bluuebunny/crossref_metadata_2025_split huggingface dataset:
Issues Associated with the Implementation of Routine Outcome Measures in Public Mental Health Services
Authors: Rock Danny , Combrinck Johann , Groves Aaron 
Published: March 2003

Objective: The purpose of this paper is to examine strategies that may facilitate the successful implementation of service-wide outcome measures in public mental health services. Conclusions: The available evidence suggests that a top-down approach to the introduction of state-wide routine outcome measurement across all public mental health services is likely to have only limited success. A centrally co-ordinated but locally directed bottom-up approach may be a more successful long-term strategy. Such an approach could make optimum use of a small team of “outcome experts”, while the use of strategies such as the development of local clinical guidelines would increase the co-operation and participation of the wider clinical community. An initial collection of clinical and social demographics could provide important contextual information on service populations and would initiate the administrative and communication networks that would need to be developed for later routine, multi-site data collection.
Radiosurgery at the Royal Adelaide Hospital: The first 41/2years’ clinical experience
Authors: Roos De , Brophy Bp , Zavgorodni Sf , Francis Jw 
Published: March 2003

SUMMARYRadiosurgery refers to the treatment of small lesions localized by stereotactic technology using highly focused radiation. This review utilizes prospectively gathered data from the Royal Adelaide Hospital Radiosurgery unit to summarize experience with the first 62 patients (65 lesions) treated between November 1993 and May 1998. This experience included acoustic neuromas (23 patients), arteriovenous malformations (18), brain metastases (12), meningiomas (6), and glomus tumour, subependymoma, dural arteriovenous fistula (1 each). Although follow up is relatively short, the outcome in terms of morbidity and tumour control is thus far comparable with results reported in the literature. Radiosurgery provides a viable alternative to neurosurgery and conventional external beam radiotherapy for several benign and malignant intracranial lesions.
Pulmonary inflammatory pseudotumour in children
Authors: Patankar Tufail , Prasad Srinivasa , Shenoy Asha , Rathod Krantikumar 
Published: March 2003

SUMMARYInflammatory pulmonary pseudotumour is an uncommon, non‐neoplastic, occasionally aggressive spindle cell proliferative process of uncertain nosology. It has distinctive histopathological features and benign clinico‐biological behaviour with multifocal lesions or recurrences in a minority of cases. Recognition of this entity is of paramount importance because it has considerable therapeutic and prognostic implications. The radiological features of two patients with pulmonary pseudotumour that was confirmed on histopathological examination are described.
Hyperimmunoglobulinaemia E syndrome: Pulmonary imaging features
Authors: Jhaveri Kartik S , Sahani Dushyant V , Shetty Prashant G , Shroff Manu M 
Published: March 2003

SUMMARYHyperimmunoglobulinaemia E (hyper‐IgE) syndrome (Job’s syndrome) is a rare disease that presents with recurrent cutaneous and sinopulmonary infections, and which begins in infancy and is associated with extreme hyper‐IgE. The pulmonary imaging features typically consist of recurrent alveolar lung infections, pneumatocoeles and, occasionally, pneumothorax. Various other causes of pneumatocoeles in children can be excluded on the basis of clinical history and other data. Computed tomography may add valuable information for the management of these patients.
Invasive lobular carcinoma: Sonographic features of cancers detected in a BreastScreen Program
Authors: Cawson Jennifer N , Law Eu‐Meng , Kavanagh Anne M 
Published: March 2003

SUMMARYSixty‐two screen‐detected invasive lobular carcinomas (ILC) were studied for sonographic, mammographic, clinical and histological findings. Ultrasound (US) features were compared with 60 invasive duct cancers (IDC). Size and axillary lymph node status in ILC were compared with all other cancers detected. In 41 ILC examined with US, 36 were found as masses (87.8% sensitivity; 95% CI 77.8–97.8%). Some US features of ILC and IDC differed: ILC were 9.94 times more likely to be hyperechoic (odds ratio, OR, 9.94; 95% CI 3.28–31.74) and 77% less likely to be taller than wide (OR 0.23; 95% CI 0.18–0.62). Thirty‐three ILC showed typical malignant features of spiculate margins and acoustic shadowing. invasive lobular carcinomas had a greater mean diameter (20.4 mm; n = 60) than other invasive cancers (14.4 mm; n = 322) (P < 0.001). Ultrasound‐guided needle biopsy was the method of diagnosis in 26 of 41 impalpable ILC (63%). Ultrasound has high sensitivity in characterizing screen‐detected ILC, which may have atypical sonographic features including hyperechogenicity and a wider than tall shape. Ultrasound was an important contributor to diagnosis.
Randomized prospective comparison of non‐contrast enhanced helical computed tomography and intravenous urography in the diagnosis of acute ureteric colic
Authors: Homer Jocelyn A , Davies‐Payne David L , Peddinti Bhavani S 
Published: March 2003

