Gastrojejunocolic fistula following surgery for peptic ulcer.
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BACKGROUND: In October 2004, a flawed systematic review entitled "Interactive Health Communication Applications for People with Chronic Disease" was published in the Cochrane Library, accompanied by several press releases in which authors warned the public of the negative health consequences of interactive health communication applications, including the Internet. Within days of the review's publication, scientists identified major coding errors and other methodological problems that invalidated the principal conclusions of the study and led to a retraction. While the original study results and their negative conclusions were widely publicized in the media, the retraction seemed to go unnoticed. OBJECTIVE: This paper aims to document an unprecedented case of misinformation from a Cochrane review and its impact on media, scientists, and patients. As well, it aims to identify the generic factors leading to the incident and suggest remedies. METHODS: This was a qualitative study of the events leading to the retraction of the publication and of the reactions from media, scientists, and patients. This includes a review and content analysis of academic and mass media articles responding to the publication and retraction. Mass media articles were retrieved in May 2005 from LexisNexis Academic and Google and were classified and tallied. The extended case method is employed, and the analysis is also applied to comparable publishing events. RESULTS: A search on LexisNexis Academic database with the query "Elizabeth Murray AND health" for the period of June 2004 to May 2005 revealed a total of 15 press reports, of which only 1 addressed the retraction. Google was searched for references to the review, and the first 200 retrieved hits were analyzed. Of these, 170 pages were not related to the review. Of the remaining 30 pages, 23 (77%) were reports about the original publication that did not mention the retraction, 1 (3%) was a bibliography not mentioning the retraction, and 6 (20%) addressed the retraction, of which only 1 was a non-Cochrane-related source. CONCLUSIONS: Analyzed retrievals showed that the mass media gave more coverage to the Cochrane review than to the retraction or to a related systematic review with a similar scope but a different conclusion. Questionable results were prematurely disseminated, oversimplified, and sensationalized, while the retraction was hardly noticed by the public. Open commentary by scientists and patients helped to rapidly identify the errors but did not prevent or correct the dissemination of misinformation.
BACKGROUND: Anterior transposition of the inferior oblique muscle is a popular treatment for dissociated vertical divergence. It seems that this surgical procedure may alter the palpebral fissure. OBJECTIVES: To investigate the alteration of the palpebral fissure with inferior oblique muscle anterior transposition when it is performed as the sole operative procedure and to report the cases of patients who developed noticeable upper eyelid retraction after inferior oblique muscle anterior transposition preceded by large superior rectus muscle recessions. METHODS: The change in the height of the palpebral fissure surgery was evaluated from photographs by 2 masked observers in 3 groups of patients. The control group underwent inferior oblique muscle recession without transposition. The second group (or the insertion study group) underwent transposition of the inferior oblique muscle that was level with the inferior rectus muscle insertion. The third group (or the 2-mm study group) had the inferior oblique muscle placed 2 mm anterior to the inferior rectus muscle insertion. Also, the insertion study and the control groups were evaluated after surgery for bulging and elevation of the lower eyelid on upgaze. RESULTS: The narrowing of the palpebral fissure after surgery (mean + SD) was -0.14 + 0.6 mm in the 16 patients in the control group, -1.2 + 0.9 mm in the 14 patient in the insertion study group, and -2.1 + 0.5 mm in the 6 patients in the 2-mm study group. The differences were statistically significant between the control and the insertion study groups (P= .001, t test) and between the control and the 2-mm study groups (P< .001, t test). One of the 16 control patients and 10 of the 14 insertion study patients showed bulging of the lower eyelid on upgaze after surgery. This difference was statistically significant (P<.001, Fisher exact test). In addition, 3 patients were seen who developed marked upper eyelid retraction when anterior transposition of the inferior oblique muscles followed previous large superior rectus muscle recessions. CONCLUSIONS: Anterior transposition of the inferior oblique muscle causes significant narrowing of the palpebral fissure as a sole procedure. When preceded by large superior rectus muscle recessions, it can cause upper eyelid retraction. Arch Ophthalmol. 2000;118:1542-1546
