bluuebunny/crossref_metadata_2025_split huggingface dataset:
Indications for and Accuracy of Magnetic Resonance Imaging and Computed Tomography in Orbital Disease
Authors: Ainsworth J.R. , Hadley D.M. , Macpherson P. , McFadzean R. , Lawrence A. , Teasdale G.M. 
Published: January 2017

All patients referred for orbital imaging to the neuroradiology department of the Institute of Neurological Sciences in Glasgow over a three year period were enrolled in the study and were scheduled to undergo both magnetic resonance imaging and computed tomography. A total of 101 of the 110 referred patients were deemed suitable for analysis. Details of key presenting symptoms, signs, and a pre-imaging diagnosis were recorded prospectively. A final diagnosis was obtained by histology in 65% of cases with an orbital abnormality, by a minimum of one year of clinical review in 19.5%, by response to antibiotic or steriod therapy in 8.5%, or by conclusive investigations such as carotid angiography in 7% of patients. 29% of the patients had no detectable orbital disease despite a minimum one years' follow-up, and so were regarded as a, “normal” group. The images were interpreted prospectively by separate masked observers. The diagnostic accuracies of the two techniques were compared to the final diagnosis. The two imaging methods were shown to be comparable in overall diagnostic accuracy, with a small and statistically non-significant advantage held by magnetic resonance imaging. Interpretation of the two investigations gave more accurate information in different types of disease.
Transcutaneous Bilirubinometry as a Screening Tool for Neonatal Jaundice
Authors: Suckling R.J. , Laing I.A. , Kirk J.M. 
Published: January 2017

Department of Clinical Biochemistry, Royal Hospital for Sick Children Edinburgh Between 25 and 50% of all term newborns develop clinical jaundice,1 and a serum bilirubin level above 260 microml/l (15 mg/dl) is found in 3% of normal term infants.2 In the United Kingdom many newborn infants with clinical jaundice have blood samples sent to biochemistry laboratories for assessment of the plasma bilirubin concentration. We planned to assess the cost in terms of finance, medical staff time, numbers of blood samples, and family delay in leaving hospital. We demonstrated that reflectance bilirubinometry is a reliable screening method for identifying which Caucasian infants require to have plasma bilirubin concentrations measured in the laboratory. The Minolta Airshields transcutaneous bilirubinometer provided reproducible data, saved time and costs, and often spared infants a capillary or venous blood sample. The transcutaneous bilirubinometer provides a digital assessment of skin pigmentation by xenon reflectance. It has previously been shown to be possible to derive an estimate of plasma bilirubin from the number displayed by the meter3 and it is suggested as a method for identifying which infants need plasma bilirubin estimations.4
The Use of Children's Medical Records to Predict the Risk of Asthma Attack
Authors: Neville R.G. , Bryce F.P. , Clark R.A. , Crombie I K 
Published: January 2017

Using a large data base of respiratory morbidity in children the opportunity arose to explore the link between what was written in general practice case records and the subsequent risk of a child developing an asthma attack or hospital admission due to asthma. Children with five or more consultations in one year for respiratory symptoms had a 33% risk of experiencing an asthma attack or 7.1% risk of admission in the following year. Twenty seven percent of children who received antibiotics for “respiratory infections” subsequently had an asthma attack. The potential exists to review past and present symptoms and thus attempt to predict future morbidity. Childhood asthma is an example where the quality of care offered by general practitioners could be improved if a precise estimate of risk could be used to modify clinical management.
To a 20th Century Haggis
Authors: Thompson A.M. , Aitken R.J. 
Published: January 2017

