bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Case Rate and Coinfection Rate on the Positive Predictive Value of a Registry Data-Matching Algorithm
Authors: Xia Qiang , Braunstein Sarah L. , Stadelmann Laura E. , Pathela Preeti , Torian Lucia V.
Published: January 2017

Objective.

Statistical modeling has suggested that the prevalence of false matches in data matching declines as the events become rarer or the number of matches increases. We examined the effect of case rate and coinfection rate in the population on the positive predictive value (PPV) of a matching algorithm for HIV/AIDS and sexually transmitted disease (STD) surveillance registry data.

Methods.

We used LinkPlus™, a probabilistic data-matching program, to match HIV/AIDS cases diagnosed in New York City (NYC) from 1981 to March 31, 2012, and reported to the NYC HIV/AIDS surveillance registry against syphilis and chlamydia cases diagnosed in NYC from January 1 to June 30, 2010, and reported to the NYC STD registry. Match results were manually reviewed to determine true matches.

Results.

With an agreement/disagreement comparison score cutoff value of 10.0, LinkPlus identified 3,013 matches, of which 1,582 were determined to be true by manual review. PPV varied greatly in subpopulations with different case rates and coinfection rates. PPV was the highest (91.6%) in male syphilis cases, who had a relatively low case rate but a high HIV coinfection rate, and lowest (18.0%) in female chlamydia cases, who had a high case rate but a low HIV coinfection rate. When the cutoff value was increased to 15.0, PPVs in male syphilis and female chlamydia cases increased to 98.3% and 90.5%, respectively.

Conclusions.

Case rates and coinfection rates have a significant effect on the PPV of a registry data-matching algorithm: PPV decreases as the case rate increases and coinfection rate decreases. Before conducting registry data matching, program staff should assess the case rate and coinfection rate of the population included in the data matching and select an appropriate matching algorithm.
Using Social Determinants of Health to Link Health Workforce Diversity, Care Quality and Access, and Health Disparities to Achieve Health Equity in Nursing
Authors: Williams Shanita D. , Hansen Kristen , Smithey Marian , Burnley Josepha , Koplitz Michelle , Koyama Kirk , Young Janice , Bakos Alexis
Published: January 2017

It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators—health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work—both within and outside the nursing field—that is necessary to answer these important but largely unanswered questions.
Integrating the 3Ds: A Nursing Perspective
Authors: Villarruel Antonia M. , Bigelow April , Alvarez Carmen
Published: January 2017

The 3Ds (diversity, disparities, and determinants) that serve as a framework for this supplement are concepts that are key foundations of nursing education, practice, and research. Despite this fact, however, the nursing profession has faced challenges recognizing the full potential of these concepts. While their importance is documented and acknowledged, they are not clearly evident or easily recognized within the nursing profession. In fact, there are many barriers to the integration of these concepts. We identify and address two barriers to addressing health disparities and increasing diversity: disconnects and discrimination. Furthermore, we discuss three factors—dissemination, durability, and data—that may facilitate nursing's efforts to integrate the 3Ds into the profession. Five pivotal models that address these barriers and facilitators are presented as exemplars that have the potential to guide efforts to address diversity, disparities, and social determinants of health and act as catalysts for change within the nursing profession.
The Health Resources and Services Administration Diversity Data Collection
Authors: White Kathleen M. , Zangaro George , Kepley Hayden O. , Camacho Alex
Published: January 2017

The Health Resources and Services Administration maintains a strong emphasis on increasing the diversity of the health-care workforce through its grant programs. Increasing the diversity of the workforce is important for reducing health disparities in the population caused by socioeconomic, geographic, and race/ethnicity factors because evidence suggests that minority health professionals are more likely to serve in areas with a high proportion of underrepresented racial and ethnic minority groups. The data show success in increasing the diversity of enrollees in five nursing programs.
Transitioning from Health Disparities to a Health Equity Research Agenda: The Time is Now
Authors: Srinivasan Shobha , Williams Shanita D.
Published: January 2017

Health disparities are real. The evidence base is large and irrefutable. As such, the time is now to shift the research emphasis away from solely documenting the pervasiveness of the health disparities problem and begin focusing on health equity, the highest level of health possible. The focus on health equity research will require investigators to propose projects that develop and evaluate evidence-based solutions to health differences that are driven largely by social, economic, and environmental factors. This article highlights ongoing research and programmatic efforts underway at the National Institutes of Health that hold promise for advancing population health and improving health equity.
Changes in Immunization Program Managers' Perceptions of Programs' Functional Capabilities during and after Vaccine Shortages and pH1N1
Authors: Moriarty Leah F. , Omer Saad B. , Seib Katherine , Chamberlain Allison , Wells Katelyn , Whitney Ellen , Berkelman Ruth , Bednarczyk Robert A.
Published: January 2017

Objectives.

We surveyed U.S. immunization program managers (IPMs) as part of a project to improve public health preparedness against future emergencies by leveraging the immunization system. We examined immunization program policy and Immunization Information System (IIS) functionality changes as a result of the Haemophilus influenzae type B (Hib) vaccine shortage and pandemic influenza A(H1N1) (pH1N1). Evaluating changes in immunization program functionalities and policies following emergency response situations will assist in planning for future vaccine-related emergencies.

