bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Capsular Complications of Cataract Extraction
Authors: Goulden Charles 
Published: July 2019

The author considered the following important points: (1) Anterior capsular synechia to a corneal incision (made by a keratome) after the evacuation of a traumatic cataract. This might be detached early by the use of a blunt-ended knife following a perforation of the cornea with a sharp-pointed knife, much like a tenotome. (2) The involuntary prolapse of capsule with a cataract incision. ( a) The danger of this was demonstrated as the cause of glaucoma, especially if it be found necessary to divide opaque capsular membrane after the extraction. ( b) The danger of sympathetic ophthalmia. Prolapse might be prevented: ( a) By intracapsular extraction. ( b) By extracting the lens through an intact pupil, after the use of capsule forceps, followed either by a partial or total iridectomy. (3) The treatment of opaque after-cataract. Various types of opaque capsule membrane were described. ( a) Opaque lens fibres imprisoned between anterior and posterior remains of capsule. ( b) Grey membrane made of new lens fibres from proliferating subcapsular cells. ( c) Elschnig's cells. ( d) Much thickened capsular membrane following an extensive hæmorrhage into the anterior chamber occurring about the fifth day after extraction. ( e) A thick membrane formed of fibrous tissue following the invasion of the coloboma of the iris after infection at the time of operation. The fibrous tissue comes from the undersurface of the conjunctival flap and causes an updrawn coloboma which is also made narrower by its contraction. When performing a capsulotomy thickened bands should be avoided and an incision made in thin capsule, parallel to thick bands. If the membrane is very thick and shows signs of being torn from its peripheral attachment when a single needle is used, then (1) Two needles may be used after the method of Bowman; (2) A Wheeler operation may be performed (Wheeler, 1939, Collected Papers, New York, 197); (3) Thick capsule may be divided by means of a Ziegler knife, as described by the author, but not in the manner described by Ziegler. The danger of performing a capsulotomy in the presence of soft lens matter was pointed out. The occasional occurrence of localized vitreous opacification at the site of a capsulotomy, even in the absence of iridocyclitis, was mentioned.
Enzyme Stimulation and Inhibition in the Metabolism of Drugs
Authors: Burns J J , Conney A H 
Published: July 2019

Studies in recent years have disclosed two types of drug interaction which may be important in drug therapy: (1) Administration of one drug can speed up the metabolism of another drug. Animal experiments show that this results from the ability of drugs to induce the synthesis of drug-metabolizing enzymes in liver microsomes. This effect has considerable importance in pharmacologic and toxicologic studies carried out in animals, and recent work indicates that it may explain altered therapeutic responses observed in some patients when they receive several drugs at the same time. Substances present in the environment, such as the insecticides chlordane and DDT, have been shown in animals to stimulate drug-metabolizing enzymes in liver, but the significance of this observation for man is not known. Drugs which stimulate drug metabolism also enhance the hydroxylation of testosterone, estradiol, progesterone and cortisol by enzymes in liver microsomes. Further research is required to establish the physiological importance of this interaction of drugs in steroid metabolism. (2) One drug may inhibit the metabolism of another drug and thus intensify and prolong its pharmacologic action. Although this effect is well documented in animals, recent reports suggest that this may also be important in man. For instance, the action of coumarin anticoagulants can be potentiated by administration of certain drugs which inhibit their metabolism. Monoamine oxidase inhibitors block the metabolism of certain sympathomimetic amines and this can lead to serious side-effects. Thus, hypertensive crises have been observed in patients receiving monoamine oxidase inhibitors who have eaten cheese with a high tyramine content.
Pain: Its Experimental Investigation
Authors: Smith Robert 
Published: July 2019

Dr Robert Smith discusses the relationship between pain and emotional disturbance and describes experiments which he has undertaken in general practice, using a pressure algometer. Amongst other findings, he shows that aspirin did not relieve pressure pain but did delay or even suppress the onset of ultraviolet light burns. Dr K D Keele describes experiments to define individual pain thresholds and correlates these with the pain of cardiac infarction, and the morphine requirements in that condition. Professor C A Keele considers the chemistry of pain production and describes his technique for applying chemical algogens to experimentally induced blisters. He further considers the similarity between such substances and those contained in animal and plant venoms and speculates as to an even closer relationship between these and painful medical conditions.
Adolescence
Authors: Model A 
Published: July 2019

