bluuebunny/crossref_metadata_2025_split huggingface dataset:
Who looks after people with diabetes: Primary or secondary care?
Authors: Khunti Kamlesh , Ganguli Sumita 
Published: July 2017

Summary Because the prevalence of type 2 diabetes has increased greatly over the past decade, UK general practitioners have been encouraged to develop services for people with diabetes and to offer structured diabetes care. The resultant shift from secondary care can place considerable demands on primary health care teams. Data were obtained from 108 practices in two English health districts followed up in primary and secondary care. Nearly two-thirds of the people with diabetes were being followed up only in general practice, the remainder in hospital or both. The proportion managed in primary care varied from 5.6% to 94.6%. The settings where diabetes care was most likely to be offered were training practices, practices with good nursing support, practices with a high prevalence of diabetes, and practices in which a high proportion of diabetic patients were controlled by diet or hypoglycaemic agents. Tight control of glycaemia and blood pressure is now seen as important in diabetes, and is best achieved in general practice. This survey revealed large variations in delivery of general-practice diabetes care that need to be addressed by better organization and funding.
Slimming on the Internet
Authors: Miles John , Petrie Catherine , Steel Michael 
Published: July 2017

Summary The first 50 websites identified on searching the Internet for ‘weight loss diets’ were assessed systematically and their content compared with published clinical guidelines for management of obesity. The relevance and quality of the sites varied enormously. Only 3 confined themselves to sound dietary advice. Most promoted dietary supplements or other ‘slimming aids’, often of uncertain composition and based on dubious physiological principles. Potential hazards—for example, those of very low calorie diets—were rarely highlighted and certain regimens on offer were potentially dangerous.
A histomorphometric study of the effect of chronic vitamin a deficiency on the circumvallate papilla of the rat
Authors: Chole Richard A. , Charpied George L. 
Published: July 2017

Although a deterioration of taste sensitivity is known to occur during severe vitamin A depletion, the structural changes in the taste buds themselves have not been described. Circumvallate papillae from rats deprived of vitamin A were examined histomorphometrically at intervals, and changes in the gustatory apparatus were quantitated. The cross‐sectional area of the circumvallate trenches increases 30‐fold because of keratin accumulation when vitamin A deficiency is extreme. After 190 days on a vitamin A–free diet, 38% of rats had no detectable taste buds and the remaining taste buds appeared atrophied. The involution of the taste buds may be the result of keratin buildup in the adjacent trench or a direct consequence of vitamin A deficiency. The atrophy of the gustatory apparatus during vitamin A deficiency and the consequent presumed loss of taste sensation may contribute to a diminished interest in food and the subsequent protein‐calorie malnutrition seen in vitamin A–deficient populations.
A safe, nonflammable, all‐metal, cuffless endotracheal Venturi ventilation system for use in laser surgery
Authors: Woo Peak , Vaughan Charles W. 
Published: July 2017

In this preliminary study with seven dogs, ventilation with a Sanders bronchoscope attachment coupled to the Norton metal endotracheal tube and use of a jet O2 injector system proved adequate for sustained oxygenation and acid‐base balance. This system is shown to be superior to the conventional anesthesia volume ventilator when used with the cuffless metal endotracheal tube. The ventilatory capability can be easily adjusted upward and downward by changing the driving pressures of the reducing valve. Peak intratracheal and transtracheal pressure measurements show the pressures encountered to be similar to those of conventional volume ventilation techniques. The use of the all‐metal endotracheal tube in endolaryngeal laser surgery is discussed. The advantages of such a system lie in the elimination of a flammable endotracheal tube during laser endolaryngeal surgery while preserving adequate and stable ventilation.
The effect of a leukotriene antagonist on the early response to antigen
Authors: Flowers Whan K. , Proud David , Kagey‐Sobotka Anne , Lichtenstein Lawrence M. , Naclerio Robert M. 
Published: July 2017

