bluuebunny/crossref_metadata_2025_split huggingface dataset:
Circulating herpes simplex type 1 (HSV-1)-specific CD8+T cells do not access HSV-1 latently infected trigeminal ganglia
Authors: Himmelein Susanne , St Leger Anthony J , Knickelbein Jared E , Rowe Alexander , Freeman Michael L , Hendricks Robert L 
Published: March 2011

AbstractBackgroundTherapeutic vaccines can be designed to enhance existing T cell memory populations for increased protection against re-infection. In the case of herpes simplex virus type 1, recurrent disease results from reactivation of latent virus in sensory ganglia, which is controlled in part by a ganglia-resident HSV-specific memory CD8+T cell population. Thus, an important goal of a therapeutic HSV-1 vaccine would be to enhance this population.MethodsHSV-1-infected mice were treated with TAK-779 to block CCR5- and CXCR3-mediated CD8+T cell migration during both acute and latent infections. Additionally, HSV-1-specific CD8+T cells were transferred into HSV-1 latently infected mice to mimic the effect of a therapeutic vaccine, and their migration into trigeminal ganglia (TG) was traced during steady-state latency, or during recovery of the TG-resident memory CD8+T cell population following stress-, and corticosterone-induced depletion and HSV-1 reactivation from latency. Bromodeoxy uridine (BrdU) incorporation measured cell proliferation in vivo.ResultsTAK-779 treatment during acute HSV-1 infection reduced the number of infiltrating CD8+T cells but did not alter the number of viral genome copies. TAK-779 treatment during HSV latency did not affect the size of the TG-resident memory CD8+T cell population. Transferred HSV-specific CD8+T cells failed to access latently infected TG during steady-state latency, or during recovery of the TG resident HSV-specific CD8+T cell population following exposure of latently infected mice to stress and corticosterone. Recovery of the HSV-specific CD8+T cell population after stress and corticosterone treatment occurred with homeostatic levels of cell division and did not require CD4+T cell help.ConclusionsOur findings are consistent with the notion that the CD8+T cells in latently infected TG are a tissue-resident memory (Trm) population that is maintained without replenishment from the periphery, and that when this population is disrupted, it recovers without proliferation or detectable recruitment of HSV-specific CD8+T cells from the blood. The compartmentalization of the HSV-specific CD8+memory T cell population in latently infected TG will complicate the design of therapeutic vaccines.
Assessment of disease-severity scoring systems for patients with sepsis in general internal medicine departments
Authors: Ghanem-Zoubi Nesrin O , Vardi Moshe , Laor Arie , Weber Gabriel , Bitterman Haim 
Published: March 2011

Abstract
Introduction
Due to the increasing burden on hospital systems, most elderly patients with non-surgical sepsis are admitted to general internal medicine departments. Disease-severity scoring systems are used for stratification of patients for utilization management, performance assessment, and clinical research. Some widely used scoring systems for septic patients are inappropriate when rating non-surgical patients in a non-intensive care unit (ICU) environment mainly because their calculations require types of data that are frequently unavailable. This study aimed to assess the fitness of four scoring systems for septic patients hospitalized in general internal medicine departments: modified early warning score (MEWS), simple clinical score (SCS), mortality in emergency department sepsis (MEDS) score, and rapid emergency medicine score (REMS).

Methods
We prospectively collected computerized data of septic patients admitted to general internal medicine departments in our community-based university hospital. We followed 28-day in-hospital mortality, overall in-hospital mortality, and 30- and 60-day mortality. Using a logistic regression procedure we calculated the area under ROC curve (AUC) for every scoring system.

Results
Between February 1st, 2008 and April 30th, 2009 we gathered data of 1,072 patients meeting sepsis criteria on admission to general internal medicine departments. The 28-day mortality was 19.4%. The AUC for the MEWS was 0.65-0.70, for the SCS 0.76-0.79, for the MEDS 0.73-0.75, and for the REMS, 0.74-0.79. Using Hosmer-Lemeshow statistics, a lack of fit was found for the MEDS model. All scoring systems performed better than calculations based on sepsis severity.

