bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rights to Healthcare in the United States: Inherently Unstable
Authors: Orentlicher David 
Published: January 2017

Although international covenants have long recognized a fundamental right to healthcare, and other countries provide healthcare coverage for all of their citizens, rights to healthcare in the United States have been adopted only grudgingly, and in a manner that is inherently unstable. While a solid right to healthcare would provide much benefit to individuals and society, the political and judicial branches of the U.S. government have granted rights that are incomplete and vulnerable to erosion over time.Unfortunately, enactment of the Patient Protection and Affordable Care Act (ACA) does not change these fundamental weaknesses in the regime of U.S. healthcare rights. Millions of Americans will remain uninsured after ACA takes full effect, and rather than creating a more stable right to healthcare, ACA gives unstable rights to more people. As a result, even if ACA survives its constitutional challenges, access to healthcare still will be threatened by the potential for attrition of the rights that ACA provides.
Litigating the ACA: Securing the Right to Health within a Framework of Negative Rights
Authors: Record Katherine L. 
Published: January 2017

President Obama entered the White House with a clearly defined goal: expanding healthcare coverage to all Americans. He marketed this goal to the public and Congress as a “moral imperative,” as well as a necessary means to achieving a “more effective and efficient health care system.” Yet as reform proceeded, it became clear that the latter was the preeminent, if not only, goal of most legislators. While the President's rhetoric was essential in drumming up support for historic reform, it reflects an appreciation for human rights that many Americans do not share. As Congress focused on the failings of the most expensive healthcare system in the world, it became evident that the right to health (a fundamental and nonderogable human right under international law) would not be a factor in the new legislation.This defining characteristic of reform may, paradoxically, prove invaluable in preserving the law. In challenging the Patient Protection and Affordable Care Act (ACA), litigators, politicians, and judges have focused on principles of federalism, asserting that Congress has overstepped its authority in enacting such landmark legislation. As opponents hone in on the insurance mandate and Medicaid expansion, they condemn the unprecedented expansion of coverage that moves America closer to realizing a universal right to health. The government has an extremely strong argument that these provisions are properly grounded within Congress’s authority to regulate commerce or within its taxing and spending power, although legal scholars differ on the Supreme Court’s projected interpretation of the matter. Still, the law’s basis in economic regulation, and not rights, will, if anything, prove to be its saving element.
Socio-Economic Benefits of Ambulatory Surgery and Compression Sclerotherapy for Varicose Veins
Authors: Neglén P. , Jönsson B. , Einarsson E. , Eklöf B. 
Published: January 2017

During the last two decades the treatment of varicose veins has undergone radical changes including shorter hospitalization, and the introduction of ambulatory (out-patient) surgery and modern compression sclerotherapy (CST). This article attempts to describe the changing pattern of care and its socio-economic consequences. It concludes that given optimal conditions possibly 60% of all patients suffering from varicose veins can have out-patient surgery performed, 20% need admission for surgery and the remaining 20% benefit from CST rather than surgery. Applied generally this policy would result in 30% lower costs when compared with in-patient surgery alone. The socio-economic gain is probably doubtful since productivity usually increases whereas the total health care cost does not decrease. However, in general the introduction of less costly medical methods of treatment might make it possible to use available resources in new medical fields within a given economic frame-work, preserving the same level of service.
Placebo-Controlled Trial of Naftazone in Women with Primary Uncomplicated Symptomatic Varicose Veins
Authors: Vayssairat M. ,   The French Venous Naftazone Trial Group
Published: January 2017

Objective: To evaluate the effectiveness and best time course of prescription of 30 mg/day oral naftazone (N) in women with primary uncomplicated symptomatic varicose veins (PUSVV). Design: Double-blind, placebo (P)-controlled study. Setting: Multicentre study, coordinated by a University hospital in Paris, France. Patients: 270 women with PUSVV. Interventions: Treatment with naftazone (three dosage regimens) or placebo for 14 days. Main outcome measures: Comparison by ANOVA, at day 0 and after 14 days of treatment, of (1) clinical disability, using an analogue scale 100 mm long and (2) morning and evening leg volumes. Results: The reduction in disability at day 14 was 32 ± 23 mm in the N group versus 24 ± 20 in the P group, F = 6.35, p = 0.01. Best clinical efficacy was obtained in the subgroup given 30 mg N once a day at midday (35 ± 22 mm). Differences between morning leg volumes on days 0 and 14 were 19.3 ± 74 ml in the N group versus 5.5 ± 50 in the P group, p = 0.059. Conclusion: Naftazone was more effective than placebo for the clinical improvement of women with PUSVV.
Efficacy of celecoxib versus ibuprofen for the treatment of patients with osteoarthritis of the knee: A randomized double-blind, non-inferiority trial
Authors: Gordo Ana C , Walker Chris , Armada Beatriz , Zhou Duo 
Published: January 2017

