bluuebunny/crossref_metadata_2025_split huggingface dataset:
The ecology of restoration: historical links, emerging issues and unexplored realms
Authors: Young T. P. , Petersen D. A. , Clary J. J. 
Published: June 2005

AbstractRestoration ecology is a young academic field, but one with enough history to judge it against past and current expectations of the science's potential. The practice of ecological restoration has been identified as providing ideal experimental settings for tests of ecological theory; restoration was to be the ‘acid test’ of our ecological understanding. Over the past decade, restoration science has gained a strong academic foothold, addressing problems faced by restoration practitioners, bringing new focus to existing ecological theory and fostering a handful of novel ecological ideas. In particular, recent advances in plant community ecology have been strongly linked with issues in ecological restoration. Evolving models of succession, assembly and state‐transition are at the heart of both community ecology and ecological restoration. Recent research on seed and recruitment limitation, soil processes, and diversity–function relationships also share strong links to restoration. Further opportunities may lie ahead in the ecology of plant ontogeny, and on the effects of contingency, such as year effects and priority effects. Ecology may inform current restoration practice, but there is considerable room for greater integration between academic scientists and restoration practitioners.
Comparison of circumferential margin involvement between restorative and nonrestorative resections for rectal cancer
Authors: Tekkis P. P. , Heriot A. G. , Smith J. , Thompson M. R. , Finan P. , Stamatakis J. D. ,   the Association of Coloproctology of Great Britain and Ireland
Published: June 2005

AbstractObjective  To study circumferential margin involvement (CMI) in patients undergoing restorative, compared with nonrestorative, surgery for rectal cancer.Data source  Descriptive multicentre study, using routinely collected clinical data from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) Bowel Cancer Audit database. The study encompassed 1403 newly diagnosed patients with rectal cancer undergoing either restorative (anterior resection (AR)), or nonrestorative (abdominoperineal excision of rectum (APER) or Hartmann's procedure), surgery. Operations were carried out in 39 hospitals during a variable period between April 1999 to March 2002. A logistic regression analysis was used to control for variables associated with circumferential margin involvement.Results  One thousand and thirty‐six patients satisfied the inclusion criteria. The average CMI was 12.5% (range 0–33.3% between hospitals). CMI for anterior resection was 7.5% (n = 629) compared with a CMI of 16.7% for APER (n = 306) and a CMI of 31.7% for Hartmann's procedure (n = 101); P ≤ 0.001. CMI for patients undergoing curative surgery was 7.1% (423 anterior resections, CMI 3.8% (n = 16); 181 APER, CMI 13.3% (n = 24); 29 Hartmann's procedure, CMI 17.2%). On multivariate analysis, having controlled for Dukes' stage and operative intent, the CMI was significantly different between APER and AR (odds ratio 3.3, 95%CI 2.0–5.4), but less so between Hartmann's procedure and AR (odds ratio 2.2, 95%CI 1.1–4.2).Conclusions  APER is associated with a significantly higher CMI than anterior resection. Attention to surgical technique, with a wide perineal dissection and the use of pre‐operative adjuvant therapy, may reduce CMI in patients undergoing APER.
Fast track open ileo‐colic resections for Crohn's disease
Authors: Andersen J. , Kehlet H. 
Published: June 2005

AbstractObjective  Introduction of multimodal rehabilitation programmes after open colonic surgery for noninflammatory bowel disease has reduced hospital stay to about 2–3 days, but no data are available from open ileo‐colic surgery for Crohn's disease with multimodal rehabilitation regimens. Therefore, the aim of study was to assess outcome after ileo‐colic resections for Crohn's disease with multimodal rehabilitation.Materials and methods  Thirty‐two consecutive ileo‐colic resections for Crohn's disease in 29 patients received epidural analgesia and enforced postoperative oral nutrition and mobilization with a scheduled stay of 2 days.Results  Median time to defaecation was 2.5 days and postoperative hospital stay was 3 days. During a 30‐day postoperative follow‐up there was two re‐admissions, one for mechanical bowel obstruction (9 days) and one because of fever and vomiting (6 days). Except for one wound abscess, one cystitis and one pneumonia, no other complications occurred.Conclusion  Fast‐track multimodal rehabilitation in open ileo‐colic resections for Crohn's disease reduces hospital stay and with low morbidity and readmission rate.
Almost all five year disease free survivors are cured following rectal cancer surgery, but longer term follow‐up detects some late local and systemic recurrences
Authors: Moore E. , Heald R. J. , Cecil T. D. , Sharpe G. D. , Sexton R. , Moran B. J. 
Published: June 2005

