bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of limb posture on relationships betweenin vitroradial hoof strain, load and joint angles
Authors: Hobbs S. J. , Mather J. , Rolph C. , Richards J.
Published: February 2009

Reasons for performing study: Radial strain in normal hooves has been found to vary with strain gauge location, limb posture and sample limb but reported magnitudes were considered to be low. More accurate measurement of radial strain may enhance the understanding of hoof function.

Objectives: To explorein vitroradial hoof strain in relation other kinetic and kinematic variables that may be related.

Methods: Five normal forelimbs were removed at the proximal articular surface of the third metacarpal bone (McIII). The limbs were loaded using a modified Instron test machine. Six calibrated infrared cameras captured movement from markers on the hoof and bone fixed markers on the second and first phalanxes and McIII, whilst radial hoof strain was measured using a calibrated instrumented plug. Change in strain, joint angle and load were found at simulated walking postures and bivariate correlations were used to compare the relationships between them.

Results: Radial strain was moderately correlated with proximal interphalangeal joint (PIPJ) rotation (r =−0.519). Large reductions in radial strain were found in loading and midstance with 10° of heel lift postures.

Conclusions and potential relevance: PIPJ rotation has previously been linked to the magnitude of deep digital flexor tendon (DDFT) loads and it is therefore suspected that these loads may have the greatest influence on radial strain magnitudes. Further investigation of radial strain is needed to describe the patterns fully during the stance phasein vivo.
Horizontal moment around the hoof's centre of pressure during walking in a straight line
Authors: Colborne G. R. , Heaps L. A. , Franklin S. H.
Published: February 2009

Reasons for performing study: Joint congruity and ligaments restrain the distal limb joints from excessive motion in the transverse and frontal planes, but the magnitudes and direction of the horizontal twisting moments around the hoof's centre of pressure (CoP) that induce these motions are unknown.

Objectives: To quantify the horizontal moment around the vertical axis through the hoof's CoP at walk, and to determine whether these are symmetric.

Methods: Nine sound Thoroughbred horses (mean age 5.3 years; mean mass 502 kg) were led at walk in a straight line across a Kistler force platform. Five trials were collected for each fore and hindlimb. The resultant moment around the hoof's CoP was calculated from the horizontal moment arms between the calculated CoP and the 4 horizontal forces in the transverse (X) and cranio‐caudal (Y) directions.

Results: The calculated moments were consistent within limbs and horses, but variable between horses. Hindlimbs demonstrated a biphasic moment pattern and the largest moments were typically in the first half of stance. Mean ± s.d. peak moments were internal under both hindlimbs (L: Int 14.1 ± 4.6 Nm; R: Int 13.3 ± 5.5 Nm). In the forelimbs, 7/9 horses demonstrated an asymmetric moment pattern, with the left forelimb exerting an internal moment (L: Int 6.9 ± 2.9 Nm) and the right forelimb an external moment (R: Ext 8.4 ± 4.4 Nm), while the remaining 2 horses exerted internal moments in both forelimbs (L: Int 11.7 ± 1.4 Nm; R: Int 6.6 ± 1.9 Nm).

Conclusion: In 7/9 horses, the forelimbs exerted asymmetric horizontal moments around the hoof CoP. The hindlimbs appear to behave with mechanical symmetry during stance, exerting an internal moment during retraction.

Potential relevance: Extrasagittal joint motions in the forelimb are unlikely to be symmetric and future studies should account for possible bilateral variations.
The relationship between range of motion of lumbosacral flexion‐extension and canter velocity of horses on a treadmill
Authors: Johnson J. L. , Moore‐Colyer M.
Published: February 2009

Reasons for performing study: Research into kinematics of the healthy equine back, has been performed in the walk and trot. This study focuses on back kinematics during canter, over a range of velocities. Flexion extension (FE) movements in canter are greatest in the lumbosacral (LS) region. Previous research has focused on canter velocity of 7 m/s; therefore quantification of LS kinematics at varying velocities is required to understand LS functions in equine locomotion.

Hypothesis: Range of flexion‐extension movement through the lumbosacral joint increases with increasing velocity.

Methods: Six Thoroughbred horses (mean age 9.6 years) cantered on treadmill at 4 velocities (6.0, 6.5, 7.0 and 8.0 m/s, respectively). Reflective markers were placed over the 5th lumbar vertebra (L5), the lumbosacral junction (LS) and the 3rd sacral vertebra (S3). Lumbosacral angle (LS) was defined as the angle formed between L5, LS and S3. Flexion‐extension (FE) range of motion (ROM) was analysed using a 2 camera, 3D motion capture system ProReflex1. Linear regression was used to determine strengths of relationships between speed of canter and lumbosacral FE movements.

Results: Range of FE ROM seen at the lumbosacral joint increased linearly with speed. FE ROM ranged 6.1°± 1.9 at 6 m/s, 6.3°± 1.9 at 6.5 m/s, 6.6°± 1.9 at 7 m/s and 7.2°± 1.9 at 8 m/s. Linear regression showed positive associations between speed and LS FE range of motion (r2= 0.993; P = 0.003).