Conclusions
The SCS and REMS are the most appropriate clinical scores to predict the mortality of patients with sepsis in general internal medicine departments.
Dating the age of admixture via wavelet transform analysis of genome-wide data
Authors: Pugach Irina , Matveyev Rostislav , Wollstein Andreas , Kayser Manfred , Stoneking Mark 
Published: March 2011

AbstractWe describe a PCA-based genome scan approach to analyze genome-wide admixture structure, and introduce wavelet transform analysis as a method for estimating the time of admixture. We test the wavelet transform method with simulations and apply it to genome-wide SNP data from eight admixed human populations. The wavelet transform method offers better resolution than existing methods for dating admixture, and can be applied to either SNP or sequence data from humans or other species.
Prospective Study of Laparoscopic Adjustable Gastric Banding in the West of Scotland
Authors: Jenkins J.T. , Modak P. , Galloway D.J. 
Published: March 2011

Obesity is an increasing problem in Scotland and Laparoscopic Adjustable Gastric Bands (LAGB) are an effective method of weight reduction. Most outcome data are reported from high volume units with extensive experience or dedicated bariatric practice. We aimed to assess an experienced laparoscopic surgeon's outcome working outwith a dedicated bariatric practice in the west of Scotland. Methods All LAGB procedures performed by a single surgeon were prospectively assessed from 1997 to 2004. LAGB were inserted using pars flaccida approach. Patient selection was based on BMI >35 or significant obesity related co-morbidities. Outcomes included percentage excess weight loss (%EWL) and excess BMI loss (EBL). We assessed total operating time to assess the learning curve for LAGB placement. Results 125 patients were assessed (107 F:18 M). 123 patients were in regular follow-up (98%). Median age was 44 years (range 25-63). Mean follow-up was 34 months (range 11-91). Median initial BMI was 49 (range 37-73). 31% were BMI 35-45, 36% were BMI 45-50 and 33% were BMI>50. %EWL at 1,3 and 5 years was 45, 58 and 74, respectively. EBL at 1, 3 and 5 years was 11.7, 16.1, and 21.7, respectively. Complications included 4 converted procedures, 1 failed band insertion after conversion and reoperation for removal in five. Eight patients had tubing access port problems requiring intervention. The median overall total operation time was 80 minutes (range 50 - 160). Conclusions In this cohort LAGB insertion by an experienced laparoscopic surgeon is safe with few re-operations. Satisfactory weight loss is obtained and patient compliance with follow-up is high.
Noxious Arousal Induces T Wave Abnormalities in Healthy Subjects
Authors: Dweck Marc R , Lang Christopher C , Neilson James MM , Flapan Andrew D 
Published: March 2011

Background Sudden arousal has been associated with sudden cardiac death in individuals with ischaemic heart disease, cardiac arrhythmias and the congenital long QT syndrome. This study aimed to determine the effects of arousal on ventricular repolarisation in normal individuals by examining the dynamic QT-interval-heart rate relationship and T-wave morphology changes under various ‘arousal’ scenarios. Methods 18 healthy subjects (6 female, 12 male, median age 22) underwent four separate 24-hour ECG recordings using 2-channel Holter recorders. The protocol contained five different arousal events: Natural Waking (woke naturally, then stood up); Morning Alarm (woken by alarm in the morning, then stood up); Night Alarm (woken by alarm during the night, then stood up); Morning Alarm-Remain Lying (woken by alarm in the morning but remained supine) and Lying to Standing (stood up from a supine position during the day). Holter recordings were analysed using a commercial package for dynamic assessment of the QT-RR relationship. Results In the twenty minutes after arousal no changes were seen in overall QT-RR relationship in any of the groups. However, marked T-wave morphology changes, including T wave inversion, were observed in all the arousal events. Postural changes only accounted for a small proportion of change in T wave morphology. Conclusions In healthy subjects noxious arousal causes marked changes in the morphology of the T wave. This may reflect abnormal adaptation of repolarisation to sudden changes in heart rate and autonomic tone.
Scottish Anatomy Departments: Adapting to Change
Authors: Pryde F R , Black S M 
Published: March 2011

