bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac Arrhythmias Associated with Upper Gastrointestinal Endoscopy in Elderly Subjects
Authors: McAlpine J. K. , Martin B. J. , Devine B. L. 
Published: January 2017

Continuous Holier monitoring was performed before, during and after upper gastrointestinal endoscopy in 50 unselected, consecutive elderly patients (median age 80 years: range 68–89). In contrast to other studies the patients received no atropine or opiate premedication and were monitored for a prolonged period usually 24 hours after endoscopy. Comparison of a control period when the patient was lying at rest before endoscopy with the period of endoscopy itself revealed an increased frequency of arrhythmias during endoscopy, Forty-eight per cent of patients developed a new arrhythmia or an increased frequency of existing arrythmia during endoscopy. All arrhythmias were short and self-terminating. Evidence of cardiac disease conferred a significantly increased risk of developing an arrhythmia during endoscopy.
Gastric and Colorectal Cancers in Scotland: A Study of the Geographical Distributions and Selected Associations
Authors: Williams F.L.R. , Lloyd O.L.I. 
Published: January 2017

The geographical distributions of gastric and colorectal cancers in Scotland were investigated by analysing the data available for those diseases in the Annual Reports of the Registrar General for Scotland. For gastric cancer, the standardised mortality ratios (SMRs) for the 234 traditional communities in 1969–73 and for the 56 districts in 1979–83 were calculated. For colorectal cancer, only the data for the latter period were available, and SMRs for that period were calculated similarly. Possible determinants on the resulting pattern of high and low SMRs were investigated. Gastric cancer was generally associated with industrial and urban environments, particularly in west central Scotland, although mortality in Dundee was high in both periods; this cancer also showed significant negative correlations with social class II. By contrast, colorectal cancer showed no strong geographical pattern, no urban-rural gradient, and no social class associations. The cancers showed a weak association with each other.
Factors Affecting Asthma Mortality in Scotland
Authors: Mackay T.W. , Wathen C.G. , Sudlow M.F. , Elton R.A. , Caulton E. 
Published: January 2017

Asthma mortality in the age group 5 — 44 years appeared to be stable in Scotland in both males and females at a rate of approximately 1.0 per 100,000 during the period 1970 — 1988 despite an increase in the hospital discharge rate for asthma of approximately 4% per annum during that period. Two-thirds of these deaths occurred outside hospital. There was evidence of a seasonal variation in asthma deaths with a peak mortality occurring in August, four to six weeks after the peak in total pollen counts. Monthly variation in atmospheric pollution did not appear to account for the variation in asthma mortality. It is suggested that the seasonal variation in asthma mortality provides a basis for further studies to elucidate the factors contributing to these deaths.
Seasonality of Hip Fracture and Haemorrhagic Disease of the Newborn
Authors: Douglas A.S. 
Published: January 2017

The objective is to examine and compare the seasonalities offractured neck of femur and haemorrhagic disease of the newborn. The data are from two sources. Admissions for fractured neck of femur in Scotland over five years (1983–87) are examined by age, sex, mortality, operative intervention and source of admission. Data from the United States (1927–36) are examined for infant death rates from suspected haemorrhagic disease of the newborn 3–14 days after birth. The sine curves are examined. The rhythms, while not identical, have similarities. The peaks are in January-February and the troughs in July-August. Amongst hip fractures the peak is one month earlier and the seasonal excess around 20–25 per cent in both conditions. Rickets, haemorrhagic disease of the newborn and fractured neck of femur have comparable seasonal rhythms. Vitamin D regulates the systhesis of the vitamin K dependent bone protein osteocalcin, which is functionally abnormal in postmenopausal women. This may be a significant factor in the seasonal variation of hip fracture.
Women's Experiences at Cervical Screening
Authors: Crombie I.K. , Orbell S. , Johnston G. , Robertson A.J. , Kenicer M. 
Published: January 2017

