bluuebunny/crossref_metadata_2025 huggingface dataset:
Elaboración de una escala para medir Cultura del Honor
Authors: López-Zafra Esther
Published: January 2007

En el presente estudio se propone una escala que permita medir “Cultura del Honor”. Mediante este concepto, inicialmente proveniente de la Antropología y adoptado por la Psicología Social, se pretenden explicar las diferencias en cuanto a normas culturales existentes entre grupos sociales que hacen que las justificaciones sobre actos de violencia cometidos hacia determinados grupos sociales, e.g. mujeres, se basen en el honor y en el mantenimiento del orden social de predominancia de un grupo sobre otro.

Sin embargo, no existe una escala que nos permita medir directamente el nivel en el que es importante para una persona. Además, los análisis actuales se basan en estudios sobre actitudes hacia la violencia y experimentos sobre reacciones ante una ofensa.

Utilizando las técnicas de análisis de ítems, análisis factoriales explotarorios así como la fiabilidad del instrumento conseguimos proponer una escala final compuesta por 17 ítems que forman tres factores para medir la importancia individual de la cultura del honor.
La violencia en el deporte. Un análisis desde la Psicología Social
Authors: Gómez Ángel
Published: January 2007

El deporte es una manifestación cultural de primer orden en las sociedades contemporáneas. El hecho de que vaya acompañado en muchas ocasiones de explosiones de violencia es motivo de preocupación. En el presente trabajo se defiende que la violencia en el deporte tiene su propia naturaleza y que no es asimilable a la violencia en general. Se señala que los factores psicosociales desempeñan un importante papel en su manifestación y que se pueden utilizar para conseguir su eliminación o reducción. Este puede parecer hoy un objetivo lejano, pero, pese a ello, es algo que vale la pena.
Review: Glutamate and dopamine dysregulation in schizophrenia — a synthesis and selective review
Authors: Stone James M. , Morrison Paul D. , Pilowsky Lyn S.
Published: January 2007

The dopamine hypothesis of schizophrenia is the principal explanatory model of antipsychotic drug action. Recent discoveries extend our understanding of the neurochemistry of schizophrenia, with increasing evidence of dysfunction in glutamate and GABA as well as dopamine systems. In this review, we study the evidence for dopaminergic dysfunction in schizophrenia, drawing data from neurochemical imaging studies. We also review the NMDA receptor hypofunction hypothesis of schizophrenia as a supplementary explanatory model for the illness. We examine predictions made by the NMDA receptor hypofunction hypothesis and consider how they fit with current neurochemical findings in patients and animal models. We consider the case for glutamatergic excitotoxicity as a key process in the development and progression of schizophrenia, and suggest ways in which glutamate and dopamine dysregulation may interact in the condition.
An inverse relationship between typical alcohol consumption and facial symmetry detection ability in young women
Authors: Oinonen Kirsten A. , Sterniczuk Roxanne
Published: January 2007

The relationship between monthly alcohol consumption over the past 6 months and facial symmetry perception ability was examined in young sober women with typical college-age drinking patterns. Facial symmetry detection performance was inversely related to typical monthly alcohol consumption, r (41) = —0.57, p < 0.001. Other variables that were predictive of facial symmetry detection included alcohol-related hangover and blackout frequency over the past 6 months, number of alcoholic drinks over the past week, early adolescent alcohol consumption and frequency of drug use. The relationship between alcohol use and symmetry detection could not be explained by individual differences in personality, family alcoholism history or other drug use. These findings suggest the possibility of a neurotoxic effect of alcohol on facial symmetry perception ability in female undergraduate students. As similar results did not emerge for a test of dot symmetry detection, the findings appear specific to facial symmetry. No previous studies have examined the effect of alcohol history on symmetry detection. The findings add to a growing literature indicating negative visuospatial effects of early alcohol use, and suggest the importance of further research examining alcohol and drug effects on sober facial perception in non-alcoholic populations.
Transmission disequilibrium analysis of the functional 5-HT3A receptor variant C178T in early-onset obsessive—compulsive disorder
Authors: Mössner Rainald , Döring Nicole , Scherag André , Schäfer Helmut , Herpertz-Dahlmann Beate , Remschmidt Helmut , Schulz Eberhard , Renner Tobias , Wewetzer Christoph , Warnke Andreas , Lesch Klaus-Peter , Walitza Susanne
Published: January 2007

The 5-HT3 receptor is unique among the serotonin receptors in that it is a ligand-gated ion channel. Dysfunction of the serotonin system is thought to contribute to the pathogenesis of obsessive—compulsive disorder (OCD). Apart from the standard treatment with serotonin reuptake inhibitors and behavioural therapy, a 5-HT3 receptor antagonist has recently been shown to benefit some OCD patients, suggesting the 5-HT3 receptor as a serotonergic candidate gene in the polygenic aetiology of OCD. A functional regulatory variant of the 5-HT3A receptor influences 5-HT 3 receptor expression, serotonin metabolites in cerebrospinal fluid, and amygdala reactivity. We therefore assessed whether this C178T variant influences the risk of developing OCD. In a family-based approach employing the transmission disequilibrium test, we analysed a unique sample of 75 children and adolescents with OCD, as well as their biological parents. We found no evidence for a preferential transmission of either allele to the patients — the estimated transmission rate for the C allele was 0.51 (95% CI 0.36—0.65). This argues against an involvement of the 5-HT3A receptor in the polygenic aetiology of early-onset OCD.
Lorazepam induces multiple disturbances in selective attention: attentional overload, decrement in target processing efficiency, and shifts in perceptual discrimination and response bias
Authors: Michael George Andrew , Bacon Elisabeth , Offerlin-Meyer Isabelle
Published: January 2007

