bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Oswestry Low Back Pain Disability Questionnaire a Two-Year Follow-Up of Spine Surgery Patients
Authors: Niskanen R. O. 
Published: July 2017

Background and Aims: So far there is no golden standard for the measurement of functional disability in spinal problems. The Oswestry index can be used to monitor the response to treatment and rehabilitation. It is based on a patient's subjective impression of his or her own state of disability. The purpose of this prospective study is to give a graphic presentation of the behaviour of the Oswestry index in different spine surgery groups. Material and Methods: The material includes 193 discectomy and decompressive operations. 37 of these patients had been operated earlier. The patients were observed for two years after the index operation through the mail with the Oswestry questionnaire. Results: Before an operation the average Oswestry index corresponded to severe disability on average. After successful treatment the Oswestry index dropped by 20–40 points on average. The more complex the problem the higher the postoperative lines remained. Conclusions: The results compared well with those of earlier studies. The graphs presented in this study may help the treating clinician to make conclusions on how his or her patients are doing on average after surgery.
Delay in Operative Treatment among Patients with Small Bowel Obstruction
Authors: Fevang B. T. , Fevang J. M. , Søreide O. , Svanes K. , Viste A. 
Published: July 2017

Background and Aims: Delay in operative treatment for small bowel obstruction (SBO) has been shown to affect outcome adversely. The objective of this study was to detect time trends in treatment delay for patients with SBO during the study period 1961 to 1995 and to investigate factors influencing and factors affected by delay. Materials and Methods: The records of 815 patients with 921 operations for SBO from 1961–1995 were studied. Patients with large bowel obstruction, paralytic ileus and SBO caused by abdominal cancer or intussusception were excluded. Data were analysed with descriptive statistics and multiple linear regression analyses. Results: Old age and female sex were associated with increased treatment delay. Delay in hospital increased from 5 hours (median) in the 1960'ies to 16 hours (median) in the 1990'ies. Treatment delay correlated significantly with postoperative morbidity and hospital stay. Mortality increased after prolonged treatment delay in SBO caused by hernias whereas no significant increase in mortality was observed among adhesive obstructions. Conclusions: Hospital delay increased throughout the study period. Old patients and women had a longer median treatment delay than did young ones and men. Treatment delay led to an increase in postoperative morbidity and hospital stay after surgery for SBO.
Symptomatic Outcome of Laparoscopic Fundoplication, Using a Minimal Dissection Technique
Authors: Victorzon M. , Tolonen P. 
Published: July 2017

Background and Aims: The symptomatic outcome of 135 consecutive patients operated laparoscopically for gastro-oesophageal reflux disease (GORD) by a minimal paraoesophageal dissection technique is reported. Patients and Methods: At a median (range) follow-up time of 25 months (6–82 months) we sent the patients a self-assessment questionnaire regarding symptomatic outcome of the operation. Results: Median (range) operation time was 65 minutes (33–185 minutes). Per- and postoperative complications occurred in four patients (3 %). There were no conversions and no mortality. The answering rate was 91 %. Of all patients, 87 % were free of reflux symptoms, 84 % without any medication, 99 % reported at least improvement, 90 %–95 % reported persistence of favourable outcome, 90 % were satisfied, 91 % scored the outcome as good or excellent, and 95 % of the patients were ready to recommend the operation to family or friend. However, 31 % reported dysphagia and 76 % troublesome gas bloating, causing problems in 24 % of the patients. No association between different outcome variables and crural repair could be shown. Conclusion: Laparoscopic fundoplication can be done in a simple and fast way, with minimal morbidity, short hospital stay and without compromising outcome. Nevertheless, the operation is seldom without some sequel for the patient.
Adder Bites. A Report of 68 Cases
Authors: Grönlund J. , Vuori A. , Nieminen S. 
Published: July 2017

Background and Aims: The adder (Vipera Berus) is the only venomous snake that exists naturally in Scandinavia. The aim of this study is to estimate the severity of adder bites, to form a general picture of symptoms of bites and to find out how effective the present treatment methods of adder bites are. Material and Methods: 68 true adder bites treated in Turku University Hospital during the years 1995–2000 were reviewed retrospectively. Results: There were no deaths in this material. A bite caused severe symptoms to 10 of the patients. The symptoms were moderate in 21 %, mild in 34 % and minor in 35 of the cases. Children under 10 years were the proportionally biggest age group and severe poisonings were most frequent among small children. Rapidly progressive oedema, gastrointestinal symptoms, hypotension and early leucocytosis were signs of more severe poisonings. Antivenom therapy with specific ovine Fab antivenom proved to be an effective and safe treatment in severe poisonings. Conclusions: An adder bite may also cause severe symptoms for adults. All patients should be observed at least few hours after the bite and parental fluid therapy should be started at an early stage. In the treatment of severe poisonings an antivenom therapy should be considered. Rapidly progressive symptoms and early leucocytosis may serve as a warning signal for higher probability of severe reactions.
Terror Bombing-Mechanisms, Consequences and Implications
Authors: Kluger Y. , Kashuk J. , Mayo A. 
Published: July 2017

