bluuebunny/crossref_metadata_2025 huggingface dataset:
Successful Transthoracic Repair of a Ruptured Spleen
Authors: Davies M , Law N W , Johnson C D
Published: January 2017

This paper presents a case of trauma, in which both spleen and diaphragm were damaged. Thoracotomy was done to both preserve the spleen and repair the diaphragm. A short discussion on the advantages of splenic preservation and the importance of diagnosing and repairing a ruptured diaphragm follows.
Canadian Student Study Skills: Components and Correlates
Authors: Foster Stephen F. , Nelson J. Gordon
Published: January 2017

The Canadian English version of the International Study Skills Inventory was administered to classes of university and college students. Item factor analysis and correlational analysis of factors were performed. The factor structure was described and four factors in the Study Skills, Motivation, Creativity Scales were tentatively named. Suggestions for instrument improvement and further research were discussed.
Neurological Basis of Learning Disabilities
Authors: Hutchens Teresa , Hynd George W.
Published: January 2017

The neurological basis of learning disabilities has been the focus of much debate for nearly a century. The precise neuroanatomical nature of the often subtle disturbances in behaviour that characterize this disorder has only recently begun to emerge. This article briefly reviews early conceptualizations of the neurological nature of learning disabilities and provides a current overview as to the neurodevelopmental pathology that is associated with the behavioural disturbance observed in these children. Since there is good evidence that the basis for severe learning disabilities is related to developmental neuropathology, it seems evident that learning disabilities should be found in children from diverse cultural and ethnic heritages. Other implications with regard to clinical and psychoeducational assessment as well as educational intervention are also addressed.
Book Review: Ecology and Metabolism of Plant Lipids
Authors: Babayan Vigen K.
Published: January 2017

ECOLOGY AND METABOLISM OF PLANT LIPIDS (ACS Symposium Series 325). Fulller Glenn and Nes W. David, editors. American Chemical Society, Washington, D.C., November 1986, hardcover, 374 pp. price $69.96; export price $83.95.
Patterns in the politics of drugs and tobacco: The Supreme Court and issue attention by policymakers and the press
Authors: Fogarty Brian J , Monogan James E
Published: January 2017

Past research has demonstrated lasting effects of important Supreme Court decisions on issue attention in the national media. In this light, the Court has served as an important agenda setter. We significantly expand on these findings by arguing that these salient Court decisions can raise the perceived importance of political issues and induce heightened, short-term policy attention in the broader political system. Using measures of media attention, congressional policy actions, and presidential policy actions, we utilize dynamic vector autoregressive modelling to examine the Court’s impact on issue attention in the macro policy system regarding tobacco and drug policy. Overall, this study suggests that the Supreme Court’s most important decisions might significantly affect broader issue attention in the American political system.
Educating the business information professional
Authors: Gash Sarah
Published: January 2017

Sarah Gash is Senior Lecturer at the University of Central England in Birmingham. Previous positions include: Course Resources Officer, Brighton Polytechnic and Faculty Liaison Officer, W Australia Institute of Technology. Author of Effective Literature Searching for Students, Gower 1989 and Business Information & How to Find It, Routledge, 1995.
A Rare Complication of Varicose Vein Surgery
Authors: Herman J. , Lovecek M. , Duda M. , Svach I.
Published: January 2017

Design:

Case report.

Setting:

University Hospital in the Czech Republic.

Patients:

Patient undergoing surgery for primary varicose veins.

Interventions:

The patient underwent attempted long saphenous vein stripping by passing a flexible stripper from ankle to groin. The stripper fractured at its upper end and a fragment of stripper became lodged in the internal iliac vein in the pelvis. This was removed at laparotomy. The patient made an uncomplicated recovery.

Conclusion:

Major complications of varicose vein surgery are rare. This unusual problem was probably caused by material fatigue in the stripper, leading to fracture near the upper end of the stripper.
Risk Factors for Healing and Recurrence of Chronic Venous Leg Ulcers
Authors: Barwell J. R. , Ghauri A. S. K. , Taylor M. , Deacon J. , Wakely C. , Poskitt K. R. , Whyman M. R.
Published: January 2017

Objective:

To identify independent risk factors for delayed healing and increased recurrence of chronic venous leg ulcers.

Design:

Prospective study.

Setting:

Community-based leg ulcer service.

Patients:

Six hundred and thirty-three limbs in 587 consecutive patients with an ankle-brachial pressure index (ABPI) ≥0.85.

Method:

Potential risk factors were initially assessed in a one-stop clinic incorporating clinical evaluation, ABPI and venous duplex imaging. Limbs were treated within a defined protocol. Twenty-four-week healing and 3-year ulcer recurrence rates were determined.

Results:

Of 12 potential risk factors age ( p< 0.001), ulcer chronicity ( p< 0.001) and popliteal vein reflux ( p< 0.005) were independent risks for delayed healing. Of 13 potential risk factors rheumatoid arthritis ( p<0.005) and healing time ( p < 0.05) were independent risks for ulcer recurrence. Isolated superficial venous reflux treated by saphenous vein surgery predicted reduced ulcer recurrence ( p< 0.005).

Conclusion:

Targeting in primary care of ulcer patients with specific characteristics might encourage earlier referral and appropriate resource management. Leg ulcer patients with superficial venous reflux might benefit from surgical correction.
The Prevalence of Venous Disease by Gender and Ethnicity in a Balanced Sample of Four Ethnic Groups in Southern California
Authors: Langer R. D. , Criqui M. H. , Denenberg J. , Fronek A.
Published: January 2017

Objective:

To determine the prevalence of venous disease in a community.

