bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Plain Abdominal X-ray in the Acute Abdomen
Authors: Stower M J , Mikulin T , Hardcastle J D , Amar S S , Kean D M
Published: January 2017

The prognostic value of an erect and supine abdominal X-ray was studied prospectively in 97 patients with an acute abdomen. Although 64 (66%) of the radiographs showed an abnormality, the surgical registrar altered his clinical diagnosis on only seven occasions and changed his management on four. A consultant radiologist was the most accurate at reporting the X-rays even without seeing the patient, whilst junior surgical and radiological staff were as accurate as each other. A surgical registrar, however, was more accurate than junior radiologists in making a diagnosis. The investigation was of immediate clinical value in only 4% of the patients, and its use could probably be limited without detriment to patients.
Doctor-Patient Communication in Surgery
Authors: Richards Jessica , McDonald Peter
Published: January 2017

The efficiency of communication between junior hospital doctors and 77 general surgical patients was assessed by using standardized questionnaires before and after the doctor/patient interview on both the patient and the house doctor. Patients were better informed about their illness than their surgery, and doctors wrongly estimated patients' knowledge in 41% of cases. Self-reported preoperative anxiety of patients was low and was estimated wrongly by house doctors in 58% of cases. In 52% of cases house doctors were considered by patients to be the most important source of information, but patients had little comprehension of the seniority of other doctors. Although 60% of patients were satisfied with the communication, the majority complained of lack of information concerning convalescence, postoperative pain and routine ward procedures.
Serum Parathyroid Hormone Levels in the Hypercalcaemia of Urological Malignant Disease
Authors: Ramsay J W A , Hendry W F
Published: January 2017

Serum parathyroid hormone (PTH) levels have been measured in 8 patients with hypercalcaemia associated with urological malignancy: 3 renal cell carcinomas, 2 adenocarcinomas of prostate, 2 transitional cell carcinomas of bladder and one transitional cell carcinoma of kidney. Five (63%) of these 8 patients had bone metastases. PTH was detectable in the serum of all 8 hypercalcaemic patients, but in only 2 cases was the PTH level above the normal range, and in one of these a coincidental parathyroid adenoma was found to be responsible for the hypercalcaemia. It appears that these tumours can produce a hormone-like substance with biological effects similar to PTH.
Plasma Catecholamines and Lipoproteins in Chronic Psychological Stress
Authors: O'Donnell L , O'Meara N , Owens D , Johnson A , Collins P , Tomkin G
Published: January 2017

Changes in plasma catecholamines, lipoproteins and dietary intake were examined in 13 medical students during a 3-month period prior to their examinations, and in 12 controls. In the medical students mean ± s.e.(mean) plasma cholesterol increased over the study period (3.98 ± 0.16 v. 4.26 ± 0.16 mmol/l, P < 0.05) and this was reflected by a rise in low-density lipoprotein cholesterol (2.53 ± 0.15 v. 2.71 ± 0.17 mmol/l, P < 0.05). Both supine adrenaline (0.45 ± 0.05 v. 0.70 ± 0.07 nmol/l, P < 0.01) and noradrenaline (2.74 ± 0.18 v. 3.40 ± 0.31 nmol/l, P < 0.05) increased over this period. Apart from a decline in the modest alcohol consumption (9.1 ± 3.45 v. 2.6 ± 1.4 g/day, P < 0.02) there was no change in dietary intake in the medical students. There were no significant changes in plasma catecholamines, lipoproteins or dietary intake in control subjects over the study period.

Changes in catecholamines and lipoproteins occurring in association with chronic psychological stress may contribute to the increased coronary heart disease mortality associated with Type A behaviour and stressful life events.
Outcome of Supracondylar Fractures of the Humerus in Children
Authors: Thomas A P , Alpar E K
Published: January 2017

Seventy patients who had sustained supracondylar fractures of the humerus as children were examined. Loss of carrying angle of the elbow occurred if the fracture was immobilized in a varus position during healing. Varus malalignment could have been obviated if comparative radiographs of the other elbow had been taken and the Baumann angles compared. Rotation and posterior displacement at the fracture had little bearing on the outcome. Immobilization of the fracture in a collar and cuff sling was as effective as more elaborate methods.
Restricted Interests and Autism: Further Assessment of Preferences for a Variety of Leisure Items
Authors: Spear Monica A. , Karsten Amanda , White Emily A.
Published: January 2017

Researchers have yet to identify the conditions under which people diagnosed with autism spectrum disorder demonstrate restricted interests; it is possible that the impression of restricted interests is strengthened when a limited variety of items are included in a client’s preference assessments. This study will extend past research on preferences of children with autism by (a) examining participants’ preferences for unreplenished (familiar) play or leisure items versus items that are replenished frequently, (b) assessing if participants who prefer replenished items select items with properties that are matched or unmatched to their most preferred unreplenished item, and (c) assessing if participants who show an exclusive preference for unreplenished items will select replenished items during response-restriction and enhanced-replenished pool manipulations. Participants were four adolescents with autism and a caregiver-reported history of restricted interests. One participant selected both unreplenished (familiar) items and replenished (novel) items without further manipulations. The remaining three participants only selected replenished-matched leisure items after additional manipulations. Results are discussed in terms of the ethical and practical importance of assessing a range of potential reinforcers, particularly with clients who demonstrate restricted interests.
The Relationship Between Parenteral Nutrition and Central Line–Associated Bloodstream Infections: 2009–2014
Authors: Fonseca Gabriela , Burgermaster Marissa , Larson Elaine , Seres David S.
Published: January 2017

