bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symptomatic Carotid Occlusion Is Frequently Associated With Microembolization
Authors: Liberman Ava L. , Zandieh Ali , Loomis Caitlin , Raser-Schramm Jonathan M. , Wilson Christina A. , Torres Jose , Ishida Koto , Pawar Swaroop , Davis Rebecca , Mullen Michael T. , Messé Steven R. , Kasner Scott E. , Cucchiara Brett L. 
Published: January 2017

Background and Purpose—
Symptomatic carotid artery disease is associated with significant morbidity and mortality. The pathophysiologic mechanisms of cerebral ischemia among patients with carotid occlusion remain underexplored.

Methods—
We conducted a prospective observational cohort study of patients hospitalized within 7 days of ischemic stroke or transient ischemic attack because of ≥50% carotid artery stenosis or occlusion. Transcranial Doppler emboli detection was performed in the middle cerebral artery ipsilateral to the symptomatic carotid. We describe the prevalence of microembolic signals (MES), characterize infarct topography, and report clinical outcomes at 90 days.

Results—

Forty-seven patients, 19 with carotid occlusion and 28 with carotid stenosis, had complete transcranial Doppler recordings and were included in the final analysis. MES were present in 38%. There was no difference in MES between those with carotid occlusion (7/19, 37%) compared with stenosis (11/28, 39%;
P
=0.87). In patients with radiographic evidence of infarction (n=39), 38% had a watershed pattern of infarction, 41% had a nonwatershed pattern, and 21% had a combination. MES were present in 40% of patients with a watershed pattern of infarction. Recurrent cerebral ischemia occurred in 9 patients (19%; 6 with transient ischemic attack, 3 with ischemic stroke). There was no difference in the rate of recurrence in those with compared to those without MES.

Conclusions—
Cerebral embolization plays an important role in the pathophysiology of ischemia in both carotid occlusion and stenosis, even among patients with watershed infarcts. The role of aggressive antithrombotic and antiplatelet therapy for symptomatic carotid occlusions may warrant further investigation given our findings.
Traumatic Deaths in Jamaica: A Coroner's (Medico-Legal) Autopsy Study from the University Hospital of the West Indies
Authors: Escoffery Carlos T , Shirley Suzanne E 
Published: January 2017

This study reviewed the trauma-related deaths in a coroner's (medico-legal) autopsy series at the University Hospital of the West Indies and represents only the second such study reported from Jamaica. The autopsy protocols of all coroner's autopsies performed during the 15-year period January 1, 1983 to December 31, 1997 were reviewed retrospectively, and the clinico-pathological characteristics of trauma-related deaths were analysed. Trauma accounted for 470 (28.7%) of the 1,640 coroner's autopsies and the causes of death in descending order of frequency were motor vehicle accidents [MVAs] (44.9%), blunt injuries (17.7%), burns (16.8%), firearm injuries (13.6%) and stab injuries (7.0%). The 21–30 age group was the most commonly affected and the overall male: female ratio was 4:1. The distribution of injuries (excluding burns) by anatomical region was head and neck (43.8%), chest (8.9%), abdomen and pelvis (4.3%), extremities (0.9%) and multiple sites (25.3%). Forty-nine (23.2%) of the victims of MVAs were documented to have been pedestrians. Blunt trauma was most commonly due to accidental falls followed by assaults. Flame burns accounted for 90% of burn cases. There were seven (1.5%) cases of suicide overall. In this series the majority of trauma-related deaths occurred in young males and were due to MVAs. Strategies aimed at reducing trauma-related mortality should therefore emphasize road traffic safety programmes, particularly targeting the young.
Sudden Adult Death: A Medico-Legal Series of 77 Cases between 1995 and 2000
Authors: De La Grandmaison G Lorin , Durigon M 
Published: January 2017

