bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutcracker oesophagus: a double‐blind, placebo‐controlled, cross‐over study of the effects of lansoprazole
Authors: Borjesson M. , Rolny P. , Mannheimer C. , Pilhall M. 
Published: December 2004

SummaryBackground : Nutcracker oesophagus is characterized by high‐amplitude oesophageal contractions. Recent data have shown a high prevalence of gastro‐oesophageal acid reflux in patients with nutcracker oesophagus and, in open‐label trials, patients seemed to benefit from acid suppression. Therefore, it has been suggested that non‐cardiac chest pain in patients with nutcracker oesophagus may be related to reflux rather than to the motor abnormality itself.Aims : To investigate the effect of intensive acid‐suppressive treatment on chest pain in patients with nutcracker oesophagus.Methods : Nineteen patients with nutcracker oesophagus received lansoprazole or placebo in a double‐blind, randomized, cross‐over study.Results : Significant reductions in pain intensity (P < 0.006) and pain duration (P < 0.05) were registered during the study. The magnitude of symptom relief achieved with lansoprazole did not differ significantly from that achieved with placebo. The motility pattern did not change during the study.Conclusions : This study does not prove that acid‐suppressive therapy is effective for pain relief in nutcracker oesophagus. As the amelioration of pain was not accompanied by any change in the nutcracker oesophagus pattern, it is unlikely that the high‐amplitude oesophageal contractions are the cause of pain. Thus, the possible role of acid in the pathophysiology of pain in nutcracker oesophagus needs further study.
Neuroretinitis associated with cat‐scratch disease in Japanese patients
Authors: Kodama Tatsuo , Masuda Hisashi , Ohira Akihiro 
Published: December 2004

Abstract.Purpose:  To clarify the prevalence and clinical profile of neuroretinitis associated with cat‐scratch disease (CSD) in Japan. Methods:  Japanese patients were searched using a computer web site, Japana Centra Revuo Medicina. Location of patients, medical history, systemic and intraocular findings, treatments and visual outcome were examined. Results:  We reviewed 15 eyes of 14 patients, including our own case. Incidences of the disease were more common in summer than in winter and presented in the warmer parts of Japan. All patients had been previously healthy and had been exposed to cats or flea bites. Of the 14 patients, 13 (93%) had febrile illness and seven of these (54%) had lymphadenopathy. Uveitis and macular stars were observed in 11 of 15 eyes (73%). Most patients were treated with antibiotics and systemic steroids and visual prognoses were good. Conclusions:  The clinical features of CSD‐associated neuroretinitis in Japan are similar to those in other countries. Its distribution may correlate with the prevalence of Bartonella henselae‐seropositive cats in Japan.
Treatment approaches for clients with a stroke‐affected upper limb: Are we following evidence‐based practice?
Authors: Gustafsson Louise , McKenna Kryss 
Published: December 2004

Stroke rehabilitation is an area of practice that many occupational therapists encounter during their career. The literature promotes a wide range of management techniques and support devices for people who have a stroke‐affected upper limb, but little is known about the validity of those that occupational therapists actually use in practice. A questionnaire was sent to occupational therapists working in Queensland and northern New South Wales facilities (n = 35), in which adults with a stroke were likely to be treated. Eighteen respondents answered questions about the management techniques and support devices used in their facility, and their perception of the benefit of these devices in the reduction of hemiplegic shoulder pain. Results are discussed with reference to evidence‐based practice and indicate an urgent need for the collation and dissemination of the best current evidence available for the management techniques and support devices used in this area, as well as further research to extend this evidence.
Incorporating a Spiritual History into a Psychiatric Assessment
Authors: D'Souza Russell 
Published: December 2004