Design:

Cross-sectional study

Setting:

Southern California university.

Participants:

Current and retired university employees and spouses were randomly invited within strata based on gender, ethnicity (Caucasian, Hispanic, Black, Asian) and age. These analyses used a random subsample of 75 participants of each gender and ethnicity.

Main outcome measures:

Cosmetic and functional venous disease determined by standardised examination including ultrasound and visual inspection.

Results:

Telangiectases were present in 83% of women and 51% of men. Rates increased with age and were highest in Caucasians and lowest in Blacks. Corresponding rates for varicose veins were 33% and 17% with no ethnic differences. Superficial functional disease was found in 26% of women and 15% of men, without ethnic variation. Deep disease was present in 11% without gender or ethnic effects.

Conclusions:

Telangiectases varied by gender, ethnicity, and age. Varicose veins varied by gender. All conditions except deep disease were more common in women.
Mercury Strain-Gauge Plethysmography Venous Mode: Non-Invasive Technique of Choice in Vascular Pathology
Authors: Barroy J.P. , Munck D. , Paturiaux E. , Goldstein M.
Published: January 2017

Mercury strain-gauge plethysmography venous mode is a non-invasive technique for exploration of the haemodynamics of the extremities. The plethysmographic parameters used are: (1) the venous inflow (in ml/100 ml/min); (2) the venous outflow (in ml/100 ml/min); (3) the venous capacity in ml/100ml; (4) the venous distensibility index in ml/100 ml/ mmHg; and (5) the venous pressure measured by ‘hysteresis curve’. This method permits us to analyse the venous haemodynamics of both extremities simultaneously (the normal limb serving as the control), to obtain a precise diagnosis and to appreciate the efficacy of treatment at follow-up.

The aetiology of the swollen limb can be precisely identified in 95% of the studied cases: oedema in superficial venous insufficiency, oedema in the deep venous insufficiency, oedema of inflammatory origin, oedema in the arterial insufficiency, oedema of cardiac origin, lymphoedema.

During the last 3 years, we have followed up 580 patients with this method.
Microvascular Evaluation by Laser—Dopper Flowmetry of the Effects of Centellase in the Treatment of Severe Venous Hypertension and Leg Ulcers
Authors: Belcaro G.
Published: January 2017

A study of the microcirculation in patients with venous hyperterision and perimalleolar ulcers was used to evaluate the effects of medical treatment by Centellase 60. The evaluation of the resting flow and the observation of the venous response before and after treatment shows an interesting, positive effect of Centellase 60 in 25 patients with venous ulceration treated for 4 weeks.

The decrease of the resting flow and the increased efficacy of the venous vasomotor response was both significant and associated with a significant decrease of the ulcerated areas.

Laser-Doppler flowmetry was useful to demonstrate microcirculatory changes which were not revealed by standard techniques such as ambulatory venous pressure. It may be useful to reveal variations in venous hypertension produced by other treatments such as elastic compression or ‘venoactive’ drugs.
Graduated Compression Stockings in the Prevention of Postoperative Deep Vein Thrombosis: A Comparative Study of Pressure Profiles and Patient Compliance
Authors: Williamson M. , Thomas S. , Edwards A. , Johnson R. , Riggs J. , Lewis M. H.
Published: January 2017

Graded support stockings are widely used in the prophylaxis of postoperative deep vein thrombosis (DVT). For many years (following the results of early trials) one brand has dominated the market. We now describe an assessment of an alternative brand.

Fifty patients undergoing major abdominal surgery were provided with graduated support stockings postoperatively for the prophylaxis of DVT. Two different makes of stockings were used, one on each leg; the leg randomly determined by an odd or even year of birth. Data was collected from each patient in order to determine patient compliance. Patients experienced no significant difference in comfort between the two makes, although, on balance, product ‘A’ was found to be more comfortable. No pressure sores were caused by either stocking type and there was no clinical evidence of DVT in any of the 50 patients. However, there were two cases of pulmonary embolus.

Samples of both stockings were tested in a materials testing laboratory, to determine the pressure gradients which they could be expected to apply in normal use, and the results of these tests suggest that there are major differences in the performance of the products concerned.
Preliminary Results of External Sapheno–Femoral Valvuloplasty: A Trial by the Italian Society of Phlebolymphology
Authors: Donini I. , Corcos L. , De Anna D. , Gasbarro V. , Pozza E. , Zamboni P.
Published: January 2017

A multicentric trial was conducted to compare the various methods, materials and results employed in external valvuloplasty of the sapheno-femoral junction. Dacron, PTFE and absorbable prostheses have been used and have lead to the following conclusions: careful diagnosis and selection of patients is necessary; dilatation of both terminal and sub-terminal saphenous valves should be treated; at present, PTFE seems the best material to use (follow-up for the absorbable material is too short); the operation is effective and can be recommended in selected cases.
Progesterone Augments the Venoconstrictor Effect of Ruscus without Altering Adrenergic Reactivity
Authors: Miller Virginia M. , Marcelon Gilbert , Vanhoutte Paul M.
Published: January 2017

Chronic administration of oestrogen and/or progesterone does not affect adrenergic neurotransmission or contractions initiated by sympathomimetic amines in the cutaneous venous smooth muscle of the dog. However, contractions initiated by the venotropic Ruscus-extract are enhanced following chronic exposure to progesterone, an affect that can be reversed by oestrogen. The contractions are mediated by an adrenergic and non-adrenergic component. The adrenergic component is enhanced by progesterone and decreased by oestrogen; the non-adrenergic component is most prominent when the serum-levels of the female steroid hormones are low.
Improvement of Ambulatory Venous Hypertension by Narrowing of the Femoral Vein in Congenital Absence of Venous Valves
Authors: Partsch B. , Mayer W. , Partsch H.
Published: January 2017

Objective:

To assess the effect of femoral vein compression in a patient with congenital avalvulae.