Among all the autopsies performed between 1995 and 2000 in our Department, 77 adult cases of sudden death were selected. Sex, age, place of death, circumstances of death, causes of death and heart weight were reported from these 77 post-mortem records. A complete forensic autopsy was performed in every case. Sudden death occurred more frequently in males at rest. Strenuous activity was rarely involved in sudden death and 72.7% of the cases died from cardiovascular disease, mainly coronary atherosclerosis. Non-cardiac causes were dominated by pulmonary and neurological diseases. Cardiomegaly was a frequent finding in cases who died from cardiac pathology. This study underlines the importance of complete medico-legal investigations in case of sudden death. Multiple heart samples are required in order to detect focal microscopic lesions, such as myocarditis and some forms of cardiomyopathy with minimal gross abnormalities. The post-mortem diagnosis of such cardiomyopathies is very important because the family of the deceased may undergo a possible screening. Toxicology is useful in the diagnosis of epileptic seizure and in identifying drugs like metamphetamine as a risk factor for some lethal cardiovascular pathologies such as aortic dissection. Molecular biology can also be helpful when limits of morphological diagnosis have been reached.
Male Victims of Sexual Assault
Authors: Mezey Gillian , King Michael 
Published: January 2017

Adult male victims of sexual assault appear to have similar reactions to female victims, but are more stigmatized, may experience greater subsequent anger and guilt, and are even less likely to report the offence than females. Increased recognition of these assaults is called for, both in law and by victim support agencies, in order to reduce the stigma, encourage reporting and facilitate the enforcement of criminal justice.
Fitness to Plead and Psychiatric Reports
Authors: Larkin E P , Collins P J 
Published: January 2017

The role of the psychiatrist in the determination of fitness to plead is reviewed by reference to 77 pre-trial psychiatric reports prepared on 31 Special Hospital patients detained under the provision of Section 5(1)(c) (Unfit to Plead) of the Criminal Procedure (Insanity) Act 1964. Each psychiatric report was analysed using a standardized checklist which addressed the legal criteria used to determine fitness to plead, the nature of the alleged offence and the clinical diagnosis. The results showed that almost 40% of the reports made no mention of fitness to plead at all and that only one-third of the reports made a statement about fitness to plead which was supported by reference to standard legal criteria. The results of this study support earlier work which has suggested that psychiatrists have a poor understanding of the issues surrounding fitness to plead and criminal responsibility. These findings are discussed in relation to recommendations made by the Report of the Committee on Mentally Abnormal Offenders, 1975 (Butler Report) and legislative changes introduced by the Mental Health Act 1983.
1. An Autopsy Case of Suicide by Hanging with Multiple Stab Wounds of the Neck and Chest
Authors: Maeda H , Imura M , Higuchi T , Noguchi K 
Published: January 2017

We report, from the aspect of “acting” capability, an autopsy case of suicide by hanging in which multiple deep stab wounds were observed in the neck and chest. A 49-year-old man was found dead in a state typical of hanging. His car was found about 100m away with a blood-stained climber's knife on the seat. Multiple incised and stab wounds were in the neck, with a lesion of the right inner jugular vein. Three penetrating stab wounds of the chest punctured the lungs, with pooling of about 500ml of blood in the left thorax and about 100ml in the right. Two other shallow stab wounds were in the chest. All the above wounds were explainable as self-inflicted. From the autopsy findings and the circumstantial evidence, it was concluded that he walked approximately 100m after stabbing his neck and chest and finally committed suicide by hanging
Psychiatrie In-Patient Suicide Rates: A 21-Year Study
Authors: Ganesvaran T , Shah A K 
Published: January 2017

Psychiatric in-patient suicides were traced from the hospital death register for the 21-year period 1973 to 1993. Suicide rates for each of the 21 years were calculated and an overall rate of 3.68 per 1,000 admissions was found. Suicide rates for the period after 1987 were significantly lower than for the period before 1987. However, there was a significant upward trend during the last three years of the study period. The role of the new Mental Health Act (introduced in 1987) on reducing the suicide rate and the effects of the amalgamation of three hospitals on increasing the rate are discussed.
Helicobacter Pylori Eradication for Peptic Ulceration: An Observational Study in a Scottish Primary Care Setting
Authors: Forrest E. H. , MacKenzie J. F. , Stuart R. C. , Morris A. J. 
Published: January 2017