Background: Parenteral nutrition (PN) administered via central venous catheter has been identified as an independent risk factor for central line–associated bloodstream infections (CLABSIs). The aim of this study was to provide an updated description of the relationship between PN and CLABSI and assess temporal trends in CLABSI rates for individuals who received PN from 2009–2014, after the Centers for Medicare & Medicaid declared CLABSI a “never event.” Methods: Using data obtained from all adult patient discharges between January 1, 2009, and December 31, 2014, from 2 affiliated hospitals in a large health system in New York City, univariate and multivariate analyses were performed to examine the relationship between PN and CLABSIs as well as temporal trends. Results: Among 38,674 patients with central lines, 3517 developed CLABSIs and 767 patients were prescribed PN. PN was an independent risk factor for developing CLABSI among our patients (odds ratio [OR], 2.65; 95% confidence interval [CI], 2.20–3.19). The incidence of CLABSI among patients who were prescribed PN was not significantly different across the years of this study, even after adjusting for severity of illness. Conclusion: PN remains a significant risk factor for CLABSIs; further work is needed to identify effective strategies to reduce rates of CLABSI among patients receiving PN.
A Systematic Review: Outcomes in Adult Recurrent Respiratory Papillomatosis Treated with Intralesional Cidofovir or Bevacizumab
Authors: Drejet Sarah , Halum Stacey , Brigger Matthew , Skopelja Elaine , Parker Noah P.
Published: January 2017

Objectives

(1) To systematically identify studies evaluating the use of intralesional cidofovir or bevacizumab as an adjunct in adult recurrent respiratory papillomatosis, determine disease severity and functional outcomes, and assess study quality. (2) To compare outcomes between the 2 adjuncts.

Data Sources

Ovid Medline, EMBASE, Scopus, and Clinical‐Trials.gov.

Review Methods

Data sources were systematically searched. A priori inclusion and exclusion criteria were instituted. Quality was evaluated with the Newcastle‐Ottawa Quality Assessment Scale. A priori criteria were instituted to select studies suitable for comparison.

Results

A total of 254 identified studies led to 16 for full‐text review, including 14 for cidofovir and 2 for bevacizumab. Disease severity outcomes were reported in all studies, including remission rate, Derkay scores, time interval between operations, and/or lesion volume reduction. Remission rate was the most commonly reported (14 studies). Functional outcomes were reported in 5 studies (36%), including quality‐of‐life questionnaires, acoustic/aerodynamic analysis, and perceptual voice analysis. Voice‐related quality of life was the most commonly reported (2 studies). Of 16 studies, 12 (75%) were rated poor quality. Reports almost invariably showed improved disease severity and functional outcomes following treatment; however, variable outcome measures and inadequate follow‐up disallowed direct comparison of adjuncts.

Conclusion

Remission rate was the most commonly reported disease severity outcome, and voice‐related quality of life was the most commonly reported functional outcome. Most studies were of poor quality. No studies met criteria for comparative analysis between adjuncts. Future research would be improved by reporting consistent and comparable disease severity and functional outcomes, treatment protocols, and follow‐up.
Inefficiencies in Computed Tomography Sinus Imaging for Management of Sinonasal Disease: Results of a Tertiary Care Center
Authors: Sharma Giriraj K. , Foulad Allen , Shamouelian David , Bhandarkar Naveen D.
Published: January 2017

Objective

A subset of patients with sinonasal disease who obtain a diagnostic computed tomography (CT) sinus scan may require repeat preoperative CT due to the inadequacy of diagnostic CT for image‐guided sinus surgery (IGSS). This leads to increased CT utilization, health care costs, and patient exposure to ionizing radiation. The objective of this study is to determine the frequencies of diagnostic CT sinus studies that were inadequate for IGSS and repeat CT studies for purposes of IGSS.

Study Design

A retrospective chart study was performed between May 2012 and August 2013.

Setting

Tertiary care rhinology practice.

Subjects and Methods

New patients with any sinonasal diagnosis who presented with CT sinus scans acquired from outside institutions were included. CT scans were considered inadequate for IGSS for any of the following reasons: >1.5‐mm slice thickness, oblique axial planes due to gantry tilt, and incompletely defined or missing IGSS anatomic landmarks.

Results

Of 183 patients, 85 (46%) presented with diagnostic CT sinus scans that were inadequate for IGSS. Seventy‐one patients met indications for IGSS, of which 37 (52%) required repeat CT due to an IGSS‐inadequate diagnostic scan.

Conclusion

The frequency of repeat preoperative CT sinus imaging may be high at tertiary care centers where IGSS is performed. A standardized IGSS‐adequate CT sinus protocol may avoid the need for repeat preoperative scans. Potential advantages include improved efficiency, decreased health care costs, and reduced ionizing radiation exposure to the patient.
Therapeutic Management of Pyriform Sinus Cancer: Results of a Single‐Center Study of 122 Patients
Authors: Donnadieu Jérôme , Klopp‐Dutote Nathalie , Biet‐Hornstein Aurélie , Strunski Vladimir , Mortuaire Geoffrey , Page Cyril
Published: January 2017

Objective

To analyze the survival rate of a nonselected pyriform sinus cancer population.

Study Design

Case series with chart review.

