bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in Skin Microcirculation at Periulcerous Sites in Patients with Chronic Venous Ulcers during Leg Elevation
Authors: Barnes M. D. , Mani R. , Barrett D. F. , White J. E. 
Published: January 2017

Objective: To investigate the effect of limb elevation on the microcirculation of the skin in patients with venous ulceration of the leg. Design: Prospective study in patients receiving in patient treatment for venous ulceration. Setting: Health Service teaching hospital. Patients: Thirteen patients with venous ulceration of the lower limb for more than two years were investigated. Interventions: Patients were admitted to hospital and treated by bedrest with elevation of the lower limbs by 10° above the horizontal. Main outcome measures: Laser Doppler fluximetry and transcutaneous oximetry of the skin surrounding the venous ulcers was undertaken. Results: The laser Doppler fluximetry in the periculcerous region increased by 10.8 A.U. (95% CI 17 to 4.54). However, the transcutaneous oxygen measurements did not change during the period of treatment. Conclusions: Admission to hospital with elevation of the limb for patients with venous ulceration results in ***microcirculatory changes which are probably attributable to reduction in lower limb oedema.
The Prevalence of Venous Disease in Primary Lymphoedema
Authors: Chaudhry H. L. , Mortimer P. S. , Evans J. E. , Dormandy J. A. 
Published: January 2017

Objective: To assess the prevalence of venous incompetence in primary lymphoedema. Design: Retrospective study. Setting: Outpatients attending St George's Hospital, London, UK. Patients: Forty-six patients (61 limbs) with primary lymphoedema extracted from a consecutive series of patients presenting with swollen legs. Only those with clinical and lymphoscintigraphic evidence of lymphoedema were included. Patients with any clinical evidence of venous disease were excluded. Controls: Seventeen subjects (33 limbs) with no history or clinical evidence of either lymphoedema or venous disease. Methods: Light reflective rheography (LRR) and quantitative isotopic lymphoscintigraphy. Main outcome measures: Venous refilling times (RT) with and without tourniquet control. Statistical analysis: Prevalence of venous incompetence in lymphoedema patients compared with normal controls and literature values. Results: In the patients, seven of 61 limbs (11.5%) had a venous RT of less than 25 s; eight limbs (13.1%) had a venous RT between 25 and 40 s. An above-knee tourniquet corrected the RT in all 15 limbs indicating superficial venous incompetence. In the controls, one of 33 limbs (3%) had a venous RT between 25 and 40 s. An above-knee tourniquet corrected the RT indicating superficial venous incompetence. Conclusion: Covert venous insufficiency may complicate primary lymphoedema. This has implications for both the pathophysiology of the oedema and its management.
Safety and efficiency of flow diverters for treating small intracranial aneurysms: A systematic review and meta-analysis
Authors: Yao Xiyang , Ma Junwei , Li Haiying , Shen Haitao , Lu Xiaojun , Chen Gang 
Published: January 2017

Background We evaluated the safety and efficiency of flow diverters (FDs) in treating small intracranial aneurysms (IAs). Materials and Methods We reviewed the literature published in PubMed and EMBASE. R for Project software was used to calculate the complete aneurysm occlusion rates, procedure-related neurologic mortality, procedure-related neurologic morbidity and procedure-related permanent morbidity. Results Ten observational studies were included in this analysis. The complete aneurysm occlusion rate was 84.23% (80.34%–87.76%), the procedure-related neurologic mortality was 0.87% (0.29%–1.74%), the procedure-related neurologic morbidity rate was 5.22% (3.62%–7.1%), the intracerebral haemorrhage rate was 1.42% (0.64%–2.49%), the ischemic rate was 2.35% (1.31%–3.68%), the subarachnoid haemorrhage rate was 0.03% (0%–0.32%) and the procedure-related permanent morbidity was 2.41% (0.81%–4.83%). Conclusions Treatment of small IAs with FDs may be correlated with high complete occlusion rates and low complication rates. Future long-term follow-up randomized trials will determine the optimal treatment for small IAs.
Relationship between hyperuricemia and risk of coronary heart disease in a middle-aged and elderly Chinese population
Authors: Yang Ye , Tian Jian , Zeng Chao , Wei Jie , Li Liang-Jun , Xie Xi , Yang Tuo , Li Hui , Lei Guang-Hua 
Published: January 2017