Our objective in this review is to describe the unique features of bombing injury and to outline some special elements of their management. This is to allow the timely improvement and adjustment of existing mass casualty protocols. Forensic studies, detonation and explosion, mechanisms of injury in explosion and their bodily effects, chemical effects of the explosive, site of the explosion and the wounding potential, the Multidimensional Injury Pattern, diagnostic evaluation of Multidimensional Injury Pattern, and surgical and treatment dilemmas associated with it are described and discussed.
Epidemiology of Severely and Fatally Injured Patients in Western Part of Norway
Authors: Hansen K. S. , Morild I. , Engesæter L. B. , Viste A. 
Published: July 2017

Background and Aims: Analysis of the injury mechanism and characteristics of severely and fatally injured patients in the western part of Norway. Material and Methods: We did a prospective registration of all severely injured patients hospitalized during a three-year period. The files of severely injured patients that died at scene or during transport were retrospectively retrieved from the Forensic Department. A total of 558 patients with an Injury Severity Score > 15 were included. Results: Four-hundred-forty-four men (79.6 %) and 114 women (20.4 %) with a median age of 36 and 51.5 years respectively were included. The proportion of female patients older than 80 years were 19.3 % compared to 5.6 % for men. A total of 215 (38.5 %) patients died and 149 (69.3 %) of these patients died on scene or during transport. The incidence of severely injured patients in Hordaland County was 30 per 100 000 inhabitants per year. The incidence was lowest among children below 5 years (7/100 000/year) and highest among persons older than 80 years (95/100 000/year). Men had a 3.8 times greater risk of getting seriously injured compared to women. Road traffic accidents were the cause of the injuries in 235 (42.1%) patients and 35.8% of these patients died. A total of 215 (38.5 %) patients were injured due to falls and 30.2 % of these patients died. Patients who had sustained falls were significantly older than patents with other injury mechanisms (p < 0.001, CI = 13.0–20.2). The proportion of patients with penetrating injuries was 7.3 %. Conclusion: The incidence of severely injured patients was 30/100000/year. Men and elderly people had a higher risk of getting severely injured. Falls were the dominating injury mechanism among elderly.
Does Technical Failure of Revascularization during Coronary Artery Bypass Grafting Predict Severity of Poststernotomy Mediastinitis?
Authors: Mennander A. , Maaranen P. , Negre B. , Tarkka M. 
Published: July 2017

Background and Aims: To assess the impact of unsuccessful revascularization in relation to poststernotomy mediastinitis (PSM), which affects long-term outcome after coronary artery bypass grafting (CABG). Material and Methods: An active approach for the follow-up of PSM involved a step by step treatment protocol of conventional surgery and plastic reconstructive surgery. 47 patients treated for PSM after CABG were identified and further evaluated. Complete revascularization was considered unsuccessful when technical hazards were reported during CABG. When PSM subsided after thorough debridement and sternal refixation without plastic reconstructive surgery, such as omentoplasty or muscle transposition, PSM was categorized as mild PSM. If treatment required plastic reconstructive surgery, PSM was categorized as severe PSM. Preoperative coronary artery angiographic status and success of revascularization were compared to postoperative outcome in relation to mild and severe PSM. Results: 36 patients suffered from mild PSM and 11 patients from severe PSM. Preoperative clinical status did not differ among patients. Two patients (4.3 %) died during hospitalization. The need for plastic reconstructive surgery was significant (p < 0.05) among patients with unsuccessful revascularization. 35 out of 41 patients (85 %) without problems of graft anastomosis during CABG (successful revascularization) were associated with mild PSM, whereas only 6 out of 41 patients (15 %) with successful revascularization during CABG required plastic reconstructive surgery (p < 0.05). Technical failure of graft anastomosis (3 cases) or poor outflow of internal thoracic artery (2 cases) were statistically associated with severe PSM. Conclusion: Technical failures of revascularization during CABG may delay recovery from PSM.
Endoscopic Therapy for Chronic Pancreatitis
Authors: Delhaye M. , Arvanitakis M. , Bali M. , Matos C. , Devière J. 
Published: July 2017