Concerns about attendance for cervical screening has focussed on determining the reasons why some women never attend. Less attention has been paid to whether women continue to attend for further smears, although this is essential for further screening. This study investigated woemn's experiences of cervical screening and their views on subsequent attendance. Three hundred and thirty nine women aged 20–64 were identified from a computerised register of cervical smears as having had a smear test within the previous three years. They were interviewed at home about their most recent experience of screening. Just over half of the women (53%) recalled being anxious before the test, and about one fifth reported embarrassment (19%) or pain (20%) during it. The frequencies of discomfort were higher amongst those who were anxious about the test, athough 24% of those who were embarrassed and 28% who had pain reported being unconcerned beforehand. The frequencies of pain and embarrassment were only slightly higher when the smear taker was male. Many women (22%) reported being concerned about the test result although only 10% of those who were concerned were recalled for further assessment. Although a number of women had unpleasant experiences, almost all (95%) who were under 60 years of age said they were likely to attend for a subsequent smear. Taking cervical smears is often an unpleasant experience for women, although some of the distressing events could easily have been avoided. Attention to technique and to the concerns of individual patients, especially ensuring privacy, could reduce the extent of the problem. The uptake of subsequent smears should be monitored to ensure that women are not being discouraged from attendance.
Seasonality and other Epidemiological Features of Haemolytic Uraemic Syndrome and E. Coli

O

157 Isolates in Scotland
Authors: Douglas A. S. , Kurien A. 
Published: January 2017

The main objective was to determine whether there was seasonality in presentation of haemolytic uraemic syndrome (HUS) in children and adults, and compare this with the reporting of E. coli O157. The data came from Scotland, examining admissions during 1980–95 and E. coli isolates 1984–95. Seasonality was sought by fitting a sine curve to monthly or four-weekly data throughout the year. Seasonality was present for HUS and E. coli isolates in patients under 15 years of age but not in those above that age. The highest point of the sine curve was in July/August but there was a high plateau from June to September. The timing was similar to other diarrhoeal disease. This is an epidemiological study, the purpose being to clarify the seasonal features of HUS. E. coli infection is an important food hazard and a sound knowledge of the epidemiology, could lead to optimal control. The Scottish geographic distribution is illustrated.
A Retrospective Epidemiological Analysis of Non-Accidental Head Injury in Children in Scotland over a 15 Year Period
Authors: Barlow K. M. , Milne S. , Aitken K. , Minns R. A. 
Published: January 2017

A retrospective analysis of the epidemiological characteristics of non-accidental head injury (NAHI) in children in Scotland over the last fifteen years from 1981 until March 1996 was performed. The information was provided by the Information and Statistics Division of the Scottish Health Service. The average incidence of NAHI calculated over this period was 0.04 cases per year per 1000 children under 5 years. Fifty-five per cent of all cases occurred in those children who were less than a year old. 41% of cases were inflicted by a parent but in 47% the perpetrator could not be identified. The mortality rate was found to be 2%. Non-accidental head injury cases identified using the ICD-9 coding classification system gives a surprisingly low incidence. This number is probably an underestimate and the reasons for this are discussed. A prospective epidemiological analysis of NAHI in children in Scotland is being undertaken to determine the true incidence.
Structural Changes in Cotton: Effect of Premercerization Conditions on Subsequent Cross-Linking
Authors: Wade Ricardo H. , Vigo Tyrone L. 
Published: January 2017

Structural changes due to tension applied to caustic-swollen yarns were studied. It was found that the cross-linking of yarns which had been mercerized slack, at normal length, or slack and then restretched to normal length produced differences in tenacity and X-ray orientation. It was concluded that this was due to structural rearrangements induced by the application of load to fiber systems. Differences in wet pickup of the cross-linking resin were shown to produce differences in the fiber fragmentation pattern but not in the layer-expansion pattern. Only a fraction of the added cross-linking resin was considered to have contributed to the properties usually attributed to cross-linked yarns. The regions believed responsible for the effect of cross-linking are the less ordered lattices close to the crystalline structures. The strength retained after cross-linking was dependent on the tension and the method of its application. Differences in the degree of conversion of cellulose I to cellulose II were noted in the slack-mercerized yarns treated with different alkali metal hydroxides. These differences, with the exception of lithium hydroxide, correlated with swelling effectiveness of the alkalis used.
Some Low-Angle X-Ray Evidence on the Structural Changes in Thermally- and Plasma-Treated Wool
Authors: Lee Kay Sue 
Published: January 2017