Objective To investigate the relationship between hyperuricemia and coronary heart disease (CHD) risk based on the Framingham risk score (FRS) in a middle-aged and elderly Chinese population. Methods This cross-sectional study enrolled patients undergoing routine check-ups at Xiangya Hospital between October 2013 and November 2014. Hyperuricemia was defined as uric acid ≥416 mmol/l for males and ≥360 mmol/l for females. A 10-year CHD risk was calculated from FRS. A multivariable logistic analysis model was used to evaluate associations. Results Of the 6347 patients, 3415 (53.8%) were male, 1543 (24.3%) had a CHD risk ≥10% (i.e. intermediate and high risk) and the prevalence of hyperuricemia was 18.1% ( n = 1148). After adjusting for potential confounding factors, the 10-year CHD risk was increased in patients with hyperuricemia compared with those without hyperuricemia by 0.28 times in the total population (odds ratio [OR] 1.28; 95% confidence interval [CI] 1.09, 1.48), by 0.25 times in the male population (OR 1.25; 95% CI 1.06, 1.47) and by 2.76 times in the female population (OR 3.76; 95% CI 2.08, 6.79). Conclusion Hyperuricemia was positively associated with a 10-year risk of CHD suggesting that it might be an independent CHD risk factor in middle-aged and elderly individuals.
Comparison of two preventive treatments for patients with recurrent miscarriages carrying a C677T methylenetetrahydrofolate reductase mutation: 5-year experience
Authors: Merviel Philippe , Cabry Rosalie , Lourdel Emmanuelle , Lanta Segolene , Amant Carole , Copin Henri , Benkhalifa Moncef 
Published: January 2017

Objective To investigate the effect of anticoagulant treatment on pregnancy outcomes in patients with previous recurrent miscarriages (RM) who carry a methylenetetrahydrofolate reductase ( MTHFR) gene mutation. Methods In this longitudinal retrospective study, patients with RM were treated during pregnancy with either: (i) 100 mg/day aspirin and 5 mg/day folic acid (group 1); or the same protocol plus 0.4 mg/day enoxaparin (group 2). An age-matched group of triparous women without RM or thrombophilia was used as the control group (group 3). Results This study enrolled 246 women with RM (123 per treatment group) and age-matched controls ( n = 117). The delivery rate was significantly lower in group 1 than group 2 (46.3% versus 79.7%, respectively). The miscarriage rate was significantly lower in group 2 compared with group 1 (20.3% versus 51.2%, respectively). In the control group 3, the delivery rate was 86.3% and the miscarriage rate was 12.8%. Conclusion Treatment with low-dose aspirin, enoxaparin and folic acid was the most effective therapy in women with RM who carried a C677T MTHFR mutation.
Medication literacy status of outpatients in ambulatory care settings in Changsha, China
Authors: Zheng Feng , Ding Siqing , Luo Aijing , Zhong Zhuqing , Duan Yinglong , Shen Zhiying 
Published: January 2017

Objective To assess medication literacy status and to examine risk factors of inadequate medication literacy of outpatients in ambulatory care settings. Methods Study participants were recruited randomly from outpatient departments in four tertiary hospitals (Xiangya Hospital of Central South University, Second Xiangya Hospital of Central South University, Third Xiangya Hospital of Central South University, People’s Hospital of Hunan Province) in Changsha, Hunan, China, between October 2014 and January 2015. Medication literacy was assessed using the Medication Literacy Scale, Chinese version. Demographic and clinical data were collected using structured interviews. Multiple logistic regression analysis was used to estimate the independent effects of demographic and clinical factors on medication literacy. Results Of 465 participants, 425 (91.4%) produced valid responses for analysis. The mean medication literacy score was 8.31 (standard deviation = 3.47). Medication literacy was adequate in 131 participants (30.8%), marginally adequate in 248 (58.4%), and inadequate in 46 (10.8%). The risk of inadequate medication literacy was greater for older and unmarried patients but lower for more educated patients. Conclusion Many Chinese outpatients in ambulatory care have inadequate medication literacy. Greater age, low education, and unmarried status are important risk factors of inadequate medication literacy.
Genotyping Leishmania promastigotes isolated from patients with cutaneous leishmaniasis in south-eastern Turkey
Authors: Ekşi Fahriye , Özgöztaşı Orhan , Karslıgil Tekin , Sağlam Mustafa 
Published: January 2017