Objectives To document changes to the academic infrastructure of Scottish departments of anatomy over the past 20 years and compare the strategic approaches adopted by each institution to ensure continued provision of the subject to medical students Design Interviews with principal anatomy staff members to obtain targeted information (staff numbers, staff recruitment, student numbers, staff:student ratio and contact hours in the medical curriculum) by investigating three temporal snapshots chosen at 10 year intervals (academic years 1983/4, 1993/4 and 2003/4) Participants Principal teaching staff members from the anatomy departments at the five Scottish medical schools: University of Aberdeen, University of Dundee, University of Edinburgh, University of Glasgow and the University of St Andrews. Additional information was forthcoming from the admissions office of each University. Results Over the past 20 years the Scottish anatomy schools have weathered a variety of external and internal influences and each school has adopted very individual strategies to the delivery and maintenance of their subject. Some schools have unquestionably been more affected than others but all have responded in a unique way to the demands of the disciplines they choose to subserve. In general, each school has seen a decline in the compliment of teachers (staff + demonstrators) whereas the student number has increased dramatically. Each department has micromanaged its proportions of lectures, dissecting room practical time and tutorials to best fit their student base, staff capabilities and the requirements of, and/or alterations to, the medical curriculum offered in their institution.
Osteoporosis Assessment and Treatment in Older Patients who Have Sustained a Hip Fracture
Authors: Lowdon Douglas W , Quinn Catherine , Mole Pat , Leese Graham P 
Published: March 2011

Background and aims Currently fracture sufferers are not being assessed or treated for osteoporosis. Osteoporosis guidelines differ in their secondary prevention recommendations, with the Scottish Intercollegiate Guideline Network (SIGN) advocating bone densitometry in all fracture patients and anti-resorptive treatment only if evidence-based criteria are confirmed, but the National Institute of Clinical Excellence (NICE) technology appraisal recommends treatment for all older females without this bone densitometry confirmation. We aimed to determine the rate of referral for bone densitometry, the numbers achieving SIGN criteria for anti-resorptive therapy, and the rate of osteoporosis treatment in patients with hip fracture Methods A retrospective review of all patients older than 65 years who had sustained a hip fracture in Tayside between April 2003 and July 2005 was performed Results Only 8.6% of hip fracture patients underwent bone densitometry, of which 90.6% of females older than 75 years met SIGN criteria for anti-resorptive treatment. 74.3% of all patients referred for bone densitometry were treated with an anti-resorptive agent, compared to only to 12.7% of the large majority group who were not assessed for osteoporosis Conclusion Osteoporosis investigation and therefore treatment remains sub-optimal in hip fracture patients. Almost all females, older than 75 years, with a hip fracture met evidence-based criteria for anti-resorptive treatment. NICE guidance, recommending anti-resorptive treatment without bone densitometry confirmation of reduced bone mineral density, should maybe be implemented for this specific group of patients in an attempt to increase osteoporosis treatment rates.
Comparative Evaluation of Laparoscopic Versus Open Nephrectomy in Children
Authors: Sekaran P , Mackinlay Ga , Lam J 
Published: March 2011

Background and Aims To assess the benefits of laparoscopic nephrectomy in children as compared to open surgery and to ascertain whether or not the retroperitoneal technique offers any surgical advantage over the transperitoneal approach. Methods and Results This study gathered retrospective data on a consecutive series of 51 paediatric patients comparing; operative time, length of hospital stay and analgesic requirement. Results show that when laparoscopic surgery is compared with the open technique it took 25 mins longer to perform, there was a shorter post operative stay by 2.5 days, and a 50% reduction in morphine use. Patients who had the retroperitoneal technique were discharged from hospital within one day. Conclusions Compared to previous studies, the findings in this study suggest that there are distinct benefits in laparoscopy for children. There is some evidence in favour of the retroperitoneal technique. Patients are in hospital for shorter periods and need less analgesia.
Do multidisciplinary team members correctly interpret the abbreviations used in the medical records?
Authors: Parvaiz M , Singh Gk , Hafeez R , Sharma H 
Published: March 2011

