bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSESSING LEG LENGTH DISCREPANCY AFTER FEMORAL FRACTURE: CLINICAL EXAMINATION OR COMPUTED TOMOGRAPHY?
Authors: Harris Ian , Hatfield Angela , Walton Judie 
Published: May 2005

Introduction:  Femoral shaft fractures treated with intramedullary nailing often heal with a leg length discrepancy (LLD). LLD is commonly evaluated by clinical examination and computed tomography (CT) scanogram. We assessed the correlation between these two techniques of calculating LLD.Methods:  We reviewed 35 skeletally mature patients who sustained a femoral shaft fracture between January 1997 and December 1999. Leg length was measured clinically with direct measurement and a block test. Each patient was asked whether they felt they walked with a limp and whether they felt they had a leg length discrepancy. Each patient underwent a CT scanogram to measure femoral and total leg length. The correlation between clinical examination and scanogram was analysed using the Pearson Product Moment Correlation.Results:  Of the 35 patients, 15 patients (43%) had a measurable LLD. There was a positive correlation between direct leg length measurement and the block test (P = 0.003), and between the block test and patient perception of limp and LLD. CT scanogram was performed on 29/35 patients. There was no correlation between CT scanogram and clinical measurement of leg length or between CT scanogram and patient perception of LLD or limp.Discussion:  Leg length discrepancy commonly occurs following treatment of femoral shaft fractures. We found that there was a strong correlation between direct leg length measurement and the block test, and between both methods of clinical leg length measurement and patient perception of a limp or LLD. Our study found no correlation between CT scanogram and clinical leg length measurement or patient perception of limp or LLD.Conclusion:  Our study shows that physical examination (direct measurement and the block test) is more reliable and clinically relevant than CT scanogram measurement in the assessment of LLD after femoral fracture.
SUBSEQUENT SURGERY AFTER INITIAL BREAST CONSERVING SURGERY: A POPULATION BASED STUDY
Authors: Spilsbury Katrina , Semmens James B. , Saunders Christobel M. , Hall Sonja E. , Holman C. D. J. 
Published: May 2005

Background:  In line with current Australian early breast cancer management guidelines, more women are having breast conserving surgery to treat breast cancer when appropriate. Some women will undergo further surgery because of involved margins, early local relapse, or other factors including patient choice. The aim of this study was to investigate whether socio‐economic, demographic or hospital factors were associated with the risk of re‐excision or subsequent mastectomy.Methods:  A record linkage population‐based study on 12 711 women diagnosed with breast cancer in Western Australia from 1982 to 2000 who underwent breast surgery within 12 months of diagnosis was performed. Logistic regression was used to identify social, demographic and hospital factors associated with the risk of undergoing further surgery following initial breast conserving surgery.Results:  The proportion of women undergoing initial breast conserving surgery doubled from 33% in 1982–1985 to 72% in 1998–2000. The proportion of women who underwent further surgery following initial breast conserving surgery decreased from 50 to 30% over the same period. The risk of re‐excision or subsequent mastectomy was between 2.4 (95% CI 1.7–3.4) and 5.0 (95% CI 3.4–7.4) times greater if initial surgery was performed in a non‐metropolitan hospital compared to Perth hospitals. Younger women were between 1.7 (95% CI 1.4–2.0) and 2.1 (95% CI 1.5–3.0) times more likely to undergo re‐excisions compared to women aged 50–64 years of age.Conclusions:  Young women and women initially treated in non‐metropolitan hospitals were at an increased risk of re‐excision or a subsequent mastectomy following initial breast conserving surgery to treat breast cancer. Efforts need to be directed towards improving specialist health services outside of Perth if women continue to be treated for breast cancer in non‐metropolitan hospitals.
TUMOUR CELL FREQUENCY IN PLEURAL LAVAGE IN CASES WITH STAGE I EPIDERMOID LUNG CANCER WITH NO VISCERAL PLEURAL INVOLVEMENT
Authors: Oguzkaya Fahri , Akçali Yigit , Bilgin Mehmet , Haberal Arif , Akgün Hülya 
Published: May 2005