Objective: To explore the importance of incorporating spiritual history into a psychiatric assessment and to develop and test a format for taking a spiritual history. Methods: An overview of training and practice issues involved in taking a spiritual history is dealt with, and then the formal requirements developed, which include questioning style, content and form of the spiritual history, the evaluation of values and precautions to be considered. Finally its integration into clinical practice is considered. Results: There are training exercises the clinician can do before taking a spiritual history. Clinicians must develop a trusting therapeutic relationship with the patient and approach the topic of spirituality with sensitivity. For a spiritual history to be useful an evaluation of the patient's value structure and possible expectation system needs to be undertaken and then available resources need to be identified. Conclusions: A spiritual history needs to be incorporated into a psychiatric assessment. Clinicians should be trained to explore the patient's spirituality with sensitivity and skill so that the information obtained can be integrated into the greater psychiatric assessment and management of the patient, thus fulfilling the much required whole person assessment and therapy in the biomedical model.
Will the Atypical Antipsychotics be Analgesics?
Authors: Pridmore Saxby , Samilowitz Hazel , Oberoi Gajinder 
Published: December 2004

Objective: To review the literature for evidence suggestive of a potential role for the atypical antipsychotics that are available in Australia in the management of pain. Method: PubMed was searched for appropriate papers, and drug companies were invited to provide information. Results: Two preclinical and six clinical reports suggested that the atypical antipsychotics may have analgesic properties. Conclusions: There is justification for further trials of atypical antipsychotic medications in chronic pain. Should such studies bear fruit, psychiatrists are well qualified to use these medications in the management of chronic pain.
Australian and New Zealand Clinical Practice Guidelines for Specialist Adult Mental Health Care: An Introduction
Authors: Boyce Philip , Ellis Peter , Penrose-Wall Jonine 
Published: December 2004

Objective: To introduce, for College Fellows, Associates and Trainees and other readers of Australasian Psychiatry, the Australian and New Zealand Clinical Practice Guidelines for Specialist Adult Mental Health Care. Conclusions: For clinical practice guidelines to be applied appropriately and with confidence in practice, their development process, quality characteristics and limitations must be transparent to health systems, guideline users and consumers. Moreover, their status as evidence-based guidelines or consensus guidelines, or mixed-status guidelines, must be made explicit. This introduction to the Australian and New Zealand Clinical Practice Guidelines for Specialist Adult Mental Health Care is designed to assist you in implementing the guidelines in your practice. These are guidelines to assist practice. They are not a set of prescriptions about what to do. The process for developing the six guidelines is summarized. It involved over 70 individuals directly, who worked over a 2-year period in six independent guideline development teams to synthesize the research findings and to consult on draft recommendations. The teams included consumer and carer writing panels for most of the consumer guidelines. The series includes titles on schizophrenia; bipolar disorder; depression; panic and agoraphobia; anorexia nervosa; and deliberate self-harm. Full versions of the guidelines are to be published in the Australian and New Zealand Journal of Psychiatry. Consumer versions are published elsewhere. Extended versions and background material is available on the RANZCP website.
Perianal infections: Reader agreement and diagnostic performance of fat‐suppressed contrast‐enhanced MRI
Authors: Erden Ayşe , Geçim Ethem , Fitoz Suat , H Elhan Atilla , Erden .llhan , Tükel Selma 
Published: December 2004

SummaryWe aimed to determine the diagnostic performance of the contrast‐enhanced fat‐suppression technique in the detectability of perianal infections and to compare this technique with different MR sequences used for this purpose. Thirty consecutive patients with clinically suspected anorectal infections were examined with fast spin‐echo (FSE) T2‐weighted, short‐inversion‐time inversion recovery (STIR), and fat‐suppressed and non‐fat‐suppressed T1‐weighted spoiled gradient‐echo (SGE) (in‐phase) dynamic contrast‐enhanced sequences. The results of MRI were correlated with the findings of surgery, which was considered as the standard of reference. Receiver‐operating‐characteristic curves were reconstructed to describe and compare the diagnostic value of each MR technique. The values of kappa were used as a measure of observer reliability. Diagnostic performances of STIR, FSE T2‐weighted and fat‐suppressed and non‐fat‐suppressed, contrast‐enhanced SGE T1‐weighted techniques showed statistically insignificant differences in detection of perianal infections. There was almost perfect interobserver agreement regarding the presence of lesions on each MR technique. Fat‐suppressed, contrast‐enhanced SGE T1‐weighted MRI showed adequate diagnostic performance in the detection of perianal infections. However, its significance is not different from the other MR sequences used for the present study.
Ultrasonic fetal weight estimation and tolerance to measurement error: A comparative analysis
Authors: Mongelli Max , Tambyraja Ranjit 
Published: December 2004