AbstractBackground  The necessity, timing and benefits of follow‐up after rectal cancer surgery remain controversial, with two years traditionally considered adequate to detect most local recurrences. This unit has a policy of lifetime follow‐up, and this paper investigates, at 23 years, the value of prolonged surveillance.Method  Six hundred and sixty consecutive patients undergoing surgery for rectal cancer were prospectively followed‐up between 1978 and 2002, and local or systemic recurrence recorded. This analysis was performed on the 509/660 (76%) patients who underwent potentially curative surgery.Results  Total mesorectal excision (TME) was performed in 422/509 (83%) patients, mesorectal transection in 78 (15%), and local excision in 9 (2%). Follow‐up ranged from 1 to 23 years (mean = 9.7). Seven (1.4%) patients had local recurrence alone, 11 (2.2%) local plus systemic, and 86 (17%) systemic recurrence alone. Of the local recurrences 3 (17%) became evident within 1 year, 9 (50%) within 2 years, 16 (89%) within 5 years, and 2 (11%) presented after 5 years, at 5.6 and 5.8 years. Of the systemic recurrences 26 (27%) became evident within 1 year, 57 (59%) within 2 years, 93 (96%) within 5 years, and 4 (4%) presented after 5 years at 5.3, 5.3, 5.4 and 7.9 years.Conclusion  This long‐term surveillance of patients undergoing curative surgery for rectal cancer demonstrates that most local and systemic recurrences occur within 5 years. Almost half occurred more than 2 years after surgery. However, those centres wishing to set standards of care, or evaluate current or new therapies in rectal cancer treatment, should be aware that unexpected late recurrences occasionally develop.
Postoperative complications in patients irradiated pre‐operatively for rectal cancer: report of a randomised trial comparing short‐term radiotherapy vs chemoradiation
Authors: Bujko K. , Nowacki M. P. , Kępka L. , Olędzki J. , Bębenek M. , Kryj M. ,   the Polish Colorectal Study Group
Published: June 2005

AbstractObjective  The primary outcome was sphincter preservation. No benefit was found with chemoradiation. The aim of this report is to analyse postoperative complications, which were the secondary outcome.Material and methods  Patients with resectable T3–4 low rectal carcinoma were randomised to receive either pre‐operative 5 × 5 Gy irradiation with subsequent total mesorectal excision (TME) performed within 7 days or chemoradiation (50.4 Gy, 1.8 Gy per fraction plus bolus 5‐fluorouracil and leucovorin) followed by TME after 4–6 weeks.Results  Three hundred and five patients (153 in 5 × 5 Gy group and 152 in chemoradiation group) were analysed. The rates of patients with postoperative complications for the 5 × 5 Gy group and for the chemoradiation group were 27 vs 21%, respectively (P = 0.27). If the values were expressed in terms of number of complications, the rates were 31 vs 22%, respectively (P = 0.06). The corresponding values for severe complications were 10 vs 11% (P = 0.85) of patients with complications and 12 vs 11% (P = 0.85) of events.Conclusion  The study did not demonstrate a statistically significant difference in the rate of postoperative complications after short‐course pre‐operative radiotherapy compared with full course chemoradiation.
The ileo neo rectal anastomosis (INRA) in patients with familial adenomatous polyposis: clinical results at two years
Authors: Strijbos S. A. M. , Hueting W. E. , Schipper M. E. I. , Oostvogel H. J. M. , Van Vroonhoven TH. J. M. V. , Gooszen H. G. , Van Laarhoven C. J. H. M. 
Published: June 2005

AbstractBackground  Ileo neo rectal anastomosis (INRA) is a promising alternative for patients with familial adenomatous polyposis (FAP) to restorative proctocolectomy with its morbidity and unpredictable functional outcome to colectomy with ileo rectal anastomosis (IRA) with the continuing risk of rectal cancer. The aims of the present study were to evaluate the function of the neorectum, to assess the morbidity and complications of the operation and to determine the incidence of neorectal polyps.Methods  Data of all patients having INRA, including bowel function and complications, were prospectively recorded. The reservoir capacity was determined repeatedly by physiologic tests. The anal sphincter complex was assessed by manometry and ultrasound examination. Evaluation of the neorectal mucosa was performed by endoscopy.Results  Six patients underwent the INRA procedure for FAP. Median defaecation frequency two years postoperatively was 5.5/24 h (range 4–7) including 1/night (range 0–2). Endoscopic examination showed normal mucosa and no evidence of polyp formation in all patients.Conclusion  INRA affords a good functional reservoir and is accompanied by few reservoir‐related complications. At a minimum follow up period of two years, no growth of polyps in the neorectum occurred.
One‐stage resection without colonic lavage in emergency surgery of the left colon
Authors: Patriti A. , Contine A. , Carbone E. , Gullà N. , Donini A. 
Published: June 2005