Design:

Single patient study.

Setting:

Department of Dermatology; Teaching Hospital, Vienna, Austria.

Patient:

A single patient with the rare condition of congenital absence of venous valves.

Interventions:

Compression of the thigh using a thigh

Main outcome measures:

Ambulatory venous pressure Measurement.

Results:

The ambulatory venous pressure was reduced when the thigh calf pressure was increased in excess of 70 mmHg.

Conclusion:

Thigh compression in a patient with congenital absence of venous valves resulted in a temporary valve mechanism permitting orthograde flow during muscle systole, but inhibiting venous reflux.
Techniques of Sclerotherapy: A Method to Distend Leg Veins with the Patient in a Horizontal Position Prior to Needle Insertion
Authors: Bundens W. P.
Published: January 2017

Objective:

To demonstrate the efficacy of the use of a large contoured thigh cuff to distend varicose veins, with the patient in a horizontal position, prior to needle insertion for sclerotherapy.

Design:

Prospective study in varicose vein patients treated by injection-compression sclerotherapy.

Setting:

Outpatient Surgery Clinic, University of California San Diego, La Jolla, California.

Patients:

Patients presenting with varicose veins on the lower thigh and below.

Interventions:

Patients underwent injection-compression sclerotherapy. Needles insertion was done with the patient in a horizontal position after veins were distended using a large contoured thigh cuff.

Main outcome measures:

Successful vein distension and needle insertion.

Results:

Ninety-five percent of patients had adequate vein distension for needle insertion.

Conclusion:

Vein distension, prior to needle insertion for sclerotherapy can be achieved by using a large contoured thigh cuff.
Marjolin's Ulcer: A Report of Three Cases and Review of the Literature
Authors: Hassan S. A. , Cheatle T. R. , Fox J. A.
Published: January 2017

Objective:

To report three cases of Marjolin's ulcer and review the literature on the subject.

Design:

Case report.

Setting:

Edgware General Hospital, Edgware, Middlesex.

Patients:

Three patients presenting with Marjolin's ulcer.

Interventions:

Amputation (2 cases) and excision with skin grafting (1 case).

Main outcome measures:

Disease control.

Results:

Satisfactory control of disease in all three.
Endothelium-Derived Relaxing Factor Release from Normal and Varicose Human Saphenous Veins
Authors: Payne S. P. K. , Sayers R. D. , Watt P. A. C. , Bell P. R. F. , Thurston H.
Published: January 2017

Objective:

To evaluate the role of endothelium-derived relaxing factor (EDRF) in the regulation of smooth muscle tone in normal and varicose human saphenous veins.

Design:

An in vitro study of site-matched saphenous vein samples from patients undergoing varicose vein surgery or carotid endarterectomy.

Setting:

Department of Surgery, University of Leicester, Leicester Royal Infirmary.

Patients:

Nine patients undergoing varicose vein surgery and seven patients undergoing carotid endarterectomy.

Measurements:

Vein samples were contracted with noradrenaline and relaxation studies performed with acetylcholine (endothelium-dependent) and sodium nitroprusside (endothelium-independent).

Results:

There was no statistical difference in either smooth muscle contraction in response to noradrenaline or in endothelial-dependent relaxation in response to acetylcholine. All veins retained the ability to relax in response to nitroprusside.

Conclusions:

No evidence of a defect in either smooth muscle function or EDRF release has been found that may contribute to the aetiology of varicose veins.
Angiomatosis at the Saphenofemoral Junction
Authors: Lechter A. , Lopez G. , Theuzaba E. , Franco C. , Bayona G.
Published: January 2017

Objective:

To describe 12 patients with a vascular malformation found at the saphenofemoral junction during dissection of the inguinal region for surgery of varicose veins.

Design:

Retrospective study of cases found during the period from 1986 to 1991.

Setting:

University Hospital of the Military School of Medicine, Bogota, Colombia.

Patients:

Twelve patients, 11 unilateral and one bilateral, representing 0.5% of our total experience in surgery of varicose veins in 5 years.

Interventions:

Surgical resection of the angiomatous malformation.

Main outcome measures:

Clinical assessment of patients and histological examination of excised tissue.

Results:

The excised angiomatous tissue was found to contain irregular venous vessels, associated with lymphatic nodular structures and surrounded by adipose tissue. A satisfactory clinical outcome was obtained in patients where the angiomatous tissue could be excised.

Conclusions:

Vascular surgeons treating varicose veins should be aware of the possibility of finding vascular angiomatous malformation of the saphenofemoral junction. Surgical resection of these benign lesions results in a satisfactory clinical outcome.
Double-Blind Trial of the Efficacy of Troxerutin in Chronic Venous Insufficiency
Authors: Vin F. , Chabanel A. , Taccoen A. , Ducros J. , Gruffaz J. , Hutinel B. , Maillet P. , Samama M.
Published: January 2017

Objective:

To evaluate the efficacy of troxerutin in chronic venous insufficiency.

