bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Delayed Arrival: From Davy (1800) to Morton (1846)
Authors: Adams Aileen K 
Published: March 2018

Dr Adams was previously consultant anaesthetist to Addenbrooke's Hospital, Cambridge, with a special interest in ophthalmic and neuroanaesthesia, and Associate Lecturer in Cambridge University. She was Dean of the Faculty of Anaesthetists of the Royal College of Surgeons of England in 1985, now the Royal College of Anaesthetists, of which she is currently Honorary Archivist/Curator. She was Hunterian Professor in the Royal College of Surgeons in 1993, and is a past president of the History of Anaesthesia Society. Within the RSM she was president of the Section of Anaesthetics in 1985-1986 and of the Section of the History of Medicine in 1994-1995, having served as Honorary Secretary of each. She is now an Honorary Treasurer of the Society.
Tracheostomy in Children
Authors: Shinkwin C A , Gibbin K P 
Published: March 2018

Tracheostomy is more hazardous in children than in adults, and carries special risks in the very young. The past 20 years have seen a large shift in the age distribution of tracheostomy. Whereas formerly the operation was done largely for management of epiglottitis and laryngotracheobronchitis, today the prime indication is subglottic stenosis in infants consequent upon intubation for respiratory distress syndrome and prematurity. We have reviewed experience with 57 tracheostomies in 56 children under 12 years old managed from a university hospital. All operations were done as elective procedures, in standard fashion, by otolaryngologists. Forty (70%) were in children under 1 year old, the indications being upper airways obstruction (41), failed extubation (11), and long-term assisted ventilation (5). Subglottic stenosis was the commonest cause of obstruction (21 operations). In 91.4 accumulated years with a tracheostomy there were 11 complications related to tracheostomy, one of which (a blocked tube) was fatal. Thirty-nine children were decannulated, the mean duration of cannulation being 21 months. In this series we suggest that the low morbidity and mortality rates were due to management by otolaryngologists; to postoperative intensive care; and, for the majority cared for at home, to careful education of parents and visits by specialist nurses.
Smoking and Menstrual Problems in 16-Year-Olds
Authors: Charlton Anne , While David 
Published: March 2018

The British Birth Cohort Study (BCS70) is a cohort study which follows all the people born in England, Scotland and Wales in the week of 5–11 April 1970. The data described here were from the postal questionnaires returned by 2181 young women aged between 16 and 16½ in 1986. Thirty-nine per cent of the respondents had never smoked, 39% had smoked at some time and 22% were regular smokers. Most of the respondents indicated that they had one or more of the following symptoms associated with menstruation: pain, depression, irritability, headaches, cramps. Analysis of the data showed that regular smokers were significantly more likely than those who had never smoked to have all these symptoms. Whilst the percentage of ‘sometime smokers’ experiencing pain, depression and headaches fell between smokers and ‘never-smokers’, the percentage experiencing unpleasant symptoms in general, irritability and cramps was the same as for regular smokers. If causality could be demonstrated, messages about immediate health problems such as these might be more powerful health education to young women than information about long-term risks.
Personal Child Health Record and Advice Booklet Programme in Tuzla, Bosnia Herzegovina
Authors: McMaster P , McMaster H J , Southall D P 
Published: March 2018

Personal child health records, held by the parents, have potential advantages in times of civil disorder. Via health and community workers, 939 booklets (incorporating health records and health advice) were distributed to displaced and other families near Tuzla. Subsequently mothers were invited to bring their children for examination. Five hundred and seventy-one children with their booklets returned to the clinics. The survey revealed high rates of dental caries (305 cases), anaemia (36), and scabies (20). The war had not affected the duration of breast feeding, and the children's nutrition was generally satisfactory. Immunization status was generally good, though rates were unacceptably low in children from certain areas, reflecting not only deficient provision in their place of origin but also failings in the programme for displaced persons. An informal survey indicated that parents and older children appreciated the health-information content of the booklet. In a disaster of this sort, the personal child health record and advice booklet serves the combined purpose of yielding essential epidemiological data, providing a permanent health record, and meeting a need for health education material.
Self-Administered Disposable Micro-Enemas before Outpatient Sigmoidoscopy
Authors: Marsh S K , Huddy S P J 
Published: March 2018