Dr A Model describes his experience in general practice with adolescent patients. He describes their problems and shows how these differ according to age and sex, and considers the role of the general practitioner in their eyes.Dr Faith Spicer describes the sexual problems of adolescence and shows how these differ between the sexes. She enquires into the emotional and mental processes which contribute to early sex experience in the young.Dr A Ryle contrasts working in a student health service with his experience of adolescents in general practice. He concludes that there should be a range of alternative sources of help for adolescents.
Old People [Abridged]
Authors: Meyrick R L 
Published: July 2019

Dr Roger Meyrick outlines the scope of geriatrics and defines three categories of elderly people characterized by reduced activity, reduced resources and reduced independence. Dr John Agate considers the deprivations which may occur in old age such as: malnutrition, vitamin deficiencies, deprivation of minerals and water, hypothermia and psychological deprivation. The role of the family doctor in the care of the elderly is discussed by both speakers.
The Relevance of Object Size to the Recognizability of Drawings by Individuals with Congenital Blindness
Authors: Szubielska Magdalena , Niestorowicz Ewa , Marek Bogusław 
Published: July 2019

Introduction: The aim of this study was to determine whether individuals with congenital blindness make more recognizable drawings of known objects that are furniture sized (table, man, tree) rather than hand sized (egg, coconut, banana; Hypothesis 1). We also investigated whether knowledge that the tactile drawings had been produced by people who are blind increased judges’ perceptions of their recognizability (Hypothesis 2). Methods: The raised-line drawings were made by children and teenagers who are blind and had no prior experience in tactile graphics. After a minimal initial training in line drawing, the subjects were asked to draw six objects from memory. The judges used a 7-point Likert-type scale to assess recognizability. All objects were identified for the judges prior to their assessment. One group of judges was told that the drawings they were assessing were made by persons who are blind, while the second group was informed that the drawings were made without the use of sight. Results: The real-life size of the objects depicted in the drawings affected judges’ perception of their recognizability. Depictions of hand-sized objects were found to be less recognizable than were depictions of furniture-sized objects. Knowledge of the artists’ blindness had no effect on the judgments of recognizability. Discussion: Hypothesis 1 was confirmed, which suggests that individuals with congenital blindness have more difficulty in creating drawings of hand-sized objects than they did creating drawings of furniture-sized objects. Hypothesis 2 was not confirmed, which is inconsistent with the results of previous research in which the awareness of the artists’ disability status influenced the assessment of the artworks. Although the present research focused on recognizability, the issue in earlier research was aesthetic judgment. Implications for practitioners: Although few people would question the importance of illustrations in books for sighted children, the value of tactile graphics and the benefits of engaging children who have visual impairments in making and exploring raised-line drawings are not always understood. Full participation in subjects that rely on visual information such as geometry, art, and geography by learners who are born blind requires access to tactile graphics. Basic training in raised-line drawing may be sufficient for some children, particularly those who are older (aged 10 years or more), with congenital blindness who have never drawn before to create from memory recognizable drawings of known objects, especially larger objects.
Feasibility of ischemic leg ulcer healing using percutaneous techniques: a real-life study
Authors: Kehagias Elias , Ioannou Christos V , Bouloukaki Izolde , Papadaki Evangelia , Galanakis Nikolaos , Kontopodis Nikolaos , Tsetis Dimitrios 
Published: July 2019

