bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment with antipsychotics and the risk of diabetes in clinical practice
Authors: Kessing Lars Vedel , Thomsen Anders Frøkjær , Mogensen Ulla Brasch , Andersen Per Kragh 
Published: September 2010

BackgroundTreatment with antipsychotics seems to increase the risk of developing diabetes but the association is poorly characterised in clinical practice.AimsTo investigate and characterise the incidence of diabetes for people treated with antipsychotic medication in clinical practice.MethodThe study used the linkage of registers of all prescribed antipsychotics, antidiabetics and diagnoses of diabetes in Denmark during a period from 1996 to 2005 and identified all people treated with antipsychotics in Denmark and a random sample of about 30% of the total Danish population.ResultsIn total, 345 937 patients who purchased antipsychotics and 1 426 488 unexposed individuals were included in the study. Among the total population, 50 379 individuals subsequently developed incident diabetes. Compared with unexposed individuals, treatment with first- (rate ratio, RR = 1.53, 95% CI 1.49–1.56) as well as second-generation (RR = 1.32, 95% CI 1.22–1.42) antipsychotics was associated with increased risk of subsequent incident diabetes. The rate of incident diabetes varied substantially between individual second-generation antipsychotic drugs (olanzapine, risperidone clozapine compared with unexposed individuals: low to moderate rate ratio between 1.17 and 1.57; ziprasidone and sertindol: two or more times increased rate ratio; amisulpride, quetiapine and aripiprazole: no significantly increased rate ratio). For both first- and second-generation antipsychotics, the incidence of diabetes increased with the number of prescriptions. Additionally, the incidence of diabetes increased with the number of combined antipsychotic drugs.ConclusionsIn clinical practice, treatment with first- and second-generation antipsychotics is associated with an increased risk of developing incident diabetes with large differences between individual drugs. The risk increases with the duration of treatment and with polypharmacy of antipsychotic drugs.
Cyclic variations in demand for out-of-hours services in child and adolescent psychiatry: implications for service planning
Authors: Hillen Thomas , Szaniecki Eduardo 
Published: September 2010

Aims and methodWe examined peaks and troughs in demand for out-of-hours consultations and assessments in child and adolescent psychiatry and whether these have implications for service development. All out-of-hours referrals in three teaching hospitals providing services to a large and diverse inner-city population were prospectively registered from 1 January 2002 to 31 December 2005.ResultsIn total, 323 individuals under 18 years were referred; 21.6 (95% CI 19.3-24.0) per 100 000 general population per year. Bedside assessments were required in 37%, the remainder were dealt with by telephone. The work took more than 4 h for 22%; 46% of individuals presenting were aged 16-18 years. Significant diurnal variation was observed with a peak in referrals between 17.00 h and 00.59 h. More referrals were made when daytime liaison services were closed (odds ratio (OR) = 2.46, 95% CI 1.15-1.87), after referral pathways had been clarified (OR = 2.33, 95% CI 1.92-3.23) and during spring (OR = 1.50, 95% CI 1.14-1.98). Other factors analysed showed no association with referral activity.Clinical implicationsCyclic variations in the demand for out-of-hours services in child and adolescent psychiatry should be considered for service planning. Although paediatric psychiatric emergencies are relatively rare, they can take up considerable clinician time.
Written information on bipolar affective disorder: the patients' perspective
Authors: White Daniel C. , Schelten Sofia Laureano , Kelly Brendan D. , Casey Patricia 
Published: September 2010

Aims and methodThe mental health information available to people with bipolar affective disorder is variable in quality. We conducted a qualitative survey in an urban out-patient department to elicit the opinions of people with bipolar affective disorder on the written information provided by three health information providers.ResultsParticipants' responses were generally positive for each leaflet. The two leaflets rated highest by participants used quality assurance tools. However, 20-30% had difficulty understanding the leaflets. Medical jargon and verbosity were common criticisms.Clinical implicationsProfessional bodies such as the Royal College of Psychiatrists play an important role in providing patients with written information. Quality assurance standards should be used in the production of patient information. A tool measuring individuals' appraisal of information may ensure information is appropriate to their requirements.
Assessing the security needs of patients in medium secure psychiatric care in Northern Ireland
Authors: McClean Rowan James 
Published: September 2010