Methods.

We administered three consecutive surveys to IPMs from 64 state, city, and territorial jurisdictions in 2009, 2010, and 2012. We compared IPMs' responses across either two or three years (e.g., changes in response or consistent responses across years) using McNemar's test.

Results.

Immunization programs maintained increases in functionality related to communication systems with health-care providers during this period. Immunization programs often did not maintain changes to IIS functionalities made from 2009 to 2010 (e.g., identifying high-risk and priority populations, tracking adverse events, and mapping disease risk) in the post-pandemic period (2010–2012). About half of IPMs reporting additional IIS functionality in identifying high-risk populations from 2009 to 2010 reported no longer having this function in 2012. There was an 18% decline in respondents reporting geographic information systems risk-mapping capability in IIS from 2010 to 2012.

Conclusions.

Because of the Hib vaccine shortage and pH1N1, immunization program needs and efforts changed to address evolving situations. The lack of sustained increases in resources or system functions after the pandemic highlights the need for comprehensive, sustainable public health emergency preparedness systems and related resources.
Improving Emergency Preparedness System Readiness through Simulation and Interprofessional Education
Authors: Miller Jane Lindsay , Rambeck Joan H. , Snyder Annamay
Published: January 2017

We applied emerging evidence in simulation science to create a curriculum in emergency response for health science students and professionals. Our research project was designed to ( 1) test the effectiveness of specific immersive simulations, ( 2) create reliable assessment tools for emergency response and team communication skills, and ( 3) assess participants' retention and transfer of skills over time. We collected both quantitative and qualitative data about individual and team knowledge, skills, and attitudes. Content experts designed and pilot-tested scaled quantitative tools. Qualitative evaluations administered immediately after simulations and longitudinal surveys administered 6–12 months later measured student participants' individual perceptions of their confidence, readiness for emergency response, and transfer of skills to their day-to-day experience. Results from 312 participants enrolled in nine workshops during a 24-month period indicated that the 10-hour curriculum is efficient (compared with larger-scale or longer training programs) and effective in improving skills. The curriculum may be useful for public health practitioners interested in addressing public health emergency preparedness competencies and Institute of Medicine research priority areas.
Local Health Department Planning for a Radiological Emergency: An Application of the AHP2 Tool to Emergency Preparedness Prioritization
Authors: Dalnoki-Veress F. , McKallagat Chris , Klebesadal Amy
Published: January 2017

Objective.

We tested the Analytical Hierarchy Process tool for its use in public health to identify potential gaps in emergency preparedness by local health departments (LHDs) in California and Hawaii during a radiological emergency.

Methods.

We developed a dedicated tool called All-Hazards Preparedness Squared (AHP2) that can be used by those who are responsible for all-hazards preparedness planning and response to guide them while making strategic decisions both in preparing for and responding to a slow-moving incident while it is unfolding. The tool is an Internet-based survey that can be distributed among teams responsible for emergency preparedness and response. Twenty-eight participants from 16 LHDs in California and Hawaii responsible for coordinating preparedness and response in a radiological emergency participated in using the tool in 2013. We used the data to compare the perceived importance of different elements of preparedness among participants and identify gaps in preparedness of their organizations for meeting the challenges presented by a radiological incident.

Results.

Clarity of information and transfer of information (to and from agency to public, state, and federal partners) were public health officials' dominant concerns while responding to an emergency. Participants also found that there were gaps in the adequacy of training and awareness of the chain of command during a radiological emergency.

Conclusion.

This preliminary study indicates that the AHP2 tool could be used for decision making in all-hazards preparedness planning and response.
Inspection Frequency, Sociodemographic Factors, and Food Safety Violations in Chain and Nonchain Restaurants, Philadelphia, Pennsylvania, 2013-2014
Authors: Leinwand Sarah E. , Glanz Karen , Keenan Brendan T. , Branas Charles C.
Published: January 2017

Objectives:

We explored how restaurant inspection frequency and restaurant neighborhood sociodemographic characteristics are related to food safety inspection outcomes in chain and nonchain restaurants to better understand external factors that may influence inspection outcomes.

Methods:

We categorized the results of restaurant inspections in Philadelphia, Pennsylvania, in 2013 and 2014 by restaurant type (chain or nonchain), inspection frequency (1, 2, or ≥3 per 2-year study period), and violation type (total number of violations, foodborne-illness risk factor violation, or good retail practice violation). We collected 2013 US Census block group sociodemographic data for each restaurant neighborhood. We used nested mixed-effects regression analyses to determine the association between restaurant inspection frequency and inspection violations, as well as between inspection violations and restaurant neighborhood sociodemographic variables, stratified by restaurant type.

