bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Use of Cell Salvage during Obstetric Procedures: An Audit of Scotland's Maternity Units
Authors: Harkness M , Clark V 
Published: March 2011

Background Concerns about the safety and supply of donor blood mean that clinicians are increasingly looking for alternatives to allogenic blood transfusion. One such alternative is cell salvage. Theoretical concerns about the safety of giving salvaged blood to obstetric patients have so far limited its use in maternity patients, but its use in obstetrics is now growing. Aims To determine how many Scottish maternity units use cell salvage and what barriers anaesthetists see to its use in obstetrics. Methods A survey was posted to one consultant anaesthetist at each of Scotland's 18 consultant led maternity units. Results Two out of 18 maternity units in Scotland use cell salvage. Perceived barriers to use include lack of machine, insufficient cases and lack of familiarity with the technology. Only 4/15 anaesthetists saw safety concerns as a barrier to using the technology. Conclusion It would appear that practical issues such as staff training and maintaining familiarity with the technology are greater barriers to the use of cell salvage during obstetric procedures than concerns over safety or financial costs. Although cell salvage would appear to be safe, its use in obstetrics must be accompanied by ongoing audit and detailed data should be collected for each case.
Successful Use of National Cancer Registry Data to Monitor the Effective Use of Imatinib for Treating Chronic Myeloid Leukaemia
Authors: Shepherd P , Dhanapala C , Maguire C , White J , Drummond M , Holyoake T , Johnson PRE 
Published: March 2011

Imatinib is a tyrosine kinase inhibitor, which selectively antagonises the BCR-ABL molecular pathway which causes chronic myeloid leukaemia (CML). Imatinib was first approved by the Scottish Medicines Consortium (SMC) in January 2002 with the recommendation that its use be audited. The cost of the drug has major financial implications for health resources. Methods All imatinib usage since its first prescription in Scotland in September 2000 to July 2003 was audited through pharmacy records and through the Scotland Leukaemia Registry (SLR), an existing national registry of patients with CML. Results One hundred and four patients in Chronic Phase (CP), 36 in Accelerated Phase (AP) and five in Blast Phase (BP) received imatinib. The median duration of therapy was not reached for CP, 17 months for AP, and two months for BP patients. Major (complete) cytogenetic response rates were 74% (63%) and 38% (24%) respectively for CP and AP. Overall survival for all CP patients from the start of imatinib therapy was 94% at one year, 91% at two years and 83% at three years. An audit of the effectiveness of the SLR as an auditing agency, showed complete registration in 95% of cases. Conclusions We believe such data collection should be an important ongoing resource for assessing outcomes in a rare form of leukaemia but one which already has major implications for health economics and will continue to do so given the future development of dual tyrosine kinase inhibitors for imatinib resistant cases.
Endosalpingiosis Masquerading as Ovarian Carcinoma and Presenting on Cervical Smear
Authors: Mcintosh A , Teo UL , Millan DWM , Alexander-Sefre F 
Published: March 2011

Background Endosalpingiosis is a common, pathological finding with no symptoms. Histological differentiation of endosalpingiosis from malignancy can be a challenge to pathologists and hence potential for unwarranted surgical intervention exists. Case We report a case of endosalpingiosis with an unusual initial presentation of an abnormal cervical smear suggestive of adenocarcinoma. This finding was further supported by laparoscopic findings resembling ovarian carcinoma, hence leading to major surgical intervention. The final pathology revealed no evidence of neoplastic changes. Conclusion Greater awareness of endosalpingiosis and its masquerading features is needed to avoid unnecessary surgical interventions.
Detection of Adverse Events in a Scottish Hospital Using a Consensus-based Methodology
Authors: Williams DJ , Olsen S , Crichton W , Witte K , Flin R , Ingram J , Campbell MK , Watson M , Hopf Y , Cuthbertson BH 
Published: March 2011

