bluuebunny/crossref_metadata_2025_split huggingface dataset:
Selection criteria for endoscopic retrograde cholangiopancreaticography (ERCP) in patients with gallstone disease
Authors: Trondsen Frik , Edwin Bjørn , Reiertsen Ola , Fagertun Hans , Rosseland Arne R. 
Published: December 2004

AbstractEndoscopic retrograde cholangiopancreatography (ERCP) has been used in patients referred for cholecystectomy when clinical information, biochemical values, or ultrasonography (clinical characterization) have indicated possible presence of common bile duct stones. A retropective study of 599 patients treated for gallstone disease was used to develop a characterization procedure for predicting common bile duct stones by a discriminant analysis procedure. The variables selected by the analysis as the best combination for CBDS prediction were age (years), the values of bilirubin (micromol/I), ALAT (U/I) and gamma GT (U/I). The characterization was false positive in 22 cases (3.7%) and false negative in 11 cases (1.8%), compared to 198 false positive cases (33.1%) and three false negative cases (0.5%) by the clincal characterization. A leaving‐one‐out correction did not change the results. In a test set of 157 cholecystectomy patients, clinical characterization was false positive in 44.6% of the patients, compared to 4.5% false positive results when using the discriminant analysis procedure. The discriminant analysis procedure would have missed one patient with common bile duct stones. Selection by the discriminant analysis characterization procedure seems to reduce the frequency of preoperative ERCP significantly without an inerease in undetected common bile duct stones.
Gastritis in Barrett's esophagus
Authors: Mason Rodney J. , Bremner Cedric G. 
Published: December 2004

AbstractDuodenogastric reflux has been implicated in the pathogenesis of complicated Barrett's esophagus and gastric ulceration. A group of 123 Barrett's patients were followed for a mean of 41 months; 9 (7%) developed gastric ulceration (GU). Of the Barrett's patients treated by antireflux surgery, 14% developed GU. We reviewed the gastric histology on 54 Barrett's patients (34 men, 20 women; average age 64 years) at presentation and classified the gastritis according to the Sydney system. A normal histologic pattern was present in seven patients; 15 patients had chronic pangastritis, 9 chronic antral gastritis, and 18 chronic gastritis of the corpus. Five patients had acute gastritis only, and in 74% there was reactive chronic gastritis. Of the patients with chronic gastritis, 45% (19 of 42) had histologic evidence of duodenogastric reflux, established by the bile reflux index. The presence of reactive chronic gastritis in Barrett's patients may have important pathophysiologic and therapeutic implications.
Pattern of arterial aneurysms in acquired immunodeficiency disease
Authors: Marks Charles , Kuskov Sergey 
Published: December 2004

AbstractThe ever‐spreading incidence of infection with the human immunodeficiency virus (HIV) has introduced a spectrum of unusual, subtle, and often life‐threatening lesions that can affect almost every organ and tissue in the body. With the introduction of laboratory serologic evidence of HIV infection, the spectrum of indicator diseases has extended beyond the classic opportunistic infections and Kaposi sarcoma. An analysis of 28 patients in Zimbabwe with focal areas of vascular disease treated during a 4‐year period (1989–1993) defined 16 patients ranging in age from 12 to 46 years appropriate for special scrutiny as they evinced none of the usual causes of vascular disease. Twelve of the patients were HIV‐positive; in two patients the serologic status was unknown; and two patients were HIV‐negative at the time of their presentation. There were special clinical features in this group of patients selected for study: (1) They were young with a mean age of 31 years; (2) they were all indigenous Africans with no evidence of atherosclerosis; and there was (3) rapid development of focal necrotizing vasculitis with aneurysm formation and rupture or (4) slow, progressive development of granulomatous vasculitis. The sites of cardiovascular involvement included the left ventricle; aortic arch; thoracic, thoracoabdominal, and abdominal aorta; and iliac, femoral, gluteal, popliteal, and subclavian arteries. It is inferred that the association between HIV‐positive status and arterial aneurysms or fibroproliferative aortic occlusion are causally related and that the principles of vascular surgery can be successfully applied to their treatment.
Corticotropin‐releasing hormone test: Improvement of the diagnostic accuracy of simultaneous and bilateral inferior petrosal sinus sampling in patients with cushing syndrome
Authors: Zarrilli Lucio , Colao Annamaria , Merola Bartolomeo , La Tessa Giuseppe , Spaziante Renato , Tripodi Francesca S. , Di Sarno Antonella , Marzano Luigi A. , Lombardi Gaetano 
Published: December 2004