There is a general consensus that benzodiazepines affect attentional processes, yet only few studies have tried to investigate these impairments in detail. The purpose of the present study was to investigate the effects of a single dose of Lorazepam on performance in a target cancellation task with important time constraints. We measured correct target detections and correct distractor rejections, misses and false positives. The results show that Lorazepam produces multiple kinds of shifts in performance, which suggests that it impairs multipLe processes: (a) the evolution of performance over time was not the same between the placebo and the Lorazepam groups, with the Lorazepam affecting performance quite early after the beginning of the test. This is suggestive of a depletion of attentional resources during sequential attentional processing; (b) Lorazepam affected differently target and distractor processing, with target detection being the most impaired; (c) misses were more frequent under Lorazepam than under placebo, but no such difference was observed as far as false positives were concerned. Signal detection analyses showed that Lorazepam (d) decreased perceptual discrimination, and (e) reliably increased response bias. Our results bring new insights on the multiple effects of Lorazepam on selective attention which, when combined, may have deleterious effects on human performance.
A single dose of citalopram increases fear recognition in healthy subjects
Authors: Browning M. , Reid C. , Cowen P.J. , Goodwin G.M. , Harmer C.J.
Published: January 2007

We have previously shown that a single dose of intravenous citalopram in healthy volunteers enhances the detection of fearful facial expressions, suggesting an effect of acute selective serotonin re-uptake inhibitor (SSRI) treatment on the processing of anxiety-related stimuli. The aim of the present study was to confirm and extend this finding by studying the effects of a single dose of oral citalopram on a range of tasks designed to assess different aspects of emotional processing.

A total of 32 healthy volunteers were randomly allocated to double-blind treatment with either citalopram 20 mg orally or placebo. Participants then completed a series of tasks assessing emotional aspects of attention (visual-probe task), perception (categorization of facial affect), memory (emotional memory task) and reactivity to threat (emotion potentiated startle).

Relative to placebo-treated subjects, participants treated with citalopram demonstrated improved recognition of fearful faces and increased baseline startle response. However, the citalopram group also showed an attentional bias towards positive words.

Our data suggest that acute oral citalopram increases the processing of anxiety-related stimuli in healthy volunteers. This mechanism could underlie the known tendency of SSRIs to increase anxiety in patients early in treatment. Our data also suggests that some of the positive biases in emotional processing produced by SSRI treatment might be detectable at the beginning of treatment.
Rhodiola rosea L. extract reduces stress- and CRF-induced anorexia in rats
Authors: Mattioli Laura , Perfumi Marina
Published: January 2007

Rhodiola rosea l. is one of the most popular adaptogen and anti-stress plants in European and Asiatic traditional medicine. Its pharmacological properties appear to depend on its ability to modulate the activation of several components of the complex stress-response system. Exposure to both physical and psychological stress reduces feeding in rodents. The aim of this work was thus to determine whether in rats an hydroalcoholic R. rosea extract standardized in 3% rosavin and 1% salidroside (RHO) reverses hypophagia induced by (1) physical stress due to 60 min immobilization; (2) intracerebroventricular injection of corticotrophin-releasing factor (CRF, 0.2 μg/rat), the major mediator of stress responses in mammals; (3) intraperitoneal injection of Escherichia coli Lipopolysaccharide (LPS, 100 μg/kg); (4) intraperitoneal administration of fluoxetine (FLU, 8 mg/kg). The effect of the same doses of the plant extract was also tested in freely-feeding and in 20 h food-deprived rats. RHO was administered acutely by gavage to male Wistar rats 1 h before the experiments. The results show that at 15 and 20 mg/kg, RHO reversed the anorectic effects induced both by immobilization and by intracerebroventricular CRF injection. Moreover, at the same doses, RHO failed to reduce the anorectic effect induced both by LPS and FLU, and did not modify food intake in both freely-feeding and food-deprived rats. These findings strongly demonstrated that RHO is able selectively to attenuate stress-induced anorexia, providing functional evidence of claimed adaptogen and anti-stress properties of Rhodiola rosea L.
Placental transfer of quetiapine in relation to P-glycoprotein activity
Authors: Rahi Melissa , Heikkinen Tuija , Härtter Sebastian , Hakkola Jukka , Hakala Kristo , Wallerman Ola , Wadelius Mia , Wadelius Claes , Laine Kari
Published: January 2007