Three cases of bilateral traumatic abducens nerve palsy were presented and the mechanism of damage to the abducens nerve was discussed in relation to the analysis of traumatic force at the time of impact and topographical anatomy of the abducens nerve in detail. Case 1. A 70 year old man sustained a traffic accident with one hour loss of consciousness. Physical examination revealed a contused area on the medial side of his right forehead. Neurological examination revealed bilateral abducens nerve palsy (Fig. 1). There were no ther cranial nerve abnormalities. Roentgenograms of the skull, including views of the base and orbit showed no fracture. At follow up examination 12 months later, bilateral Duane's retraction syndrome could be noticed with slight increase in size of the pupil on each side of lateral gaze (Fig. 2). Case 2. A 32 year old women sustained a traffic accident with 31 days of loss of consciousness. At the time of admission, bilateral abducens nerve palsy and slight left hemiparesis were noticed in semicomatose condition. Right carotid angiogtam showed no evidence of intracranial hematoma. One month later, the right eye began to abduct and 2 months later, the left eye began to abduct. Three months after the injury, bilateral abducens nerve palsy could no longer be demonstrated. No retraction syndrome was observed during this period. Case 3. A 3 year old boy sustained a traffic accident with 32 days of loss of consciousness. At the time of admission, neurological examination showed bilateral abducens palsy and left sided decerebrate posture in comatose condition. At the time of discharge 3 months after admission, bilateral abducens palsy, right hemiataxia, left spastic hemiparesis and scanning speach were noticed. Three months later, right eye began to abduct and 4 months later, the left eye began to abduct. At follow up examination 6 months later, there was no evidence of abducens nerve palsy. Topographical details of anatomy of the abducens nerve are shown in Fig. 3, 4. It is greatly speculated that both abducens nerves are streched by the lineal accerelated force on mid sagittal plane at the time of impact, then the apex of petrous pyramid acts as the fulculum, so that the abducens nerves are compressed, contused and streched at this point (Fig. 5-a). The authors pointed out that the abducens nerve are impossible to be damaged at the petroclinoid ligament (Grüber's lig.) by the upward movement of the brainstem, because the abducens nerve is fixed downward below this ligament by the dura and apex of the petrous pyramid (Fig. 4-b, c). One case showed bilateral acquired retraction syndrome with slight increase in size of the pupil on each side of lateral gaze, the fact greatly suggesting that the sympathetic nerve have intimate relationship to the miss direction during the recovery stage of abducens nerve palsy.
Targeting of the NG2 proteoglycan to cellular retraction fibers was studied by expressing mutant NG2 molecules lacking specific structural elements of the proteoglycan. Both the cytoplasmic domain and the chondroitin sulfate chain of NG2 appear to have roles in sorting NG2 to subcellular microdomains destined to become retraction fibers. Neither of these structural features alone is sufficient to allow optimal targeting of NG2 to retraction fibers, but together they promote efficient localization of the proteoglycan to these sites. This pattern of NG2 sorting seems to be necessary for optimal retraction fiber formation, as cells expressing poorly targeted NG2 mutants are noticeably deficient in their ability to extend retraction fibers. Furthermore, retraction fiber formation correlates strongly with the tendency of cells to assume a polarized morphology with NG2-positive retraction fibers at one pole of the cell and actin-rich lamellipodia at the other. This polarization can be triggered either through engagement of NG2 by the substratum or by exposure to lysophosphatidic acid, a potent activator of the rho GTPase. These results suggest a possible role for NG2 in regulating rho-dependent mechanisms in the trailing processes of motile cells.
19 subjects (10 men, 9 women) ages 19 to 30 years (M = 23.2, SD = 3.3) volunteered to participate in a study to investigate the just-noticeable-difference in movement extent for neck retraction and neck rotation. Testing was carried out with stopped movements, conducted according to the method of constant stimuli, and repeated both with and without vision in a comfortable seated position. Sensitivity was greatest for neck-retraction movements, which had lower just-noticeable-difference than either left or right rotation movements. Having full vision available gave no significant advantage in any direction when discriminating between different extents of midrange head movements.
To assess the contribution of the plasmin/matrix metalloproteinase cascade in lattices retraction, human gingival fibroblast-populated collagen lattices were supplemented with plasminogen. The rate of lattice retraction was enhanced by addition of plasminogen. This effect was concomitant to plasmin generation, prostromelysin-1 and procollagenase activation. Plasminogen-mediated initiation of that proteolytic cascade was accompanied by conspicuous changes in cell morphology and collagen fibers organization. At day 1 of culture fibroblasts shifted from a rounded (control) to an elongated (in presence of plgn) shape. At the latest stage of retraction, intense vacuolization around fibroblasts was noticed in plgn-supplemented lattices which paralleled the increased collagen degradation. Plgn-enhancing influence on the initial phase of lattice retraction could be totally annihilated by either aprotinin or Batimastat. Those data emphasize the crucial importance of the plasmin-MMP proteolytic cascade in granulation tissue retraction in a healing wound.