Background Percutaneous transluminal angioplasty is established as the first-line vascular procedure in patients with lower extremity artery disease. Purpose We aimed to evaluate the technical and clinical effectiveness of percutaneous transluminal angioplasty in the management of ischemic foot ulcers. Material and Methods All consecutive patients presenting with a foot ulcer at the outpatient vascular surgery clinic of our hospital between June 2009 and June 2015 were evaluated using foot pulse assessment, ankle-brachial index, and duplex scanning. If non-invasive parameters suggested lower extremity artery disease, CT angiography and/or digital subtraction angiography were performed and a percutaneous transluminal angioplasty was carried out when feasible during the same session. All patients were followed until healing, amputation, death, or for at least two years. Short- and long-term clinical success was evaluated based on ulcer size and appearance. Patients with worsening ulcers after percutaneous transluminal angioplasty underwent bypass grafting or amputation. Results Percutaneous transluminal angioplasty was performed in 161 patients (100%) with stenoses > 50%, including cases lesions > 10 cm and/or multiple/calcified lesions, 144 of which completed the study. In 88 (61.2%) patients, percutaneous transluminal angioplasty was performed in the suprapopliteal axis exclusively, in 10 (6.8%) patients in the infrapopliteal axis only, and in 46 (31.9%) in both levels. Percutaneous transluminal angioplasty was technically successful in 141 (98%) patients. After 3.1 years, the rate of healing was 68%, limb salvage 88%, overall survival 69.5%, and amputation-free survival 64%. Conclusion Our data suggest that percutaneous transluminal angioplasty for ischemic foot ulceration treatment is in the majority of patients feasible, effective, and safe with high rates of healing and limb salvage.
New inflammatory indicators: association of high eosinophil-to-lymphocyte ratio and low lymphocyte-to-monocyte ratio with smoking
Authors: Çekici Yusuf , Yılmaz Mücahid , Seçen Özlem 
Published: July 2019

Objective Smoking has been proven to increase systemic inflammation in previous studies using different biomarkers. The eosinophil-to-lymphocyte ratio (ELR), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR) are new indicators of systemic inflammation that are used as predictors of systemic inflammation, morbidity, and mortality associated with many diseases. We investigated the effects of smoking on these inflammatory indicators. Methods In total, 616 consecutive smoking healthy subjects and 387 age-matched nonsmoking healthy subjects were enrolled. White blood cell counts (neutrophils, lymphocytes, basophils, eosinophils, and monocytes) were determined by electrical impedance with an automatic blood cell counting device. The ELR, LMR, and NLR were calculated based on these cell counts. Smoking habits of participants were calculated as pack/year. Results The NLR and ELR were significantly higher and the LMR was significantly lower in smokers than nonsmokers. The pack-years were positively correlated with the NLR and ELR and negatively correlated with the LMR. Conclusion A high NLR and ELR and low LMR are associated with cigarette smoking and may be useful indicators of systemic inflammation activity, even in healthy smokers. Smokers with a high NLR and ELR and low LMR can easily be identified during routine blood analysis and might benefit from preventive treatment.
Biomechanical Comparison of Onlay Distal Biceps Tendon Repair: All-Suture Anchors Versus Titanium Suture Anchors
Authors: Otto Alexander , Mehl Julian , Obopilwe Elifho , Cote Mark , Lacheta Lucca , Scheiderer Bastian , Imhoff Andreas B. , Mazzocca Augustus D. , Siebenlist Sebastian 
Published: July 2019

Background: A rupture of the distal biceps tendon is the most common tendon rupture of the elbow and has received increased attention in the past few years. Newly developed all-suture anchors have the potential to minimize surgical trauma and the risk of adverse events because of the use of flexible drills and smaller drill diameters. Purpose/Hypothesis: The purpose was to biomechanically compare all-suture anchors and titanium suture anchors for distal biceps tendon repair in cadaveric specimens. The hypothesis was that all-suture anchors would show no differences in load to failure or displacement under cyclic loading compared with titanium suture anchors. Study Design: Controlled laboratory study. Methods: Sixteen unpaired, fresh-frozen human cadaveric elbows were randomized to 2 groups, which underwent onlay distal biceps tendon repair with 2 anchors. Bone mineral density at the radial tuberosity was evaluated in each specimen. In the first group, distal biceps tendon repair was performed using all-suture anchors. In the second group, titanium suture anchors were applied. After cyclic loading for 3000 cycles, the repair constructs were loaded to failure. The peak load to failure as well as repair construct stiffness and mode of failure were determined. Results: The mean (±SD) peak load was 293.53 ± 122.15 N for all-suture anchors and 280.02 ± 69.34 N for titanium suture anchors ( P = .834); mean stiffness was 19.78 ± 2.95 N/mm and 19.30 ± 4.98 N/mm, respectively ( P = .834). The mode of failure was anchor pullout for all specimens during load to failure. At the proximal position, all-suture anchors showed a displacement of 1.53 ± 0.80 mm, and titanium suture anchors showed a displacement of 0.81 ± 0.50 mm ( P = .021) under cyclic loading. At the distal position, a displacement of 1.86 ± 1.04 mm for all-suture anchors and 1.53 ± 1.15 mm for titanium suture anchors was measured ( P = .345). A positive correlation between bone mineral density and load to failure was observed ( r = 0.605; P = .013). Conclusion: All-suture anchors were biomechanically equivalent at time zero to titanium suture anchors for onlay distal biceps tendon repair. While the proximally placed all-suture anchors demonstrated greater displacement than titanium suture anchors, the comparable displacement at the distal position as well as the similar load and mechanism of failure make this difference unlikely to be clinically significant. Clinical Relevance: All-suture anchors performed similarly to titanium suture anchors for onlay distal biceps tendon repair at time zero and represent a reasonable alternative.
What Tests Are Useful to Investigate a Possible Infection of Total Ankle Arthroplasty (TAA)? What Are Their Thresholds?
Authors: Uçkay Ilker , Pedowitz David , Assal Mathieu , Stull Justin D. 
Published: July 2019