Design:

Randomized, double-blind, multicentre, prospective controlled trial.

Setting:

Hôtel Dieu Hospital and Notre Dame de Bon Secours Hospital, Paris, France.

Patients:

Sixty-nine patients with truncal varicose veins.

Intervention:

After a single-blind 15-day placebo run-in period, one group ( n = 34) received troxerutin 3500 mg daily for 2 months. The other group ( n = 35) received a placebo.

Main outcome measures:

Subjective symptoms, ankle circumference, venous refilling time with photoplethysmography, erythrocyte aggregation using the SEFAM aggregameter and fibrinogen level.

Results:

Leg aching ( p < 0.001) and venous function score ( p < 0.001) improvements were significantly higher in the troxerutin group (83% and −3.7) compared with the placebo group (23% and −0.7). A significant difference in favour of troxerutin was found for erythrocyte aggregation kinetic indexes ( p < 0.001) and dissociation threshold ( p < 0.01).

Conclusions:

This study confirmed the dual action of the drug: a parietal effect and a rheological effect.
Pathophysiology of Chronic Venous Insufficiency
Authors: Bauersachs J. , Fleming I. , Busse R.
Published: January 2017

Objective:

To review the physiological mechanisms determining venous return to the heart and the pathophysiological events culminating in chronic venous insufficiency (CVI), focusing primarily on the role of alterations in nitric oxide (NO) production by the vascular endothelium.

Background:

Congenital valve incompetence, thrombotic damage or venous outflow obstruction result in the development of chronic venous hypertension which frequently leads to ulceration. One major aetiological factor of trophic changes in the skin of patients with CVI is the phenomenon of leucocyte trapping.

Hypothesis:

It has been suggested that endothelial dysfunction, effectively resulting in a decrease in cellular levels of NO, is a key event in the initiation of enhanced adhesion molecule expression.

Data:

P-selectin, monocyte chemoattractant protein-1 and vascular cell adhesion molecule-1 expression can be enhanced by attenuating endothelial NO production. The mechanism by which NO alters the expression of genes encoding these adhesion molecules would appear to involve an interaction with transcription factors, in particular NF*** xB.

Conclusion:

Impaired endothelial NO synthesis associated with CVI may enhance the expression of adhesion molecules and chemotactic factors and lead to leucocyte adhesion and extravasation.
Laser Doppler Flux in the Venous Wall
Authors: Belcaro G. , Nicolaides A. N. , Laurora G. , Cesarone M. R. , De Sanctis M. T. , Incande L. , Ricci A.
Published: January 2017

Objectives:

To evaluate in vivo the perfusion of the venous wall in normal veins, varicose veins and in femoral veins of post-phlebitic limbs recording wall flux with laser Doppler flowmetry. As there is some evidence that both structure and microcirculatory dynamic responses are altered in the abnormal vein wall, we also aimed to study the response of vein wall perfusion to locally induced vasodilatation following papaverine infusion.

Design:

Open prospective study in patients with venous insufficiency and in patients undergoing coronary revascularization with a normal venous system.

Setting:

Cardiovascular Institute, Chieti University, Pierangeli Clinic, Italy and Irvine Laboratory, St Mary's Hospital, London, UK.

Patients:

Twenty-four normal long saphenous veins and 11 common femoral veins (35 normal veins, 35 subjects) and 42 varicose veins (42 patients).

Measurements:

Venous wall flux was measured on the external surface of normal long saphenous veins and common femoral veins. Measurements were also made on varicose veins before ligation of the sapheno-femoral junction. All measurements were made when at least three-quarters of the adventitia and periadventitia tissue were still intact for a length of 3 cm.

Results:

Flux in the normal vein wall was higher ( t = 5.88; p<0.05) than in varicose veins and in veins of post-phlebitic limbs. There was no difference in flux between varicose veins and post-phlebitic veins. After intravenous papaverine injection in a subgroup of eight normal and eight varicose veins, in the wall of normal veins there was a significant increase in flux (from 8.5 (SD 5.1) units to 13.2 (SD 3.8) units; p<0.05) which was not observed in varicose veins.

Conclusions:

A higher vein wall perfusion was observed in normal veins compared with varicose veins and post-phlebitic limb veins. Greater vascular reactivity to intraluminal papaverine injection was observed in normal veins.
Angioscopic External Valvuloplasty in the Treatment of Varicose Veins
Authors: Satokawa H. , Hoshino S. , Igari T. , Takase S. , Ogawa T.
Published: January 2017

Objective:

To report on the surgical treatment of varicose veins by angioscopic valvuloplasty to preserve the long saphenous vein (LSV) and the efficacy of this method compared with conventional stripping and high ligation.

Methods:

A total of 306 limbs in 187 patients with reflux at the sapheno-femoral junction to below knee level were operated on using intraoperative angioscopy to diagnose valve insufficiency. Angioscopic external valvuloplasty was attempted for the subterminal valves in the LSV by three techniques: total plication of the dilated annulus by running polypropylene sutures (technique 1), plication by autogenous femorofascial sleeve or Dacron-reinforced silicone (technique 2), and plication of the commissure with shortening of the cusps from outside the vein wall (technique 3). Partial stripping or segmental ligation was performed for varicose veins below knee level and the incompetent perforating veins were treated simultaneously by suprafascial ligation.