Atypical antipsychotic drugs are well tolerated and thus often preferred in women of fertile age; yet the information on their placental transfer and use during the prenatal period is limited. The aim of this study was to study the placental transfer of quetiapine, a widely used atypical antipsychotic, with special reference to the role of the placental transporter protein, P-glycoprotein (P-gp). This was performed in 18 dually perfused placentas, using the well established P-gp inhibitors PSC833 (valspodar) and GG918 to inhibit the function of P-gp. We also aimed to clarify the significance of two potentially functional ABCB1 single nuclear polymorphisms (SNPs), 2677G> T/A and 3435C> T, on the transplacental transfer (TPT) of quetiapine. The placental transfer of quetiapine in the control group as measured by TPTAUC % (absolute fraction of the dose crossing placenta) was 3.7%, which is 29% less than the transfer of the freely diffusible antipyrine, which was 5.2%. The P-gp inhibitors had no significant effect on the transfer of quetiapine as measured by TPTAUC % ( P = 0.77). No correlation was found between the transplacental transfer of quetiapine (TPTAUC %) and placental P-gp expression ( P = 0.61). The 3435T allele in exon 26 was associated with significantly higher placental transfer of quetiapine ( P = 0.04). We conclude that quetiapine passes the human placenta but that the blood—placental barrier partially limits the transplacental transfer of quetiapine. Administration of P-gp inhibiting drugs with quetiapine is not likely to increase fetal exposure to quetiapine, although the ABCB1 C3435T polymorphism may contribute to inter-individual variation in fetal exposure to quetiapine.
Measuring similarities between gene expression profiles through new data transformations
Authors: Kim Kyungpil , Zhang Shibo , Jiang Keni , Cai Li , Lee In-Beum , Feldman Lewis J , Huang Haiyan
Published: January 2007

Background

Clustering methods are widely used on gene expression data to categorize genes with similar expression profiles. Finding an appropriate (dis)similarity measure is critical to the analysis. In our study, we developed a new measure for clustering the genes when the key factor is the shape of the profile, and when the expression magnitude should also be accounted for in determining the gene relationship. This is achieved by modeling the shape and magnitude parameters separately in a gene expression profile, and then using the estimated shape and magnitude parameters to define a measure in a new feature space.

Results

We explored several different transformation schemes to construct the feature spaces that include a space whose features are determined by the mutual differences of the original expression components, a space derived from a parametric covariance matrix, and the principal component space in traditional PCA analysis. The former two are the newly proposed and the latter is explored for comparison purposes. The new measures we defined in these feature spaces were employed in a K-means clustering procedure to perform analyses. Applying these algorithms to a simulation dataset, a developing mouse retina SAGE dataset, a small yeast sporulation cDNA dataset, and a maize root affymetrix microarray dataset, we found from the results that the algorithm associated with the first feature space, named TransChisq, showed clear advantages over other methods.

Conclusion

The proposed TransChisq is very promising in capturing meaningful gene expression clusters. This study also demonstrates the importance of data transformations in defining an efficient distance measure. Our method should provide new insights in analyzing gene expression data. The clustering algorithms are available upon request.
Transient trimethylaminuria related to menstruation
Authors: Shimizu Makiko , Cashman John R , Yamazaki Hiroshi
Published: January 2007

Background

Trimethylaminuria, or fish odor syndrome, includes a transient or mild malodor caused by an excessive amount of malodorous trimethylamine as a result of body secretions. Herein, we describe data to support the proposal that menses can be an additional factor causing transient trimethylaminuria in self-reported subjects suffering from malodor and even in healthy women harboring functionally active flavin-containing monooxygenase 3 (FMO3).

Methods

FMO3 metabolic capacity (conversion of trimethylamine to trimethylamine N-oxide) was defined as the urinary ratio of trimethylamine N-oxide to total trimethylamine.

Results

Self-reported Case (A) that was homozygous for inactive Arg500stop FMO3, showed decreased metabolic capacity of FMO3 (i.e., ~10% the unaffected metabolic capacity) during 120 days of observation. For Case (B) that was homozygous for common [Glu158Lys; Glu308Gly] FMO3 polymorphisms, metabolic capacity of FMO3 was almost ~90%, except for a few days surrounding menstruation showing < 40% metabolic capacity. In comparison, three healthy control subjects that harbored heterozygous polymorphisms for [Glu158Lys; Glu308Gly] FMO3 or homozygous for wild FMO3 showed normal (> 90%) metabolic capacity, however, on days around menstruation the FMO3 metabolic capacity was decreased to ~60–70%.

Conclusion

Together, these results indicate that abnormal FMO3 capacity is caused by menstruation particularly in the presence, in homozygous form, of mild genetic variants such as [Glu158Lys; Glu308Gly] that cause a reduced FMO3 function.
Immune-mediated changes in actinic keratosis following topical treatment with imiquimod 5% cream
Authors: Torres Abel , Storey Leslie , Anders Makala , Miller Richard L , Bulbulian Barbara J , Jin Jizhong , Raghavan Shalini , Lee James , Slade Herbert B , Birmachu Woubalem
Published: January 2007

Background

The objective of this study was to identify the molecular processes responsible for the anti-lesional activity of imiquimod in subjects with actinic keratosis using global gene expression profiling.