Setting

University hospital.

Subjects and Methods

A total of 122 patients were included in this study covering the 2002‐2008 period. All patients had squamous cell carcinoma originating from the pyriform sinus. Survival and prognostic factors were analyzed.

Results

The 3‐ and 5‐year overall survival rates were 39.7% and 2.4%, respectively. The 3‐ and 5‐year survival rates without recurrence were 34% and 27%, respectively. The median survival rates by UICC stage were as follows: stage 1 and 2 patients, 60 months; stage 3, 40 months; stage 4, 19 months. Stage 4 patients had a lower median survival rate than other stages (P =. 039). The 5‐year survival rate was 46% for patients having T3‐T4 operable cancers treated by surgery vs 45% for patients treated by laryngeal conservation protocol (not significant). The 5‐year survival rate for patients having nonoperable T4 cancers was 17.2%. The 3‐ and 5‐year overall survival rates of N0 patients was significantly higher than N1 patients (P =. 042). N2 and N3 patients had 100% 5‐year mortality.

Conclusion

This study showed that overall survival and therapeutic management depend on the initial stage of pyriform sinus cancer, notably on the N status. In particular, nonoperable T4 pyriform sinus cancer and N2 and N3 patients had a very poor prognosis. A laryngeal conservation protocol seemed as effective as surgical management in terms of survival.
Long-term consequences of atrial fibrillation after aortic valve replacement
Authors: Kohno Hiroki , Ueda Hideki , Matsuura Kaoru , Tamura Yusaku , Watanabe Michiko , Matsumiya Goro
Published: January 2017

Background

Atrial fibrillation is a common complication after cardiac surgery, but the risk factors and long-term outcome after primary isolated aortic valve replacement remains to be clarified.

Methods

A single-center retrospective study was conducted on 157 patients who underwent first-time isolated aortic valve replacement between April 1999 and February 2015. Fifty-eight patients developed new-onset atrial fibrillation within 6 months postoperatively, and they were compared with patients who remained in sinus rhythm. Multivariate analyses, which incorporated the propensity score patient matching technique, were conducted to evaluate the long-term outcome of new-onset postoperative atrial fibrillation and identify patients at risk of developing this arrhythmia.

Results

At a mean follow-up of 52.4 months (range 8.4–200.7 months), mortality was significantly higher in patients who developed atrial fibrillation compared to those who remained in sinus rhythm (2.8%/patient-year vs. 0.2%/patient-year, respectively; p < 0.05). Patients developing atrial fibrillation were also at an independently increased risk of stroke and readmission during follow-up. Risk analysis revealed that advanced age (>70 years) and absence of a postoperative β-blocker were predictors of atrial fibrillation.

Conclusions

New-onset atrial fibrillation after first-time isolated aortic valve replacement correlated significantly with late morbidity and mortality. Advanced age and absence of a postoperative β-blocker may increase the incidence of atrial fibrillation.
Clinical implications of the anatomical variation of deep venous thrombosis
Authors: El-Menyar Ayman , Asim Mohammad , Jabbour Gaby , Al-Thani Hassan
Published: January 2017

Introduction

Little is known about the anatomic variation and its implication in patients with lower limb deep venous thrombosis (DVT). We studied the clinical presentation, site of thrombosis and risk factors based on the anatomic distribution of lower limb DVT.

Methods

A retrospective analysis of clinically suspected DVT cases was conducted between 2008 and 2012. DVT was categorized by the location of the thrombosed segment and limb involved. The DVT anatomic segments were assessed according to left-to-right ratio, predisposing factors and clinical presentations.

Results

A total of 637 patients with DVT were included with a mean age of 50 ± 17 years (51%; females). The most frequently thrombosed segments were popliteal, posterior tibial and profunda femoris veins. DVT was more common at the left side, with a left-to-right ratio of 1.5:1. Bilateral DVT cases (38.5%) had more prior history of DVT as compared to left- (20.3%) and right-sided DVTs (22.6%); p = 0.01. Bilateral DVT was complicated more with post-thrombotic syndrome (leg ulcer) ( p = 0.02). The rates of pulmonary embolism (25%) and mortality (23.1%) were significantly higher for bilateral DVT in comparison to left- and right-sided DVT. Abnormal coagulation profile was significantly associated with posterior tibial DVT (81% vs. 71.4%; p = 0.01) as compared to patients with normal coagulation profile.

Conclusion

Lower limb DVTs are more common at the left side; however, patients with bilateral DVT have higher frequency of recurrence, post-thrombotic syndrome, pulmonary embolism and mortality. The anatomic segments of DVT show specific distribution depending on the predisposing factors. These findings could improve our understanding of the pathophysiology and management of DVT patients.
Microangiopathy in Severe Chronic Venous Insufficiency Evaluated by Fluorescence Video-Microscopy
Authors: Haselbach P. , Vollenweider U. , Moneta G. , Bollinger A.
Published: January 2017