Objective To compare the efficacy and tolerability of celecoxib and ibuprofen for the treatment of knee osteoarthritis symptoms. Method In this 6-week, multicentre, double-blind, non-inferiority trial, patients were randomized to 200 mg celecoxib once daily, 800 mg ibuprofen three times daily or placebo. The primary outcome was non-inferiority of celecoxib to ibuprofen in Patient’s Assessment of Arthritis Pain (scored 0–100). Secondary outcomes included the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, Pain Satisfaction Scale, and upper gastrointestinal tolerability. Results A total of 388 patients were treated (celecoxib n = 153; ibuprofen n = 156; placebo n = 79). Mean difference (95% confidence interval) between celecoxib and ibuprofen in the Patient’s Assessment of Arthritis Pain was 2.76 (−3.38, 8.90). As the lower bound was greater than −10, celecoxib was non-inferior to ibuprofen. The WOMAC total score was significantly improved with celecoxib and ibuprofen, versus placebo. Patients receiving celecoxib were significantly more satisfied (versus placebo) in 10 of 11 measures on the Pain Satisfaction Scale versus three measures with ibuprofen. Upper gastrointestinal events were less frequent with celecoxib (1.3%) than ibuprofen (5.1%) or placebo (2.5%). Conclusion Celecoxib was well tolerated and as effective as ibuprofen for symptoms associated with knee osteoarthritis. ClinicalTrials.gov identifier NCT00630929
Autologous stem cell transplantation as frontline strategy for peripheral T-cell lymphoma: A single-centre experience
Authors: Han Xiao , Zhang Wei , Zhou Daobin , Ruan Jing , Duan Minghui , Zhu Tienan , Li Jian , Cai Huacong , Cao Xinxin , Ouyang Mingqi 
Published: January 2017

Objective To determine the efficacy and prognosis of autologous hematopoietic stem cell transplantation (ASCT) as frontline treatment for peripheral T cell lymphoma (PTCL). Methods Clinical data from 46 PTCL patients who achieved complete (CR) or partial remission (PR) after ASCT from October 1996 to July 2014 were analysed retrospectively. Results Median patient age was 32 (range: 15–68) years. Disease types included PTCL, unspecified type, in 23 patients, anaplastic large cell lymphoma in eight, angioimmunoblastic lymphoma in eight, extranodal NK/T-cell lymphoma in five, and hepatosplenic T-cell lymphoma and enteropathy associated T-cell lymphoma in one each. Of these patients, 80% had Prognostic Index for Peripheral T-cell Lymphoma scores ≥1. Thirty-four patients had pre-transplantation CR and 12 had PR. Median follow up was 37 (6–176) months. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 77.1% and 61.9%, respectively. Multivariate analysis showed that pre-transplantation CR was an independent risk factor for survival, and CR was more common than PR (OS 81% vs 59.3%; PFS 71.8% vs 17.8%). Conclusion Frontline consolidation treatment with ASCT was associated with favourable outcomes in patients with PTCL. Pre-transplantation CR was a prognostic factor for survival, suggesting that ASCT may be favoured as front-line consolidation therapy after first complete remission.
Effectiveness of contrast-enhanced ultrasound and serum liver enzyme measurement in detection and classification of blunt liver trauma
Authors: Zhao Da-wei , Tian Meng , Zhang Le-tian , Li Tao , Bi Jie , He Jia-ying , Zhang Ying-ying 
Published: January 2017