Recommendation: Overall, the approach to a potentially infected total ankle arthroplasty (TAA) does not change compared to other periprosthetic joint infections (PJIs). There are no novel or unique diagnostic procedures for TAA infection, specifically. Joint aspiration or intraoperative tissue/synovial biopsies with microbiological cultures are the most important diagnostic tests for suspected TAA infections. In the absence of specific data related to TAA, the threshold for these tests should be derived from the hip and knee PJI literature. Level of Evidence: Strong Delegate Vote: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
What Strategies Can Be Implemented to Help Isolate the Causative Organism in Patients With Infection of the Foot and Ankle?
Authors: Ellington Kent , Raikin Steven , Bemenderfer Thomas B. 
Published: July 2019

Recommendation: Transfer of synovial aspirate in blood culture bottles, obtaining deep biopsy of tissues and bone, obtaining multiple samples, increasing incubation period of cultures, and the use of molecular techniques for culture negative cases are some of the strategies that can help improve the ability to isolate the causative organism(s) in infections of foot and ankle. Level of Evidence: Moderate. Delegate Vote: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
What Is the Optimal Antibiotic (Type, Dose and Route of Administration) Treatment for Infections After Foot/Ankle Fracture or Fusion Procedures?
Authors: Pedowitz David , Stull Justin 
Published: July 2019

Recommendation: The optimal antibiotic treatment after foot/ankle fractures or fusion should be determined based on the result of culture. In the absence of culture results, administered antibiotics should include coverage against common pathogens such as Staphylococcus aureus. Level of Evidence: Strong. Delegate Vote: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus).
Effect of statin treatment on circulating malondialdehyde concentrations: a systematic review and meta-analysis
Authors: Zinellu Angelo , Paliogiannis Panagiotis , Usai Maria Franca , Carru Ciriaco , Mangoni Arduino A. 
Published: July 2019

Background: The effect of statins on oxidative stress markers, such as malondialdehyde (MDA), is still a matter of debate. We sought to address this issue by conducting a systematic review and meta-analysis of published data on the effect of statin treatment on systemic MDA concentrations. Methods: A literature search was conducted on MEDLINE/ PubMed, ISI Web of Sciences and Scopus. Data were pooled using a random-effects model. Results: A total of 35 studies assessing MDA concentrations before and after statin treatment in 1512 participants (mean age 53.6 years, 48.7% males) were identified. Extreme between-study heterogeneity was observed (I2 = 96.0%, p < 0.001). Pooled standardized mean difference (SMD) showed a significant reduction in plasma MDA concentrations after treatment (SMD = −1.47 µmol/l, 95% confidence interval = −1.89 to −1.05 μmol/l; p < 0.001). Similarly, a subgroup analysis of 10 studies that also included a placebo group showed a significant reduction in plasma MDA concentrations with statins (−1.03 μmol/l, 95% confidence interval = −1.52 to −0.29 μmol/l; p = 0.036). Conclusions: This systematic review and meta-analysis showed that statin treatment significantly reduces systemic MDA concentrations. However, the results should be interpreted with caution because of extreme between-study heterogeneity, which warrants further intervention studies.
High Rate of Recurrent Meniscal Tear and Lateral Compartment Osteoarthritis in Patients Treated for Symptomatic Lateral Discoid Meniscus: A Population-Based Study
Authors: Sabbag Orlando D. , Hevesi Mario , Sanders Thomas L. , Camp Christopher L. , Dahm Diane L. , Levy Bruce A. , Stuart Michael J. , Krych Aaron J. 
Published: July 2019