SUMMARYNon‐contrast enhanced helical CT has become an accepted technique for evaluating acute ureteric colic. The results of a randomized prospective comparison of the accuracy, cost and radiation dose of CT and intravenous urography (IVU) are presented. All patients presenting to the Emergency Department with symptoms and signs suggestive of ureteric colic over a 16‐month period (n = 242) were randomized to CT or IVU. Follow up was obtained for 228 patients (94%), with 14 patients (6%) lost to follow up. One hundred and twenty‐three patients (54%) underwent CT and 105 (46%) had an IVU. At follow up the sensitivity and specificity of CT were each 100%, while those of IVU were 99% and 100%, respectively. Computed tomography demonstrated seven of 26 (27%) potential alternative diagnoses, whereas IVU suggested one of 23 (4%). Estimates of the average effective dose were calculated for CT (4.95 mSv) and IVU (1.48 mSv, 95% confidence interval (CI) 0.7–2.27). Radiation dose and intravenous contrast material safety are discussed and the relative costs are considered. Computed tomography is as accurate as IVU in the diagnosis of acute ureteric colic. It confers certain major diagnostic benefits, and is a fast, well‐tolerated technique. Its accompanying higher effective radiation dose is recognized.
Measurement of the transverse cerebellar diameter in preterm neonates and its use in assessment of gestational age
Authors: Davies Mark W , Swaminathan Mohan , Betheras F Rex 
Published: March 2003

SUMMARYThis study aims to confirm the relationship between gestational age (GA) and transverse cerebellar diameter (TCD), to define the prediction of GA by TCD, and assess the reliability of TCD measurements. Infants were included in the study if they had a routine cranial ultrasound scan by day 3, and the TCD was measured. Infants were excluded from the study if the GA was not known, if there was any cranio‐spinal malformation or grade 3 or 4 intraventricular haemorrhage (IVH). The GA assessment was an early pregnancy scan or certain dates. Cranial ultrasound scans were done with a LOGIQ 500 scanner (GE Medical Systems, Waukesha, WI, USA) with a 7 MHz curvilinear sector probe (GE LOGIQ‐C721; GE Medical Systems). The posterior fossa was scanned using the asterion as the acoustic window with the TCD measured in the coronal plane. Intra‐ and interobserver reliability were assessed. A total of 221 infants of known GA had their TCD measured. The linear regression for GA versus TCD is: GAweeks = (0.470 × TCDmillimetres) + 13.162 (r = 0.89, r2 = 0.79, P < 0.001). The 95% confidence interval predicts GA to ± 2.33 weeks for a given TCD. Intra‐ and interobserver intraclass correlation coefficients are 0.98 and 0.99, respectively. Transverse cerebellar diameter correlates closely with GA and predicts GA to ± 2.33 weeks. Measurements of TCD have excellent reproducibility.
Lhermitte–Duclos disease associated with Cowden’s syndrome: Case report and literature review
Authors: Murray Conor , Shipman Peter , Khangure Mark , Chakera Turab , Robbins Peter , McAuliffe William , Davis Stephen 
Published: March 2003

SUMMARYLhermitte–Duclos disease (LDD) is a rare entity that may occur in the setting of Cowden’s syndrome (CS). Accurate preoperative diagnosis can be made on the characteristic CT and MR appearances, thereby obviating the need for biopsy. It is important to be aware of the link between LDD and CS so that appropriate genetic counselling and tumour surveillance can be undertaken.
Diagnosis of choledocholithiasis and bile duct stenosis by magnetic resonance cholangiogram
Authors: Hussein Fawzia MY , Alsumait Basil , Aman Sami , Sinan Tariq , Alkandari Khalid , Hniya M Haroon da , Alsaeed Osama 
Published: March 2003