AbstractObjective  Intra‐operative colonic lavage is a widespread procedure introduced to decompress and clean the colon of its faecal load during emergency surgery of the left colon in order to perform a safe anastomosis. This type of lavage is never performed at our institution. The aim of this study was to evaluate the safety and acceptability of emergency left‐sided colectomy without colonic lavage in a consecutive series of patients admitted at our department for perforation and obstruction of the left colon.Patients and methods  All 44 patients (29 with obstruction and 15 with perforation) on whom a one‐stage left‐sided colon resection was performed without colonic lavage between January 1998 and June 2004 were evaluated in a retrospective review. During this period all patients with acute disease of the left colon underwent a one stage resection without colonic lavage. The only exclusion criteria for anastomosis were: haemodynamic instability, ASA > 3, unresectable tumour. Death, anastomotic leakage and wound infection were main outcome measures.Result  The leak rate was 4.5% and mortality 2.3% due to one case of postoperative myocardial infarction. A 16% morbidity rate was recorded due to 4 wound infections and 3 minor complications.Conclusion  The procedure is safe. The low morbidity and mortality of one stage resection without colonic lavage can justify future prospective studies enrolling a large number of patients to compare its results with those obtained by one stage resection with colonic lavage.
Do forceps biopsies truthfully reflect the nature of endoscopically uncovered polypoid lesions of the colon?
Authors: Stermer E. , Bejar J. , Miselevich I. , Goldstein O. , Keren D. , Lavy A. , Boss J. H. , Keren D. 
Published: June 2005

AbstractBackground  Total excision of colonic polyps is not always attainable and in some patients it is clinically contraindicated. Also, a resected polyp may be lost at any step between its endoscopic removal and its embedding in paraffin. The aim of this study was to compare the histological features of colonic polyps as analysed by the study of biopsy‐forceps obtained samples with those assessed on scrutinizing the totally resected growths.Patients and methods  This prospective study included a cohort of 59 patients in whom, in the course of an elective colonoscopy, a total excision of a 6 mm‐sized or larger polyp was called for. Sizeable biopsies were obtained by means of an Olympus Multibyte forceps prior to the total polypectomy. Subsequent to the study of the polypectomy specimens, the forceps biopsy samples were submitted for histological examination. The pathologists were blinded as to the source of the tissue they were studying. The diagnoses rendered by evaluating the biopsy samples and polypectomy specimens of each patient were contrasted with each other.Results  Major discrepancies between the histological features of the fragments captured by the biopsy‐forceps and the factual nature of the totally removed polyps were uncovered in 11 (18.6%) of 59 cases. Intriguingly, the grade of the tumours was underrated in all the 11 cases, as judged by contrasting the tentative diagnoses of the forceps‐biopsies with the decisive diagnoses of the polypectomies. Importantly, 2 adenocarcinomas would have been missed by just looking at the forceps‐retrieved sample.Conclusions  In our experience, a discordance of 18.6% is to be expected between the diagnoses rendered after examining forceps‐biopsies of and totally excised colonic polyps. Nevertheless, it is advisable to procure biopsies prior to the excision of the growths, because on those occasions in which patients' growths cannot be removed or have not been retrieved for one reason or another, a small forceps‐captured tissue sample correctly reflects the characteristics of the polyp in 81.4% of the cases. Finally, the biopsies may be discarded in the event that total removal was successful.
Ligasure™vs conventional diathermy haemorrhoidectomy: long‐term follow‐up of a randomised clinical trial
Authors: Peters C. J. , Botterill I. , Ambrose N. S. , Hick D. , Casey J. , Jayne D. G. 
Published: June 2005