Results:

The subterminal valves were classified as follows: valves with elongated and atrophic cusps – type I, 136 (44%); valves with expanded and depressed commissures with cusp changes – type II, 108 (35%); valves that had cusps with other deformities – type III, 38 (13%); and absence of valves between the saphenofemoral junction and mid-thigh level, 24 limbs (8%). Valvuloplasty of the LSV was successfully performed in 62 limbs (20%). There were two cases with occlusion of the LSV (3%) and four with recurrence of varicose veins (6%) at 2–89 (mean 55, SD 21) months follow-up.

Conclusions:

Angioscopic external valvuloplasty is effective in the treatment of varicose veins to preserve the LSV. Further data are needed for complete evaluation of this procedure.
Anatomical Distribution of Chronic Venous Insufficiency in a Chinese Population
Authors: Ting A. C. W. , Cheng S. W. K. , Wu L. L. H. , Cheung G. C. Y.
Published: January 2017

Objective:

To study the anatomical distribution of chronic venous insufficiency (CVI) in a Chinese population by means of duplex scanning.

Procedures:

A total of 582 limbs in 291 patients with primary venous insufficiency were classified clinically into three different groups according to SVS/ISCVS criteria and evaluated prospectively with duplex scanning.

Results:

One hundred and thirty-one limbs were classified into group I (CEAP clinical class 0), 291 into group II (CEAP clinical classes 1 and 2) and 160 into group III (CEAP clinical classes 3–6). Mixed deep and superficial venous incompetence was found in 70% and 83% of limbs in groups II and III, respectively. Reflux was also demonstrated in 73% of group I limbs.

Conclusions:

Most of our patients had mixed deep and superficial venous incompetence. The prevalence of deep venous incompetence in this population, in which deep vein thrombosis is rare, suggests a pattern of venous incompetence other than postphlebitic deep vein valvular dysfunction. The prevalence of reflux in the asymptomatic contralateral limbs implies a bilateral predisposition to venous reflux and thus a possible developmental origin of CVI.
The Relationship between Ultrasonic Ambulatory Venous Pressure and Residual Volume Fraction in Primary Venous Insufficiency
Authors: Zamboni P. , Quaglio D. , Cisno C. , Marchetti F. , Cisno L. , Marcellino M. G.
Published: January 2017

Objective:

To study the relationship between two non-invasive methods for determining ambulatory venous pressure (AVP) in primary chronic venous insufficiency of the lower limbs.

Design:

Comparison between ultrasonic AVP (US-AVP) and residual volume fraction (RVF) determined by means of air plethysmography (APG).

Setting:

Department of Surgery and Vascular Laboratory, University of Ferrara, Italy.

Patients:

Twenty-one subjects affected by primary chronic venous insufficiency (CVI).

Main outcome measure:

A comparison of the AVP values extrapolated from the change in ultrasonic diameter of the saphenous vein after exercise and from RVF values. Ultrasonographic extrapolation was also made by the means of the software Venometer and compared with manual assessment.

Results:

Linear regression analysis demonstrated that US-AVP values were significantly correlated with RVF values ( r = 0.86 and p<0.0001). Assessment by Venometer as compared with manual calculation showed a high degree of correlation ( r = 0.98), p<0.0001).

Conclusions:

The two methods for non-invasive assessment of AVP appear to be closely and significantly correlated. The Venometer allows reliable and rapid extrapolation of AVP values.
Endostripping: A New Minimally Invasive Technique for Limited Stripping of the Greater Saphenous Vein
Authors: Shamiyeh A. , Schrenk P. , Rieger R. , Wayand W.
Published: January 2017

Objective:

To describe a new technique for limited stripping (in the thigh) of the greater saphenous vein (GSV) to avoid painful postoperative haematomas.

Design:

Pilot study.

Setting:

General Hospital Linz, Second Surgical Department, Linz, Austria.

Patients:

Sixteen patients undergoing primary varicose vein surgery for varices on the long saphenous vein. CEAP clinical stage: C2 ( n = 12), C3 ( n = 4).

Intervention:

Removal of the GSV from the thigh by endoscopic dissection with electrocautery division of the main tributaries. Phlebectomy for varices in GSV tributaries.

Main outcome measures:

Clinical assessment of the extent of haematomas and cosmetic appearance.

Results:

Fifteen of 16 operations were completed as intended without any technical problem. In one case conversion to conventional stripping was required due to adhesion of the saphenous vein to a previous operation scar in the thigh. The median total operation time for one limb was 57 min. A postoperative haematoma occurred in only one patient. There was no additional postoperative complication.

Conclusion:

Endostripping is a new technique for stripping of the GSV and reduces postoperative haematoma. It can be performed in a reasonable operation time and is safe. The value of this technique should be assessed in clinical trials.
Hypercapnia is essential to reduce the cerebral oxidative metabolism during extreme apnea in humans
Authors: Bain Anthony R , Ainslie Philip N , Barak Otto F , Hoiland Ryan L , Drvis Ivan , Mijacika Tanja , Bailey Damian M , Santoro Antoinette , DeMasi Daniel K , Dujic Zeljko , MacLeod David B
Published: January 2017