SummaryThe objective of the present study was to test the hypothesis that volumetric formulae for fetal weight estimation are more tolerant to measurement error than exponential models. A mathematical model of normal fetal growth was constructed, using published British reference standards for biometric variables. Observed measurements were computer‐generated by contaminating reference measurements with error terms according to their published coefficients of variation. The error in weight estimation was computed as the percentage difference between weight estimates derived from the observed biometric variables and the true measurements. A total of nine weight estimation formulae were tested. Campbell's formula appeared to be most affected by observational errors, especially before 38 weeks. In this range, they varied up to 9%. The most tolerant was Shepard's formula, with errors of only approximately 2.8%. Other formulae showed errors of approximately 5−6%. With the exception of Campbell's formula, the effect of gestational age was minimal. There was no correlation between percentage error and fetal size. Combining ultrasound biometric variables into a fetal weight estimate does not always exaggerate the errors of the original measurements. There were no significant differences between volumetric and exponential formulae.
Role of radiology in the treatment of malignant hilar biliary strictures 2: 10 years of single‐institution experience with percutaneous treatment
Authors: Hii Michael WJ , Gibson Robert N , Speer Anthony G , Collier Neil A , Sherson Noel , Jardine Cate 
Published: December 2004

SummaryWe reviewed the results of percutaneous intervention of hilar biliary malignancy over a 10‐year period at a single institution: the Royal Melbourne Hospital. Ninety‐nine patients (100 treated in total) were included. Information was retrieved by retrospective examination of patient notes and radiology, combined with interviews with family and relevant physicians. Sixty‐nine patients were treated with insertion of semipermanent stents, 19 had external drain tubes, and 25 received percutaneous access for Iridium brachytherapy. Adequate drainage was achieved in 87% of the patients stented, and percutaneous access was successful in 96% of patients planned for brachytherapy. Of those patients undergoing endoprosthesis insertion, early complications occurred in 39% and late complications in 23%. Average survival for the entire patient population was 227.3 days, with a median of 167 days. Longer survival times (213 vs 142 days) and lower complication rates (44 vs 64%) are observed with metal stents in comparison with plastic stents. Percutaneous intervention is an important treatment option in hilar biliary malignancy, particularly in patients unfit for surgery. Reasonable survival with good palliation is the most common outcome, and most patients do not require further intervention.
Type of consent does not influence patient recall of serious potential radiation toxicity of adjuvant breast radiotherapy
Authors: Graham Peter 
Published: December 2004

SummaryIn a sample of 174 women who had received verbal consent (n = 35), general written consent (n = 34) or detailed toxicity‐specific written consent (n = 105), no significant differences were found in recall of serious potential toxicities by consent type. Age younger than 70 years and employment outside of the home were significantly associated with better recall. Factors not significantly associated with different recall rates were work status, use of interpreters for consent, time elapsed from treatment or the extent of radiotherapy (tangents only vs other). Overall recall was poor. Twenty‐eight percent of women could not correctly recall if their treatment risked any of four nominated complications (lymphoedema, pneumonitis, rib fracture or brachial plexopathy). Significant numbers of women erroneously attributed a number of ‘complications’ or symptoms to radiotherapy.
How safe is Australian radiotherapy?
Authors: Hamilton Chris , Oliver Lyn , Coulter Kristine 
Published: December 2004

