bluuebunny/crossref_metadata_2025_split huggingface dataset:
Colorectal cancer screening: do they practice what they preach?
Authors: Colquhoun Patrick , Newstead Graham , Weiss Eric G. , Efron Jonathan , Nogueras Juan J. , Vernava Anthony M. , Wexner Steven D. 
Published: November 2003

Introduction:  Compliance for voluntary colorectal cancer (CRC) screening reported by the American Society of Colon and Rectal Surgeons (ASCRS) is>85%. This high rate is assumed to be the result of heightened awareness of CRC. The purpose of the present paper was to determine if observed participation rates in the USA are the result of increased awareness of CRC alone.Methods:  Postal survey of Colorectal Surgical Society of Australia (CSSA).Results:  A response rate of 65% (52\80) was observed. As in the ASCRS, the majority of members support screening (94%); but 4% (2\52) reported that they do not advocate CRC screening, which was lower than that observed in the ASCRS survey (P = 0.03). A total of 94% support screening of baseline risk (BLR) patients at age 50 or less. Support was similar for annual fecal occult blood testing (FOBT; CSSA 54% vs ASCRS 56%, P = NS) for patients with BLR, but much less support for colonoscopy every 10 years (CSq10) was observed (CSSA 31% vs ASCRS 68%, P < 0.01). Similar to the ASCRS, CS every 5 years (CSq5) was the most common strategy advocated to patients with a family history of polyps (CSSA 75% vs ASCRS 78%, P = NS) and cancer (CSSA 94% vs ASCRS 94%, P = NS), respectively. A total of 25% (13\52) of CSSA members report participating in CRC screening, compared to the 55% reported by the ASCRS (P < 0.01). As in the ASCRS, CSq5 (69%) was the most common form of screening undergone. None of the CSSA members were being screened with more than one test, compared to the 46% reported by the ASCRS (P < 0.01). Of those who had not been screened, 82%(31\38) reported that they do plan to undergo CRC screening compared to 99% reported by the ASCRS (P < 0.05).Conclusion:  Screening compliance is significantly higher in the ASCRS than in the CSSA. Awareness of CRC is not the only obstacle to improving screening compliance.
Boerhaave's syndrome: 10 years experience and review of the literature
Authors: Hill Andrew G. , Tiu Albert T. , Martin Iain G. 
Published: November 2003

Background:  Spontaneous oesophageal rupture, also known as Boerhaave's syndrome, is a rare condition. It has a high mortality and its management is clouded with controversy.Methods:  A retrospective review of cases presenting to Middlemore Hospital over a period of 10 years was performed.Results:  A total of eight patients were found to have spontaneous oesophageal perforation. Six were managed operatively and two were managed non‐operatively. There were seven men and one woman, whose ages ranged from 37 to 80 years (median: 64 years) at presentation. Six patients underwent thoracotomy. Five patients had primary closure of oesophageal perforation, two of these with tissue reinforcement. One patient underwent lavage alone without primary closure because there was widespread inflammation from the perforation. Two of the patients were managed non‐operatively. Both subsequently died. The median postoperative stay was 36 days (range: 12−60 days). There was no postoperative mortality.Conclusion:  Boerhaave's syndrome is rare and its management is not uniform. A review of the literature demonstrates wide disparity in management due to the rarity of the condition. Primary repair is appropriate for ruptures diagnosed early. Many are diagnosed late and T‐tube drainage may be the simplest way to manage this difficult condition in this situation.
Surgical management of endoscopic retrograde cholangiopancreatography‐related perforations
Authors: Preetha Madhukumar , Chung Yaw‐Fui A. , Chan Weng‐Hoong , Ong Hock‐Soo , Chow Pierce K. H. , Wong Wai‐Keong , Ooi London L. P. J. , Soo Khee‐Chee 
Published: November 2003