Many colorectal carcinomas can be diagnosed by rigid sigmoidoscopy. One important limiting factor in the usefulness of this investigation is the presence of faeces; another is inability to negotiate the recto-sigmoid bend. 101 patients (47 men) were sent a Microlax enema with instruction to use it before their first attendance in the outpatient department. The grade of preparation [on a scale of 0 (empty rectum) to 3, with grades 0 and 1 providing an adequate view], height achieved with the sigmoidoscope and whether or not the extent of the examination was limited by faeces were recorded. These data were compared with results in 78 patients (38 men) who did not receive any special preparation. There were no serious difficulties with self-administration. An adequate view was obtained in 89 (88%) of those who had received an enema and in 41 (53%) of those who were unprepared (P< 0.001, χ2 test). The height achieved and the percentage of patients in whom the sigmoidoscopy was not limited by faeces were also significantly increased. The mailing of micro-enemas to patients who are likely to need sigmoidoscopy is a cheap measure that increases diagnostic yield and saves reattendances.
Educating Psychiatric Patients about their Treatment: Do Fact Sheets Work?
Authors: Evans Mark , Macpherson Rob , Thompson Emma , Babiker Isam 
Published: March 2018

Psychiatric patients are sometimes given fact sheets about their treatment but the benefits of these are uncertain. We tested three strategies in three cohorts of psychiatric inpatients—fact sheets alone, fact sheets and subsequent discussion, and control. Knowledge of medication was assessed by questionnaire. For various reasons, only 33 of the 77 patients were included in the study or analysis. Of the patients who had been given fact sheets, 87% independently read them and reported finding them helpful whilst all asked for more information. Receiving a fact sheet alone had no significant effect, whereas having discussed it with a health care professional was associated with a significant increase in knowledge about medication. Patients receiving fact sheets selectively learned more about side-effects than about drug action or precautions. This strategy for patient education could be used by ward nurses and deserves further evaluation.
Venous stent patency may be affected by collateral vein lumen size
Authors: van Vuuren Timme MAJ , Doganci Suat , Toonder Irwin M , Graaf Rick De , Wittens Cees HA 
Published: March 2018

Purpose Deep venous thrombosis causes blood flow deviation. It is hypothesized that with stent placement, developed collateral veins become redundant. This article evaluates the relation between the surface area of the collaterals and stent patency. Methods The azygos and hemiazygos veins were identified and the largest surface area was measured at thoracic level. Patency rates of stented tracts were evaluated and related to collateral vein lumen size. Results The vena cava occlusion and the azygos and hemiazygos vein surface area measurements were positive and statistically significant related (OR 1.01, 95% CI 1.003−1.019, p = 0.004) respectively (and OR 1.007, 95% CI 1.001−1.013, p = 0.004). An azygos surface area measurement of 23 (p<0.001) and hemiazygos surface area measurement of 40 (p = 0.008) was shown as cut-off point related to higher occlusion rates. Conclusions The surface area of major venous collateral pathways seems to be related to stent occlusion in deep venous interventions.
Clinical features predicting group A streptococcal pharyngitis in a Japanese paediatric primary emergency medical centre
Authors: Nishiyama Masahiro , Morioka Ichiro , Taniguchi-Ikeda Mariko , Mori Takeshi , Tomioka Kazumi , Nakanishi Keita , Fujimura Junya , Nishimura Noriyuki , Nozu Kandai , Nagase Hiroaki , Ishibashi Kazuto , Ishida Akihito , Iijima Kazumoto 
Published: March 2018

