bluuebunny/crossref_metadata_2025_split huggingface dataset:
Haemostasis in head and neck surgical procedures: Valsalva manoeuvre versus Trendelenburg tilt
Authors: Moumoulidis I , Del Pero Martinez M , Brennan L , Jani P 
Published: April 2010

INTRODUCTION The aim of the study was to identify whether Trendelenburg position helps detect any further bleeding points following Valsalva manoeuvre in order to achieve adequate haemostasis in head and neck surgery. PATIENTS AND METHODS Fifty consecutive patients undergoing major head and neck surgical procedures were included. The protocol consisted in performing Valsalva manoeuvre to check haemostasis and treated any bleeding points identified. The operating table was tilted 30° and haemostasis was checked again and treated accordingly. The number of vessels identified and the treatment was recorded. RESULTS Twelve male and 38 female patients were included. The median age was 53 years and 74% had an ASA of 1. Twelve patients had complicating features such as retrosternal extensions or raised T4 levels pre-operatively. Thyroid resections were the most common operations performed. The total number of bleeding vessels identified in Trendelenburg tilt was significantly greater than when using Valsalva manoeuvre (P < 0.0001). All bleeding points found on Valsalva manoeuvre were minor (< 2 mm) and dealt with using diathermy. In Trendelenburg position, 11% of bleeding vessels required ties or stitching. The time taken during Valsalva manoeuvre was 60 s on average and 360 s in Trendelenburg position. CONCLUSIONS The results show that the Trendelenburg position is vastly superior to the Valsalva manoeuvre in identifying bleeding vessels at haemostasis. It has become our practice to put patients in Trendelenburg tilt routinely (we have discontinued the Valsalva manoeuvre), to check its adequacy before closing the wound. We have not noticed any intracranial complications using a tilt angle of 30°.
An Assessment of Cumulative Axial and Torsional Fatigue in a Cobalt-Base Superalloy
Authors: Kalluri Sreeramesh , Bonacuse Peter J. 
Published: April 2010

Abstract
Cumulative fatigue under axial and torsional loading conditions can include both load-order (high/low and low/high) as well as load-type sequence (axial/torsional and torsional/axial) effects. Previously reported experimental studies on a cobalt-base superalloy, Haynes 188 at 538°C, addressed these effects. These studies characterized the cumulative axial and torsional fatigue behavior under high amplitude followed by low amplitude (Kalluri, S. and Bonacuse, P. J., “Cumulative Axial and Torsional Fatigue: An Investigation of Load-Type Sequence Effects,” in Multiaxial Fatigue and Deformation: Testing and Prediction, ASTM STP 1387, S. Kalluri, and P. J. Bonacuse, Eds., American Society for Testing and Materials, West Conshohocken, PA, 2000, pp. 281–301) and low amplitude followed by high amplitude (Bonacuse, P. and Kalluri, S. “Sequenced Axial and Torsional Cumulative Fatigue: Low Amplitude Followed by High Amplitude Loading,” Biaxial/Multiaxial Fatigue and Fracture, ESIS Publication 31, A. Carpinteri, M. De Freitas, and A. Spagnoli, Eds., Elsevier, New York, 2003, pp. 165–182) conditions. In both studies, experiments with the following four load-type sequences were performed: (a) axial/axial, (b) torsional/torsional, (c) axial/torsional, and (d) torsional/axial. In this paper, the cumulative axial and torsional fatigue data generated in the two previous studies are combined to generate a comprehensive cumulative fatigue database on both the load-order and load-type sequence effects. This comprehensive database is used to examine applicability of the Palmgren–Langer–Miner linear damage rule and a nonlinear damage curve approach for Haynes 188 subjected to the load-order and load-type sequencing described above. Summations of life fractions from the experiments are compared to the predictions from both the linear and nonlinear cumulative fatigue damage approaches. The significance of load-order versus load-type sequence effects for axial and torsional loading conditions is discussed. Possible reasons for the observed differences between the computed and observed summations of cycle fractions are rationalized in terms of the observed evolutions of cyclic axial and shear stress ranges in the cumulative fatigue tests.
Pheochromocytomas detected by biochemical screening in predisposed subjects are associated with lower prevalence of clinical and biochemical manifestations and smaller tumors than pheochromocytomas detected by signs and symptoms
Authors: van Duinen N , Steenvoorden D , Bonsing B A , Vuyk J , Vriends A H J T , Jansen J C , Romijn J A , Corssmit E P M 
Published: May 2010

