bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health and Health Care Utilization among Obese and Diabetic Baby Boomers and Older Adults
Authors: Ahn SangNam , Smith Matthew Lee , Dickerson Justin B. , Ory Marcia G. 
Published: October 2012

Purpose. Examine how sociodemographic, health, behavioral, and health care utilization factors are associated with being obese or having diabetes among baby boomers and older adults. Design. Cross-sectional data were drawn from the 2007–2008 National Health and Nutrition Examination Survey. Setting. United States. Subjects. A sample of 3439 baby boomers and older adults included (mean age, 62 years). Measures. Covariates included sociodemographics, health outcomes, behaviors, and inpatient and outpatient health care utilization. Analysis. Multinomial logistic regression was used to explore which similar or different covariates were associated with different health states between baby boomers and older adults. Results. Approximately 8% of baby boomers and 10% of older adults had the twin diagnoses of obesity and diabetes. Having both obesity and diabetes was more common among baby boomers and older adults who were African-American (odds ratio [OR] = 1.79, p = .029 for baby boomers; OR = 3.45, p < .001 for older adults), perceived their general health as fair/poor (OR = 7.67, p < .001; OR = 4.13, p < .001), and utilized outpatient care more often (OR = 8.28, p < .001; OR = 5.35, p = .004). Being obese only was observed less among baby boomers who were current smokers (OR = .45, p < .001), whereas it was observed more among older adults who were former smokers (OR = 1.25, p = .046). Having diabetes only was observed more among baby boomers who had hypertension (OR = 2.44, p = .01), whereas it was observed more among older adults who had very high cholesterol (OR = 2.31, p = .029). Conclusion. Identifying chronic disease risk factors during middle age is important for ameliorating further complications in later life. Knowing more about the correlates of obesity and diabetes among different age groups can help health care planners better target preventive health care services.
Psychogenic Vertigo
Authors: Shah Henal , Mukherjee Sayantani 
Published: October 2012

ABSTRACTPsychogenic vertigo is a disorder that merits attention from both ENT and psychiatry services as its genesis and complex symptomatology have roots in both these fields. This article is an endeavor to sift through all information that is available about it and present concisely about its evolution, its current status and all clinical aspects that are of contemporary relevance.How to cite this articleShah H, Mukherjee S. Psychogenic Vertigo. Otorhinolaryngol Clin Int J 2012;4(2):77-80.
Clinical Drug Trials on Human Beings viz-a-viz Sanctions related to Animal Experimentation: Need to do Introspection?
Authors: Aulakh Roosy , Gautam Chander Shekhar , Cheema Prabhjot Singh 
Published: October 2012

ABSTRACT
Health care law is totally localized in its nature, but research for the development of new drugs has crossed man-made geographical limits. Weaker legal sanctions, poverty, illiteracy and inaccessibility to legal system have all contributed to make India a favored hub for contact research organizations. Many recent clinical drug trials in India have sparked controversy. However, in India today, we are more bothered about animal protection, but show little concern for volunteers in human trials. It is gradually becoming difficult to conduct research on animals; however, research on human beings is far easier. Sanctions against violation of rights of human volunteers in clinical trials are often only a perceived phenomenon. They are not protected as they should be. Regulatory framework needs thorough introspection, debate, reconsideration and strict implementation. These guidelines should not only be recommendatory but mandatory in nature and those who indulge in violations, shall be punished as per the law of the land effectively.

How to cite this article
Gautam CS, Aulakh R, Cheema PS. Clinical Drug Trials on Human Beings viz-a-viz Sanctions related to Animal Experimentation: Need to do Introspection? J Postgrad Med Edu Res 2012;46(3):113-116.
End of Life Care: A Curricular and Practice Need
Authors: Jindal SK 
Published: October 2012

ABSTRACT
End of life (EOL) care is a subset of palliative care during the terminal phase of an illness. It primarily aims to provide psychosocial supports and symptomatic relief employing a step-ladder approach to management of physical pain, breathlessness and other distressing symptoms. Futile aggressive and invasive treatments are either withheld or withdrawn. The EOL care accepts the principles of stopping disease-modifying therapy after all possible reversible factors of the illness are excluded. It does not imply the non-use of curative treatment whenever it is considered useful. In case of the ‘double-effect’ of a drug, it gives preference to symptomrelieving over the harmful effects, which are accepted as of secondary importance.
EOL care is governed by well established moral principles and individual's freedom of choice. It allows the normal and natural process of death to happen for an incurable and end-stage disease.

