bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ring Uncemented Plastic on Metal Hip Replacements-Results from an Independent Unit
Authors: Mok D W H , Bryant K M 
Published: January 2017

We present 251 Ring uncemented plastic on metal (UPM) hip replacements with a follow-up of 2–5 years. Judging the functional results by the Harris hip evaluation for the surviving 234 hips, 79.8% were good to excellent, 11.7% fair, and 8.5% poor at an average of 3 years. The mortality within one month of surgery was 0.79%. There were 4 cases of deep infection (1.59%), 3 of which required excision arthroplasty. At 3 years, 6 hips (2.39%) had required revision, all for aseptic femoral loosening, 2 of which also had acetabular loosening. Ring UPM hip is both safe and reliable in the hands of many surgeons outside Ring's unit.
Topical and low-dose intravenous tranexamic acid in cyanotic cardiac surgery
Authors: Patel Jigar , Prajapati Mrugesh , Patel Hardik , Gandhi Hemang , Deodhar Shilpa , Pandya Himani 
Published: January 2017

Background Coagulopathy is a major problem in surgery for cyanotic congenital heart disease. Tranexamic acid has been used both topically and systemically and plays a vital role in pediatric cardiac surgery by reducing blood loss and blood product requirement. We aimed to determine the anti-fibrinolytic effectiveness of low-dose systemic or topical tranexamic acid or a combination of both. Methods Seventy-five patients were divided in 3 groups of 25. Group A patients were given tranexamic acid 20 mg kg−1 intravenously after sternotomy and 20 mg kg−1 after heparin reversal. Group B patients were given tranexamic acid 50 mg kg−1 in 20 mL of saline intrapericardially before sternal closure, with the drain clamped for 20 min. Group C patients were given tranexamic acid 20 mg kg−1 intravenously after sternotomy and 50 mg kg−1 intrapericardially before sternal closure. A number of clinical variables were recorded in the first 3 postoperative days. Ventilator time, intensive care unit stay, and outcome were also recorded. Results Chest tube drainage and blood product requirements were lowest in group C. Blood urea and serum creatinine levels were higher in groups A and C ( p < 0.05). Intensive care unit stay and ventilator time were similar in all 3 groups. No patient died and none had a seizure or other neurological event or thromboembolic complication postoperatively. Conclusion The combination of low-dose intravenous and topical tranexamic acid reduces postoperative blood loss and blood product requirement without incurring neurological, renal or thromboembolic complications. We recommend the routine use of topical and low-dose systemic tranexamic acid in cyanotic pediatric cardiac surgery.
Ovarian Vein Embolisation as an Adjunct in the Treatment of Vulval and Atypical Leg Varicosities
Authors: Garrett J. P. , Wetton C. W. N. , Tyrrell M. R. 
Published: January 2017

Objective: To assess the safety and technical success of percutaneous transcatheter embolisation of ovarian veins as an adjunct in the treatment of vulval and leg varicosities. Design: Prospective case series. Setting: Vascular surgery and radiology departments of a District General Hospital. Patients: Thirteen patients with atypical leg and vulval varicosities. Interventions: Via a transbrachial approach, selective cannulation of the ovarian veins was performed. If preliminary venography showed ovarian vein incompetence, transcatheter embolisation of the ovarian veins was performed. Results: In 12 of 13 cases, venography proved incompetence of the ovarian veins. The ovarian veins were successfully embolised in all of these (8 bilaterally, 4 unilaterally). Complete occlusion requires long (20 cm) coils to the main vessels. There were no significant complications. Conclusion: This procedure is safe and well tolerated. It confirms incompetence of the ovarian veins in selected patients and allows for embolisation in the majority.
Treatment of Varicose Veins by Foam Sclerotherapy: Two Clinical Series
Authors: Cavezzi A. , Frullini A. , Ricci S. , Tessari L. 
Published: January 2017