Background and Aims Abbreviations are commonly used in the medical world to save time and space whilst writing in the patients’ case notes. As various specialties have evolved, each has developed a collection of commonly used abbreviations within its practice, which may not be easily recognisable to those working as an allied branch. The purpose of this study was to assess whether we, the multidisciplinary team members, interpret the abbreviations used in the medical records correctly? Methods and Results We analysed orthopaedic inpatient admission case notes (n = 45) for the use of abbreviations (n = 57) and their appreciation by different members of the multidisciplinary team (n = 175) by means of a standardised questionnaire. We found a wide variation in understanding and interpretation of orthopaedic abbreviations among health care professionals. Even the orthopaedic surgeons could answer correctly 57.2% only, followed by physiotherapists (49.9%). Non-orthopaedic groups produced significantly less number of correct answers than the orthopaedic surgeons (p <0.019). Interestingly, nursing and physiotherapy departments produced significantly fewer mal-interpretations than the orthopaedic surgeons (p <0.023). Conclusions Whilst abbreviations may indeed save time, the use of confusing abbreviations is unacceptable. We recommend that acronym obsession should be discouraged in order to reduce possible clinical error.
The Use of the Artificial Urinary Sphincter in the West of Scotland: a Single Centre 10-year Experience
Authors: Ramsay AK , Granitsiotis P , Conn IG 
Published: March 2011

Background The artificial urinary sphincter (AUS) has been used successfully to treat sphincter weakness incontinence in males over the past 30 years. Postoperative complications are well-recognised, but patient satisfaction remains high. Methods We performed a retrospective single centre study of all patients who had an artificial urinary sphincter inserted over a 10-year period. We assessed patient satisfaction and continence post operatively as well as complication rate and need for revision or replacement surgery. Results Thirty-eight male patients (mean age 57 years) and 1 female patient had an AMS 800 (American Medical systems) AUS inserted between 1995 and 2005. Five (13%) patients have required replacement surgery to date. Male patients were divided into two groups according to the aetiology of their incontinence: neuropathic (n=11) and non-neuropathic (n=27). Social continence was achieved in all patients. Three (11%) non-neuropathic patients developed complications. Revision surgery was undertaken in 4 (15%) of non-neuropathic patients and in 1 (9%) neuropathic patient. The mean lifespan of the AUS in patients who required further surgery is 6.6 years. Conclusion For patients with severe sphincter weakness incontinence the AMS 800 AUS is a safe and reliable solution. Our results are comparable with previous published studies of larger patient numbers from dedicated reconstructive units.
The Changing Face of Infection: a Comparative Review of Admissions to a Regional Infection Unit Over Three Decades.
Authors: Franklin G.F , Robson D , Cadwgan A , Macfarlane TV , Douglas JK , Hamilton D , Mackenzie AR , Laing RBS , Douglas JG 
Published: March 2011

Background and Aims Our group previously published retrospective analyses of 12 months of admissions to the Grampian Regional Infectious Diseases Unit from 1980-81 and from 1991. This study aimed to collect data in 2001 and to compare annual admission numbers, diagnoses, duration of stay and outcome in 1980-81, 1991 and 2001. Methods Data on all admissions was collected prospectively throughout 2001. This was compared with the previously published data. Results Total admissions rose from 605 in 1980-81 to 900 in 1991 and to 1152 in 2001. Sixty one percent of admissions in 1980-81 were confirmed as having infection compared to 72% in 1991 and to 83% in 2001. The most common reason for admission in 2001 was skin and soft tissue infection, but this was only the ninth commonest reason in 1981. Mean length of stay fell from 9.6 days in 1980-81 to 7.4 days in1991 and to 5.5 days in 2001. The mortality rate fell from 3.1% in 1981 and 1991 to 1.0% in 2001. Conclusions This study demonstrates significant changes in type, number and outcome of admissions to a regional infection unit. We discuss possible reasons for these changes.
Variations in all Cause and Cardiovascular Mortality by Country of Birth in Scotland, 1997-2003
Authors: Fischbacher CM , Steiner M , Bhopal R , Chalmers J , Jamieson J , Knowles D , Povey C 
Published: March 2011