Objective This study was performed to identify the correlation between contrast-enhanced ultrasound (CEUS) and contrast-enhanced multidetector computed tomography (CE-MDCT) as well as the correlation between serum liver enzyme concentrations and CE-MDCT in classification of the severity of blunt hepatic trauma using CE-MDCT as a reference standard. Materials and methods A blunt liver trauma model was created using 20 rabbits, and CE-MDCT, CEUS, and serum liver enzyme assays were performed. A radiologist and an ultrasound physician independently evaluated the degree of liver trauma. The diagnostic performance of CEUS and serum liver enzyme measurements was compared with that of CE-MDCT using Spearman’s correlation analysis and Pearson’s correlation analysis, respectively. Results Spearman’s rank correlation coefficient between the CEUS-based classification and CE-MDCT was 0.888. The aspartate aminotransferase and lactate dehydrogenase concentrations and the aspartate aminotransferase/alanine aminotransferase ratio were positively correlated with the grade of liver injury; Pearson’s correlation coefficients were 0.664, 0.704, and 0.503, respectively. The gamma-glutamyltransferase concentration had a significantly negative correlation with the grade of liver injury (r = −0.467). Conclusions CEUS and serum liver enzyme measurement exhibited high consistency with CE-MDCT for both detection and grading of intraparenchymal lesions in blunt liver trauma. These techniques may permit more accurate diagnosis of liver trauma.
A Controlled Comparative Trial of Mianserin and Diazepam in the Treatment of Anxiety States in Psychiatric Out-Patients
Authors: Conti L , Pinder R M 
Published: January 2017

Forty psychiatric out-patients with primary anxiety entered a double-blind trial comparing 2 weeks of treatment with mianserin 30–60 mg daily or diazepam 15–30 mg daily, followed by 2 weeks of single-blind placebo administration. Both drugs were effective anti-anxiety agents, but mianserin was significantly superior in efficacy as measured by the Physician's Global Rating of Severity of Illness. No differences between treatments were apparent using the Hamilton Rating Scale for Anxiety. There were no significant differences in terms of side-effects, and both drugs increased anticholinergic effects such as dry mouth, blurred vision and constipation over baseline values. With one exception in the mianserin group, all patients who entered placebo treatment became worse.
A Comparative Double-Blind Study of Tiaprofenic Acid and Aspirin in the Treatment of Muscular Rheumatism, Fibrositis, Sprains and Soft Tissue Injuries in General Practice
Authors: Donald J F , Molla A Layes 
Published: January 2017

Analgesic and anti-inflammatory properties of tiaprofenic acid 200 mg t.d.s. were compared with those of aspirin 600 mg t.d.s. in 100 patients in general practice suffering from muscular rheumatic pain, fibrositis, sprains and soft tissue injuries. Tiaprofenic acid was shown to be better than aspirin in relieving pain by clinical assessment although both drugs were equally effective according to patients daily assessment. It was not possible to demonstrate any anti-inflammatory action by reduction of swelling, but this was only present in 20% of patients initially. Side-effects, none serious, were similar in both groups.
Phage-Types and Susceptibility to 26 Antibiotics of Nosocomial Strains of Acinetobacter Isolated in Portugal
Authors: Ferreira M O Santos , Vieu J F , Klein B 
Published: January 2017

Sixty-two strains of Acinetobacter calcoaceticus isolated from pathological samples or from the environment in several hospitals in Lisbon, were studied by means of two complementary phage-typing systems. Eighteen phage-types or sub-types, one group of uncommon types (9·6%) and one group of untypable strains (20·9%) were found. A new phage-type (No. 104) and a new sub-type (No. 18) were defined among the Portuguese strains. The in vitro activity of 26 antibiotics against 48 nosocomial strains was studied by the Kirby-Bauer method. The most active antibiotics were, in decreasing order, amikacin, carbenicillin, tobramycin, minocycline, dibekacin, doxycycline, sisomycin, trimethoprim-sulphamethoxacole, ticarcillin and piperacillin. The strains were also tested against 4 new beta-lactam antibiotics, and the MICs were determined by an agar dilution method. N-formimidoyl-thienamycin was found to be the most active against Acinetobacter and ceftazidime was considerably more active than apalcillin and cefotaxime.
Update on Ibuprofen: Review Article
Authors: Busson Mervyn 
Published: January 2017