SummaryMany incidents and near‐incidents are known to occur in Australian radiation oncology departments. The vast majority of incidents are minor in nature; however, a small percentage represent major threats to good patient care, administrative structures and public confidence. A small, but regular, number of incidents result in ad hoc local and/or state committees of enquiry or tort actions, and inevitably have substantial personal and departmental repercussions. Apart from some local databases on treatment‐delivery incidents maintained by radiation therapists, no systematic data collection or analysis of treatment incidents exists for radiation oncology in Australia. The present paper argues the case for a prospective, systematic approach to the recording and analysis of treatment‐related incidents and near incidents. Major barriers to such a scheme, including fear of litigation, misuse of information and lack of understanding on the nature of an incident are discussed.
Cystosarcoma phyllodes: Our institutional experience
Authors: Joshi Sanjeev C , Sharma Daya N , Bahadur Anil K , Maurya Rajesh , Kumar Sanjeev , Khurana Nita 
Published: December 2004

SummaryTwenty‐six patients of Cystosarcoma phyllodes, treated between July 1994 and July 2001, were analysed retrospectively. Median age at presentation was 38 years (range 13−61 years). Mean size of the lesion was 6 cm. There were 77% left‐sided lesions and 23% right‐sided lesions. Histologically, 58% lesions were benign, 11% borderline and 31% malignant lesions. All patients underwent definitive surgical procedure in the form of wide local excision or mastectomy. Four patients received postoperative radiotherapy. Median follow‐up period was 35 months. Six patients showed recurrence, and four of these were malignant. Median disease‐free survival period was 34 months.
Hemimegalencephaly with tuberous sclerosis: A longitudinal imaging study
Authors: Parmar Hemant , Patkar Deepak , Shah Jeshil , Patankar Tufail 
Published: December 2004

SummaryHemimegalencephaly is a rare cerebral malformation characterized by asymmetry of the hemispheres and cortical dysplasias. We report clinical and imaging findings in a child with hemimegalencephaly involving the right cerebral hemisphere with associated manifestations of tuberous sclerosis complex. Gross abnormal myelination pattern and gyral abnormalities were seen in the enlarged hemisphere. Subsequent scans showed atrophy of the frontoparietal region in the enlarged hemisphere and normal growth of the opposite hemisphere exceeding the size of the abnormal hemisphere in the frontoparietal region. A few white‐matter lesions that were seen in the normal hemisphere on neonatal scan were difficult to appreciate on subsequent MR studies. The white‐matter lesions were better seen in the neonatal period, whereas cortical tubers were better detected at a later age.
Extramedullary fat fluid level on MRI as a specific sign for osteomyelitis
Authors: Hui Cathryn L , Naidoo Parm 
Published: December 2004

SummaryThe role of MR in the early diagnosis of acute osteomyelitis is well known. In the context of florid cellulitis, abnormalities of marrow signal are not uncommon, although they are often non‐specific. Marrow oedema and enhancement in the context of deep cellulitis might reflect either reactive marrow oedema or true osteomyelitis. More specific signs lend favour to the diagnosis of osteomyelitis: these include focal bone destruction, periosteal reaction and sequestra. The observation of an extramedullary fat‐fluid sign is also a specific sign for osteomyelitis, as illustrated in the following case report. This sign is an indication of cortical breach and, thus, in the setting of infection and in the absence of trauma confirms the presence of osteomyelitis. To our knowledge, this additional specific sign of osteomyelitis has not been previously reported on MR.
Small bowel CT fat density target sign in chronic radiation enteritis
Authors: Chen Steven , Harisinghani Mukesh G , Wittenberg Jack 
Published: December 2004

SummaryOn CT, a thickened intestinal wall configured with a middle layer of low attenuation surrounded on each side by layers of higher attenuation has been termed the target sign. The presence of fat within the submucosal layer of the small intestine is a well‐known manifestation of Crohn's disease, but has not been reported in other chronic intestinal diseases. We describe CT findings of fat density target sign in a patient with prior radiation.
Follicular lymphoid hyperplasia simulating intussusception in a 6‐year‐old boy: Clinical, radiological and histopathological findings
Authors: Poll Ludger W , Lackmann Gerd‐M , May Philip , Willnow Ulrich , Braunstein Stefan , Engelbrecht Volkher , Kemperdick Helmut 
Published: December 2004