How to cite this article
Jindal SK. End of Life Care: A Curricular and Practice Need. J Postgrad Med Edu Res 2012;46(3): 117-121.
Clinical Outcome following Surgical Intervention for Periprosthetic Hip Fractures at a Tertiary Referral Centre
Authors: Matharu Gulraj S. , Pynsent Paul B. , Dunlop David J. , Revell Matthew P. 
Published: October 2012

Complications following surgical intervention for periprosthetic hip fractures are not uncommon. We report the clinical outcome following definitive surgical intervention for this indication at a single tertiary referral centre. All patients admitted between 2003 and 2009 undergoing such treatment were included. Patient demographics, all surgical interventions, complications following definitive fracture treatment, and postoperative mortality were recorded. Radiographs were reviewed to determine the Vancouver classification for each fracture. There were 67 patients (mean age at revision 76.7 years; 61% female). Fractures occurred around primary total hip arthroplasties (43%), revision arthroplasties (34%), and hip hemiarthroplasties (23%). Mean time to fracture from the most recent arthroplasty performed was 7.0 years. Most fractures were Vancouver type B2 (49%). The majority of patients underwent revision total hip arthroplasty (96%), using long-stemmed prostheses or proximal femoral endoprostheses, with cables for fracture fixation. Wound infection and systemic complications were seen in 16% and 13% respectively. One or more further surgical interventions were performed in 12%. There were no deaths in-hospital or at 30-days, with 10 fatalities (15%) at a mean 2-year follow-up. Lower rates of re-intervention and mortality were observed when surgery for acute periprosthetic hip fractures was performed at a tertiary centre. Revision hip arthroplasty with or without fracture fixation proved an effective and safe treatment of periprosthetic hip fractures in a high-risk patient population.
Serum Lactate is a Prognostic Indicator in Patients with Hip Fracture
Authors: Uzoigwe Chika E. , Venkatesan Muralidharan , Smith Robert , Burnand Henry G.F. , Young Peter S. , Cheesman Caroline L. , Middleton Rory G. 
Published: October 2012

Background and Purpose Serum lactate has been shown to be an indicator of adverse clinical outcomes in patients admitted secondary to general trauma or sepsis. We retrospectively investigated whether admission serum venous lactate can predict in-hospital mortality in patients with hip fractures. Method and Results Over a 38-month period the admission venous lactate of 807 patients with hip fractures was collated. Mean age was 82 years. The overall in-hospital mortality for this cohort was 9.4%. Mortality was not influenced by the fracture pattern or the type of surgery - be it internal fixation or arthroplasty (p = 0.7). A critical threshold of 3 mmol/L with respect to the influence of venous lactate level on mortality was identified. Mortality rate in those with a lactate level of less than 3 mmol/L was 8.6% and 14.2% for those whose level was 3 mmol/L or greater. A 1 mmol/L increase in venous lactate was associated with a 1.2 (1.02–1.41) increased risk of in-hospital mortality. Patients with a venous lactate of 3 mmol/L or higher had twice the odds of death in hospital compared to matched individuals. There was no statistically significant difference in ASA distribution between those with a lactate of less than or greater than 3 mmol/L. Conclusions Patients with an elevated venous lactate following hip trauma should be identified as being at increased risk of death and may benefit from targeted medical therapy.
The centennial of Bowen’s disease—a critical review on the occasion of the 100th anniversary of its original description
Authors: Weyers Wolfgang 
Published: October 2012