Results:

Compared with nonchain restaurants, chain restaurants had significantly fewer total violations per inspection (mean [SD]: 6.5 [4.6] vs 9.6 [6.8] violations, P < .001). For nonchain restaurants, an increase from 1 to 2 inspections resulted in 0.8 ( P < .001) fewer mean violations per inspection, and an increase from 1 to ≥3 inspections resulted in 1.6 ( P < .001) fewer mean violations; this association was not seen in chain restaurants. For nonchain restaurants, a higher proportion of black residents in a restaurant neighborhood was associated with 0.6 ( P < .001) fewer mean foodborne-illness risk factor violations but 1.0 ( P < .001) more mean good retail practice violations per inspection.

Conclusions:

A risk-based stratified approach to restaurant food safety inspection frequency, based on whether or not restaurants are part of chains, could reduce the frequency of violations, particularly in restaurants with the most violations.
Promoting EFL Teacher Research Engagement through a Research Support Programme
Authors: Al-Maamari Faisal , Al-Aamri Kamla , Khammash Samar , Al-Wahaibi Munira
Published: January 2017

Existing initiatives purporting to promote teacher research are often found to be inadequate to encourage EFL teachers to engage in research due to the fact that they impose a top down, expert model approach to research engagement. This study reports on a pioneering programme at Sultan Qaboos University Language Centre in the Sultanate of Oman which has adopted a bottom up, practitioner-based approach to research. Drawing on questionnaire and interview data, the article examines the teachers’ perceptions of their experiences in initiating and carrying out teacher research using this programme. The findings indicate that whilst contextual constraints similar to those cited in the literature remain unyielding, the research support programme has been effective in supporting teachers to initiate and lead their own research studies. This success is discussed in relation to the programme’s basis in a practitioner practice to theory model versus expert theory to practice models of teacher research engagement. As EFL teacher research is increasingly gaining popularity and acceptance worldwide, the study has implications for EFL institutions looking for effective ways to promote teacher research engagement in a collegial way.
Trilucent Breast Implants — A Personal Review of the Current Controversies (May 1999)
Authors: Mcgregor J. C.
Published: January 2017

Trilucent (“Soya Bean”) breast implants were marketed as a safe alternative to silicon implants. Following their use in the UK for the past four years, a reassessment of this has currently been announced (March 1999) and further implantation has been suspended by the Trilucent company in conjunction with the MDA (Medical Devices Agency). This has been the result of some reports of adverse reactions to the triglyceride filling material when the implant ruptures. All patients with trilucent implants were advised to return to their respective surgeons for review and advice.

A personal review has been undertaken by the author of this paper. The results obtained are discussed. The majority of patients were concerned, but were happy with cosmetic results, and did not at present wish their implants removed. None appeared as yet to have had serious complications that could be attributed to the implants.
Embolisation of Renal Arteriovenous Malformation (AVM) in Pregnancy
Authors: Macdonald S. , Edwards R.D.
Published: January 2017

A case of congenital renal arteriovenous malformation (AVM), presenting with profuse haematuria in the second trimester of pregnancy is reported. Selective embolisation with polyvinyl alcohol particles and absolute alcohol successfully ablated the lesion and a healthy infant was delivered at term five months later. Renal angiography at three years showed no evidence of the lesion.
Tamoxifen Therapy in Steroid Resistant Reidel's Thyroiditis
Authors: De M. , Jaap A. , Dempster J.
Published: January 2017

Riedel's thyroiditis is a rare chronic inflammatory disorder characterised by extensive fibrosis of the thyroid gland and sometimes the surrounding tissues. We report a case of Riedel's Thyroiditis in a middle aged female presenting with goitre, stridor and dyspnoea. She initially responded to corticosteroid treatment and subsequently to Tamoxifen. The rationale for these treatments are discussed.
Isolated Hydatid Cyst of the Breast
Authors: Acar T. , Gömcel Σ. , Güzel K. , Yazgan A. , AydΩn R.
Published: January 2017

Although common in sheep-breeding communities, hydatid disease is actually found worldwide. Man is an occasional intermediate host in whom the disease is manifested by the presence of one or more hydatid cysts, usually located in the liver or lung and rarely at other sites such as the breast, as in our patient. A case of an isolated breast involvement that was diagnosed during surgery is presented and is followed by a brief discussion on the topic.
Giant Submucosal Colonic Lipomata: Report of a Case and Review of the Literature
Authors: Montgomery D A , Reidy J
Published: January 2017

Giant submucosal colonic lipomas are an uncommon cause of colonic symptoms. There is great debate in the literature as to how best to deal with these. We present a patient with a large colonic lipoma causing abdominal pain and altered bowel habit. It was successfully treated by open colostomy and resection.
The Prevalence and Management of Hyperglycaemia in Patients with Rheumatoid Arthritis on Corticosteroid Therapy
Authors: Panthakalam S , Bhatnagar D , Klimiuk P
Published: January 2017