Objective: To assess the efficacy and safety of sclerotherapy of varicose veins (VV) with sclerosing foam (SF) made using Tessari's method (three-way tap and two plastic syringes). Design: Two multi-centre prospective clinical series were documented (CS1 and CS2). In CS1, which ran from March to December 2000, 177 patients (39 men, 138 women), mean age 56 years, were treated in three centres for W related to incompetence of saphenous veins, recurrence, perforators or collaterals. Conventional or duplex-guided sclerotherapy was performed using SF made of purified sodium tetradecyl sulphate (PSTS) 0.2−3% (Fibro-vein, STD Pharmaceuticals, UK) and air. An average of 1.6 (SD 0.8) sessions per patient were performed and 2.9 (SD 1.0) ml of SF (i.e. 0.6 ml of PSTS) per session was employed. An elastic stocking providing 20 −30 or 30−40 mmHg compression was worn by patients following treatment. All the patients were reviewed (clinical examination and colour duplex ultrasonography) at 1 month. Sixty-six patients had a further follow-up 45−370 days after treatment. The 17 patients in CS2, a multi-centre study, were treated in March and April 2001. An independent observer assessed patients with major W (CEAP and W type distribution similar to CS1) before and after the treatment, and also observed the treatment, which was carried out using the technique employed in CS1. Results: In CS1 at 1 month follow-up there was: (A) obliteration of the vessel or antegrade flow in 161 (91%) patients, (B) minimal retrograde flow in the treated vein, without visible W, in 15 (8.4%) cases and (C) persistence of vessel patency with retrograde flow and visible W (failure) in 1 (0.6%) case. At 45−370 days (mean 138 days) follow-up results were: type A in 44 (67%) cases, type B in 17 (26%) cases and type C in 5 (8%) cases. The main complications were extension of sclerothrombus from superficial to deep veins (n = 2), allergy (n = 1), malaise (n = 1) and scotoma (n = 1). In CS2 at 30 days follow-up 100% of the treated venous segments had a type A outcome after an average of 1.4 sessions. No relevant complication occurred in this series. Conclusions: Sclerotherapy of major VV by means of SF prepared by Tessari's method is a safe and effective form of treatment. Low doses and a low concentration of drug may be successfully employed. Further studies are needed to establish the long- term results and overall safety of this form of foam sclerotherapy.
Surgical Treatment of Popliteal Vein Entrapment Causing Symptoms
Authors: Hirokawa M. , Iwai T. , Inoue Y. , Sato S. 
Published: January 2017

Objective: To review series of cases in which surgery was used to treat popliteal vein entrapment (PVE). Methods: Between 1984 and 2001, 11 patients (all women; mean age 27.6 years; 14 limbs) underwent surgery for PVE causing calf ache, swelling, and tenderness of the popliteal fossa. Preoperative evidence of PVE included positive results on a passive dorsi-flexion test, compression of the popliteal vein on ascending venography, hypertrophied or aberrant muscle in the popliteal fossa on CT scanning and elevated below-knee venous pressure. The medial or third head of the gastrocnemius muscle was partly or totally resected under the guidance of intraoperative venous pressure measurement and venography. Results: No operative complications occurred. During 3-10 years of follow-up, 57% of limbs were symptom-free, 21% were improved and 21% were unchanged. Conclusion: Treatment of PVE by resection of muscle fibres under the guidance of objective intraoperative assessments was effective in most patients.
An Italian Survey on the Prophylaxis of Venous Thromboembolism
Authors: Belcaro G. , Laurora G. , D'Aulerio A. , Ricci A. , Mezzanotte A. 
Published: January 2017

Objective: To determine the current usage of prophylactic regimes to prevent deep vein thrombosis in surgical departments in Italy. Design: Survey by questionnaire sent to 500 surgical departments. Participants: Surgical departments performing more than 500 surgical operations, selected randomly by the process of quota sampling. Main outcome measures: Assessment of the methods or prophylaxis, reasons for use of prophylaxis and assessment of outcome of prophylactic measures. Results: There were 326 completed questionnaires returned indicating that prophylaxis was used routinely in 58% of the centres, 29% of centres used more than 1 method of prophylaxis with subcutaneous heparin and elastic compression being the most commonly used modalities. Conclusion: Insufficient use of prophylactic measures to prevent deep vein thrombosis in Italy still leads to an excessive number of postoperative venous thromboses.
A Retrospective Follow-up Study of Patients with Suspected Deep Vein Thrombosis and Negative Results of Colour Duplex Ultrasound
Authors: Norén A. , Lindmarker P. , Rosfors S. 
Published: January 2017

