bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of pragmatics in reflexive interpretation by Turkish learners of English
Authors: Demirci Mahide
Published: January 2017

This study investigates the effects of pragmatic principles on the acquisition of the binding of English reflexives by adult Turkish second language (L2) learners. The study compares pragmatically biased and pragmatically neutral sentences to determine whether pragmatic bias towards a non-local antecedent overrides the parameter setting of English and causes learners to choose as possible antecedents NPs outside the binding domain. Both group and individual results indicate that pragmatically biased sentences compel the subjects to consider pragmatic information to the extent that it can affect their choice of local antecedent. Acquisition theories should account for the role that pragmatic information might play in the assignment of possible antecedents for reflexives.This study incorporates Huang's (1994) ‘pragmatic theory of anaphora’ in which the interpretation of a reflexive is subject to the I-principle, a pragmatic strategy which finds an antecedent for the reflexive that gives the most informative, stereotypical interpretation in keeping with our knowledge about the world.
The status of thematic verbs in the second language acquisition of Chinese: against inevitability of thematic-verb raising in second language acquisition
Authors: Yuan Boping
Published: January 2017

This article reports a study investigating the status of thematic verbs in second language acquisition (SLA) of Chinese by French-speaking, German-speaking, and English-speaking learners. Both French and German are languages which allow thematic verbs to raise. In contrast, thematic verbs in English and Chinese must remain in situ under V at PF. It has been widely reported in the second-language and nonnative language (L2) literature that (optional) thematic-verb raising occurs in SLA, and L2 researchers have accounted for this phenomenon on the basis of some hypotheses proposed for the initial state of SLA. Although these hypotheses differ from each other in explaining the presence of thematic-verb raising in SLA, they all predict that thematic-verb raising is inevitable in SLA by speakers of a verb-raising language. Some go so far as to predict thematic-verb raising in SLA by speakers of a non-verb-raising language. The study reported in this article provides robust evidence that the thematic verb does not raise in SLA of Chinese, which casts doubt on the reliability of these hypotheses in the L2 literature. Both judgement data and oral production data in the study clearly indicate that thematic verbs remain in situ in L2 Chinese. No optionality occurs at any proficiency level. These findings are accounted for in terms of the absence of verbal inflection in Chinese and the evidence in the L2 Chinese input data for the specification of the abstract features associated with the head of IP.
Individual differences, cognitive abilities, aptitude complexes and learning conditions in second language acquisition
Authors: Robinson Peter
Published: January 2017

Individual differences in resource availability, and the patterns of cognitive abilities they contribute to, are important to:

• explaining variation between learners in the effectiveness of second language (L2) instructional treatments;

• describing differences in implicit, incidental and explicit L2 learning processes; and

• explaining child-adult differences in acquisition processes, and therefore to any general theory of second language acquisition (SLA).

In this article I describe a framework for research into the effects of cognitive abilities on SLA which is based on four interlocking hypotheses. These hypotheses are drawn from research in psychology, education and SLA and, where possible, I present evidence to support each of them. The hypotheses are:

1) the Aptitude Complex Hypothesis;

2) the Ability Differentiation Hypothesis;

3) the Fundamental Difference Hypothesis; and

4) the Fundamental Similarity Hypothesis.

The hypotheses, and the relationships between them, define an Aptitude Complex/Ability Differentiation framework for further examining the influence of individual differences in cognitive abilities on SLA, and for developing a theoretically motivated measure of language learning aptitude. I argue that such research should adopt the interactionist approach described by Snow (1994) to identifying individual difference/learning condition interactions at a number of levels. I illustrate some of these interactions.
Analysing interlanguage: how do we know what learners know?
Authors: Lakshmanan Usha , Selinker Larry
Published: January 2017

In this article, we address the important issue of ‘how we know what learners know’ based on evidence from second language (L2) learners’ spontaneous speech samples gathered longitudinally. We first examine some of the problems involved in the analysis of spontaneous speech, with focus on L2 studies within the generative framework. Next, we revisit the issue of the comparative fallacy in L2 research. We first consider the effects of the comparative fallacy in relation to analyses of interlanguage with a target language bias. Next, we extend the comparative fallacy to include interlanguage analysis where the bias is towards the native language. We argue that the comparative fallacy in interlanguage studies, regardless of the nature of the bias (i.e., target language or native language) can lead to the underestimation and/or overestimation of the learners’ linguistic competence.
Neovascularization in Recurrence of the Varicose Great Saphenous Vein following Transection
Authors: Glass G.M.
Published: January 2017

Recurrence of varicose veins after surgical treatment is widely attributed to morphological and haemodynamic changes in pre-existing collateral veins. Transection of the great saphenous vein in the thigh under local analgesia was used to promote healing of varicose ulceration. When healing was complete, saphenofemoral ligation combined with stripping or multiple ligation was performed. At the same time the vascular changes at the site of transection were investigated in 10 patients by phlebography, surgical exploration and examination of the excised vessels by radiographic and histological methods. The results showed that the continuity of the vein was restored by growth of new vessels in the surrounding tissues and vein wall. Some vessels increased in size, developing smooth muscle and elastic tissue in their walls, while the majority underwent regression. It was concluded that the theory of recurrence through pre-existing veins requires revision.
Stanozolol and the Treatment of Severe Chronic Venous Insufficiency
Authors: Neumann H.A.M. , van den Broek M.J.T.B.
Published: January 2017

