bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can We Measure Growth?
Authors: Voss Linda D 
Published: January 2017

Poor installation and maintenance of height measuring equipment is a serious problem in the community. With care, however, height can be measured with sufficient precision (± 0.5 cm) to identify unusually short or tall stature. Height velocity, on the other hand, is liable to misinterpretation. It cannot be estimated with sufficient precision to identify abnormal growth in the short term. There is no correlation between two successive 12 month velocities. When a trend towards poor velocity is beyond all doubt then it will be apparent on the height chart alone. In addition, “poor” or “excessive” growth is conditional on the height of the child: short children do not grow at the same rate as tall. A diagnosis of abnormal growth requires long term monitoring and is best seen as a series of height measurements crossing the centiles on the height chart. Given the correct equipment and training, height or length can be measured with a fair degree of precision in the youngest of children. The earlier measurements begin, the sooner an abnormal pattern of growth will become evident. The regular monitoring of height should be standard practice and available to each and every child.
An Offshore Silicon Valley? The Emerging Irish Software Industry
Authors: Riain Seán Ó 
Published: January 2017

This paper assesses the development potential of local inter-firm networks in Newly Industrializing Countries. This is done through an analysis of the role of such networks in the growth of the software industry in the Republic of Ireland. Transnational software companies located in Ireland developed extensive local supply networks. Local social networks and a local culture of innovation contributed to the growth of an indigenous software development sector. While local networks can generate significant competitive advantage for a region they are inevitably internationalized as successful firms organize globally or as the region attracts further foreign investment. Corporations utilize local networks to solve problems of cost, control and innovation management in the globalization of production and corporate organization. While fostering local networks can be an effective public policy, it is not sufficient for development. The role of the state in supporting, guiding and bargaining with local firms in these networks remains a crucial aspect of development strategy.
The New Macrolide Antibiotics: Azithromycin, Clarithromycin, Dirithromycin, and Roxithromycin
Authors: Bahal Neeta , Nahata Milap C. 
Published: January 2017

OBJECTIVE: To review the chemistry, antimicrobial spectrum, pharmacokinetics, clinical trials, adverse effects, and drug interactions of four new macrolide antibiotics: Azithromycin, clarithromycin, dirithromycin, and roxithromycin. DATA SOURCES: Information was obtained from comparative clinical trials, abstracts, conference proceedings, and review articles. Indexing terms included azithromycin, clarithromycin, dirithromycin, erythromycin, roxithromycin, and macrolide antibiotics. STUDY SELECTION: Emphasis was placed on comparative clinical trials involving the new macrolide antibiotics. DATA EXTRACTION: Data from human studies published in the English language were evaluated. Trials were assessed by sample size, macrolide dosage regimen, and therapeutic response. DATA SYNTHESIS: The erythromycins have gained widespread use in treating a variety of infections. Although they are effective, limitations include the need to administer four times a day and the intolerable adverse gastrointestinal effects. Four of the more extensively studied agents, azithromycin, clarithromycin, dirithromycin, and roxithromycin, are currently being studied in patients. Based on the studies to date, the newer macrolides may offer several advantages over erythromycin, including: (1) greater antimicrobial activity against certain organisms; (2) longer elimination half-life, thus allowing less frequent administration; and (3) lower incidence of adverse gastrointestinal effects. CONCLUSIONS: The new macrolide antibiotics appear to offer an improvement over erythromycin. Definitive conclusions about the role of these drugs should await completion of ongoing clinical studies.
Computers in Healthcare: Overview and Bibliography
Authors: Dasta Joseph F. , Greer Marianne L. , Speedie Stuart M. 
Published: January 2017