Objective To determine, using a consensus based methodology, the rate and nature of adverse events (AEs) among patients admitted to acute medicine, acute surgery and obstetrics in a large teaching hospital in Scotland. Methods Retrospective case-note review of 450 medical, nursing and medication records to identify and classify adverse events. Results For 354 patients whose length of stay was greater than 24 hours, the overall adverse event rate was 7.9% which ranged from 0% in obstetrics, 7.2% in acute medicine to 13% in acute surgery. Among all AEs, 43% were deemed preventable by a consensus group and 59% of the AEs contributed to a proportion of the patients’ hospital stay or led to hospital readmission. Whilst nurse identification of adverse events was highly specific (94%), its sensitivity was poor (43%). Only 10% of the identified AEs were identified by the hospital's voluntary reporting system for adverse events. The estimated additional cost of adverse events in terms of bed days was £69,189 which if extrapolated Scotland-wide could cost £297 million per annum. Conclusions This study supports the need to continue the traditional retrospective record review to identify adverse events. The current hospital-based reporting of adverse events does not provide a complete measure of adverse events and needs to be complemented by other measures.
Manipulation Under Anaesthesia and Early Physiotherapy Facilitate Recovery of Patients with Frozen Shoulder Syndrome
Authors: Ng CY , Amin AK , Narborough S , McMullan L , Cook R , Brenkel IJ 
Published: March 2011

Aim The aim of this study was to examine the efficacy of manipulation under anaesthesia (MUA) followed by early physiotherapy in treating frozen shoulder syndrome. Methods In a prospective trial conducted between 26th August 2002 and 25th June 2004 in 86 patients with frozen shoulder syndrome, MUA was performed as a day procedure. Main outcomes were Disabilities of the Arm, Shoulder and Hand (DASH) score, a visual analogue score (VAS) for pain and range of movement, which were measured preoperatively and at six weeks postprocedure. Results Fifty (58.1%) patients had complete data. The average age was 54.5 years. The mean duration of symptoms until MUA was 13 months. The mean DASH score decreased from 48.07 to 15.84 (p<0.0005). The mean VAS reduced from 6.07 to 1.88 (p<0.0005). Flexion improved from 104.18 to 157.56 (p<0.0005); abduction from 70.48 to 150.00 (p<0.0005); and external rotation from 13.88 to 45.62 (p<0.0005). Conclusion MUA combined with early physiotherapy alleviates pain and facilitates recovery of function in patients with frozen shoulder syndrome.
Familial Esophageal Atresia
Authors: El-Nabulsi B , Carachi R 
Published: March 2011

Summary The population incidence of oesophageal atresia is 1 in 3000 live birth. Most cases are sporadic but familial cases have been reported. The etiology of oesophageal atresia is multifactorial pathogenic mechanism, in which environmental and polygenic factors contribute to the development of the anomaly. Only 6–7% of cases have abnormal karyotype on chromosomal analysis. When a family history of oesophageal atresia exist, the parents should be offered genetic counseling. Antenatal screening by detailed ultrasound scans which should be done at expert centers. After birth the pediatrician should role out an oesophageal atresia by the passage of a nasogastric tube.
Aggressiveness of Inflammation in Histological Prostatitis – Correlation with Total and Free Prostate Specific Antigen Levels in Men with Biochemical Criteria for Prostate Biopsy
Authors: Stimac G , Reljic A , Spajic B , Dimanovski J , Ruzic B , Ulamec M , Sonicki Z , Kraus O 
Published: March 2011

Background and Aims Although prostatitis can contribute to the lack of prostate specific antigen (tPSA) specificity, there is disagreement concerning the effect of histological inflammation on free PSA (fPSA). We investigated the correlation between aggressiveness of histological inflammation and tPSA, fPSA and f/tPSA in patients without detectable prostate cancer (PC). Methods The study included 106 patients with tPSA <10 ng/mL, without clinical prostatitis and with biopsy negative for PC. The inflammation in prostate biopsies was scored for aggressiveness using the four-point scale reported by Irani. The patients were divided into two groups of less aggressive and more aggressive inflammation and compared by use of regression analysis. Results The median tPSA, fPSA and f/tPSA levels were 6.39 ng/mL, 1.1 ng/mL and 16% in the less aggressive inflammation group and 7.3 ng/mL, 0.79 ng/mL and 10.7% in the more aggressive inflammation group, respectively. There was no significant between-group difference in tPSA levels (P=0.16), however, statistically significant between-group differences were recorded in fPSA and f/tPSA levels (P<0.001 both). Spearman's analysis yielded a significant negative correlation of inflammation aggressiveness with fPSA (r=-0.34; P<0.001) and f/tPSA (r=-0.45; P<0.001). Free PSA and f/tPSA were lower in the group with more aggressive inflammation. Conclusions Histological inflammation has a high prevalence in cancer-free prostate biopsy specimens and exerts similar effects on fPSA and f/tPSA levels as PC. Our study suggests histological prostatitis to be an important cause of decreased fPSA and f/tPSA values; therefore, when it is identified, antibiotic or anti-inflammatory therapy should be introduced to reduce the percentage of men with a continuing indication for prostate biopsy.
The Association Between Drug Related Deaths and Prior Contact with Hospital-Based Services
Authors: Thanacoody RHK , Jay J , Sherval J 
Published: March 2011