Non-steroidal anti-inflammatory drugs (NSAIDs) have become the principal mode of therapy for rheumatic diseases and their use has continued to increase despite concern expressed recently regarding potential hazards (Figure 1). Prior to 1969, a limited number of NSAID drugs were available. Aspirin and indomethacin became the mainstay of treatment but tolerability, particularly gastric irritation, at doses necessary to control rheumatic symptoms limited the usefulness of these valuable agents. The pyrazolone, phenylbutazone, showed slightly better gastro-intestinal (GIT) tolerability but has since been associated with an increased risk of blood dyscrasiae and is now only available for restricted use in most countries. Ibuprofen was the first of a new breed of NSAIDs originally introduced into the United Kingdom in 1969. Chemically quite distinct from its forerunners it was the first of the propionic acid derivatives to be used in rheumatic practice. The propionics have since become the largest, single and most important group of NSAIDs accounting for 50% of NSAID prescriptions in the United Kingdom. It is estimated that over 100 million patients worldwide have received ibuprofen which is now available in over 100 countries throughout the world including all the major markets. Ibuprofen was developed directly as a result of the problems associated with the use of corticosteroids in the treatment of rheumatoid arthritis and also because of the gastro-intestinal irritation and general intolerability of the established NSAIDs, at that time. Ibuprofen was readily accepted because, unlike the previous drugs, its therapeutic efficacy was easily seen to outweigh the severity of its side-effects. Ibuprofen was the first new drug with the potency of aspirin but without its major disadvantages.
Trigeminal neuralgia – diagnosis and treatment
Authors: Maarbjerg Stine , Di Stefano Giulia , Bendtsen Lars , Cruccu Giorgio 
Published: January 2017

Introduction Trigeminal neuralgia (TN) is characterized by touch-evoked unilateral brief shock-like paroxysmal pain in one or more divisions of the trigeminal nerve. In addition to the paroxysmal pain, some patients also have continuous pain. TN is divided into classical TN (CTN) and secondary TN (STN). Etiology and pathophysiology Demyelination of primary sensory trigeminal afferents in the root entry zone is the predominant pathophysiological mechanism. Most likely, demyelination paves the way for generation of ectopic impulses and ephaptic crosstalk. In a significant proportion of the patients, the demyelination is caused by a neurovascular conflict with morphological changes such as compression of the trigeminal root. However, there are also other unknown etiological factors, as only half of the CTN patients have morphological changes. STN is caused by multiple sclerosis or a space-occupying lesion affecting the trigeminal nerve. Differential diagnosis and treatment Important differential diagnoses include trigeminal autonomic cephalalgias, posttraumatic or postherpetic pain and other facial pains. First line treatment is prophylactic medication with sodium channel blockers, and second line treatment is neurosurgical intervention. Future perspectives Future studies should focus on genetics, unexplored etiological factors, sensory function, the neurosurgical outcome and complications, combination and neuromodulation treatment as well as development of new drugs with better tolerability.
The Immunohistochemical Investigation of Epidermal Growth Factor (EGF) Receptors in Various Gynecological Tumors
Authors: Wittmaack F. M. , Schwörer D. , Wintzer H. O. , Von Kleist S. , Pfleidere A. , Bauknecht T. 
Published: January 2017

Monoclonal antibodies to the extracellular domain of the EGF-receptor were used for immunohistochemical staining. Nine of 10 squamous cell carcinomas of the cervix, vagina, and vulva showed strong staining for EGF-receptors. Of 12 endometrial carcinomas and 19 ovarian tumors approximately 50% revealed moderate staining. Cells with immunohistochemically identifiable EGF-receptors and those without coexist in EGF-receptor positive tumors. The percentage of positive cells in endometrial carcinomas was higher than in ovarian carcinomas, 80% and 25%, respectively. There was good correlation between the immunohistochemical detection of EGF-receptors and the amount of EGF-receptors quantitated by biochemical methods, although immunohistochemistry appeared to be somewhat less sensitive (especially in breast carcinomas).
Histological Study of Murine Fibrosarcoma Treated with Prostaglandin Inhibitors
Authors: Valdez J.C. , Mercau G.T. , Vitalone H. , Perdigon G. 
Published: January 2017