ContextSporadic pheochromocytomas are detected by clinical signs and symptoms, whereas pheochromocytomas in patients with a known hereditary predisposition for these tumors are detected by repetitive screening for catecholamine excess.ObjectiveTo document the clinical, biochemical, and pathological differences between patients with sporadic pheochromocytomas, detected by signs and symptoms and patients with pheochromocytomas, detected by biochemical screening in established hereditary syndromes.DesignRetrospective follow-up study.Patients and methodsWe included 60 consecutive patients diagnosed with pheochromocytoma (pheochromocytomas detected by signs and symptoms: n=28 and pheochromocytomas detected by screening: n=32) in our center.ResultsPatients with pheochromocytomas detected by screening presented with less complaints of diaphoresis (P<0.01), palpitations (P=0.01), paleness (P=0.01), nausea (P<0.01), and vomiting (P=0.01) compared with patients with symptomatic pheochromocytomas. Patients with pheochromocytomas detected by screening tended to be younger at the time of diagnosis (41±2 vs 47±3 years, P=0.07). In addition, patients with pheochromocytomas detected by screening had significantly lower rates of 24-h urinary catecholamine excretion, and considerably smaller tumors (3.7±0.5 vs 7.3±0.7 cm, P<0.01).ConclusionsPheochromocytomas detected by screening of patients with a hereditary predisposition have a much lower prevalence of signs and symptoms, lower catecholamine excess, and smaller tumors, compared with sporadic pheochromocytomas, detected by signs and symptoms. These data support the benefits of screening for pheochromocytomas in patients with hereditary syndromes predisposing for these tumors.
Stem Cells, Cloning, and Political Liberalism
Authors: Stabile Bonnie B. 
Published: May 2010

AbstractThis paper examines the political and policy making challenges posed by human embryonic stem cell research and somatic cell nuclear transfer, known colloquially as cloning, by applying two facets of John Rawls' construct of political liberalism—the burdens of judgment and overlapping consensus—to consider how such seemingly intractable controversies are resolved in a constitutional democracy. The analysis underscores the importance of both civic and scientific education to promoting the capacity of citizens to achieve what Rawls calls an overlapping consensus of reasonable comprehensive doctrines.
Behavioral Features of Men Who Have Sex with Men (MSM) in Harbin, China
Authors: Tang Houlin , Zhang Weidong , Lv Fan 
Published: May 2010

AbstractBackground: Incidence of homosexuality has been underestimated in China. This study was intended to investigate behavioral features of men having sex with men (MSM) practicing different sexual orientations, and to explore their contribution to the transmission of HIV/AIDS for the effective prevention and intervention measures. Methods: A standardized questionnaire was used to interview 673 MSM in the Harbin city, Heilongjiang province, from June to July in 2006. The information was used to characterize the sexual orientation and behavioral of the MSM. Results: The prevalence of homosexual and bisexual men among MSM were 78.9% and 16.7%, respectively. The rate of receptive anal intercourse was higher among homosexual men (?2 = 18.5, p<0.001), while the rate of inserting anal intercourse was higher among bisexual men (?2 = 18.4, p<0.001). A total of 59.7% of MSM searched for sexual partners on the internet; 1.7% of MSM reported having experience with drug use; and 13.1% of them reported having received an HIV antibody test. Conclusion: The incidence of MSM who also engage in sex with female partners is very high. MSM, including both with homosexual and bisexual orientations, may serve as a contributing factor to transmit HIV from the high risk population to lower risk populations in the presence of unprotected sex.
Addressing the Inadequacies of the Current Healthcare Model with a Universal Healthcare System in the United States
Authors: All Angelo Homayoun 
Published: May 2010

AbstractDespite the immense amount of resources available in the United States, more than 46 million U.S. citizens remain uninsured. The United States has the means and the resources to provide universal health care. However, before initiating remedial steps, problems associated with the current healthcare system must be analyzed. The healthcare dilemma can be resolved by changing patient behavior, provider performance, reducing unnecessary costs, and better allocation of resources. These changes will necessitate deviations from the current model and, to be successful, should be made step by step and gradually.
Transportation and Health: the Good and the Bad
Authors: Button Kenneth J 
Published: May 2010