The sulfidopeptide leukotrienes (LT) C4, D4, and E4 increase in nasal secretions during the nasal response to antigen challenge, and nasal challenge with LTD4 induces nasal congestion. To further assess the role of leukotrienes, we administered an oral LTD4 antagonist, L‐649,923, to 12 patients who had nasal allergy to grass and ragweed pollen, in a double‐blind, placebo‐controlled, crossover study. Patients were challenged intranasally with increasing doses of pollen on each of 2 days, and the recovered nasal lavage fluids were assayed for histamine, TAME‐esterase activity, and immunoreactive LTC4/D4/E4. The patients graded runny nose, congestion, and throat irritation, and sneezes were counted. Significant (p < 0.01) increases in all parameters were found when comparing antigen challenge with diluent challenge, but no differences were seen among the treatment groups. Thus, oral L‐649,923 was not effective in blocking the symptoms of the early nasal allergic response.
The Lung in Zwoegerziekte
Authors: Ressang A. A. , de Boer G. F. , de Wijn G. C. 
Published: July 2017

The lungs in zwoegerziekte, a chronic pulmonary disease, are greatly increased in weight, do not collapse, and are either pale and dry or mottled with grey consolidation. The initial stage is characterized by peribronchial, perivascular, and solitary lymphoid hyperplasia and cellular infiltration of alveolar septa with consequent thickening. Fibrosis or myofibrosis, thickening of arterial walls, epithelial proliferation of air passages, and alveolar fetalization characterized the end stage. Pathologically zwoegerziekte, maedi, and progressive pneumonia have predominantly a mesenchymal reaction and belong to a single entity, chronic interstitial pneumonia of sheep. Zwoegerziekte bears close pathologic similarity to ‘la bouhite’ and ‘Graaff-Reinet disease’ but differs from pulmonary adenomatosis. Whether atypical pneumonia, also a type of interstitial pneumonia but different from maedi, occur in The Netherlands and may complicate some cases of zwoegerziekte is not known.
Nocturnal headache: systemic arterial pressure and heart rate during sleep
Authors: Cirignotta Fabio , Coccagna Giorgio , Sacquegna Tommaso , Sforza Emiliana , Lamontanara Giuseppe , Zucconi Marco , Cortelli Pietro , Lugaresi Elio 
Published: July 2017

In order to evaluate autonomic nervous system changes occurring before nocturnal headache attacks, we studied three subjects (one male, two females) suffering from chronic migraine. All three patients underwent a nocturnal polygraphic recording including continuous monitoring of systemic arterial pressure and heart rate. Two subjects showed increases and irregularities of arterial pressure before awakening with headache. These changes began during N–REM sleep and lasted during REM sleep preceding the awakening with headache. Heart rate did not change before the attacks. These findings do not support the hypothesis that autonomic instability during REM sleep represents the precipitating factor of the attacks. On a étudié avec des méthodes polygrafiques trois sujets (1 homme et deux femmes) souffrant d'hémicranie chronique avec des crises nocturnes. Chez deux malades les crises étaient précédées d'augmentation et d'irrégularité de la tension artérielle. Ces modifications commençaient pendant le sommeil N-REM et contineaient pendant le sommeil REM qui précédait le réveil avec hémicranie. La fréquence cardiaque n'a pas subi de modification avant les crises. Les résultats obtenus ne confirment l'hypothèse selon laquelle le facteur causant les crises est l'instabilité anticronique à la fase REM. Sono stati studiati con metodiche poligrafiche 3 soggetti (1 maschio e 2 femmine) affetti da emicrania cronica con attacchi notturni. In 2 di essi gli attacchi erano preceduti da incrementi ed irregolarità della pressione arteriosa. Tali modificazioni iniziavano durante il sonno N-REM e perduravano nel corso del sonno REM che precedeva il risveglio con cefalea. La frequenza cardiaca non si modificava prima dell'attacco. I risultati ottenuti non confermano l'ipotesi che il fattore precipitante gli attacchi emicranici sia l'instabilità anticronica della fase REM.
Neuroendocrinological signs of central neurotransmission disorders
Authors: Polleri Alessandro , Nappi Giuseppe , Murialdo Giovanni , Sances Grazia , Masturzo Paola , Savoldi Faustino 
Published: July 2017