Reducing drug related deaths has been identified as a health priority by the Scottish Executive. Aims This study investigates the association between drug related deaths in the Lothian region and prior contact with hospital-based services in the Edinburgh Royal Infirmary. Design/Setting Retrospective analysis of 90 drug related deaths in Lothian from 2003-2005. Hospital episodes within five years of death were identified by searching the electronic patient record system within the Edinburgh Royal Infirmary. Findings Seventy-five of the 90 drug related deaths occurred in the hospital catchment area. Forty five of these 75 deaths (60%) occurred in patients who had used hospital-based services in the previous five years. The median time from hospital contact to deaths was five months and median number of hospital attendances/admissions was three (range 1 – 26). Conclusion Liaison between emergency departments, clinical toxicology services and community based drug addiction services is important to identify drug misusers at high risk. A hospital-based specialist nurse-led liaison service may be able to fulfil this role.
To See or Not to See? ……. That is the question: An analysis of out-patient follow-up arrangements and non-attendance in a community paediatric population
Authors: Cordiner D , Logie L , Becher Jc 
Published: March 2011

Objective To investigate the relationship between the number of outpatient appointments made; the distance traveled to attend these and the proportion of these appointments missed. Design Retrospective Cohort Study. Setting Community Paediatrics. Participants Eighteen pre-school children on the Special Needs Register. Results With an increase in the number of appointments made and the distances involved in attending these, the number of missed appointments tends to increase. Conclusions We need to educate parents as to the importance of follow-up, include families in decision making about appointments and rationalize the number of appointments made.
Emergency Percutaneous Endovascular Stenting of a Spontaneous Ruptured Popliteal Aneurysm
Authors: Rj Drummond , Murch C , Kettlewell S 
Published: March 2011

Spontaneous rupture of a popliteal aneurysm is a relatively uncommon event with a significant risk of limb loss. The elderly patient with multiple co-morbidities presents a particular risk for surgical intervention in these cases. In this case we present such a situation successfully treated by endovascular means with a satisfactory outcome.
Acute limb ischemia as a first presentation of a thyrotoxic patient: A Case Report
Authors: Yassin Musaab , Canna Khalid , Bain Donald 
Published: March 2011

Introduction Arterial embolism in thyrotoxic atrial fibrillation is more common than is realized and can be the first presentation of undiagnosed hyperthyroidism. Report Acute limb ischemia as a first presentation of hyperthyroidism Discussion A medical condition can modify a surgical approach to achieve successful results.
Survey of Anaphylaxis Management by General Practitioners in Scotland
Authors: Lowe G , Kirkwood E , Harkness S 
Published: March 2011

Aim To obtain a snapshot of how patients with potentially lifethreatening allergies are managed within a Primary Care setting. Methodology A questionnaire-based survey sent to all General Practitioners in Scotland. Results Six hundred and thirteen replies were suitable for analysis. Ninety percent of respondents had prescribed adrenaline auto-injector pens, almost exclusively the EpiPen device. Less than half were personally confident in their use and only 17% had access to a dummy trainer pen for demonstration purposes. Twenty seven percent would prescribe one auto-injector only. Six percent reported accidental mis-firing of adrenaline pens, although with no serious sequelae. Refusal of pens by patients was noted by 1%. In the event of an anaphylactic emergency, 90% of respondents would use adrenaline as first-line treatment, although only half would use the UK Resuscitation Council recommended adult dose of 0.5mg by the intramuscular route (or 0.3mg by auto-injector). Eleven percent would give adrenaline by the slower subcutaneous route and 3% by the intravenous route. Thirty six percent had themselves treated such a case outside of hospital. Sixty two percent of respondents would seek specialist investigation of anaphylaxis, although only 31% felt that ready access was available. Frequent concerns were raised about current provision of care for patients with allergic disease and their own ability to deal with this. Conclusion Investment is required, both to provide basic training and ongoing support for Primary healthcare staff in the management of allergic disease, and also for necessary accompanying specialist support.
Scottish Stroke Research Network: the first three years
Authors: McCormick K , Langhorne P , Graham FEJ , McFarlane C ,   CLOTS collaboration
Published: March 2011