AbstractTransportation has contributed in many ways to improve human life and well‐being. From humanitarian assistance to rapid sharing, food and pharmaceutical transportation does benefit mankind in ways that are not always appreciated. Unfortunately, transportation can negatively impact human health in two broad ways: accidents and environmental pollution. It can also facilitate the spread of infectious diseases. Safe and responsible use of transportation technology is of concern to all users, operators, and technologists, including healthcare providers. Medical professionals should participate in safety and educational campaigns, bioengineering and human factors research, and advocacy of the timely introduction of health and safety policies for a more responsible operation of transportation and new technology insertion.
In the News
Authors: Jacobs William , Nicogossian Arnauld 
Published: May 2010

AbstractThe Editors of the Journal are pleased to provide the readership with the most recent medical and health news. In the Editors' opinion, the materials summarized in this section have the potential for the development of health policies, standards or for use in the daily practice and counseling of patients in preventative care. For additional information readers might wish to visit internet‐based medical news websites, some free of charge, such as MedScape, Stone Heart, American College of Physicians and the World Medical Association.
HIV: The Hidden Face of Human Trafficking
Authors: Stein Richard A. 
Published: May 2010

AbstractHuman trafficking emerges as one of the most significant social, legal, medical, and public health crises of our time. A relatively under‐explored facet of human trafficking is the victim' risk to become infected with HIV and other sexually transmitted pathogens. Several studies reported that significant percentages of trafficking victims are HIV‐positive. In addition, some of the HIV‐positive victims are co‐infected with hepatitis B, tuberculosis, or syphilis. The large numbers of clients, together with the unprotected sexual relationships that many trafficking victims are forced to have, greatly heighten their risk to become infected. Furthermore, just like trafficking, HIV represents a taboo topic in many societies worldwide, and the marginalization of rescued trafficking victims by families and society significantly compounds their suffering and increases their susceptibility for further abuse. The interface between human trafficking and HIV represents an important area that needs to be explored in future studies, and should receive increased attention from public health officials.
The Use of Peripherally Inserted Central Catheters in Cancer Patients
Authors: Lin Su-Chen , Wen Kuei-Yen , Liu Chin-Yen , Wei Chih-Hsin 
Published: May 2010

Abstract
From 2002 to 2006, 524 cancer patients who underwent PICC insertion by nursing staff were studied. 568 PICCs were in place for a total of 32068 days (mean duration: 56 days; range: 1 to 487 days). The complication rates were phlebitis – 24.07%, broken/leaking catheter – 12.33%, accidental removal – 7.44%, occlusion – 14.68%, and infection – 1.77%. Group A patients who underwent PICC insertion for the major purpose of receiving repeated chemotherapy had higher incidences of phlebitis, broken/leakage catheter and infection. Group B patients who underwent PICC insertion for the major purpose of hospice care had a higher incidence of accidental removal.
Establishing a Nurse-Led Central Venous Catheter Insertion Service
Authors: Alexandrou Evan , Spencer Tim , Frost Steven A. , Parr Michael , Davidson Patricia M. , Hillman Ken M. 
Published: May 2010

Abstract
Background: Health care systems promote care models that deliver both safety and quality. Nurse-led vascular access teams show promise as a model to achieve hospital efficiencies and improve patient outcomes.
Objectives: The aim of this paper is to discuss the process of establishing a nurse-led central venous catheter (CVC) insertion service in a university affiliated hospital using a process evaluation method.
Method: Archival information, including reports, communications and minutes of departmental meetings were reviewed. Key stakeholders involved in establishing this nurse-led service at the time were interviewed.
Results: A nurse-led CVC insertion service was first established in 1996 and has increased in service provision over 13 years. Initially there was scepticism from some medical practitioners about the feasibility of a nurse performing a traditional medical procedure. The service currently provides central venous access across the hospital including critical care areas. The service places up to 500 catheters per annum.
Conclusions: Establishing a nurse-led CVC insertion service has increased organizational efficiencies and provided an infrastructure for support of best practice. The support of senior management and medical practitioners was crucial to the successful implementation of this model of care.
Prevalence and Predictors of Overweight and Insulin Resistance in Offspring of Mothers With Gestational Diabetes Mellitus
Authors: Boerschmann Heike , Pflüger Maren , Henneberger Lydia , Ziegler Anette-G. , Hummel Sandra 
Published: May 2010

OBJECTIVE
Gestational diabetes mellitus (GDM) is associated with high birth weight in the offspring. This may lead to overweight and insulin resistance during childhood. The aim of the study was to assess the impact of GDM on overweight risk and insulin resistance in offspring.