Modulation mechanisms of nociception have several neurotransmission interactions that are impaired in the disorder of painful perceptions. Neurotransmission changes may show up in several ways on the clinical level. They also have endocrinological correlations, since the neurotransmission systems implicated in the nociception disorders share transmitters with the regulation system operating at the pituitary level. In this sense, nocipathies exhibit analogies and may be compared to disorders of motricity and behaviour that also show endocrine changes that may be likewise explained. Though specifically different in each instance, the neurotransmission alteration that is a common denominator of these disorders allows comparisons, especially in those situations, such as the nocipathic and behavioural ones, where correlations are relevant on clinical and interpretative grounds. Les mécanismes de modulation de la nociception ont des interactions multiples de la neurotransmission qui sont compromises dans les nocipathies. Ces altérations de la neurotransmission peuvent avoir différents aspects cliniques. Elles ont aussi des corrélations endocriniennes, du moment que le système de neurotransmission en question a des neurotransmetteurs en commune avec le système regulatoire de l'hypophyse. Donc, les nocipathies montrent des analogies avec les maladies de la motricité et du comportement, qui présentent de même des troubles endocrins sujets à une interprétation similaire. L'alteration de la néurotransmission, quoique spécifiquement différente chez chaque condition clinique, est un commune dénomiteur à ces disordres et permet de confronter entre eux situations où des corrélations peuvent avoir importance sur le niveau clinique et interprétatif. I meccanismi di modulazione della nocicezione hanno multiple interazioni neurotrasmettitoriali che sono compromesse nelle nocipatie. Le alterazioni neurotrasmettitoriali possono manifestarsi in modo diverso sul piano clinico. Esse hanno anche correlazioni endocrine, poichè il sistema neurotrasmettitoriale in questione è condiviso nei suoi elementi dal sistema regolatorio dell’ ipofisi. Così, le nocipatie mostrano analogie e possono essere paragonate con malattie della motricità e del comportamento, che danno anch'esse luogo a turbe endocrine di analoga interpretazione. L'alterazione neurotrasmettitoriale, benché specificamente diversa in ciascun quadro clinico, è un denominatore comune di questi disordini, consente paragoni specialmente in quelle situazioni, come nocipatie e disturbi del comportamento, in cui le correlazioni possono aver rilievo sul piano clinico ed interpretativo.
Substance P and endogenous opioids: how and where they could play a role in cluster headache
Authors: Sicuteri Federigo , Rainò Liborio , Geppetti Pierangelo 
Published: July 2017

Substance P appears to be involved in the transmission of pain signals from the periphery to the spinal cord and brain stem. Substance P containing neurons are responsible for the neurogenic vasodilation identical to that obtained by substance P release evoked by antidromic stimulation of these fibres. Both endogenous opioids and somatostatin inhibit the release of substance P from central and peripheral endings. Present pharmacological investigations conclude that morphine and somatostatin are as effective as ergotamine in reducing the pain of CH. All three drugs are significantly more active than placebo. Somatostatin and opiates could act by inhibiting the release of substance P. La Substance P (SP) représente le probable transmitteur des sensations douloureuses de la périphérie à la moelle épinière et au tronc encéphalique. Les neurones contenants la SP semblent être aussi responsables de la vasodilatation neurogenique identique à celle qui peut être obtenue par le “release” de SP, induit par la stimolation antidromique de ces fibres. Soit ces opiaces endogènes que la somatostatine (SR1F) inhibent le “release” de SP par les terminaisons nerveuses céntrales et périphériques. Notre étude clinique parvient à la conclusion que la morphine et le SRIF ont une efficacité semblabe à celle de l'ergotamine en rediure la douleur pendant l'attaque de céphalée “en chapelet”, et que tous les troi medicaments sont significativement actifs plus que le placebo. Le SRIF et les opiacés pourraient agir en inhibant le “release” de SP par les terminaissons neuronales céntrales et périphériques. La sostanza P viene indicata come il probabile trasmettitore delle sensazioni dolorifiche dalla periferia al midollo spinale ed al tronco encefalico. I neuroni contenenti SP sembrano inoltre essere responsabili della vasodilatazione neurogenica identica a quella ottenibile dal “release” di SP indotto dalla stimoalzione antidromica di queste fibre. Sia gli oppiacei endogeni che la Somatostatina inibiscono il “release” di sostanza P dai terminali nervosi centrali e periferici. Dalla presente ricerca emerge che la morfina ed il SRIF hanno una efficacia simile a quella dell'ergotamina nel ridurre il dolore nell'attacco di CH, e che tutti e tre i farmaci sono significativamente più attivi rispetto al placebo. SRIF ed oppiacei potrebbero agire inibendo il release di SP dalle terminazioni nervose sia a livello centrale che periferico.
Histamine skin test in cluster headache: effects of dihydroergotamine with timed release
Authors: Giacovazzo Mario , Romiti Alfredo , Martelletti Paolo , Gallo Maria Francesca , Megale Gaetano 
Published: July 2017