Aims and methodTo determine the security needs of patients in medium secure services in Northern Ireland and to identify those requiring long-term secure care. Patients were rated on the Security Needs Assessment Profile.ResultsFifteen patients (45%) could be managed in conditions of low security. Twelve patients (36%) require over 5 years' further treatment in secure care. Particular security needs include relational nursing skills, restricted access to alcohol and drugs, and robust physical security.Clinical implicationsThis study should be replicated across the UK to determine whether forensic services are responding to patients' needs. Pathways out of medium security need to be better developed, with regional expansion of low secure services.
Involuntary treatment in the community: role of community treatment orders
Authors: Woolley Sarah 
Published: September 2010

SummaryAlthough community treatment orders (CTOs) have been used internationally since the 1980s, they were only introduced into England and Wales in 2007 by amendments to the 1983 Mental Health Act. Aimed to replace the common use of extended Section 17 leave to enforce community treatment, CTOs are believed to offer patients more protection owing to stringent criteria for their use. Literature reviews, however, do not demonstrate any evidence favouring the use of CTOs and in this age of evidence-based medicine it is questionable whether psychiatrists will change from a familiar practice to an unproven one.
The concentric all-polyethylene Exeter acetabular component in primary total hip replacement
Authors: Veitch S. W. , Whitehouse S. L. , Howell J. R , Hubble M. J. W. , Gie G. A. , Timperley A. J. 
Published: September 2010

We report the outcome of the flangeless, cemented all-polyethylene Exeter acetabular component at a mean of 14.6 years (10 to 17) after operation. Of the 263 hips in 243 patients, 122 prostheses are still in situ; 112 patients (119 hips) have died, 18 hips have been revised, and three patients (four hips) were lost to follow-up. Radiographs at the final review were available for 110 of the 122 surviving hips. There were acetabular radiolucent lines in 54 hips (49%). Two acetabular components had migrated but neither patient required revision. The Kaplan-Meier survivorship at 15 years with 61 hips at risk with revision for any cause as the endpoint was 89.9% (95% confidence interval (CI) 84.6 to 95.2) and for aseptic loosening of the acetabular component or lysis 91.7% (95% CI 86.6 to 96.8). In 210 hips with a diagnosis of primary osteoarthritis, survivorship with revision for any cause as the endpoint was 93.2% (95% CI 88.1 to 98.3), and for aseptic loosening of the acetabular component 95.0% (95% CI 90.3 to 99.7). The cemented all-polyethylene Exeter acetabular component has an excellent long-term survivorship.
Anteroposterior positioning of the tibial component and its effect on the mechanics of patellofemoral contact
Authors: Didden K. , Luyckx T. , Bellemans J. , Labey L. , Innocenti B. , Vandenneucker H. 
Published: September 2010

The biomechanics of the patellofemoral joint can become disturbed during total knee replacement by alterations induced by the position and shape of the different prosthetic components. The role of the patella and femoral trochlea has been well studied. We have examined the effect of anterior or posterior positioning of the tibial component on the mechanisms of patellofemoral contact in total knee replacement. The hypothesis was that placing the tibial component more posteriorly would reduce patellofemoral contact stress while providing a more efficient lever arm during extension of the knee. We studied five different positions of the tibial component using a six degrees of freedom dynamic knee simulator system based on the Oxford rig, while simulating an active knee squat under physiological loading conditions. The patellofemoral contact force decreased at a mean of 2.2% for every millimetre of posterior translation of the tibial component. Anterior positions of the tibial component were associated with elevation of the patellofemoral joint pressure, which was particularly marked in flexion > 90°. From our results we believe that more posterior positioning of the tibial component in total knee replacement would be beneficial to the patellofemoral joint.
The use of minimally invasive techniques in multi-level surgery for children with cerebral palsy
Authors: Thompson N. , Stebbins J. , Seniorou M. , Wainwright A. M. , Newham D. J. , Theologis T. N. 
Published: September 2010