Background and Aims: Corticosteroids are commonly used in the treatment of RA. Hyperglycaemia resulting from cortiosteroid use can lead to problems, particularly in those with impaired glucose tolerance and diabetes mellitus. We have examined how rheumatology clinics monitored and managed hyperglycaemia at base line and during treatment of patients with rheumatoid arthritis on corticosteroids. Methods: Case notes of 102 patients with established RA, on long term steroids were reviewed. We recorded a) blood glucose level at base line and whilst on steroids b) when and whether hyperglycaemia was addressed. Results: There were 24 males and 78 females, with mean age of 62 ± 15 years. Patients were on corticosteroids for a median duration of 24 months. Seventy-five per cent of patients were treated with oral prednisolone, the rest, except one patient on deflazacort, were on methyl prednisolone. Blood glucose was measured at baseline in 97% of patients with 37% and 38% being monitored at three months and six months respectively and 36% annually thereafter. Nine patients (8.8%) developed diabetes mellitus during treatment, but one patient was detected and managed. There were six patients with existing diabetes mellitus in whom glycaemic control worsened between three to six months, but only one patient had treatment adjusted. Conclusions and recommendations: Physicians need to be aware that corticosteroids can increase blood glucose, worsen preexisting diabetes and predispose to diabetes mellitus. Patients on long-term corticosteroids should be monitored at regular intervals as corticosteroid induced glycaemic excursions may lead to the development of diabetes mellitus and increased coronary risk.
The Presentation of Bronchial Carcinoma
Authors: le Roux B. T.
Published: January 2017

Bronchial carcinoma in 4,000 patients investigated over a 15-year period, presented in these ways:

With some or all of the cardinal symptoms of respiratory disease (68%). Daily haemoptysis, and recurrent febrile respiratory illness with complete or incomplete recovery between episodes, were two manners of presentation particularly suggestive of the diagnosis of bronchial carcinoma.

Without symptoms and because of an abnormality detected on a chest radiograph made for routine purposes (5%).

With evidence of extension of or metastases from bronchial carcinoma without respiratory symptoms or with respiratory symptoms long accepted and not recently changed (13%). Evidence of extension of bronchial carcinoma was established by investigation in 45 per cent of the whole series.

With non-specific symptoms such as loss of weight or dyspepsia and without respiratory symptoms (12%).

With unusual symptoms which were not respiratory or with the humoral or neural concomitants of bronchial carcinoma such as hypertrophic pulmonary osteoarthropathy without, or with only unobtrusive respiratory symptoms (2%). The incidence of bronchial carcinoma amongst coal miners in the South East Region of Scotland may be disproportionately high.
Epidermoid Cyst of the Testis
Authors: Ewen S. W. B.
Published: January 2017

An epidermoid cyst of the testis is described. These tumours are rare and are thought to represent a keratinization of the epithelium of the rete testis. The histological features are completely benign and the prognosis is consequently good, in contrast to other testicular tumours.
Some Characteristics of Geriatric Patients
Authors: Isaacs B.
Published: January 2017

A group of 255 patients accepted for a geriatric unit in Glasgow was compared with a random sample of old people in the community matched with the patients for age, sex and economic status; and with a group of old people admitted to a general medical unit. The social factors which increased the probability of becoming a geriatric patient were: advanced old age; being a widower, bachelor or spinster; having no children; and living alone. The medical factors were the presence of two or more of the following symptoms: stroke, falls, gait loss, incontinence, and mental abnormality. These symptoms were associated with insufficient community care, heavy burden on relatives, high mortality and low discharge rate from hospital. Geriatric patients are drawn predominantly, although not exclusively, from a ‘hard core’ of socially disadvantaged old people with multiple diseases; they present with symptoms which deprive them of the ability for self-care and frequently they are in the terminal stage of their lives.
Ectopic Pregnancy in Nairobi, Kenya
Authors: Maley C. A. , Auma S.
Published: January 2017

One hundred and nineteen cases of ectopic pregnancy treated in the Department of Gynaecology, Kenyatta National Hospital, Nairobi, are described. Ectopic pregnancy accounted for almost one third of the abdominal operations performed in the department. Pelvic inflammatory disease seemed to be the cause of this high incidence. Culdocentesis proved useful for diagnosis, but should be employed with caution in a population in whom pelvic sepsis is common.

The value and safety of auto-transfusion is emphasised.
Renin, Angiotensin and Aldosterone in Human Pregnancy and the Menstrual Cycle
Authors: Robertson J. I. S. , Weir R. J. , Düsterdieck G. O. , Fraser R. , Tree M.
Published: January 2017

Aldosterone secretion is frequently, although not invariably, increased above the normal non-pregnant range in normal pregnancy. Substantial increases in plasma aldosterone concentration have also been demonstrated as early as the sixteenth week. In pregnancy, aldosterone secretion rate responds in the usual way to changes in sodium intake.

Plasma renin concentration is frequently, but not invariably, raised above the normal non-pregnant range. Plasma renin-substrate is consistently raised in pregnancy. Plasma angiotensin II has also been shown usually to be raised in a series of pregnant women.

A significant positive correlation has been shown between the maternal plasma aldosterone concentration and the product of the concurrent plasma renin and renin-substrate concentrations. This suggests that the increased plasma aldosterone in pregnancy is the consequence of an increase in circulating angiotensin II, which in turn is related to the level of both renin and its substrate in maternal blood. For these reasons, estimations of renin activity in pregnancy are of dubious value.