Objectives To identify clinical features that predict Group A streptococcal (GAS) pharyngitis in a Japanese paediatric primary emergency medical centre. Methods The prevalence of GAS pharyngitis according to age and body temperature (BT) was calculated among 3098 paediatric patients with pharyngitis. The numbers of GAS-positive and -negative patients for each clinical parameter, and each point increase in the McIsaac score were compared and likelihood ratios (LRs) were calculated. Results The prevalence of GAS pharyngitis was extremely low in patients aged < 1 (1.2%) and 1 year (3.9%). The GAS-positive rate was significantly higher in patients with a BT < 38.0°C compared with ≥ 38.0°C (30.0% vs. 19.8%). A BT ≥ 38.0°C was not a predictive finding for GAS pharyngitis (positive LR: 0.82). Rash was the most useful individual predictor, and a McIsaac score of 4 or 5 increased the probability; however, the positive LRs were 1.74 and 1.30, respectively. Conclusions The prevalence of GAS pharyngitis is extremely low in patients aged < 1 and 1 year, and a BT ≥ 38.0°C is not a predictive symptom. Although a rash and McIsaac score of 4 or 5 are associated with an increased probability, they cannot be used to confirm GAS infection.
Effect of α-lipoic acid on symptoms and quality of life in patients with painful diabetic neuropathy
Authors: Agathos Evangelos , Tentolouris Anastasios , Eleftheriadou Ioanna , Katsaouni Panagiota , Nemtzas Ioannis , Petrou Alexandra , Papanikolaou Christina , Tentolouris Nikolaos 
Published: March 2018

Objective To examine the effect of α-lipoic acid on neuropathic symptoms in patients with diabetic neuropathy (DN). Methods Patients with painful DN were treated with 600 mg/day α-lipoic acid, orally, for 40 days. Neuropathy Symptom Score (NSS), Subjective Peripheral Neuropathy Screen Questionnaire (SPNSQ) and douleur neuropathique (DN)4 questionnaire scores were assessed at baseline and day 40. Quality-of-life treatment effects were assessed by Brief Pain Inventory (BPI), Neuropathic Pain Symptom Inventory (NPSI) and Sheehan Disability Scale (SDS). Changes in body weight, arterial blood pressure, fasting serum glucose and lipids were also assessed. Results Out of 72 patients included, significant reductions in neuropathic symptoms were shown by reduced NSS, SPNSQ and DN4 scores at day 40 versus baseline. BPI, NPSI, and SDS in terms of work disability, social life disability, and family life disability scores were also significantly reduced. Moreover, 50% of patients rated their health condition as ‘very much better’ or ‘much better’ following α-lipoic acid administration. Fasting triglyceride levels were reduced, but no difference was found in body weight, blood pressure, fasting glucose, or other lipids at day 40 versus baseline. Conclusions A-lipoic acid administration was associated with reduced neuropathic symptoms and triglycerides, and improved quality of life.
Optimizing stability in AO/OTA 31-A2 intertrochanteric fracture fixation in older patients with osteoporosis
Authors: Zhang Chi , Xu Bo , Liang Guanzhao , Zeng Xianshang , Zeng Dan , Chen Deng , Ge Zhe , Yu Weiguang , Zhang Xinchao 
Published: March 2018

Objectives To compare the functional and radiographic outcomes of InterTAN nail (IT) and proximal femoral nail anti-rotation (PFNA) for managing primary AO/OTA 31-A2 intertrochanteric hip fractures (IHFs) in older osteoporotic patients. Methods Patients aged 60 years or older who received surgical treatment for IHFs (AO/OTA 3.1A2.1-A2.3) with IT or PFNA were retrospectively evaluated. The primary outcome was the postoperative treatment failure rate. The secondary outcome was the Harris Hip Score (HHS). Results A total of 326 osteoporotic cases (326 hips: IT, n = 162; PFNA, n = 164) were assessed with a mean follow-up of 43.5 months (range, 38–48 months). For the entire cohort, the incidence of postoperative treatment failure (periprosthetic fracture and reoperation) was 29/326 (8.9%); the IT-treated cohort (7/162, 4.3%) had a significantly lower rate compared with the PFNA-treated cohort (22/165, 13.3%). The incidence of postoperative periprosthetic fractures was significantly lower in the IT-treated cohort than in the PFNA-treated cohort (2.5% vs 7.9%). The postoperative HHS at the final follow-up was not significantly different between the groups. Conclusion IT might show a better outcome in managing osteoporotic AO/OTA 31-A2 IHFs in terms of periprosthetic fracture and reoperation compared with PFNA.
Driving after an injury or disease affecting the brain: an analysis of clinical data
Authors: Samuelsson Kersti , Modig-Arding Ingalill , Wressle Ewa 
Published: March 2018