Conclusions and potential relevance: Results show linear relationships between LS FE movements and submaximal canter velocities. These results provide information on the LS joint at canter. Understanding the effects of velocity on the back of healthy horses may aid our understanding of the demands placed on this joint in sport horses at this gait.
Quantification of surface EMG signals to monitor the effect of a Botox treatment in six healthy ponies and two horses with stringhalt: Preliminary study
Authors: Wijnberg I. D. , Schrama S. E. A. , Elgersma A. E. , Maree J. T. M. , De Cocq P. , Back W.
Published: February 2009

Reasons for performing the study: Therapeutic options for stringhalt in horses are limited, whereas medical experiences with botulinum toxin type A (Botox) have been positive. To evaluate its effectiveness in horses, surface electromyography (sEMG) signals before and after injection need to be quantified.

Hypothesis: Treatment of healthy ponies and cases with Botox should reduce muscle activity in injected muscles and reduce spastic movements without adverse side effects.

Methods: Unilaterally, theextensor digitorum longus, extensor digitorum lateralisandlateral vastusmuscles of 6 healthy mature Shetland ponies and 2 talented Dutch Warmblood dressage horses with stringhalt were injected (maximum of 400 iu per pony and 700 iu per case; 100 iu in 5 ml NaCl divided into 5 injections) with Botox under needle EMG guidance. Surface EMG data were evaluated using customised software, and in the individuals gait was analysed using Proreflex. Statistical analysis was performed using mixed models and independent samplettest (P<0.05).

Results: Surface EMG signals were quantified using customised software. The area under the curve (integrated EMG) in time was used as variable. It became significantly reduced in injected muscles after injection of Botox in normal ponies (P<0.05). This effect was present from Day 1 until Day 84 after injection. In the 2 cases, after injection of 3 muscles, the integrated EMG in time became significantly reduced in all 3 muscles. Kinematic measurements confirmed reduction of frequency and amplitude of hyperflexing or hyperabducting strides of the affected hindlimbs. The duration of effect was also seen in the cases until around 12 weeks after injection.

Conclusions and potential relevance: After EMG guided injections of Botox, sEMG signals recorded from injected muscle were reduced, which proves this to be a useful tool in statistically evaluating a treatment effect. The positive results of this pilot study encourage further research with a larger group of clinical cases.
The current status of antibiotic use in equine reproduction
Authors: LeBlanc M. M.
Published: February 2009

Antibiotics are infused into the uterine lumen, added to semen extenders and given systemically for infections of the reproductive tract of the mare and stallion. Evidence‐based guidelines for determining treatment length and route of administration are limited and use is frequently based on convenience or tradition. Current recommended antibiotic use for the treatment of bacterial and fungal endometritis, placentitis and metritis in the mare and genital infections of the stallion are presented. Antibiotic classes used for reproductive problems are also reviewed.
Reflecting on Social Emotional Learning: A Critical Perspective on Trends in the United States
Authors: Hoffman Diane M.
Published: February 2009

This critical cultural analysis of trends in the field of social emotional learning (SEL) in the United States considers how ideas concerning emotional skills and competencies have informed programmatic discourse. While currently stressing links between SEL and academic achievement, program literature also places emphasis on ideals of caring, community, and diversity. However, recommended practices across programs tend to undermine these ideals by focusing on emotional and behavioral control strategies that privilege individualist models of self. SEL in practice thus becomes another way to focus attention on measurement and remediation of individual deficits rather than a way to redirect educators’ focus toward the relational contexts of classrooms and schools. The promise of SEL to foster increased achievement and equity in American education may not be realized unless more work is done to connect ideals with practices and to address the political and cultural assumptions that are being built into contemporary approaches.
Injection Molding of Long Fiber Reinforced Thermoplastic Composites
Authors: Kumar K. S. , Patel V. , Tyagi A. , Bhatnagar N. , Ghosh A. K.
Published: February 2009

Long fiber reinforced thermoplastic composites are one of the fastest growing segments experiencing 30% growth per year, over the last decade. This study describes the development of long fiber reinforced thermoplastic (LFRT) composites and the effect of fiber length on mold and process parameters of injection molding process. LFRT pellets of different sizes were prepared by an extrusion process using a specially designed impregnation die and palletized into different lengths. These pellets were injection molded to develop LFRT composites. Fiber length distributions were analyzed using a profile projector and an image analyzer software system. Maleic anhydride grafted polypropylene (MA-g-PP) was added to improve the adhesion between glass fibers and polypropylene. Improvement in mechanical properties were analyzed for different pellet sizes with different fiber content for long fiber reinforced polypropylene (LFPP) and long fiber reinforced polyamide (LFPA) composite.
Analytical Model for the Throughput and Drive Power Calculation in the Melting Section of Single Screw Plasticizing Units considering Wall-Slippage
Authors: Potente H. , Bornemann M. , Kurte-Jardin M.
Published: February 2009

In single-screw extrusion the simulation of the plasticizing process by means of software tools becomes more and more important. These programs need mathematical models that have to be improved continuously to simulate the process values realistically. A two-part article presents an analytical approach to calculate the pressure/throughput and drive power behaviour of wall-slipping polymers in the melting section of single-screw plasticizing units. The investigations that are conducted are based on the notion commonly found in the literature of a melt film forming between the barrel and a compact solid bed, with the simultaneous development of a melt pool. As boundary condition for describing the wall slippage, a critical shear stress, as of which a slippage process commences, and also a slippage-velocity-dependent shear stress is assumed. In this first part of the publication, the investigations focus on the processes that take place in the melt film. A new model is developed for describing the process behaviour in this area.
Analytical Model for the Throughput and Drive Power Calculation in the Melting Section of Single Screw Plasticizing Units considering Wall-Slippage
Authors: Potente H. , Bornemann M. , Kurte-Jardin M.
Published: February 2009