The increased renin, angiotensin and aldosterone concentrations may represent a tendency to maternal sodium depletion, probably mainly a consequence of the increased glomerular filtration rate. It is possible that the nausea and other symptoms of early pregnancy may be a consequence of this tendency to sodium depletion, with its attendant hormonal changes. In ‘pre-eclampsia’, renin and aldosterone values are generally slightly lower than in normal pregnancy. Human chorion can apparently synthesize renin independently of the kidney. The physiological significance of this remains at present obscure, but it seems unlikely that this source contributes much, if at all, to the often elevated maternal plasma renin.

Plasma renin, renin-activity and angiotensin II concentrations, and aldosterone secretion are increased in the luteal phase of the menstrual cycle.
Home Interviews with Relatives of Deceased Persons: A Means of Obtaining Histories of Exposure to a Hazardous Substance
Authors: Finlayson Angela , McEwen J. , Mair A.
Published: January 2017

This paper describes techniques used in tracing and obtaining cooperation from relatives in a retrospective study in Scotland. The purpose of the study was to investigate the associations between the development of mesothelioma and exposure to asbestos dust. From the information obtained from relatives, it was possible to show that, compared with controls, patients who died of mesothelioma had a significantly greater occupational exposure to asbestos.
Combined Carbimazole-131I Treatment for Thyrotoxicosis
Authors: McDougall J. R. , Greig W. R.
Published: January 2017

A sequential therapeutic regime was prescribed for 74 thyrotoxic patients. Every patient received carbimazole in conventional doses for 20 weeks; the average time to obtain control was 10.2 weeks. The patients although older than those usually treated with antithyroid drugs (range 38–68 years) showed no difference in the expected rate of control or in the recognised incidence of side effects. Following the carbimazole therapy the patients were alternatively allotted to receive standard or low (50% of standard) doses of 131I, the individual doses being calculated from simple formulae. After the radio-iodine all of the patients were treated with carbimazole for a further 20 weeks.

Review of the patients after completion of the trial and subsequent follow up without therapy shows that 42.1 per cent of the standard dose group remain euthyroid after one therapy dose of 131I, 36.8 per cent have relapsed and 21.1 per cent have become hypothyroid. In the low dose group 44.4 per cent are euthyroid, 47.2 per cent have had a recurrence and 8.4 per cent have become hypothyroid. The results are discussed in the light of current views about the treatment of thyrotoxicosis with drugs and with radioactive iodine.
Pulmonary Artery Calcification
Authors: Philp T.
Published: January 2017

Pulmonary artery calcification detected radiologically is invariably associated with the Eisenmenger Syndrome. Its appearance is relatively uncommon and 4 further cases are described. It is suggested that the relative rarity of the cases of pulmonary artery calcification in this syndrome is due to the fact that the majority of patients die before the age of 40 years.

If there is associated calcification in the arch of the aorta the reversed shunt is likely to be at ductus level. If such calcification is absent from the aorta the shunt is more likely to be at ventricular or atrial level.
Agranulocytosis Caused by Procainamide
Authors: Hickson B. , Davidson R. J. L. , Walker W.
Published: January 2017

Two patients taking procainamide developed agranulocytosis with septicaemia. Both recovered from the agranulocytosis, but one died of haemorrhagic pancreatitis and anuria. The latter had a strongly positive antinuclear antibody (A.N.A.) test. The frequency and relationship of the agranulocytosis and the lupoid syndrome caused by procainamide are briefly discussed. Precautionary measures for the early recognition of this grave hazard in exposed patients are advocated.
The Hazards of Ocean Cruises for the Elderly and Infirm
Authors: Cameron D. C.
Published: January 2017

It is the responsibility of all doctors to be aware of the risks of sea cruises and to advise individual patients about such hazards. It is wrong to send patients with fatal illnesses for a last ‘happy fling’ as the result is often far from that intended.

Shipping lines have the responsibility of maintaining adequate medical staff and improving equipment.

A supervised air flight to a stable environment may be better advice and enable the patient's life to be richer and happier in this final period. In spite of these reservations, sea travel can be a rewarding experience for elderly but healthy people.
Endocrinological Studies in Two Patients with Post Contraceptive Cyclic Dysfunction
Authors: Adamopoulos D. A. , Loraine J. A. , Ginsburg J. , Loudon N. B.
Published: January 2017

Serial assays of urinary oestrogens, pregnanediol, follicle-stimulating hormone (FSH) and luteinising hormone (LH) have been performed in two women who developed amenorrhoea as a result of medication by oral contraceptives. Oestrogen levels were generally within the range normally found during the follicular phase of the menstrual cycle. However, in both subjects during part of the investigation there was a rise to midcycle levels; in the first woman this occurred spontaneously and in the second as a result of clomiphene treatment. Urinary LH activity was present in both patients throughout the study but in neither was a midcycle peak of LH output observed. The findings are compatible with the view that long term therapy by oral contraceptives may impair the cyclic release of gonadotrophins at the hypothalamic level thus resulting in amenorrhoea and anovulation.
Ventilatory Function and Transfer Factor in Ankylosing Spondylitis
Authors: Citrin D. L. , Boyd G. , Bradley G. W.
Published: January 2017