Background and Aims Country of birth provides a proxy for ethnic group for recent migrants. Major differences in mortality by country of birth have been demonstrated in England and Wales, but similar published data for Scotland are lacking. We aimed to examine variations in mortality by country of birth for Scottish residents. Methods We calculated standardised mortality ratios by country of birth for Scottish residents aged 25 years and over between January 1997 and March 2003. Results and Conclusion Comparisons with England and Wales showed high allcause, coronary heart disease (CHD) and stroke mortality among Scottish residents born in Scotland, Northern Ireland, the Republic of Ireland, India and Hong Kong. However, most country of birth groups had similar or lower mortality than the Scottish born. These are the first data on mortality by country of birth in Scotland and they demonstrate major variations. Comparisons within the Scottish population might be interpreted as reassuring, since they do not show the excesses in CHD mortality by country of birth reported in England and Wales. However, the use of England and Wales as a comparison group shows a substantial excess of CHD risk among South Asians in Scotland, comparable to that reported in England and Wales.
A Survey of Attention Deficit Hyperactivity Disorder Follow-up Services Provided by Child and Adolescent Psychiatry Departments in Scotland
Authors: Skilling GD , Robinson J , Fielding S 
Published: March 2011

Background/Aim Current clinical guidelines offer few recommendations for follow-up of patients diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). We aimed to establish what follow-up services were in place for children and young people with ADHD across Scotland, to highlight variations within these services and to examine their level of adherence to those national guidelines on follow-up which do exist. Method A postal survey of child and adolescent psychiatry departments across Scotland was carried out. Seventeen departments were contacted and the response rate was 100%. We compared results from areas with and without designated ADHD follow-up teams. We looked specifically at numbers and type of professional involved and the structure of the follow-up services provided. Results and Conclusion Forty one percent of services had a designated ADHD follow-up team. These services held a significantly higher proportion of regular ADHD clinics and involved more staff from different professional groups. There were wide variations in services provided by child and adolescent psychiatrists for ADHD follow-up across Scotland. Further research on the effects on prognosis and outcome of designated ADHD services would allow for the enhancement of current clinical guidelines and more effective service planning and provision.
Cervical Lymphadenopathy Resulting in a Diagnosis of Lymphoma
Authors: Savage SAH , Wotherspoon HA , Fitzsimons EJ , Mackenzie K 
Published: March 2011

Background and Aims Currently there is no protocol in the west of Scotland for the investigation of a patient with a lymph node in the neck which might contain lymphoma. The aim of this audit was to examine the current management of these patients. Methods Data were collected on 112 patients diagnosed as having lymphoma from a neck node biopsy within a 12 month period from 1st November 2004 to 31st October 2005. Biopsy data were collected in combination with the first point of consultation, investigations used to arrive at diagnosis and any associated complications. Results Eighty seven percent of patients underwent excision biopsy with complications noted in 7%. Fine needle aspiration cytology (FNAC) was carried out in 60% of which 34% were ultrasound guided. Core biopsy was carried out in 17% of which 63% were ultrasound guided. Forty-five percent of patients were first referred to ear, nose and throat (ENT) surgery, 17% to general surgery, 14% to haematology, 13% to general medicine and 11% to other specialties. Conclusion This audit shows that there was a wide range of first points of consultation and diagnostic procedures used. It is recommended that there should be access for all patients with cervical lymphadenopathy to a weekly neck lump clinic with standardised protocols for lymphoma diagnosis. This should ensure that patients are diagnosed accurately and treated in a timely manner.
Medical Needs and Survival of NHS Continuing Care Residents
Authors: Moylan T , Roberts M , Murray S 
Published: March 2011

Background and Aims To determine the medical needs and survival of patients admitted to NHS continuing care beds for the frail elderly. Methods A retrospective cohort study of admissions during one year to 222 beds in south-east Glasgow. Case-sheet review identified the diagnoses on admission. Medical interventions were allocated to one of six predetermined categories. Mortality data was collected up to four years after admission. Results One hundred and eighty nine patients (65 male and 133 female) were admitted, 183 (92%) for NHS continuing care. The overall survival at three months was 47.8% and 38.5% at six months. In total 1585 interventions were recorded, 56.3% of admissions required one or more major intervention. Seventy eight (75.7%) of these were managed in the continuing care setting avoiding transfer to an acute hospital bed. Conclusions Older people resident in NHS continuing care have a short life expectancy and require frequent medical interventions. Much of this can be provided in the NHS continuing care setting avoiding admission to the acute sector. Shift of care for these patients to private nursing homes may not provide such support.