The histamine skin test, as modified by Giacovazzo, was carried out on 20 patients with cluster headache and on 20 control subjects, 10 of whom suffered from migraine and 10 who were healthy volunteers not presenting any form of headache. The test was carried out before and after 30 days treatment with timed-release dihydroergotamine methanesulphonate in a dose of 10 mg/day. Data recorded on a “headache time chart” before and after treatment were evaluated by statistical analysis. Block variance analysis was used to evaluate results of three parameters (latency time, hyperemia diameter, extinction time) emerging from the histamine skin test before and after treatment. A statistical comparison was also made of data obtained in basal conditions in the three groups of subjects, in order to confirm the usefulness of this simple test in the diagnosis of cluster headache. Les auteurs ont effectué le test cutané à l'histamine, d'après la méthode Giacovazzo, sur 20 personnes souffrant de céphalée de Horton, et sur 20 autres, parmi lesquelles 10 souffrant de migraines et les autres, volontaires, n'étant affectés d'aucun type de céphalée. Le test a été réalisé avant et après un traitement à base de 10 milligrammes par jour d'une préparation de dihydroergotamine métasulfonée se libérant d'une façon programmée, et ce durant 30 jours consécutifs. Les résultats enregistrés sur la “fiche des relevés horaires de la céphalée” ont été analysés statistiquement avant et après le traitement thérapeutique. C'est ensuite qu'ont été analysés, grâce à la méthode de variance à blocs (phases pré et post thérapie), les trois paramètres déduits du test cutané à l'histamine (temps de latence, diamètre d'hyperhémie, temps d'extinction). Et, il a finalement été possible, à l'appui de la validité diagnostique de ce simple test, de confronter statistiquement les résultats des trois paramètres de base relatifs aux différents groupes de patients. E’ stato eseguito il test cutaneo all'istamina, secondo Giacovazzo, in 20 pazienti di cefalea a grappolo e in 20 soggetti di controllo, dei quali 10 affetti da emicrania e 10 volontari sani. Il test è stato eseguito prima e dopo trattamento con 10 mg al dì, per trenta giorni, di un preparato di diidroergotamina metansulfonato a liberazione programmata. Sono stati analizzati statisticamente i dati dedotti dalla “carta oraria della cefalea”, prima e dopo trattamento terapeutico. Il metodo della varianza per blocchi è stato usato per confrontare (fasi pre e post terapia) i tre parametri dedotti dal test cutaneo all'istamina (tempo di latenza, diametro di iperemia, tempo di estinzione). Un ulteriore confronto statistico è stato infine ese-guito tra i dati desunti dai tre parametri in condizioni di base, nei vari gruppi di pazienti, a conforto della validità diagnostica di questo semplice test.
DHE retard for prophylactic therapy of migraine: efficacy and tolerability
Authors: Centonze Vincenzo , Attolini Ettore , Santoiemma Luigi , Brucoli Caterina , Macinagrossa Giuseppe , Campanozzi Fausto , Albano Ottavio 
Published: July 2017