OBJECTIVE: The objective of this article is to provide an overview of computer technology and an associated bibliography, emphasizing institutional-based healthcare applications and pharmacoinformatics. DATA SOURCES: References were selected from the authors' files and from a computerized search over the last five years on computers in healthcare/medical informatics and in pharmacy. STUDY SELECTION: Articles selected for review and discussion were considered to be important contributions to the respective areas listed in the bibliography and representative of advancements in computer applications in healthcare and pharmacy. DATA SYNTHESIS: The computer has become an important support tool for healthcare professionals. Medical informatics and the discipline related to pharmacy, called pharmacoinformatics, have evolved from the cognitive underpinnings of medicine, pharmacy, and computer science. Recent developments in computer technology have resulted in computers that are fast, increasingly portable, and user friendly. Hospital information systems employ computers in various ways to deal with the vast amount of information used by various departments. Standards for electronic data exchange are being developed to increase the integration potential of these systems. Hospital pharmacists have used computers for drug distribution, financial analysis and inventory control, drug interaction detection, pharmacokinetic dosing, drug information, and drug therapy monitoring. Expert systems are being developed in several areas of drug therapy. Pharmacy educators have developed interactive courseware to help students learn problem-solving skills in the areas of calculations, therapeutics, and drug information. CONCLUSIONS: Pharmacists need to become more involved with applications of technology to pharmacy. Properly implemented, computers can provide more time for pharmacists to use their cognitive skills in the delivery of pharmaceutical care.
Availability of Narcotics and Pharmacists' Attitudes toward Narcotic Prescriptions for Cancer Patients
Authors: Holdsworth Mark T. , Raisch Dennis W. 
Published: January 2017

OBJECTIVE: To determine narcotic availability and pharmacist apprehension toward dispensing narcotics for cancer patients. DESIGN: Mailing of a one-page survey. SETTING: All pharmacies in the state of New Mexico. PARTICIPANTS: Of the 309 pharmacies, 76.1 percent (235) completed the survey. MEASUREMENTS AND MAIN RESULTS: Apprehension was significantly elevated for methadone, hydromorphone, and for morphine doses >500 mg/d (p<0.001). The most common reasons listed for apprehension were forgery (46.4 percent), theft (40.4 percent), high dosages (23.8 percent), narcotic investigations (18.7 percent), and patient addiction (9.4 percent). Hydromorphone was available (in stock) in 80.5 percent of the pharmacies, followed by morphine 30-mg sustained-release tablets (64.5 percent) and methadone (53.4 percent). The vast majority of pharmacists were willing to order strong narcotics for specific patients. Pharmacists working in chain stores expressed a higher level of apprehension toward dispensing methadone and more frequently cited forgery as a reason for apprehension. Distance from a metropolitan area and practice setting best predicted apprehension to forgery (p=0.01). CONCLUSIONS: Pharmacists do not appear to be a major obstruction to adequate analgesia for cancer patients in New Mexico but may require further education regarding lack of narcotic addiction and dosing in patients with cancer.
Kinematics of a Total Arthroplasty of the Ankle: Comparison to Normal Ankle Motion
Authors: Michelson James D. , Schmidt Guy R. , Mizel Mark S. 
Published: January 2017

Although the concept of a total ankle arthroplasty has been advanced as a method for treating severe ankle arthritis, the clinical experience with all of the models developed has been discouraging. Both the constrained designs, which maximize joint contact area by restricting the available motion, and the unconstrained designs, which allow more normal motion at the expense of higher contact stresses, uniformly result in implant loosening, pain, and clinical failure in 2 to 7 years. This has led to the recommendation against the use of a total ankle arthroplasty except in very low-demand patients. Failure of ankle implants can be ascribed to either anatomic considerations (e.g. -the talus is too small to accommodate the stress transfers of a prosthesis), or mechanical etiologies. Abnormal 3-dimensional motion of the ankle following arthroplasty would fall into the latter category. This study examined the motion that occurs after implantation of an unconstrained-type total ankle arthroplasty. Using previously validated methodology, axially loaded ankle specimens were cycled through an arc of plantarflex/dorsiflexion while measuring the resulting coupled internal/external and varus/valgus rotations. The average coupled motions in prosthetic ankles were not significantly different than their intact controls. There was, however, a significantly increased amount of hysteresis (defined as the difference between the upper and lower pathways of coupled motion at any given sagittal position) that occurred as the ankle was dorsiflexed and plantar flexed. The increased hysteresis was seen in both the axial and coronal planes. This indicates that there was a greater permitted envelop of motion in the prosthetic ankles compared to normal ankles. It is hypothesized that this subtle change in ankle kinematics caused by the arthroplasty leads to abnormal stress transfer at the prosthesis-bone interface, thereby promoting early implant failure.
Increased Bone Mineral Density Adjacent to Hydroxy-Apatite-Coated Ankle Arthroplasty
Authors: Zerahn Bo , Kofoed Hakon , Borgwardt Arne 
Published: January 2017