RESEARCH DESIGN AND METHODS
BMI measurements were collected at age 2, 8, and 11 years from 232 offspring of mothers with GDM (OGDM) and compared with those from 757 offspring of mothers with type 1 diabetes (OT1D) and 431 offspring of nondiabetic mothers (ONDM) born between 1989 and 2000. Insulin resistance (homeostasis model assessment of insulin resistance [HOMA-IR]) was determined at age 8 and 11 years in 751 children (74 OGDM). Overweight was defined as BMI percentile ≥90; insulin resistance was defined by HOMA-IR.

RESULTS
Overweight prevalence was increased in OGDM compared with OT1D and to ONDM throughout childhood (age 11 years 31.1, 15.8, and 15.5%; P = 0.005). Maternal obesity was an important predictor of overweight risk in children (age 11 years odds ratio 7.0 [95% CI 1.8–27.7]; P = 0.006); birth size and maternal smoking during pregnancy were inconsistently associated with and treatment of GDM during pregnancy did not affect overweight risk. HOMA-IR was increased in OGDM compared with offspring of ONDM mothers (P = 0.01, adjusted for sex and age) and was associated with the child's BMI (P = 0.004).

CONCLUSIONS
Overweight and insulin resistance in children is increased in OGDM compared with OT1D or ONDM. The finding that overweight risk is associated mainly with maternal obesity suggests that familial predisposition contributes to childhood growth in these offspring.
Prevalence and Clinical Outcome of Hyperglycemia in the Perioperative Period in Noncardiac Surgery
Authors: Frisch Anna , Chandra Prakash , Smiley Dawn , Peng Limin , Rizzo Monica , Gatcliffe Chelsea , Hudson Megan , Mendoza Jose , Johnson Rachel , Lin Erica , Umpierrez Guillermo E. 
Published: May 2010

OBJECTIVE
Hospital hyperglycemia, in individuals with and without diabetes, has been identified as a marker of poor clinical outcome in cardiac surgery patients. However, the impact of perioperative hyperglycemia on clinical outcome in general and noncardiac surgery patients is not known.

RESEARCH DESIGN AND METHODS
This was an observational study with the aim of determining the relationship between pre- and postsurgery blood glucose levels and hospital length of stay (LOS), complications, and mortality in 3,184 noncardiac surgery patients consecutively admitted to Emory University Hospital (Atlanta, GA) between 1 January 2007 and 30 June 2007.

RESULTS
The overall 30-day mortality was 2.3%, with nonsurvivors having significantly higher blood glucose levels before and after surgery (both P &lt; 0.01) than survivors. Perioperative hyperglycemia was associated with increased hospital and intensive care unit LOS (P &lt; 0.001) as well as higher numbers of postoperative cases of pneumonia (P &lt; 0.001), systemic blood infection (P &lt; 0.001), urinary tract infection (P &lt; 0.001), acute renal failure (P = 0.005), and acute myocardial infarction (P = 0.005). In multivariate analysis (adjusted for age, sex, race, and surgery severity), the risk of death increased in proportion to perioperative glucose levels; however, this association was significant only for patients without a history of diabetes (P = 0.008) compared with patients with known diabetes (P = 0.748).

CONCLUSIONS
Perioperative hyperglycemia is associated with increased LOS, hospital complications, and mortality after noncardiac general surgery. Randomized controlled trials are needed to determine whether perioperative diabetes management improves clinical outcome in noncardiac surgery patients.
Fluid balance, glomerular filtration rate, and urine output in dogs anesthetized for an orthopedic surgical procedure
Authors: Boscan Pedro , Pypendop Bruno H. , Siao Kristine T. , Francey Thierry , Dowers Kristy , Cowgill Larry , Ilkiw Jan E. 
Published: May 2010

