bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Multi-Centre Study of Community-Directed Ivermectin Distributors' (CDDs') Involvement in other Healthcare and Development Programme Activities in Cameroon, Togo, Sudan, Nigeria and Uganda
Authors: Sama M T , Homeida M , Ngang P , Liese B H , Amazigo U , Seketeli A 
Published: January 2017

A multi-centre study to determine whether community-directed distributors (CDDs) are capable of carrying out additional healthcare and developmental activities in their communities was carried out in Cameroon, Nigeria, Sudan, Uganda and Togo to ascertain the potential effects of their involvement on the implementation of community-directed treatment with ivermectin (CDTI). Both quantitative and qualitative methods were used to collect data from households, community-directed distributors, community leaders, and health workers. The results showed no major decrease in the CDDs' performance in CDTI: On the contrary, the involvement of CDDs in other health and development activities motivated them to perform their CDTI functions better. However, the results did not show any significant increase in therapeutic coverage of ivermectin distribution. The expansion of the CDDs' experience to include additional healthcare and development related activities would be of interest to onchocerciasis control programmes – it will strengthen CDTI sustainability through greater integration.
Profile of Cataract Patients in the Eye, Ear, Nose and Throat Hospital, Rangoon
Authors: Le-Le-Win  , Thein-Hlang  , San-Shwe  , Than-Htun-Oo  , Ko-Ko-Tin  
Published: January 2017

We report on our experience of cataract surgery in the Eye, Ear, Nose and Throat Hospital (EENTH), Rangoon. Cataract patients constituted 52070 of all those admitted with eye diseases to the EENTH in a year. The mean number of cataract cases operated per month was 282. Among cataracts the senile form was the commonest. The female to male ratio for senile cataract patients was 1.2, and the average age at admission was 68 years. The mean duration of stay in hospital was 7 days with an operation time of 19min. The patients had to come to hospital for follow-up for an average period of 3.1 months to complete treatment. The need to consider cataract surgery as an outpatient procedure is discussed.
Use of Physiotherapy Records to Monitor the Efficacy of a Poliomyelitis Vaccination Programme in Ilorin, Nigeria 1981–1988
Authors: Babaniyi O A , Yeye-Agba B , Parakoyi D B 
Published: January 2017

During the 8 years of a poliomyelitis control programme in Ilorin Local Government Area, Nigeria, a maximum of 85% of children aged 12–23 months were estimated to have received three doses of trivalent oral polio vaccine (TOPV). The estimated incidence of paralytic poliomyelitis decreased by 65%, suggesting a low vaccine efficacy of approximately 76% for the currently used TOPV. A more detailed study of TOPV efficacy (eg case control or cohort study) is required, however, to provide a more accurate estimate. Similar low-cost efforts at documenting the impact of TOPV on the incidence of poliomyelitis, using physiotherapy clinics as independent sentinels, are needed from many other centres. To increase the efficacy of the primary series of TOPV in Nigeria, the number of doses constituting the primary series should be increased to four (including one at birth), as recommended by the World Health Organization.
Setting Standards for Primary Health Services
Authors: Garner P , Thomason J 
Published: January 2017

Primary health service coverage has increased in many developing countries over the last 10 years. The number of components included in the basic package has also expanded. This has led in some countries to primary health workers becoming overloaded with responsibilities. To maintain high quality care, primary health workers not only need appropriate training, but clear performance guidelines, as well as essential resources and supportive supervision. We report on the establishment of standards for primary health services by the Ministry of Health in Papua New Guinea (PNG).
Clinical Pattern of Perforated Prepyloric and Duodenal Ulcer at Ile-Ife, Nigeria
Authors: Lawal O O , Oluwole S F , Fadiran O A , Campbell B 
Published: January 2017

