete fecal continence with no postoperative anal strictures. The colostomy remained in place in one patient with Crohn’s disease and in another with ulcerative rectocolitis.ConclusionsThe posterior sagittal transrectal approach provided easy access and identification of RUFs and good surgical exposure, with no subsequent strictures or fecal incontinence. Our data show that the York‐Mason technique alone is a highly effective option for treating an iatrogenic postoperative RUF.
Surgical Management of Small Gastrointestinal Stromal Tumors of the Stomach
Authors: Iwahashi Makoto , Takifuji Katsunari , Ojima Toshiyasu , Nakamura Masaki , Nakamori Mikihito , Nakatani Yoshihiro , Ueda Kentaro , Ishida Koichiro , Naka Teiji , Ono Kazuo , Yamaue Hiroki 
Published: December 2005

AbstractSmall gastrointestinal stromal tumors (GISTs) (<3 cm) occasionally are found in the stomach during endoscopy. There is no consensus about the surgical management of these small tumors, although this clinical issue is crucial because some of the tumors show unexpected malignant behavior. In this study, we evaluated the clinical management of patients with gastric GISTs who underwent surgical resection. Altogether, 31 patients with gastric GISTs were examined retrospectively. Surgical resection was fundamentally indicated for the patients with gastric GISTs suspected to be malignant by endoscopy or endoscopic ultrasonography (EUS). The malignant grade of the GISTs was evaluated by the mitotic rate, tumor size, and MIB‐1 index. EUS was useful for differentiating benign from malignant GISTs; but by limiting the study to patients with small tumors (<3 cm), the diagnostic value of EUS was not satisfactory for defining the surgical indication. Tumors that were <50 mm were successfully treated by laparoscopic surgery. Of the 31 patients, 4 had a relapse of the disease, and 1 of those 4 patients had a small tumor (30 mm). All of the recurrences were classified in the high risk category. Surgery is indicated for gastric GISTs that are ≥20 mm or are suspected to be malignant based on EUS findings. Laparoscopic resection is feasible and is recommended as the treatment of choice for patients with tumors < 50 mm. Risk assessment can be most useful for predicting recurrence.
Role of Interval Appendectomy in the Management of Complicated Appendicitis in Children
Authors: Vane Dennis W. , Fernandez Nathanial 
Published: December 2005

AbstractIntroductionThe aim of this study was to ascertain the optimal treatment for children with complicated appendicitis. We reviewed an inception cohort of children with documented complicated appendicitis to develop criteria for interval appendectomy. We compared the outcomes of two treatments: immediate operation and interval appendectomy.MethodsChildren with complicated appendicitis were separated into two groups. Group 1 patients had had symptoms of complicated appendicitis for less than 72 hours or appeared toxic. Group 2 patients had had symptoms of complicated appendicitis for longer than 72 hours and did not appear toxic. Group 1 underwent immediate operation treated by criteria previously published. Group 2 patients were treated in hospital with triple antibiotics until they were afebrile, had normal white blood cell counts, tolerated an oral diet, and had adequate pain control. They were discharged on oral metronidazole or metronidazole plus Bactrim for 6 weeks and then underwent interval appendectomy.ResultsA total of 86 children had complicated appendicitis; 59 were operated on immediately, and 27 underwent an interval appendectomy. Complications included one wound infection and two intraabdominal abscesses (all in group 1). There was one death (group 1). The length of stay for the immediate operation group was 4.9 ± 1.7 days; the initial‐admission length of stay for the interval appendectomy group was 4.1 ± 1.0 days with a subsequent postoperative stay of 0.9 ± 0.8 days. One patient in the interval appendectomy group was treated off protocol.ConclusionsTreating selected children with interval appendectomy led to a decrease in complications and a shorter length of stay in this limited population. Interval appendectomy is a safe, cost‐effective, useful adjunct treatment for children with complicated appendicitis.
Prognostic Factors for Sporadic Medullary Thyroid Carcinoma
Authors: Gülben Kaptan , Berberoğlu Uğur , Boyabatlı Mustafa 
Published: December 2005