Thirty-eight patients with ankylosing spondylitis, with a wide range of disease severity and duration were studied for evidence of parenchymal lung disease. Significant restriction of ventilatory excursion and reduction of lung volume was confirmed. The transfer factor was normal. In no case was there radiological or functional evidence of pulmonary fibrosis, even in those with extensive long standing spinal disease.
*Virus B Hepatitis in Greater Glasgow
Authors: Chaudhuri A. K. R.
Published: January 2017

During the 2-year period (1971–72), 71 patients with virus B hepatitis were studied in Greater Glasgow. In this region, virus B hepatitis is most prevalent in adult males. With the introduction of routine screening of the blood donor population for HB Ag, there has been a significant reduction (p <0.02) in post-transfusion hepatitis. Seventy per cent of the patients in 1972 had no obvious history of exposure to HB Ag. Twenty seven per cent of the patients in this series had severe hepatitis. For clarification of our understanding of the natural history of virus B hepatitis in Greater Glasgow, further co-ordinated study is needed.
Recent Advances in the Behavioural Measurement of Obsessional Illness Difficulties Common to These and other Measures
Authors: Philpott R.
Published: January 2017

Research into the effect of treatment on phobic and obsessional disorders has been hampered by the need for agreed and acceptable criteria in clinical evaluation and therapeutic comparison. Methods of measurement now available, including two recently developed scales, are described.
Erythromycin Resistance in Neonatal Staphylococcal Infection: A Long-Term Survey
Authors: Forfar J. O.
Published: January 2017

Twenty years ago staphylococcal infection was a major problem among newborn infants in hospitals. Hygienic measures had not proved very effective and the use of antibiotics, although clearly open to question, seemed a possible method of control. Erythromycin, a new antibiotic effective against staphylococci, had just been introduced but reports from the United States suggested that resistance could occur within months of usage.

In trials in two hospitals in which erythromycin was not being used elsewhere, erythromycin resistance developed but took years to do so. The longer the period of usage was extended the greater the resistance. Withdrawal of the drug resulted ultimately in the disappearance of resistance. The resistant staphylococci spread throughout the hospital. The staphylococcal infection rate in the units where erythromycin was used did not fall but the mortality rate from staphylococcal infection did.
Clinical Attitudes to the Autopsy
Authors: McGoogan Euphemia , Cameron H. M.
Published: January 2017

An enquiry into the attitudes of clinical consultants to autopsies was conducted by questionnaire. Responses indicate that most of the consultants accept that the autopsy is important in hospital practice and in teaching. There are, however, marked differences of view on the reasons for doing autopsies, and on the results of autopsies (e.g. in altering diagnoses or revealing unsuspected pathology), differences which influence the frequency with which autopsies are requested. Some clinicians believe that increasing resistance by relatives to granting permission contributes to the falling rate, but this is a minority view. Clinicians also vary in their reactions to the falling rate, some regarding it as worrying while others are not concerned.
Non Calculous Cholecystitis: An 8 Year Review of Cases Treated by Elective Cholecystectomy
Authors: Jones A. G. , Blair D. W.
Published: January 2017

From a total of 248 cases of cholecystectomy, 36 were found to be without stones. These cases of acalculous cholecystitis have been reviewed with regard to signs, symptoms and radiological investigations. The complications of operative treatment have been documented and the etiology of the condition discussed.

As a result of favourable outcome of operative treatment in these patients, it is suggested that surgery should be considered even in the absence of positive radiological findings at an earlier date.
Post-Partum Cardiomyopathy
Authors: Ng W. H. , Reid J. M.
Published: January 2017

A report is presented of a patient who developed signs of cardiac failure 6 weeks after the birth of her fourth child. Detailed cardiac investigation indicated the diagnosis to be post-partum cardiomyopathy, a condition more commonly encountered in Negro women and comparatively rare in this country. The aetiology and mode of presentation are discussed.
The Problems, Diagnosis and Treatment of Infection by Staphylococcus Aureus
Authors: Williams R. F.
Published: January 2017

Present-day problems of infection by Staphylococcus aureus are described against a brief historical account of the evolution of the multiple antibiotic-resistant ‘hospital staph’. which caused such immense problems of hospital cross-infection in the 1950's and 1960's. These problems have lessened considerably since that time, but staphylococcal infection still remains as a cause of morbidity and mortality. Diagnosis and treatment are not always straightforward. Apart from applying general supportive measures, and appropriate surgical intervention when necessary, the attending doctor is faced with making a choice from a multiplicity of antibiotic agents. A brief account of the main antibiotic agents currently available is given with comments on some of the disadvantages and complications attendant on their use. The potential dangers of staphylococcal sepsis and the need for rapid diagnosis and prompt vigorous treatment are stressed.
Sleep and Hypnotics
Authors: Lader M.
Published: January 2017

Sleep is an enigma and the clinical importance of disturbed sleep is not clear. Much has been learnt in the past 25 years of the physiology of normal and abnormal sleep. Complaints of insomnia can be related to several causes - normal extreme patterns, psychiatric, physical, specific and drug-related. The treatment of insomnia is essentially that of the primary condition. Hypnotics have a limited role and their use should always be carefully considered.
Intestinal Obstruction in Pregnancy
Authors: Milne B. , Johnstone M. S.
Published: January 2017