Introduction Traffic safety may be affected if a licence holder has experienced illness or injury that may have an impact on cognition. Occupational therapists are involved in assessing cognitive functions that might affect a patient’s ability to drive a car using different evaluation tools in different countries and settings. The aim of this study was to look at the predictive value of some of the assessment tools available to occupational therapists for making judgements about resuming driving after cognitive impairment due to brain trauma or disease. Method A retrospective study based on clinical data from 204 patients referred to a specialist department for recommendations on ability to drive after brain injury or disease. All patients underwent three assessments: stroke drivers screening assessment, useful field of view and simulated driving skill. In addition, an on-road assessment was added in 76% of the sample. Results Useful field of view had the highest sensitivity (78%) and, combined with the results from the simulator, the sensitivity was 87%. The specificity for the two methods was 55%. Conclusion The results from useful field of view and a simulator test combined best predicted the final recommendation from the multi-professional team discussion on which clients should be recommended not to resume driving.
Hip precautions after hip operation (HippityHop): Protocol for a before and after study evaluating hip precautions following total hip replacement
Authors: Lightfoot Courtney , Sehat Khosrow , Drury Gary , Brewin Catherine , Coole Carol , Drummond Avril 
Published: March 2018

Introduction Hip precautions are routinely used despite inconclusive evidence that they reduce dislocations and concern that they impede activities of daily living. This study compares a change in practice locally from implementing routine hip precautions to no routine precautions, in order to: 1. Compare patient outcomes in quality of life, functional performance, pain, sleep, mood, and satisfaction. 2. Ascertain staff and patient perceptions of the two regimes. 3. Determine the cost of precautions. Method Phase one patients will receive hip precautions, while phase two patients will receive no routine precautions. We propose to collect data from 342 participants at baseline, and at one week, six weeks, and three months postoperatively. Interviews will be conducted with 20 staff and 20 patients, and data collected relating to costs. Results Statistical analysis will be conducted to compare the two groups to determine any differences in patient outcomes. Thematic analysis will be used to identify and report themes within the interview data. Conclusion If there are no additional advantages to hip precautions, patients could resume everyday activities more quickly, potentially improving their quality of life. Conversely, if withdrawing hip precautions is detrimental, evidence for precautions will be provided.
Defective functional connectivity between posterior hypothalamus and regions of the diencephalic-mesencephalic junction in chronic cluster headache
Authors: Ferraro Stefania , Nigri Anna , Bruzzone Maria Grazia , Brivio Luca , Proietti Cecchini Alberto , Verri Mattia , Chiapparini Luisa , Leone Massimo 
Published: March 2018

Objective We tested the hypothesis of a defective functional connectivity between the posterior hypothalamus and diencephalic-mesencephalic regions in chronic cluster headache based on: a) clinical and neuro-endocrinological findings in cluster headache patients; b) neuroimaging findings during cluster headache attacks; c) neuroimaging findings in drug-refractory chronic cluster headache patients improved after successful deep brain stimulation. Methods Resting state functional magnetic resonance imaging, associated with a seed-based approach, was employed to investigate the functional connectivity of the posterior hypothalamus in chronic cluster headache patients (n = 17) compared to age and sex-matched healthy subjects (n = 16). Random-effect analyses were performed to study differences between patients and controls in ipsilateral and contralateral-to-the-pain posterior hypothalamus functional connectivity. Results Cluster headache patients showed an increased functional connectivity between the ipsilateral posterior hypothalamus and a number of diencephalic-mesencephalic structures, comprising ventral tegmental area, dorsal nuclei of raphe, and bilateral substantia nigra, sub-thalamic nucleus, and red nucleus ( p < 0.005 FDR-corrected vs . control group). No difference between patients and controls was found comparing the contralateral hypothalami. Conclusions The observed deranged functional connectivity between the posterior ipsilateral hypothalamus and diencephalic-mesencephalic regions in chronic cluster headache patients mainly involves structures that are part of (i.e. ventral tegmental area, substantia nigra) or modulate (dorsal nuclei of raphe, sub-thalamic nucleus) the midbrain dopaminergic systems. The midbrain dopaminergic systems could play a role in cluster headache pathophysiology and in particular in the chronicization process. Future studies are needed to better clarify if this finding is specific to cluster headache or if it represents an unspecific response to chronic pain.
Meaningful Change Scores in the Knee Injury and Osteoarthritis Outcome Score in Patients Undergoing Anterior Cruciate Ligament Reconstruction
Authors: Ingelsrud Lina Holm , Terwee Caroline B. , Terluin Berend , Granan Lars-Petter , Engebretsen Lars , Mills Kathryn A.G. , Roos Ewa M. 
Published: March 2018