When endoscopic therapy is used for the treatment of patients with painful chronic pancreatitis, extracorporeal shock wave lithotripsy (ESWL) can be proposed as a first-line approach when obstructive ductal stone(s) induce upstream dilation of the main pancreatic duct. Stone fragmentation by ESWL is followed by endoscopic ductal drainage using pancreatic sphincterotomy, fragmented stone(s) extraction, and pancreatic stenting in case of ductal stricture. After completion of endoscopic pancreatic ductal drainage, long-term clinical benefit can be expected for two thirds of the patients. Best clinical results are associated with absence or cessation of smoking and with early treatment in the course of chronic pancreatitis, while alcohol abuse increases the risks of diabetes, steatorrhea and mortality. The complications of chronic pancreatitis are mainly the development of pseudocyst secondary to the downstream ductal obstruction, and biliary obstruction caused by fibrotic changes in the head of the pancreas. Successful endoscopic pseudocyst drainage is currently obtained in most patients, and carries a low complication rate. Biliary stenting is a safe and effective technique for the short-term treatment of symptomatic bile duct stricture due to chronic pancreatitis, but permanent resolution is obtained in only 25% of cases. In conclusion, endoscopic management is now considered to be the preferred interventional treatment of chronic pancreatitis, for patients selected on the basis of the anatomical changes caused by the disease. This treatment is generally safe, minimally invasive, often effective for years, does not prevent further surgery, and can be repeated.
The Use of Methionine for Acute Paracetamol Poisoning
Authors: Crome P , Volans G N , Vale J A , Widdop B , Goulding R , Williams R S 
Published: July 2017

Since September 1974 the London Centre of the National Poisons Information Service has advocated the use of methionine for acute paracetamol poisoning and this paper presents a preliminary report of its outcome. Seventeen patients, all of whom had high plasma paracetamol levels, received oral methionine within ten hours of the ingestion of the overdose. Eleven of these patients suffered no hepatic damage, while the remaining six showed varying degrees of liver failure with a mean maximum aspartate aminotransferase (AST) of 1,098 iu/l. There were no deaths in this group. Among fourteen patients who had taken similar paracetamol overdoses and received no antidotal treatment, all developed liver damage and seven of these died. These two groups were not, however, accurately matched for dose of paracetamol, plasma paracetamol levels or interval before reaching hospital. Comparison was therefore made with two other recently published series of untreated patients. A significant reduction was noted in the incidence of liver damage and in the mean maximum AST. Although this survey was not controlled, it is suggested that oral methionine, which has a low incidence of side-effects, may be effective in reducing the incidence and severity of paracetamol-induced liver damage, provided the overdose is not massive.
Performance vs. Preference
Authors: Bailey Robert W. 
Published: July 2017

One of the main tenets of most company-sponsored quality programs is that the customer is always right. Designers frequently evaluate the goodness of their systems by simply asking users whether or not they like the interface. The fallacy of this approach is that users genrally make judgements based on their “preferences” and tend to ignore the more important performance issues. System designers frequently use their own preferences to make decisions, and then make major inferences about how users will perform with their system. Several past studies are reviewed to show that users can perform well and not like a system, or like a system and still not perform well. Two recent studies are reported showing a mismatch between designer's preferences for certain interface decisions, and measured user performance when using the resulting interfaces. It is proposed that better user interfaces are possible if we clearly separate the performance and preference concepts, recognize the limitations of each, and work to optimize one or the other (there is usually not sufficient time to optimize both). The only way to ensure that systems will elicit acceptable levels of performance is to conduct performance-oriented usability tests.
Process Safety Management System Performance Measures for the Chemical Industry
Authors: Connelly Edward 
Published: July 2017

The Center for Chemical Process Safety of the American Institute of Chemical Engineers has developed a twelve-element model management system for process safety. Concord has worked with CCPS to develop performance measures for two of the elements, namely “Management of Change” and “Training”. A unique feature of the measures is that they continuously assess the performance of the elements, a feature somewhat analogous to the control of a plant. This contrasts with an audit evaluation which captures a snapshot of the management system performance at a particular instant of time. Of special interest here is the method used to build the measures which employed chemical plant process safety experts performing the functions for which they are accepted as experts. For instance, analysis of the management systems used a method well known to chemical engineers for assessing chemical process safety, the Hazard and Operability Study (HAZOP) (AIChE/CCPS 1985) process. Further, synthesis of the performance measures employed process safety experts in a role they perform in their professions - assessment of the level of performance of various demonstrations of process safety management systems. This methodology is believed to be a reliable way of obtaining information from experts. That method is described in this paper.
Enhancing the Performance of Interface Evaluators Using Non-Empirical Usability Methods
Authors: Desurvire Heather , Thomas John C. 
Published: July 2017