Objective: Investigation of the frequency of symptomatic venous thromboembolic disease 3 months after negative results of colour duplex ultrasound investigation of the lower extremities in patients with suspected deep venous thrombosis (DVT). Design: Retrospective analyses of consecutive ultrasound investigations and a survey in patients with normal findings. Setting: Patients were investigated at two clinical vascular laboratories in teaching hospitals. Main outcome measures: Objective verification of symptomatic venous thromboembolism during 3 months follow-up by a questionnaire and retrospective analyses of diagnostic procedures for venous thromboembolism. Results: Eighty-seven per cent answered a questionnaire and the majority had temporary symptoms which were explained by other diagnoses than DVT. In one patient a DVT was phlebographically verified 1 week after the ultrasonographic investigation, which showed only superficial thrombophlebitis. Conclusion: Patients with suspected DVT and a negative colour duplex investigation of the deep veins are unlikely to develop clinically important venous thromboembolic disease within 3 months.
Benzodiazepine maintenance in opiate substitution treatment: Good or bad? A retrospective primary care case-note review
Authors: Bakker Adam , Streel Emmanuel 
Published: January 2017

Background: Co-prescribing benzodiazepines to patients in opiate substitution treatment is controversial and often alleged to increase mortality. In an inner-London general practice, patients with problematic benzodiazepine co-dependence were allowed benzodiazepine maintenance treatment (BMT) since 1994, providing an opportunity for analysis. Method: 1) Case-note review of all 278 opiate substitution treatment patients, accruing 1289 patient treatment years; 46% had concurrent BMT. 2) National Health Service database search for patients who died after leaving accrued a further 883 years of information; only patients who left the UK were unaccounted for (4%). Three groups were studied: 1) never obtained benzodiazepine prescription (NOB): n=80); 2) briefly/occasionally prescribed benzodiazepines (BOP): n=71; 3) BMT: n=127. Outcomes measured: Treatment retention (months); deaths/100 patient treatment years; deaths after leaving the service/100 years of information. Results: Treatment retention: NOB: 34 months; BOP: 51 months; BMT: 72 months. In-treatment mortality: NOB: 1.79/100 patient treatment years; BOP: 0.33/100 patient treatment years; BMT: 1.31/100 patient treatment years. Deaths after leaving service: NOB: 2.24/100 years of information, BOP: 0.63/100 years of information. However, mortality for previously BMT-patients increased by 450% to 5.90/100 years of information. Discussion: BMT patients had longer treatment retention than NOB or BOP and lower mortality than NOB patients. It is unlikely that patients had access to prescribed benzodiazepines on leaving the service because of restrictions in the national guidelines but co-dependent patients are a high-risk group who may stand to gain most benefit from opiate substitution treatment if combined with benzodiazepine-maintenance.
Long-Term Tolerability Study of Voltaren
Authors: Miura T 
Published: January 2017

Clinical and laboratory examinations were conducted in order to assess the long-term tolerability of Voltaren, a new anti-inflammatory and analgesic agent. Pre-treatment, repeated on-treatment and after-treatment investigations of haemoglobin, erythrocyte count, total and differential leucocyte count, platelet count, SGOT, SGPT, alkaline phosphatase, total serum proteins and urinary protein and sugar were conducted in 13 patients. The period of treatment with Voltaren was 110 to 559 days. In all these tests, there were no unwanted effects attributable to long-term treatment with Voltaren. Our study would indicate that Voltaren is a safe drug which has no effect on the organs of haemopoiesis, nor on hepatic or renal function, even in long-term therapy. Therefore, Voltaren can be used as an anti-inflammatory and analgesic agent not only in short-term therapy but also in the long-term treatment of chronic diseases.
A Placebo Controlled Trial of Viloxazine with and without Tranquillizers in Depressive Illness
Authors: Magnus R V 
Published: January 2017