AbstractTwenty‐six consecutive patients with ACTH‐dependent Cushing syndrome were subjected to simultaneous, bilateral inferior petrosal sinus sampling for ACTH assay before and after ACTH‐releasing hormone (CRH) stimulation. The baseline ACTH inferior petrosal sinus/periphery (IPS/P) ratio was ≥2 in 12 of 26 patients (46%), whereas the CRH‐stimulated IPS/P ratio was ≥ 3 in 19 of 26 patients (73%). A pituitary adenoma, ACTH‐secreting at immunostaining, was surgically proved in all of the 19 patients who had an ACTH IPS/P ratio ≥ 2 basally or ≥ 3 after the CRH test but also in three other patients who did not have such ratios. The value of the basal IPS/P ratio and the complete lack of ACTH increase after CRH led to the diagnosis of an ectopic ACTH syndrome in four patients: a bronchial carcinoid was found in three patients, and the site of the tumor was still unknown in the other. In conclusion, the CRH test improved the diagnostic accuracy of inferior petrosal sinus sampling from 61.5% (12 pituitary, 4 ectopic) to 92.0% (19 pituitary, 4 ectopic). Thus it should be performed during the diagnostic process.
Integration of risk factors to allow patient selection for adjuvant systemic therapy in lymph node‐negative breast cancer patients
Authors: Wood William C. 
Published: December 2004

AbstractThe selection of patients with axillary lymph node‐negative breast cancer who should receive adjuvant therapy today is confused by an expanding arsenal of putative prognostic factors. The size of the primary tumor remains the dominant factor in sorting among this group of patients, with general agreement that tumors 1 cm or less should be spared adjuvant systemic therapy outside of a clinical trial. There are a few favorable histologic subgroups that may be added to this excluded group: ductal carcinoma in situ and pure tubular, papillary, and typical medullary tumors. For the larger tumor (generally >2 cm in diameter, but always >3 cm), there is little disagreement that adjuvant therapy is indicated. The host of additional prognostic factors are directed mainly toward the group of tumors that fall between these two categories. Nuclear grade, S‐phase, and perhaps p53 mutations influence decisions for treatment by their elevation. Although the decision remains with the patient and the recommendation with the mature judgment of the clinician, the prognostic indicators available continue to multiply. That an indicator can retrospectively sort prognosis is of limited interest. It requires prospective validation in another patient population, reproducibility in other laboratories, and multivariate analysis among factors measured on the same population of patients to integrate a factor into clinical decision‐making. It is only beginning to be accomplished. The next generation of factors being sought are those that predict for response or lack or response to specific therapies, rather than merely indicating natural history. Estrogen and progesterone receptors are the prototypes of this class of indicators.
Risk factors and management of local recurrence following breast conservation surgery
Authors: Osteen Robert T. 
Published: December 2004

AbstractAlthough a number of histologic and treatment factors that individually and in combination predict for an increased risk of local recurrence after breast conserving surgery can be identified, none so obviously compromises survival that breast conservation is contraindicated because that risk factor is present. In‐breast recurrence is associated with the risk of any disease remaining after lumpectomy if the breast is not irradiated and the risk of large amounts of residual disease if irradiation is used. Some risk factors appear to predict for both local recurrence and distant recurrence, whereas others predict an increased risk of local recurrence but appear to have little effect on the risk of metastatic disease. Overall, the relation between in‐breast recurrence and the risk of systemic metastases is poorly understood. Furthermore, the efficacy of chemotherapy in decreasing the risk of systemic metastases after in‐breast recurrence has not been evaluated. Mastectomy is the treatment of choice for in‐breast recurrence after breast conserving surgery and radiation therapy. A few patients are candidates for a second attempt at breast conservation.
Management of inflammatory breast cancer
Authors: Singletary Sonja E. , Ames Frederick C. , Buzdar Aman U. 
Published: December 2004