A series of events occurred when wool was heated in vacuum. At some stages structural changes in the thermally-treated wool were observed, as reflected in the low-angle x-ray diffraction patterns. An increase in the intensity of the 39 Å meridional reflection and the appearance of a 4-point diagram with azimuthal angle of 45° at about 46 Å spacing were observed when wool was heated near 170°C for 90 min. Similar results were found in samples heated at higher temperatures but for shorter time. The most heat-resistant meridional reflection is the 66 Å. The low-angle x-ray diffraction patterns of plasma-treated wool showed only disappearance of the sharp lipid ring at 48 Å. No intensification of any reflection was observed. Prolonged treatment with plasma destroys the low-angle x-ray diffraction pattern of wool.
Review of Fabric Filtration and Air-Pollution Control Applications
Authors: Frederick E. R. 
Published: January 2017

Fabric filtration, the proven engineering process for recovering air-borne industrial particulates, is remarkably effective for controlling air pollution. Since 1969 the total filter market has doubled, an upsurge attributable largely to this application. Government regulations have profound influence on this added filter market, especially since other control processes have been severely strained to meet emission limits as effectively or as economically. The successes attributable to baghouses in the air-management field are numerous and widespread. Nevertheless, significant limitations are evident, due mostly to restrictions in filtration know-how and in the properties of available media. Of greatest concern is the lack of an accurate understanding of basic engineering principles. Current research confirms that electrostatic effects play an important role in the collection process, making it possible for fabric filtration to evolve into a more predictable science. The ability of fabric filters to control particulate matter—even the hazardous fine particles—the expansion of this practice into other air-pollution control applications—notably for flyash collection—and the tightening of regulations indicate that the filter fiber and media market will expand significantly, the growth rate being enhanced by increasing user confidence, improved consistency, and better applications of materials.
Sorption and Desorption of a Cationic Polymer by Human Hair: Effects of Salt Solutions
Authors: Faucher J. A. , Goddard E. D. , Hannan R. B. 
Published: January 2017

Sorption of Polymer JR, a cationic cellulose ether, by human hair is greatly decreased in the presence of added electrolytes. This reflects the competition between cations of the added salt and the quaternary ammonium groups of the polymer for sorption sites in the substrate. In this respect the hair can be regarded as a “strong-acid” ion-exchanger, and it displays a selectivity to ions similar to that observed for conventional resin exchangers. Cations can be ranked in order according to their ability to decrease the sorption of Polymer JR as follows: La+++ > Al+++ < Fe+++ < Ca++ < Fe++ < Cs+ < Na+ < Li+. Salts also promote desorption of Polymer JR that is already sorbed by hair. However, selectivity is less evident in desorption than in sorption and is only observed at relatively low concentrations of salt. About half of the sorbed polymer is readily removed by salt solutions; the rest appears to be tightly attached to the substrate.
Are Deaths Due to Prematurity Avoidable in Developing Countries?
Authors: Pattinson R C 
Published: January 2017

Our aim was to assess the potential for reducing the perinatal mortality rate (PNMR) related to spontaneous preterm delivery. Data from 44 Perinatal Problem Identification Program sentinel sites around South Africa were used. In each perinatal death the primary cause as well as missed opportunities and substandard care were discussed and allocated. 3045 perinatal deaths in 78 343 births of ≥ 1000 g were analysed. There were 518 perinatal deaths (17%)whose primary obstetric cause of death was due to spontaneous preterm labour (PNMR7.48/1000 births). The most common avoidable factors were delay in seeking help during labour (14.7%), Jack of neonatal facilities (10.0%), lack of transport (7.3%) and inappropriate response to the presence of premature rupture membranes (4.6%). Few perinatal deaths could be ascribed to poor antenatal or intrapartum management of spontaneous preterm labour. The vast majority of spontaneous preterm births could not be prevented within the health institutions. Prevention of deaths due to prematurity outside of metropolitan areas will rely on the neonatal care being adapted to reduced resources.
Feasibility of Outpatient Surgery in the Tropics
Authors: Favretti F , Pucciarelli S , Lise M , Tieba M , Rotigliano G F , Banzata O 
Published: January 2017