Fluorescence video microscopy after intravenous injection of Na-fluorescein was used to study capillary morphology, pericapillary halo diameters, microvascular flow distribution and transcapillary diffusion of the dye in 15 healthy controls and 15 patients with severe chronic venous insufficiency (CVI). The recordings were made in the medial ankle region. Transcapillary diffusion was monitored within a densitometer window encompassing 3.2 mm2 of skin surface. Microangiopathy known from previous studies was documented in the patients with severe CVI. The number of skin capillaries within the field of observation was not reduced. In some cases inhomogeneous microvascular flow distribution and probable microthrombosis were detected. Mean halo size averaged 81 — 15 μm in the controls and 146 ± 47 μm in the patients (P < 0.001). Unexpectedly, transcapillary diffusion of Na-fluorescein was not significantly increased in the field of measurement. Possible explanations include asynchronous inflow of the dye, the presence of thrombosed and therefore not perfused capillaries, a pericapillary fibrin layer limiting diffusion and redistribution of flow in favour of the subcutaneous tissue.
Intra-Operative Phlebography of the Short Saphenous Vein
Authors: Corcos Leonardo , Peruzzi Giampiero , Romeo Vincenzina , Fiori Carlo
Published: January 2017

The short saphenous vein is more and more often held responsible for the onset and development of varicose conditions and post-operative recurrence. In order to perform complete posterior saphenectomy account must be taken of the frequent anatomical variations in the outflow of this vein. A method of intra-operative phlebography of the short saphenous vein has been developed. The results confirm the high rate of the anatomical variations. Intra-operative phlebography facilitates complete posterior saphenectomy without negative effects in terms of surgical trauma and cosmetic results, thanks to the new technical developments.
Comparison of Strain-Gauge and Photocell Venous Function Testing with Invasive Pressure Measurements. A Prospective Study in Deep Venous Insufficiency
Authors: van den Broek Theodore A.A. , Rauwerda John A. , Kuijper Caroline F. , Bakker Fred C. , van Rij Gerhard L.
Published: January 2017

Of noninvasive venous function tests two are well known: photoplethysmography (PPG) and strain-gauge plethysmography (SGP). Their effectiveness in assessment of insufficiency in candidates for venous reconstructive surgery however, is debated. The two methods were studied in these patients, and compared to invasive measurements. Nineteen limbs of patients with deep venous disease, and seven limbs of healthly volunteers were evaluated. Measurements were taken in standing, as well as in the more patient-compliant sitting position. Venous reflux time (RT) proved to be significantly different in patients vs. controls. Differences between expelled volume of controls and patients were only significant for invasive measurements in any position ( p < 0.01), but not with one of the noninvasive methods.

RT invasively and non-invasively measured were well correlated in both positions with PPG ( R = 0.83 – 0.86), and with SGP ( R = 0.85 — 0.92). The percentage residual pressure however, showed in both methods a poor correlation of < 0.50.

The studied noninvasive techniques offer no alternative to invasive measurements in the evaluation of patients with deep venous disease, considered for venous reconstructive surgery.
Plethysmographic Measurement of Venous Flow Resistance and Venous Capacity in Humans with Primary Lymphoedema
Authors: Rouweler B. J. F. Klein , Kuiper J. P. , Brakkee A. J. M.
Published: January 2017

Venous flow resistance ( Rv) and venous capacity ( C10) was measured by strain-gauge plethysmography in patients with primary lympoedema of the legs. In the calf, Rv was significantly higher than normal and increased with the clinical severity of the oedema, while C10 was significantly lower than normal. Potential causes are discussed. No indications were found that the specificity of Rv, when used as a diagnostic criterion for recent deep vein thrombosis, is influenced by primary lymphoedema.
Injection Sclerotherapy for Varicose Veins — A Comparison of Materials for Applying Local Compression
Authors: Stanley Paul R. W. , Bickerton David R. , Campbell William B.
Published: January 2017

One-hundred-and-two patients undergoing sclerotherapy for varicose veins were randomized for the use of adhesive Molefoam (Scholl®) or traditional Sorbo pads (STD®) under the compression bandage. A total of 413 injections were performed.

Molefoam was found to offer practical advantages over Sorbo pads and was associated with a lower incidence of minor skin irritation, which was seen only in patients sensitive to Elastoplast®.

The use of Molefoam provides a helpful modification in compression sclerotherapy for lower limb varicose veins.
Incompetent Transplanted Arm Vein Valves: Surgical Correction and Result
Authors: Sottiurai V. S.
Published: January 2017

Nine arm vein valve transplantations were performed when the valves of femoral or popliteal veins were damaged beyond valvuloplasty in deep-valve correction. In four of the nine arm vein valves (44%) incompetence was recognized immediately following transplantation. Valvuloplasty successfully restored valvular competence of the four transplanted arm veins. Intraoperative direct venous pressure of the dorsalis pedis in the supine position improved by 5–30 mmHg (mean 8 mmHg) in six of seven limbs following vein-valve transplantation. Competence of the arm vein valve should be tested before and after transplantation. Valvuloplasty of the incompetent transplanted valves is feasible and has produced no added susceptibility to thrombosis and recurrent incompetence.
A Methodological Study of Venous Valvular Insufficiency and Musculovenous Pump Function of the Lower Leg
Authors: Rosfors S.
Published: January 2017

Objective:

To assess venous valvular function of the lower limb using Duplex scanning and descending phlebography, and compare the results obtained with clinical examination and other methods of monitoring venous function of the lower limb, including venous photoplethysmography, strain-gauge phlethysmography, foot volumetry and intramuscular pressure readings.

Design:

Non-randomised, retrospective study of patients referred for investigation of venous disease. Patients investigated included a group of 20 who had previously undergone fasciotomy of the lower limb, and a group of healthy controls.

Setting:

Patients referred to St Goran's Hospital, Stockholm, Sweden.