Methods

A double-blind, placebo-controlled, randomized study was conducted to evaluate gene expression changes in actinic keratosis treated with imiquimod 5% cream. Male subjects (N = 17) with ≥ 5 actinic keratosis on the scalp applied placebo cream or imiquimod 3 times a week on nonconsecutive days for 4 weeks. To elucidate the molecular processes involved in actinic keratosis lesion regression by imiquimod, gene expression analysis using oligonucleotide arrays and real time reverse transcriptase polymerase chain reaction were performed on shave biopsies of lesions taken before and after treatment.

Results

Imiquimod modulated the expression of a large number of genes important in both the innate and adaptive immune response, including increased expression of interferon-inducible genes with known antiviral, anti-proliferative and immune modulatory activity, as well as various Toll-like receptors. In addition, imiquimod increased the expression of genes associated with activation of macrophages, dendritic cells, cytotoxic T cells, and natural killer cells, as well as activation of apoptotic pathways.

Conclusion

Data suggest that topical application of imiquimod stimulates cells in the skin to secrete cytokines and chemokines that lead to inflammatory cell influx into the lesions and subsequent apoptotic and immune cell-mediated destruction of lesions.
Abbreviated method of determining vein volume in balloon-controlled vein ablation
Authors: Raines J K , de Quevedo W Garcia , Jahrmarkt S , Mackay E , Morrison N , Almeida- J I
Published: January 2007

Traditional surgical ligation and stripping for the treatment of saphenous vein incompetence has been replaced by minimally invasive alternative treatments during the last five years. Endovenous ablation with radiofrequency (RP) and laser (EVL) have proven to be safe, durable, and widely accepted by patients. Catheter-delivered sclerotherapy (CDS) with foam and liquid for ablation of the great saphenous vein is also under investigation. In this technique, vein volume must be measured accurately by ultrasound just prior to the procedure and can require up to 11 diameter measurements. The purpose of this study was to identify an abbreviated method of determining vein volume to expedite associated endovenous procedures. Seventy-five veins were treated in 55 subjects with catheter-directed sclerotherapy in a three-center clinical study using a standardized protocol. Vein volume was carefully calculated by determining vein diameter over the Treatment Length in 4 cm intervals. These measurements were compared to vein volume calculations where only three measurements were taken. Our results suggest that the abbreviated method is capable of significantly reducing the number of diameter measurements without sacrificing accuracy. We found the method produced a vein volume that fell within 1 mL or 15% of the actual vein volume in 80% of cases. The abbreviated method cannot be used with accuracy in veins that are Erratic.
Can preoperative duplex marking of the saphenopopliteal junction be avoided?
Authors: Kambal A A , Najem M , Jacobs D , Modaresi K , Smart P , Renton S , Hussain S T
Published: January 2007

Objectives: Patients undergoing saphenopopliteal junction (SPJ) surgery are currently subjected to two duplex scans. The first is to confirm the reflux, and the second is done preoperatively to accurately mark the SPJ for surgery. The aim of this study was to assess whether the use of hand-held Doppler (HHD) can substitute the second duplex scan.

Methods: Sixty limbs with suspected SPJ reflux were studied. Patients underwent an initial duplex scan. The report detailed the position of SPJ in relation to popliteal crease. Guided by this, a HHD was then used to mark the SPJ. Deviation of the HHD mark from the duplex one of ≤10 mm was considered acceptable for surgical accuracy.

Results: HHD accurately localized all 27 patients with SPJ reflux (100% accuracy). The distances between the HHD and duplex points in this group ranged between 0 and 5 mm (median=0). Twenty-five patients had SPJ with no reflux, and 22 of them were accurately localized (88%). The distances between the two points in the latter group ranged between 0 and 16 mm (median=3).

Conclusion: HHD, guided by the routine duplex scan, can accurately mark SPJ with reflux. A second duplex is not required for marking prior to surgery. This will reduce the workload of the vascular laboratory.
Prevalence and management of ovarian venous insufficiency in the presence of leg venous insufficiency
Authors: Sutaria R , Subramanian A , Burns B , Hafez H
Published: January 2007

Objective: The correlation between ovarian venous insufficiency and lower limb venous insufficiency remains poorly understood. Clinically, incompetent ovarian veins in association with lower extremity varicose veins are suspected when leg varicose veins are found in atypical distributions. Such distributions include upper lateral or posterior thigh, on the buttocks, crossing the inguinal ligament, and also in the vulval or perineal regions. The aim of this study was to determine the prevalence of ovarian venous insufficiency in those with clinically suspicious varicose veins, and to assess the effectiveness of ovarian venous embolization/ligation in treating this condition.

Methods: Between June 2001 and December 2004, 424 female patients with lower limb superficial venous insufficiency were seen by a single vascular surgeon. These patients were clinically assessed, and those with atypical varicose veins were investigated with venous duplex examination and magnetic resonance imaging (MRI) venography. Patients with proven ovarian venous insufficiency were offered venography with a view to embolization or laparoscopic ligation.

Results: A total of seven patients were clinically suspected of having ovarian venous insufficiency, of which three had recurrent varicose veins (42.9%). Of these, six were confirmed on MRI venography with the left side being more affected than the right; one of them had an occluded vena cava, three were treated by embolization, and two had laparoscopic ligation.

