bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Pedigree of Congenital Optic Atrophy Embracing Sixteen Affected Cases in Six Generations
Authors: Thompson A. Hugh , Cashell G. T. Willoughby 
Published: July 2019

A family including six generations and 31 individuals is described. Sixteen were affected with congenital optic atrophy; in ten of these the condition has been verified by expert examination. Out of the sixteen, ten were males and six females, a sex-incidence differing considerably from that in Leber's disease. In our pedigree, inheritance is dominant and is always through an affected mother, never through an unaffected mother or through the father. In typical Leber's disease it is through an unaffected mother, i.e. it is recessive. In the family now described, the optic atrophy appears to be stationary. In all the cases that have been seen the discs are white, with well-defined margins and no filling-in of the central cups, even in those cases that retain some useful vision. Instead of a central scotoma as in Leber's disease, there is peripheral restriction, in some cases severe, but in others only slight. No ring or paracentral scotoma or any colour scotoma have been demonstrated. Except the atrophic discs there are no definite ophthalmoscopic changes. Nystagmus is either constant or intermittent in nearly all the cases. No other congenital anomalies have been noted, either in the affected or the unaffected members of our pedigree, or are known to exist in any relatives. There is no consanguinity which might be a factor in the causation. There are several recorded pedigrees of family optic atrophy differing from Leber's disease in some respects, but the only ones at all resembling ours are those of (1) J. M. Griscom and (2) Rampoldi. In (1) eight males and six females included in three generations had optic atrophy dating from early childhood. The inheritance was dominant but was through an affected father. In (2) seven members of a pedigree of four generations are presumed to have had optic atrophy inherited directly from an affected father in two cases, and from an affected mother in four. Taken together, these instances suggest that there may exist a form of congenital or family optic atrophy in which inheritance is of the dominant type, which in some families is transmitted through the father only, in others through the mother, and in others sometimes through the father and sometimes through the mother.
An Experimental Investigation of the Lymphatic System of the Teeth and Jaws
Authors: MacGregor Alexander 
Published: July 2019

A review of the literature is given, followed by a consideration of the available methods of demonstrating the lymphatic system in the area of the teeth and jaws.A new method of demonstrating this system by the injection or application of lead acetate intra vitam, is described, and the technique is explained. The method can be employed to reveal macroscopic or microscopic lymph channels in any part of the body, and is especially of value where decalcification of the hard tissues has to be carried out in the preparation of the sections.The various types of experiments which have been performed are described, and the macroscopic and microscopic results dealt with separately.Among the macroscopic results, the lymphatic drainage of various parts the jaws is described, and the large amount of anastomosis and cross anastomosis between the vessels is shown. A comparison of the lymphatic system in this region in the guinea-pig, cat, dog, and monkey is given, and it is demonstrated that the guinea-pig and monkey possess submental and supraclavicular lymph nodes which assist in the drainage of this area in addition to the submaxillary and cervical groups of nodes possessed by the cat and the dog.Among the microscopic results, the way in which the mass makes its way from the gingival tissues through the bone, and is found in the pulp, dentine, and cementum of the tooth, even where no pressure is applied, is described. The communication of the lymphatic vessels of the pulp with those of the periodontal membrane and the path of the mass down the periodontal membrane from the gingival trough, and its entry into the alveolar bone from this situation are demonstrated, and the way in which the mass reaches the pulp, dentine, and cementum of the tooth from the gingival tissues is discussed.The significance of various concentrations of the mass in the tissues, particularly the dentine, is also discussed. Control experiments are described, the conclusions which have been reached are given, and the lines on which further experiments are being continued are indicated.Finally, the application of the results to the pathology of infection in this region, particularly paradontal disease, is given, and also their application to the phenomena of injection anæsthesia.
Respiration in High Flying
Authors: Marshall G. Struan 
Published: July 2019

Atmospheric pressure falls, as height increases, to about one-ninth of its sea-level value at 50,000 feet. The intake of oxygen into the blood depends on the partial pressure of oxygen in the inspired air, which is about one-fifth of the atmospheric pressure. But since the gaseous content of the lungs is saturated with water vapour at body temperature, 47 mm. Hg. of the atmospheric pressure in the lungs is due to water vapour and is therefore not available for oxygen or other gases, while the alveolar air contains also an almost constant pressure of 40 mm. CO2. Mental and physical output demand an adequate partial pressure of O2; they begin to be limited as soon as this falls, and at heights above 18,000 feet are seriously reduced. Consequently in order to fly higher than about 15,000 feet it is necessary to increase the partial pressure of oxygen in the inspired air. Up to about 44,000 feet this can be done by merely raising the percentage of oxygen, usually by allowing a regulated stream of oxygen to enter a small naso-buccal mask, but preferably by a closed system in which the negative pressure of inspiration opens a valve and allows oxygen to enter a bag from which it is inspired. Beyond 44,000 feet as a limit (and a lesser height for safety) it is necessary to create a local atmospheric pressure around the pilot higher than that of the surrounding air, by enclosing him in an airtight sit or cabin in which a relatively increased pressure with a maximum value of about 2½ lb. per square inch is maintained, while he breathes pure oxygen. This device was used in the recent British world record high flight, when a height of 50,000 feet was attained. The pressure-suit used by the pilot on this occasion and the decompression chamber recently built at Farnborough are described in detail.
Preventive Medicine in Relation to Aviation
Authors: Whittingham H. E. 
Published: July 2019