Some issues are extremely simple if looked at without prejudice. This is also true for carcinomas. Carcinomas are malignant neoplasms of epithelial cells. Where are they going to arise? In the epithelium. Therefore, at the outset, they must be confined to the epithelium. How are they going to look in the beginning? Small and inconspicuous. How are they going to develop? They will grow and unfold the capacities with which they are endowed unless they are destroyed. This is nothing special but true for every living matter.
But unprejudiced reflection is difficult because we all adopt conceptions of our time that channel our thinking. For many centuries, carcinomas were never treated before they had metastasized. Recurrences were soon to occur, and most patients died shortly after seeking treatment. The incurability of cancer was so deeply rooted in the worldview of physicians that the diagnosis of cancer was always challenged when a patient survived. Because carcinomas were excised only in stages far advanced, the bulk of the tumor was present in the dermis or deeper structures. That circumstance prompted Rudolf Virchow in 1855 to suggest derivation of carcinomas from cells of connective tissue, a concept to which he adhered for many years afterward. In 1865, Carl Thiersch proved the epithelial origin of cancer, but he believed that the true reason for the epithelial proliferation was a pathological weakness of the connective tissue that enabled sprouts of epithelium to grow in. As late as in 1894, Hugo Ribbert averred that carcinomas did not result from growth of epithelium into connective tissue but from growth of connective tissue into the overlying epithelium [1].
Clovis Technology and Settlement in the American Southeast: Using Biface Analysis to Evaluate Dispersal Models
Authors: Smallwood Ashley M. 
Published: October 2012

AbstractKelly and Todd’s (1988) “high-technology forager” model predicts Clovis groups were highly mobile populations that left behind behaviorally consistent records of Clovis fluted points as evidence of their short-term occupations. Anderson’s (1990, 1996) staging-area model predicts that Clovis settlement was more gradual; groups entered the continent and slowed migration to concentrate territorial ranges around resource-rich river valleys, and these staging areas became the demographic foundations for early cultural regionalization. This study analyzes southeastern Clovis point data and biface assemblages from Carson-Conn-Short; Topper, and Williamson to test the technological implications of these two models. Significant subregional variation exists in Clovis point morphology and biface production techniques. This variation suggests the subregions represent distinct populations who distinctly altered aspects of their technology but maintained fundamental elements of the Clovis tradition. These findings are at odds with the high-technology forager model and more closely fit the staging-area model.
Beveled Projectile Points and Ballistics Technology
Authors: Lipo Carl P. , Dunnell Robert C. , O’Brien Michael J. , Harper Veronica , Dudgeon John 
Published: October 2012

AbstractExplanations for beveled blade edges on projectile points have been debated in North America archaeology since the first systematic description oflithic assemblages in the nineteenth century. Debate has centered around two opposing perspectives. One views beveled edges as features of projectile points that cause them to spin during flight. The other views beveling as a product of edge resharpening that is done unifacially to conserve scarce resources. Here we use a fluid-dynamics model to simulate the effect beveling has on projectiles. Expectations derived from this modeling are evaluated using windtunnel experiments. Our findings indicate that beveling produces in-flight rotation that serves as a means of increasing accuracy in relatively low-velocity flight paths.
Mud Wasp Nests as Markers of Middle Holocene House Structures in the Central Mississippi Valley
Authors: Krakker James J. 
Published: October 2012

AbstractLumps of burned clay recovered from the Lepold site (23RI59) include four mud wasp nests deposited 5500 to 6200 BP. or perhaps slightly earlier. These provide indirect evidence of structures at the site. Existence of structures would be consistent with intensive occupation and increased occupation episode length evident at this site and elsewhere in the central Mississippi valley during the Middle Holocene.
Éducation populaire et réappropriation autochtone du système de conseils communautaires de développement au Guatemala
Authors: Hébert Martin 
Published: October 2012