Intervention:

Venous photoplethysmography, foot volumetry, strain-gauge plethysmography, photoplethysmography, Dopplex/Duplex ultrasound, phlebography, intravenous pressure and intramuscular pressure readings in various sub-groups.

Main outcome measures:

Determination of sites of venous reflux in the lower limb using Duplex/Doppler and phlebography, and correlation of the results obtained with other methods of investigation of lower limb venous function.

Results:

Poor correlation was found between descending phlebography and Duplex scanning, although good correlation was found between the number of segments with reflux and clinical condition. PPG recovery time was very variable, depending on transducer position, numbers of dorsiflexions performed, and reflux in superficial veins.
Light Microscopy, Immunohistochemistry and Electron Microscopy of the Valves of the Lower Limb Veins and Jugular Veins
Authors: Butterworth D. M. , Rose S. S. , Clark P. , Rowland P. , Knight S. , Haboubi N. Y.
Published: January 2017

Objectives:

To demonstrate the light, electron microscopy and immunohistochemistry appearances of the valves of lower limb veins and jugular veins of subject with evidence of venous disease.

Design:

A prospective study of saphenous veins obtained at post mortem examination and jugular vein obtained at time of surgery.

Setting:

Health Service district general hospital.

Patients:

Patients with no evidence of venous disease being treated in the hospital for unrelated conditions, or examined at autopsy in the Department of Pathology.

Interventions:

Sections of saphenous vein from the lower limb and jugular vein were examined using conventional histology, immunohistochemical staining and electron microscopy.

Main outcome measures:

Microscopic and electron microscopic appearances of histological sections of venous valves.

Results:

The valve agger contains an increased amount of fibrous tissue compared with the vein wall and saphenous and jugular veins. However, in saphenous veins the muscle layer of the wall could be traced across the base of the agger, but this was deficient in jugular valves. Electron microscopic examination showed that most of the valve cusp was composed of collagen fibrils, aggregated in irregularly arranged bundles. Elastic fibre material was present in the subendothelial zones. Nerve and muscle fibres were not present in the cusp.

Conclusions:

Valve cusps in both high and low pressure systems are similar, and the authors suggest that cusp/agger/vein wall complex is important for valve function.
Prevention of Post-Thrombotic Syndrome with Hidrosmina: A Prospective Pilot Study
Authors: Monreal M. , Callejas J. M. , Martorell A. , Sahuquillo J. C. , Contel E.
Published: January 2017

Objective:

In a previous study we demonstrated the beneficial effect of some venoactive drugs when administered to patients with established post-thrombotic syndrome (PTS). The aim of the present study was to assess prospectively the efficacy of one of such drugs in preventing the development of PTS signs.

Design:

Prospective, randomized, open study.

Patients:

100 consecutive patients with a first episode of deep vein thrombosis (DVT), whose diagnosis had been verified with either venography or real-time ultrasonography, were entered in the study.

Interventions:

In addition to anticoagulant therapy, and immediately prior to discharge, patients were randomly allocated to receive Hidrosmina (Venosmil, FAES, Spain) 600 mg daily or no additional treatment. Each patient was followed-up in our outpatient clinic at 4-monthly intervals for a 3-year period. At each visit, patients were carefully examined for the presence of oedema, pigmentation, induration and ulceration. A simple scoring system, as reported by the SVS and the ISCS, was used to assess the severity of symptoms and signs.

Results:

After excluding 17 patients with recurrent DVT, there remained 83 patients, 10 of whom had bilateral DVT. No signs of PTS were found during the 3-year period in 65 out of 93 limbs (70%). Class 1 signs were found in 21 out of 93 limbs (23%), class 2 in 6 out of 93 limbs (6%) and class 3 signs in one limb. PTS was more commonly found in patients in whom DVT had involved the popliteal vein (20/50 vs. 8/43; p < 0.05). Furthermore, PTS developed in 7 out of 46 limbs (15%) in patients taking Hidrosmina vs. 21 out of 47 limbs (45%) in patients not taking the drug ( p < 0.005).

Conclusions:

In this pilot study our findings demonstrate that long-term therapy with Hidrosmina may be useful in preventing the development of PTS signs.
Public Understanding of Science and K-12 STEM Education Outcomes: Effects of Idaho Parents’ Orientation Toward Science on Students’ Attitudes Toward Science
Authors: Mihelich John A. , Sarathchandra Dilshani , Hormel Leontina , Storrs Debbie A. , Wiest Michelle M.
Published: January 2017

Over the past few decades, public anxiety about how people interact with science has spawned cycles of discourse across a wide range of media, public and private initiatives, and substantial research endeavors. National and international STEM (science, technology, engineering, and math) education initiatives and research have addressed how students interact with science and pursue careers in STEM fields. Researchers concerned with adult interaction with science have focused on factors that influence how citizens gather and interpret scientific knowledge and form positions on scientific issues, applications, and/or policy in a politicized democratic milieu. Building from research on how the public interacts with science in and outside of formal education, this study focuses on attitudes toward science among students in 4th, 7th, and 10th grades and their parents. Little research to date has paired the STEM experiences of adults with their children. We find that the extent to which parents are positively oriented toward science significantly shapes their children’s attitudes toward science. Furthermore, between 7th and 10th grades, students with parents holding positive orientations toward science are more likely to sustain positive attitudes toward science. Since the foundation for most adults’ interactions with science develops in the K-12 environment, we demonstrate that the foundation, as expressed in adulthood, may directly affect the ways the next generation of students interacts with science. We offer insights into the importance of developing student learning into the social scientific research on public understanding of science and how important scientific issues of today interplay with society.
Clinical characteristics and cytokine changes in children with pneumonia requiring mechanical ventilation
Authors: Nguyen Thi Dieu Thuy , Pham Nhat An , Craig Timothy J , Duong-Quy Sy
Published: January 2017

Objective

To assess clinical characteristics and cytokine levels in children with severe pneumonia who required ventilatory support.