The cerebral metabolic rate of oxygen (CMRO2) is reduced during apnea that yields profound hypoxia and hypercapnia. In this study, to dissociate the impact of hypoxia and hypercapnia on the reduction in CMRO2, 11 breath-hold competitors completed three apneas under: (a) normal conditions (NM), yielding severe hypercapnia and hypoxemia, (b) with prior hyperventilation (HV), yielding severe hypoxemia only, and (c) with prior 100% oxygen breathing (HX), yielding the greatest level of hypercapnia, but in the absence of hypoxemia. The CMRO2 was calculated from the product of cerebral blood flow (ultrasound) and the radial artery-jugular venous oxygen content difference (cannulation). Secondary measures included net-cerebral glucose/lactate exchange and nonoxidative metabolism. Reductions in CMRO2 were largest in the HX condition (−44 ± 15%, p < 0.05), with the most severe hypercapnia (PaCO2 = 58 ± 5 mmHg) but maintained oxygen saturation. The CMRO2 was reduced by 24 ± 27% in NM ( p = 0.05), but unchanged in the HV apnea where hypercapnia was absent. A net-cerebral lactate release was observed at the end of apnea in the HV and NM condition, but not in the HX apnea (main effect p < 0.05). These novel data support hypercapnia/pH as a key mechanism mediating reductions in CMRO2 during apnea, and show that severe hypoxemia stimulates lactate release from the brain.
Evaluation of Leponex (Clozapine) in Schizophrenia with Acute Symptomatology
Authors: Singer K , Lam C M
Published: January 2017

Thirty-three in-patients, diagnosed as suffering from schizophrenia with acute symptomatology, were involved in a double-blind cross-over trial comparing Leponex (clozapine) with placebo. Leponex was found to be effective, particularly in the control of paranoid manifestations and excited and aggressive behaviour, with rapid onset of action. The drug should however be used with some caution at this stage because of its hypotensive effects, which led to collapse in 13% of cases in the initial stages of treatment. This side-effect could be avoided by starting on low dosage.
Fluspirilene in Schizophrenia
Authors: Cottrell W M , Magnus Ralph V
Published: January 2017

Forty patients have been treated for two months with fluspirilene, a new injectable diphenylbutylpiperidine administered intramuscularly once per week. Chronic cases improved satisfactorily and acute cases did rather better, particularly in relation to delusions.

When the average dose was low ( 5.4 mg) extra-pyramidal effects were uncommon, but if 12 mg was given, more side-effects were encountered. Two patients on fluspirilene 4 mg weekly had dystonic reactions.

If marked hypertension was present, the systolic pressure fell by about 60 mm Hg.
A Practical Regimen for Weight Reduction in Family Practice
Authors: Alien G S
Published: January 2017

The effectiveness of a weight reduction programme consisting of motivation of the patient, use of an anorectic drug (Tenuate, 25 mg), and diet and exercise was assessed in 110 obese patients in a 12 week, double-blind, placebo-controlled study. The differences in weight loss with continuous therapy (Tenuate) vs placebo and with intermittent therapy (Tenuateplacebo-Tenuate) vs placebo were statistically significant (p = 0·0001 and p = 0·0004 respectively).

No deleterious effects on blood pressure, pulse rate, ECG, and chest x-ray were seen. Only 1 of the original 174 patients dropped out of the study because of side-effects.
Oxprenolol—A Beta-Blocking Agent in the Treatment of the Climacteric
Authors: Elsdon-Dew R W
Published: January 2017

Fifty-six patients with symptoms attributable to the menopause, were given either oxprenolol 80 mg three times a day or the general practitioner's normal therapy. Allocation to either treatment was done randomly. Thirty patients were given oxprenolol—26 patients were given the doctor's usual therapy each for 1 month. Both treatments significantly reduced the number of hot flushes per day, but there was no significant difference between them. Other parameters measured were tension, headaches, sleep and depression, and again both treatments were relatively effective, without any significant difference between them. The merits of the various therapeutic approaches to the menopausal syndrome are discussed.
The Effect of Formebolone, a New Anabolic Steroid, on Nitrogen, Phosphorus and Calcium Balance in Man
Authors: Noel P R , Leahy J S
Published: January 2017

The anabolic effect of Formebolone on the retention of nitrogen, phosphorus and calcium in adult male volunteers was evaluated over a period of 21 days. The study was divided into a pre-dosc period to establish baseline data, a period where the drug was given daily followed by a third period after treatment had ceased to investigate whether the effects were in any way prolonged. Formebolone was well tolerated and showed a positive effect on nitrogen balance and bodyweight change in all subjects. The effects on calcium and phosphorus balance were less clear-cut but indicated increased retention of both elements.
Comparison of Efficacy of Amoxapine and Imipramine in a Multi-Clinic Double-Blind Study Using the WHO Schedule for a Standard Assessment of Patients with Depressive Disorders
Authors: Takahashi Ryo , Sakuma Akira , Hara Toshio , Kazamatsuri Hajime , Mori Atsuyoshi , Saito Yoichi , Murasaki Mitsukuni , Oguchi Toru , Sakurai Yukihiko , Yuzuriha Taro , Takemura Michio , Kurokawa Hidezo , Kurita Hiroshi
Published: January 2017

A multi-clinic double-blind controlled study on amoxapine in comparison with imipramine, using the WHO Schedule for a Standard Assessment of Patients with Depressive Disorders, was performed and the data were analyzed with 111 patients.

The assessment of severity of illness and overall improvement indicated clearly the superiority of the antidepressive effect of amoxapine to that of imipramine.

The onset of antidepressive effect of amoxapine was clearly more rapid than that of imipramine, and in more than half of the patients in the amoxapine group the improvement was seen within four days following the drug administration, Amoxapine was superior to imipramine in terms of safety and usefulness. The side-effects due to amoxapine appeared less frequently and were less serious than with imipramine. The difference between amoxapine and imipramine was especially remarkable for hypotensive effect.