In a previous work we reported that treatment with indomethacin, aspirin and piroxicam in inbred BALB/c mice bearing a transplantable fibrosarcoma induced by methylcholanthrene produced tumor regressions in 45, 32 and 30 per cent of the animals, respectively. In the remaining mice, in which there was no tumor regression, tumor volumes varied (small 0.05<0,5 cm3 medium 0,5<1,35 cm3 and large > 1,35 cm3). In this histological study we observed that the antitumoral effect of these nonsteroidal antiinflammatory drugs occurred together with a remarkable tumor encapsulation and a decrease in the physical characteristics of malignancy of the tumor cells. The tumor-associated macrophages, which can be detected only by the iron-dextran phagocytosis but not by that of colloidal carbon or trypan blue, were found in the peritumoral area in all cases under study. Their numbers and/or phagocytic capacity were slightly increased in both regressing and small tumors with respect to large, medium and control tumors. These findings suggest that the action of these prostaglandin synthesis inhibiting drugs would permit tumor encapsulation by an improvement in the macrophage-fibroblast relationship together with a decrease in the malignancy of the tumor cells.
IL-1α, IL-6 and TNF-α in Cutaneous Lesions of Lupus Erythematosus are Inhibited by Topical Application of Calcipotriol
Authors: Feliciani C. , Amerio P. , Pour S. Mohammad , Allegretti T. , Proietto G. , Coviello C. , Amerio P. , Vena G.A. 
Published: January 2017

Lupus Erythematosus (LE) is an autoimmune disorder with an unknown etiology and pathogenesis. Skin lesions of LE express several cytokines which correlate to histological findings such as IL-1 and IL-6 which are mediators of epidermal growth and proliferation. Skin lesions of LE are generally treated with immunosuppressive agents such as oral or topically applied corticosteroids. Recently a new drug, calcipotriol, a vitamin D3 analogue has been useful in treatment of psoriasis with no ad verse effect on calcium metabolism. This drug shares immunomodulatory effects with vit. D3 by inhibiting several cytokines produced by keratinocytes. In order to test the clinical effectiveness of calcipotriol in cutaneous lesions of LE we have investigated several proinflammatory cytokines such as: IL-1α, IL-1β, IL-4, IL-5, IL-6, IL-8, MCP-1, TNF-α. Using an avidin-biotin immunoperoxidase system we have found IL-1 in both forms, IL-6 and TNF-α in basal keratinocytes in patients affected with LE, after treatment they were reverted to normal. This inhibition is induced at a molecular level as demostrated by reduced IL-1, IL-6 and TNFα mRNA expression. This is the first report showing that calcipotriol is effective in cutaneous lesions of LE and suggesting that this action is due to an inhibition of protein synthesis and mRNA expression for IL-1α, IL-6 and TNFα.
Suicidal Ideation in Major Depression: Sex Differences and Impact of Comorbid Anxiety
Authors: Schaffer Ayal , Levitt Anthony J , Bagby R Michael , Kennedy Sidney H , Levitan Robert D , Joffe Russell T 
Published: January 2017

Background: Being female and having comorbid anxiety are both thought to increase suicidality in patients with major depression. Whether these effects are independent or related to severity of depression is not known. Method We conducted a retrospective review of 533 patients (190 men, 343 women) with major depression at the time of assessment. Results Suicidal ideation was present in 57.8% of all patients, and 43.2% of all patients had a lifetime anxiety disorder. Significantly more women than men experienced suicidal ideation, and both men and women with a lifetime anxiety disorder were more likely to be suicidal. Age and severity of depression did not account for these results. Conclusions In patients with a current major depression, being female and having a lifetime anxiety disorder increase suicidality independently of one another and independently of severity of depression.
Individual Predictors of Posttraumatic Distress: A Structural Equation Model
Authors: Regehr Cheryl , Hemsworth David , Hill John 
Published: January 2017

Objective: Recent research has called into question the “dose-effect” model of understanding response to trauma and has turned attention to the contribution of personality and environmental factors. This research seeks to model the interrelation of relational capacity (a component of personality), perceptions of social support, and posttraumatic distress. Method: A group of firefighters (n = 164) completed questionnaires that addressed exposure to traumatic events, social support, current level of distress, and relational capacity. Structural equation modelling was used to develop a framework for understanding traumatic reactions. Results: The overall fit of the hypothesized model was excellent. Relational capacity had a significant negative effect on support, indicating that perceived social support decreased as disturbances in relational capacity increased. Perceived social support had a significant negative effect on level of distress. Conclusion: While some emotional response to disturbing events may be normal, the severity of symptoms covaries with the ability of the individual to develop and sustain supportive relationships to buffer the impact of events.