Following features seem to characterize retinal detachments in children. High rate of difficult anatomical problems: invisible retinal breaks, macular or paramacular breaks, giant breaks or desinsertions (37% of our cases). High rate of severe traumatic macular lesions. Important delay in treatment with prolonged macular impairment. These facts explain the prognosis. Difficulties in the treatment of retinal breaks explain anatomical results (75% cure rate vs 78,6% for all the retinal detachments treated). In the same way they explain the high rate of multiple operations. Macular impairment and multiple operations explain visual results: 1/3 of the non amblyopic eyes recover a visual acuity comparable to the initial. So, the macular in children does not seem to have a special functional recuperation ability. Two supplementary facts may be mentioned. Delay in treatment has no adverse effect in anatomic prognosis. Non giant "simple" desinsertions expose to a noticeable risk of massive vitreous retraction.
By this notice, the Editor and the Publisher of the Journal of Surgical Oncology retract from publication the following article: "Factors Affecting Hospital Readmission Rates for Breast Cancer Patients in Western Australia," Michael A. Martin, Ramona Meyricke, Terry O'Neill, and Steven Roberts, Journal of Surgical Oncology, Published online January 17, 2007, DOI: 10.1002/jso.20742. The article has been formally deemed a duplicate submission. The Editor and the Publisher of the Journal of Surgical Oncology regret the occurrence of this unfortunate incident.
In 11 patients, 18 teeth, with extra-alveolar periods ranging from 6 h to 48 days were replanted after root-filling with chloroform resin and guttapercha. After observation periods from 1 to 7 years, only 1 tooth was lost (after 5 years), but the remaining 17 teeth were clinically well functioning. All teeth were ankylotic and subjected to replacement resorption of various extent. Inflammatory root resorption and periradicular osteitis were not observed. Marginal bone loss up to 5 mm was noticed, but was accompanied by gingival retraction and thus pathological periodontal pockets (5 mm) were not observed. Consequently, teeth replanted after long extra-alveolar periods (even several days) can function for many years and thus postpone prosthetic treatment.
Ureterocutaneostomy, the anastomosis of the ureter to the skin, represents the most simple supravesical urinary derivation. It can be performed as unilateral, bilateral, bilateral with one orifice, or rarely as transuretero-ureterocutaneostomy. In period 1993-1998 on the Clinic of Urology, Clinical Center of Serbia, ureterocutaneostomy was performed in 155 patients as definitive type of urinary derivation. The most frequent indication for this type of derivation was the bladder tumor (130 out of 155 pts.). The rest of 25 pts. had carcinoma of vaginal portion of uterus, vesico-vaginal fistula (most frequently after irradiation), high ureteric lesions bladder neurogenic disfunction or rare bladder diseases. Having in mind short period of follow up two major complications were noticed: stenosis of uretero-cutaneostomy and retraction of anastomosis with consecutive formation of subcutaneous urinoma and abscesses formation. Although rarely used as definitive type of urinary anastomosis, ureterocutaneostomy has its place in wide spectrum of urinary derivations, since it is the only way to help those patients that have no other option of urinary derivation that might provide better way of social and professional rehabilitation.
The distributions of microfilaments and microtubules were studied during transient hormone-induced changes in cell shape (retraction-respreading). Two cell types (fibroblasts and bone cells), differentially responsive to parathyroid hormone (PTH) and prostaglandin E2 (PGE2), were analysed. The cytoplasm of fibroblasts retracted in response to PGE2 but not PTH, whereas bone cells could respond to both PGE2 and PTH. Time-lapse photomicrography indicated that the retraction began within minutes of hormone addition, while respreading occurred over longer times, up to 8 h. Affinity-purified actin and tubulin antibodies were used to follow the appearance of microtubules and microfilaments during both the retraction and the respreading phases. Microtubules appeared not to reorganize noticeably, although they were squeezed closer together in cellular pseudopods; no extensive loss or growth was detectable. Microfilaments did alter drastically their appearance and distributions. Soon after hormone addition when earliest detectable cytoplasmic retraction was evident, microfilament bundles appeared to break down. Remaining microfilament bundles consisted of relatively short, non-aligned fragments or aggregates. During respreading, microfilament bundles regrew and realigned throughout the cytoplasm. These data suggest a primary role for microfilaments, but probably not microtubules, in these cell shape changes.
This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of the request of the editor. In 2018, CHEST published a notice1 that all articles authored by Joachim Boldt be read with caution due to expressions of concern about falsified data. In 2020, CHEST received additional evidence of research misconduct and breaches of scientific integrity that were discovered following an investigation by the author's former institution, the University of Giessen2. In light of this new evidence, this article has been retracted by CHEST. 1. Irwin, R.S., MD, Master FCCP. Notice From the Editor in Chief. CHEST 153(3), p. 767. 2. Mukherjee, J. Statement on the scientific credibility of articles published by Joachim Boldt, formerly professor at Justus Liebig University (JLU), Giessen, Germany. https://ars.els-cdn.com/content/image/1-s2.0-S000709122030163X-mmc3.pdf.