Intestinal obstruction is an unusual complication of pregnancy, but may be encountered more frequently in the future. Two patients with such a complication are described. Relief of the obstruction was achieved by surgical intervention in one patient and by delivery of a term baby in the other. The management of intestinal obstruction in late pregnancy is discussed.
Screening by Culture for the Detection of Gonorrhoea in Women
Authors: Young H. , Harris A. B. , Urquhart D. , Robertson D. H. H.
Published: January 2017

The number of gonoccal infections detected by each of three sets of diagnostic cultures from the urethra, cervix, rectum and occasionally the throat, were Calculated for 1976 when Thayer Martin (TM) medium was used and for 1977 when Modified New York City (MNYC) medium was used.

In [1977, 98.7 per cent (451/457) of the total infections diagnosed were confirmed by culture compared with 88.3 per cent (324/367) of infections diagnosed in 1976 (P<0.001). The first set of diagnostic tests detected 97.6 per cent (440/451) of culture-positive infections in 1977 compared with only 88.9 per cent (228/324) in 1976 (P<0.001). The efficiency of screening with a single endocervical culture was also calculated. This procedure would have detected 90.2 per cent (407/451) of culture-positive infections in 1977 when MNYC medium was used compared with only 78.1 per cent (253/324) in 1976 when TM medium was used (P<0.001). It is suggested that the statistically significant improvement in the culture results for 1977 resulted from the introduction of MNYC medium since all other diagnostic procedures were identical to those in 1976. Other advantages associated with the use of MNYC medium are discussed.
Liver Disease in Rheumatoid Arthritis
Authors: Mills P. R. , MacSween R. N. M. , Dick W. C. , More I. A. , Watkinson G.
Published: January 2017

Patients with active rheumatoid arthritis frequently have hepatosplenomegaly and biochemical features of hepatic disease. A prospective study with liver biopsy has been carried out in a series of 31 rheumatoid arthritis patients with clinical and/or biochemical evidence of hepatic dysfunction. Four of the 31 (13%) were found to have definable chronic liver disease, normal hepatic histology or non-specific reactive changes being found in the remainder. In the large majority of patients the hepatic abnormality in rheumatoid arthritis remains functional and unexplained.
Prevention of Skateboard Injuries
Authors: Morgan W. J. , Galloway D. J. , Patel A. R.
Published: January 2017

Skateboarding has become extremely popular in the United Kingdom, and it is estimated that over two million skateboards have been sold. Previous surveys have shown the dangers of the sport, fractures of the limbs being a particularly common form of injury. Consequently the provision of skateboard parks and the wearing of adequate protective clothing were considered necessary to reduce the severity of the injuries sustained. Our survey does not support this view, and suggests that fractures are more likely to occur in people with full protective clothing and skating in a park. The reasons for this are discussed. It is also suggested that expert instruction in the use of the skateboard has been neglected as a means of accident prevention.
Clinical Applications of Sodium Nitroprusside
Authors: MacRae W. R. , Hillis W. S.
Published: January 2017

Sodium nitroprusside has its place in two main spheres of medical practice. It is used for the production of deliberate hypotension during anaesthesia to reduce surgical bleeding, and in the management of the acute phase of certain cardiac conditions. This paper considers the value of the drug separately in these two clinical situations.
Infection after Depressed Fracture in the West of Scotland
Authors: Sande G. M. , Galbraith S. L. , McLatchie G.
Published: January 2017

Of 216 compound depressed fractures of the skull seen between the years 1974–1978, nine (4%) became infected. This is significantly less than the 10% found in previous years. Efforts are being intensified to train primary surgeons, stressing the importance of immediate referral and early treatment.
An Unusual Case of Maternal Death
Authors: Watson R. , Kennedy J. H.
Published: January 2017

A 21-year-old primigravid patient presented at 16 weeks gestation with rectal pain. She developed peritonitis at 36 weeks gestation. At laparotomy a very inflamed right fallopian tube and ovary was removed together with a healthy looking appendix. Premature labour occurred two days later with delivery of a stillborn infant. Her general condition deteriorated. On rectal biopsy a mucin secreting carcinoma, probably of secondary origin, was found. Shortly before her death a poorly differentiated adenocarcinoma of the breast was diagnosed.
Cervical Intraepithelial Neoplasia in Immunosuppressed Women after Renal Transplantation
Authors: Cordiner J. W. , Sharp F. , Briggs J. D.
Published: January 2017

All 26 immunosuppressed renal transplant females attending the Renal Unit at the Western Infirmary, Glasgow were screened by cervical cytology and colposcopy for evidence of cervical neoplasia. Five patients (19.2%) were discovered to have cervical intraepithelial neoplasia, confirming the expected increase in this ‘at risk’ group. Regular cervical screening in these immunosuppressed women is recommended strongly.
The Validity of Emergency Recommendations for Compulsory Psychiatric Care
Authors: Masterton G. , Newlands C. A. , Timbury G. C.
Published: January 2017

Retrospective scrutiny of the documents authorising 240 consecutive emergency detentions to a Glasgow psychiatric hospital over a three-year period revealed that 15 per cent were incorrectly completed. Fourteen documents (5.8%) failed to meet a list ofminimum requirements supplied by the Central Legal Office and were therefore invalid. Invalid documentation was associated with a failure to use the recommended form. In practice, these documents were recognised at the hospital of detention and patients were either properly detained, informally admitted, or in three cases, discharged.