Background:  A retrospective review was carried out of consecutive cases of endoscopic retrograde cholangiopancreatography (ERCP)‐related perforation to identify risk factors and technique affecting surgical outcome.Methods:  Eighteen patients (0.45%) out of 4030 ERCP performed were operated on for ERCP‐related perforation at Singapore General Hospital.Results:  The group's median age was 72.5 years and 14 patients had ductal stone disease. Five perforations were discovered at ERCP while 10 required computed tomography for diagnosis. Eight patients were operated on within 24 h whereas 10 patients had surgery after 24 h. Five of six with type I (lateral duodenal) perforations had early surgery versus one of seven with type II (peri‐Vaterian; P = 0.03). There were four type III (bile duct) perforations and one type IV (retroperitoneal air). Five of six patients with type I perforation had simple repair compared with five of seven type II requiring the complex duodenal diversion procedure (P = 0.10). Three patients (16.7%) succumbed after surgery due to sepsis and myocardial infarction. Advanced age>70 years resulted in higher mortality of 30% versus none in patients <70 years (P = 0.22).Conclusions:  Early diagnosis is important but difficult especially for the type II perforations. Duodenal diversion is used more frequently in patients with type II perforations and those operated on late. Advanced age contributes to poorer outcome in surgical treatment of ERCP perforations.
Intraparathyroid cyst: a tumour of branchial origin and a possible pitfall for targeted parathyroid surgery
Authors: Armstrong Jonathan , Leteurtre Emmanuelle , Proye Charles 
Published: November 2003

Background:  Parathyroid cysts account for 0.5% of parathyroid pathologies. They usually contain sky‐high levels of parathyroid hormone (PTH) but are not necessarily associated with primary hyperparathyroidism (PHPT). Their origin is subject to debate. We provide evidence for a branchial origin and illustrate some potential problems they pose for targeted parathyroid surgery.Methods:  The present study is a single institution retrospective study of 1702 parathyroid and 10 021 thyroid operations performed over a period of 12 years (1990−2001). Twenty‐three cases of parathyroid cyst were found: three palpable neck masses, four cases associated with PHPT and 16 incidental findings at the time of thyroid surgery. Intracystic PTH measurements and immunostaining of the lining wall of the cyst were obtained in 16 out of 23 and 18 out of 23 cases, respectively.Results:  Intracystic PTH levels were elevated in 15 out of 16 cases (average 3877, range 36 000−23 pg\mL). The wall of the cyst stained positively for epithelial cuboidal cell markers (CK +ve) and negatively for PTH (PTH −ve) in 18 out of 18 cases. In only one quarter of the cases associated with PHPT was the cyst the hypersecreting gland, nevertheless it contained less than the average PTH level (1440 vs 3877) and did not take up sestamibi. Results were conflicting in the other three cases. Histological studies on the present series suggest a branchial pouch origin.Conclusion:  Despite containing high levels of PTH, parathyroid cysts are of branchial origin and when associated with PHPT are rarely responsible for the disease. Targeted parathyroid surgery should not rely only on ultrasound and intraparathyroid PTH measurements.
Functional outcome and quality of life after ileal pouch−anal anastomosis in children and adults
Authors: Chew Simon S. B. , Kerdic Richard I. , Yang Jia‐Lin , Shi Edward C. P. , Newstead Graham L. , Douglas Philip R. 
Published: November 2003

Background:  In the past, children with ulcerative colitis were treated with a total colectomy, ileostomy and mucous fistula; ileal pouch−anal anastomosis was postponed until adulthood. The aim of the present study was to assess the functional outcome and quality of life after ileal pouch−anal anastomosis and determine whether it is justified to perform the operation in children when surgery is indicated.Methods:  A retrospective review of 38 medical records was carried out, of which there were 19 paediatric patients and 19 adult patients (control). A questionnaire survey was conducted. Telephone interviews were carried out for the non‐respondents.Results:  Sixteen patients in the paediatric group (nine boys, mean age: 12 years) and 16 patients in the adult group (10 men, mean age: 39 years) were available for analysis. There was no operative mortality. The mean bowel frequency per week was 37 and 42. Furthermore, bowel frequency during the day was slightly lower in the paediatric group. Children had marginally better continence than adults. In the quality of life assessment, the mean utilities in the paediatric group were 0.69 and 0.84 in the preoperative and postoperative status, respectively. These were similar to those in the adult group (0.62 and 0.82). Both groups achieved significantly favourable postoperative responses in terms of ability to perform social activity, recreation and enjoying food.Conclusions:  Ileal pouch−anal anastomosis in children is safe, results in good functional outcome and improves the quality of life. Hence, it is justified to perform ileal pouch−anal anastomosis as soon as surgery is indicated rather than as a delayed procedure.
Carotid redo surgery: both safe and durable
Authors: Harris Richard A. , Stow Nicholas , Fisher Charles M. , Neale Michael L. , Appleberg Michael 
Published: November 2003