A two-part article presents a process model developed at the KTP for describing the pressure/throughput and drive power behaviour of wall-slipping polymers in the melting section of single-screw plasticizing units. After a new model for describing the flow behaviour in the melt film was developed in the first part of the paper, this second part now covers the adaptation of an existing process model for pure melt conveyance to allow for the processes that take place in the melt pool, and the extension of the model to include the drive power calculation. Following this, the two individual models are then coupled through the assumption of a constant pressure gradient in the conveying direction. Using the overall model that is generated, the pressure/throughput and power behaviour during melting are investigated on the basis of the influencing dimensionless variables. This requires the geometry of the solid bed and the solid bed velocity to be specified as input variables. Apart from this, the other material parameters that need to be defined are the viscosity of the polymer melt, the critical shear stress, a material-specific parameter for describing the slipping-velocity-dependent shear stress and the operating point of the process that is taken as a basis.
Extrusion Scale-up: An Optimization-based Methodology
Authors: Covas J. A. , Gaspar-Cunha A.
Published: February 2009

Given a reference extruder with a certain geometry and operating point, the aim of scale-up is to define the geometry and operating conditions of a target extruder (generally of significantly different size) in order to subject the material being processed to the same flow and heat transfer conditions, thus yielding products with the same characteristics. Since existing scale-up rules are crude, as they usually consider a single performance measure and produce unsatisfactory results, this work approaches scale-up as a multi-criteria optimization problem, where the aim is to define the geometry/operating conditions of the target extruder that minimize the differences between the values of various performance criteria for the reference and target extruders. Some case studies are discussed involving individual and multi-criteria scaling-up in terms of operating conditions, geometry, and both together, the usefulness of the approach being demonstrated. A few experiments are also performed in order to validate the concept.
‘Wanted’: Organs, Passports and the Integrity of the Transient's Body
Authors: ROSELLO MIREILLE
Published: February 2009

This article focuses on Stephen Frears's 2003 Dirty Pretty Things. I argue that Frears's portrayal of the encounter between a Nigerian man and a Turkish woman in contemporary London invites us to re-conceptualize the relationship between the migrant and the host country. The film invites us to compare the circulation of migrants across a globalized transnational world to organs removed from one body and implanted into another. It questions our usual definitions of home and belonging, host and guest, health and the power to circulate. It both refers to the hospitality paradigm and radically rephrases it by making us consider the relationship between migrants and nations according to a different grid (hospitality vs./or organ trafficking). It does not simply propose an alternative grand narrative but rewrites a familiar script without trying to erase it.
Trading Hospitality: Kant, Cosmopolitics and Commercium
Authors: MORGAN DIANE
Published: February 2009

This paper engages with the topic of hospitality in its reading of Kant as a thinker of ‘globality’; that is, as one who is keenly attuned to the various and complex ways humans strive to ‘hospitalize’ this planet in their attempts to transform it into a working and living environment. Despite having no illusions about actual international traders’ practices, who all too often perpetuate injustices and commit crimes, he sets out a project for a different conception of commercium as a cultural practice which should remind us of the finite nature of our planet and its resources, and of our own vulnerable dependence on it. This account of a more enlightened ‘spirit of trade’, which is sensitive to cultural difference and environmental issues, is the product of a mobile way of thinking which would favour a more fluid communication with people on the move.
Excavation of the defensive ditches at Balmuildy Roman Fort, Glasgow, 1999
Authors: LESLIE ALAN , MACGREGOR GAVIN , DUFFY PAUL R. J. , DUNCAN J. S. , MILLER J. , RAMSAY S. , WALLACE C. , WILL R. S.
Published: February 2009

Excavation by GUARD in 1999 on the southern defences of Balmuildy Roman fort exposed small sections of three ditches: two to the W of the S gate of the fort, one to the E. All were found in locations consistent with Miller's 1922 excavation plan of the site, though, contrary to expectations, none of these features appeared to have been previously excavated.

The limited investigations produced no information which would substantially alter our understanding of the chronological context or occupational history of the Roman fort, though the undisturbed character of the evidence was surprising. The waterlogged conditions in the innermost ditch to the W of the S gate preserved organic material within the fill, and it was considered worthwhile attempting to study the environmental material in some detail, presenting as it did an opportunity to provide some stratigraphically secure evidence for the fort's contemporary environment with the original excavation report, which – in common with others of its time – largely ignored this type of evidence. The terminal of the middle ditch to the W of the S gate produced pottery of Antonine date from the primary fill. Two radiocarbon dates were also obtained from the fill of the inner ditch: one, of 37 BC-AD 217, was derived from early in the sequence of ditch fills, while a second, of AD 439–661, was obtained from a later, charcoal-rich layer sealing accumulated peat deposits.
PRESENT ABSENTEES: THE ARAB SCHOOL CURRICULUM IN ISRAEL AS A TOOL FOR DE-EDUCATING INDIGENOUS PALESTINIANS
Authors: ABU-SAAD Professor ISMAEL
Published: February 2009