Background: Meaningful change scores in the Knee injury and Osteoarthritis Outcome Score (KOOS) in patients undergoing anterior cruciate ligament (ACL) reconstruction have not yet been established. Purpose: To define the minimal important change (MIC) for the KOOS after ACL reconstruction. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: KOOS and anchor questions with 7-point scales ranging from “better, an important improvement” to “worse, an important worsening” were completed postoperatively by randomly chosen participants from the Norwegian Knee Ligament Registry. Presurgery KOOS scores were retrieved from the registry. The MIC for improvement was calculated with anchor-based approaches using the predictive modeling method adjusted for the proportion of improved patients, the mean change method, and the receiver operating characteristic (ROC) method. Results: Complete data for at least one of the KOOS subscales were obtained from 542 (45.3%) participants. Predictive modeling MIC values were 12.1 for the KOOS subscales of Sport and Recreational Function and 18.3 for Knee-Related Quality of Life. These values aid in interpreting within-group improvement over time and can be used as responder criteria when comparing groups. The corresponding and much lower values for the subscales of Pain (2.5), Symptoms (–1.2), and Activities of Daily Living (2.4) are the results from patients reporting, on average, only mild problems with these domains preoperatively. Although 4% to 10% of patients reported subscale-specific worsening, MIC deterioration calculations were not possible. The ROC MIC values were associated with high degrees of misclassification. Values obtained by the mean change method were considered less reliable because these estimates are derived from subgroups of patients. Average KOOS change scores were approximately similar for patients reporting acceptable symptoms postoperatively and patients reporting important improvements on the anchor items after surgery. Conclusion: KOOS users should apply subscale-specific cutoffs for meaningful improvement. Our results confirm using the subscales of Sport and Recreational Function and Knee-Related Quality of Life as primary patient-reported outcomes after ACL reconstruction. The predictive modeling approach gave the most robust estimates of MIC values. Our data suggest that reporting acceptable symptoms postoperatively corresponds to reporting an important improvement after ACL reconstruction.
Ethnic Differences in Mental Health Status and Service Utilization: A Population-Based Study in Ontario, Canada
Authors: Chiu Maria , Amartey Abigail , Wang Xuesong , Kurdyak Paul 
Published: March 2018

Background: The purpose of this study was to compare the prevalence of self-reported mental health factors, mental health service use, and unmet needs across the 4 largest ethnic groups in Ontario, Canada: white, South Asian, Chinese, and black groups. Methods: The study population was derived from the Canadian Community Health Survey, using a cross-sectional sample of 254,951 white, South Asian, Chinese, and black residents living in Ontario, Canada, between 2001 and 2014. Age- and sex-standardized prevalence estimates for mental health factors, mental health service use, and unmet needs were calculated for each of the 4 ethnic groups overall and by sociodemographic characteristics. Results: We found that self-reported physician-diagnosed mood and anxiety disorders and mental health service use were generally lower among South Asian, Chinese, and black respondents compared to white respondents. Chinese individuals reported the weakest sense of belonging to their local community and the poorest self-rated mental health and were nearly as likely to report suicidal thoughts in the past year as white respondents. Among those self-reporting fair or poor mental health, less than half sought help from a mental health professional, ranging from only 19.8% in the Chinese group to 50.8% in the white group. Conclusions: The prevalence of mental health factors and mental health service use varied widely across ethnic groups. Efforts are needed to better understand and address cultural and system-level barriers surrounding high unmet needs and to identify ethnically tailored and culturally appropriate clinical supports and practices to ensure equitable and timely mental health care.