Aim:  To examine the outcomes and complications of surgery for recurrent carotid stenosis.Methods:  From 1974 to 2000, 1922 carotid endarterectomies were performed in our unit. A retrospective cohort analysis of these records identified 24 patients (1.2%) who underwent surgery for recurrent stenosis.Results:  There were 13 men and 11 women in the group. Median follow up was 7.2 years (interquartile range 4.4−12.4 years). The indication for redo surgery was either symptomatic severe (80−99%) or moderate (50−79%) restenosis, or severe asymptomatic (80−99%) restenosis. Repair was performed by patch angioplasty (88%), endarterectomy alone (8%) or interposition grafting (4%). Within the 30 day perioperative period there were no deaths, no strokes (major or minor), or significant cardiac morbidity. One patient (4%) developed a permanent spinal accessory nerve deficit. Another patient (4%) required further re‐intervention for recurrent disease.Conclusions:  Very low surgical morbidity and mortality was achieved in our unit by implementing a policy of selective re‐intervention for carotid restenosis. Redo carotid endarterectomy can therefore be recommended as having no greater morbidity than primary carotid endarterectomy. Carotid angioplasty and stenting are not recommended as a routine alternative treatment.
Changes in interaction biodiversity induced by an introduced ungulate
Authors: Vázquez Diego P. , Simberloff Daniel 
Published: November 2003

AbstractLong‐term conservation of biodiversity may depend not only on the maintenance of its component parts but also on their interactions. Here we provide strong evidence that an introduced species is able to affect the network of interactions among coexisting species. We studied plant–pollinator interactions in native forest sites with and without domestic cattle and used these data to construct plant–pollinator interaction networks. Results from nonmetric multidimensional scaling and permutation tests suggest that the presence of cattle has significantly modified the structure of the plant–pollinator interaction network. The effect of cattle on network structure was mainly because of the modification of a few highly frequent interactions, which are likely important from a functional perspective. This overwhelming influence of a few interactions on observed community patterns should serve as a caution to those studying community and ecosystem properties.
Multitrophic links between arbuscular mycorrhizal fungi and insect parasitoids
Authors: Gange Alan C. , Brown Valerie K. , Aplin David M. 
Published: November 2003

AbstractThe effects of arbuscular mycorrhizal colonization of Leucanthemum vulgare on parasitism of a leaf‐mining insect was studied in a field and a laboratory experiment. In the field, parasitism of Chromatomyia syngenesiae by Diglyphus isaea was lower on mycorrhizal plants, compared with plants where the association was reduced. A laboratory experiment, in which L. vulgare was inoculated with three species of AM fungi, showed that the effects on parasitism rates were mycorrhizal species‐dependent. Some fungal combinations increased parasitism, some decreased it, while others had no effect. It is concluded that the most likely cause of these differences is plant size, with parasitoid searching efficiency being reduced on the larger plants, resulting from certain mycorrhizal species combinations. However, a mycorrhizal effect on herbivore‐produced plant volatiles cannot be ruled out.
Migraine Frequency and Intensity: Relationship With Disability and Psychological Factors
Authors: Magnusson Jane E. , Becker Werner J. 
Published: November 2003

Background.—Migraine can be disabling, but it varies greatly in frequency and intensity between individuals. It is not clear which clinical features have the greatest impact on a migraineur's quality of life.Objective.—To determine the influence of headache intensity and frequency on headache‐related disability.Methods.—Patients who were referred to a headache clinic and given a diagnosis of migraine with or without aura or transformed migraine (n = 115) were divided into different groups based on headache frequency and mean headache intensity. Headache frequency was determined from patient diaries. Headache intensity also was assessed from patient diaries and from scores on the pain severity scale of the Multidimensional Pain Inventory (MPI). Headache‐related disability was assessed with the Headache Disability Inventory and by scores on the activity interference scale of the MPI. The degree of depression present was assessed with the Beck Depression Inventory, and emotional distress was measured by scores on the affective distress scale of the MPI.Results.—In our patient population, higher mean headache intensity levels were associated with higher levels of headache‐related disability. Our results also suggested that increased headache intensity is associated with higher levels of depression and emotional distress, although this correlation was statistically significant in only 1 of 4 comparisons. Headache frequency did not correlate with disability, depression, or emotional distress.Conclusions.—For a headache referral population, headache intensity appears to be a major determinant of headache‐related disability, and it also correlates, to some extent, with the degree of depression and emotional distress present. Headache frequency was not clearly related to disability or psychological factors.
Topiramate as an Adjunctive Treatment in Migraine Prophylaxis
Authors: Martínez Héctor R. , Londoño Orlando , Cantú‐Martínez Leonel , Carmen Tarín Luz del , Castillo Carlos D. 
Published: November 2003