The Arab and Jewish school systems in Israel have separate curricula and both are determined by the Ministry of Education. This article argues that the Arab curriculum is designed to ‘de-educate’, or dispossess, indigenous Palestinians pupils of the knowledge of their own people and history. It gives them only carefully screened and censored exposure to their history, culture and identity; and suppresses any aspects that challenge or contradict the Zionist narrative and mission. Furthermore, the attempts of Palestinian educators to create a more balanced or inclusive curriculum have been largely excluded by the formal, state-approved curriculum. Yet, the Palestinian community must play a crucial role in remembering, discussing and retelling its own history.
Highly Compliant Rigid Risers: Field Test Benchmarking a Time Domain VIV Algorithm
Authors: Grant Robert , Litton Richard , Finn Lyle , Maher Jim , Lambrakos Kostas
Published: February 2009

This paper presents a time domain procedure for calculating the Vortex Induced Vibration (VIV) of risers, and compares the computer simulation resultswith large scale physical test data.

The model test data was acquired by the Phase 1 HCR riser JIP [1]. That projectconducted large scale model tests of Highly Compliant Rigid Risers in about 800ft of still water with dynamic vessel heave simulated by a mechanical actuator. Most of the tests exhibited significant intermittent Vortex Induced Vibration(VIV) which impacts in-plane riser response and strength with in-plane dragamplification, and impacts riser fatigue with high frequency VIV bendingstress.

The time domain method introduced here simulates the dynamic response(including VIV) of any arbitrary riser configuration to the combined action ofuniform or sheared current, waves and floating vessel wave-induced motion. Theanalysis results can be used to assess the riser's strength and fatigueintegrity. Possible riser types include vertically tensioned risers, SCRs, LazyWave SCRs and Compliant Vertical Access Risers (CVARs).

Introduction

A 1998 Joint Industry Project performed large-scale model tests and analysis ofthe 3 Highly Compliant Rigid (HCR) riser configurations illustrated on Figure 1through Figure 3. The risers were modeled with a 1.5 inch diameter pipe-stringin an 800 ft water depth, zero-current lake. Harmonic displacements wereintroduced at the riser top to simulate wave-induced vessel motions. Short, instrumented pipe joints (Pups) measured dynamic 2-axis bending andacceleration, and tension at locations with high bending. Pup response wassampled at 40 Hz which was rapid enough to capture the VIV response which wastypically in the 1 Hz to 5 Hz range. For analysis, pup response was resolvedinto components in and out of the plane of the riser.

One of the most eye-opening model test findings was that for all 3 riser typesand for most of the excitation intensities, the risers exhibited significantintermittent VIV. This VIV is typically ignored by analysis. It changes thein-plane response by effectively increasing the in-plane drag coefficient, andit produces cyclic out-of-plane bending which reduces the fatigue life.

Typical VIV analysis in the offshore industry uses frequency domain proceduresthat must assume a linear riser system. For linear methods to be valid, theriser tension and geometry must remain constant with time. These linearprocedures were originally developed to address vertical drilling risers thatsatisfy these restrictions with their constant tension and well defined flexjoint end conditions. However, recent attempts have been made to apply them tomore challenging SCRs.
Norwegian Deepwater Program: Improved Predictions of Vortex-Induced Vibrations
Authors: Halse Karl H.
Published: February 2009

The paper describes the activity within the Riser and Mooring Project of the Norwegian Deepwater Program to improve the confidence in the prediction ofvortex-induced vibrations of deepwater risers. A drilling riser wasinstrumented to measure the riser vibrations during three deepwater drillingcampaigns offshore Norway. The full-scale data were analysed and used tocalibrate the input parameters of the SHEAR7 analysis program and to benchmarkother available prediction tools. The activity included an experimental testprogram to assess the effect of wave action and/or floater motion on thevortex-induced vibrations of risers. The paper gives an overview of the workconducted and presents the lessons learned.

Introduction

The Norwegian Deepwater Program (NDP) was formed in late 1996 by the oilcompanies which were awarded deepwater license shares under the Norwegian 15th Licensing Round [1]. The objectives of this 4 years R&D program was tojointly address technological aspects of deepwater developments common to theawarded blocks. The blocks are found in and around the Vøring Plateau in waterdepths ranging from 500m to 1400m. Five different projects were initiatedwithin the NDP:Metocean,Seabed,Riser & Mooring,Subsea, andEnvironmental Issues.

The activities described in this paper are a partof the Riser & Mooring (R&M) Project.

One of the technological challenges identified as being common to all thedeepwater blocks, was the ability to predict vortex-induced vibrations (VIV) ofrisers with reasonable accuracy. The VIV response of marine risers becomes moreimportant as the water depth increases. There are two main reasons for thisconcern. Firstly, the increased water depth leads to longer and more flexiblestructures, and secondly, the current-induced excitation becomes more importantrelative to the wave-induced excitation as the water depth increases. Theresulting VIV response adds contribution to the fatigue damage accumulation, but may also become a problem for deepwater drilling operations due to theincreased drag loads which follows as a secondary effect of the VIVresponse.