AbstractInflammatory breast cancer (IBC) is a rare but often fatal disease. This review discusses the following conclusions: (1) The diagnosis IBC is based on the clinical triad of erythema, ridging with peau d'orange, and rapid onset. The importance of histologic evidence of dermal lymphatic involvement is controversial. (2) Combining doxorubicin‐containing chemotherapy with mastectomy or radiation therapy improves survival over that achieved with mastectomy or irradiation alone. (3) Mastectomy after induction chemotherapy may not improve survival or decrease locoregional recurrence rates, but the surgery does provide important prognostic information on treatment response and enables use of a lower radiation dose afterward, which results in reduced long‐term complications. (4) The optimal number of cycles and dose intensity of chemotherapy for IBC remain undefined.
Salvage surgery for recurrence after breast conservation
Authors: Osborne Michael P. , Simmons Rache M. 
Published: December 2004

AbstractBreast conservation surgery and radiation therapy are chosen with increasing frequency in breast cancer management. In addition to the risk of developing a contralateral malignancy, these women are at risk for local recurrence or a new primary lesion in the conserved breast. Most of these ipsilateral recurrences can be treated successfully with salvage mastectomy. The prognosis with salvage mastectomy depends on several factors, including the method of diagnosis of the recurrent tumor, the size of the recurrence, the extent of breast involvement at recurrence, the time interval from initial surgery to recurrence, the involvement of axillary nodes at the initial diagnosis and at the time of recurrence, and the histopathology of the recurrent tumor.
Elective laparoscopic appendectomy in patients with familial Mediterranean fever
Authors: Reissman Petachia , Durst Arieh L. , Rivkind Avraham , Szold Amiki , Ben‐Chetrit Eldad 
Published: December 2004

AbstractFamilial Mediterranean fever (FMF) also known as bereditary polyserositis, is an inherited disorder commonly found in Armenians, Turks, Arabs, Balkans, and Jews originating from North African countries. The diagnosis of FMF is based on clinical findings and family history, as no specific diagnostic test is yet available. One of its main clinical features is recurrent acute episodes of peritonitis. During such an episode, physical examination and laboratory findings may be similar to those for acute appendicitis. Therefore up to two‐thirds of FMF patients undergo emergency appendectomy, with the appendix being normal in most cases. As laparoscopic appendectomy has proved to be safe and advantageous, and to prevent misdiagnosis and unnecessary emergency surgery, we performed elective laparoscopic appendectomy in 13 FMF patients ranging in age from 8 to 32 years. They had been suffering from the disease for 1 to 12 years (mean 3.8) and had had an average of 3.5 yearly episodes of FMF peritonitis. All procedures were concluded by laparoscopy without conversion to open surgery. The average postoperative hospital stay was 3.07 days. The only complication was superficial wound infection in one patient (7.6%), and the mean time to regain full normal activity was 8.5 days. We conclude that elective laparoscopic appendectomy in FMF patients is safe. It helps to exclude appendicitis as a cause for peritonitis in these patients and may prevent unnecessary emergency surgery.
Direct Round Window Application of Gentamicin with Varying Delivery Vehicles: A Comparison of Ototoxicity
Authors: Sheppard William M. , Wanamaker Hayes H. , Pack Adam , Yamamoto Satoshi , Slepecky Norma 
Published: December 2004

OBJECTIVETo evaluate patterns of ototoxic damage sustained from gentamicin applied directly to the round window in varying delivery vehicles.SETTINGThe search for a reliable method of drug delivery to the inner ear continues. Vehicles such as Gelfoam, hyaluronic acid, and fibrin may allow for a more reproducible pattern of ototoxic damage.STUDY DESIGNHistological evaluation of vestibular and cochlear damage was performed on Mongolian gerbils after a known dosage of gentamicin in different delivery vehicles.RESULTSVariable ototoxic damage was caused by Gelfoam and fibrin‐based vehicles. No ototoxic damage was found in the Healon vehicle. The vehicle of fibrin and Gelfoam combined resulted in severe damage. There was no evidence of selective cochlear or vestibular ototoxicity in any of the vehicles tested.CONCLUSIONS AND SIGNIFICANCEThe fibrin/Gelfoam vehicle was the only delivery system to produce reliable damage. Ototoxic damage depended on the vehicle. We found no evidence for selective vestibular ototoxicity with gentamicin.
Effects of Viscosity, Taste, and Bolus Volume on Swallowing Apnea Duration of Normal Adults
Authors: Butler Susan G. , Postma Gregory N. , Fischer Eileen 
Published: December 2004