We measured bone mineral density (BMD) in patients treated with a unilateral hydroxy-apatite-coated ankle arthroplasty. The study comprised 11 consecutive patients measured preoperatively and postoperatively after 3, 6, and 12 months (group I) and 17 patients measured once at 12 to 82 months follow-up (group II). BMD was measured in the distal tibia adjacent to the prosthesis and in the calcaneus. BMD of the calcaneus was measured bilaterally as an indicator of changes in foot load. In group I BMD was significantly increased in the distal tibia after 6 and 12 months compared to preoperative values. In group II BMD of the distal tibia was significantly higher compared to the non-operated side. No radiolucencies were detected during follow-up in any case. The increase in BMD and the radiogaphic findings after uncemented ankle arthroplasty indicates that it is being loaded by the prosthesis. This may indicate a well fixed prosthesis.
Plantarflexion Torque Following Reconstruction of Achilles Tendinosis or Rupture with Flexor Hallucis Longus Augmentation
Authors: Monroe Michael T. , Dixon David J. , Beals Timothy C. , Pomeroy Gregory , Crowley David L. , Manoli Arthur 
Published: January 2017

Nine patients treated surgically for Achilles tendon rupture (7 patients) or tendinosis (2 patients) with primary repair or debridement and augmentation with the flexor hallucis longus muscle-tendon unit were evaluated at a mean of 19 months postoperative. Subjective evaluation revealed a high level of satisfaction. All patients returned to work and only two patients reported limitation in their recreational activities. The mean post-operative AOFAS Ankle-Hindfoot Score was 90 points. Four patients reported mild occasional pain and one patient complained of moderate daily pain. Motion assessment showed a 20% increase in the hallux MTP dorsiflexion compared to the non-operative side (p = 0.045). No difference in ankle motion was noted. Cybex II+ dynamic evaluation of plantarflexion peak torque was complete on both extremities. The torque deficit on the reconstructed extremity was 20% (p = 0.01) at 120 degrees per second and 26% (p = 0.003) at 30 degrees per second. There is no significant difference between the torque deficit recorded for patients with Achilles rupture and those with Achilles tendinosis. A trend toward improved torque production with longer follow up was observed.
ACE Phenotyping as a Guide Toward Personalized Therapy With ACE Inhibitors
Authors: Danilov Sergei M. , Tovsky Stan I. , Schwartz David E. , Dull Randal O. 
Published: January 2017

Background: Angiotensin-converting enzyme (ACE) inhibitors (ACEI) are widely used in the management of cardiovascular diseases but with significant interindividual variability in the patient’s response. Objectives: To investigate whether interindividual variability in the response to ACE inhibitors is explained by the “ACE phenotype”—for example, variability in plasma ACE concentration, activity, and conformation and/or the degree of ACE inhibition in each individual. Methods: The ACE phenotype was determined in plasma of 14 patients with hypertension treated chronically for 4 weeks with 40 mg enalapril (E) or 20 mg E + 16 mg candesartan (EC) and in 20 patients with hypertension treated acutely with a single dose (20 mg) of E with or without pretreatment with hydrochlorothiazide. The ACE phenotyping included (1) plasma ACE concentration; (2) ACE activity (with 2 substrates: Hip-His-Leu and Z-Phe-His-Leu and calculation of their ratio); (3) detection of ACE inhibitors in patient’s blood (indicator of patient compliance) and the degree of ACE inhibition (ie, adherence); and (4) ACE conformation. Results: Enalapril reduced systolic and diastolic blood pressure in most patients; however, 20% of patients were considered nonresponders. Chronic treatment results in 40% increase in serum ACE concentrations, with the exception of 1 patient. There was a trend toward better response to ACEI among patients who had a higher plasma ACE concentration. Conclusion: Due to the fact that “20% of patients do not respond to ACEI by blood pressure drop,” the initial blood ACE level could not be a predictor of blood pressure reduction in an individual patient. However, ACE phenotyping provides important information about conformational and kinetic changes in ACE of individual patients, and this could be a reason for resistance to ACE inhibitors in some nonresponders.
Malignant Pilomatrixoma Arising on the Previously Irradiated Face: Case Report and Literature Review
Authors: Karaaslan Onder , Can Murat Melih , Silistreli Ayse Ozlem Karatas , Bedir Yagmur Kaan , Caliskan Gorkem 
Published: January 2017