La mise en place d’une structure de participation citoyenne fondée sur la création de conseils communautaires de développement (COCODES) au Guatemala est l’une des mesures inscrites dans les accords de paix de 1996 susceptible de promouvoir une plus grande justice distributive dans ce pays. Mais, même si elle est inscrite dans la loi, la création de ces comités se butte à la résistance des élites traditionnelles, en particulier celle des maires et des administrations municipales, qui voient leur pouvoir miné par cette nouvelle structure participative. Dans un tel contexte, marqué par une histoire de répression violente de l’activisme autochtone et de méfiance généralisée concernant la mise en place de structures autonomes face à l’État, les revendications autochtones ont trouvé un véhicule efficace au sein de mouvements dont l’objectif explicite est la simple application de la loi de participation citoyenne, et dans la promotion des COCODES. En surface, cette stratégie semble marquer un recul par rapport aux mouvements autonomistes observés dans d’autres régions d’Amérique latine, mais l’auteur de cet article soutient l’idée que, dans un contexte marqué par une grande histoire de violence, les initiatives autochtones pour l’application « de la loi » décrites ici sont, en fait, des formes de mobilisation politique et jouent un rôle important dans la contestation des discriminations traditionnelles.
La disparition de la langue huronne
Authors: Lainé Mathieu-Joffre 
Published: October 2012

La date exacte de la disparition de la langue huronne est incertaine. De manière générale, les historiens estiment qu’elle a disparu au tournant du xxe siècle, mais il semble que ce soit plutôt au milieu du xixe siècle. En effet, les sources et les témoignages historiques dont nous disposons semblent indiquer que la langue huronne est tombée en désuétude entre 1829 et 1849. Il n’existe d’ailleurs aucune preuve historique permettant de croire que la langue huronne était parlée (ou même connue) par les aînés de Wendake au tournant du xxe siècle.
Le Plan Nord, monstre à deux têtes et autres chimères géographiques
Authors: Rivard Étienne , Desbiens Caroline 
Published: October 2012

Ce texte cherche à dépeindre la duplicité du « Plan Nord » en matière de développement. Le Plan Nord présente en effet deux visages : si l’un d’eux affiche une image du développement axée sur les dimensions culturelle et sociale et permet d’envisager le Nord comme un chantier interculturel, l’autre visage, en contrepartie, accuse un regard essentiellement économiste et capitaliste du développement et prône l’exploitation rentable des ressources premières. Dans notre perspective, principalement géographique, les promoteurs et les acteurs du Plan Nord sont en voie d’imposer les vues « sudistes » sur le Nord et restent avant tout aveugles aux pistes de dialogue culturel qui se présentent à eux. Il s’agit là surtout d’un vieux scénario à la veille de se répéter.
La vertu politique
Authors: De Ligio Giulio 
Published: October 2012

Nous présentons dans cet article les lignes de force du jugement politique de Raymond Aron au regard de la polarité ami-ennemi. À la lumière de cette question, la philosophie politique d’Aron a été réexaminée pour montrer son « intention » et la manière dont elle parvient à rendre raison du « dialogue » entre la politique intérieure et les relations internationales, la norme et l’exception, la « signification » de la politique (ou de l’ami) et la possibilité permanente de la guerre (ou de l’ennemi). L’analyse que fait Aron du « critère » du politique avancé par Carl Schmitt constitue un « cas éminent » de sa démarche. Nous cherchons donc dans cet article à définir « la leçon » du regard aronien en ce qui concerne l’intelligence du monde politique, de ses configurations changeantes et de son véritable sérieux.
Maxillary Verrucous Carcinoma Coincident With Cervical Lymph Node Metastasis of Colon Adenocarcinoma
Authors: Yano Kato Hatsumi , Ishibashi Hiroaki , Nariai Yoshiki , Hideshima Katsumi , Vieth Michael , Sekine Joji 
Published: October 2012

Abstract
Cervical lymph node metastasis is an extremely rare event in oral verrucous carcinoma. Isolated cervical lymph node metastasis of colon cancer is also rare. This article describes a case of maxillary verrucous carcinoma accompanied by colon adenocarcinoma that metastasized to a cervical lymph node in a 69-year-old Japanese woman. During preoperative evaluation for maxillary verrucous carcinoma, enlarged cervical lymph nodes and colon cancer were suspected by positron emission tomography. Colonoscopy with biopsies confirmed primary colon adenocarcinoma. Left radical neck dissection, partial maxillectomy, and full-thickness skin graft to the mucosa of the upper lip were performed before treatment of colon adenocarcinoma. Cervical lymph nodes showed metastasis from colon adenocarcinoma, and right hemicolectomy was performed. This is the first case report of synchronous oral verrucous carcinoma and colon adenocarcinoma with cervical lymph node metastasis.
Liver Hydatid Cyst Rupture Into the Peritoneal Cavity After Abdominal Trauma: Case Report and Literature Review
Authors: Yilmaz Mehmet , Akbulut Sami , Kahraman Aysegul , Yilmaz Sezai 
Published: October 2012