Two double-blind four-way crossover studies are reported, comparing the antidepressant effect of 14-day courses of: viloxazine, viloxazine with a tranquillizer either perphenazine or diazepam or tranquillizer alone, against a placebo. In one study the antidepressant effect of viloxazine at a dose of 150 mg daily was statistically greater than that of placebo, whilst in the second study viloxazine was statistically superior to diazepam (15 mg daily). In depressed patients with a clear anxiety component, viloxazine alone seemed preferable to a combination with a tranquillizer as such a combination did not produce an enhanced clinical effect and the incidence of side-effects was possibly increased. Viloxazine was generally well tolerated and side-effects, when they occurred, were generally a mild upper gastro-intestinal disturbance.
Management of Constipation in Terminally Ill Patients
Authors: Crowther A G O 
Published: January 2017

This small study was carried out to assess the effectiveness of lactulose syrup (Duphalac®) in the management of constipation in forty-six patients with terminal illnesses. The daily dose of lactulose was titrated to meet the individual patients requirements and was found to be in the region of 20 to 30 mls twice daily, despite the almost universal administration of opiates as analgesics. The study lasted 21 days in each patient capable of completing the assessment. Constipation was relieved within an average of 3 to 4 days, and of the 512 days observed, there were 203 days in which a bowel movement occurred. Of these motions 71% were recorded as easy to move, rather than hard (21%) or loose (8%). Faecal incontinence and nausea attributable to lactulose treatment were extremely rare. Therefore, lactulose appeared to be a useful treatment for constipation in the terminally ill patient.
Cimetidine in the Treatment of Duodenal Ulcer: Double-Blind Study
Authors: Villalobos J J , Elizondo J , Guevara L , Centeno F 
Published: January 2017

To determine the efficacy and safety of cimetidine in the treatment of duodenal ulcer, forty-five patients with this diagnosis were selected for a double-blind study. Diagnosis was confirmed by endoscopy and photography of the lesion. Cimetidine in the form of 200 mg tablets was administered to twenty-four patients at the rate of 1 tablet t.i.d.p.c. and 2 tablets h.s. The same dosage of an identically appearing placebo tablet was given to twenty-one patients. The only other medication permitted was an aluminum + magnesium gel antacid p.r.n. Patients and medication were randomized, the same patients being seen by the same physician throughout the six-week observation period. Laboratory monitoring of patients (complete blood counts, blood chemistry, urinalysis, gastric acidity) took place at one, two, four and six weeks as did clinical observation. Three placebo patients withdrew from the study. The patients on cimetidine showed a statistically significant greater number of healed ulcers, early and late in the treatment; earlier and more persistent pain relief in a greater number; and considerably fewer requiring antacid than those patients on placebo. No side-effects were noted.
A Comparison of the Hypnotic Activity of Loprazolam, Temazepam and Placebo in General Practice
Authors: Gringras M , Beaumont G , Ankier S I 
Published: January 2017

One hundred and ninety-seven patients exhibiting a disturbed sleep pattern were recruited by thirty-five general practitioners into this single-blind randomized parallel group multicentre study. There were twelve patient withdrawals or drop-outs leaving sixty-one, sixty-three and sixty-one patients who, following 2 nights on placebo as baseline, completed 5 consecutive nights of treatment on loprazolam (1 mg), temazepam (20 mg) and placebo, respectively. Loprazolam and temazepam were found to have similar hypnotic activity with both treatments being superior to placebo. There was no statistical difference in the side-effect profile of the three treatment groups.
Notes from prison
Authors: Maryniak Irena 
Published: January 2017

When they visited me in prison they would always emphasise that the case was in their hands, that the judges, the prosecution, the whole system was subordinate to them. Nobody can live on a salary, they said. This is the free market. Everyone has to find other means to survive: bribes, business interests, protection rackets… They were pretty convincing about their unlimited power. When I asked them about the practicalities of controlling the judiciary, the two FSS men rocked with laughter. First you have to ‘work’ on them, they volunteered cheerfully, catch them out when they're not on the level. Then you take them aside and paint their future in the darkest possible terms — if they're exposed. By then they'll be sweating and ready to do anything to ensure that the FSS preserve their reputation. Then you sweeten them up. After that they'll be only too keen to show their gratitude. They'll be under threat of compromise for life. It had taken me a long time to understand why the two FSS men had kept so ‘sweetly’ persuading me to give them information about drug-taking among children of politicians, financiers, and the artistic elite. They laughed, as ever. ‘It's dynamite,’ they said. ‘You can get anyone by the throat if you threaten to compromise their children. After all,’ they said, amazed at my inability to understand these elementary things, ‘the elections are coming.’
VAST HELL
Authors: Martínez Guillermo 
Published: January 2017