SUMMARYWe evaluated the diagnostic accuracy of magnetic resonance cholangiography (MRC) in the diagnosis of bile duct calculi and stenosis. Two‐dimensional fast spin echo (FSE) MR cholangiograms were performed using torso multicoil array as a surface coil and respiratory triggering in 50 patients suspected of having bile duct disease. Coronal and axial images were acquired and reviewed prospectively by two radiologists. Direct cholangiographic correlation (endoscopic retrograde cholangiopancreatography [ERCP], intraoperative cholangiogram, percutaneous transhepatic cholangiogram) and surgery were available for comparison and were reviewed by two radiologists. The sensitivity, specificity and accuracy of MRC in diagnosing bile duct dilatation, choledocholithiasis and stenosis were evaluated. It yielded a sensitivity and a specificity of 100% in diagnosing bile duct dilatation. In the diagnosis of choledocholithiasis, MRC yielded a sensitivity of 95%, a specificity and an accuracy of 96%. Bile duct stenosis was diagnosed with a sensitivity and a specificity of 100%. We concluded that MRC exhibited high accuracy in diagnosing bile duct stenosis and choledocholithiasis.
Waiting for radiation therapy: Does it matter?
Authors: Seel Matthew , Foroudi Farshad 
Published: March 2003

SUMMARYThe aim of this study was to determine the direct and indirect effects of prolonged waiting times for radiation therapy. We used the Medline, CancerNet and EMBASE databases to search the international research using the keywords radiotherapy, waiting times and delay. The negative effects of prolonged waiting times for radiation therapy can be broken down into direct and indirect effects. Direct effects include tumour control factors and patient factors. Indirect effects include changes in referral patterns and change in management of tumours. The precise effects of prolonged waiting times for radiation therapy are difficult to define. Evidence exists for some tumour sites, such as postoperative head and neck, small‐cell lung cancer and high‐grade cerebral gliomas, that tumour control might be adversely affected. The effect on other tumour sites is less established. Patient factors are likely to be consistent across all tumour types and indirect effects are hard to quantify.
Toxic leucoencephalopathy after heroin inhalation
Authors: Au‐Yeung Kai , Lai Chi 
Published: March 2003

SUMMARYThe neurological symptoms after inhalation of contaminated heroin vapour could be the result of toxic leucoencephalopathy. We describe a case of a 53‐year‐old man who has typical symptoms and MR features of toxic leucoencephalopathy.
MR findings of primary Ewing's sarcoma of greater wing of sphenoid
Authors: Singh Paramjeet , Jain Manoj , Singh DP , Kalra Naveen , Khandelwal N , Suri S 
Published: March 2003

SummaryPrimary Ewing's sarcoma of the skull is a very rare entity. We report MRI findings in a case of Ewing's sarcoma of the greater wing of sphenoid in a 4‐year‐old patient. Magnetic resonance imaging showed markedly heterogenous signal intensity with areas of haemorrhage and necrosis. It also demonstrated the exact extent of tumour due to its multiplanar capabilities and was, therefore, helpful in planning surgery.
Bilateral common carotid occlusion without neurological deficit
Authors: Karaköse Serdar , Karabacakoglu Aydin , Solak Hasan 
Published: March 2003

SummaryA 40‐year‐old man presented with pain and numbness in his right arm. On his clinical examination, no neurological deficit was found. Bilateral common carotid artery duplex sonography scan demonstrated no flow in either lumen. No abnormality was recognized on brain CT. On cerebral digital substraction angiogram, total occlusion of the brachiocephalic trunk and left carotid artery were shown. There was a modest stenosis in the left vertebral artery. Collateral circulation feeding the intracranial carotid system mainly originated from the left vertebrobasilar system. Previous cases of bilateral carotid occlusion are reviewed and discussed.
Radiosurgery for brain metastases at the Royal Adelaide Hospital: Are we treating the right patients?
Authors: Roos Daniel E , Brophy Brian P , Zavgorodni Sergei F , Katsilis Evangelos S 
Published: March 2003