OBJECTIVEThe effects of viscosity, taste, and nectar‐thick liquid bolus volume on swallowing apnea duration (SAD) were examined.STUDY DESIGN AND SETTINGTwenty‐two adults, comprised of 10 males and 12 females, participated. SAD was assessed via nasal airflow during swallow conditions of viscosity (thin liquid, thick liquid, and puree), taste (water, apple juice, lemon concentrate), and nectar‐thick liquid bolus volumes (5, 10, 15, and 20 mL) across three trials.RESULTSA significant main effect of nectar‐thick liquid bolus volume was found (P < 0.05). Viscosity and taste were not significant.CONCLUSIONSSAD increased with increases in bolus volume; however, neither changes in bolus viscosity nor changes in taste affected SAD.SIGNIFICANCEThese findings indicate that since viscosity was not significant, the normative data previously published (by this PI) with 60 healthy adults stratified by age and gender can be utilized for comparison to disordered swallowing without regard to the bolus viscosity being used. EBM rating: D. (Otolaryngol Head Neck Surg 2004;131:860–3.)
The Role of Oxidants and Antioxidants in Otitis Media with Effusion in Children
Authors: Yilmaz Taner , Koçcan Elif Gülin , Besler H. Tanju , Yilmaz Gonca , Gürsel Bülent 
Published: December 2004

OBJECTIVEDetermine the possible role of oxidants and antioxidants in the pathogenesis of otitis media with effusion in children.STUDY DESIGN AND SETTINGRandomized controlled trial, tertiary referral center. The study group was made up of children with otitis media with effusion who were to undergo bilateral ventilation tube insertion and adenoidectomy. The control group was comprised of otherwise healthy children. The blood levels of antioxidants (retinol, β‐carotene, (α‐tocopherol, laycopene, ascorbic acid, superoxide dismutase, glutathione peroxidase, GSH) and oxidation products (malondialdehyde) were determined before and 1 month after the operation in the study group and once only in the control group. These substances were also measured in the adenoid tissue and middle ear fluids.RESULTSIn the study group, the blood levels of antioxidants and oxidants before and after the operation were significantly different when compared with the control group (P < 0.05). In the study group, the blood antioxidant levels increased and oxidant levels decreased significantly after the operation (P < 0.05). The levels after the operation never reached those of the control group.CONCLUSIONS AND SIGNIFICANCEOxidants and antioxidants played a significant role in the pathogenesis of otitis media with effusion in children. These children are under significant oxidative stress. Insertion of a ventilation tube and adenoidectomy significantly decreased the oxidative stress in these patients, but could not normalize it completely. Additional studies are necessary in the clinical use of antioxidants in otitis media with effusion.
A Comparison of the Results of Monolayer versus Smear Cytopreparatory Techniques for Fine‐Needle Aspiration in 100 Consecutive Patients Undergoing Thyroidectomy: A Surgeon's Perspective
Authors: Witt Robert L. 
Published: December 2004

OBJECTIVETo compare thyroid fine‐needle aspiration (FNA) using monolayer (MT) versus conventional smear (CS) cytopreparatory techniques with final histology.STUDY DESIGNRetrospective review of 100 consecutive thyroidectomies.SETTINGTertiary care university affiliated medical center.RESULTS26% of MT aspirates were inadequate compared with 3% of CS aspirates (P < 0.05). The negative predictive values for MT and CS were 86% and 100%, respectively. The positive predictive values for MT and CS were 69% and 90%, respectively.CONCLUSIONSFewer inadequate specimens will be obtained with CS than with MT. A clinician performing FNA can obtain adequate specimens at a rate comparable to that of a hospital‐based cytopathologist.SIGNIFICANCECS provides greater assurance to the patient and the surgeon that a thyroid nodule with a FNA interpreted as benign can be observed. A higher percentage of patients with malignant tumor will receive thyroidectomy with the use of CS technique for FNA. EBM rating: B‐3. (Otolaryngol Head Neck Surg 2004;131:964–7.)
Nightly Variability of Sleep‐Disordered Breathing Measured over 3 Nights
Authors: Stepnowsky Carl J. , Orr William C. , Davidson Terence M. 
Published: December 2004