The true Scots haggis is oft revered, as chieftain o' the pudding race, we sought a taste o' Scotland's ain, to try to find amongst Celt and all, what haggis to commend to folk. Six chieftains fine were caught and killed, were baked and split for all to taste, with mashed neaps each haggis lay, and wi'champit tatties aim to taste, the best, the worst, an' all between. Not one did ken the hills they'd trod from Dingwall, Edinburgh and Glasgow sent, from tin and vegetable too, 20 blinded souls did taste their fill, and score them each in turn. MacSweens, they cried, is best to us, But Dingwall and M&S, are good to taste the Haggis fine, while tinned with marked disdain, lay cooling on their plates and mine. Now, who liked what? I hear you say, Scots and Sassenachs liked the same, lads and lassies too, though others will to veggie haggis stray. Even if you're from a foreign land, the tinned is best left in the can, what well-meaning Scots may send, taste ye not, wee poor timorous beasties, oh. Auld Reekie breeds fine haggis still, For every palate to enjoy, with Tam O'Shanter galloping on, in memory of the fine Scots bard who 200 years have failed to still.
ERISA Preemption of Chapter 58: The Future of the “Pay or Play” Model of Health Care Legislation
Authors: Stiefel Jared 
Published: January 2017

The problem of the uninsured in this country continues to grow. Over the past five years, proportion of uninsured Americans has risen from 14.6% to 15.9% of the population. The statistics show disparities in insurance coverage among the various races, between native-born and non native-born citizens, and between other groups. The Center on Budget and Policy Priorities partially links this change to the continuous decline in employer sponsored health insurance plans. This is a problem that needs to be addressed and addressed quickly.Further exacerbating this problem is the cost of the uninsured and the government-insured to the taxpayers of the country. It is estimated that Medicare and Medicaid, the two largest government financed health care programs, will cost $301.5 and $176 billion respectively. These costs are projected to increase at a rate above GDP.Since states are partially responsible for Medicaid costs and have a responsibility for the health of their citizenry, many states have taken it upon themselves to try to correct these problems.
Off-Label Prescription Advertising, the FDA and the First Amendment: A Study in the Values of Commercial Speech Protection
Authors: Klasmeier Coleen , Redish Martin H. 
Published: January 2017

In order to protect the nation from harmful or worthless drugs and devices, the Food and Drug Administration (FDA or the Agency) is legislatively authorized to restrict the sale of prescription drugs or medical devices to those whose efficacy and safety have been reviewed and approved by the Agency. Drugs and devices are approved for a specific medical purpose. In numerous instances, however, the medical profession has discovered that treatments approved for one purpose may also serve other valuable medical purposes. Indeed, on a number of occasions such “off-label” treatments have proven to be essential to the successful treatment of some very serious illnesses.In these off-label situations, the FDA is faced with a dilemma. On the one hand, off-label use of prescription drug and devices gives rise to a series of major problems for the FDA. While the drug and devices in question have been vetted and approved by the FDA for their designated purpose, at no point has the FDA reviewed the supporting scientific data to determine efficacy for the off-label purpose.
The Politics of Information: Informed Consent in Abortion and End-of-Life Decision Making
Authors: Suter Sonia M. 
Published: January 2017

The politics of reproduction dominate the political landscape now more than ever. One area of controversy has been informed consent statutes for abortion, which have been praised by the pro-life movement but derided by the pro-choice movement. More recently, legislatures have begun to enact informed consent statutes with respect to end-of-life decision making, an area almost as politically controversial as abortion. Like many abortion disclosure laws, some of these have been entitled “Right to Know” statutes. Yet, the supporters and opponents of each set of statutes tend not to be the same, aligning to a large extent based on their place in the culture wars over life and death.In this Article, I strive not only to show the remarkably similar critiques each side marshals but also to use these concerns to think in more nuanced ways about the goals of informed consent and whether the disclosure mandates achieve those goals. I first argue in favor of the aspirational goals of informed consent as a process that allows patients to participate in their medical decision making. While conceding the inherently political nature of abortion and end-of-life care, I also contend that the significance of decisions regarding those matters warrants, at least in theory, legislative efforts to ensure that patients have the opportunity to engage in deliberative and informed decision making.In describing and responding to the similar critiques of both sets of laws—the political bias of the statutes; the efforts to persuade, especially with non-medical information; the potential vulnerability of the targeted audience; and the interference with physician discretion—I uncover and challenge some of the presumptions about informed consent inherent in those critiques. Although information that persuades or influences is not per se problematic, I argue that disclosure of information that is inaccurate, untrue, or emotionally inflammatory harms informed consent. Even well-crafted informed consent mandates, however, are insufficient to promote truly deliberative decision making because they oversimplify the complexity of these decisions and fail to respond to the fact that informed consent is a process that requires more than simply the delivery of information; it also requires dialogue and discussion. This Article ends with suggestions for ways to try to promote such a dialogue.
Plainly Constitutional: The Upholding of Plain Tobacco Packaging by the High Court of Australia
Authors: Liberman Jonathan 
Published: January 2017