Discussion: The prevalence of clinically detectable ovarian venous insufficiency in association with lower extremity varicose veins is in the region of 1.65%. Compared with the estimated prevalence of incidental ovarian venous insufficiency of 10–47%, this suggests that only a minority of incompetent ovarian veins will present with clinically detectable lower limb venous insufficiency. In our opinion, patients with signs suggestive of ovarian venous insufficiency in association with lower limb venous insufficiency should have their ovarian insufficiency controlled prior to embarking on limb venous surgery.
Quantification of venous reflux parameters using duplex scanning and air plethysmography
Authors: Yamaki T , Nozaki M , Sakurai H , Takeuchi M , Kono T , Soejima K
Published: January 2007

Objective: To compare different duplex-and air plethysmography (APG)-derived parameters between patients with relatively early and those with advanced chronic venous insufficiency (CVI), and to investigate the indicative parameters reflecting the progression of CVI.

Methods: Design: Prospective study at the University Hospital. Patients: In total 686 limbs in 574 patients at various clinical stages of CVI were included. The clinical manifestations were categorized according to the CEAP (clinical, aetiologic, anatomic and pathophysiologic) classification, and the patients were divided into two groups: group I (C1-3EP,SAS,D,PPR,O, relatively early stage of CVI) and group II (C4-6EP,SAS,D,PPR,O, advanced CVI). The distribution of venous insufficiency including the sapheno-femoral junction (SFJ), great saphenous vein (GSV), sapheno–popliteal junction (SPJ), common femoral vein (CFV), femoral vein (FV), popliteal vein (POPV), thigh perforators (TPV) and calf perforators (CPV) was determined by duplex ultrasound. The main duplex-derived parameters assessed were the reflux time (RT; s), peak reflux velocity (PRV; cm/s) and peak reflux flow (PRF; mL/s). The venous reflux was assumed to be present if the duration of reflux was ≥0.5 s. The data obtained by APG were on VV (mL), VFI (mL/s), EF (%) and RVF (%).

Results: There was no significant difference in overall superficial venous reflux between the groups ( P=0.331). The frequency of deep and perforating vein incompetence differed only when superficial reflux was included in group II. The VFI and RVF were significantly higher in secondary CVI than in primary CVI ( P=0.0001, 0.003, respectively). In the secondary CVI, patients with reflux and obstruction showed significantly higher RVF than those with reflux alone ( P=0.003). The RT did not improve the discrimination power between the groups. In contrast, the PRV had significant discrimination power at the SFJ ( P<0.0001) and SPJ ( P=0.022), and in the GSV ( P<0.0001), the FV ( P=0.017), and the POPV ( P=0.0003). The PRF was significantly higher in group II at the SFJ ( P<0.0001), in the GSV ( P=0.002), in the CFV ( P=0.011), in the FV ( P=0.027), and the POPV ( P=0.016).

Conclusions: This present study has suggested the importance of superficial venous insufficiency in the development of advanced CVI. In the secondary CVI, obstruction affects the RVF alone. The PRV and PRF are better parameters than the RT for discrimination of clinical severity in both superficial and deep venous insufficiency, and should be used to quantify venous valvular insufficiency.
Is venous reflux a common disease in post-thrombotic patients with unilateral deep vein thrombosis episode?
Authors: Asbeutah A M , Asfar S K , Shawaz N J , Al-Muzaini A F , Cameron J D , McGrath B P
Published: January 2007

Objectives: To investigate reflux development and changes in resting venous diameters in the DVT and the non-DVT lower limbs.

Methods: Twenty subjects (40 limbs) with acute unilateral proximal DVT diagnosed by ultrasound, who were treated with low-molecular-weight-heparin (LMWH), followed by at least three months of oral warfarin therapy, were enrolled in the study. The limbs were classified according to CEAP (clinical, aetiologic, anatomic, pathophysiology) clinical classification on a scale of 0–6. Duplex ultrasound (DUS) was employed to assess DVT resolution, vein diameter and venous reflux in both limbs at intervals of zero, three, six and 12 months. Venous reflux was defined as a valve closure time more than 1 s.

Results: There were 13 men and seven women, average age was 40.8 years and average body mass index 27.7 kg/m2. In the DVT limbs at three, six and 12 months, deep veins were non-occluded in 40%, 60% and 85%, respectively. By 12 months, 16 (80%) had developed venous reflux, mostly in the femoral (FV) and popliteal veins (PV); eight limbs (40%) were in clinical classes 4–6. In the contralateral 20 non-DVT limbs, four limbs developed borderline reflux at the sapheno-femoral junction (SFJ) after six months and mean diameters of SFJ, FV and PV increased significantly.

Conclusions: Venous reflux is highly likely to occur in DVT limbs within a year follow-up period. Venous dilatation can occur in the contralateral unaffected lower limb, consistent with a systemic effect. Our results are suggestive and further studies are needed.
Common peroneal nerve injury as a complication of short saphenous vein surgery
Authors: Atkin G K , Round T , Vattipally V R , Das S K
Published: January 2007

Objectives: To determine the incidence of common peroneal nerve (CPN) injury following short saphenous vein surgery (SSV) in a UK district general hospital, and establish possible risk factors, and preventative strategies to minimize the risk of nerve injury following this type of surgery.

Methods: Retrospective review of all cases of SSV surgery performed in a single institution during the period January 2002–October 2004.