Background:  The presence of tumour cells in the pleural lavage of lung cancer patients with no malignant pleural effusion is a negative prognosticator. In the present study we aimed to determine the lowest frequency of positive pleural lavage in lung cancer.Methods:  The study included 26 consecutive patients who underwent thoracotomy for curative resection for Stage I epidermoid lung cancer. The cases had neither visceral pleural involvement nor obstructive pneumopathy. The patients were applied pleural lavage cytology immediately after thoracotomy.Results:  The frequency of malignant cells in pleural lavage was 7.7% (Stage IA, n = 1, and IB, n = 1).Conclusion:  Our series, in which we predicted the lowest probability of the presence of tumour cells in pleural lavage, had such a frequency of positive tumour cells that shouldn't be neglected. The present study concluded that pleural lavage cytology before pulmonary resection should routinely be performed in ‘all’ lung cancers and that pleural lavage cytology may also be included in the current staging system.
PERFORMING A COLONOSCOPY 12 MONTHS AFTER SURGERY FOR COLORECTAL NEOPLASIA
Authors: Platell Cameron , Salama Paul , Barwood Nigel , Makin Gregory 
Published: May 2005

Background:  There appears to be acceptance that following up patients after surgery for colorectal neoplasia is of value. However, specific issues relating to which investigations to perform and how often remain unresolved. The aim of this project was to evaluate the clinical utility of performing a colonoscopy 12 months after curative surgery for colorectal neoplasia.Methods:  Patients were selected if they had undergone a curative resection for colorectal neoplasia, and if they had had a completed colonoscopy prior to surgery. Study endpoints included: (i) compliance with follow up; (ii) the prevalence, total number, size, and histology of polyps; and (iii) identification of recurrent or metachronous cancer.Results:  The study group included 253 patients of mean age 69.7 years (SD 11.6) and a male : female ratio of 1.4:1.0. Colonoscopies were completed on 90% of patients at a mean of 1.1 years following surgery. A total of 149 polyps were identified in 30% of patients. On histology, 42% were tubular adenomas, 6% tubulo‐villous adenomas, 7% were villous adenomas, and 37% were hyperplastic. Advanced adenomas were identified in 7.9% of patients (95% CI 4.8–12.1%). No recurrent or metachronous cancers were identified.Conclusion:  We have observed a high prevalence of advanced adenomas in patients undergoing a 12‐month, follow‐up colonoscopy after curative surgery for colorectal neoplasia. The significance of these observations requires further evaluation.
DAMAGE CONTROL SURGERY AND ANGIOGRAPHY IN CASES OF ACUTE MESENTERIC ISCHAEMIA
Authors: Freeman Anthony J. , Graham John C. 
Published: May 2005

Background:  Acute mesenteric arterial occlusion typically presents late and has an estimated mortality of 60–80%. This report examines the evolution of a novel management approach to this difficult surgical problem at a teaching hospital in rural Australia.Methods:  A retrospective review of 20 consecutive cases that presented to Lismore Base Hospital, Lismore, New South Wales, between 1995 and 2003 was performed.Results:  Of the 16 patients who were actively treated, 10 survived. Mortality was associated with attempting an emergency operative revascularisation and not performing a second‐look laparotomy. All three patients who had a damage control approach at the initial operation survived and in four cases endovascular intervention successfully achieved reperfusion of acutely ischaemic bowel.Conclusions:  Evidence from the series of patients described suggests that damage control surgery and early angiography improve survival in patients suffering acute mesenteric ischaemia. A damage control approach involves emergency resection of ischaemic bowel with no attempt to restore gastrointestinal continuity and formation of a laparostomy. Patients are stabilised in the intensive care unit (ICU) and angiography can be arranged to either plan a definitive bypass procedure or alternatively endovascular therapies can be carried out in an attempt to arrest gastrointestinal infarction. Definitive surgery is then considered after 2–3 days. This approach is particularly attractive if immediate specialist vascular expertise is not available.
ENDOVASCULAR ABDOMINAL AORTIC ANEURYSM REPAIR: A 7 YEAR EXPERIENCE AT THE LAUNCESTON GENERAL HOSPITAL
Authors: Borchard Kate L. A. , Birch Simone E. , Hewitt Peter M. , Stary David , Scott Alan R. 
Published: May 2005