High morbidity and mortality often attend perforation of duodenal ulcer. Over a 6-year period at Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria, 22 patients presented with prepyloric or duodenal ulcer perforations- a relatively low yearly rate of about four. Of the 15 patients evaluated, approximately three-quarters were working class young men and eight 53%) had no ulcer history. The high morbidity, and 20% mortality rate, observed were attributable to late presentation and the presence of advanced bacterial peritonitis in 67% of the patients at admission. Imprecise clinical features in those with small perforations led to misdiagnosis in a third of cases. Treatment of perforations in the majority (93%) of patients was by simple closure or truncal vagotomy and pyloroplasty. An increase in patients' awareness of the potentials of optimal operative management should encourage earlier presentation.
Cancer Awareness among a Nigerian Population
Authors: Uche E E O 
Published: January 2017

We conducted a population survey with the objective of identifying the level of cancer awareness. In Nigeria many patients present late for medical care. We analysed data from 460 literate Nigerians. Three hundred and sixty (78.3%) had heard about cancer, 34.1% identified particular risk age categories, while 62.2% said that cancer could occur at any time. Awareness of warning signs and sites of cancer location was very poor and only 33% recognized that a breast lump was a warning sign. Knowledge of methods of early detection was also very low and only 50% said that cancer is curable when detected early. This investigative survey highlighted a considerable ignorance and lack of awareness of cancer among the Nigerian population.
The New Dietary Ingredient Safety Provision of DSHEA: A Return to Congressional Intent
Authors: Bass Scott , Marden Emily 
Published: January 2017

In the ten years since the passage of the Dietary Supplement Health and Education Act of 1994 (“DSHEA”), dietary supplements have become a widely available and important element of individualized preventative healthcare. Congress created DSHEA in response to great consumer demand, thereby embracing the dietary supplement category and opening the door for the growth of the dietary supplement industry. DSHEA introduced an expansive definition of dietary supplements and laid out available claims and strict safety standards for such products.While the statute has remained unchanged since its passage in 1994, the Food and Drug Administration (“FDA”) appears to be in the process of re-interpreting sections of DSHEA in ways that could fundamentally limit the availability of dietary supplements. Specifically, FDA has been utilizing DSHEA's “new dietary ingredient” (“NDI”) safety provision to narrow the scope of ingredients that can be considered, even before addressing their safety, for use in dietary supplements.
Overcoming Barriers and Ensuring Access to HPV Vaccines in Low-Income Countries
Authors: Tsu Vivien Davis 
Published: January 2017

AbstractThe inequitable burden of cervical cancer falls on women in poorer countries, due primarily to a disparity in access to screening services. To ensure that access to the new human papillomavirus (“HPV”) vaccines is not similarly skewed toward higher-income populations, it is important to understand the appropriate priority group for receiving vaccines, the potential barriers to reaching that group, and the options for overcoming those barriers. Based on vaccine efficacy data, the likelihood of achieving high coverage with various groups, and the resultant cost-effectiveness ratios, it is widely agreed that young adolescent girls should be the primary recipients. Potential barriers include the fact that young adolescents are not currently reached by many health services; that there might be stigma attached to a vaccine for a sexually transmitted infection; that financing for the vaccine must be allocated; and that there is limited political commitment to women's health, to cancer prevention, or to this particular vaccine when so many other new vaccines are also becoming available. Despite these very real challenges, there is reason to be cautiously optimistic that those most in need of an HPV vaccine can receive it in programs that are affordable, effective, and acceptable to girls, their families, and their societies.
The Death of Jesse Gelsinger: New Evidence of the Influence of Money and Prestige in Human Research
Authors: Wilson Robin Fretwell 
Published: January 2017

Ten years ago, Jesse Gelsinger died while participating in a human genetherapy trial at the University of Pennsylvania (“Penn”). His death came to signify the corrosive influence of financial interests in human subjects research. After Jesse's death, the media reported that one researcher, Dr. James Wilson, held shares in a biotech company, Genovo, which stood to gain from the research's outcome—shares that The Wall Street Journal later valued at $13.5 million, although Wilson maintains he did not make nearly this much. At the time Penn authorized Wilson's deal, internal Penn documents implicitly valued Wilson's stake in Genovo at approximately $28.5 to $33 million.Jesse's death sparked two separate lawsuits: one by the family, who sued in tort, and one by the federal government, which framed alleged errors in the research trial as a civil False Claims Act violation.
Transsphenoidal Surgery for Cushing's Disease
Authors: Fahlbusch R , Buchfelder M , Müller O A 
Published: January 2017