The antidepressive effect of amoxapine was superior to that of imipramine for almost all symptoms and signs. Amoxapine displayed an especially remarkable effect on psychomotor retardation, depressive feeling, anxiety and tension, somatic complaints and sleep disturbance.
Magnapen Treatment of Infections in the Elderly
Authors: Middleton R S W , Sinha H K
Published: January 2017

Magnapen is a combination of two well-proven semi-synthetic penicillins which together offer the theoretical advantages of a broad spectrum of activity, good bioavailability and a low incidence of side-effects. It is of particular value in treating infections in the elderly. In this study the theory is borne out in practice in a population presenting special problems for which this combination seems particularly appropriate.

Ninety-six patients have been treated with a course of Magnapen syrup. Of the total entered into the study, 73% of patients were clinically cured following therapy, with a further 19% improved. Clinical failure occurred in 8% of patients. Fifty-two patients were bacteriologically assessable, forty-seven of whom (90%) had infecting organisms cleared by therapy.

Side-effects occurred in four patients (4%), one of whom had to discontinue therapy.
A Multicentre Double-Blind Comparison of Oxaprozin Aspirin Therapy on Rheumatoid Arthritis
Authors: Hubsher Jerome A , Ballard Ian M , Walker Barry R , Gold Jerome A
Published: January 2017

Preliminary clinical studies showed that oxaprozin (4,5 Diphenyl-2-oxazolepropionic acid) has anti-inflammatory and analgesic properties with a plasma half-life of about 40 hours. Consequently, a multicentre, double-blind parallel trial was conducted for 12 weeks at thirteen investigator sites, utilizing 212 patients with classic rheumatoid arthritis and comparing oxaprozin 600 mg/day, oxaprozin 1200 mg/day and aspirin 3900 mg/day.

Both the oxaprozin and aspirin-treated patients had statistically significant improvement from baseline periods, in most key categories evaluated. Oxaprozin administered twice a day (b.i.d.) was as effective as aspirin administered four times a day (q.i.d.) and caused significantly less tinnitus (p < 0.001). Fewer patients receiving high dose oxaprozin (2%) dropped out of the study because of unsatisfactory response than did those receiving aspirin (10%). There were no clinically significant laboratory abnormalities in the gastro-intestinal, renal, hepatic or haematological parameters monitored. This study suggests that oxaprozin is effective and well tolerated in the treatment of rheumatoid arthritis.
Salicylsalicylic Acid Revisited: A Multicentre Study
Authors: Ré O N
Published: January 2017

Twenty-eight medical specialists (internists, rheumatologists) selected 102 primarily arthritic patients for a two-week efficacy and safety field study of salicylsalicylic acid. Data were gathered on pain, morning stiffness, range of motion, serum salicylate concentration, erythrocyte sedimentation rate (ESR) and gastro-intestinal bleeding before and after a 15-day drug trial. Results showed a 67% favourable clinical response in the physician's global evaluation and a 60% improvement in pain; the drug itself was well tolerated by 96% of patients. Response correlations with morning stiffness and range of motion were equivocal. Of fifty-four patients examined before and after treatment for intestinal bleeding, only two (3.7%) had detectable faecal blood loss. Good clinical response had a statistically significant association with serum drug concentrations of 13.6 to 13.8 mg%; unsatisfactory response was noted in those patients with mean serum salicylate levels of 8.6 mg%. ESR decreased or was unchanged in thirty-five patients with satisfactory clinical response and in fourteen patients with unsatisfactory response.
A Study of Premarin Intravenous and its Influence on Blood Loss during Transurethral Prostatectomy
Authors: Gray N , Polakow E S
Published: January 2017

In a double-blind comparative study conjugated equine oestrogens (USP) (Premarin Intravenous) and saline were administered intravenously to patients undergoing transurethral prostatectomy. This paper proves that the placebo group (saline) displays a tendency, as indicated by two statistical tests, towards a significant increase in the red blood cells lost in the 24-hours after the operation. The Premarin Intravenous group showed no such tendency.
Hydrocortisone Alcoholic Solution in Eczematous External Otitis
Authors: Buch-Rasmussen A
Published: January 2017

A double-blind, randomized study is described involving a total of fifty-five patients suffering from eczematous external otitis comparing for efficacy hydrocortisone alcoholic solution and hydrocortisone-17-α-butyrate. The trial duration was seven days. No difference in efficacy could be demonstrated between the two preparations. No side-effects were observed.
An Evaluation of Debrisan in Chronic Leg Ulcers and Pressure Sores
Authors: Allen P C , Turmer A D
Published: January 2017

Debrisan (Dextranomer) was subjected to a simple open assessment in the treatment of fifty-three chronic leg ulcers and thirty pressure sores in eight hospitals. It was found that 70% of leg ulcers and 76% of pressure sores improved, with a noticeable cleansing effect being evident in 79% and 83% respectively. No side-effects were recorded.
Three Methods of Application of Econazole in the Treatment of Vaginal Candidiasis
Authors: Rhemrev P E R , Lestienne M C , Karoussos K
Published: January 2017

Pointing out the fact that there is a generalized increase in the incidence of vaginal candidiasis the authors describe a study involving a total of sixty-one patients to evaluate econazole in the treatment of the condition.
A Double-Blind Trial: Vivalan against Placebo in Depressed Elderly Patients
Authors: Knorring Von L
Published: January 2017

A double-blind controlled study of viloxazine against placebo in elderly depressed patients with a primary diagnosis of depressive illness records statistically significant improvements in depression ratings in the viloxazine group after three weeks.