Background:  To review our 7 year experience of endovascular abdominal aortic aneurysm repair (EVR) and to compare this to open repair (OR) during the same time period.Methods:  One hundred and one EVR and 65 OR patients were studied. Parameters analysed included patient and procedure details, intensive care unit (ICU) and hospital admission time, and morbidity and mortality with particular emphasis on procedure‐related problems.Results:  Endovascular grafts were deployed with successful abdominal aortic aneurysm (AAA) exclusion in 100 patients. Primary technical success was achieved in 84%, clinical success in 86% and secondary success in 90% of cases. Complications occurred in 63% and 88% of EVR and OR patients, respectively. Early device‐related complications occurred in 40 EVR patients (40%); 24 (60%) were corrected immediately by further stenting. Late device‐related complications occurred in 15 EVR patients (15%); four (27%) required additional stenting. Most of the complications in the OR group were systemic (89%) resulting in longer ICU and hospital stays (median 48 vs 17 h and 13 vs 4 days for OR and EVR, respectively). Death within 30 days of the procedure occurred in three EVR patients. There was no perioperative mortality in the OR group.Conclusion:  Endovascular AAA repair can be undertaken successfully in a district general hospital. The majority of local and device‐related complications can be corrected immediately, while those persisting beyond the initial procedure usually resolve spontaneously. EVR offers a minimally invasive approach to a problem that in the past has involved major surgery.
Qualitative Linguistic Terms and Geographic Concepts: Quantifiers in Definitions
Authors: Tomai Eleni , Kavouras Marinos 
Published: May 2005

AbstractDefinitions of categories in existent geospatial ontologies are an invaluable source of information because they provide us with essential knowledge about concepts and their properties. A closer examination reveals that definitions also contain supplementary linguistic items, which are mainly qualitative expressions, such as quantifiers. This inclusion of modifiers in definitions affects the way values are assigned to the categories’ properties (semantic properties and relations). This paper introduces a methodology for: (1) representing the essence of qualitative information to clarify the identity relations among categories; and (2) assessing their semantic similarity in order to disambiguate the taxonomic structure of existent geospatial ontologies.
A Conceptual Framework for Uncertainty Investigation in Map‐based Land Cover Change Modelling
Authors: Leyk Stefan , Boesch Ruedi , Weibel Robert 
Published: May 2005

AbstractUncertainty research represents a research stream of high interest within the community of geographical information science. Its elements, terminology and typology are still under strong discussion and adopted methods for analysis are currently under intensive development. This paper presents a conceptual framework for systematic investigation of uncertainty which occurs in applications of land cover change modelling in Geographical Information Systems (GIS) based on historical map data. Historical, in this context, means the map is old enough to allow identification of changes in landscape elements of interest, such as vegetation. To date such analyses are rarely conducted or not satisfactorily carried out, despite the fact that historical map data represent a potentially rich information source. The general validity and practicability of the framework for related applications is demonstrated with reference to one example in which forest cover change in Switzerland is investigated. The conceptual model consists of three domains in which main potential sources of uncertainty are systematically exposed. Existing links between data quality research and uncertainty are investigated to access the complex nature of uncertainty and to characterise the most suitable concepts for analysis. In accordance with these concepts appropriate methods and procedures are suggested to assess uncertainty in each domain. One domain is the production‐oriented amount of uncertainty which is inherent in the historical map. Vagueness and ambiguity represent suitable concepts for analysis. Transformation‐oriented uncertainty as the second domain occurs owing to editing and processing of digital data. Thereby, the suitable concept of uncertainty is error. The third domain is the application‐oriented uncertainty which occurs in comparing semantically different data. This domain relates to multi‐temporal discord which assumes the assessment of ‘equi‐temporal’ ambiguity and is thus connected to the production‐oriented domain. The framework provides an estimation of the overall amount of uncertainty. This can be linked to subsequent assessment of ‘fitness for use’. Thus the model provides a practicable and systematic approach to access the complex nature of uncertainty in the scope of land cover change modelling.
Buffer Operation on Spatial Data with Limited Accuracy
Authors: Sadahiro Yukio 
Published: May 2005