In November 2011, Australia became the first country in the world to legislate for “plain packaging” of tobacco products. As of December 1, 2012, the packaging of tobacco products sold in Australia must be a standard, drab dark brown color; and the printing of tobacco company logos, brand imagery, colors, or promotional text on that packaging and on individual tobacco products is prohibited. While the Australian scheme is described as “plain packaging,” tobacco packaging is required to be far from “plain” in the ordinary sense of the word. The scheme requires large health warnings composed of graphics, warning statements and explanatory messages, and information messages.Plain packaging of tobacco products—which has also been called “generic packaging” or “standardized packaging”—is not a new idea. It was proposed as far back as June 1986, when the Canadian Medical Association agreed to a motion in favor of its adoption.
Fast foods perception among adolescents by gender and weight status
Authors: Allehdan Sabika S , Tayyem Reema F , Bawadi Hiba A , Al-Awwad Narmeen J , Al-Mannai Mariam , Musaiger Abdulrahman O 
Published: January 2017

Background: Fast food restaurants have become widespread in both developed and developing countries due to nutritional and economic transitions. The frequency of fast food intake is relatively high among adolescents; however, fast food consumption is positively associated with total energy intake and obesity in adolescents. Objective: This study aimed to examine the perception of Jordanian adolescents towards fast foods relative to gender and obesity. Methods: A cross-sectional survey was conducted on 400 boys and 395 girls, aged 15–18 years. The adolescents completed a validated questionnaire to measure the perception of adolescents towards fast foods during the year 2013–2014. Weight and height were measured. Numbers who were non-overweight, overweight, and obese were calculated for each age and sex using the International Obesity Task Force (IOTF) standard. Results: The majority of participants perceived foods which are eaten as sandwiches as fast foods. A significant difference between boy and girl adolescents was reported regarding perception of French fries ( p < 0.012), fried chicken ( p < 0.001), fattayer ( p < 0.001), foul (boiled broad beans) sandwich ( p < 0.001), falafel sandwich ( p < 0.044) and fried eggs sandwich ( p < 0.001) as fast foods. Girls were significantly more enthusiastic than boys to consider cuscusi plate ( p < 0.001), rice dishes ( p < 0.002), Chinese foods ( p < 0.001), Indian foods ( p < 0.010), Mexican foods ( p < 0.011), and Italian foods ( p < 0.004) as non-fast foods. The difference between obese and non-obese regarding the perception of fast foods was only significant among boy participants. Western or non-Arab foods, food prepared fast and eaten fast in self-service outlets, and food rich in calories were significantly perceived as fast food by Jordanian adolescents ( p < 0.05). Conclusions: The perception of foods as fast foods or non-fast foods was significantly different between both genders as well as in obese and non-obese male Jordanian adolescents.
Knowledge, attitudes and perception on dietary salt reduction of two communities in Grahamstown, South Africa
Authors: Mushoriwa Fadzai , Townsend Nick , Srinivas Sunitha 
Published: January 2017