Research networks were introduced in the UK to facilitate and improve clinical research and stroke was seen as a priority topic for local research network development. The Scottish Stroke Research Network (SSRN) is one of 11 stroke research networks in the UK. In this article we review the progress of the Scottish Stroke Research Network in the three years since inception. Between 2006–2009 the number of active hospital research sites has increased from 10 to 22 expanding to involve 20 stroke research nurses. There was a corresponding 58% increase in recruitment of participants into stroke studies, from 376 in 2006/07 to 594 in 2008/09. The majority (17/20) of our current studies are interventional. Data from one of these, the CLOTs trial (Clots in Legs Or sTocking after Stroke), demonstrates that the annual recruitment in Scotland increased from a median of 94 (range 6–122) patients per year in the six years before the SSRN, to 140 (135–158) patients per year after SSRN involvement. We currently screen about 50% of Scottish stroke patients and approximately 5% of Scottish stroke patients are participating in research studies that we support. The SSRN has made good progress in the first three years. Increasing the recruitment of screened patients remains a challenge.
Current Practice of Obtaining Informed Consent for Local Steroid Injection among the Shoulder and Elbow Surgeons in United Kingdom
Authors: Lim CS , Miles J , Peckham TJ 
Published: March 2011

Background Local steroid injection is a common procedure and not without risks. Aim To establish the current practice of obtaining informed consent for local steroid injection among shoulder and elbow surgeons in the UK. Methods A postal questionnaire survey was distributed to 176 orthopaedics surgeons in UK who were members of the British Elbow and Shoulder Society. Results 68% of the surgeons considered local steroid injection invasive. 88% of the surgeons obtained verbal consent only. Of these, only 19% recorded the discussion. Almost all the surgeons (96%) explained the desired effects and 26% provided statistical evidence of local steroid injection. About 88% of the surgeons mentioned other drugs included in the injection. Only 13% of them mentioned the dose of the steroid used. 82% and 77% of the surgeons offered alternative treatment options and the right to refuse injection respectively. 85% and 59% of the surgeons discussed local and systemic risks of steroid injection, respectively. The most common risk mentioned by the surgeons is short term increase of pain. Conclusions Majority of the surgeons used verbal consent only for local steroid injection. The consent discussion was not regularly documented in case notes and the information delivered varies.
A Dynamic Model of Sponsored Search Advertising
Authors: Yao Song , Mela Carl F. 
Published: March 2011

Sponsored search advertising is ascendant—Forrester Research reports expenditures rose 28% in 2007 to $8.1 billion and will continue to rise at a 26% compound annual growth rate [VanBoskirk, S. 2007. U.S. interactive marketing forecast, 2007 to 2012. Forrester Research (October 10)], approaching half the level of television advertising and making sponsored search one of the major advertising trends to affect the marketing landscape. Yet little empirical research exists to explore how the interaction of various agents (searchers, advertisers, and the search engine) in keyword markets affects consumer welfare and firm profits. The dynamic structural model we propose serves as a foundation to explore these outcomes. We fit this model to a proprietary data set provided by an anonymous search engine. These data include consumer search and clicking behavior, advertiser bidding behavior, and search engine information such as keyword pricing and website design. With respect to advertisers, we find evidence of dynamic bidding behavior. Advertiser value for clicks on their links averages about 26 cents. Given the typical $22 retail price of the software products advertised on the considered search engine, this implies a conversion rate (sales per click) of about 1.2%, well within common estimates of 1%–2% [Narcisse, E. 2007. Magid: Casual free to pay conversion rate too low. GameDaily.com (September 20)]. With respect to consumers, we find that frequent clickers place a greater emphasis on the position of the sponsored advertising link. We further find that about 10% of consumers do 90% of the clicks. We then conduct several policy simulations to illustrate the effects of changes in search engine policy. First, we find the search engine obtains revenue gains of 1% by sharing individual-level information with advertisers and enabling them to vary their bids by consumer segment. This also improves advertiser revenue by 6% and consumer welfare by 1.6%. Second, we find that a switch from a first- to second-price auction results in truth telling (advertiser bids rise to advertiser valuations). However, the second-price auction has little impact on search engine profits. Third, consumer search tools lead to a platform revenue increase of 2.9% and an increase of consumer welfare by 3.8%. However, these tools, by reducing advertising exposures, lower advertiser profits by 2.1%.
Clinical Laboratory Detection of AmpC β-Lactamase
Authors: Rand Kenneth H. , Turner Bradley , Seifert Hilary , Hansen Christine , Johnson Judith A. , Zimmer Andrea 
Published: March 2011