A report on an analysis of an open (pilot) study is given for evaluating the effectiveness of stanozolol in the treatment of chronic venous insufficiency (CVI). Twelve patients with CVI grade II–III according to Widmer were treated for 6 months with the modified anabolic steroid stanozolol. Evaluation of the influence of this drug on CVI was monitored with transcutaneous oxygen tension measurements (Tc Po2), light reflection rheography (LRR), histopathology and immunofluorescence techniques. After 3 and 6 months a statistically significant extension of the refilling time by LRR was observed. There is also a significant change in Tc Po2measurements at 3 months but not at 6 months. With immunofluorescence and peroxidase techniques, fibrinogen and collagen IV deposits are found in the majority of cases around the capillaries. It is postulated that these deposits play an important role in the pathogenesis of CVI. After treatment with stanozolol a significant reduction of the dermal space was observed in the lipodermatosclerotic plaque. It is concluded that in the treatment of CVI grade II–III stanozolol can be useful. A randomised double blind clinical trial is necessary to confirm this effectiveness.
Vascular Complications of Varicose Vein Surgery in Ireland
Authors: Redmond H.P. , Broe P.J. , Bouchier-Hayes D.J.
Published: January 2017

Various complications of varicose vein surgery known to the authors are discussed. Eleven vascular injuries were reported, six arterial and five venous. These were variously crush, transection or stripping injuries. Inexperienced surgical skill was identified as a major contributing factor. Ten of the eleven injuries were recognized immediately and were referred for repair. There were no serious sequelae. Recommendations are made to avoid similar injuries in the future.
Pysiological Evaluation of Venous Obstruction in the Post-Thrombotic Leg
Authors: Åkesson Henrik , Brudin Lars , Jensen Ragnar , Ohlin Per , Plate Gunnar
Published: January 2017

The accuracy and value of occlusion plethysmography (OP) in assessing post-thrombotic iliac and femoral vein obstruction was determined in 45 patients (85 legs) six months after an acute iliofemoral venous thromboses using contrast phlebography (CP) as reference method. The additional value of femoral venous pressure (FVP) measurements in assessing the physiological importance of iliac vein obstructions was determined in 34 of these patients (60 legs).

The sensitivity and specificity of OP in detecting femoral and iliac vein obstructions was 79% and 84% respectively. OP was unable to distinguish femoral from iliac lesions and stenosis from obstructions. A maximum venous outflow (MVO) <30 ml·100 ml−1 ·min−1 was greatly associated with venous obstruction which was very uncommon if the MVO >50 ml·100 ml−1 ·min−1.

Resting FVPs were of little value in assessing iliac venous outflow. Exercise pressures and comparison with normal contralateral veins improved the association with anatomical obstruction. A difference in FVP change with exercise exceeding l mmHg as compared to the contralateral leg was most predictive of an iliac vein obstruction.

Patients with obvious clinical symptoms of venous outflow obstruction (venous claudication) all had iliac vein obstruction, abnormal OP and an FVP change with exercise exceeding 5 mmHg. This demonstrates the ability of OP and FVP to reflect physiological rather than morphological post-thrombotic venous obstruction.
Relationship between Blood Groups (ABO) and Varicose Veins of the Lower Limbs. A Case-Control Study
Authors: Cornu-Thenard André , Dab William , de Vicenzi Isabelle , Valty Jean
Published: January 2017

Numerous studies have already shown the existence of a relationship between blood groups of the ABO system and certain vascular diseases: group A and atheromatous disease1,4,5,7,9,12; group A and deep venous thrombosis of the lower limbs6,11,13. However, no study has reported an association between varicose veins and the ABO blood groups.

The aim of this study was to investigate the possible existence of such an association.
Venous Function of the Leg in Patients with Acute Myocardial Infarction
Authors: Kierkegaard Asbjörn , Norgren Lars , Thilen Ulf
Published: January 2017

Venous volume and venous outflow of the calf were studied with strain gauge plethysmography in 50 unselected patients with an acute myocardial infarction. These parameters increased during the first days if the course of the infarction was uncomplicated. In complicated myocardial infarction however, no such increase was registered. In patients without complications, venous volume and venous outflow were higher in those who were mobilized compared to inactive ones, and patients with an anterior infarction had higher values than those with other locations of their myocardial infarction. Deterioration of venous function apparently is associated with more severe disease, and may predispose to a further complication, deep vein thrombosis.
Treatment of Venous Lipodermatosclerosis and Ulceration in Venous Hypertension by Elastic Compression and Fibrinolytic Enhancement with Defibrotide
Authors: Belcaro G. , Marelli C.
Published: January 2017

The value of elastic compression and defibrotide, a profibrinolytic and antithrombotic drug, in patients with venous hypertension, lipodermatosclerosis and ulceration was assessed in a cross-over trial. Elastic compression alone and in association with defibrotide (800 mg/day) were completed the study (18 were treated with the combined treatment in the first 3 months and 14 in the second period). We evaluated the decrease of the areas of liposclerosis and ulceration by computerized analysis of the areas. We also studied the decrease of leg circumference and subjective clinical improvement by an analogue scale line. Patients were also evaluated by laser-Doppler flowimetry, transcutaneous PO2 and PCO2 measurements, capillary permeability and fibrinolytic activity. Both forms of treatment were active in reducing the areas of liposclerosis and ulceration but combined treatment with defibrotide and elastic compression was significantly more effective in reducing both liposclerosis and ulceration, and in improving microcirculatory parameters and capillary permeability. The improvement in objective evaluation was comparable to the clinical improvement measured by the analogue score. The positive variation of all parameters studied was associated with a significant increase of fibrinolytic activity during the administration of defibrotide.