The semi-empirical VIV prediction tools available to the industry are allbased on empirical data for sub-critical Reynolds numbers. The main objectivesof the work described in this paper have been to calibrate and validate VIVprediction tools against high Reynolds number data obtained under realisticenvironmental conditions. The work was carried out in three phases.
Is there any relationship between toxoplasma infection and reactive arthritis?
Authors: Sert M , Ozbek S , Paydas S , Yaman A
Published: February 2009

Background:

The diagnosis of reactive arthritis is a challenging clinical problem in daily practice. Although there are many triggering infectious agents for reactive arthritis, Toxoplasmosis, a worldwide parasitic infection has not been reported.

Aim:

We investigated the serologic evidence of Toxoplasma gondii (T. gondii) infection in patients with newly diagnosed reactive arthritis after six weeks of the onset of the first symptom but no demonstrable triggering agent for reactive arthritis.

Setting and Design:

Clinical controlled study.

Materials and Methods:

We screened serologically the serum toxoplasma IgM and IgG antibody (Ab) titers which revealed toxoplasma infection in 50 patients with reactive arthritis (40 female, 10 men) and no demonstrable triggering agent and control subjects (32 female, 8 male).

Statistical Analysis:

SPSS 10.0 software package program was used.

Results:

The mean age of the patients and controls was similar (41.3± 12.0 vs. 39.6±11.8 years) respectively. The prevalence of IgG Ab titers of T. gondii in patients and controls were found to be 52% and 47.5%, respectively. Mean serum Toxoplasma IgG Ab levels were found to be 16.5±14.5 IU/ml, and 16.9±13.8 IU/ml in patients and control subjects respectively (P <0.05). We did not find any Toxoplasma IgM Ab titer demonstrating the acute or sub-acute infection in the serum of patients or controls.

Conclusion:

Although past Toxoplasma infection was prevalent in both groups, we did not find any subject with acute Toxoplasma infection in patients with newly diagnosed reactive arthritis and healthy controls. Despite the fact that our study group was small, we suggest that T. gondii does not seem to be a triggering agent for reactive arthritis and past infection may be a coincidental finding.
Use of recombinant factor VIIa for emergency reversal of anticoagulation
Authors: Ingerslev J , Vanek T , Culic S
Published: February 2009

Context:

There is limited data regarding the use of activated recombinant factor VII (rFVIIa) in anticoagulated patients requiring reversal.

Aims:

To identify and describe characteristics of subjects who received rFVIIa as part of emergency treatment aimed at improving hemostasis.

Settings and Design:

Data was obtained from an international peer-reviewed registry haemostasis.com. This registry contains data reported by physicians, who had elected to use rFVIIa to control bleeding in an emergency clinical situation. The contributors' approval for inclusion in the study was obtained and they were requested to validate and update information.

Materials and Methods:

Database review of cases receiving rFVIIa to manage bleeding coherent with the use of anticoagulant therapy.

Statistical Analysis:

The Wilcoxon signed rank test was used to compare requirements for blood products and crystalloids/colloids during the 24h preceding and following rFVIIa administration, as well as changes in the levels of clotting factors during that period.

Results:

Eighteen patients were treated with rFVIIa (median dose: 87.35 µg/kg; range: 20.0-106.0 µg/kg) for bleeding. Anticoagulants requiring reversal included low-molecular-weight heparin (n = 6), unfractionated heparin (n =8), coumarin (n =3) and warfarin (n=1). All patients had failed to respond to traditional antidotes and blood products. Following administration, bleeding stopped in 10, markedly decreased in five and slowed in the remaining three. Amongst 12/16 patients, a response was observed within 2.0 h of first administration. The requirement for blood products and crystalloids/colloids decreased (P <0.05) after rFVIIa administration. rFVIIa was well tolerated.

Conclusions:

rFVIIa may play a role in control of untoward bleeding in subjects receiving anticoagulation therapy.
Microscopic papillary thyroid cancer as an incidental finding in patients treated surgically for presumably benign thyroid disease
Authors: Sakorafas GH , Stafyla V , Kolettis T , Tolumis G , Kassaras G , Peros G
Published: February 2009

Background:

Papillary thyroid microcarcinoma (PTMC) is a relatively common entity in the general population.

Aim:

To present our experience with papillary thyroid microcarcinoma of the thyroid as an incidental finding in patients treated surgically for presumably benign thyroid disease.

Settings and Design:

Histology reports of patients treated surgically with a preoperative diagnosis of benign thyroid disease were reviewed to identify patients with PTMC. Patients with a preoperative diagnosis of thyroid cancer were excluded from this study.

Materials and Methods:

The files of 380 patients who underwent surgery for presumably benign thyroid disease in our hospital from 1990 to 2002 were reviewed. Data regarding patient's demographics, pathology findings, management and outcomes, were retrieved.

Statistical Analysis Used:

The findings are expressed as absolute numbers and as percentages (with reference to the total number of patients of this study).

Results:

Twenty-seven patients with PTMC diagnosed incidentally following thyroid surgery for presumably benign thyroid disease (27/380 or 7.1%) (multinodular goiter = 20 patients, follicular adenoma = 6 patients, diffuse hyperplasia of the thyroid = 1 patient) are presented. Mean diameter of PTMC was 4.4 mm. In 11 patients (40.7%) the tumor was multifocal and in about half of them tumor foci were found in both thyroid lobes. In two patients the tumor infiltrated the thyroid capsule. Total/near-total thyroidectomy was performed in all these patients (in three as completion thyroidectomy). All patients received suppression therapy and 20 of them underwent adjuvant radioiodine therapy. Follow-up (mean 4.56 years, range 1-12 years) was completed in 25 patients; all these patients were alive and disease-free.