Introduction—The progress of aviation.The protection of communities against diseases liable to be imported by aircraft.Relationship between the incubation period of infectious diseases and time taken by air journeys to distant lands.Administrative measures for the sanitary control of air-traffic:—The International Sanitary Convention for Aerial Navigation (1993). The role of the Office International d'Hygiène Publique, and the Health Organization of the League of Nations. The Public Health (Aircraft) Regulations, 1938. Types of aerodromes for sanitary purposes.Practical measures for the sanitary control of aerodromes and aircraft especially as regards insects, passengers, and freight.Possible transmission of yellow fever by aircraft: antimeasures, including vaccination.The protection of flying personnel against diseases due to flying.Vision—glare; ocular fatigue of night and blind flying; blacking-out; night blindness. Hearing — Noise; aerial telephony; middle-ear deafness, and excessive vestibular stimulation. Respiration—oxygen want. Fatigue. Digestion—ballooning of stomach; air-sickness; rations for long-distance flights; water supply.
The Electrical Activity of a Denervated Ear
Authors: Rawdon-Smith A. F. , Hawkins J. E. 
Published: July 2019

The electrical response from the cochlea of a cat which had previously been denervated by intracranial crushing of the auditory nerve was submitted to a lengthy study, the results of which may be summarized as follows:- The responses to acoustical stimulation derived from electrodes placed on the round window margin and in the chin muscles were studied by means of an amplifier and cathode ray oscillograph, in the usual way. Transient stimuli whose polarity could be reversed were employed to demonstrate the absence of any electrical component of neural origin such as is invariably present in a normal ear. In all other respects, however, the responses were unaffected, and both threshold contours (the so-called “electrical audiogram”) and equal response contours for approximately pure-tone stimuli demonstrated close comparability with those for normal ears. Harmonic analysis of the cochlear response yielded results departing from the normal only in such respects as would be expected in view of the complete absence of nervous component in the analysed wave. From these data, it is argued that this animal presented a case in which normal electrical responses were obtained from the peripheral organ, despite virtually complete degeneration of the auditory nerve, and, it follows, complete unilateral deafness. Subsequent histological examination confirmed these observations, and it is urged, therefore, that the validity of the view that the cochlear response provides an index of the hearing ability of an animal, as is sometimes stated, is open to question. Additionally, this experiment finally discredits the hypothesis that the cochlear response itself is, in any sense, neural in origin; it further indicates the necessity for caution in the interpretation of results obtained from normal ears, where the cochlear response, however derived, is in some degree adulterated by the simultaneous presence of an action potential component.
The Pathology of Tumours of the Urinary Tract
Authors: Newcomb W. D. 
Published: July 2019

Attention is called to the difference between the pathologist's and the radiologist's point of view. The reasons for this difference are discussed with special emphasis on renal tumours. Classification of renal tumours. The first main groups are innocent and malignant. Are these really clear-cut or do they blend into one another? The commoner innocent renal tumours are adenoma, fibroma, myoma, lipoma, and angioma. These are rarely of any clinical importance but adenoma is a possible source of hypernephroma. Many elaborate classifications of cancer of the kidney have been proposed but the following four groups are sufficient for most puposes: Carcinoma, hypernephroma, sarcoma, and teratoid tumours. Much the commonest malignant renal tumour in adults is the hypernephroma, thought by Grawitz and others to be derived from ectopic adrenal rests. There is still no agreement concerning their origin but three views are held at the present time: ( a) All are carcinoma of renal tubules. ( b) Some are derived from renal tubules and some from ectopic adrenal. ( c) All are formed from adrenal tissue. These views are discussed with special reference to material in St. Mary's Hospital Museum, and it is suggested that the first view is the most probable although the second cannot be excluded. The teratoid tumours are the commonest in infants and swine. The differences between them and hypernephromata are described. The renal Pelvis, ureter, and bladder all have tumours of the same type and can conveniently be considered together. Connective tissue tumours, both innocent and malignant, are very rare. Papilloma and carcinoma are rare in the pelvis and ureter, but commoner in the bladder. The relation between these two tumours is discussed.
The Organization of Hospital Services for Casualties Due to the Bombing of Cities, Based on Experience Gained in Barcelona—with Special Reference to the Classification of Casualties
Authors: Trueta J. 
Published: July 2019