AbstractObjective  Ligasure™ haemorrhoidectomy has short‐term benefits over conventional diathermy haemorrhoidectomy. The current study aimed to determine the long‐term efficacy of Ligasure™ haemorrhoidectomy.Subjects and methods  Forty patients, previously randomised to Ligasure™ or diathermy haemorrhoidectomy in 2002, were invited to participate in the study. Haemorrhoidal symptoms and patient satisfaction were recorded. Incontinence was quantified and sphincter anatomy and function assessed by endoanal ultrasound and anorectal manometry.Results  Thirty (75%) patients participated in the study (14 Ligasure™, 16 conventional). There was no difference in age, sex distribution, or length of follow‐up (Ligasure™: 37 months; conventional: 36 months) between the groups. Both techniques achieved good symptom control, but with a trend to less recurrent bleeding following Ligasure™. Incontinence scores and patient satisfaction were similar. A significant difference was observed in internal sphincter thickness (Ligasure™: 2.5 mm, 2.2–2.8 (mean, 95%CI) vs conventional: 1.88 mm, 1.7–2.1, P = 0.005) and rectal urge sensation (Ligasure™: 284 mls, 211–378 vs conventional: 173 mls, 129–217, P = 0.08).Conclusion  Ligasure™ is as effective as conventional diathermy haemorrhoidectomy in achieving long‐term symptom control. Less radical haemorrhoidal excision with the Ligasure™ could explain the differences in internal sphincter thickness and urge sensation, and might make it the preferred method for patients with compromised sphincter function.
Lactate determination in vaginal fluids: a new method in the diagnosis of prelabour rupture of membranes
Authors: Wiberg‐Itzel Eva , Cnattingius Sven , Nordström Lennart 
Published: June 2005

Objectives  To assess whether lactate determination in vaginal fluids, ‘Lac test’, can be used as a diagnostic test for prelabour rupture of membranes (PROM) and to derive the best cutoff value for a positive test.Design  Prospective observational study.Setting  Labour ward at Söder Hospital in Stockholm, a large clinical service.Population  Women living in the centre of Stockholm, the capital of Sweden.Methods  We selected 200 cases with a history of suspect PROM for determination of lactate concentrations in vaginal fluid. In 100 of these cases, actim PROM tests were also analysed.Main outcome measures  Sensitivity, specificity, positive and negative predictive values, likelihood ratios (LR) and Kappa indices in the identification of visible amniotic fluid at speculum examination.Results  A lactate concentration ≥4.5 mmol/L was found to be the best cutoff value for a positive test. The ‘Lac test’ had a sensitivity of 86%, specificity 92%, positive and negative predictive values of 92% and 87%, respectively. Corresponding values for the actim PROM test were 60%, 98%, 97% and 71%. LR for a positive ‘Lac test’ was 10.75 and for a negative test 0.15. Corresponding values for the PROM test were 30.0 and 0.4, respectively. The Kappa index was higher for the ‘Lac test’ as compared with the actim PROM test (78% and 59%, respectively).Conclusion  Lactate determination is a valid test in cases with a history of suspect PROM and may even be a better predictor than the actim PROM test.
Does regular cervical screening protect women from microinvasive squamous cell carcinoma of the cervix? A retrospective case–control study
Authors: Sykes Peter H. , Reddy Jessamine , Peddie David J. 
Published: June 2005

Objectives  To compare the smear histories of women with microinvasive squamous cell carcinoma (SCC) of the cervix to those of women with cervical intraepithelial neoplasia grade 3 (CIN3).Design  Retrospective case–control study.Setting  A large public hospital gynaecology unit.Sample  Twenty‐nine consecutive women with microinvasive SCC FIGO stage 1A1 (cases). Fifty‐five age‐matched controls with histologically confirmed CIN3 (controls).Methods  The cases and controls were selected from institutional databases; smear histories and other information was retrieved from hospital notes or following consent from other records.Main outcome measures  The time from index smear to prior screening smear and participation in the National Screening Programme (NCSP).Results  Only 35% of cases compared with 78% controls had a smear in the last 3 years (P= 0.00008.) Cases had a longer median interval between the abnormal smear that resulted in diagnosis and the previous screening smear (4 years) compared with controls (2 years). Cases were less likely to be enrolled in the NCSP (65%) prior to their index smear than controls (85%).Conclusion  Delayed interval screening was more frequent in women with 1A1 SCC than CIN3.
Transabdominal amnioinfusion in preterm premature rupture of membranes: a randomised controlled trial
Authors: Tranquilli Andrea Luigi , Giannubilo Stefano Raffaele , Bezzeccheri Valeria , Scagnoli Caterina 
Published: June 2005