Conclusions:

PTMC is not an uncommon incidental finding after surgery for presumably benign thyroid disease (7.1% in our series). The possibility of an underlying PTMC should be taken into account in the management of patients with nodular thyroid disease; total/near total thyroidectomy should be considered, at least in selected patients with presumably benign nodular thyroid disease.
The role of family configuration in early childhood intellectual development in the context of an extended family system in Pakistan
Authors: Avan BI , Rahbar MH , Raza SA
Published: February 2009

Context:

The confluence theory of intelligence by Zajonc and Markus emphasizes that individual intellectual difference of children manifests itself in the context of family configuration. Instead of assuming its generalizability, careful scientific work is required before applying the model to South Asian cultures where, predominantly, an extended family type exists.

Aims:

To assess the role of extended family configuration on the child's intellectual development in a South Asian setting.

Settings and Design:

A cross-sectional study was conducted on 4-5-year-old preschool children residing in Karachi, Pakistan.

Materials and Methods:

Three hundred and forty-two child and mother dyads were assessed through a validated cognitive psychometric tool and through a structured questionnaire. Children who were registered at the main Mother and Child Health Centres (MCH) of the Aga Khan Health Services, Pakistan (AKHSP) Karachi and who were born between July 1st 1993-June 30th 1994 with traceable birth records at the maternity homes, were considered for this study.

Statistical Analysis:

Multivariate linear regression models were used to identify the individual effect of family configuration on the intellectual scores.

Results:

Family configuration variables such as number of co-residents (P < 0.05) and the number of siblings (P < 0.01) in the house were significantly correlated with the psychometric score. Even after controlling for gender, socio-economic status, birth order and birth intervals, significant differentials were observed in favor of an extended family system on a child's intellectual development.

Conclusion:

The findings suggest the positive role of co-residents of an extended family environment on the intellectual development in early childhood.
An international review of tobacco smoking among medical students
Authors: Smith DR , Leggat PA
Published: February 2009

We conducted a systematic international review of tobacco smoking habits among medical students. Particular attention was paid to countries where smoking rates have been historically well-documented in local journals, but were less often included in larger international review articles. The methodology involved a search of relevant medical subject headings, after which the reference lists of journal papers were also examined to find additional publications. A total of 66 manuscripts met the inclusion criteria. The most common countries previously studied included India, the United States, Australia, Japan, Pakistan, Turkey and the United Kingdom. Overall, our review suggests that the prevalence of smoking among medical students varies widely amongst different countries and also between male and female students within the same areas. Consistently low smoking rates were found in Australia and the United States, while generally high rates were reported in Spain and Turkey. Given their important future role as exemplars, more effective measures to help reduce tobacco smoking among medical students are clearly needed worldwide.
Psoriatic arthritis as a distinct disease entity
Authors: Leung YY , Tam LS , Kun EW , Li EK
Published: February 2009

Psoriatic arthritis (PsA) is a chronic systemic inflammatory disease characterized by joint inflammation associated with cutaneous psoriasis. For many years, the amount of attention directed to PsA had been less than that for various other arthropathies. With the advances in understanding its pathogensis, it is now recognized as a distinct disease entity with characteristic features. Psoriatic arthritis has a greater tendency towards asymmetric oligoarticular involvement, distal interphalangeal involvement and spondylitis. Associated features such as enthesitis and dactylitis are more common. Specific radiological features include ankylosis and bone resorption. With the availability of potent new therapeutic agents for psoriasis and PsA, interest in research and clinical care for these conditions has been reinvigorated. Anti-TNF therapy has achieved encouraging efficacy in both the joints and skin disease, improving function and quality of life and inhibiting radiological progression measured in patients with PsA and psoriasis. Biologic agents may have the potential in addressing the unmet medical need in patients with PsA.
Bullying among trainee doctors in Southern India
Authors: Bairy KL , Thirumalaikolundusubramanian P , Sivagnanam G , Saraswathi S , Sachidananda A , Shalini A
Published: February 2009

Background:

Workplace bullying is an important and serious issue in a healthcare setting because of its potential impact on the welfare of care-providers as well as the consumers.

Aims:

To gauge the extent of bullying among the medical community in India; as a subsidiary objective, to assess the personality trait of the bullying victims.

Settings and Design:

A cross-sectional, anonymous, self-reported questionnaire survey was undertaken among a convenient sample of all the trainee doctors at a Government Medical College in Tamil Nadu, India.

Materials and Methods:

A questionnaire, in English with standard written explanation of bullying was used. Basic information like age, sex, job grade and the specialty in case of Postgraduates (PGs) were also collected.

Statistical Analysis:

The results were subjected to descriptive statistical analysis and Chi-square test for comparison of frequencies.

Results:

A total of 174 doctors (115 PGs and 59 junior doctors), took part in the study with a cent percent response. Nearly half of the surveyed population reported being subjected to bullying. Nearly 54 (53%) of the men and 35 (48%) of women were subjected to bullying. Significant proportions (P <0.0001) of medical personnel and paramedical staff bullied the PGs and junior doctors, respectively. More than 85 (90%) of bullying incidents went unreported. A significant (P <0.0001) percentage of PGs and junior doctors revealed a personality trait towards bully.