Abstract
Objective—To determine fluid retention, glomerular filtration rate, and urine output in dogs anesthetized for a surgical orthopedic procedure.
Animals—23 dogs treated with a tibial plateau leveling osteotomy.
Procedures—12 dogs were used as a control group. Cardiac output was measured in 5 dogs, and 6 dogs received carprofen for at least 14 days. Dogs received oxymorphone, atropine, propofol, and isoflurane for anesthesia (duration, 4 hours). Urine and blood samples were obtained for analysis every 30 minutes. Lactated Ringer's solution was administered at 10 mL/kg/h. Urine output was measured and glomerular filtration rate was estimated. Fluid retention was measured by use of body weight, fluid balance, and bioimpedance spectroscopy.
Results—No difference was found among control, cardiac output, or carprofen groups, so data were combined. Median urine output and glomerular filtration rate were 0.46 mL/kg/h and 1.84 mL/kg/min. Dogs retained a large amount of fluids during anesthesia, as indicated by increased body weight, positive fluid balance, increased total body water volume, and increased extracellular fluid volume. The PCV, total protein concentration, and esophageal temperature decreased in a linear manner.
Conclusions and Clinical Relevance—Dogs anesthetized for a tibial plateau leveling osteotomy retained a large amount of fluids, had low urinary output, and had decreased PCV, total protein concentration, and esophageal temperature. Evaluation of urine output alone in anesthetized dogs may not be an adequate indicator of fluid balance.
Identification of variants of the SPINK1 gene and their association with pancreatitis in Miniature Schnauzers
Authors: Bishop Micah A. , Xenoulis Panagiotis G. , Levinski Melinda D. , Suchodolski Jan S. , Steiner Jörg M. 
Published: May 2010

Abstract
Objective—To evaluate the serine protease inhibitor, Kazal type 1 (SPINK1) gene for variants and to determine their possible association with pancreatitis in Miniature Schnauzers.
Animals—39 Miniature Schnauzers with pancreatitis, 25 healthy Miniature Schnauzers, and 23 healthy dogs of other breeds.
Procedures—The entire canine SPINK1 gene with its intron-exon boundaries was initially sequenced in 22 Miniature Schnauzers. Then, 2 regions of the gene were sequenced in 65 additional canine DNA samples at the locations of variants identified in the initial sequencing of the entire SPINK1 gene.
Results—Analysis of the SPINK1 gene in Miniature Schnauzers revealed 3 closely associated variants in healthy Miniature Schnauzers and Miniature Schnauzers with pancreatitis. These variants consisted of 2 missense mutations in the second exon (N20K and N25T) and a poly T insertion in the third intron that was near the boundary of exon 3 (IVS3+26–27ins(T)33–39,15_61dup11). Pancreatitis was significantly associated with homozygous alleles for these 3 variants in Miniature Schnauzers. In healthy dogs of other breeds, only the 2 exon variants were identified.
Conclusions and Clinical Relevance—Variants of the SPINK1 gene may be associated with the development of pancreatitis in Miniature Schnauzers.
Evaluation of the effect of phosphodiesterase on equine platelet activation and the effect of antigen challenge on platelet phosphodiesterase activity in horses with recurrent airway obstruction
Authors: Dunkel Bettina , Rickards Karen J. , Werling Dirk , Page Clive P. , Cunningham Fiona M. 
Published: May 2010

Abstract
Objective—To determine whether expression of equine platelet activation–dependent surface markers is influenced by phospodiesterase (PDE) isoenzyme activity and whether antigen challenge alters platelet PDE activity in horses with recurrent airway obstruction (RAO).
Animals—16 horses.
Procedures—7 healthy horses were used for in vitro experiments, 6 horses with RAO were used for antigen challenge, and 6 healthy horses were used as control animals. Three of the healthy horses had also been used in the in vitro experiments. Effects of PDE inhibition and activation of adenylyl cyclase on CD41/61 and CD62P expression on platelets and platelet-neutrophil aggregate formation in vitro were investigated via flow cytometry. Platelet PDE activity and sensitivity to inhibition of PDE3 and PDE5 isoenzymes were examined in horses with RAO and control horses before and after antigen challenge.
Results—Inhibition of PDE or activation of adenylyl cyclase significantly inhibited stimulus-induced expression of CD41/61 and CD62P (by approx 94% and 40%, respectively) and percentage of CD62P positive cells (by approx 30%). Only the PDE3 inhibitor, trequinsin, caused a significant (53%) reduction in platelet-neutrophil aggregate formation. Platelet PDE activity decreased following antigen challenge in RAO-affected horses and control horses. In horses with RAO, a significant increase in sensitivity of platelet PDE to inhibition by the PDE5 inhibitor zaprinast was observed after 5 hours.
Conclusions and Clinical Relevance—Results provided further evidence that PDE3 is an important regulator of equine platelet activation and suggested that changes in regulation of platelet PDE5 may contribute to antigen-induced response in horses with RAO.