The feasibility of outpatient surgery was investigated at a regional hospital in a Third World country. A series of 73 patients with uncomplicated hernias (inguinal, femoral) and hydroceles were allocated at random to receive standard surgical treatment either as inpatients (group 1) or as outpatients (group 2). Patients living within a 4 km radius of the hospital or who agreed to stay in specially provided quarters nearby were eligible to take part in the study. Patients not able to follow the basic hygiene rules taught by the local staff were excluded. The morbidity rate was 5/36 (13.8%) in group 1 and 8/37 (21.6%) in group 2. No statistically significant differences were demonstrated between the complications that occurred in the two groups.
Am I Liable? The Problem of Defining Falsity under the False Claims Act
Authors: Kim Lonie 
Published: January 2017

The Federal False Claims Act (FCA) creates civil liability for entities that falsely or fraudulently contract with the government to provide services or goods in exchange for federal funds. FCA cases often arise in healthcare contexts in which the government pays entities for providing products and services to eligible beneficiaries. With the growth of Medicare and Medicaid funding for healthcare services, there has been a corresponding increase of false claims and FCA cases, in the healthcare context. For instance, of the over 30 billion recovered by the government for FCA cases in the last fifteen years, recoveries from Health and Human Services constitutes over 20 billion.An FCA case may involve a false representation that a service has been provided when in fact it has not. Such a case may also involve a false representation of compliance with underlying governmental requirements for payment. Recently, there has been growing confusion as to how to address cases in which the defendant is not the party actually submitting the allegedly false claim, but the party that caused the false claim to be filed.
Intractable Pain: A Neglected Area of Medical Education in the UK
Authors: Marcer D , Deighton S 
Published: January 2017

Unease over the previous management of 67 patients referred for treatment to 3 pain relief clinics led us to investigate the current state of education in pain and pain control in the UK. Twenty-seven medical schools provided data which revealed; (i) in 4 schools no teaching whatsoever is given in these subjects; (ii) in the remainder it is accorded an average of 3.5 hours during the 5 year course, with little evidence of multidisciplinary teaching; (iii) only 10 schools (37%) regularly set questions on pain control in formal examinations. A survey of 219 general practitioners revealed a wide-ranging lack of knowledge about the facilities and approach to treatment at their local pain relief clinic. These findings have wide reaching implications for medical education. At the undergraduate level they demonstrate a need for more multidisciplinary teaching and practical experience in specialist units. Thereafter specialists in pain control must enable practising doctors to keep abreast of new developments. This may require them to devote more time writing for a non-specialist audience and devising short, postgraduate courses.
The Epidemiology of Chronic Venous Diseases
Authors: Adhikari A. , Criqui M. H. , Wooll V. , Denenberg J. O. , Fronek A. , Langer R. D. , Klauber M. 
Published: January 2017