Guillermo Martínez was born in Bahía Blanca, in the province of Buenos Aires, Argentina, in 1962, four years before General Onganía came into power. In 1982 he was awarded the first prize in the National Short Story Competition ‘Roberto Arlt’ for his book La jungla sin bestias (The Beastless Jungle); six years later he received the first prize from the Fondo Nacional de las Artes for his second collection of short stories, Infierno Grande (Vast Hell). His first novel, Acerca de Rodorer (Concerning Rodorer) was published in 1992. Martínez belongs to the generation of writers who grew up in the midst of the Argentina of the ‘dirty war’ between the military dictatorship and the guerrilla, a war that left the country shattered and from which Argentina has not recovered in spite of the present government's attempts to erase all memory of those past atrocities. The war did violence to everyone and everything, including the Argentine language. The writers of Martínez's generation were forced to reconstruct a tongue destroyed by the abuse of power, by irrational violence, by forced stupidity which infected words like a virus infects the blood. Their task was not only to bear witness and to build imaginary landscapes for their chronicles which are not, it must be said, mere documentaries. First they had to rescue the words themselves from debasement, using a pared-down, clear-cut language, free from the rhetoric, far-fetched metaphor and bombast so dear to the military heart.
Usefulness of 13C-Urea Breath Test in the Diagnosis of Gastric Helicobacter Pylori Infection
Authors: D'Elios M.M. , Amedei A. , Benagiano M. , Azzurri A. , Del Prete G. 
Published: January 2017

Helicobacter pylori chronically infects half of the human population and is associated with gastritis, peptic ulcer and gastric cancer. 13C-urea breath test (UBT) is the main in vivo tool for the diagnosis of H. pylori infection. In this study, the safety and the accuracy of UBT were evaluated. A group of 492 dyspeptic patients was studied by UBT, the results were expressed as the difference over baseline at 30 min (DOB30). All patients were evaluated for systemic, gastrointestinal or allergic-type adverse reactions after ingestion of 75 mg 13C-urea and citric acid in aqueous solution. The first 256 patients enrolled also underwent endoscopy and gastric biopsy. Patients positive on histology were considered infected. UBT was well tolerated and none of the 492 patients had any systemic or allergic-type adverse reaction. Among the 256 patients studied with histology, 116 were H. pylori positive on biopsies. Using 4% o as cut-off value for DOB30, 115 out of the 256 patients were positive on UBT, with only 2 false positive and 3 false negative. With this threshold, the sensitivity, specificity, and accuracy of the UBT were 97.4%, 98.5%, and 98.0%, respectively. 13C-UBT has proven to be a safe and simple, yet accurate, test for the non-invasive diagnosis and monitoring of H. pylori infection.
A Survey of the Use of Community Treatment Orders by Psychiatrists in Saskatchewan
Authors: O'Reilly RL , Keegan DL , Elias JW 
Published: January 2017

Objective: To determine the pattern of use and satisfaction with community treatment orders (CTOs) by psychiatrists in Saskatchewan. Method: All psychiatrists who were licensed to practise by the College of Physicians and Surgeons of Saskatchewan were surveyed by mail in July 1998. Results: The response rate was 72%. The responding psychiatrists were treating 14 patients on CTOs at the time of the survey. Psychiatrists were generally satisfied with the operation of CTOs, though many felt that commitment of only of 3 months before mandatory renewal was too short a period. Almost one-half expected their use of treatment orders to increase. Conclusion: While CTOs are used for only a small number of patients in Saskatchewan, they are a clinically useful tool for dealing with a group of otherwise difficult-to-treat patients.