This study compares the initial outcomes of minimally invasive techniques for single-event multi-level surgery with conventional single-event multi-level surgery. The minimally invasive techniques included derotation osteotomies using closed corticotomy and fixation with titanium elastic nails and percutaneous lengthening of muscles where possible. A prospective cohort study of two matched groups was undertaken. Ten children with diplegic cerebral palsy with a mean age of ten years six months (7.11 to 13.9) had multi-level minimally invasive surgery and were matched for ambulatory level and compared with ten children with a mean age of 11 years four months (7.9 to 14.4) who had conventional single-event multi-level surgery. Gait kinematics, the Gillette Gait Index, isometric muscle strength and gross motor function were assessed before and 12 months after operation. The minimally invasive group had significantly reduced operation time and blood loss with a significantly improved time to mobilisation. There were no complications intra-operatively or during hospitalisation in either group. There was significant improvement in gait kinematics and the Gillette Gait Index in both groups with no difference between them. There was a trend to improved muscle strength in the multi-level group. There was no significant difference in gross motor function between the groups. We consider that minimally invasive single-event multi-level surgery can be achieved safely and effectively with significant advantages over conventional techniques in children with diplegic cerebral palsy.
Stress-shielding of the proximal femur using an extensively porous-coated femoral component without allograft in revision surgery
Authors: Garcia-Cimbrelo E. , Garcia-Rey E. , Cruz-Pardos A. , Madero R. 
Published: September 2010

Revision surgery of the hip was performed on 114 hips using an extensively porous-coated femoral component. Of these, 95 hips (94 patients) had a mean follow-up of 10.2 years (5 to 17). No cortical struts were used and the cortical index and the femoral cortical width were measured at different levels.There were two revisions for aseptic loosening. Survivorship at 12 years for all causes of failure was 96.9% (95% confidence interval 93.5 to 100) in the best-case scenario. Fibrous or unstable fixation was associated with major bone defects. The cortical index (p = 0.045) and the lateral cortical thickness (p = 0.008) decreased at the proximal level over time while the medial cortex increased (p = 0.001) at the proximal and distal levels. An increase in the proximal medial cortex was found in patients with an extended transtrochanteric osteotomy (p = 0.026) and in those with components shorter than 25 cm (p = 0.008).The use of the extensively porous-coated femoral component can provide a solution for difficult cases in revision surgery. Radiological bony ingrowth is common. Although without clinical relevance at the end of follow-up, the thickness of the medial femoral cortex often increased while that of the lateral cortex decreased. In cases in which a shorter component was used and in those undertaken using an extended trochanteric osteotomy, there was a greater increase in thickness of the femoral cortex over time.
Resection of a physeal bar under computer-assisted guidance
Authors: Kang H. G. , Yoon S. J. , Kim J. R. 
Published: September 2010

Excision of a physeal bar and filling the space with interposition material may allow resumption of normal growth. Both the extent and the location of the bar and the amount of growth remaining from physis must be determined. Computer-assisted surgery is being used increasingly in various fields of orthopaedics. We describe the management of a patient with premature physeal arrest of the right distal tibia in which resection of a physeal bar was achieved under real-time three-dimensional intra-operative monitoring by computer-assisted navigation. The advantage of this method over other means of imaging is that intra-operative identification can increase the accuracy of resection of the bar.
The patellar thinning osteotomy in patellofemoral arthritis
Authors: Vaquero J. , Calvo J. A. , Chana F. , Perez-Mañanes R. 
Published: September 2010