Conclusions:

Workplace bullying is common among trainee doctors and usually goes unreported.
Study of association between use of complementary and alternative medicine and non-compliance with modern medicine in patients presenting to the emergency department
Authors: Jose VM , Bhalla A , Sharma N , Hota D , Sivaprasad S , Pandhi P
Published: February 2009

Context:

Complementary and alternative medicines (CAMs) are extensively used by the public. Noncompliance is an important cause of therapy failure.

Aim:

This study was done to determine prevalence of emergency admission due to noncompliance with modern medicine following switching over to CAM and to identify any significant association for CAM use among noncompliers.

Setting and Design:

This cross-sectional study was conducted in the emergency unit of a tertiary healthcare institute.

Materials and Methods:

Demographic factors and system affected were compared between compliers and noncompliers. Prevalence, reasons and nature of noncompliance were determined. Age, gender, outcome, relation strength and potential preventability of noncompliance, precipitating and previous disease and noncompliant drugs were compared for significant association between CAM using and other noncompliers. Statistical Analysis: Student's 't' test, Chi square test and odds ratio were used.

Results:

Of the 506 patients interviewed 168 (33%) were noncompliant. In 160 (95%) patients noncompliance was due to under-dosing. Lack of knowledge and CAM use constituted 144 (86%) noncompliance-related admissions. Thirty-three (7%) admissions were strongly related to noncompliance and CAM use. Age, gender, outcome, drug use and diseases except chronic obstructive pulmonary disease (COPD) and asthma showed no association while relation strength and potential preventability of emergency admission was less with CAM-using noncompliers. Noncompliance was observed for hypertension, diabetes, COPD and asthma, seizure disorder, tuberculosis and hemophilia besides hepatic and renal failure. The CAM noncompliers used CAM more for modern medicine incurable or unaffordable than curable diseases.

Conclusion:

Advice for regular treatment and frequent monitoring can decrease CAM use-related noncompliance admissions.
Pott′s puffy tumor following an insect bite
Authors: Raja V , Low C , Sastry A , Moriarty B
Published: February 2009

Pott's puffy tumor, a feature of osteomyelitis of the frontal bone, is a rare entity, especially in adults. Sir Percival Pott originally described this condition as a complication of trauma to the frontal bone. This is also a recognized complication of fronto-ethmoidal sinusitis. We present a rare case of Pott's puffy tumor caused by an insect bite presenting initially as a preseptal cellulitis and explore its pathogenesis and management.
Neostigmine does not prolong the duration of analgesia produced by caudal bupivacaine in children undergoing urethroplasty
Authors: Bhardwaj N , Yaddanapudi S , Ghai B , Wig J
Published: February 2009

Context:

Neostigmine extends the duration of analgesia produced by caudal bupivacaine in children.

Aims:

To study the effect of different doses of caudal neostigmine on the duration of postoperative analgesia.

Settings and Design:

A randomized, double-blind study was conducted in 120 boys aged 1-12 years undergoing urethroplasty under combined general and caudal anesthesia.

Materials and Methods:

Children were administered 1.875 mg/kg bupivacaine alone (Group B), or with 2, 3 or 4 µg/kg of neostigmine (groups BN2, BN3or BN4respectively) as caudal drug (0.75 ml/kg). Children with a pain score of 4 or more (OPS and NRS) postoperatively were administered rescue analgesic. Time to first analgesic and the number of analgesic doses administered in the 24h were recorded.

Statistical Analysis:

Parametric data were analyzed using ANOVA. Kaplan-Meier survival curves for the time to first analgesic administration were plotted and compared using log rank analysis. Chi-square test was used to analyze the incidence data.

Results:

The median [IQR] time to first analgesic in Group B (540 [240-1441] min) was similar to that in Groups BN2(450 [240-720]), BN3(600 [360-1020]) and BN4(990 [420-1441]). Significantly more patients in Groups B (9 [34.6%]) and BN4(13 [44.8%]) required no supplemental analgesic for 24h than those in Groups BN2and BN3(4 [13.8%] and 4 [13.3%]). The number of analgesic doses required in 24h in the four groups was similar.

Conclusion:

Addition of neostigmine to 1.875 mg/kg of caudal bupivacaine did not prolong the analgesia following urethroplasty in children.
Laparoscopic cholecystectomy accompanied by simultaneous umbilical hernia repair
Authors: Kamer E , Unalp HR , Derici H , Tansug T , Onal MA
Published: February 2009

Background:

Umbilical defects may cause technical problems for general surgeons in patients during laparoscopic cholecystectomy (LC) operations and may increase the incidence of incisional hernia.

Aim:

The objectives of this study were to determine the optimal repair method for umbilical hernias that already exist or are encountered incidentally and to present data regarding potential problems that may occur during LC.

Settings and Design:

Medical records of patients who had received simultaneous umbilical hernia repair (UHR) with LC were investigated retrospectively.

Materials and Methods:

Cholelithiasis was accompanied by umbilical hernia in 64 (8.6%) out of 745 patients who underwent LC and UHR simultaneously in our hospital between 2000 and 2004.