AbstractIntroductionMedullary thyroid carcinoma (MTC) originates from the thyroid parafollicular cells and accounts for 3% to 10% of all thyroid malignancies. Approximately 84% of cases are sporadic. The aim of this study was to evaluate the outcomes of treatment for sporadic medullary thyroid carcinoma (SMTC) and define the prognostic factors for overall survival.MethodsThe records of 32 SMTC patients treated at Ankara Oncology Education and Research Hospital between September 1993 and April 2003 were retrospectively evaluated. The effects of age, gender, tumor localization, extent of the primary surgical resection, tumor size, capsule invasion, lymph node metastasis, extranodal extension, tumor stage, local recurrence, and distant metastasis on the overall survival rate were evaluated by univariate and multivariate analyses.ResultsThere were 32 patients (19 females, 13 males) with a median age of 45 years (21–76 years). Altogether, 22 patients had undergone complete resection and 10 patients incomplete resection. The median follow‐up was 48 months (9–111 months), and the overall 5‐year survival rate was 51%. Based on the univariate analysis, the extent of primary surgical resection, pathologic tumor size, capsule invasion, lymph node invasion, extranodal extension, tumor stage, local recurrence, and distant metastasis were factors that significantly affected survival. In the multivariate analysis, however, only the extent of the primary surgical resection, capsule invasion, and distant metastasis were found to be statistically significant factors.ConclusionsThe extent of the primary surgical resection significantly influences the survival of patients with SMTC. Capsule invasion and distant metastasis were additional factors affecting the prognosis.
Complications Following D3 Gastrectomy: Post Hoc Analysis of a Randomized Trial
Authors: Wu Chew‐Wun , Chang I‐Shou , Lo Su‐shun , Hsieh Mao‐Chin , Chen Jen‐Hao , Lui Wing‐Yiu , Whang‐Peng Jacqueline 
Published: December 2005

AbstractIntroductionA single institutional surgical trial for gastric cancer had demonstrated increased morbidity but not mortality. This report analyzes risk factors affecting morbidity.MethodsRisk factors for morbidity in 221 patients treated with curative intent were evaluated in a prospective randomized trial comparing D1 and D3 surgery for curable gastric cancer.ResultsThe surgeon’s experience after 25 nodal dissections had no influence on surgical or overall complications, nor did the patients’ co‐morbidity (e.g., respiratory system disease, cardiac disease, diabetes mellitus). Distal pancreatectomy negatively affected surgical morbidity [relative risk (RR) 6.21, 95% confidence interval (CI) 1.869–20.626] and overall morbidity (RR 5.50, 95% CI 1.671–18.082). All of the patients with a distal pancreatectomy underwent concomitant splenectomy. Multivariate analysis found splenectomy and nodal dissection to be the only two independent risk factors adversely affecting operative morbidity. The RR of splenectomy for surgical complications was 4.19 (95% CI 1.327–13.208), and for overall complications it was 3.88 (95% CI 1.259–11.973). The RR of nodal dissection for surgical complications was 2.51 (95% CI 1.336–4.730), and for overall complications it was 1.93 (95% CI 1.149–3.255).ConclusionsSplenectomy (with or without pancreatectomy) and nodal dissection are risk factors for operative morbidity but not mortality.
Effects of Peritoneal Lavage with Scolicidal Agents on Survival and Adhesion Formation in Rats
Authors: Topcu Omer , Kuzu Isinsu , Karayalcin Kaan 
Published: December 2005