Methods

In this prospective, descriptive, cross-sectional study, blood and endotracheal fluid samples were obtained from patients with severe pneumonia, aged <5 years, within 24 h following intubation. Blood samples were also obtained from age-matched healthy controls. Cytokine levels were investigated using flow cytometry-assisted immunoassay.

Results

Forty-five patients with severe pneumonia requiring mechanical ventilation (aged 10 ± 5 months) and 35 healthy age-matched controls were included. Patients with severe pneumonia had significantly increased serum interleukin (IL)-6, IL-8, and granulocyte/macrophage colony-stimulating factor concentrations compared with controls (80.84 pg/ml versus 2.06 pg/ml, 90.03 pg/ml versus 6.62 pg/ml, and 115.58 pg/ml versus 11.47 pg/ml, respectively). In the severe pneumonia group, serum IL-10 levels were significantly higher in patients aged <6 months versus those aged 6–12 months. Age-group differences in serum cytokine levels did not correspond to age-group differences in endotracheal-fluid cytokine levels. Serum IL-6 levels were significantly higher in patients who subsequently died versus those who survived (267.12 pg/ml versus 20.75 pg/ml, respectively).

Conclusion

High IL-6 concentrations were associated with mortality in patients <5 years of age with severe pneumonia requiring mechanical ventilation.
Reliability of home-based, motor function measure in hereditary neuromuscular diseases
Authors: Ruiz-Cortes Xiomara , Ortiz–Corredor Fernando , Mendoza-Pulido Camilo
Published: January 2017

Objective

To evaluate the reliability of the motor function measure (MFM) scale in the assessment of disease severity and progression when administered at home and clinic and assess its correlation with the Paediatric Outcomes Data Collection Instrument (PODCI).

Methods

In this prospective study, two assessors rated children with hereditary neuromuscular diseases (HNMDs) using the MFM at the clinic and then 2 weeks later at the patients’ home. Intraclass correlation coefficient (ICC) was calculated for the reliability of the MFM and its domains. The reliability of each item was assessed and the correlation between MFM and three domains of PODCI was evaluated.

Results

A total of 48 children (5–17 years of age) were assessed in both locations and the MFM scale demonstrated excellent inter-rater reliability (ICC, 0.98). Weighted kappa ranged from excellent to poor. Correlation of the home-based MFM with the PODCI domain ‘basic mobility and transfers’ was excellent, with the ‘upper extremity’ domain was moderate, but there was no correlation with the ‘happiness’ domain.

Conclusion

The MFM is a reliable tool for assessing patients with HNMD when used in a home-based setting.
Proximal fibular osteotomy: a new surgery for pain relief and improvement of joint function in patients with knee osteoarthritis
Authors: Wang Xiaohu , Wei Lei , Lv Zhi , Zhao Bin , Duan Zhiqing , Wu Wenjin , Zhang Bin , Wei Xiaochun
Published: January 2017

Objective

To explore the effects of proximal fibular osteotomy as a new surgery for pain relief and improvement of medial joint space and function in patients with knee osteoarthritis.

Methods

From January 2015 to May 2015, 47 patients who underwent proximal fibular osteotomy for medial compartment osteoarthritis were retrospectively followed up. Preoperative and postoperative weight-bearing and whole lower extremity radiographs were obtained to analyse the alignment of the lower extremity and ratio of the knee joint space (medial/lateral compartment). Knee pain was assessed using a visual analogue scale, and knee ambulation activities were evaluated using the American Knee Society score preoperatively and postoperatively.

Results

Medial pain relief was observed in almost all patients after proximal fibular osteotomy. Most patients exhibited improved walking postoperatively. Weight-bearing lower extremity radiographs showed an average increase in the postoperative medial knee joint space. Additionally, obvious correction of alignment was observed in the whole lower extremity radiographs in 8 of 47 patients.

Conclusions

The present study demonstrates that proximal fibular osteotomy effectively relieves pain and improves joint function in patients with medial compartment osteoarthritis at a mean of 13.38 months postoperatively.
Management of acute Achilles tendon rupture with tendon-bundle technique
Authors: Li Chun-Guang , Li Bing , Yang Yun-Feng
Published: January 2017

Objective

* These authors contributed equally to this work. To explore tendon-bundle technique for treating Achilles tendon rupture with no defects.

Methods

Patients with full unilateral Achilles tendon rupture with no defects were included. The Achilles tendon medial edge surgical repair approach was used, revealing horsetail-like rupture bundles. Tendon bundles were anatomically realigned and repaired end-to-end using 5-0 sutures. Patients were followed-up for 1 year, and assessed for differences between the repaired versus healthy limb.