Introduction: Dietary salt reduction has been identified as a cost effective way of addressing the global burden of non-communicable diseases (NCDs), particularly cardiovascular diseases. The World Health Organization has recommended three main strategies for achieving population-wide salt reduction in all member states: food reformulation, policies and consumer awareness campaigns. In 2013, the South African Ministry of Health announced the mandatory salt reduction legislation for the food manufacturing sector. These were set to come into effect on 30 June 2016. This decision was influenced by the need to reduce the incidence of NCDs and the fact that processed food is the source of 54% of the salt consumed in the South African diet. However, with discretionary salt also being a significant contributor, there is need for consumer awareness campaigns. The aim of this study was to assess the knowledge, attitudes and practices of guardians and cooks at two non-governmental organisations based in Grahamstown, South Africa, towards dietary salt reduction. Method: Data was collected through observation and explorative, voice-recorded semi-structured interviews and transcribed data was analysed using NVivo®. Results: At both centres, salt shakers were not placed on the tables during mealtimes. Only 14% the participants perceived their personal salt intake to be a little. No participants were aware of the recommended daily salt intake limit or the relationship between salt and sodium. Only five out of the 19 participants had previously received information on dietary salt reduction from sources such as healthcare professionals and the media. Conclusion: The results from the first phase of this study highlighted gaps in the participants’ knowledge, attitudes and practices towards dietary salt reduction. The aim of the second phase of the research is to design and implement a context specific and culturally appropriate educational intervention on dietary salt reduction.
Changes in Metalloproteinase (MMP-1, MMP-2) Expression in the Proximal Region of the Varicose Saphenous Vein Wall in Young Subjects
Authors: Buján J. , Jurado F. , Gimeno M. J. , García-Honduvilla N. , Pascual G. , Jiménez J. , Bellón J. M. 
Published: January 2017

Objective: An evaluation of the proteoglycan perlecan, collagen I and III, and metalloproteinases MMP−1, −2, −3 and −9 was performed to explore the possible relationships between ageing, affected vein region and reactive state of the varicose vein wall. Methods: Segments of saphenous vein were obtained from healthy subjects and from those with varicose veins. The vein specimens were subdivided according to subject age (<50/^50) and vein source (distal/proximal). Results: The walls of control vein specimens acquired a more collagenous appearance with age. These changes were not accompanied by significant modifications in the immunohistochemical markers used. In specimens from young patients, proximal varicose vein segments showed an increase in MMP-1, MMP-2 and MMP-9 expression. Subjects of more advanced age showed an increase in perlecan expression. Conclusion: This increase in MMPs could lead to the acceleration of the final fibrosclerotic process characteristic of the varicose vein wall.
Limited Usefulness of Tests of Coagulation Defects for Predicting Symptomatic Pulmonary Embolism after an Initial Episode of Deep Vein Thrombosis
Authors: Yasuhara H. , Muto T. 
Published: January 2017

Objective: To establish the usefulness of currently available tests of coagulation defects for predicting symptomatic pulmonary embolism (PE) in patients with lower extremity deep vein thrombosis (DVT). Methods: Between 1980 and 1996, 294 patients with DVT were followed for a mean period of 7.9 years. The coagulation defects included low activity of antithrom-bin III, protein C, protein S or plasminogen, and positivity for lupus anticoagulant or anticardiolipin antibody. The influences of these coagulation abnorm-alities on PE incidence were analysed, using a Cox regression hazards model. Results: Coagulation defects were found to be an important variable predicting PE (risk ratio = 7.272). ‘PE-free survival’ in patients with no coagulation defect was significantly longer than that in patients with one or more of these defects ( p = 0.0001). The sensitivity of coagulation tests for predicting PE was only 47% despite the negative predictive value of 93%. Conclusions: Determining these defects has limited usefulness in identifying patients who would be appropriate candidates for intensive anticoagulation therapy.
Oedema in Chronic Venous Insufficiency: Physiopathology and Investigation
Authors: Allegra C. , Carlizza A. 
Published: January 2017

Aim: To review the physiology of the venous system in the leg and the events in the microcirculation of the skin leading to development of the symptoms of chronic venous insufficiency (CVI). Method: A review of current literature in the field of CVI has been conducted, with particular reference to the microcirculation and the means of investigating this. Synthesis: Venous valvular incompetence and obstruction in the lower limb causes damage to the microcirculation of the skin. The resulting venous hypertension is resisted by the microcirculation. Cutaneous vasomotion alters, with a prevalence of closing periods of the pre-capillary sphincters, limiting capillary hypertension and resulting in capillary haemoconcentration. This phenomenon promotes drainage of fluids from the interstitial spaces and prevents hypoxic damage to the endothelium. In severe CVI this defence mechanism is overwhelmed, vasomotion declines and arteriolar vasoparalysis occurs. The capillary bed is filled and the intracapillary pressure increases. Reduced microcircula-tory perfusion flow velocity favours capillary plugging by white cells. Leucocyte activation damages the endothelium through the release of proteolytic enzymes, oxygen metabolites and lipid oxidation products. Increased permeability of the endothelium allows passage of fibrinogen and results in a perivascular fibrin cuff. Initially this protects the capillary but later blocks oxygen exchange. These events lead to capillary thrombosis with destruction of capillaries with tissue ischaemia and trophic lesions. Conclusions: The result of venous hypertension in the large veins of the lower limb is damage to the microcirculation of the skin. This leads to lipodermato-sclerosis and eventually ulceration in some patients.
Catheter-Directed Thrombolysis for the Treatment of Acute Iliofemoral Deep Venous Thombosis
Authors: Comerota A. J. , Kagan S. A. 
Published: January 2017