SummaryAlthough non‐randomized data strongly suggest improved outcome from radiosurgery (RS) for brain metastases relative to whole brain radiotherapy (WBRT) alone, selection factors account for much of the observed differences. This retrospective review of the 16 brain metastases patients treated so far with RS at the Royal Adelaide Hospital confirms a median survival of 10.1 months, consistent with recent multi‐institutional pooled results and significantly longer than the median survival of 3−6 months typically reported for WBRT alone. The emerging randomized trials comparing surgery, RS and WBRT for brain metastases are reviewed in the context of the Radiation Therapy Oncology Group Recursive Partitioning Analysis prognostic Class concept in order to assess whether we are using this resource intensive technique to treat the ‘right’ patients. We conclude that it is reasonable to continue our current policy of considering RS primarily for patients of good performance status with solitary brain metastases. We have a flexible approach to adjuvant WBRT which appears to decrease brain relapse, but not improve survival.
Hydatid disease of bone: A mimic of other skeletal pathologies
Authors: Morris Burzin S , Madiwale Chitra V , Garg Ashwin , Chavhan Govind B 
Published: March 2003

SummarySkeletal hydatidosis results from the deposition of the larval form of the Echinococcus, a genus of tapeworm. The incidence of bone disease is extremely low as most larvae are trapped by the liver and lung upon release of the embryo into the portal blood stream. The interpretation of imaging studies can prove very confusing because bone changes evolve with time, and the non‐specificity of these findings often leads to a mistaken diagnosis. We present the case of a 35‐year‐old woman with long‐standing pain in the left hip joint in which the findings on CT were thought of as being either tuberculous or neoplastic in nature. The result of a CT‐guided biopsy and another done following surgery concurred on an unexpected diagnosis of a hydatid cyst. This case illustrates that in the absence of a high index of suspicion for echinococcal infection, the semblance of imaging findings of hydatid disease in bone to those of other skeletal pathologies can lead to misinterpretation.
Pancreatic cancer: Preliminary experience with sodium iodide fluorodeoxyglucose positron emission tomography in Australia
Authors: Keith CJ , Miles KA , Wong D 
Published: March 2003

SummaryPrevious studies of fluorodeoxyglucose positron emission tomography (FDG‐PET) in pancreatic cancer have used Bismuth Germinate detector systems. This preliminary Australian study aims to confirm the accuracy of FDG‐PET in pancreatic cancer using a dedicated sodium iodide (NaI) PET system. Fifteen consecutive patients underwent FDG‐PET using a GE QUEST dedicated NaI PET scanner. The indications were the characterization of a pancreatic mass seen on CT or ultrasonographic imaging (nine cases), diagnosis or exclusion of recurrent disease following surgery and adjuvant therapy (four cases) and presurgical staging of primary pancreatic cancer (two cases). The final diagnosis was determined from histology or, when no histology was available, by radiological and clinical follow up. The FDG‐PET accurately characterized eight out of nine pancreatic masses (seven were true negative, one was true positive and one was false positive). Of the four cases performed to determine recurrent disease, three were accurately diagnosed (two true negatives and one true positive). In the fourth case, PET accurately detected a liver metastasis but did not detect the local recurrence. Results in the two cases where PET was performed for preoperative staging comprised one true positive and one false negative. Sodium iodide FDG‐PET is useful in the diagnosis of pancreatic cancer, particularly in the presence of a previously detected mass.
Imaging of primary leiomyosarcoma of the seminal vesicle
Authors: Upreti Lalendra , Bhargava Satish K , Kumar Atin 
Published: March 2003

SummaryLeiomyosarcoma of the seminal vesicle is exceedingly rare. The ultrasound and CT findings in a recent case are described. These consist of a mass causing enlargement of the right seminal vesicle with involvement of the urinary bladder and prostate. The prostate gland was displaced inferiorly and to the left. Surgical resection and subsequent histology confirmed the diagnosis. The role of imaging in retrovesical masses is also discussed.
MRI in greater trochanter pain syndrome
Authors: Walsh Geraldine , Archibald Colin G 
Published: March 2003

SummaryThe greater trochanter pain syndrome refers to pain on the lateral aspect of the hip joint. This is frequently attributed to trochanteric bursitis and distension of the subgluteal bursae. Associated tears of the tendons of gluteus medius and minimus have been described and may result from repetitive frictional trauma to these tendons and their associated bursae secondary to impingement beneath the tensor fascia lata. Occasionally tendinous damage may result from acute local direct trauma or a hyperadductive strain injury. We describe MRI in two patients with chronic lateral hip pain.
ENDOTHELIUM‐DERIVED HYPERPOLARIZING FACTOR(S): SPECIES AND TISSUE HETEROGENEITY
Authors: Triggle CR , Waldron H Dong, Gj , Cole WC 
Published: March 2003