Objective Cutaneous leishmaniasis (CL) is a significant disease in south-eastern Anatolia because it is prevalent among Syrian refugees. We identified the causative Leishmania species in CL patients using molecular methods. Methods Novy–MacNeal–Nicolle medium was inoculated with aspirated fluid from suspected CL lesions and tested for amastigotes with Giemsa staining. PCR amplified the internal transcribed spacer 1 (ITS1) of the Leishmania genome in cultures containing Leishmania promastigotes from 100 patients, which were genotyped with a restriction fragment length polymorphism (RFLP) analysis. A phylogenetic tree was constructed from ITS1 sequences of 95 culture fluid samples from these patients. Results Leishmania amastigotes were detected in 92% of cultures with growth. Leishmania promastigotes were typed as Leishmania tropica with both PCR–RFLP and sequencing. Conclusions Identification of L. tropica as the causative agent of CL in our region allows the clinical course to be predicted, and guides treatment decisions and preventive measures.
Association between Lp-PLA2 and coronary heart disease in Chinese patients
Authors: Yang Li , Liu Yin , Wang Shufeng , Liu Ting , Cong Hongliang 
Published: January 2017

Objective To evaluate the association between plasma lipoprotein-associated phospholipase A2 (Lp-PLA2; known to release inflammatory mediators that promote atherosclerosis) and coronary heart disease (CHD) in Chinese patients. Methods This observational, cross-sectional study included a patient cohort who were assessed by coronary angiography and divided into patients with coronary heart disease and patients with normal coronary angiography (controls). Data for several biochemical indicators were collected. Plasma Lp-PLA2 concentrations were measured by enzyme-linked immunosorbent assay. Univariate and multivariate logistic regression were used to analyse the association between Lp-PLA2 concentration and CHD. Results A total of 531 patients were included, comprising 391 with CHD and 140 with normal coronary angiography (controls). Plasma Lp-PLA2 concentration was significantly higher in patients with CHD versus controls (median, 251 µg/l versus 219 µg/l, respectively), and particularly among patients with acute myocardial infarction and stable angina pectoris (249 µg/l and 266 µg/l, respectively). Multivariate analysis showed that Lp-PLA2 ≥ 292 µg/l (upper quartile of the whole cohort) was independently associated with CHD (odds ratio 2.814, 95% confidence interval 1.519, 5.214). Conclusion Plasma Lp-PLA2 concentration was independently associated with CHD in Chinese patients.
Simultaneous Analysis of the Single and Multiple Dose Pharmacokinetics of the Non-Steroidal Anti-Inflammatory, Alclofenac
Authors: Sennello Lawrence T , Sonders Robert C , Jochimsen William G , Friedmann Nadav 
Published: January 2017

Two clinical studies were conducted to study the pharmacokinetics of alclofenac in healthy adult male volunteers when the drug was administered in both single and multiple dosing regimens. The first study involved the participation of thirty-two subjects, each of whom received single 500 mg and 1000 mg oral doses of alclofenac, using a complete crossover experimental design. The second study involved the participation of sixteen subjects, eight of whom received a 500 mg dose, and eight of whom received a 1000 mg dose of alclofenac every eight hours for ninety-six consecutive hours (four days) with no crossover. In the first study, plasma alclofenac levels were monitored for ten hours post-dosing, while in the second study, drug levels were monitored for four and one-half days (i.e. through twelve hours after the last dose). Initially, using the programme NONLIN, single dose data were fit to a bi-exponential equation, with output from these fits serving as initial estimates for a second fit to the same equation. The results of these second fits were then used as initial estimates to fit the multiple dosing data to a multiple dosing one-compartment model with first order absorption and elimination. Finally, all sets of data were simultaneously fit to the one-compartment open model, with both single and multiple dosing, in an attempt to obtain a uniform interpretation, with a single set of parameters that would adequately describe the plasma alclofenac levels to be expected with a variety of dosing regimens. It was found that the kinetics did not significantly change upon going from single to multiple dosing, and that with the exception of the apparent absorption rate constant, a single set of parameters adequately described all the data collected. The rate of absorption seemed to be somewhat dose-dependent at these levels, being slower after 1000 mg doses than after 500 mg doses. For this reason, the simultaneous fitting program was allowed to estimate different absorption rate constants for the 500 mg and 1000 mg doses. The results of these simultaneous analyses were: Vol Distribution/Fraction Abs = 6.56 Litres Absorption Half-Life (500 mg) = 14 Minutes Absorption Half-Life (1000 mg) = 30 Minutes Elimination Half-Life = 2.1 Hours Absorption Lag Time = 14 Minutes
Irostrene (Ferric Sodium Edetate) Treatment of Anaemic Infants
Authors: Kahn Jarl , Larsen Stig 
Published: January 2017