Results: Sixty-four patients underwent SSV surgery during the review period. Three patients (4.7%) developed a CPN injury postoperatively. One patient recovered fully after 24 h, whereas the other two patients' symptoms recovered within six months. All three patients had a saphenopopliteal junction (SPJ) located high above the popliteal skin crease.

Conclusions: CPN injury during SSV surgery occurs with an appreciable frequency. In view of this, there is a need for a revised approach to the management of SSV disease, possibly incorporating less-invasive techniques such as endovenous closure.
Rapid healing of chronic venous ulcers following ultrasound-guided foam sclerotherapy
Authors: Hertzman P A , Owens R
Published: January 2007

Objective: To measure the short term response of venous ulcers in patients treated with ultrasound-guided foam sclerotherapy (UGFS) at a two-week clinic in Honduras.

Methods: Nine females (ages 25-86; mean 48.1 years) with 13 venous ulcers and saphenofemoral junction reflux were treated with UGFS (polidocanol 3% foam; 1–4 injections; 2–11 cc; Mean Volume 5.4 cc). The dimensions of each ulcer and of the great saphenous vein (GSV) were measured before treatment and one week later.

Results: At one week follow-up 2 ulcers healed, 2 GSVs closed, and there was significant improvement in ulcer dimensions (p=0.00) and size of GSV (p=0.00).

Conclusions: Venous ulcers in patients with serve venous insufficiency responded quickly to UGFS. Long-term follow-up will be important to determine the sustainability of these results.
Remote patient–provider communication and quality of life: empirical test of a dialogic model of cancer care
Authors: Chumbler Neale R , Mkanta William N , Richardson Lisa C , Harris Linda , Darkins Adam , Kobb Rita , Ryan Patricia
Published: January 2007

We examined the feasibility of a Cancer Care Dialogues Model, with daily telehealth interactions between patients at home and their care coordinator, who acted as an adjunct to the oncologist. The patient and the care coordinator used a home messaging device, connected via the ordinary telephone network. Thirty-four patients with a new diagnosis of cancer and whose treatment plan included chemotherapy taken at a single clinic were enrolled and followed for six months. The home messaging device collected information daily on common symptoms associated with chemotherapy. On average, the patients had the home messaging device for 120 days (range 30–180). The mean cooperation rate was 84% (range 4–100). No variables were significantly associated with patient cooperation in the dialogues over time. The health-related quality of life (HRQL) mean score at baseline was 73.9 (SD 15.4), and the mean score at six months was 78.4 (SD 14.5). After adjusting for demographic and clinical factors, there was a 6.5-point increase in HRQL score between the baseline and end of treatment, which represented an important clinical difference. Management of nervousness/worry over time through cancer care dialogues is important in maintaining HRQL and can be assisted by remote home messaging.
Equivalence of functional communication assessment in speech pathology using videoconferencing
Authors: Palsbo Susan E
Published: January 2007

We examined the equivalence of videoconferencing assessment of communication by speech-language pathologists (SLPs). Using a randomized, double-crossover agreement study, 24 post-stroke patients were randomized to a remote or face-to-face administration of a subset of the Boston Diagnostic Aphasia Examination and to remote or face-to-face assessment of speech comprehension, speech expression and motor speech. The videoconferencing equipment was operated at a transmission speed of 384 kbit/s. Each patient was simultaneously scored by both the face-to-face and the remote SLPs. SLPs were blind to each other's results. Percentage agreement within the 95% limits of agreement ranged from 92% to 100% for each functional communication measure, regardless of assessment site and administration of the aphasia examination. The results suggest that assessment of a patient's functional communication using videoconferencing is equivalent to a face-to-face encounter.
Post-surgical telehealth support for children and family care-givers
Authors: Young Lynne , Siden Harold , Tredwell Stephen
Published: January 2007

Early discharge of children following surgery shifts the burden of care from professionals in hospital to family care-givers at home. We evaluated the relative effectiveness of telephone and videophone follow-up for children and families after a child's scoliosis surgery. Fourty-three patients and their families were enrolled in the study with 21 dyads receiving videophone and 22 dyads telephone support. At discharge, those in the intervention arm were provided with a videophone operating on the ordinary telephone network (PSTN). Data were gathered during telehealth contact on post-discharge day 3 and during extra calls with the clinic nurse, and during sessions with a research assistant comprising a follow-up call and an interview at the six-week post-surgical visit. Calls and interviews were recorded and transcribed. Data were analysed using constant comparative analysis. The results showed that videophone and telephone use provided care continuity for patients and their families following a child's back surgery. The relative effect of the videophone and telephone technology depended on the fit between the characteristics of the patients and families and the capacities of the technology. When implementing telehealth for follow-up care, a participatory process is recommended to ensure a fit between user characteristics and technology.
Human factors considerations in implementing telemedicine systems to accommodate older adults
Authors: Stronge Aideen J , Rogers Wendy A , Fisk Arthur D
Published: January 2007