Despite being established for the treatment of peptic ulcer (PU) disease, few studies have assessed the long-term effectiveness and economic benefits of Helicobacter pylori (Hp) eradication in primary care. Our aim was to investigate the effect of community based Hp eradication for patients with chronic peptic ulcer disease requiring maintenance acid suppression. The endpoints used were the patient s dyspeptic symptoms and the requirement for the prescription of maintenance acid suppression therapy. The study area covered seven general practices in the Glasgow area. Patients with previously diagnosed peptic ulcer disease receiving prescribed acid suppression therapy were invited to a dyspepsia clinic. Hp status was assessed by Helisal rapid blood test (HRBT). Positive patients received Hp eradication therapy and were reviewed six weeks later. At six months a review of practice records was carried out, and two years after eradication a postal questionnaire was sent to participating patients. A total of 243 patients attended the initial clinic of which 81.9% were HRBT positive. 156 of 196 patients offered Hp eradication re-attended at six weeks. The per protocol eradication rate was 91.7%. After six months patients who had received eradication therapy were less likely to require maintenance acid suppression therapy compared with those to whom eradication was not given. Two years after treatment 76.5% of patients felt their symptoms were improved, but 42.2% were still receiving maintenance therapy. The estimated cost of treatment per month per patient had fallen from £20.23 to £9.39 after eradication. In conclusion we felt that community based Hp eradication for patients with chronic PU disease is effective, however it does not completely alleviate dyspepsia. Predictors of symptomatic response or of no longer requiring acid suppression therapy after two years were younger age of onset of PU disease and absence of pre-documented gastro-oesophageal reflux disease or hiatus hernia. Hp eradication improves patient s symptoms, reduces the requirement for maintenance acid suppression and is cost-effective after two years follow-up in this targeted group.
Thrombolysis and its Implications in the Management of Stroke in the Accident and Emergency Department
Authors: Quaba O. , Robertson C. E. 
Published: January 2017

Objectives: Examination of initial management of stroke patients in the emergency setting to assess feasibility of thrombolysis for acute ischaemic stroke. Methods: Retrospective analysis of all patients presenting with a clinical diagnosis of stroke over a two month period. Exclusion criteria for thrombolysis were applied to assess the number of patients that would potentially have been eligible for thrombolysis. Results: Of 94 patients identified with clinical stroke, only 57 (60.6%) had a CT scan; 23 (24.4%) were confirmed as having had an acute ischaemic stroke. Mean delay in scanning was 2.2 days (range 0–15 days). Even if all patients had presented and been scanned within three hours (as required for thrombolysis), only six (6.4%) patients would have been eligible for thrombolysis. Conclusions: The great majority of patients presenting with clinical stroke do not fulfil the criteria for thrombolysis. Current practice involves significant delays in CT scanning, which has implications for resource structuring should thrombolysis become widely available.
Prospective Observational Survey of the Utilisation of Anaesthetists and the Outcome following Cardiac Arrest Calls
Authors: Price R J , Garrioch M A 
Published: January 2017

Background and Aims: We wanted to determine whether the practice of routinely sending an anaesthetist to cardiac arrests is common within Scotland. We also wished to evaluate the interventions performed by our intensive care anaesthetist when responding to cardiac arrest calls. Methods: We performed a telephone survey of the 26 Scottish hospitals with an intensive care unit. We conducted a prospective observational survey over a period of six months in one Scottish teaching hospital. Structured interviews with the anaesthetist who responded to the cardiac arrest call were undertaken. Results: Routine attendance of an anaesthetist at cardiac arrests occurs in 25 of the 26 hospitals surveyed. We analysed 68 of 73 arrest calls. In 28 calls (41%) there was no requirement for anaesthetic intervention. In 40 (59%) the anaesthetist intervened. The interventions were for cardiac arrest procedures in 33 cases and ventilatory failure in the remaining 7 cases. One patient survived to hospital discharge: a mortality of 98%. Conclusions: Patients who remain in cardiac arrest upon the arrival of the anaesthetist have a very high mortality. The practice of routinely sending an anaesthetist to cardiac arrest calls is not justified.
High Incidence of ‘Asymptomatic’ Urinary Tract Infection in Infant Schoolgirls
Authors: Mair Marie I. 
Published: January 2017

Two thousand one hundred and sixty five Renfrewshire entrant schoolchildren were screened for bacteriuria and pyuria. The correlation between these two criteria of urinary tract infection was found to be very high. Two of 960 boys and 31 of 1205 girls were found to have persistent significant bacteriuria and pyuria. The method used is described and compared with other methods. Investigation, treatment and follow-up of the affected children is described.
The Prevalence of Ampicillin, Cephalosporin and Sulphonamide Resistance Amongst Urinary Tract Pathogens
Authors: Andrews J. , Bywater M. J. , Emmerson A. M. , Keane C. , Reeves D. S. , Wise R. 
Published: January 2017