Background: Malignant pilomatrixoma (also known as pilomatrix carcinoma) is a very rare malignant neoplasm derived from the hair matrix. These slow-growing malignancies of the skin are found in the lower dermis and subcutaneous fat layer. They can exhibit local aggressive behavior or distant metastasis. This malignancy can arise as a solitary lesion de novo or through transformation of a pilomatrixoma over a long period. There is no known distinct etiologic factor or predisposing condition for this kind of malignancy. Objective and Conclusion: We present an interesting case of a 65-year-old man with a pilomatrix carcinoma arising on the previously irradiated face due to the malignant neoplasm of the parotid gland. This is the first report of a pilomatrix carcinoma that has developed on a region that has undergone radiotherapy for another malignancy. Renseignements de base: Le pilomatrixome malin (aussi appelé « carcinome à pilomatrix ») est une tumeur maligne très rare issue de la matrice du poil. Ces tumeurs cutanées malignes à croissance lente se trouvent dans le derme profond et la couche adipeuse sous-cutanée. Elles peuvent présenter un comportement agressif local ou des métastases distales. Cette tumeur maligne peut se développer sous forme de lésion solitaire de novo ou à la suite d'une transformation d'un pilomatrixome de longue durée. Aucun facteur étiologique distinct et aucune condition prédisposante pour ce type de tumeur maligne ne sont connus. Objectif and conclusion: Nous exposons le cas intéressant d'un homme de 65 ans présentant un carcinome à pilomatrix au visage et dont le visage a été préalablement irradié pour traiter une tumeur maligne de la glande parotide. Il s'agit du premier cas de carcinome à pilomatrix rapporté qui s'est développé à un endroit qui a subi une radiothérapie pour traiter une autre tumeur maligne.
Effective Treatment of Nodular Amyloidosis with Carbon Dioxide Laser
Authors: Lesiak Aleksandra , Rakowski Adam , Brzezinska Agnieszka , Rogowski-Tylman Michal , Kolano Pawel , Sysa-Jedrzejowska Anna , Narbutt Joanna 
Published: January 2017

Background: Nodular amyloidosis is a rare form of localized cutaneous amyloidosis that is characterized by nodules located on the extremities, trunk, genitalia, or face. In treatment regimens, many approaches have been described, including carbon dioxide (CO2) laser therapy. Objective: We present a case of a 60-year-old white male with a 20-year history of disseminated waxy, purpuric, yellowish, and bullous skin lesions on the trunk and extremities. The skin changes were accompanied by pain during palpation and were temporarily pruritic. Method: Based on histologic and direct immunofluorescence test findings, the diagnosis of cutaneous nodular amyloidosis was established. Skin lesions were treated with a CO2 laser. During surgery, treated tissue was found to be slightly friable, and there was a little problem with hemostasis that correlated with amyloid infiltration of the dermis and blood vessels. However, after 8 weeks, we observed clinical improvement of all treated areas with the presence of atrophic scars. In the regions of laser therapy, no recurrence of the disease was observed during a 12-month follow-up. Conclusion: Based on these results, we conclude that CO2 laser has a beneficial effect in the treatment of nodular amyloidosis; however, surgery procedures may be associated sometimes with tissue friability and poor hemostasis. Contexte: L'amylose nodulaire est une forme rare d'amylose cutanée localisée, qui se caractérise par des nodules situés sur les membres, le tronc, les organes génitaux, et la face. Diverses formes de traitement ont été décrites, notamment le traitement au laser à gaz carbonique (CO2). Objectif: Nous exposons ici le cas d'un homme de 60 ans, de race blanche, présentant, depuis une vingtaine d'années, des lésions cutanées bulleuses, jaunâtres, purpuriques, et d'apparence cireuse, disséminées sur le tronc et les membres. Les lésions s'accompagnaient de douleur à la palpation et étaient prurigineuses pendant un certain temps. Méthode: Le diagnostic d'amylose nodulaire cutanée a été posé d'après les résultats de l'examen histologique et de l'immunofluorescence directe. Les lésions ont été traitées au laser à CO2. Les tissus se montraient légèrement friables durant la chirurgie, et l'hémostase était quelque peu difficile en raison de l'infiltration amyloïde du derme et des vaisseaux sanguins. Toutefois, une amélioration clinique de toutes les régions traitées a été marquée, au bout de 8 semaines, par l'apparition de cicatrices atrophiques. Il n'y a pas eu de récidive de la maladie dans les régions traitées au laser, au cours d'un suivi de 12 mois. Conclusion: Nous avons déduit des résultats que le laser à CO2 avait un effet favorable sur l'amylose nodulaire; cependant, l'intervention chirurgicale peut parfois être gênée par la friabilité des tissus et une mauvaise hémostase.
Should the ‘C’ in ‘ABCDE’ Be Altered to Reflect the Trend towards Hypotensive Resuscitation?
Authors: Sapsford W. 
Published: January 2017