Abstract
The aim of this study was to review the literature regarding the rupture of hydatid cysts into the abdominal cavity after trauma. We present both a new case of hydatid cyst rupture that occurred after blunt abdominal trauma and a literature review of studies published in the English language about hydatid cyst rupture after trauma; studies were accessed from PubMed, Google Scholar, EBSCO, EMBASE, and MEDLINE databases. We identified 22 articles published between 2000 and 2011 about hydatid cyst rupture after trauma. Of these, 5 articles were excluded because of insufficient data, duplication, or absence of intra-abdominal dissemination. The other 17 studies included 68 patients (38 males and 30 females) aged 8 to 76 years who had a ruptured hydatid cyst detected after trauma. The most common trauma included traffic accidents and falls. Despite optimal surgical and antihelmintic therapy, 7 patients developed recurrence. Complications included biliary fistula in 5 patients, incisional hernia in 2 patients, and gastrocutaneous fistula in 1 patient. Death occurred from intraoperative anaphylactic shock in 1 patient and gastrointestinal bleeding and pulmonary failure in 1 patient. Rupture of a hydatid cyst into the peritoneal cavity is rare and challenging for the surgeon. This condition is included in the differential diagnosis of the acute abdomen in endemic areas, especially in young patients.
Radiologic and Endoscopic Characteristics of Laparoscopic Antireflux Wrap: Correlation With Outcome
Authors: Braghetto Italo , Korn Owen , Csendes Attila , Valladares Héctor , Davanzo Cristóbal , Debandi Aníbal 
Published: October 2012

AbstractAfter antireflux surgery for gastroesophageal reflux disease, 10% to 15% of patients may have unsuccessful results as a result of abnormal restoration of the esophagogastric junction. The purpose of this study was to evaluate the postoperative endoscopic and radiologic characteristics of the antireflux barrier and their correlation with the postoperative results. After surgery, endoscopic and radiologic features of the antireflux wrap were evaluated in 120 consecutive patients. Jobe's classification of the postoperative valve was used for the definition of a “normal” or “defective” wrap. Patients were evaluated 3 to 5 years later in order to determine the clinical and objective failed fundoplication. A “normal” antireflux wrap was associated with successful results in 81.7% of the patients. On the contrary, defective radiologic or endoscopic antireflux wrap was observed in 19% of cases. Among these patients, hypotensive lower esophageal sphincter was observed in 50% to 65% of patients, abnormal 24-hour pH monitoring in 91%, and recurrent postoperative erosive esophagitis in 50% of patients, respectively (P &lt; 0.001). “Defective” antireflux fundoplication is associated with recurrent reflux symptoms, presence of endoscopic esophagitis, hypotensive lower esophageal sphincter, and abnormal acid reflux.
Preoperative Ambulatory Inspiratory Muscle Training in Patients Undergoing Esophagectomy. A Pilot Study
Authors: Agrelli Taciana Freitas , de Carvalho Ramos Marisa , Guglielminetti Rachel , Silva Alex Augusto , Crema Eduardo 
Published: October 2012

Abstract
A major decline in pulmonary function is observed on the first day after upper abdominal surgery. This decline can reduce vital and inspiratory capacity and can culminate in restrictive lung diseases that cause atelectasis, reduced diaphragm movement, and respiratory insufficiency. The objective of this study was to evaluate the efficacy of preoperative ambulatory respiratory muscle training in patients undergoing esophagectomy. The sample consisted of 20 adult patients (14 men [70%] and 6 women [30%]) with a diagnosis of advanced chagasic megaesophagus. A significant increase in maximum inspiratory pressure was observed after inspiratory muscle training when compared with baseline values (from −55.059 ± 18.359 to −76.286 ± 16.786). Preoperative ambulatory inspiratory muscle training was effective in increasing respiratory muscle strength in patients undergoing esophagectomy and contributed to the prevention of postoperative complications.