A series of 101 patients with Cushing's disease underwent transsphenoidal surgery. Diagnosis was fundamentally based on dynamic testing, mainly on the dosage-dependent suppression of cortisol after dexamethasone. The effect of surgery was monitored by intraoperative ACTH measurements. In 96 out of 101 patients a microadenoma of the pituitary was identified and removed selectively. In 74% of patients there was a clinical and endocrinological remission of Cushing's disease. Four ‘operative failures’ after selective adenomectomy underwent hypophysectomy in a second operation and each remitted. Thus the overall remission rate was 77%. In general, bilateral adrenalectomy was performed in patients who had failed to remit after selective adenomectomy. Although there is a considerable mortality and morbidity in patients with Cushing's syndrome, complications attributed to surgery were low. Two patients died postoperatively. In general, an improvement of disturbed pituitary function was noted after selective adenomectomy.
Plasma and Lipoprotein Lipids and Apolipoproteins AI, AII and B in Patients with Chronic Airflow Limitation
Authors: Bolton C H , Mulloy E , Harvey J , Downs L G , Hartog M 
Published: January 2017

Plasma and lipoprotein cholesterol and triglycerides, and plasma apolipoproteins AI, AII and B were compared in patients with chronic airflow limitation, and normal controls matched for body mass index. The controls were non-smokers, and free from respiratory disease. High-density lipoprotein (HDL) cholesterol concentration was significantly elevated in the patients, due mainly to a raised HDL2 cholesterol level. HDL triglyceride was significantly lower in the patients. All other lipids were not different from normal. Apolipoprotein AI levels were significantly raised in the patients but other apolipoproteins were unchanged. The changes found may account in part for the fact that patients with chronic airflow limitation have a lower incidence of atherosclerotic heart disease.
Pre-Scheduled PID Control of a Solar Thermal Power Plant
Authors: Meaburn A. , Hughes F. M. 
Published: January 2017

Efficient operation of a distributed solar collector field requires effective regulation of the outlet temperature. Control schemes utilising PI-based controllers, whether adaptive or fixed parameter, have been shown to be unsuitable for this application with a stable well-damped response only obtained at the expense of an unacceptably low speed of response. The reason for this is that collector fields possess low-frequency resonance dynamics which tend to restrict the bandwidth of such controllers. This paper examines the suitability and capability of PID controllers in this application area. Using experimental frequency response data, the Ziegler-Nichols tuning method for PID design is demonstrated to yield an unstable closed-loop system. However, by adopting a strategy which specifically aims to counter the adverse phase characteristics of the plant at resonance, good effective closed-loop control can be achieved. This is implemented as a pre-scheduled control scheme on the Acurex collector field at the Plataforma Solar de Almeria and tested in conjunction with a feedforward control scheme.
What is happened may not be what appears to be happening: a corpus study of ‘passive’ unaccusatives in L2 English
Authors: Oshita Hiroyuki 
Published: January 2017

Second Language (L2) researchers have been studying ‘passive’ unaccusative errors such as What was happened?, but have not yet reached a consensus about the ultimate cause of this unique interlanguage structure. This article critically reviews five major accounts proposed in the literature, namely: • transfer of a compound tense/aspect structure in the learner's first language (L1); • overgeneralization of adjectival passive formation in English; • nontarget lexical causativization; • identification of the passive morphosyntax with the lack of a logical subject; and • nontarget overt marking of syntactic NP movement. By analysing each account in terms of its ramifications in light of the data already available in the literature and additional data from a large corpus of nonnative English, I demonstrate that the most plausible account of the ‘passive’ unaccusative structure is to regard it as an overt marker of NP movement, an overgeneralization of the passive morphosyntax of the target English.
Influence of Preoperative Duplex Ultrasonography on the Operative Procedure for Primary Varicose Vein Surgery
Authors: Rautio T. , Perälä J. , Wiik H. , Haukipuro K. , Juvonen T. 
Published: January 2017