1. Endothelium‐derived relaxing factor is almost universally considered to be synonymous with nitric oxide (NO); however, it is now well established that at least two other chemically distinct species (prostacyclin (PGI2) and a hyperpolarizing factor) may also contribute to endothelium‐dependent relaxation.2. Only relatively few studies have provided definitive evidence that an endothelium‐derived hyperpolarizing factor (EDHF), which is neither NO nor PGI2, exists as a chemical mediator.3. There is a lack of agreement as to the likely chemical identity of this putative factor. Some evidence suggests that EDHF may be a cytochrome P450‐derived arachidonic acid product, possibly an epoxyeicosatrienoic acid (EET); conflicting evidence supports an endogenous cannabinoid as the mediator and still other studies infer an unknown mediator that is neither a cytochrome P450 nor a cannabinoid.4. Data from our laboratory with a rabbit carotid artery ‘sandwich’ preparation have provided evidence that a mediator that meets the pharmacological expectations of a cytochrome P450 product is an EDHF.5. Data from guinea‐pig mesenteric arterioles suggest that EDHF is not a cytochrome P450 product, whereas in guinea‐pig middle cerebral arteries, relaxation mediated by the NO/PGI2‐independent mediator(s) is sensitive to cytochrome P450 inhibitors. In addition, in the rabbit middle cerebral artery, it is likely that endothelium‐dependent hyperpolarization is mediated by both NO and PGI2.6. In conclusion, these data indicate that EDHF is unlikely to be a single factor and that considerable tissue and species differences exist for the nature and cellular targets of the hyperpolarizing factors.
RELATIONSHIPS BETWEEN THE ENDOTHELIN AND NITRIC OXIDE PATHWAYS
Authors: Warner Timothy D 
Published: March 2003

1. In the normal blood vessel, the vascular endothelium regulates the tone of the underlying smooth muscle and the reactivity of blood elements, such as platelets and neutrophils, by the release of mediators, in particular nitric oxide (NO) and endothelin‐1 (ET‐1).2. Nitric oxide is a potent vasodilator that also inhibits platelet and neutrophil aggregation and adhesion; ET‐1 is the most potent mammalian vasoconstrictor peptide yet found. Recently, much research effort has focused on examining the interactions between these two important mediators. At a simple level, ET‐1 acts on specific receptors on the endothelium to increase the release of NO, while NO depresses the production and/or release of ET‐1 from endothelial cells.3. While ET‐1 appears to have a relatively small influence on the basal regulation of blood pressure, NO appears central. For example, inhibition of NO production in normotensive animals produces a marked elevation in blood pressure.4. Conversely, numerous vascular disease states have been associated with elevations in the production and/or release of ET‐1 and it has been implicated in the deleterious changes associated with ischaemia–reperfusion injury, subarachnoid haemorrhage and hypertension. In these conditions, NO production may also be increased by the induction of NO synthetic pathways within the vascular smooth muscle. Endothelin‐1 may also be produced by the vascular smooth muscle under similar circumstances.5. Therefore, in pathological states, a new balance between NO and ET‐1 production may be central to changes in blood vessel reactivity, smooth muscle proliferation and blood coagulability.
ACUTE INTERACTIONS BETWEEN ENDOTHELIN AND NITRIC OXIDE IN THE CONTROL OF RENAL HAEMODYNAMICS
Authors: Baylis Chris 
Published: March 2003

1. Endogenous endothelin (ET) does contribute to control of renal vascular tone via nitric oxide (NO)‐dependent vasodilation in the rat.2. Endothelin mediates some of the renal vascular responses to acute nitric oxide synthase (NOS) inhibition, being particularly important when a rise in renal perfusion pressure occurs.3. Tonically produced NO blunts the renal vasoconstrictor responses to acutely administered ET.4. The similarity between the renal vascular responses to ET administration and NOS inhibition is not fortuitous but, in part, reflects important interactions between these vasoactive agents.