Viloxazine was effective and well tolerated at doses of 100 to 200 mg in depressed elderly patients, several of whom had concurrent cardiac disease.
Treatment of Essential Hypertension with a Combination of Propranolol and Bendrofluazide
Authors: Solomon L R , Dawes P M
Published: January 2017

The effect of conventional propranolol and bendrofluazide tablets given twice daily has been compared with an equivalent dosage combined in a single capsule given twice daily in fourteen patients with essential hypertension. Good blood pressure control was achieved on both regimes in the majority of patients and there was no significant difference in treatment response between the two regimes. Use of the combined capsule is convenient and may improve patient compliance.
Sisomicin: An Aminoglycoside Antibiotic that is Highly Effective against Pseudomonas
Authors: Sanders W Eugene , Sanders Christine C
Published: January 2017

The in vitro activity of sisomicin against Pseudomonas is two- to eight-fold greater then gentamicin or amikacin, and similar to tobramycin. Minimal inhibitory concentrations of sisomicin are usually <1.0 μg/ml. Sisomicin interacts synergistically with a variety of penicillins against many Pseudomonas, including strains resistant to gentamicin. The degree of cross-resistance between sisomicin and other aminoglycosides varies depending upon mechanism. Many strains with inactivating enzymes are resistant to sisomicin, gentamicin and tobramycin. However, due to high intrinsic potency, sisomicin is active against many strains that are resistant to other aminoglycosides as a result of impermeability. Thus sisomicin is active against 4% to 66% of strains resistant to gentamicin, tobramycin or amikacin. The ability of sisomicin to protect animals from fatal Pseudomonas infections has been assessed in 29 paired tests with tobramycin and 36 paired tests with gentamicin. The dose of sisomicin in mg/kg required to protect 50% of animals from death is, on average, 1.5 times lower than tobramycin and 3.1 times lower than gentamicin. Sisomicin also interacts synergistically with carbenicillin or ticarcillin in treatment of experimental infections in animals. The human pharmacology of sisomicin is similar to gentamicin. Rates of adverse reactions to sisomicin are comparable to those seen with gentamicin or tobramycin. Clinical trials have shown sisomicin to be as effective, and in some instances more effective, than gentamicin, tobramycin, or amikacin. In several studies, the efficacy of sisomicin, administered in lower doses than gentamicin, was equal to or greater than gentamicin. Infections caused by gentamicin-resistant Pseudomonas have responded to sisomicin. Also, several patients who failed to respond to either gentamicin or tobramycin have been successfully treated with sisomicin. In view of its high intrinsic potency both in vitro and in vivo, sisomicin may become a preferred agent for treatment of serious Pseudomonas infections due to sensitive strains.
The Treatment of Urinary Tract Infections in Out-Patients. A Double-Blind Comparison between Trimethoprim and Nitrofurantoin
Authors: Sander Jan , Aandahl Einar , Fellner Helga , Kalstad Steinar
Published: January 2017

The rate of side-effects should today be more important for the choice of an agent for treatment of acute urinary tract infections than the cure rate, as this usually is above 90%. The side-effects with co-trimoxazole (trimethoprim-sulphamethoxazol) have been viewed as caused mainly by the sulphonamide component.

In this randomized, double-blind trial Group A has been treated with trimethoprim 200 mg x 2 and Group B with nitrofurantoin 50 mg x 4 for a duration of 10 days.

There was no difference in cure rate between the two groups.

The rate of side-effects was 26% in Group A and 12% in Group B. In Group A 12% had skin eruptions, mostly appearing on Day 7 or later, in Group B 1.3% had eruptions. These differences are statistically significant (p < 0.05). This result, together with a survey of the literature, indicates that the frequency of these rashes might be related both to dosage and duration of treatment. The origin of the side-effects caused by co-trimoxazole should be reconsidered. The in vitro sensitivity against trimethoprim and nitrofurantoin was tested using a disc diffusion method in 98 infecting strains from patients in this study. Two per cent were resistant against trimethoprim and 81% against nitrofurantoin. We found no correlation between the size of the inhibition zone and bacteriological cure rate. This makes the value of the disc diffusion method in out-patients with acute urinary tract infections questionable.
The Effect of Ticlopidine upon Platelet Function, Haemorrhage and Post-Operative Thrombosis in Patients Undergoing Suprapubic Prostatectomy
Authors: Brommer E J P
Published: January 2017

In order to study its protective effect against post-operative thrombosis, Ticlopidine was administered to one out of two randomized groups of patients undergoing suprapubic prostatectomy. Bleeding time, platelet function, and haematological parameters were followed. Blood loss during operation and post-operatively were estimated, transfusions required and subjective tolerance were recorded. Among twenty-six evaluated patients receiving Ticlopidine, positive leg scans were found in four, whereas among twenty patients treated with acenocoumarol post-operatively, positive leg scans were found in seven patients. The difference is not statistically significant, thus Ticlopidine appears to offer a protection against deep venous thrombosis comparable to that of acenocoumarol. A score is introduced for comparison of the results of aggregation tests. Platelet aggregability diminished during the use of the drug, but the adhesiveness was not influenced by Ticlopidine. The bleeding time was prolonged in both groups studied. Ticlopidine did not raise per-operative blood loss and caused only slightly more haematuria post-operatively. The subjective tolerance was good.