Statistical Analysis Used:

The Mann-Whitney U, Chi-square, One-Way Anova, Kaplan-Meier survival analysis, the log-rank test and t test were used for statistical analyses.

Results:

LC was followed by UHR using primary suture (Group 1), Mayo repair (Group 2) and flat mesh-based repair (Group 3) in 32 (50%), 18 (28.1%) and 14 (21.9%) patients, respectively. Mean body mass indexes (BMI) of patients were 26.6 kg/m2, 29.2 kg/m2 and 39.9 kg/m2 in Groups 1, 2 and 3, respectively. Recurrence rates were 9.4%, 5.6% and none (0%) in Groups 1, 2 and 3, respectively. Recurrence was observed in three (7.0%) out of 43(67.2%) patients with BMI≥30 kg/m2 while umbilical hernia recurred in one (4.8%) out of 21 (32.8%) patients with BMI<30 kg/m2. Overall morbidity and mortality rates were 14.1% and 0%, respectively.

Conclusions:

The outcomes of the UHR with mesh after laparoscopic surgeries appear to be better for either obese or non-obese patients than primary suture techniques in recurrence rates.
Central retinal vein occlusion associated with thrombotic thrombocytopenic purpura/ hemolytic uremic syndrome
Authors: Issa SA , Qasem Q
Published: February 2009

We aim to describe a case of central retinal vein occlusion associated with this is a case report of a 45-year-old patient who was admitted for management of thrombotic thrombocytopenic purpura (TTP). He developed left central retinal vein occlusion three months later. The retinal vein occlusion resolved gradually as his TTP started to respond to medical treatment but significant macular edema persisted. Focal argon laser treatment resulted in complete resolution of the macular edema.
The oxidative hypothesis of senescence
Authors: Gilca M , Stoian I , Atanasiu V , Virgolici B
Published: February 2009

The oxidative hypothesis of senescence, since its origin in 1956, has garnered significant evidence and growing support among scientists for the notion that free radicals play an important role in ageing, either as "damaging" molecules or as signaling molecules. Age-increasing oxidative injuries induced by free radicals, higher susceptibility to oxidative stress in short-lived organisms, genetic manipulations that alter both oxidative resistance and longevity and the anti-ageing effect of caloric restriction and intermittent fasting are a few examples of accepted scientific facts that support the oxidative theory of senescence. Though not completely understood due to the complex "network" of redox regulatory systems, the implication of oxidative stress in the ageing process is now well documented. Moreover, it is compatible with other current ageing theories (e.g., those implicating the mitochondrial damage/mitochondrial-lysosomal axis, stress-induced premature senescence, biological "garbage" accumulation, etc).

This review is intended to summarize and critically discuss the redox mechanisms involved during the ageing process: sources of oxidant agents in ageing (mitochondrial -electron transport chain, nitric oxide synthase reaction- and non-mitochondrial- Fenton reaction, microsomal cytochrome P450 enzymes, peroxisomal β -oxidation and respiratory burst of phagocytic cells), antioxidant changes in ageing (enzymatic- superoxide dismutase, glutathione-reductase, glutathion peroxidase, catalase- and non-enzymatic glutathione, ascorbate, urate, bilirubine, melatonin, tocopherols, carotenoids, ubiquinol), alteration of oxidative damage repairing mechanisms and the role of free radicals as signaling molecules in ageing.
A prospective randomized comparative study of the effects of intranasal and transdermal 17 β-estradiol on postmenopausal symptoms and vaginal cytology
Authors: Odabasi AR , Yuksel H , Demircan SS , Kacar DF , Culhaci N , Ozkara E E
Published: February 2009

Context:

Investigating the adverse effects of oral hormone replacement therapy (HRT), the clinical effectiveness of alternative combinations and route of administrations.

Aim:

To compare the effects of intranasal and transdermal 17β-estradiol combined with vaginal progesterone on vasomotor symptoms and vaginal cytology.

Settings and Design:

A 12-week, prospective, randomized comparative study was conducted between July 2005 and September 2006.

Materials and Methods:

Eighty postmenopausal women aged between 42-57 years, who had scores of ≥1.7 on the menopause rating scale-I (MRS-I) items "1-6", were randomly assigned to receive intranasal (300 µg/day, n =40) or transdermal (50 µg/day, n =40) 17β-estradiol continuously. All patients also received a vaginal progesterone gel twice weekly. Vasomotor symptoms were evaluated at weeks 0, 4, 8 and 12. Vaginal maturation index (VMI) was evaluated at weeks 0 and 12 of the study.

Statistical Analyses:

The Mann-Whitney U and the Wilcoxon tests were used. P <0.05 was regarded as significant.

Results:

Thirty-two women in the intranasal and 29 women in the transdermal group completed the study. The total score of the MRS, the sum-scores of Factor 1 "HOT FLUSHES" and Factor 2 "PSYCHE" significantly decreased in both groups at week 4. Factor 3 "ATROPHY" scores significantly decreased only in the transdermal group at week 12. The VMI showed no changes within and between the two groups at the end of the study.

Conclusion:

Intranasal and transdermal 17β-estradiol combined with vaginal progesterone gel as a continuous HRT caused a similar decrease in vasomotor symptoms but did not have any significant effect on VMI after 12 weeks of treatment in this study population.