It is suggested that doctors who make Emergency Recommendations without using the printedform should always discuss the wording oftheir letter with the receiving psychiatrist who should in turn be familiar with the six minimum requirements of the Central Legal Office.
Home Enteral Tube Feeding with a Liquid Diet in the Long Term Management of Inflammatory Bowel Disease and Intestinal Failure
Authors: Main A. N. H. , Morgan R. J. , Hall M. J. , Russell R. I. , Shenkin A. , Fell G. S.
Published: January 2017

A 35-year-old man, who had spent 10[Formula: see text] out of 18 months in hospital, has required repeated courses of intravenous nutrition (IVN) because of nutritional failure due to severe inflammatory bowel disease. He has been maintained on a nocturnal pump-fed liquid diet supplementing his day-time oral diet jar five months, four of which have been at home. The cost of such therapy is less than with an elemental diet and there are other advantages. This regime has been shown to be nutritionally adequate. The need to assess other cheaper liquid diets in patients with intestinal failure is recognised.
The Relevance of Spasticity to Function
Authors: McLellan D. L.
Published: January 2017

The particular and general features of spasticity are described, together with some reference to the physician's emphasis on changes in tone as opposed to the therapist's concentration on function. Spasticity is a complex phenomenon, impairing movement in various ways that depend partly upon the kinetics of the movement itself. Electromyographic recordings during voluntary movement may provide unexpected and useful information. The distinctive value of centrally and locally acting drugs in each of these circumstances is discussed.
The use of Bromocriptine in Ovulatory Infertility
Authors: Cooke I. D. , Lenton E. A.
Published: January 2017

Attention has been drawn to the particularly low fertility rate associated wth those infertile women who have no detectable abnormality as judged by classical gynaecological investigation. A proportion of these patients, defined as having ovulatory infertility, were shown to have deficient progesterone production during the early part of the luteal phase although the luteal phase was of normal length. This group of patients has also been shown to have a high incidence of transient hyperprolactinaemia, most of which occurs during the luteal phase. Although the use of bromocriptine has been associated with successful conception in some patients with ovulatory infertility the response is as yet unpredictable and a precise regime has still to be defined.
The Plasma Fibrinogen Level and Vascular Diseases
Authors: Lowe G. D. O. , Forbes C. D.
Published: January 2017

An increase in the level of plasma fibrinogen is associated with occlusive arterial diseases, venous thrombo-embolism and may precede disseminated intravascular coagulation. In addition fibrinogen levels may be predictive of fatal coronary artery disease and post-operative venous thrombosis. It is possible that fibrinogen may produce its effects by increase in blood and plasma viscosity, by arterial wall infiltration or by its effects on platelet function. Acute reduction in fibrinogen levels by ancrod (Arvin) alters all these parameters and may return them to normal. As yet no study has been carried out with long term reduction of fibrinogen by stanozolol but this is now feasible and such a trial is indicated.
The Potential of Fibrinolytic Therapy for Patients with Skin Disorders
Authors: Marks R. , Manna V.
Published: January 2017

Fibrin deposition is a major feature of the pathological findings in certain skin disorders including the stasis syndrome, cutaneous vasculitis and dermatitis herpetiformis. Depression of tissue fibrinolysis has been described in these disorders. This paper reviews the potential usefulness of fibrinolytic therapy for the above disorders and describes an animal model of a sloughing ulcer based on vascular damage which emulates the changes found in stasis. Topical streptokinase and streptodornase application was found to improve the rate of healing in the animal model and work is under way to assess other fibrinolytic agents including stanozolol.
The Management of Ureteroceles—A Review of 45 Patients
Authors: Clason A. E. , McGeorge A. , Wong A. L. , Davidson P.
Published: January 2017

The experience of 45 patients with 50 ureteroceles is reviewed. The ureteroceles occurred more commonly in females, presented in all age groups, and the commonest symptoms were those of urinary tract infection. The ureteroceles were identified on intravenous urography either as ‘negative’ filling defects in the bladder, or varying degrees of hydroureteronephrosis, and a high incidence of renal duplication was noted. Trans-urethral diathermy incision was effective treatment for 74 per cent of adult ureteroceles; the remaining adult and the paediatric patients requiring a variety of procedures ranging from no treatment to nephroureterectomy.
Gout and Pseudogout Precipitated by Parathyroidectomy
Authors: Kellett Hilary A. , MacLaren I. F. , Toft A. D.
Published: January 2017

It is uncommon for acute synovitis to be associated with the simultaneous presence within a joint of crystals of both monosodium urate and calcium pyrophosphate. We report a hypercalcaemic patient with gout and chondrocalcinosis in whom hypocalcaemia following removal of a parathyroid adenoma precipitated acute gout and pseudogout.