A total of 2,031 clinical isolates of Gram negative bacilli was obtained from hospitals in 4 centres and these cultures were tested for resistance to ampicillin, cephazolin and sulphonamide. Ampicillin and sulphonamide resistance in outpatients ranged from 15 to 28 per cent of E. coli strains and 4 to 11 per cent of Proteus mirabilis strains. Resistance to cephazolin in outpatients ranged from 0 to 3 per cent of E. coli and 0 to 6 per cent of Proteus mirabilis. Resistance patterns for E. coli, Proteus mirabilis and Klebsiella strains isolated from inpatients were much higher and varied widely. These patterns are presented and the reasons for these variations discussed.
Penicillins in Perspective
Authors: McAllister T.A. 
Published: January 2017

Fifty-three years after their discovery the penicillins still present a challenge to laboratory workers and clinicians. They are members of the broader beta-lactam group and are susceptible to inactivation by beta-lactamases from Gram-positive and Gram-negative bacteria. Countering these enzymes is achieved by producing more stable penicillin molecules or by using enzyme-blocking agents like clavulanic acid to protect the antibiotics. The field is confusing and to assist in defining the present-day role of the group, the concept of a microbiological profile is considered. The modes and sites of action of the penicillins and the beta-lactamases are presented and both are classified. The place of penicillins in the treatment of life-threatening and lesser infections, and in prophylaxis, is discussed.
Co-Ordinating Geriatric and General Medical Services; Experience of a Geriatric Assessment Ward in the Royal Infirmary of Edinburgh
Authors: MacLennan W.J. , Chapman B.J. , Smith M. , Prescott R.J. , Wang J.X. 
Published: January 2017

The paper describes the work of an assessment unit setup to provide a service for frail elderly patients admitted to general medical units at the Royal Infirmary of Edinburgh during the period of April 1989 to March 1990. Patients were selected on the basis of diagnosis, mental and physical function, age and social background and transferred to the assessment ward within 24 hours of admission to a medical ward. Most of the 376 patients admitted to the ward had a high level of multiple pathology and physical incapacity and a third had an acute confusional state. The mean length of stay was 19.4 days. There was a 13% mortality with 71% of survivors returning to their own homes. Review of mobility and self care capacity of the group revealed a striking increase in function during their stay in the ward. Factors increasing the likelihood of discharge included having a spouse, receiving support at home, having a low initial dependence rating. Adverse factors included having cerebrovascular disease, having dementia and initial maintenance of urine and faeces.
Changes in Cotton and Nylon Fabrics Caused by Increments of Accelerotor, Schiefer, and Stoll Abrasion
Authors: Galbraith Ruth , Boyle Margaret , Cormany Esther , Davison Suzanne , Ginter Adella , Ericson June , Lapitsky Mary , Lund Lillian , Cooper Margaret 
Published: January 2017

Two fabrics, 100% cotton and 100% nylon, were abraded with Stoll (inflated diaphragm), Schiefer, and Accelerotor instruments. Fabrics were given nine levels of abrasion, ranging from slight distortion of the fabric surface to fabric rupture, with each type of instrument. After abrasion, selected physical properties of the fabrics were measured and microscopic studies were made to determine the types of fabric, yarn, and fiber damage caused by the three abraders. The Stoll abrader caused severe fabric damage at very low levels of abrasion because the abradant pressure was highly localized in the center of the abraded area. The Schiefer and Accelerotor instruments caused uniform abrasion over the entire areas and abrasive damage to the fabric structure built up more slowly than with the Stoll. Both the Accelerotor and the Schiefer were more sensitive to differences in fiber toughness than was the Stoll. An imbalance between warp and filling yarn crimps had a much greater effect on the rate of damage and point of attack for the two flat abrasion testers than it had on Accelerotor abrasion. The tumbling action of the Accelerotor caused the greatest increases in fabric thickness by shaking fiber ends loose from the yarn structure and then cutting or breaking them off more slowly than did the Stoll abrader.
Phosphorus-Nitrogen Flame Retardant via Copper Complex
Authors: Donaldson D. J. , Daigle D. J. 
Published: January 2017