Background.—Anticonvulsants now are commonly used for headache prevention. Topiramate, one of the newer anticonvulsants, recently has been demonstrated to be effective as monotherapy for migraine prophylaxis.Objective.—To assess the efficacy, safety, and tolerability of topiramate as adjunctive prophylactic therapy for migraine.Material and Methods.—A prospective trial involving patients with more than 3 migraine attacks per month was performed. Patients continued their usual prophylactic treatment. Baseline analgesic use and frequency and duration of migraine attacks were recorded. A 4‐point visual analog scale evaluated severity. Laboratory tests, electrocardiogram, and computed tomography or magnetic resonance imaging were performed before study entry. After informed consent was obtained, patients were instructed to take 25 mg of topiramate per day, with 25‐ to 50‐mg weekly increments to a maximum of 100 mg per day. Safety was assessed at the first month; tolerability and efficacy were assessed every week for the first month and then every month for 3 months. Effectiveness was assessed by comparing baseline and on‐treatment migraine status, and data were analyzed by the Fisher exact test.Results.—Twenty‐five women and 11 men (mean age, 44 years) were evaluated. Existing prophylactic treatment was either propranolol or flunarizine (or both) in 80% of the patients. At 3 months of therapy with topiramate, headache frequency decreased from 17 to 3 episodes per month, headache duration from 559 to 32 minutes, and intensity from 9 to 1 by visual analog scale (P < .001). Improvement in frequency and severity of migraine was observed in 83% of patients. Slight or no changes in headache were observed in 6 patients. Tolerability was good in 30 patients. The most common side effects were acroparesthesias, weight loss, sleepiness, and headache worsening. No adverse interaction with propranolol or flunarizine was observed.Conclusions.—These results suggest that topiramate is efficacious and safe as an adjunctive treatment in patients with migraine whose prior response to prophylactic management has been less than satisfactory.
Effect of Endovascular Treatment on Headaches in Patients With Unruptured Intracranial Aneurysms
Authors: Qureshi Adnan I. , Suri M. Fareed K. , Kim Stanley H. , Olson Karen , Siddiqui Amir M. , Yahia Abutaher M. , Guterman Lee R. , Hopkins L. Nelson 
Published: November 2003

Background.—Patients with unruptured intracranial aneurysms often present with headaches.Objective.—To determine the effect of endovascular treatment on the character and frequency of headaches in patients with unruptured intracranial aneurysms.Methods.—We reviewed the medical records of all patients who underwent endovascular treatment for unruptured intracranial aneurysms within a 9.5‐year period. These patients were mailed a standard questionnaire in which they were asked about the frequency and character of any headache experienced before or after (or both) endovascular treatment. They were also asked to grade improvement or worsening of headaches after the procedure as mild (activities of daily living were not affected), moderate (activities of daily living were affected), or significant (the change resulted in an ability to perform new activities of daily living or an inability to perform previous activities of daily living).Results.—Forty‐seven patients with unruptured aneurysms who underwent Guglielmi detachable coil embolization responded to the questionnaire. Of these, 32 patients (mean age, 52.7 years [SD, 13.4]; 22 were women) had experienced headaches before the procedure. Nineteen patients (59%) reported improvement in severity of headaches after embolization. Improvement was graded as significant by 7 patients, moderate by 8, and mild by 4. Two patients (6%) reported worsening severity of headaches graded as moderate. Five of 15 patients without headaches before embolization reported onset of mild (n = 4) or severe (n = 1) headaches after treatment.Conclusion.—Guglielmi detachable coil embolization of unruptured intracranial aneurysms was associated with reduction in severity of headaches in the majority of patients who had experienced preprocedural headaches.
Work Attendance Despite Headache and Its Economic Impact: A Comparison Between Two Workplaces
Authors: Raak Ragnhild , Raak Anders 
Published: November 2003