AbstractThe quality of spatial data is limited by the accuracy of their sources such as paper maps and satellite images. It is also reduced by errors in map digitization and photo interpretation. Spatial operations performed on spatial data such as map overlay, buffer operations and spatial smoothing, do not always work correctly because their accuracy depends on the quality of spatial data. The present paper evaluates the accuracy of the buffer operation on a point and a line segment in relation to the positional accuracy of spatial data. Two quantitative measures are introduced to assess the accuracy of the buffer operation. Their explicit forms are derived for a point, and a condition is presented where the measures can be evaluated efficiently by numerical calculation. Applications provide empirical findings that deepen our understanding of the relationship between the accuracy of spatial data and that of the buffer operation.
Spatial Analysis of 1991 Gulf War Troop Locations in Relationship with Postwar Health Symptom Reports Using GIS Techniques
Authors: Proctor Susan P , Gopal Sucharita , Imai Asuka , Wolfe Jessica , Ozonoff David , White Roberta F 
Published: May 2005

AbstractSpatial autocorrelation analysis was used to identify spatial patterns of 1991 Gulf War (GW) troop locations in relationship to subsequent postwar diagnosis of chronic multisymptom illness (CMI). Criteria for the diagnosis of CMI include reporting from at least two of three symptom clusters: fatigue, musculoskeletal pain, and mood and cognition. A GIS‐based methodology was used to examine associations between potential hazardous exposures or deployment situations and postwar health outcomes using troop location data as a surrogate. GW veterans from the Devens Cohort Study were queried about specific symptoms approximately four years after the 1991 deployment to the Persian Gulf. Global and local statistics were calculated using the Moran's I and G statistics for six selected date periods chosen a priori to mark important GW‐service events or exposure scenarios among 173 members of the cohort. Global Moran's I statistics did not detect global spatial patterns at any of the six specified data periods, thus, indicating there is no significant spatial autocorrelation of locations over the entire Gulf region for veterans meeting criteria for severe postwar CMI. However, when applying local G* and local Moran's I statistics, significant spatial clusters (primarily in the coastal Dammam/Dharhan and the central inland areas of Saudi Arabia) were identified for several of the selected time periods. Further study using GIS techniques, coupled with epidemiological methods, to examine spatial and temporal patterns with larger sample sizes of GW veterans is warranted to ascertain if the observed spatial patterns can be confirmed.
Impacts of Spatial Partitioning in Hydroecological Models: Predicting Grassland Productivity with RHESSys
Authors: Mitchell Scott W , Csillag Ferenc , Tague Christina 
Published: May 2005