No side effects were observed during this study. These results suggest that defibrotide treatment is effective in treating liposclerosis and ulceration in postphlebitic limbs with venous hypertension, improving both microcirculatory parameters and subjective symptoms.
Decreased Tocopherol Concentration of Varicose Veins is Associated with a Decrease in Antilipoperoxidant Activity without Similar Changes in Plasma
Authors: Deby Carol , Hariton Claude , Pincemail Joël , Coget Jean
Published: January 2017

Antilipoperoxidant and antiradicalar powers were determined in human varicose saphenous veins, and correlated with tocopherol content in plasma or venous homogenates. No difference was found between plasma levels of tocopherol in samples from controls (10.25 ± 1.93 μg ml−1) and from patients with varicose veins (11.50 ± 4.05 μg ml−1), while a significant decrease in tocopherol level was observed in varicose saphenous vein (4.46 ± 1.75 μg/100 mg) as compared to normal vein homogenates (6.25 ± 1.52μg/100mg). In addition, a positive linear correlation ( r = 0.939, p < 0.001) between the antilipoperoxidant activity of venous tissues and their tocopherol content was noticed, whereas no similar relation exists with the plasma tocopherol concentrations. Moreover, a negative linear correlation ( r = 0.814, p < 0.001) between plasma and vessel-wall anti-OH properties was demonstrated, without similar correlation between anti-OH power and the tocopherol levels, neither for the plasma nor for the venous samples.

Concerning antiradicalar activities, a positive linear correlation ( r = 0.761, p < 0.001) was noticed between anti-OH power and anti-ferryl ion properties observed in venous wall homogenates.

This study provides a new valuation in man concerning the implication of tocopherol in the oxidative status of venous tissue.
Liposclerotic Skin: A Diffusion Block or a Perfusion Problem?
Authors: Stibe E. , Cheatle T. R. , Smith P. D. Coleridge , Scurr J. H.
Published: January 2017

There is continued debate as to whether skin damage in venous disease results from an oxygen diffusion block or from abnormal perfusion.

Transcutaneous oxygen pressure and laser-Doppler flux were measured in 15 patients with chronic venous insuffiency (CVI) and lipodermatosclerosis and in 15 normal controls. The time for Tc Po2 to regain resting values after 5 min of ischaemia was measured, as was the time taken for laser-Doppler flux to reach 95% of peak flow.

Tc Po2 was reduced in patients with CVI (median 26 mmHg, interquartile range (IQR) 16–46) compared to controls (median 55 mmHg, IQR 40–65). Hyperaemic responsiveness, as assessed by calculating the ratio of peak laser-Doppler flux following 5 min of ischaemia, was also reduced (median (CVI) 1.5, IQR 1.1–2; median (control 3.3, IQR 1.8–4.8). However, following ischaemia Tc Po2 took no longer to regain resting levels in venous patients than in controls, whereas there was a trend towards delay in reaching peak skin blood flow.

These findings suggest a primary perfusion deficit in skin damaged by venous hypertension rather than an oxygen diffusion block.
Non-Thrombotic Deep Venous Incompetence with Special Reference to Anatomic, Haemodynamic and Therapeutic Aspects
Authors: Almgren Bo
Published: January 2017

This investigation was undertaken to study non-thrombotic deep venous insufficiency (DVI) in patients with varicose veins or other venous symptoms.

Deep venous reflux was observed in 3.5% of the ‘normal’ limbs in patients with unilateral varicose veins. A high incidence of reflux was found in limbs with untreated (21%, P < 0.001) and with recurrent varicose veins (43%, P < 0.001) compared with that in ‘normal’ limbs.

Among patients with non-thrombotic DVI the most common patterns were isolated reflux in the superficial femoral vein (51%), and combined reflux in the superficial and deep femoral veins (44%). Isolated reflux in the deep femoral vein occured in 5%. Complete visualization of the deep femoral vein is a new diagnostic sign that strongly correlates ( P < 0.001) with reflux in this vein.

femoropopliteal and isolated popliteal reflux caused abnormal venous pressure values even in asymptomatic patients. Incompetence of calf perforators strongly influenced these values.