Heuristic Evaluation has been shown to be a quick cost-effective methodology that can lead to early identification of many of the same user interface errors as laboratory usability studies. In this paper, we describe a method designed to enhance the performance of expert, system developer, and non-expert evaluators. The evaluators most proficient at Heuristic Evaluation are Human-Factors Experts (Desurvire, Lawrence and Atwood, 1991; Desurvire, Kondziela and Atwood, 1992; Jeffries, Miller, Wharton and Uyeda, 1991) and most notably, “double experts” (Nielsen, 1992). Similar results were obtained for the Cognitive Walkthrough developed by Lewis, Polson, Wharton and Rieman, 1990 (Desurvire, et al., 1992; Jeffries, et al., 1991). We were interested in whether a non-empirical method could be developed in which evaluators other than Human Factors Experts can perform nearly as well as Experts. Desurvire, et al. (1992) found that Heuristic Evaluation and Cognitive Walkthroughs not only predicted problems observed in laboratory studies but also encouraged evaluators to suggest improvements. In addition, non-empirical methods stimulated evaluators to point out problems that would be likely to occur in actual use, but would not be observed in laboratory studies. We were interested in expanding this finding by developing a method that encouraged a broader scope of thinking, and thus a broader evaluation. In this paper, we describe the method Programmed Amplification of Valuable Experts (PAVE) and how it enhanced the performance of System Developers and Non-Human-Factors-Expert evaluators. Future work is discussed in which real users in the field will be compared to these results.
Exercise-Associated Muscle Cramps
Authors: Miller Kevin C. , Stone Marcus S. , Huxel Kellie C. , Edwards Jeffrey E. 
Published: July 2017

Context: Exercise-associated muscle cramps (EAMC) are a common condition experienced by recreational and competitive athletes. Despite their commonality and prevalence, their cause remains unknown. Theories for the cause of EAMC are primarily based on anecdotal and observational studies rather than sound experimental evidence. Without a clear cause, treatments and prevention strategies for EAMC are often unsuccessful. Evidence Acquisition: A search of Medline (EBSCO), SPORTDiscus, and Silverplatter (CINHAL) was undertaken for journal articles written in English between the years 1955 and 2008. Additional references were collected by a careful analysis of the citations of others’ research and textbooks. Results: Dehydration/electrolyte and neuromuscular causes are the most widely discussed theories for the cause of EAMC; however, strong experimental evidence for either theory is lacking. Conclusions: EAMC are likely due to several factors coalescing to cause EAMC. The variety of treatments and prevention strategies for EAMC are evidence of the uncertainty in their cause. Acute EAMC treatment should focus on moderate static stretching of the affected muscle followed by a proper medical history to determine any predisposing conditions that may have triggered the onset of EAMC. Based on physical findings, prevention programs should be implemented to include fluid and electrolyte balance strategies and/or neuromuscular training.
Upper Limb Biomechanics During the Volleyball Serve and Spike
Authors: Reeser Jonathan C. , Fleisig Glenn S. , Bolt Becky , Ruan Mianfang 
Published: July 2017

Background: The shoulder is the third-most commonly injured body part in volleyball, with the majority of shoulder problems resulting from chronic overuse. Hypothesis: Significant kinetic differences exist among specific types of volleyball serves and spikes. Study Design: Controlled laboratory study. Methods: Fourteen healthy female collegiate volleyball players performed 5 successful trials of 4 skills: 2 directional spikes, an off-speed roll shot, and the float serve. Volunteers who were competent in jump serves (n, 5) performed 5 trials of that skill. A 240-Hz 3-dimensional automatic digitizing system captured each trial. Multivariate analysis of variance and post hoc paired t tests were used to compare kinetic parameters for the shoulder and elbow across all the skills (except the jump serve). A similar statistical analysis was performed for upper extremity kinematics. Results: Forces, torques, and angular velocities at the shoulder and elbow were lowest for the roll shot and second-lowest for the float serve. No differences were detected between the cross-body and straight-ahead spikes. Although there was an insufficient number of participants to statistically analyze the jump serve, the data for it appear similar to those of the cross-body and straight-ahead spikes. Shoulder abduction at the instant of ball contact was approximately 130° for all skills, which is substantially greater than that previously reported for female athletes performing tennis serves or baseball pitches. Conclusion: Because shoulder kinetics were greatest during spiking, the volleyball player with symptoms of shoulder overuse may wish to reduce the number of repetitions performed during practice. Limiting the number of jump serves may also reduce the athlete’s risk of overuse-related shoulder dysfunction. Clinical Relevance: Volleyball-specific overhead skills, such as the spike and serve, produce considerable upper extremity force and torque, which may contribute to the risk of shoulder injury.