AbstractIntraoperative irrigation of the peritoneal cavity with scolicidal agents is frequently recommended when dealing with traumatic or spontaneous rupture of hydatid cysts. The present experimental study was designed to examine the influence of various scolicidal agents on adhesion formation and survival. A total of 149 rats were randomly allocated to nine groups. Peritoneal lavage through a median laparotomy was performed with the following scolicidal agents. Group 1 (0.9% saline: controls), group 2 (20% hypertonic saline), group 3 (0.04% chlorhexidine gluconate), group 4 (3% hydrogen peroxide), group 5 (0.5% silver nitrate), group 6 (1% polyvinylpyrrolidone‐iodine, or PVP‐I ), group 7 (5% PVP‐I), group 8 (0.5% cetrimide/0.05% chlorhexidine), and group 9 (10% PVP‐I). The surviving animals were sacrificed on postoperative day 15. Adhesion formation was macroscopically graded by the Nair criteria. The severity of adhesion formation was evaluated microscopically using the fibrosing scoring criteria and the strain test. Group 9 (10% PVP‐I) was excluded from the adhesion evaluation because all of the rats died in this group. The mortality rate was significantly higher in groups 5 and 7 than in groups 1, 2, 3, 4, 6, and 8. Adhesion scores were significantly lower in groups 1, 2, 3, and 4 than in groups 5, 6, 7, and 8. The lowest adhesion score was found in group 3 and the highest in the group 7. These results indicate that 0.04% chlorhexidine gluconate, the most potent scolicidal agent in vitro and in vivo, was associated with the lowest adhesion formation and mortality among various scolicidal agents in this experimental study.
Clinical Characteristics and Prognosis of Pediatric Hepatocellular Carcinoma
Authors: Yu Seung‐Beom , Kim Hyun‐Young , Eo Hong , Won Jae‐Kyung , Jung Sung‐Eun , Park Kwi‐Won , Kim Woo‐Ki 
Published: December 2005

AbstractIntroductionHepatocellular carcinoma (HCC) is a rare pediatric malignancy that is usually advanced at diagnosis, with a relatively poor prognosis. Extensive treatment, including complete tumor resection, is believed to be necessary for cure. This study was performed to analyze treatment results and to search for prognostic factors of pediatric HCC.MethodsBetween March 1982 and February 2004 a total of 16 children had been diagnosed as having HCC in our institution, and a retrospective analysis was performed.ResultsThe median age at diagnosis was 10.5 years, and the male/female ratio was 11:5. As a predisposing condition, hepatitis B virus (HBV) infections were present in 11 (68.8%) and liver cirrhosis in 8 (50.0%). Including 1 patient with a liver transplant, 4 patients (25.0%) underwent a primary operation with complete tumor resection, and 11 (68.8%) received neoadjuvant chemotherapy because of their inoperable state at diagnosis. After neoadjuvant chemotherapy, complete tumor resection was performed in four (36.4%). Thus complete resection was undertaken in a total of eight patients (50.0%). The estimated 5‐year survival rate of all patients was 27.3%. The 5‐year survival rate for patients who underwent complete tumor resection was 62.5%, and for those who underwent palliative resection or no operation it was 0%. The statistically significant prognostic factors were tumor stage, presence of metastasis, and complete tumor resection.ConclusionsThis study confirmed that complete tumor resection is essential for cure in pediatric patients with HCC, and neoadjuvant chemotherapy improves the tumors’ resectability.
Randomised clinical trial comparing oral versus depot formulations of zuclopenthixol in patients with schizophrenia and previous violence
Authors: Arango C. , Bombín I. , González-Salvador T. , García-Cabeza I. , Bobes J. 
Published: December 2005

AbstractObjectiveThe aim of this longitudinal study was to determine whether the depot formulation of an antipsychotic reduces violence in outpatients with schizophrenia as compared to oral administration of the same antipsychotic.MethodsForty-six previously violent patients with schizophrenia were randomised to receive treatment with oral or depot zuclopenthixol for 1 year. Clinicians interviewed patients at baseline and every month thereafter to assess treatment adherence. An interviewer blinded to treatment assignments interviewed an informant about any violent behaviour during the previous month.ResultsViolence during the follow-up year was inversely proportional to treatment adherence, better compliance, and greater reduction of positive symptoms. Lower frequency of violent acts was observed in the depot group. The level of insight at baseline was not significantly associated with violence recidivism. Regardless of route of administration, treatmentnon-adherence was the best predictor of violence.ConclusionsSome patients with schizophrenia and prior violent behaviour may benefit from the depot formulation of antipsychotic medication.