OBJECTIVETo examine the nightly variability of sleep‐disordered breathing (SDB) as measured by the apnea‐hypopnea index (AHI).STUDY DESIGN AND SETTINGRetrospective comparison of 3 sequential nights of testing performed in the home in 1091 patients who were referred for diagnostic testing of SDB.RESULTSThe Pearson and Intraclass correlation coefficients ranged between 0.88 and 0.90 for each pair of nights. Based on night 1, approximately 90% of patients were classified consistently with “AHI‐high” (the highest AHI measured across the 3 nights) using an AHI threshold of 5. However, 10% were misclassified on night 1 relative to the highest AHI level.CONCLUSION AND SIGNIFICANCEThese findings suggest that (1) 1 night of diagnostic testing for SDB is not sufficient to diagnosis SDB in approximately 1 of every 10 cases, and (2) there is little, if any, significant nightly change in SDB in the home environment. EBM rating: D. (Otolaryngol Head Neck Surg 2004;131:837–43.)
The Impact of Sleep‐Disordered Breathing on Cognition and Behavior in Children: A Review and Meta‐Synthesis of the Literature
Authors: Ebert Charles S. , Drake Amelia F. 
Published: December 2004

OBJECTIVESThe goal of this review is to provide a synthesis of the current literature addressing the effects of sleep‐disordered breathing on cognition and behavior in children aged 2–18.STUDY DESIGN AND SETTINGA computerized search was performed to include studies between 1966 and 2001. Studies were assessed based on research question, sampling, intervention, outcomes, confounding, and statistical methods. Sensitivity analyses were performed for quantitative assessments of selection bias, misclassification, and confounding.RESULTSSeventeen reports with 5312 patients were reviewed. The majority of these studies demonstrated poor sampling, insufficient consideration of confounders, and imprecise use of statistical tools. However, there was little evidence of bias in two studies when scrutinized using a sensitivity analysis.CONCLUSIONSDespite suggested links between daytime behavior problems and neurocognitive deficits, there is little certainty for causality based on the quality of the evidence.SIGNIFICANCEBy discussing the quality of the current evidence, we hope to improve study design and contribute to the development of an understanding of this complex topic.
Insemination potential of male Trichogramma evanescens
Authors: Jacob Sébastien , Boivin Guy 
Published: December 2004

AbstractReproduction strategies of male parasitoids have received less attention than those of the females. In hymenopteran parasitoids that reproduce by arrhenotokous parthenogenesis, virgin females are able to reproduce, but they are constrained to produce only males. In such species, the number of sperm transferred to females is of prime importance for female reproductive success. In this study, we measured the insemination potential of male Trichogramma evanescens Westwood (Hymenoptera: Trichogrammatidae). Independent of their age and their sperm‐depletion status, males continued to mate with females until the end of their life. They quickly depleted their sperm supply by fertilizing 18 females during their lifetime, among which 80% were inseminated during the first 24 h. They fathered around 400 daughters over their lifetime. Our results suggest an absence of imaginal spermatogenesis in T. evanescens males that can be designated as prospermatogenic. Sperm is thus a limited resource in this species and females might encounter males with varying amounts of sperm.
Intoxicants and suicidal behaviour among adolescents: changes in levels and associations from 1992 to 2002
Authors: Rossow Ingeborg , Grøholt Berit , Wichstrøm Lars 
Published: December 2004

ABSTRACTAims To assess whether a substantial increase in substance use over a 10‐year period has had an impact on the level of, or associations with, non‐fatal suicidal behaviour among Norwegian teenagers.Design, setting and participants Two cross‐sectional school surveys applying identical procedures and measures in 1992 and 2002, using national samples comprising 11 000 and 12 000 13–19‐year‐old students.Findings A significant proportion of the increase in the prevalence of attempted suicide among girls could be attributed to the increase in substance use, taking into account other risk and protective factors. Among boys no net increase in the prevalence of attempted suicide was observed, and the impact of substance use on suicidal behaviour was lower in 2002 than in 1992. Yet, it also appeared that unobserved protective factors may have countered the impact of increased substance use among boys. For both genders a larger fraction of attempted suicides was attributable to alcohol intoxication than to use of any other substance.Conclusions A significant increase in use of alcohol and drugs may not necessarily be reflected in changes in the level of suicidal behaviour. Further studies applying other data sources and designs are warranted to supplement and validate the present findings.