Objective: Acute iliofemoral deep venous thrombosis (DVT) is a serious venous thrombotic disorder with potentially morbid post-thrombotic sequelae. The purpose of this report is to present our single-centre evolution of technique and the results of catheter-directed thrombolysis for the treatment of acute iliofemoral DVT, and put it into perspective with current literature. Patients and methods: Between May 1988 and April 2000, 54 patients were treated with catheter-directed thrombolysis for occlusive iliofemoral and vena caval thrombosis. Average age was 45 years (range 17-68 years) and the duration of leg symptoms was 5.2 days (range 2-30 days). Routine vena caval filters were not used, although caval filters were inserted in patients with irregular and non-occlusive vena caval thrombus. Initially, urokinase infusion via a right jugular vein and/or contralateral femoral vein approach was used, delivering a 250000-500000 U bolus followed by continuous infusion of 250000-300000 LVh. Catheter delivery has evolved to an ultrasound-guided popliteal or posterior tibial vein puncture and the use of recombinant tissue plasminogen activator at a bolus dose of 4–8 mg followed by 2–4 mg/h. All patients received heparin infusion at 500-1000 U/h. Results: Fifty-one of the 54 patients had successful catheter positioning. Forty-five (83%) had a successful outcome. Of those that failed, 2 were treated with a known chronic occlusion and in 2 patients plasminogen deficiency was suspected. Two patients had persistent iliac vein lesions which led to early re-thrombosis. Overall, 14 (26%) were asymptomatic, 28 (52%) demonstrated moderate improvement, 6 (11%) showed mild improvement and 6 (11%) had no clinical improvement. Serious complications occurred in 5 patients (9%). Four (7%) required blood transfusion and 1 (2%) required operative evacuation of an inguinal haematoma with repair of the common femoral vein. Eight patients (15%) developed a puncture site haematoma and 1 patient (2%) had a guidewire perforation of the common femoral vein. Conclusions: Catheter-directed thrombolysis is the preferred treatment for symptomatic iliofemoral DVT. Following successful lysis, residual iliac vein lesions should be corrected with balloon angioplasty and stenting if necessary. Considering the current results and those of contemporary series, a successful outcome can be anticipated in 80-85% of patients, with a significant improvement in quality of life when compared with standard anticoagulation.
A Modern Leg Ulcer Service
Authors: Barwell J. R. , Deacon J. , Taylor M. , Wakely C. , Poskitt K. R. , Whyman M. R. 
Published: January 2017

Aim: To define the components and organization of a modern leg ulcer service that is acceptable to patients cost effective and produces high quality outcomes. Method: Analysis of data from published literature as well as experience from the organisation of a leg ulcer service in Gloucestershire. Synthesis: Assessment of leg ulcers requires the services of a vascular laboratory to assess the venous and arteria systems. Effective systems of compression must be employed. Staff and patients must be educated to understand the principals behind their use. For some patients pinch-grafting may be appropriate. Where arterial disease is present in the lower limb, reconstructive surgery should be used for the lower limb vessels The organisation of such a service must ensure good liaison between General Practitioners, community nurses and hospital specialists. Many patients may be managed in community leg ulcer clinics. In some cases, the advice of specialists such as rheumatologists and dermatologists may be required. Conclusions: A national framework for leg ulceir management is needed within which resources are made available in a way that satisfy local needs. Such a framework must be based on management protocols derived from evidence-based practices that have been developed through the experiences of modern leg ulcer services.