Results

Out of 24 patients (18 male, 6 female; aged 19–56 years) at 1 year following surgery, mean American Orthopaedic Foot and Ankle Society score was 92.4 ± 5.9; mean differences between the surgically repaired versus contralateral side in dorsiflexion and plantarflexion angle were 3.5 ± 2.3° and 5.6 ± 3.2°, respectively; mean difference in calf circumference between the two sides was 0.9 ± 0.5 cm; and mean increase in Achilles tendon width versus the healthy side was 0.8 ± 0.2 cm. By 1 year post-surgery, there were no significant between-side differences in dorsiflexion and plantarflexion angle, or calf circumference.

Conclusions

Tendon-bundle surgery resulted in good ankle function restoration and low complication rates. Tendon-bundle surgery may reduce blood supply destruction and maximally preserve Achilles tendon length, and may be effective for treating Achilles tendon rupture with no defects.
Biological Correlates of Piracetam Clinical Effects in Psychotic Patients
Authors: Kabeš J , Erban L , Hanzliček L , Skondia V
Published: January 2017

The purpose of this controlled clinical trial was to demonstrate possible correlations between changes in bioenergetic metabolism and psychotropic drug administration in the treatment of functional psychosis. The study included twenty-six patients, eleven with schizophrenia, three with chronic atypical depression and twelve with drug-resistant endogenous depressions. All patients were kept on continuous psychotropic medication for at least 3 weeks before starting the trial, and piracetam was given additionally in a fixed dosage of 2400 mg daily; the same number of identical capsules was given during the pre- and post-treatment placebo periods.

Psycho-pathological evaluation of the patients was by the BPRS; clinical and biochemical data were evaluated statistically by the analysis of regression. The results show that in schizophrenic patients an improvement was observed in those cases who had improved biochemically, i.e. where the A TP values had increased. In drug-resistant depressions there was a rapid and significant clinical improvement after piracetam co-administration, and this went in step with a significant rise in A TP levels.
The Clinical Effect of Ketotifen in Bronchial Asthma
Authors: Labus J , Hlinka V , Krchnavý A
Published: January 2017

A therapeutic trial using ketotifen, a prophylactic agent for the long-term treatment of bronchial asthma, was undertaken. Twenty-nine patients with a mean age of 33 years and suffering from bronchial asthma for six months to 20 years (mean 8.6 years) were treated for three months. Ketotifen demonstrated good results in alleviating the impact of the disease on the asthmatic patient. The lowering of the frequency of asthmatic attacks, their duration and the degree of dyspnoea was accompanied by a normalization of lung function parameters. An analysis of further respiratory investigations showed that the best results are to be obtained in the uncomplicated asthmatic. The need for the prophylactic treatment of asthma with an agent such as ketotifen is stressed, as only in this way can irreversible changes be prevented.
Experience with Sustained-Release Oxprenolol (Slow Trasicor) in the Management of Hypertension in General Practice
Authors: Forrest W A
Published: January 2017

One thousand two hundred and ninety-five hypertensive patients with an average blood pressure of 180/110 mm Hg currently treated with a mean daily dose of methyldopa 1025 mg were studied. In two-thirds of these patients a diuretic was also prescribed. While the dose of diuretic remained constant, the daily dose of methyldopa was reduced in a stepwise fashion over a period of six weeks, and totally withdrawn by eight weeks. Simultaneously, sustained-release (SR) oxprenolol 160 mg was introduced up to a maximum dose of 320 mg (two tablets daily).

One hundred and seventeen patients (13.7% of the total) withdrew from the study, of whom sixty-eight (5.3%) were for drug-related reasons.

In the 1,118 patients completing the study the average blood pressure fell steadily during the trial to a final level of 159/95 mm Hg. SR oxprenolol was very well tolerated by the majority and the incidence of the troublesome symptoms of tiredness, depression, headache and sexual problems reported initially with methyldopa, was significantly reduced. Three-quarters of the patients reported that they felt better with this new treatment.

This study demonstrates the feasibility of substituting once daily SR oxprenolol in hypertensive patients whose blood pressure is inadequately controlled by methyldopa therapy, and the subsequent improvement in blood pressure is inadequately controlled by methyldopa therapy, and the subsequent improvement in blood pressure control and patient well-being.
Azatadine Maleate/Pseudoephedrine Sulfate Repetabs versus Placebo in the Treatment of Severe Perennial Allergic Rhinitis
Authors: Zubizaretta Julio
Published: January 2017

Sixty patients took part in a randomized double-blind comparison of azatadine/pseudoephedrine versus placebo for the treatment of severe perennial allergic rhinitis. After 2 weeks of therapy subjective patient appraisal as well as objective physician evaluation showed the active drug combination to have a beneficial effect (72% good to excellent improvement versus 40% for placebo) in reducing the signs and symptoms of this allergic disorder. No adverse reactions were reported.
A Comparative Trial of Slow-Release Aminophylline, Salbutamol and a Half Dose Combination in the Prevention of Childhood Asthma
Authors: Blumenthal I
Published: January 2017

The effect of slow-release aminophylline, salbutamol and a half dose combination of both was compared in children with chronic asthma. Drugs were given over three consecutive 5-week periods during which patients recorded daily peak flow measurements and symptom scores. At the end of each treatment period pulmonary function tests were done.