Objective: To evaluate the impact of duplex ultrasonography on the treatment plan of patients with uncomplicated primary varicose veins. Methods: Forty-nine consecutive patients (62 legs) with primary uncomplicated varicose veins were examined clinically and with hand-held Doppler (HHD) and duplex ultrasonography in an outpatient clinic on the same day. The plans for subsequent treatment were recorded separately after the two ultrasound examinations. Results: The accuracy of the HHD examination was 0.71 in the saphenofemoral junction (SFJ) and long saphenous vein (LSV trunk). In fifty-six limbs (90%) duplex scanning did not affect the surgical treatment of the patients. Conclusions: Most operations on primary varicose veins can be performed on the basis of clinical and HHD examinations by an experienced surgeon. Duplex ultrasonography can be used selectively in the patients with suspected saphenopopliteal junction (SPJ) reflux or equivocal HHD findings.
Tourniquets Cannot Identify Superficial Venous Reflux Nor Predict the Haemodynamic Outcome of Saphenous Vein Surgery
Authors: Scriven J. M. , Bianchi V. , Hartshorne T. , London N. J. M. 
Published: January 2017

Objective: To evaluate the ability of tourniquets or manual venous compression to predict the haemodynamic outcome of saphenous vein surgery. Design: Prospective, observational study using colour duplex scanning and photoplethysmography (PPG) in patients undergoing saphenous vein surgery. Patients and methods: Twenty-six patients (26 limbs) undergoing saphenous vein surgery underwent colour duplex and PPG assessment before and after the application of tourniquets or manual venous compression. The effect of compression on the superficial and deep veins was assessed by colour duplex scanning. The haemodynamic effect of compression was measured using PPG 90% refill times (PPGRT90) and the results compared with the postoperative PPGRT90. Results: Pneumatic tourniquets occluded 27% of saphenous veins. Manual compression significantly lengthened PPGRT90 compared with pneumatic tourniquets but neither method could usefully predict the postoperative PPGRT90. Conclusion: Neither pneumatic tourniquets nor manual venous compression predict postoperative venous refill times. We advise caution in the interpretation of tourniquet testing.
Effect of Paroven on Skin Oxygenation in Patients with Varicose Veins
Authors: Burnand K.G. , Powell S. , Bishop C. , Stacey M. , Pulvertaft T. 
Published: January 2017

A double blind placebo-controlled clinical trial was undertaken to investigate the effect of 500 mg bd of Paroven taken for four weeks on the tissue oxygenation, ankle oedema and calf pump function of 48 patients with chronic venous disease. There was no evidence that Paroven reduced ankle swelling or improved calf pump function, but it did cause a significant improvement in transcutaneous oxygen levels measured in the calf skin of the ulcer hearing area ( p = 0.026) which was confirmed when the oxygen levels of the active and placebo treated groups were compared at the end of four weeks treatment ( p = 0.02). This improvement in tissue oxygenation may be the result of alterations in the capillary exchange produced by the drug and may account for the symptomatic benefit associated with its use.
Diagnosis and Surgical Aspects of Congenital Venous Angiodysplasia in the Extremities
Authors: Paes E. , Vollmar J. 
Published: January 2017

Objective: An evaluation of the treatment of patients with venous angiodysplasia and severe chronic insufficiency. Design: The clinical series of patients with venous angiodysplasia of Klippel-Trenaunay (K-T) and Servelle-Martorell (S-M) type. Setting: Primary care teaching hospital. Patients: Eighty-three patients with angiodysplasia type K-T characterized by the triad of local giantism, varicose veins and naevus flammeus. Malformations of the deep venous system were present in 96%. The predominant vascular lesion in patients with the S-M syndrome ( n=34) was a haemangiomatosis, involving both the skeleton and soft tissues, causing growth retardation in the affected extremity. A malformation of the deep venous system could be seen in all patients. Main outcome measures: Healing of skin ulcers and varicose bleeding of the lower extremities. Interventions: Conservative treatments included external compression bandages or stockings. In 14 patients, surgical extirpation of superficial veins was used. Results: All the ulcers were treated successfully, and no haemorrhage reoccurred. Haemodynamic studies showed an improvement of the venous reflux disease in 86% of patients. Conclusion: Venous angiodysplasia of the lower extremity is nearly always associated with malformation of the deep venous system. Surgery is indicated for the elimination of a pathological short circuit flow in atypical drainage veins of the affected leg, especially when skin lesions are present. For any type of surgery, a careful preoperative angiographic and haemodynamic evaluation is mandatory.
Videophlebography with Foot Venous Pressure Measurements: Description of a Technique for Diagnosing Venous Dysfunction
Authors: Björgell O. , Ekberg O. , Åkesson H. , Olsson R. 
Published: January 2017