Isolated patellofemoral osteoarthritis can be a disabling disease. When conservative treatment fails, surgical options can be unpredictable and may be considered too aggressive for middle-aged and active people. We analysed the clinical and radiological results of a new coronal osteotomy involving thinning of the patella in a selected group of patients with isolated patellofemoral osteoarthritis. Since 1991, 31 patients (35 knees) have been treated, of whom 34 were available for follow-up at a mean of 9.1 years. The Knee Society Score, the Patellar score and the Short-form-36 questionnaire were used for clinical evaluation. We also examined the radiological features to confirm bone consolidation and assess the progression of osteoarthritis. A significant improvement in the functional scores and radiological parameters was noted. All patients except one were satisfied with the operation. Radiological progression of the patellofemoral osteoarthritis was slowed but radiological femorotibial osteoarthritis progressed in 23 (65%) cases, with a total knee replacement becoming necessary in four cases without technical problems in resurfacing the patella. We compared the results with other forms of surgical treatment reported in the literature. This treatment offers good clinical and radiological results, presenting an alternative method of managing patellofemoral osteoarthritis.
A comparison of hemiarthroplasty with total hip replacement for displaced intracapsular fracture of the femoral neck
Authors: van den Bekerom M. P. J. , Hilverdink E. F. , Sierevelt I. N. , Reuling E. M. B. P. , Schnater J. M. , Bonke H. , Goslings J. C. , van Dijk C. N. , Raaymakers E. L. F. B. 
Published: September 2010

The aim of this study was to analyse the functional outcome after a displaced intracapsular fracture of the femoral neck in active patients aged over 70 years without osteoarthritis or rheumatoid arthritis of the hip, randomised to receive either a hemiarthroplasty or a total hip replacement (THR). We studied 252 patients of whom 47 (19%) were men, with a mean age of 81.1 years (70.2 to 95.6). They were randomly allocated to be treated with either a cemented hemiarthroplasty (137 patients) or cemented THR (115 patients). At one- and five-year follow-up no differences were observed in the modified Harris hip score, revision rate of the prosthesis, local and general complications, or mortality. The intra-operative blood loss was lower in the hemiarthroplasty group (7% > 500 ml) than in the THR group (26% > 500 ml) and the duration of surgery was longer in the THR group (28% > 1.5 hours versus 12% > 1.5 hours). There were no dislocations of any bipolar hemiarthroplasty and eight dislocations of a THR during follow-up.Because of a higher intra-operative blood loss (p < 0.001), an increased duration of the operation (p < 0.001) and a higher number of early and late dislocations (p = 0.002), we do not recommend THR as the treatment of choice in patients aged ≥ 70 years with a fracture of the femoral neck in the absence of advanced radiological osteoarthritis or rheumatoid arthritis of the hip.
Bacterial cleanup: lateral diffusion of hydrophobic molecules through protein channel walls
Authors: van den Berg Bert 
Published: September 2010

AbstractThe outer membrane (OM) of Gram-negative bacteria forms a very efficient barrier against the permeation of both hydrophilic and hydrophobic compounds, owing to the presence of lipopolysaccharides on the outside of the cell. Although much is known about the OM passage of hydrophilic molecules, it is much less clear how hydrophobic molecules cross this barrier. Members of the FadL channel family, which are widespread in Gram-negative bacteria, are so far the only proteins with an established role in the uptake of hydrophobic molecules across the OM. Recent structural and biochemical research has shown that these channels operate according to a unique lateral diffusion mechanism, in which the substrate moves from the lumen of the barrel into the OM via an unusual opening in the wall of the barrel. Understanding how hydrophobic molecules cross the OM is not only of fundamental importance but could also have applications in the design of novel, hydrophobic drugs, biofuel production and the generation of more efficient bacterial biodegrader strains.
Water Characteristic Curves of Recycled Materials
Authors: Rahardjo H. , Vilayvong K. , Leong E. C. 
Published: September 2010

Abstract
Water characteristic curves (WCCs) of recycled materials are not well researched. In this study, the WCCs of three specimens from recycled concrete aggregate, three specimens from reclaimed asphalt pavement, and one specimen from spent copper slag are studied. The objective of this study is to obtain WCCs of the recycled materials by using the Tempe cell pressure extractor for standard soil-water characteristic curve determination. Properties of drying WCC of the recycled materials were determined by using a best fit WCC equation. The results showed air-entry value of the recycled materials with high gravel content that occurred at low matric suction below 1.0 kPa and a steep WCC. The results from the WCC and saturated coefficient of permeability tests were incorporated into a statistical model to indirectly predict the permeability function of the recycled materials. The permeability functions of the recycled materials are also presented.
Accuracy of several parameters of hypothalamic–pituitary–adrenal axis activity in predicting before surgery the metabolic effects of the removal of an adrenal incidentaloma
Authors: Eller-Vainicher Cristina , Morelli Valentina , Salcuni Antonio Stefano , Battista Claudia , Torlontano Massimo , Coletti Francesca , Iorio Laura , Cairoli Elisa , Beck-Peccoz Paolo , Arosio Maura , Ambrosi Bruno , Scillitani Alfredo , Chiodini Iacopo 
Published: September 2010