Objective: To review the prevalence of and risk factors for varicose veins, chronic venous insufficiency (CVI) and venous leg ulcers. Data sources: MEDLINE was searched for the terms prevalence and varicose veins, chronic venous insufficiency, or venous leg ulcers. Study selection: The extant world literature (1966–1999) with a minimum of an available English abstract was collected. Ninety-nine studies were reviewed. Data extraction: Data were extracted on prevalence of diseases of the veins in the lower limb, age and gender of the subject populations, and other risk factors for those diseases examined by the original researchers. Data synthesis: The two most prominent risk factors for venous disease are increasing age and female gender. Additional risk factors for venous disease with at least some documentation in the literature include dietary patterns, obesity, physical activity, standing occupations, constrictive clothing, connective tissue laxity, and hormonal differences, including pregnancy. Family history is also a prominent risk factor, suggesting a genetic component. Conclusions: Varicose veins are found more commonly in women, and with increased age. The increase with age is linear, suggesting a constant incidence and cumulative prevalence. CVI is also more common in women and increases with age, but data are limited. Venous leg ulcers are much less common than varicose veins or CVI and show less of a female preponderance, but increase exponentially with age, suggesting a true increasing incidence with age.
Colour Flow Duplex Scanning as a Preoperative Guide for Mapping and for Local Anaesthesia in Varicose Vein Surgery
Authors: Cavezzi A. , Carigi V. , Collura M. 
Published: January 2017

Objective: To evaluate duplex or colour flow duplex ultrasound scanning (CFDS) in varicose vein surgery as a perioperative guide for mapping, marking and local anaesthesia (LA), on the basis of our experience since 1990. Design: Retrospective clinical series. Patients and methods: A total of 3150 interventions for varicose veins were performed on an outpatient basis since 1990. This review of the last 4 years' experience (January 1996 to December 1999) deals with 1824 operations (457 men, 938 women; mean age 55.3 years). Duplex scanning or CFDS was used for perioperative investigation in all the patients, but also to guide skin marking and to help in the injection of LA (mepivacaine chloridrate 0.25–0.4%). The surgical approach varied according to the patient's morphohaemodynamic findings. Results: Several different preoperative patterns of varicose vein disease resulted in a ‘made-to-measure’ surgical approach, allowing segmental saphenous stripping in 99.9% of the patients, and ligation of perforating veins in 0.9% of cases. Immediate postoperative walking was possible in 99.8% of the patients and 3–6 h hospitalisation time in 99.5%. LA caused only minor complications (haematoma, urticaria) in 15 cases. Duplex monitoring of infiltration has facilitated LA usage, decreasing the doses and concentrations required and improving its efficacy. The operation costs decreased with time; major complications were 2 deep vein thromboses, one with a probable pulmonary embolism. Conclusion: The use of duplex scanning or CFDS in varicose vein surgery has permitted accurate preoperative evaluation and a guide to injection of LA, resulting in more conservative and targeted surgery. Patient compliance and cost-efficacy were also improved.
Graduated Compression Elastic Stockings Reduce Lipodermatosclerosis and Ulcer Recurrence
Authors: Vandongen Y. K. , Stacey M. C. 
Published: January 2017

Objective: To assess the effect of elastic stockings on reducing the area of lipodermatosclerosis in patients with healed venous ulceration. Design: Patients in this study were part of a randomised controlled trial to assess elastic stockings in preventing venous ulcer recurrence. Setting: Leg ulcer clinic at a tertiary teaching hospital. Patients: Consecutive consenting patients with leg ulcers due to venous disease alone, that had healed 2 weeks previously. Interventions: Patients were randomised to below-knee graduated compression stockings (Venosan 2003) or no stockings. Main outcome measures: Patients had the area of lipodermatosclerosis measured on admission to the study and at 6-monthly intervals. Time to ulcer recurrence was also recorded for a 2-year follow-up period. Results: One hundred and fifty-three patients were randomised to the main study (stockings 72, no stockings 81); 52 had re-ulcerated by 6 months (15 stockings, 37 no stockings). Lipodermatosclerosis was significantly reduced after 6 and 12 months in those patients wearing stockings but not in the control group (repeat measures ANOVA p = 0.01, p = 0.04). The initial area of lipodermatosclerosis was significantly larger in those patients who re-ulcerated within 2 years of entering the study compared with those who did not re-ulcerate (re-ulceration, 293 cm2; no re-ulceration, 50 cm2). Conclusions: Elastic stockings alone can improve the skin changes of lipodermatosclerosis and lower the rate of ulcer recurrence.