Objective: To introduce phlebography with simultaneous video recording of the fluoroscopy (VIP, videophlebography), to improve phlebography performed in patients with venous dysfunction. Ambulatory foot venous pressure (AVP) was measured in the same session. Design: Descriptive study of an improved phlebographic technique. Setting: University Hospital MAS, Malmö, Sweden. Study group: Forty-one consecutive patients (50 legs) referred to phlebographic investigation. In the last 27 legs the AVP was also measured. Intervention: Phlebography with video recording and measurement of AVP. Results: In 49 out of 50 (98%) of the VIPs, information allowing a detailed description of venous function was obtained. Normal closing of venous valves, seen on the ascending VIP, combined with a normal venous pressure made it possible to exclude deep vein incompetence and avoid descending phlebography. In 16 out of 27 legs (59%) this combined approach showed that descending phlebography was unnecessary. Conclusion: VIP provides an adequate image of the venous anatomy, important in preoperative evaluation. The combination of this technique with AVP may clarify the pathophysiological abnormalities resulting from the venous dysfunction.
Venous Insufficiency of the Lower Limbs and Working Conditions
Authors: Sobaszek A. , Frimat P. , Tiberguent A. , Domont A. , Chevalier H. , Catilina P. 
Published: January 2017

Objectives: To determine the prevalence of venous insufficiency (VI) in a population of women working in the health and social sectors. In a second stage, we assessed the relative contributions of the different occupational and personal risk factors for venous disease. Design: Descriptive, randomized, multicentre, cross-sectional study during January to September 1995. Study group: One thousand eight hundred and twenty-three women working in four health sectors: operating rooms, hospital laundries, day-nurseries and offices. Methods: The study was based on a physical examination and a medical questionnaire (personal and family history of VI, symptoms, use of medical care). Working conditions, temperature and humidity recordings were studied for each activity. A typological analysis and a discriminant analysis were carried out to determine the contribution of personal and occupational factors to the course of VI. Findings: VI is highly prevalent: 76% of subjects and up to 84% in the surgical room and laundry population. Functional symptoms and the presence of varicosities (small varicose veins of the ankle and medial plantar arch) and large varicose veins are more frequent, with the highest prevalence among operating room staff (respectively, 68% and 41%). Seniority is the first and main factor to explain the severity of the disease, independently of age. The number of pregnancies is also an important factor for the severity of VI, while a family history is not. Occupational factors such as high temperature and load-carrying have a significant direct influence. Conclusion: We observed a strong relationship between occupational factors and severity of VI. Occupational factors and personal factors could be quantified on the basis of scores identified in the discriminant analysis.
Venous Aneurysm Occurring after Revisional Hip Surgery: A Case Report
Authors: Jalaluddin M. , Parnell E. J. , Corbett C. R. R. 
Published: January 2017

Objective: To report a rare case of venous aneurysm. Design: Case report. Setting: Departments of General Surgery and Orthopaedic Surgery, The Princess Royal Hospital, Haywards Heath, a district general hospital. Patient, intervention and results: A 63-year-old woman underwent revision of a right total hip replacement in 1994, using a cemented prosthesis. She continued to have pain in the region of the hip and a pulsatile swelling was noted in the right iliac fossa. A pseudoaneurysm of the external iliac artery was suspected but investigations showed a venous aneurysm of the external iliac vein. Thus far, this aneurysm has been observed without complication. In 1996 the prosthesis was revised because of loosening of the femoral component and the pain resolved. Conclusion: Vascular injury is a rare complication of total hip replacement and thermal arterial injury can occur. Iliac venous aneurysms are recognized but are extremely rare so we conclude that this lesion was caused by thermal injury.