ContextIt is unknown whether the metabolic effects of the removal of an adrenal incidentaloma (AI) can be predicted by the assessment of cortisol hypersecretion before surgery.ObjectiveTo evaluate the accuracy of several criteria of hypothalamic–pituitary–adrenal axis activity in predicting the metabolic outcome after adrenalectomy.DesignRetrospective longitudinal study.PatientsIn 55 surgically treated AI patients (Group 1) before surgery and in 53 nontreated AI patients (Group 2) at the baseline, urinary free cortisol (UFC), cortisol after 1 mg overnight dexamethasone-suppression test (1 mg-DST), ACTH, and midnight serum cortisol (MSC) were measured. In Groups 1 and 2, metabolic parameters were evaluated before and 29.6±13.8 months after surgery and at the baseline and after 35.2±10.9 months respectively.Main outcome measuresThe improvement/worsening of weight, blood pressure, glucose, and cholesterol levels (endpoints) was defined by the presence of a >5% weight decrease/increase and following the European Society of Cardiology or the ATP III criteria respectively. The accuracy of UFC, 1 mg-DST, ACTH, and MSC, singularly taken or in combination, in predicting the improvement/worsening of ≥2 endpoints was calculated.ResultsThe presence of ≥2 among UFC>70 μg/24 h (193 nmol/l), ACTH<10 pg/ml (2.2 pmol/l), 1 mg-DST>3.0 μg/dl (83 nmol/l) (UFC–ACTH–DST criterion) had the best accuracy in predicting the endpoints' improvement (sensitivity (SN) 65.2%, specificity (SP) 68.8%) after surgery. In the nontreated AI patients, this criterion predicted the worsening of ≥2 endpoints (SN 55.6%, SP 82.9%).ConclusionsThe UFC–ACTH–DST criterion seems to be the best for predicting the metabolic outcome in surgically treated AI patients.
Effects of Pesticide Use on Semen Quality among Farmers in Rural Areas of Sabah, Malaysia
Authors: Hossain Feroz , Ali Osman , D'souza Urban J.A. , Naing Daw Khin Saw 
Published: September 2010

Effects of Pesticide Use on Semen Quality among Farmers in Rural Areas of Sabah, Malaysia: Feroz Hossain, et al. School of Medicine, University Malaysia Sabah, MalaysiaObjectivesTo determine the relationship between semen quality and exposure to pesticide residues.MethodsA cross‐sectional study was conducted among male farmers from 3 different communities in Sabah, Malaysia. A total of 152 farmers participated in this study of whom 62 farmers had been exposed to either paraquat or malathion or both to varying extents. Questionnaires were designed to record a history of pesticides exposure and other potential risk factors among farmers. All semen samples were collected, processed and analyzed by qualified personnel based on WHO guidelines. Volume, pH, sperm concentration, motility, morphology and WBC count were examined and recorded. The association between pesticide exposure and semen parameters was highly significant.ResultsThe mean values of volume, pH, sperm concentration, motility, and WBC count were significantly less in the exposed group than in compared with the non‐exposed group, with p<0.005. Those who were exposed to pesticides had greater risk of having abnormal semen parameters than those in with the non exposed group, with p values of less than 0.05. The comparison between semen qualities such as lower sperm count, motility and higher percentage of sperm abnormality of those exposed to different types of pesticides (paraquat and malathion) showed no significant differences.ConclusionThe results showed a significant decline in semen quality with a decline in sperm count, motility and higher percent of teratospermia among subjects with pesticide exposure, and those who were exposed to pesticides had significantly 3 to 9 times greater risk of having abnormal semen parameters.