(1) Difference between modern “total population” war and old-fashioned war. Difference between bombing of ( a) military objectives and ( b) civilian population. ( a) The heavy bomb, e.g. 750 lb., with large fragments, upward throw, great destruction of buildings. ( b) The light bomb with finger nail fragments, horizontal throw, great velocity. There is in addition the incendiary bomb, little used in Barcelona because the buildings are built of stone and concrete. (2) Aerial bombing of a town produces injuries needing more immediate hospitalization than most front-line wounds. At the same time it is possible in a town to organize rapid collection of patients and their immediate transfer to hospital. (3) Experience shows that it is most desirable to make this transfer of patients to hospital a primary consideration. On arrival they are “ sorted” and minor injuries are given First Aid treatment and sent home, others are fully examined, classified, and dispatched to the theatres on a priority list, to nearby wards for resuscitation, to wards for rest, or sent on to plaster rooms for splintage, or to a neurosurgical centre. (4) First-aid posts in a town should be in hospitals and treat superficial injuries, &c., after primary sorting in the hospital reception room. (5) First-aid posts in outlying areas should carry out the same function for the same type of cases; all the more seriously wounded, including those with tiny penetrating wounds, should be dispatched without first aid treatment direct to hospital. (6) Hospital arrangements, for circulation of ambulances, for sorting, undressing of patients, docketing of valuables, &c. (7) Classification must be carried out by surgeons of experience and judgment. They must regard not only a standard priority list but the particular clinical picture and prognosis in each case. (8) The surgeon will furthermore draft the cases with regard to the special abilities of the surgical units available, e.g. chest, abdomen, or limbs. (9) Review of wounds in limbs, chest, abdomen, and head, caused by fragments from heavy bombs or by splinters from small light bombs. (10) Injuries from falling masonry. (11) Standard classification by urgency of operation. (12) Classification re possible early evacuation.
Virus Diseases in General Practice
Authors: Watson G I 
Published: July 2019

Dr G I Watson considers the many facets of clinical and immunological response to virus infections in man. These are illustrated with examples from his practice. Dr R E Hope-Simpson describes the ways in which viruses have become adapted so as to ensure their survival as parasites. These embrace the effects of urbanization, adaptation to a different habitat, reduction in infectivity and the development of mutants. Dr P G Higgins considers the role of the laboratory in diagnosis and treatment of virus infections. He outlines the best ways in which general practitioner and virologist can co-operate in this field.
What Is the Optimal Number of Samples for Culture in Patients Undergoing Surgery for Foot and Ankle Infections?
Authors: Tanaka Yasuhito , Aiyer Amiethab , Iwata Eiichiro , Yamamoto Yusuke , Mijares Michael R. 
Published: July 2019

Recommendation: The optimal number of samples for culture in patients undergoing surgery for foot and ankle infections is unknown. We recommend that multiple tissue samples be taken. Level of Evidence: Consensus. Delegate Vote: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
Prospective Evaluation of Opioid Use After Adoption of a Prescribing Guideline for Outpatient Foot and Ankle Surgery
Authors: Bhashyam Abhiram R. , Keyser Cornelia , Miller Christopher P. , Jacobs Jennifer , Bluman Eric , Smith Jeremy T. , Chiodo Christopher 
Published: July 2019

Background: In 2016, our provider group adopted an initial prescription opioid maximum guideline to reduce overprescription of opioids. The purpose of this study was to prospectively assess opioid consumption patterns following implementation of this guideline in patients undergoing outpatient foot and ankle surgery. Methods: Over a 1-year period, we prospectively analyzed opioid prescription and use patterns of 303 consecutive patients. Opioid consumption was verified by pill counts completed at the 2- and 6-week postoperative visits. The morphine equivalent dose was calculated for each prescription and converted to the equivalent 5-mg oxycodone “pill.” We used the regression coefficients from a regression model of opioid consumption to create a revised guideline for maximum initial opioid prescriptions based on patient age, bony vs nonbony procedure, and anatomic location (forefoot/midfoot/hindfoot/ankle). Results: On average, 37.4 pills were prescribed and 18.9 pills used (47.6% utilization). Only 17.2% of patients used their full prescription quantity. By 2 weeks, 88% of patients no longer used opioids. Only 1.3% of patients used prescription opioids beyond 6 weeks. Independent risk factors for increased opioid consumption were younger age ( P = .003), male sex ( P = .007), recent preoperative opioid use ( P = .019), bony procedures ( P < .001), and ankle/hindfoot procedures ( P = .016 and P < .001). Conclusion: This study showed the amount of opioid consumption for patients undergoing foot and ankle procedures. We present a modified guideline for the maximum initial prescription of opioids following outpatient foot and ankle procedures that can be used as a benchmark for further study in decreasing overprescribing. Level of Evidence: Level II, prospective observational cohort study.
The Praise of Collective Autoethnography
Authors: Wężniejewska Paulina , Szwabowski Oskar , Szczepaniak Colette , Pławski Marcin 
Published: July 2019