The authors evaluated the efficacy of a DHE methanesulphonate for migraine attacks and its tolerability on liver, gallbladder and cardiovascular system functions. Twenty-eight patients affected by migraine were studied. They were withdrawn from preventive therapy for at least one month and treated for three months. The drug showed a good efficacy with a statistical significant reduction of severity and duration of attacks. No variation of the biochemical and morphological parameters of liver, gallbladder and cardiovascular function were found throughout the treatment. Les Auteurs ont évalué l'efficacité contre les crises migraineuses et la tolérance, sur la base de données hépato-biliaires et cardio-vasculaires, de la DHE à liberation programmée. 28 patients migraineux ont été traités pendant 3 mois par la DHE à liberation programmée, à la dose de 10 mg par jour. Les résultats ont montré une excellente tolérance et une très bonne efficacité de la DHE à liberation programmée, en particulière contre l'intensité et la durée des crises migraineuses. Gli AA. hanno valutato l'efficacia nel controllo delle crisi emicraniche e la tollerabilità nei confronti dell'apparato epato-biliare e cardio-vascolare, di una DHE metansulfonato a cessione programmata, in grado cioé di garantire la liberazione graduale nell'arco delle 24 ore del principio attivo. Sono stati studiati 28 soggetti affetti da emicrania, esenti da almeno un mese da terapie preventive e trattati per 3 mesi con DHE retard. Il farmaco ha dimostrato una buona efficacia con significativa riduzione della intensità e della durata delle crisi. Nessuna alterazione è stata riscontrata, inoltre, a carico dei parametri valutati.
Planned release dihydroergotamine in common migraine and “tension-vascular headache”: multicentre clinical trial
Authors: Fontanari D. , Perulli L. , Conte F. , Tambato E. , Toso V. , Zanetti R. 
Published: July 2017

The antimigraine efficacy of dihydroergotamine methanesulphonate in the pharmaceutical form of planned release capsules has been evaluated. Forty-nine subjects were treated, 39 suffering from common migraine 10 from tensive vascular headache, for a period of 90 days, with an oral dose of 15 mg twice daily. The product was found to be efficacious in 71% of the common migraine cases, while unsatisfactory or nil results were obtained in the remaining 29%. In the tensive-vascular headache cases, efficacy was 40% compared to 60% unsatisfactory or nil results. Tolerance was good in 43 cases, while transient digestive disorders (nausea and vomiting) occurred in 6; in 2 cases the treatment had to be withdrawn for allergic erythema. The results demonstrate that the drug is indicated in cases of common migraine, while it does not appear to significantly influence the course of attacks of tensive-vascular headache. On a etudié l'activité thérapeutique de la dihydroergotamine à action prolongée chez 49 malades porteurs de migraine commune (39 cas) et de céphalée tensive-vasculaire (10 cas), pendant 90 jours, à la dose de 5 mg deux fois par jour per os. Dans les cas de migraine commune le produit a été efficace dans 71% des cas, alors que dans 29% on a obtenu des résultats insuffisants ou des échecs. Dans les cas de cephalée tensive-vasculaire l'efficacité a été du 40%, contre un 60% de resultats insuffisants ou des échecs. La tolérance c'est averée bonne dans 43 cas, dans 6 cas ont été appreciés des troubles digestives (nausée et vomissement) transitoires et seulement dans 2 cas on a du interrompre le traitement pour intolérance (érythème allergique). Les résultats montrent que le produit constitue une bonne indication dans les cas de migraine commune, alors qu'il ne semble pas être en mesure de modifier significativement le cours des crises de cephalée tensive-vasculaire. Si è valutata l'efficacia antiemicranica della diidroergotamina metansulfonato nella forma farmaceutica in capsule a cessione programmata. Sono stati trattati 49 soggetti, di cui 39 affeti da emicrania comune e 10 da cefalea tensivo-vascolare, per un periodo di 90 giorni, alla dose di 15 mg due volte al giorno per os. Nei casi di emicrania comune il prodotto si è dimostrato efficace nel 71%, mentre nel 29% si sono avuti risultati insufficienti o nulli. Nei casi di cefalea tensivo-vascolare l'efficacia è stata del 40%, contro un 60% di risultati insufficienti o nulli. La tolleranza è stata buona in 43 casi, in 6 casi si sono avuti disturbi digestivi transitori (nausea e vomito) e solo in 2 casi il trattamento è stato interroto per eritema allergico. I risultati mostrano che il farmaco trova indicazione nei casi di emicrania comune, mentre non sembra influenzare significativamente l'andamento delle crisi di cefalea tensivo-vascolare.