The number of older adults is increasing, and telemedicine has the potential to improve their access to health care. Telemedicine systems have been shown to benefit older adults by increasing peer support interactions, providing health-care access to older adults in rural communities, reducing the cost of health care, increasing exercise, reducing pain and depression, and, perhaps most important, improving functional independence. However, older adults may have different needs from other users when interacting with telemedicine systems, because of age-related changes in perceptual, motor and cognitive abilities. The design of telemedicine technologies should, therefore, capitalize on older adults' strengths while minimizing their weaknesses. The field of human factors has much to offer in optimizing interactions between older adults and telemedicine technologies. Future research should take advantage of human factors methodologies to best design telemedicine technologies for an older population.
Home telecare during intensive insulin treatment – metabolic control does not improve as much as expected
Authors: Ładyżyński Piotr , Wójcicki Jan M
Published: January 2007

We examined the influence of the increased frequency of data reporting on metabolic control in patients with diabetes. Data reporting was via a home telecare system that stored blood glucose values and was integrated with a simple electronic logbook. The data collected by the patient were automatically transmitted via the telephone network every night. The study population consisted of 30 patients with type I diabetes, who were randomly allocated to the home telecare group or the control group. The control group was treated based on clinical examinations performed every three weeks. In the home telecare group, the patient-collected data were transmitted to hospital daily, enabling more frequent interventions by the doctor. The average study period was 180 days (SD 22) in the home telecare group and 176 days (SD 16) in the control group. The mean level of metabolic control and the insulin dose adjustment patterns were very similar in both groups regardless of the much higher (15 times) reporting frequency in the home telecare group. The patient-collected data were not fully utilized, mainly because of too high within-day variability in glycaemic control and the high workload connected with daily data analysis.
An economic analysis of the EHAS telemedicine system in Alto Amazonas
Authors: Martínez Andrés , Villarroel Valentín , Puig-Junoy Jaume , Seoane Joaquín , del Pozo Francisco
Published: January 2007

Telemedicine systems providing voice communication and email by radio were installed at seven health centres (HCs) and 32 health posts (HPs) in the Alto Amazonas province of Peru during 2001. A cost analysis was performed to estimate the net effect on direct resource consumption from the perspective of society. Prior to the availability of the EHAS telemedicine system, there was a mean of 11.1 urgent patient referrals per year from the HPs and 14.0 referrals per year from the HCs. After the implementation of telemedicine, patient referrals fell to 2.5 per year from the HPs ( P = 0.03) and to 8.4 per year from the HCs ( P = 0.17). The net economic effect of the telemedicine programme over a four-year period was clearly positive, amounting to annual net savings of US$320,126 (using a 5% discounting rate). A one-way sensitivity analysis using a range of values for the discounting rate, and the number of urgent referrals, confirms that the programme was efficient (i.e. it made net financial savings) in all cases. From the restricted budgetary perspective of the health network, the results also demonstrate that the additional operational costs (telephone and maintenance) introduced by the telemedicine system were lower than the direct cost-savings produced for the health-care network.
Store-and-forward teledermatology results in similar clinical outcomes to conventional clinic-based care
Authors: Pak Hon , Triplett Crystal A , Lindquist Jennifer H , Grambow Steven C , Whited John D
Published: January 2007

We compared the clinical outcomes after store-and-forward teledermatology with those following conventional clinic-based consultation. Subjects were randomized to either usual care (a conventional clinic-based dermatology appointment) or a store-and-forward teledermatology consultation. All subjects received baseline digital imaging and re-imaging was performed four months later. A total of 776 subjects were approached for inclusion, and a total of 508 image sets were reviewed, 236 in usual care and 272 in teledermatology. The image sets from both study arms were used to make clinical outcome assessments between baseline and four months. A dermatologist who was blinded to the randomization rated the clinical outcomes using a three-point clinical course rating scale (1 = improved, 2 = no change, 3 = worse). In the usual care group, 65% were rated as 'improved', 32% were rated as 'no change' and 3% were rated as 'worse'. For teledermatology, 64% were rated as 'improved', 33% as 'no change' and 4% as 'worse'. The results of the study indicate that store-and-forward teledermatology consultations produce similar clinical outcomes when compared with conventional clinic-based consultations.
Telemedicine for a Children's Field Hospital in Chechnya
Authors: Ehrlich A I , Kobrinsky B A , Petlakh V I , Rozinov V M , Shabanov V E
Published: January 2007

In 2001, the Children's Field Hospital in the Gudermes area of the Chechen Republic was connected to a telemedical centre at the Scientific Institute of Pediatrics and Children's Surgery in Moscow, via the Russian SCA HeliosNet satellite system. An asymmetric satellite link, in which there was a high-speed downlink from the satellite to Gudermes and a low-speed uplink from Gudermes to the satellite was used. In total, 179 teleconsultations were carried out from October 2001 until February 2002, when the field hospital was closed. Of the 179 teleconsultations, 26 were real-time, by videoconference and the rest were asynchronous, by email. Almost half of consultations were carried out for emergency or urgent reasons, thus demonstrating the value of providing access to the necessary experts. The use of satellite communication allowed telemedical support for medical decisions in a wide range of disease and trauma in children and teenage in a conflict situation.
Implementation and evaluation of a low-cost telemedicine station in the remote Ecuadorian rainforest
Authors: Cone Stephen W , Hummel Russell , León Juan , Merrell Ronald C
Published: January 2007