Varicose vein surgery in limbs with a strong calf muscle pump resulted in significant improvement in venous pressure. The long-term results of valvuloplasty were good in 67% of the extremities. A significant improvement in venous pressure was observed in limbs with competent deep femoral vein valves, which suggests that the functional state of this vein is of great haemodynamic importance.
Paroven and Graduated Compression Hosiery for Superficial Venous Insufficiency
Authors: Anderson J. H. , Geraghty J. G. , Wilson Y. T. , Murray G. D. , McArdle C. S. , Anderson J. R.
Published: January 2017

The effects of Sigvaris graduated compression hosiery and Paroven on symptoms of superficial venous insufficiency were assessed in a prospective, randomized, crossover study. Seventy-two patients awaiting surgery for non-cosmetic symptoms associated with varicose veins received 4-week treatments in random order, namely; placebo, Paroven alone, Sigvaris graduated compression hosiery and placebo, Sigvaris graduated compression hosiery and Paroven. Symptoms were assessed before and after each treatment using linear analogue scales. No statistically significant effects were observed, but there was a consistent trend for both Paroven alone and hosiery alone to produce modest improvements in symptoms. The relief of symptoms associated with a combination of Paroven and Sigvaris graduated compression hosiery was greater than that produced by either treatment on its own.
Colour-Coded Duplex Sonography in the Diagnosis of Deep Vein Thrombosis: A Comparison with Phlebography
Authors: Irvine A.T. , Thomas M. Lea
Published: January 2017

A total of 50 legs in 34 consecutive patients with clinically suspected deep vein thrombosis (DVT) were evaluated both with colour-coded duplex sonography and phlebography, the tests being performed immediately following each other without the examiner knowing the result of the other procedure. Contrast phlebography was regarded as the standard for diagnosis. All the sonograms were considered to be technically adequate. The overall diagnostic accuracy, taking the leg as a whole from the ilio–femoral segment to the calf, was 92% and the sensitivity 78%. The accuracy in the femoral vein was 92%, sensitivity 64%. In the calf the accuracy was 90% and sensitivity 81%. although no attempt was made to localize or quantify the thrombus. The accuracy of the diagnosis of thrombus was not improved by the use of the colour-coded duplex facility. The main advantage of colour-coded duplex sonography over conventional duplex scanning is the easier identification of the venous system making it faster to perform. It is suggested that colour-coded sonography is a useful primary investigation for patients suspected of DVT or pulmonary embolism, but that about a third of patients will require contrast phlebography if the sonogram is negative or technically inadequate. It is emphasized that phlebography remains the most accurate method currently available for the diagnosis of DVT and using low osmolar contrast media is well tolerated and impressively safe.
Superficial Femoral Vein Valve Repair with Limited Anterior Plication
Authors: Belcaro G. , Ricci A. , Laurora G. , Cesarone M. R. , De Sanctis M. T. , Incandela L.
Published: January 2017

Objective:

To evaluate the effects after 3 years of a new surgical technique, limited anterior plication (LAP) of the superficial femoral vein.

Design:

Patients with venous hypertension resulting from deep and superficial venous incompetence were randomized into two treatment groups.

Setting:

Angiology and Vascular Surgery, Pierangeli Clinic, Pescara, and Cardiovascular Institute, Chieti University, Italy.

Patients:

Both groups were treated with superficial vein surgery. Group 2 was also treated with LAP.

Interventions:

Valvuloplasty of the superficial femoral vein was performed with plication of the anterior vein wall after limited dissection of the vein.

Main outcome measures:

During a 3-year follow-up results were evaluated with colour duplex and ambulatory venous pressure (AVP) measurements. Endpoints were AVP, refilling time (RT), number of incompetent venous sites, presence/absence of the reflux at the superficial femoral vein and the diameter of the vein.

Results:

No complications were observed. All femoral veins treated with LAP were competent at 36 months. Significantly lower AVP and longer RT were observed in the LAP group. The number of incompetent venous sites was lower in both groups. The average diameter of the vein was higher in Group 1.

Conclusions:

In selected subjects – moderate deep venous incompetence, functional cusps, incompetence mainly due to relative enlargement of the vein – LAP may be an alternative to external valvuloplasty.
Palpating Ankle Pulses is Insufficient in Detecting Arterial Insufficiency in Patients with Leg Ulceration
Authors: Moffatt C. J. , Oldroyd M. I. , Greenhalgh R. M. , Franks P. J.
Published: January 2017

Objective:

To investigate the ability of district nurses to detect lower limb arterial disease by palpation of ankle pulses.

Design:

Ankle pulse palpation of patients presenting with ulcerated limbs and comparison with Doppler ankle-brachial pressure index (ABPI).

Patients:

Sequential patients presenting to community ulcer clinics.

Main outcome measure:

Sensitivity and specificity of pulse palpation to detect arterial disease compared with ABPI.

Results:

Of 533 limbs with ulceration in 462 patients (mean age 74 years, 67% female), 167 (31%) had no detectable pulses at the ankle. Of the 93 limbs with ABPI <0.9, 34 (37%) had detectable pulses. Of those limbs with ABPI ≥ 0.9, 108 out of 440 (25%) had no detectable ankle pulses. Sensitivity for lack of pulses as a predictor of arterial disease (ABPI <0.9) was 63% with a specificity of 75% and positive predictive value of only 35%. Using only the absence of palpable pulses would lead to 37% of patients with arterial disease being treated inappropriately.

Conclusion:

Palpation of pedal pulses by community nurses is a poor predictor of leg arterial disease and must be used in combination with ABPI. Only when significant arterial disease is excluded should compression be applied.
Ambulatory Venous Pressure and Leg Volume Measurements before and after Surgery for Primary Varicose Veins
Authors: Vayssairat M. , Chakkour K. , Gouny P. , Taccoen A. , Cheynel C. , Baudot N. , Nussaume O.
Published: January 2017

Objective:

To compare clinical disability, ambulatory venous pressure (AVP) and leg volume before and after venous surgery, and to relate the changes to those observed after one night preoperative in-hospital rest.