Background: Little is known about the natural history of a surgically treated symptomatic lateral discoid meniscus. The goals of this study were to describe the rate and factors associated with recurrent lateral meniscal tears and progression to symptomatic lateral compartment osteoarthritis (OA) in patients surgically treated for a symptomatic lateral discoid meniscus. Hypothesis: Patients with surgically treated lateral discoid meniscus have a high incidence of meniscal retear and progression to lateral compartment OA. Study Design: Case series; Level of evidence, 4. Methods: A large geographic database was reviewed to identify and confirm patients presenting with symptomatic lateral discoid meniscus between 1998 and 2015. Charts were reviewed to document treatment and outcomes at a minimum clinical follow-up of 2 years. Results: A total of 59 patients (27 females, 32 males) with a mean age of 25.7 years (range, 4.0-66.0 years) underwent surgical management of a discoid lateral meniscus and were evaluated for a mean of 5.6 years (range, 2.0-23.7 years). Of these, 48 (82%) patients underwent partial lateral meniscectomy, with 24 patients undergoing concurrent saucerization. Eleven (18%) underwent meniscal repair. Tear-free survival following surgery was 41% at 8 years. Progression to symptomatic lateral compartment OA was 50% at 8 years. Young age (hazard ratio, 0.96; 95% CI, 0.93-0.99; P = .01) and open growth plates (hazard ratio, 3.19; 95% CI, 1.15-8.88; P = .03) were associated with increased incidence of postoperative retear. Older age at diagnosis and body mass index ≥30 kg/m2 were associated with increased risk of progression to lateral compartment OA on final radiographs. Conclusion: Patients with a surgically treated lateral discoid meniscal tear had a high rate of recurrent meniscal tear (59% at 8 years). Approximately 50% of surgically treated patients developed symptomatic lateral compartment OA at 8 years from diagnosis.
A genome-wide scan of cleft lip triads identifies parent-of-origin interaction effects between ANK3 and maternal smoking, and between ARHGEF10 and alcohol consumption
Authors: Haaland Øystein Ariansen , Romanowska Julia , Gjerdevik Miriam , Lie Rolv Terje , Gjessing Håkon Kristian , Jugessur Astanand 
Published: July 2019

Background: Although both genetic and environmental factors have been reported to influence the risk of isolated cleft lip with or without cleft palate (CL/P), the exact mechanisms behind CL/P are still largely unaccounted for. We recently developed new methods to identify parent-of-origin (PoO) interactions with environmental exposures (PoOxE) and now apply them to data from a genome-wide association study (GWAS) of families with children born with isolated CL/P. Methods: Genotypes from 1594 complete triads and 314 dyads (1908 nuclear families in total) with CL/P were available for the current analyses. Of these families, 1024 were Asian, 825 were European and 59 had other ancestries. After quality control, 341,191 SNPs remained from the original 569,244. The exposures were maternal cigarette smoking, use of alcohol, and use of vitamin supplements in the periconceptional period. Our new methodology detects if PoO effects are different across environmental strata and is implemented in the R-package Haplin. Results: Among Europeans, there was evidence of a PoOxSmoke effect for ANK3 with three SNPs (rs3793861, q=0.20, p=2.6e-6; rs7087489, q=0.20, p=3.1e-6; rs4310561, q=0.67, p=4.0e-5) and a PoOxAlcohol effect for ARHGEF10 with two SNPs (rs2294035, q=0.32, p=2.9e-6; rs4876274, q=0.76, p=1.3e-5). Conclusion: Our results indicate that the detected PoOxE effects have a plausible biological basis, and thus warrant replication in other independent cleft samples. Our demonstration of the feasibility of identifying complex interactions between relevant environmental exposures and PoO effects offers new avenues for future research aimed at unravelling the complex etiology of cleft lip defects.