This study deals with haemoglobin (Hb) measurements of healthy 1-year-old children in one district in central Norway. The aim was to study the Hb levels, to treat any children having iron deficiency anaemia (Hb ⩽ 10.8 g/100 ml), and to evaluate the effect of sodium iron edetate after 4 weeks of treatment, with a follow-up after 1 year. A total of 141 children were examined, of whom 40 had Hb ⩽ 10.8 g/ 100 ml (28.4%). The study showed that the Hb levels in healthy 1-years-olds have a normal distribution. Thirty-four children with Hb ⩽ 10.8 g/100 ml were treated for 4 weeks with sodium iron edetate (six drop-outs). The study showed a significant increase in Hb levels immediately after the treatment period as well as 4 weeks later. Hb decreases significantly immediately after ceasing treatment and continues to do so during the control period of 1 year. The Hb levels probably increase to a maximum 2 weeks after the treatment period.
Bioavailability of a Combination Preparation of Trimethoprim and Folic Acid
Authors: Soininen Kari , Kleimola Terttu 
Published: January 2017

The bioavailability of folic acid and trimethoprim was investigated from a combination preparation of folic acid (0·25 mg) and trimethoprim (100 mg) in ten healthy adult volunteers. Peroral administration of the preparation resulted in a mean peak plasma concentration of trimethoprim 1·09 mg/l (SEM 0·06). The AUC values for trimethoprim were 12·42 mg.h/l and 12·77 mg.h/l corresponding to combination preparation and plain trimethoprim, p >0·1. After administration 0·25 mg folic acid in the combination preparation, there was a significant rise in serum folic acid concentrations. The AUC from 0–8 hours was 199·8 nmol.h/l (SEM 8·1) and 166·3 nmol.h/l (SEM 14·2) corresponding to combination preparation and plain trimethoprim, p < 0·001. A loading dose of folic acid 10 mg was given intramuscularly 24 hours before drug intake. This new type of formulation of trimethoprim and folic acid has been developed in order to prevent in long-term use the adverse haematological effects induced by trimethoprim alone.
Efficacy of Low-Dose Captopril Given Twice Daily to Patients with Essential Hypertension Uncontrolled by a Beta Blocker plus Thiazide Diuretic
Authors: Muiesan G , Alicandri C , Agabiti-Rosei E , Fariello R , Montini E , Muiesan M L , Boni E , Cinquegrana A , Zaninelli A 
Published: January 2017

Thirty-two patients with moderate to severe essential hypertension whose supine diastolic blood pressure (SDBP) was ⩾95 mm Hg following 2 weeks' treatment with the optimal dosage of beta blocker-diuretic combination were randomly assigned to the addition of either Captopril 25 mg or 50 mg b.i.d. After 6 weeks' treatment, if patients were not normalized (SDBP <95 mm Hg), the dose of Captopril was doubled for a further 6 weeks. The addition of Captopril led to a significant fall in standing and supine diastolic and systolic blood pressure at the end of the sixth and twelfth week of treatment. There was no difference in the change in blood pressure between the two groups. At the end of the study SDBP was normalized in 66% of patients and a further 12·5% had their SDBP reduced by >10%. Captopril 25 or 50 mg administered twice daily proved to be a very effective antihypertensive agent when added to a beta blocker-diuretic combination in patients resistant to optimal doses of these drugs.
A Comparative Trial of Depot Pipothiazine
Authors: Steinert J , Neder A , Erba E , Pugh C R , Robinson C , Priest R G 
Published: January 2017

Thirty-nine chronic schizophrenic patients were selected for a 12-month double-blind evaluation of the effectiveness of pipothiazine palmitate (PPT) and flupenthixol decanoate (FPX) in the maintenance management of their illness. Allocation was at random and, in order to allow constant injection intervals, the patients typically received every 2 weeks either 40 mg of flupenthixol decanoate or alternating injections of 100 mg of pipothiazine palmitate and placebo. At monthly intervals the patients were assessed using both a battery of rating scales (which included the Brief Psychiatric Rating Scale (BPRS), the Extrapyramidal Symptoms Rating Scale (EPS)) and a general side-effects evaluation. At 3-monthly intervals they were also rated on the Comprehensive Psychiatric Rating Scale (CPRS) and the Zung Depression Scale. Haematological and biochemical tests were performed every 3 months. Both drugs provided good control of psychotic symptoms and side-effects were not troublesome. No substantial difference was detected on the CPRS and the Zung scales. There was a trend in favour of PPT on the BPRS survey, detectable at 6 months and reaching statistical significance by 12 months. We conclude that the PPT regime is at least as effective as the FPX treatment and probably more so. It is possible that even longer periods of control could be obtained with PPT.
Survivorship After Meniscal Allograft Transplantation According to Articular Cartilage Status
Authors: Lee Bum-Sik , Bin Seong-Il , Kim Jong-Min , Kim Won-Kyeong , Choi Jun Weon 
Published: January 2017