Copper salts were found to stabilize tetrakis (hydroxymethyl) phosphonium hydroxide (THPOH)-ammonium hydroxide solutions by formation of a complex thereby making it possible to apply THPOH to cotton fabric from a single bath without the use of gaseous ammonia. The effect of the concentration of copper salts, THPOH, and NH4OH on the stability of the solution was studied. Cotton fabric with good flame retardancy, strength retention, and hand was obtained by the use of conventional pad-cure techniques for applying the solutions. Cotton fabrics with approximately 17% add-ons retained their flame retardancy after 25 home launderings.
The Management of Tetanus 1996
Authors: Sanders R K M 
Published: January 2017

The three main basic concepts in the understanding and management of tetanus: Tetanus is polysystemic in terms of pathology and management. Most body organs, as well as the nervous system, are severely affected by tetanus toxins Prevention is not only by immunization, but also by specific treatment. Since the toxin cannot be therapeutically eradicated from the body, therapy is directed towards preventing continued spread of the toxins and the consequences of intoxication Variability in terms of prevalence and prognosis. The natural incidence and severity of tetanus varies greatly with social environment, season, climate and soil. Prognosis is influenced by age, source of infection and delay in treatment.
What Potent Blood: Non-Invasive Prenatal Genetic Diagnosis and the Transformation of Modern Prenatal Care
Authors: Chachkin Carolyn Jacobs 
Published: January 2017

What potent blood hath modest May,What fiery force the earth renews,The wealth of forms, the flush of hues ….—Ralph Waldo EmersonSomeday soon, virtually any pregnant woman will be able to learn — with 98-99% accuracy — whether her fetus has contracted a serious genetic disorder by undergoing nothing more than an inexpensive, non-invasive blood test. For years, scientists have sought a method of prenatal testing that could boast both high levels of accuracy and low levels of risk. The most promising solution lies in an exciting recent discovery: tiny quantities of fetal cells and DNA cross over into the mother's bloodstream during pregnancy. If the fetal genetic material can be successfully isolated from the maternal blood, it can be used to diagnose a number of genetic disorders, such as Down Syndrome, cystic fibrosis, Tay-Sachs disease, and sickle cell anemia. Indeed, researchers have spent the last decade developing ways to accomplish this.
Imaging Body Structure and Mapping Brain Function: A Historical Approach
Authors: Tovino Stacey A. 
Published: January 2017

Now in its second decade, functional magnetic resonance imaging (fMRI) localizes changes in blood oxygenation that occur in the brain when an individual performs a mental task. Physicians and scientists use fMRI not only to map sensory, motor, and cognitive functions, but also to study the neural correlates of a range of sensitive and potentially stigmatizing conditions, behaviors, and characteristics. Poised to move outside the traditional clinical and research contexts, fMRI raises a number of ethical, legal, and social issues that are being explored within a burgeoning neuroethics literature.In this Article, I place these issues in their proper historical context. The ethical, legal, and social issues raised by advances in functional neuroimaging are challenging and somewhat distinctive, but they are not entirely new. Earlier methods of body imaging and brain mapping, including phrenology, x-ray, positron emission tomography, and single-photon emission computed tomography, raised similar issues, and perhaps we can use our experiences with these sciences and technologies to help guide current functional neuroimaging policy.
A Double-Edged Sword: The Role of Neuroimaging in Federal Capital Sentencing
Authors: Barth Abram S. 
Published: January 2017

H.L.A. Hart has stated that certain mental conditions have an “excusing” effect on punishment, whereby “[t]he individual is not liable to punishment if at the time of his doing what would otherwise be a punishable act he is … the victim of certain types of mental disease.” The Supreme Court, however, upheld a state statute allowing for increased “punishment,” in the form of civil commitment, for sexually violent predators who suffer from a “mental abnormality.” Thus, American jurisprudence is faced with a paradoxical role of mental conditions: serving to both aggravate and mitigate sentences. This dual purpose of mental conditions becomes a pressing legal issue as mental conditions associated with brain structure or function become more detectable with the emergence of neuroimaging.In federal capital sentencing, judges are obligated to consider aggravating and mitigating factors before imposing a death sentence. There are aggravating and mitigating factors that could be implicated by mental conditions, including future dangerousness, and impaired capacity, respectively.