AbstractEnvironmental models constructed with a spatial domain require choices about the representation of space. Decisions in the adaptation of a spatial data model can have significant consequences on the ability to predict environmental function as a result of changes to levels of aggregation of input parameters and scaling issues in the processes being modelled. In some cases, it is possible to construct a systematic framework to evaluate the uncertainty in predictions using different spatial models; in other cases, the realm of possibilities plus the complexity of the environmental model in question may inhibit numeric uncertainty estimates. We demonstrate a range of potential spatial data models to parameterize a landscape‐level hydroecological model (RHESSys). The effects of data model choice are illustrated, both in terms of input parameter distributions and resulting ecophysiological predictions. Predicted productivity varied widely, as a function of both the number of modelling units, and of arbitrary decisions such as the origin of a raster grid. It is therefore important to use as much information about the modelled environment as possible. Combinations of adaptive methods to evaluate distributions of input data, plus knowledge of dominant controls of ecosystem processes, can help evaluate potential representations. In this case, variance‐based delineation of vegetation patches is shown to improve the ability to intelligently choose a patch distribution that minimizes the number of patches, while maintaining a degree of aggregation that does not overly bias the predictions.
Understanding Health Disparities and Inequities Faced by Individuals with Intellectual Disabilities
Authors: Ouellette‐Kuntz Hélène 
Published: May 2005

Background There is an increasing interest in the notion of health disparities, inequities and inequalities in Canada and elsewhere. In Canada, individuals with disabilities represent one of six groups identified as particularly vulnerable to health disparities.Method This paper combines the literature related to the concepts of inequity and inequality with the body of knowledge on health disparities faced by individuals with intellectual disabilities.Results The value of distinguishing inequity from inequality, particularly as it relates to the experience of individuals with intellectual disabilities, is highlighted.Conclusions A framework for the study of health inequities based on intellectual impairment is proposed.
Patterns of Obesity among Children and Adolescents with Intellectual Disabilities in Taiwan
Authors: Lin Jin‐Ding , Yen Chia‐Feng , Li Chi‐Wei , Wu Jia‐Ling 
Published: May 2005

Background  Obesity and the health problems associated with it have substantial economic consequences for health care systems. Little information is available concerning obesity‐related problems among people with intellectual disabilities. The aims of this study were to analyse patterns of obesity among children and adolescents with intellectual disabilities in Taiwan and to compare these data with existing national norms in an attempt to identify the scale of the problem of obesity among this population.Methods  Information was collected by postal questionnaire on a total of 279 children and adolescents with intellectual disabilities (age 4–18 years).Results  Sixty‐four per cent of participants in the study had multiple disabilities and 40% had additional health needs. In terms of general health status, most of the persons with intellectual disabilities were reported to be in fair or good health, with 9% of them being reported to be unhealthy or very unhealthy. Body mass index (BMI) was related to age, but not to gender, morbidity or prescribed medication at the time of the survey. However, average BMI was higher than relevant population norms reported in Taiwan's Third National Nutrition and Health Survey (1993–1996). The overall prevalence of obesity was 18%, with 14% of participants aged 4–6 years, 22% of participants aged 7–12 years and 16% of participants aged 13–18 years being obese. In a multiple regression analysis of BMI, age was the only significant predictor of obesity, accounting for 8% of variation.Conclusions  The findings suggest that the problem of obesity among children and adolescents with intellectual disabilities should be considered a major public health concern that warrants further attention in health care systems.
The Impact of Medical Conditions on the Support of Children with Profound Intellectual and Multiple Disabilities
Authors: Zijlstra H.P. , Vlaskamp C. 
Published: May 2005

Background The aim of this study was to analyse the impact of medical conditions of children with profound intellectual and multiple disabilities on the professional support they receive in centres for special education.Method The medical files, the daily records and daily communication records between parents and professionals were reviewed for 48 children with profound intellectual and multiple disabilities in three centres for special education in the Netherlands. In addition, interviews were held with direct service professionals and medical doctors to complete the data collection.Results Not only do major medical conditions, such as hospital admissions, but also minor medical conditions, such as an increase in body temperature or the drowsy state a child is in as a result of a seizure, have an impact on performing activities and therapies in a child's educational centre.Conclusions As a result of the prevalence of the medical conditions, professionals may decide not to carry on actions that were planned or do not offer an alternative programme. The risk of many ‘empty’ hours despite the presence of highly specialized professional support is high.