Background: Clinical outcomes after meniscal allograft transplantation (MAT) in arthritic knees are unclear, and objective estimates of graft survival according to the articular cartilage status have not been performed. Hypothesis: MAT should provide clinical benefits in knees with high-grade cartilage damage, but their graft survivorship should be inferior to that in knees with low-grade chondral degeneration after MAT. Study Design: Cohort study; Level of evidence, 3. Methods: The records of 222 consecutive patients who underwent primary MAT were reviewed to compare clinical outcomes and graft survivorship. The patients were grouped according to the degree and location of articular cartilage degeneration: low-grade chondral lesions (International Cartilage Repair Society [ICRS] grade ≤2) on both the femoral and tibial sides (ideal indication), high-grade lesions (ICRS grade 3 or 4) on either the femoral or tibial side (relative indication), and high-grade lesions on both sides (salvage indication). Kaplan-Meier survival analysis with the log-rank test was performed to compare the clinical survival rates and graft survival rates between the groups. A Lysholm score of <65 was considered a clinical failure, and graft failure was defined as a meniscal tear or meniscectomy of greater than one-third of the allograft, objectively evaluated by magnetic resonance imaging (MRI) and second-look arthroscopic surgery. Results: The mean (±SD) Lysholm score significantly improved from 63.1 ± 15.1 preoperatively to 85.1 ± 14.3 at the latest follow-up of a mean 44.6 ± 19.7 months ( P < .001). However, the postoperative scores were not significantly different between the 3 groups (85.7 ± 14.2 for ideal indication, 84.7 ± 17.0 for relative indication, and 84.7 ± 14.2 for salvage indication; P = .877). On MRI at the latest follow-up of a mean 23.0 ± 19.9 months and second-look arthroscopic surgery of a mean 19.3 ± 20.7 months, there were 25 (11.3%) failed MAT procedures (4 medial, 21 lateral); of these, 5 lateral MAT procedures (2.3%) went on to allograft removal. Clinical survival rates were not significantly different between the groups ( P = .256). However, on objective evaluation, the estimated cumulative graft survival rate at 5 years in the salvage indication group (62.2% [95% CI, 41.6-82.8]) was significantly lower than that in the other 2 groups (ideal indication: 93.8% [95% CI, 88.5-99.1]; relative indication: 90.9% [95% CI, 81.1-100.0]) ( P = .006). Conclusion: Our findings showed that MAT was an effective symptomatic treatment in knees with advanced bipolar chondral lesions. However, better graft survival can be expected when articular cartilage is intact or if chondral damage is limited to a unipolar lesion. MAT should be considered before the progression of chondral damage to a bipolar lesion for better graft survivorship and should be performed cautiously in arthritic knees.
Controlling the Environment to Prevent Suicide: International Perspectives
Authors: Leenaars Antoon , Cantor Chris , Connolly John , EchoHawk Marlene , Gailiene Danute , He Zhao Xiong , Kokorina Natalia , Lester David , Lopatin Andrew A , Rodriguez Mario , Schlebusch Lourens , Takahashi Yoshitomo , Vijayakumar Lakshmi , Wenckstern Susanne 
Published: January 2017

Background: Suicide and suicidal behaviour are multifaceted events requiring complex solutions. Controlling the environment is a neglected solution, despite strong support for this approach from the World Health Organization (WHO). Method To discuss this approach from a global view, this review is written by authors from various cultures: American, Australian, Canadian, Chinese, Cuban, Dutch, Indian, Irish, Japanese, Lithuanian, Native North American, Russian, and South African. Results We examine gun control to illustrate the environmental control approach; however, the worldwide diversity of suicide methods calls for diverse responses. Further, controlling the environment encompasses more than restricting the means of suicide, which we illustrate with examples of toned-down media reports and restricted medicine availability. Conclusions Controlling the environment may be a viable strategy for preventing suicide, although research shows that few clinicians implement such approaches.