Design:

Prospective study.

Setting:

Department of Vascular Surgery, University Hospital, Paris, France.

Subjects:

Nineteen patients with primary varicose veins and mild chronic venous insufficiency (CVI), scheduled for venous surgery.

Main outcome measures:

Clinical disability recorded by the analogue scale method, and leg volume and AVP measurements. These evaluations were repeated three times: on the day before surgery, in the afternoon; in the early morning on the day of surgery; and 2 months after surgery, in the afternoon.

Results:

Varicose vein surgery improved disability ( p = 0.001) and two AVP parameters: recovery time (RT, p = 0.0049) and the calf muscle pump index (CMPI), which rose by 345% (95% confidence intervals: 29, 659). Preoperative supine rest for one night improved disability ( p = 0.0016) and reduced leg volume ( p = 0.0002). The improvements induced by surgery correlated with the changes induced by rest, for disability ( p = 0.016), RT ( p = 0.006) and CMPI ( p = 0.033).

Conclusion:

Surgery improves venous function in patients with primary varicose veins. AVP remains a standard method of evaluating CVI. Combined with volumetry, it allows sensitive comparisons between different treatments. Because venous function varies greatly with daily activity, it is imperative to standardize the times at which venous function is evaluated.
‘Inversion’ Stripping of the Long Saphenous Vein
Authors: Wilson S. , Pryke S. , Scott R. , Walsh M. , Barker S. G. E.
Published: January 2017

Objective:

To assess a novel device designed for ‘inversion’ stripping of the long saphenous vein during varicose vein surgery.

Design:

A prospective, randomized trial.

Setting:

The Day Surgery Unit of a District General Hospital.

Patients:

Thirty consecutive patients undergoing unilateral, varicose vein surgery, all fulfilling appropriate requirements for day surgery.

Outcome:

Peroperative assessment of blood loss and postoperative assessment of complications, bruising, pain and length of stripper exit wound.

Results:

‘Inversion’ stripping caused less peroperative blood loss ( p < 0.01). It reduced postoperative morbidity (for pain at 1 week, p = 0.02) and gave an improved cosmetic result (with a smaller stripper exit wound, p < 0.01).

Conclusion:

An easy-to-use, ‘inversion’ stripping device is described that can reduce the postoperative morbidity often associated with primary varicose vein surgery and can enhance cosmesis.
Measurement of Peripheral Venous Oxygen Saturation in the Leg Using Near-Infrared Spectroscopy
Authors: Wertheim D. , Salaman R. , Melhuish J. , Williams R. , Lane I. , Harding K.
Published: January 2017

Background:

It has been suggested that poor healing of wounds may be associated with reduced tissue oxygenation. A non-invasive method of assessing peripheral venous oxygenation has been investigated.

Method:

Changes in oxyhaemoglobin (O2Hb), deoxyhaemoglobin (HHb), oxidized cytochrome aa3 (cyt aa3) and total haemoglobin (tHb) were monitored in the left lower leg of seven healthy volunteers. A short period of venous occlusion was achieved by rapidly inflating a sphygmomanometer cuff placed around the leg to 60 mmHg. The changes in O2Hb and tHb, with respect to the baseline readings, were evaluated. PSvO2 was calculated from (ΔO2Hb/ΔtHb) × 100%.

Results:

From 17 sets of readings on the seven volunteers the median PSvO2 calculated was 64% (range 50–86%).

Conclusion:

This method appears to be a simple means of evaluating PSvO2. A change in cyt aa3 was often seen associated with the venous occlusion.
Preoperative Digital Photoplethysmography Predicts Improvement in Venous Function after Superficial Venous Surgery for Chronically Ulcerated Limbs
Authors: Sullivan J. G. , Ghauri A. S. K. , Whyman M. R. , Poskitt K. R.
Published: January 2017

Objective:

To evaluate digital photoplethysmography (d-PPG) in predicting the influence of superficial surgery on venous function in chronically ulcerated limbs.

Design:

Prospective case-study.

Setting:

Vascular Laboratory of a District General Hospital.

Patients:

Patients with ulcerated limbs referred to a specialized community leg ulcer service were assessed with colour venous duplex ultrasound and ankle–brachial pressure index and offered surgery in cases of superficial venous reflux alone.

Interventions:

Superficial venous surgery. Four-layer compression bandaging.

Main outcome measures:

D-PPG derived venous refill time (VRT) and pump power (PP) were measured preoperatively with and without a tourniquet, and again after surgery.

Results:

Thirty ulcerated limbs in 27 patients were assessed. VRT increased from a median (interquartile range) of 10 s (7–17) preoperatively to 26 s (19–29)* with an above-knee tourniquet, 26 s (18–32)* with a below-knee tourniquet and 19 s (15–25)* after superficial venous surgery (* p < 0.01). PP increased from 2.3% (1.3–3.1) preoperatively to 3.0% (2.0–4.2)* with an above-knee tourniquet, 2.9% (2.1–4.3)** with a below-knee tourniquet and 4.4% (2.3–7.2)* after surgery (* p < 0.01, ** p < 0.05). The increase in VRT with an above-knee tourniquet preoperatively correlated with an increase in VRT after surgery ( r = 0.40, p < 0.05).