Abstract
Plasmid-mediated AmpC-producing Escherichia coli and Klebsiella pneumoniae have been associated with poor clinical outcomes, but they are not readily identified in hospital microbiology laboratories. We tested 753 gram-negative bloodstream isolates for AmpC by using the EDTA disk test and the modified Hodge test (n = 172) and the modified Hodge test alone (n = 581). The 30-day mortality for the AmpC group was 9% (2/23) and was 6% (3/51) for the control group. The clinical response was similar: afebrile on day 2 (AmpC group, 16/23 [70%]; control group, 32/45 [71%]) and on day 4 (AmpC group, 19/22 [86%]; control group, 37/44 [84%]). Patients with isolates in the AmpC group were more likely to be in an intensive care unit at the time of the positive blood culture (P = .01) and more likely to be intubated (P = .05) than patients with isolates in the control group. Effective antibiotic treatment within the first 48 hours was given to 47 (92%) of 51 patients with isolates in the control group but to only 14 (61%) of 23 patients with isolates in the AmpC group (P = .001). The modified Hodge test and the EDTA disk test did not identify patients at risk for a poor outcome from AmpC-producing bacterial infections.
Relationship Between Molecular Subtype of Invasive Breast Carcinoma and Expression of Gross Cystic Disease Fluid Protein 15 and Mammaglobin
Authors: Lewis Gloria H. , Subhawong Andrea Proctor , Nassar Hind , Vang Russell , Illei Peter B. , Park Ben Ho , Argani Pedram 
Published: March 2011

Abstract
We investigated the expression of gross cystic disease fluid protein 15 (GCDFP) and mammaglobin (MGB) by immunohistochemical analysis in 71 invasive breast carcinomas (IBCs) subtyped into luminal (A and B), HER2, basal-like carcinoma (BLC), and unclassified triple-negative carcinoma (UTNC) by established surrogate immunohistochemical profiles. GCDFP and MGB were less likely to be expressed in BLC than in HER2 cancers (P = .000021 and P = .013, respectively) or luminal cancers (P = .00002 and P = .00008, respectively). However, the difference in GCDFP or MGB expression between HER2 and luminal cancers was not significant (P = 1.0 and P = .671, respectively). Our results suggest that luminal cancers demonstrate similar degrees of apocrine differentiation as HER2 cancers. Most BLCs and UTNCs are negative for MGB and GCDFP. Correlation with clinical findings may be needed to exclude the possibility of a metastasis to the breast when BLCs or UTNCs are encountered in a limited sample such as a core biopsy sample.
Common Genomic Aberrations in Basaloid Squamous Cell Carcinoma and Carcinosarcoma of the Esophagus Detected by CGH and Array CGH
Authors: Schaefer Inga-Marie , Enders Christina , Polten Andreas , Haller Florian , Frölich Andreas M.J. , Cameron Silke , Schüler Philipp , Schweiger Peter , Gunawan Bastian , Beham Alexander , Füzesi László 
Published: March 2011

Abstract
Basaloid squamous cell carcinoma (BSCC) and carcinosarcoma of the esophagus are rare entities, making up fewer than 2% of esophageal malignancies. Comparative genomic hybridization (CGH) in 1 case of BSCC and 2 cases of carcinosarcoma and subsequent array CGH in 1 case each of BSCC and carcinosarcoma revealed common chromosomal gains at 2p25.3-2p12, 7q21.3-7q22.3, and 11q13.2-11q13.4. Chromosomal losses at 13q31qter were observed in both carcinosarcomas. In addition, progression of genomic instability from in situ to invasive carcinosarcoma could be demonstrated by using array CGH. Our observations suggest a common genetic origin of BSCC and carcinosarcoma.