Objective  To evaluate the role of transabdominal amnioinfusion in improving the perinatal outcomes of pregnancies complicated by preterm premature rupture of membranes (pPROM).Design  A randomised controlled trial.Setting  A teaching hospital in Italy, obstetric unit.Population  Women with singleton pregnancies complicated by pPROM, between 24 + 0 and 32 + 6 weeks of gestation.Methods  Patients were randomised 24 hours after admission to our referral hospital, to expectant management with transabdominal amnioinfusion or expectant management only.Main outcome measures  The effects of transabdominal amnioinfusion on pPROM–delivery interval and on perinatal outcomes.Results  Of the 65 women with pPROM 34 met the inclusion criteria. Seventeen women were assigned to amnioinfusion (the amnioinfusion group) and the other 17 to expectant management. Compared with the control group (median: 8 days; range: 3–14), the pPROM–delivery period was significantly longer in women who underwent amnioinfusion (median: 21 days; range: 15–29) (P < 0.05). Women with amnioinfusion were less likely to deliver within seven days since pPROM (RR: 0.18; range: 0.04–0.69 95% CI) or within two weeks (RR: 0.46; range: 0.21–1.02 95% CI). In the amnioinfusion group the neonatal survival was significantly higher at each gestational age (P < 0.01, Yates's correction for Log Rank Test) with a reduction in pulmonary hypoplasia.Conclusions  We demonstrated that compared with standard expectant management the treatment with transabdominal amnioinfusion after pPROM resulted in significant prolongation of pregnancy and better neonatal outcomes.
Cost‐effectiveness of different treatment strategies with intrapartum antibiotic prophylaxis to prevent early‐onset group B streptococcal disease
Authors: van den Akker‐van Marle M.E. , Rijnders M.E.B. , van Dommelen P. , Fekkes M. , van Wouwe J.P. , Amelink‐Verburg M.P. , Verkerk P.H. 
Published: June 2005

Objective  To estimate the costs and effects of different treatment strategies with intrapartum antibiotic prophylaxis to prevent early‐onset group B streptococcal (GBS) disease in the Netherlands. The treatment strategies include a risk‐based strategy, a screening‐based strategy, a combined screening/risk‐based strategy and the current Dutch guideline.Design  Cost‐effectiveness analysis based on decision model.Setting  Obstetric care system in the Netherlands.Population/Sample  Hypothetical cohort of 200,000 neonates.Methods  A decision analysis model was used to compare the costs and effects of different treatment strategies with no treatment. Baseline estimates were derived from literature and a survey among parents of children affected by GBS disease. The analysis was performed from a societal perspective, and costs and effects were discounted at a percentage of 3%.Main outcome measures  Cost per quality adjusted of life‐year (QALY).Result  The risk‐based strategy will prevent 352 cases of early‐onset GBS for €5.0 million, indicating a cost‐effectiveness ratio of €7600 per QALY gained. The combined screening risk‐based strategy has comparable results. The current Dutch guideline resulted in lower effects for higher costs. The screening‐based strategy shows the highest reduction in cases of early‐onset GBS, however, at a cost‐effectiveness ratio of €59,300 per QALY gained. Introducing the polymerase chain reaction (PCR) test may lead to a more favourable cost‐effectiveness ratio.Conclusion  In the Dutch system, the combined screening/risk‐based strategy and the risk‐based strategy have reasonable cost‐effectiveness ratios. If it becomes feasible to add the PCR test, the cost‐effectiveness of the combined screening/risk‐based strategy may even be more favourable.
Methionine‐deficient diet extends mouse lifespan, slows immune and lens aging, alters glucose, T4, IGF‐I and insulin levels, and increases hepatocyte MIF levels and stress resistance
Authors: Miller Richard A. , Buehner Gretchen , Chang Yayi , Harper James M. , Sigler Robert , Smith‐Wheelock Michael 
Published: May 2005

SummaryA diet deficient in the amino acid methionine has previously been shown to extend lifespan in several stocks of inbred rats. We report here that a methionine‐deficient (Meth‐R) diet also increases maximal lifespan in (BALB/cJ × C57BL/6 J)F1 mice. Compared with controls, Meth‐R mice have significantly lower levels of serum IGF‐I, insulin, glucose and thyroid hormone. Meth‐R mice also have higher levels of liver mRNA for MIF (macrophage migration inhibition factor), known to be higher in several other mouse models of extended longevity. Meth‐R mice are significantly slower to develop lens turbidity and to show age‐related changes in T‐cell subsets. They are also dramatically more resistant to oxidative liver cell injury induced by injection of toxic doses of acetaminophen. The spectrum of terminal illnesses in the Meth‐R group is similar to that seen in control mice. Studies of the cellular and molecular biology of methionine‐deprived mice may, in parallel to studies of calorie‐restricted mice, provide insights into the way in which nutritional factors modulate longevity and late‐life illnesses.