Objective.—To study work attendance despite headache in 2 different workplaces and its economic impact.Background.—Literature on the economic impact of headache traditionally has focused on direct costs. Little is known concerning headache experienced at work and its costs due to loss of effectiveness and productivity.Method.—We sent a questionnaire to 800 employees in Sweden—400 at a technology company (private employee population) and 400 at a university hospital (public employee population). We attempted to assess the prevalence of headache, work attendance despite the presence of acute headache, and the impact of acute headache upon work effectiveness. Subjects self‐scored decreased work effectiveness resulting from headache during the previous 3 months and recorded the number of days at work despite headache. From these data, we estimated the economic loss resulting from headache.Results.—The survey response rate was 71.5%. The prevalence of headache was 64% in the private employee population and 78% in the public employee population. Thirty‐nine percent of the private employees and 57% of the public employees reported experiencing headache as a result of stress. Fifty percent reported that they went to work despite headache, and the mean number of days at work despite headache, during the previous 3 months, was 6.6 days in the private employee group and 6.1 days in the public employee group. A 25% decrease in work effectiveness was estimated, and, extrapolating from our data, we calculated the cost of lost effectiveness due to headache among employers in Sweden to be approximately 1.4 billion euros a year.Conclusion.—The economic burden of headache experienced at work is substantial, suggesting that workplace‐based treatment and prevention programs emphasizing stress management may be financially, as well as clinically, advantageous.
Palaeoecology Of A Late Devonian Back Reef: Canning Basin, Western Australia
Authors: Wood Rachel 
Published: November 2003

Back‐reef ecologies within the celebrated mixed carbonate‐siliciclastic Late Devonian (late Frasnian) Pillara Limestone of Windjana Gorge, in the Canning Basin, Western Australia, are re‐interpreted as being dominated by microbial communities. Proposed microbialites are expressed as weakly‐laminated, fenestral micrite, that show unsupported primary voids, peloidal textures, disseminated bioclastic debris, and traces of microfilaments. These grew as either extensive free‐standing mounds or columns, often intergrown with encrusting metazoans, or thick post‐mortem encrustations upon skeletal benthos. In some cases, microbial encrustations are inferred to have developed in protected cavities formed by progressive burial of the reef. The calcimicrobe Shuguria also shows a preferentially cryptic habit, encrusting either primary cavities formed by skeletal benthos, microbialite, or the ceilings of mm‐sized fenestrae within microbialite. A further calcimicrobe, Rothpletzella, formed columns up to 0.3 m high in areas enriched by very coarse siliciclastic sediment.Stromatoporoid sponges with a diverse range of morphologies also formed in situ growth fabrics. Monospecific thickets of closely‐aggregating dendroid stromatoporoid sponges (Stachyodes costulata), and platy‐laminar forms (?Hermatostroma spp.) were common, as were remarkably large stromatoporoids (Actinostroma spp.) that grew as isolated individuals up to 5 m in diameter. Such sponges showed impressive powers of regeneration from partial mortality, and individual clones may have been capable of substantial longevities of up to 500 years.	Actinostroma spp. showed highly complex growth forms including platy‐multicolumnar (A. windjanicum), and a hitherto undescribed inferred whorl‐forming foliaceous morphology (Actinostroma sp.) reminiscent of the modern photosymbiotic coral Acropora palmata. These complex morphologies formed abundant primary cavities, previously thought to be only rarely developed in association with stromatoporoids.key words: Late Devonian, Canning Basin, reefs, palaeoecology, microbialite.
Protaspides of Leiostegium and their implications for membership of the order Corynexochida
Authors: Lee Dong‐Chan , Chatterton Brian D. E. 
Published: November 2003

AbstractProtaspid morphologies of Leiostegium sp. aff. L. formosum from the Lower Ordovician Garden City Formation, western United States strongly support the inclusion of the Leiostegiina in the order Corynexochida. A similar metaprotaspid morphotype is present in the three suborders of the Corynexochida, the Corynexochina, Leiostegiina, and Illaenina, supporting their corynexochid membership.