A clinical workstation was developed to provide basic telemedicine services in a medical clinic in rural Ecuador. The unit cost was less than $1000. The system provided videoconferencing and a Spanish language electronic medical record (EMR) for clinic consultations. All partners participated in the development of the EMR. Over a six-month period, almost all new patient encounters and ultrasound studies were entered into the EMR. Of 2387 patient encounters, 572 were recorded in electronic format and 80% were transmitted over the Internet for consultation. Four hundred and eight ultrasound studies were filed with the EMR and 90% were transmitted over the Internet for shared evaluation. During the six months of the study, there were no serious software or hardware problems. The doctor in Ecuador was initially trained at the laboratory in the USA. The two sites were in contact by email almost daily. Without such interaction, the performance of the software and hardware would probably have been worse. When a structured programme of instruction, protocols, EMR and technology support is in place, telemedicine can support remote rural practice.
Perception of eye contact in video teleconsultation
Authors: Tam Tony , Cafazzo Joseph A , Seto Emily , Salenieks Mary Ellen , Rossos Peter G
Published: January 2007

During patient consultations by videoconferencing, clinicians often sit as close as 1 m from the videoconferencing units, creating a significant eye gaze angle (i.e. the angle between the eye and the camera, and the eye and the centre of the display). Eye gaze angle may adversely affect the satisfaction with videoconferencing. Four videoconferencing environments were examined: desktop PC, portable telehealth unit, videoconferencing room, and a boardroom equipped with a ceiling-mounted camera and a projection screen. Two still images of each of the three subjects were captured: one at a 7° eye gaze angle and the other at 15°. Each of 53 observers ranked four pairs of images for each of the three subjects. In 87% of cases, the observers perceived better eye contact at an eye gaze angle of 7° than 15°. Also, 92% of observers responded that the difference in the perceived eye contact was important to them as patients. Improved eye contact can be realized by increasing the horizontal distance of participants from the videoconferencing unit.
would you like to see yours?
Authors: Antoniou A , Saunders MP , Bourner R , Crouch L
Published: January 2007

In 2001 the Health and Social Care Act was published. In Part 5 of this document it is stated that 'The Secretary of State may… make such provision for and in connection with requiring or regulating the processing of prescribed patient information for medical purposes as he feels necessary or expedient… in the interests of improving patient care'. Furthermore, such provision may involve requiring 'prescribed communications of any nature which contain patient information to be disclosed by health service bodies in prescribed circumstances to… the person to whom the information relates'. As part of the NHS Modernisation Programme it is proposed that all hospital outpatient clinic correspondence to the GP (clinic letters) will be copied to the patient in question.
The implications of providing patient-friendly letters in the outpatient clinic
Authors: Hall MJ , Edwards TJ , Ashley S , Walker AJ , Cosgrove C , Wilkins DC
Published: January 2007

During the past decade the government has implemented several schemes to modernise health care provision to the general public. One such initiative has been to increase patient involvement in the health care they receive. The NHS Plan in 2000 demonstrated a commitment to empower patients through increased communication with the health care professionals, stating that 'letters between clinicians about an individual patient's care will be copied to the patient as of right' from April 2004.
The need for surgical cover in a district general hospital with no emergency surgical intake
Authors: Singh I , Collins REC , James A
Published: January 2007

Kent and Canterbury Hospital recently underwent a reconfiguration such that the only emergency care provided would be for medical and acute vascular, urological and maxillo-facial services. The accident and emergency department, which had hitherto dealt with 70,000 cases per year and had been a designated centre for receiving major trauma, was redefined as an emergency care centre (ECC). General surgical emergencies from general practitioners were to be referred to one of two alternative sites, one of which under optimal conditions is 30 minutes drive away (William Harvey Hospital), while the other is 40 minutes away (Queen Elizabeth). Patients attending the ECC, whether from medical referral by the GP, ambulance transfer or self-presenting, were assessed and managed by the medical team on call. Surgical registrars were designated as non-resident on call but were available to give an opinion 24 hours per day.
Surgical training in the United States
Authors: Nicholson Craig A
Published: January 2007

Surgical education in the United States has developed along with the graduate medical education (GME) system. Changes in health care delivery and payment systems, changes in the practice and specialisation of surgery, attempts to improve the system of graduate medical training and even generational changes among those entering surgical training have influenced and changed the way surgeons are trained in the US. Although a thorough examination of these factors and their influence on surgical training is beyond the scope of this brief review, some of these influences and our current surgical training system will be described.
The Data Protection Act: six years on and still poor compliance
Authors: Peck CN , Fehily MJ , Howcroft DW , Johnson DS
Published: January 2007

The Data Protection Act (DPA) 1998 became UK law in March 2000, with the purpose of preventing the misuse of sensitive personal data. It imposed legal obligations on all medical and surgical personnel and has implications for training logbooks, audit and research. Previous studies have shown a poor awareness of and compliance with the Act, which gives us rules to follow when handling patient data. The DPA has tighter controls over electronic data than paper-based data due to the rise in the use of computers for holding such information and their potential for abuse. The aim of this study was to assess compliance with the DPA, particularly with regard to electronic logbooks.