SummaryWe report the case of a 6‐year‐old boy who initially presented with recurrent abdominal pain. Diagnostic imaging, including ultrasound and CT, showed findings typical of an ileocecal intussusception with abdominal lym‐phadenopathy. Sonographically, the morphological appearance of the intussusception did not change during a 4‐week follow‐up period. Surgery was performed on the tentative diagnosis of a tumour versus lymphoma. Upon laparatomy, intussusception was ruled out and a large, broad‐based tumour of the caecum was palpable. The histopathology after ileocecal resection revealed follicular lymphoid hyperplasia. Where there is radiological suspicion of an intussusception in children with no or insignificant symptoms, follicular lymphoid hyperplasia should be included in the differential diagnosis.
Endovascular treatment for bilateral vertebral arteriovenous fistulas in neurofibromatosis 1
Authors: Siddhartha W , Chavhan Govind B , Shrivastava Manish , Limaye Uday S 
Published: December 2004

SummaryWe report a rare case of a 36‐year‐old woman with neurofibromatosis 1 (NF1) with bilateral vertebro‐vertebral arteriovenous fistulas. The patient presented with quadriparesis and had neck pain. Angiography revealed vertebral arteriovenous fistulas bilaterally with dilated epidural venous plexuses compressing the cervical cord resulting in quadriparesis. Endovascular treatment using coils and balloons resulted in successful occlusion of both fistulas. At 6‐months postembolization, the patient had improved significantly and is now able to walk with support.
Isolated intrapetrous carotid canal atraumatic internal carotid artery dissection: MRI and digital subtraction angiography findings
Authors: Robertson David I , Stuckey Stephen L 
Published: December 2004

SummaryA case of spontaneous internal carotid artery (ICA) dissection confined to the intrapetrous carotid canal that was confirmed by angiography and magnetic resonance imaging is presented. Isolated dissection involving the intrapetrous ICA is rare; however, whenever arterial dissection is a consideration, specific review of imaging in this region is warranted.
Intractable massive ascites following radical gastrectomy, treatment with local intraperitoneal administration of OK‐432 using a unified CT and fluoroscopy system
Authors: Inaba Yoshitaka , Arai Yasuaki , Matsueda Kiyoshi , Aramaki Takeshi , Kodera Yasuhiro 
Published: December 2004

AbstractThe case of a patient who developed intractable massive ascites caused by hepatic lymphorrhea derived from surgical injury to the hepatoduodenal ligament is presented. OK‐432 was injected intraperitoneally through a catheter advanced to near the hepatoduodenal ligament, so as to expose this site to a high concentration of OK‐432. Under ultrasound guidance, it was difficult to reach this site due to massive ascites, and so we performed this procedure under CT and fluoroscopic guidance using a unified CT and angiography system. Subsequently, local administration of OK‐432 on five separate occasions resulted in resolution of the ascites. We ascribe this favourable result to the use of this unified CT and angiography system to advance the catheter to the suitable site, making possible the local administration of OK‐432.
Preadmission processes may improve length of stay for colorectal surgery
Authors: Monagle John , Waxman Bruce , Abourizk Steven , Sparrow Maryanne , Shearer Bill 
Published: December 2004

Background:  The preadmission process (PAP) is known to reduce length of stay prior to surgery, but there are few data on its effects on postoperative stay. The aim of the present study was to test the hypothesis that a PAP may reduce postoperative length of stay as well as the preoperative length of stay.Methods:  An audit of admission and discharge times for patients having major colorectal surgery was undertaken to determine the impact of the preadmission process at Dandenong Hospital. One hundred and two elective patients were identified over a 12‐month period.Results:  The 71 patients admitted through the preadmission process had a 10.7‐day average length of stay compared to 18.4 days if the patients were admitted directly by the surgeon. The reduction in length of stay was contributed to by 4 days less preoperatively and 4 days less postoperatively. Thus the benefits from a preadmission service can be realized both at admission and discharge. The nature of this impact of preadmission requires further investigation.Conclusions:  The PAP will reduce preoperative length of stay. Utilization of a PAP also appears to reduce postoperative length of stay and may reduce postoperative complications. Further investigation is required to determine the exact nature and extent of these PAP benefits.