Conclusion:

Superficial venous surgery improves venous function measured by d-PPG in chronically ulcerated limbs. Preoperative assessment with d-PPG and an above-knee tourniquet predicts functional improvement after surgery.
Improving the Diagnosis of Chronic Leg Ulcers: A One-Stop Vascular Assessment Clinic in a Community Service
Authors: Ghauri A. S. K. , Currie I. C. , Grabs A. J. , Whyman M. R. , Farndon J. R. , Poskitt K. R.
Published: January 2017

Objective:

To evaluate the influence of a specialized vascular-led community leg ulcer service on assessment and diagnosis of leg ulcers.

Design:

Before-and-after study with prospective and retrospective data collection.

Setting:

East Gloucestershire, England, UK.

Subjects:

Patients treated for chronic leg ulcers before and within a specialized service incorporating a one-stop assessment including ankle–brachial pressure index (ABPI) and colour venous duplex.

Main outcome measures:

The means of assessment and the identified aetiology of leg ulcers in community patients.

Results:

Before clinics, only 40 (26%) limbs had a diagnosis recorded. After clinics, 83 (21%) limbs had arterial disease, including 64 (16%) with mixed arterial/venous disease. Venous duplex identified 279 (70%) limbs with venous disease of which 121 (43%) had superficial venous disease alone.

Conclusion:

A one-stop assessment clinic with ABPI and colour venous duplex ultrasound within a specialized community service improves diagnosis of leg ulcers. This is essential before appropriate and safe management by specialist nurses in the community.
Clinical Trial of Cefazolin in Children with Bronchopneumonia
Authors: Faria M C
Published: January 2017

Fifty one children aged between 1 month and 11 years 9 months suffering from bronchopneumonia were treated with Cefazolin, a new cephalosporin antibiotic. The Cefazolin was given by I. M. injection in two divided doses at 70-100 mg/kg/day. Forty six of the 51 patients showed cure or improvement, often with rapidity. Treatment was evaluated with the aid of post-treatment x-rays in all cases. The high rate of response in this study indicates that Cefazolin can be used effectively on a twice-daily dose schedule in the treatment of serious infections.
Opipramol and Chlorthalidone in the Treatment of Premenstrual Tension
Authors: Kagan G , Beaumont G
Published: January 2017

Thirty-three patients under the age of 38 suffering from premenstrual tension were admitted to a clinical trial and treated for three cycles. Five received opipramol alone and twenty-eight received a combination of opipramol and chlorthalidone. Slightly better results were obtained with the combination than with opipramol alone, although the number of opipramol patients was too small for valid comparison. There was a progressive improvement over the three cycles. By the third cycle there was a 47.92% improvement in the total score for ten symptoms on opipramol and 59.2% improvement on the combination. As far as the combination was concerned, best results were obtained for the symptoms, swelling of breasts (90%) mastalgia (88.8%), swelling of ankles (83.3%), oliguria (64.2%) and emotional lability (59.2%). The effect of age, marital state and gravidity on the syndrome was examined. No major differences were found in the symptomatology as far as these three factors were concerned. Young, single nulligravid women however, showed a consistently more favourable response to therapy. In terms of individual patient response, twenty-eight patients showed moderate or much improvement by the end of the third cycle.
Benzoctamine and Chlordiazepoxide in Anxiety: Some Predictors of Improvement
Authors: Rickels Karl , Downing Robert W , Case W George , Feldman Harold S , Pereira-Ogan Jorge A , Weise Charles C
Published: January 2017

A multiple regression search analysis was conducted with 76 anxious outpatients treated in a 4 week clinical trial with either benzoctamine 60 mg/day or chlordiazepoxide 60 mg/day.

Better response was predicted:

For benzoctamine, in patients who are less educated, have an adequate occupational adjustment, and are initially higher in anxiety. For chlordiazepoxide, in patients who are more educated and have a marginal occupational adjustment. For both drugs, in patients who are black, are diagnosed as anxious rather than anxious-depressed, and are higher in initial depression. A major factor accounting for the differential effectiveness predicted for these 2 anti-anxiety agents was felt to be the large number of sedative side effects reported by patients receiving benzoctamine 60 mg/day.
Biological Activity of Low-Molecular Weight Dextran 40. The Effect on Serum Proteins, Plasma Blood Clotting Factors and Erythrocyte Sedimentation Rate
Authors: Rudowski Witold , Kostrzewska Ewa , Gregor Anita , Naleçzyńska Angela
Published: January 2017

Dextran 40 infused in doses from 1.2 to 1.5 g/kg body weight decreases the concentration of proteins in the plasma and reduces the total amount of circulating protein. Dextran 40 in vitro precipitates high-molecular weight proteins participating in blood clotting, such as factor VIII and fibrinogen and, if infused, decreases their plasma levels. Addition in vitro of Dextran 40 to blood with a high ESR reduces the value proportionally to the concentration of dextran in the blood sample: after infusion of Dextran 40 the ESR decreases by a mean value of 19.9% after infusion of 500 ml and by 36.2% after 1000 ml. No bleeding was noted with these infusions.
Drug Profile: Synadrin
Authors: Murphy J Eric
Published: January 2017

Synadrin (prenylamine lactate) is well established in the long-term management and prophylaxis of angina pectoris. It moderates the cardiac effects of sympathetic stimulation by decreasing the uptake of noradrenaline at the sympathetic nerve endings in the myocardium, and by slowing calcium transport through the endoplasmic reticulum.