Sixteen of twenty-nine children completed the trial satisfactorily and their results have been used for analysis. The data show slow-release aminophylline and salbutamol to be equally effective and the half dose combination as effective as either drug alone. The results suggest there may be a therapeutic advantage in combining a β2 agonist with theophylline when high doses of either drug alone are not fully effective or when toxic effects occur.
A Double-Blind Trial of Terfenadine and Placebo in Hay Fever Using a Substitution Technique for Non-Responders
Authors: Kagan G , Dabrowicki E , Huddlestone L , Kapur T R , Wolstencroft P
Published: January 2017

A double-blind study of terfenadine and placebo in 110 patients suffering from hay fever (confirmed by skin tests) was conducted.

A novel technique was applied using an escape envelope containing a reference drug which could be taken under controlled conditions if, after 48 hours, the patient experienced no relief. Significantly more patients on placebo opened the envelope than patients taking the active drug.

Terfenadine was demonstrated to be an effective drug in hay fever and produced no more drowsiness than placebo.
The Use of Co-Trimazine Once Daily in Acute Otitis Media and Maxillary Sinusitis in Children
Authors: Hager C , Bamberg P , Dorn G , Adam D
Published: January 2017

Fifty-eight children, 1 to 12 years old, with either acute otitis media or acute maxillary sinusitis were treated with co-trimazine once daily over a period of 10 days. All of the children with otitis and all but two with sinusitis were cured. The drug was excellently tolerated and well accepted.
Euhypnos® Forte, High Dose Temazepam for Resistant Insomnia: Post-Marketing Surveillance in 10,057 Patients Unresponsive to Conventional Hypnotic Dosage
Authors: Fowler L Keith , Schiller Maureen
Published: January 2017

A post-marketing surveillance study of Euhypnos® Forte (temazepam 20 mg) capsules for the treatment of insomnia in 10,057 patients previously unresponsive to other hypnotics given in conventional doses. Patients were prescribed a nightly dose of 40 or 60 mg, but 95% actually took 40 mg. At 2 weeks, 89% of patients found the treatment effective, as did 95% at 3 months. Hangover, severe enough to stop treatment, occurred in less than 3% of patients, and other adverse reactions such as headache, dreams, gastro-intestinal disturbance and hangover symptoms were reported by only 6% of patients at 2 weeks and 4% at 3 months. The most common reason for stopping treatment was the patient having no further need of hypnotics. Euhypnos Forte was effective in 88% of 3,800 patients who had found nitrazepam unsatisfactory and 90% of 1,013 patients unresponsive to barbiturates.
Moxalactam Therapy of Difficult Infections in Patients with Serious Underlying Conditions
Authors: Mogabgab William J , Bautnan David C , LaCorte William F , Pollock Beatrice , Pauling Bruce , Beville Rose B , Holmes Barbara J
Published: January 2017

Moxalactam was the single therapeutic agent used to treat a variety of infections in sixty-three patients, most of whom had serious concomitant illnesses. Fifty-three patient case reports qualified for evaluation, including those with pneumonia (8), urinary tract infections (18), superficial infections (6), orthopaedic infections (7), osteomyelitis (8), septicaemia (4), pansinusitis (1), and meningitis (1). Preliminary in vitro studies had indicated that most organisms, including those resistant to other antibacterial agents, would respond to moxalactam. Infecting bacteria from the fifty-three evaluable patients included a wide variety of Gram-positive and Gram-negative organisms. Doses of moxalactam ranged from 1 to 16 gl day administered intravenously or intramuscularly for 5 to 41 days. With few explainable exceptions, clinical and bacteriologic responses were adequate and satisfactory. Adverse effects were inconsequential. Allergic reactions were not observed, even in patients with a past history of reactions to penicillin.
Diclofenac Sodium in Ureteral Colic: A Double-Blind Comparison Trial with Placebo
Authors: Vignoni A , Fierro A , Moreschini G , Cau M , Agostino A , Daniele E , Foti G , Grossi E
Published: January 2017

A randomized prospective double-blind study of the analgesic effect of 75 mg intramuscular diclofenac sodium (Voltaren®), a potent prostaglandin synthetase inhibitor, versus placebo (saline solution) was carried out in 131 consecutive patients with acute ureteral colic. Diclofenac provided complete relief of pain 25 minutes after the injection in 59% of the cases, while placebo provided relief in 29% (p < 0·01).

Forty patients in the placebo group and seventeen patients in the diclofenac group needed an open injection of 75 mg diclofenac intramuscularly after 25 minutes due to persistent pain.

Fifty-four of the fifty-seven patients treated with an open injection of diclofenac achieved complete relief of pain after 30 minutes.

There were no side-effects of the treatment.
Use of Carbamazepine in Acute Psychosis: A Controlled Study
Authors: Lenzi A , Lazzerini F , Grossi E , Massimetti G , Placidi G F
Published: January 2017

A randomized double-blind study was performed to compare the therapeutic effects of lithium and carbamazepine (CBZ) each administered in combination with chlorpromazine (CPZ) for 3 weeks in women with acute psychosis. Thirty patients were studied. The initial dose was 1200 mg/day for CBZ and 900 mg/day for lithium, and it was subsequently modified according to plasma levels and clinical indications. The dose of CPZ was free and depended on the severity of symptomatology. Both treatments produced a significant improvement in psychotic symptoms without significant differences between the treatment groups. Also, as regards tolerability no clinically relevant differences were found between the two groups. During the first week of treatment the CPZ dose required in the CBZ group was significantly lower than that administered to the lithium group, indicating that CBZ had a greater sedative action; however, this difference decreased as treatment continued. These results confirm that CBZ is a valid alternative to lithium in the treatment of acute psychosis.