Background: Fluid resuscitation of trauma victims currently differs, depending on whether the Advanced Trauma Life Support (ATLS), Prehospital Trauma Life Support (PHTLS) or Battlefield Advanced Trauma Life Support (BATLS) algorithm is utilised. Resuscitation protocol depends on the situation of the patient before definitive surgical control of the haemorrhage can be achieved, that is, in the prehospital phase (the urban, rural or battlefield setting) or in the emergency room. The principle difference is between hypotensive (PHTLS and BATLS, in the prehospital phase) and normotensive (ATLS, in the emergency room) resuscitation. The aim of this review was to determine if there is sufficient evidence to consider altering the ATLS resuscitation algorithm to a hypotensive model prior to definitive surgical control of haemorrhage. Method: A literature review was conducted of the experimental and clinical evidence for hypotensive resuscitation. Results: Uncontrolled haemorrhage models are too severe. They do not realistically mimic — And their results cannot easily be extrapolated into — Clinical scenarios. One important clinical trial, inspired by these experimental models, has rightly influenced resuscitation of shocked prehospital patients towards a ‘scoop and run’ approach and permissive hypotension but it is specific to patients with penetrating trauma alone. Conclusion: There is insufficient evidence to alter the current ATLS algorithm in the emergency room in favour of hypotensive resuscitation. The future of resuscitation is considered.
Congenital Diaphragmatic Hernia: Improved Surgical Results Should Influence Abortion Decision Making
Authors: Gudbjartsson T. , Gunnarsdottir A. , Topan C. Z. , Larsson L. T. , Rosmundsson Th , Dagbjartsson A. 
Published: January 2017

Aims: To compare surgical results for congenital diaphragmatic hernia (CDH) in two Scandinavian university hospitals and to evaluate the effects of abortions on the clinical profile of CDH in Iceland. Methods: A retrospective study including all CDH-cases in Iceland 1983–2002 and children referred to Lund University Hospital 1993–2002. Aborted fetuses with CDH from a nation-wide Icelandic abort-registry were also included. Results: In Iceland, 19 out of 23 children with CDH were diagnosed < 24 hours from delivery, one with associated anomalies. Eight fetuses were diagnosed prenatally and seven of them aborted, three having isolated CDH at autopsy. In Iceland, 15 of 18 children operated on survived surgery (83% operative survival). In Lund 28 children were treated with surgery, 23 of them diagnosed early after birth or prenatally. Four children did not survive surgery (86% operative survival) and 9 (31%) had associated anomalies. All the discharged children treated in Iceland and Lund are alive, 3–22 years postoperatively. Conclusion: CDH is a serious anomaly where morbidity and mortality is directly related to other associated anomalies and pulmonary hypoplasia. However, majority of CDH patients do not have other associated anomalies. In spite of improved surgical results (operative mortality < 20%), a large proportion of pregnancies complicated with CDH are terminated. We conclude that the improved survival rate after corrective surgery must be emphasized when giving information to parents regarding abortion of fetuses with a prenatally diagnosed CDH.