Extensive clinical investigation and usage has shown Synadrin to have beneficial effects in angina within a narrow dosage range and without frequent or troublesome side-effects.
Clomipramine (Anafranil) in the Treatment of Obsessional Illnesses and Phobic Anxiety States
Authors: Marshall W K , Micev V
Published: January 2017

A method of treating patients suffering from obsessional illnesses and phobic anxiety states by means of large doses of clomipramine given in slow intravenous drips is described. Eighty-five patients are reviewed, with follow-up in every available subject carried out as long as possible. The occurrence of symptom groups is examined, and finally the response to the treatment of the major constellations of the obsessional and phobic anxiety groups is compared. An overall reduction of symptom severity by a factor of about 2.4 for the obsessional group and of about 6 for the phobic anxiety group is demonstrated.
Clomipramine (Anafranil) in the Treatment of Cataplexy
Authors: Parkes J D
Published: January 2017

Seven patients with narcolepsy and cataplexy were treated with clomipramine. This abolished cataplexy in three patients and resulted in a reduction in the frequency of attacks in the others. Tolerance to clomipramine did not develop and treatment remained effective over a one-year period. One patient had a considerable increase in weight but no other side-effects of clomipramine occurred. Clomipramine had no action on narcolepsy but given together with amphetamines resulted in a reduction in the amphetamine dosage required to control narcolepsy. The life-long nature, familial occurrence and absence of specific pathology in the narcoleptic syndrome is consistent with an inborn error of metabolism. The concentration of homovanillic acid in the CSF of six patients with narcolepsy was approximately half normal. One of these patients had not been treated with amphetamines. This finding could be explained by a reduced cerebral metabolism of catecholamines in the narcoleptic syndrome.
Biochemical and Haematological Effects of Clomipramine (Anafranil)
Authors: Bartrop R
Published: January 2017

The sporadic and frequently idiosyncratic occurrence of toxicity in several bodily systems during Anafranil therapy has been reviewed. Particular attention is given to the reports between the Madrid World Psychiatric Congress, in 1966, and the marketing of the drug four years later.

Whether the changes in haemopoietic, gastro-intestinal or electrolyte parameters represent a drug-related assault on actively dividing or metabolising cells—or whether other preparatory or coincidental factors are important—is a matter of conjecture.

Some studies had prompted work in 1970-71 to examine the possibility of adverse effects on calcium metabolism: this is not proven.

The possible significance of calcium kinetics in altering the periodicity of affective states is discussed. Little evidence of significant or lasting changes in calcium levels were shown.
Clinical and Bacteriological Response of Newborn Infants to Amikacin
Authors: Manotas C J R , Trujillo H S , Londono R G , Uribe P A , de Vidal E L , Agudelo N H
Published: January 2017

Fifteen infants (aged 2-21 days at onset of infection) were treated with a new semi-synthetic aminoglycoside antibiotic, amikacin, in a daily dose of between 126 and 350 mg depending on weight. The causative organism in the majority of cases was E coli and the most common sites from which it was isolated were the nasal and umbilical regions. Fourteen of the infants were cured and no systemic or local reactions to the treatment were observed.
The Effect of Bumetanide and Frusemide on Frequency of Micturition
Authors: Bennion-Pedley J , Postlethwaite D L , Lomas D M , Donald J F , Molla A Layes
Published: January 2017

General practice patients with mild to moderate congestive cardiac failure recorded their frequency of micturition after taking frusemide 40 mg or bumetanide 1 mg at 8 a.m. or bumetanide 1 mg at 6 p.m. Morning doses of bumetanide or frusemide caused a similar pattern of urinary frequency, although the period of increased frequency appeared to be shorter with bumetanide.

If an evening diuresis is required, bumetanide should be given between 4 and 6 p.m. The use of potent and short acting diuretics such as bumetanide allow the physician and patient scope to decide upon the most appropriate time for administration and so reduce major disruptions in the patient's daily routine.
Role of High-Dose Intravenous Frusemide Therapy in the Management of Chronic Renal Failure
Authors: Chandra Mam , Mitra M K , Gupta N N
Published: January 2017

The results of using high doses of intravenous frusemide in the management of 28 patients suffering from chronic renal failure are presented. The results are compared with those obtained from 14 patients also suffering from chronic renal failure, who received identical ‘conservative management’ but were not treated with diuretics.

Large doses of intravenous frusemide produced a satisfactory diuretic response in a higher percentage of treated patients (71%) compared with controls (36%). It was also observed that in the treated group of patients a significant diuretic response could be obtained in patients with a creatinine clearance below 4 ml per minute. The study also demonstrated that in the group of patients receiving frusemide the response was better in those who were given a progressive-dose regime; 88% of patients improved with this regime compared with 68% of patients who were treated with a fixed dose of frusemide. Transient deafness with tinnitus and vertigo were the only side-effects observed. However these effects were only seen in patients who received 1000 mg or more frusemide in one day, administered over a period of one to two hours.