The article is a palimpsest created as part of the project of collective autoethnographic writing. Its multiple forms formed the basis for the community and the intensification of friendly writing. After the assemblies, there were remnants. The remnants of practices from which one could crack meanings―but these are not the most important ones. This peculiar collection of artifacts is presented with a frail hope that the remnants still contain a messianic promise which will spread like plague. Maybe the text will revive in your hands—by reading it, you will write another version with our ghosts. We are ghosts. In words. We haunt.
Risk factors for tracheostomy after traumatic cervical spinal cord injury
Authors: Mu Zhiping , Zhang Zhengfeng 
Published: July 2019

Objective: To determine the risk factors for the need of tracheostomy after cervical spinal cord injury (CSCI) at the acute stage. Methods: The authors retrospectively reviewed 294 patients with acute traumatic CSCI in Xinqiao Hospital between 2012 and 2016 and analyzed the factors postulated to increase the risk for tracheostomy, including patient’s age, neurological impairment scale grade and level, smoking history, combined injury, and surgical intervention. Logistic regression analysis was used to identify independent risk factor for the need of tracheostomy. Results: Of 294 patients, 52 patients received tracheostomy (17.7%). The factor identified by demographics and outcomes were smoking history, cause of injury, neurological impairment scale grade and level, and combined dislocation. A multiple logistic regression model demonstrated that age of 60 years older, combined facet dislocation, C4 level high, and the American Spinal Injury Association (ASIA) A and B scale were predictive of need for tracheostomy on 95% occasions. Conclusion: The high age of 60 years, combined facet dislocation, C4 level high, and ASIA A and B scale are indispensable to predict the need for tracheostomy in patients with CSCI at the acute stage.
Dental Professionals’ Engagement in Tobacco, Electronic Cigarette, and Cannabis Patient Counseling
Authors: Chaffee B.W. , Urata J. , Couch E.T. , Silverstein S. 
Published: July 2019

Objectives: California features low smoking prevalence, cautionary electronic cigarette (e-cigarette) public messaging, and legal recreational cannabis: a unique landscape for dental professionals to navigate tobacco cessation promotion. This cross-sectional study assessed California dental professionals’ self-reported tobacco patient counseling behaviors and the correlates of providing such assistance. Methods: Statewide surveys of dental hygienists (n = 701) and dentists (n = 725) were distributed electronically. The dentist survey was weighted for sampling and nonresponse. Prevalence of asking patients about use was compared for cigarette and noncigarette products (e.g., e-cigarettes, cannabis). Multivariable models identified independent correlates of providing cessation assistance to tobacco-using patients. Results: Respondents reported frequently (often/always) documenting patient tobacco use (hygienists: 80%; dentists: 73%) but less commonly provided forms of assistance (hygienists: 27%–49%; dentists: 10%–31%). Most respondents asked patients about cigarette smoking, but noncigarette product use (cigar, hookah, pipe, e-cigarette, or cannabis) was not commonly assessed. Greater confidence and willingness to assist were positively associated with providing assistance in multivariable models, but perceived barriers (e.g., lack of time and remuneration) were not. Results were robust to model specifications. Conclusions: California dental professionals often ask about smoking but lag in providing cessation assistance and inquiring about noncigarette products. Successful efforts to encourage dental professionals’ engagement in tobacco prevention and cessation must enhance providers’ self-efficacy and motivation and likely will require system and organizational change. Knowledge Transfer Statement: Study findings identify substantial gaps in dental professionals’ engagement in patient tobacco cessation. The results identify correlates of providing assistance and of dental professionals’ willingness and confidence to do so, which could serve to inform interventions to support and enhance engagement.
Patient-Reported Outcomes in Foot and Ankle Orthopedics
Authors: Lakey Eric , Hunt Kenneth J. 
Published: July 2019

Patient-reported outcomes (PROs) are a measure of health care quality that reflect the patient’s perceptions of their own health status. Recently, there has been a renewed interest in implementation of PROs into everyday clinical practice. There are many dozens of PROs available to foot and ankle surgeons with little consensus on which measures are most appropriate for a given condition. These measures vary widely in length, validity, and content. When integrating PROs into clinical practice, we recommend that clinicians should collect, at a minimum, validated PRO scores that assess pain, function, and general health. Furthermore, concise instruments should be used wherever possible to minimize patient burden, maximize patient engagement, and ensure meaningful data are collected. In the near future, outcomes registries employing computer adaptive testing will facilitate the routine collection of PRO data from all patients. Level of Evidence: Level V, expert opinion.