It is concluded that all patients suffering from chronic renal failure should be given a trial of large doses of intravenous frusemide therapy, along with other conventional measures, particularly where facilities for dialysis are not immediately available.
Accurate Diagnosis and Treatment in Painful Shoulder Conditions
Authors: Symonds G
Published: January 2017

Seventy unselectcd patients with painful shoulders were examined by a systematic clinical method based on applied anatomy. In every patient except one, the tissue or tissues at fault were identified. Cases of tendinitis, sub-deltoid and sub-coracoid bursitis, ‘frozen shoulder', osteoarthrosis, and acromio-clavicular joint arthrosis were treated by appropriate local methods given to the affected part only. Nearly all of these patients were rapidly relieved of their symptoms to their satisfaction.
Betamethasone Dipropionate (Diprosone): A New Topical Steroid. A Multinational, Multicenter Evaluation
Authors: Pallagrosi A U
Published: January 2017

A new fluorinated steroid, betamethasone dipropionate, has been used in ten studies in 413 patients (118 psoriasis; 295 other steroid responsive dermatoses). After three-weeks treatment with 0·05% betamethasone dipropionate cream, 87·90% of patients (363) showed a complete remission or were much better, while 11·38% (47) were slightly better. A total of 116 (98·31%) of patients with psoriasis and a total of 263 (89·16%) patients with other steroid responsive dermatoses were in complete remission or slightly better. An interesting feature is the rapidity of onset of action which occurred in 53% of the patients by the second day, and by the third day 91-100% of the patients had shown some improvement. Side-effects were minor and negligible (1·6%). These results indicate that betamethasone dipropionate is an effective and safe topical steroid for dermatological use.
Clinical Trial of a New Oral Contraceptive with a Low Oestrogen Dosage: Restovar
Authors: Thiery M , Van Kets H , Demol R , Molitor M P
Published: January 2017

Two hundred and sixty-one women of fertile age were treated with Restovar, a new oral contraceptive containing 0·75 mg lynestrenol and 0·0375 mg ethinyloestradiol per tablet. During the observation period, totalling 2,544 cycles, no pregnancies occurred. The acceptability was excellent in 97% of the women and side-effects were rare and then only mild.
A Clinical Impression of a Combination-Type Contraceptive: Neo-Lyndiol
Authors: Gede C E
Published: January 2017

One hundred and sixty-five women were treated during a total of 3,281 cycles with Neo-Lyndiol, a combined oral contraceptive containing 2·5 mg lynestrenol and 0·050 mg ethinyloestradiol per tablet. The tablets were taken for 32 days, with six tablet-free days.

No pregnancies were seen and the proportion of patients experiencing irregular bleeding and side-effects was very low and in fact their complaints decreased considerably as medication continued. There was a drop-out rate of only 5·5%, which is exceptionally low.

Neo-Lyndiol proved to be a reliable preparation, controlling the cycle well and causing few side-effects.
Acute Monoarticular Presentation of Osteoarthrosis of the Knee
Authors: Pathy M S
Published: January 2017

A study of 387 patients aged 65 years and over presenting with an acute hot painful swollen joint as the major or only presentation of osteoarthrosis of the knee is discussed. Short-term phenylbutazone therapy is evaluated. Eighty-nine per cent of patients obtained good to complete relief of acute symptoms within 14 days.
A Comparison of the Short-Term Effects of Ibuprofen and Diclofenac in Spondylosis
Authors: Siegmeth W , Sieberer W
Published: January 2017

In this controlled, single-blind parallel group study, the effect of ibuprofen 1200 mg daily was compared with diclofenac 75 mg daily. Thirty patients entered the study, randomized into two groups, each group receiving one tablet three times daily for two weeks. A one-week wash-out period (i.e. a drug-free period during which only physiotherapy was given), preceded and followed the treatment on active drug. Assessments were made by the same clinician throughout who was unaware of the treatment of individual patients. Statistically significant improvement was shown by patients receiving ibuprofen for the degree of pain relief at rest and improvement was also shown for the degree of pain at rest and during exercise, for pain relief during exercise and for spinal flexion. Patients who received diclofenac showed stastistically significant improvement for forward flexion, together with improvement for the degree of pain on exercise. Side-effects were very few.
A Comparative Double-Blind Trial of the New Antidepressant Caroxazone and Amitriptyline
Authors: Cecchini S , Petri P , Ardito R , Bareggi S R , Torriti A
Published: January 2017

On the grounds of pharmacological properties and preliminary clinical trials the efficacy of the new antidepressant caroxazone was compared to amitriptyline in the management of depression.

Forty patients mostly suffering from a neurotic or anxious-neurotic depression were admitted to a double-blind trial. All patients completed the study. The Hamilton Rating Scale for Depression was used for the clinical assessment at the beginning, during and at the end of treatment.

The trial lasted three weeks. A significant improvement was seen for both drugs after seven days on most symptom scores and on total symptom score. No significant differences were found either at seven days or at the end of treatment between the two drugs. There were no significant differences in the incidence and severity of side-effects.

In conclusion, caroxazone appears as an effective and well tolerated drug in the treatment of depression.
Lack of Influence of Povidone-Iodine on Tests of Thyroid Function
Authors: Lividas D P , Piperingos G D , Sfontouris J , Koutras D A
Published: January 2017

The external application of povidone-iodine, an antiseptic agent, was tested for its influence on thyroid function. Previous workers have described some in vitro changes in thyroid function tests following its use. In the present study topical application of povidone-iodine did not affect thyroid function as measured some days later using both in vivo and radio-active iodine in vitro test methods, despite the fact that the latter are notorious for being influenced by exogenous iodine.