bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symmetrical Brodie's abscess
Authors: Chambler A F W , Chapman-Sheath P J , Pearse M F , Hollingdale J 
Published: December 2008

Summary
Chronic recurrent multifocal osteomyelitis is often confused with symmetrical Brodie's abscess as it has a similar pathogenesis. We report an otherwise healthy 17-year-old boy presenting with a true symmetrical Brodie's abscess. We conclude that a symmetrical Brodie's abscess presenting in an otherwise healthy patient is a separate clinical condition with a different management protocol.
Prostatic meningeal carcinomatosis presenting as delirium tremens
Authors: Rubins J B , Guzman-Paz M J 
Published: December 2008

Summary
We report an unusual case of prostatic carcinomatous meningitis and remind clinicians to maintain a high index of suspicion of meningeal involvement when patients with advanced prostatic cancer present with cerebral symptoms, back pain, or neurologic findings. The diagnosis may require repeated cytologic examinations of cerebrospinal fluid, and immunocytochemical stains should be considered to confirm a prostatic source if malignant cells are identified. Androgen ablative therapy may give prolonged remissions, especially in patients with previously untreated tumours.
Treatment of vitamin D deficient osteomalacia may unmask autonomous hyperparathyroidism
Authors: Taylor A V G , Wise P H 
Published: December 2008

Summary
Two cases of vitamin D deficient osteomalacia with secondary hyperparathyroidism are presented. In both cases treatment with vitamin D replacement therapy resulted in elevated calcium levels and a failure of parathormone levels to normalise, indicating autonomous parathyroid activity. Subsequent surgery in one case resulted in removal of a parathyroid adenoma. The importance of osteomalacia and its complications are discussed.
An obstetrics and gynaecology graduate residency programme in Venezuela
Authors: Faneite P 
Published: December 2008

Summary
We present our experience on the design and development of a gynaecology and obstetrics graduate residency programme, developed in the Department of Obstetrics and Gynecology at the Dr Adolfo Prince Lara Hospital, Puerto Cabello, Venezuela, in which medical specialists and residents participate synergistically. From January to September 1993, curricular activities were planned and students selected. The programme started in October 1993, with six residents for a three-year programme. Courses were given by medical specialists from the Department. In addition to a Programme Coordinator, there is also a Residents' Coordinator, appointed for a two-month term of office; specific functions were assigned for residents occupying this position. All the programmed activities for three years were accomplished, including lectures and rotations, with an important record of surgical interventions. In our grade system, residents got an average of 18 over a maximum of 20 points. Residents also participated as speakers in workshops, special courses and national medicinal meetings, in which they presented a total of nine papers. Activities were evaluated bimonthly in meetings with students and each semester by the Graduate Committee. The first class graduated in September 1996. Results suggest that resident participation in graduate programmes is an important part of their education.
An audit of prostate-specific antigen and clinical symptoms in general practice
Authors: Ramachandran S , Foster M C , Thomas D R , Roalfe A K , Hall R A 
Published: December 2008

Summary
The objective was to devise local guidelines for the referral of patients with suspected prostatic carcinoma following evaluation by a retrospective audit of the value of the prostate-specific antigen concentration, together with age, urological symptoms, and digital rectal examination in the diagnosis of carcinoma of the prostate. Relevant details were collected from the notes of 582 patients from general practice and hospital. The significant diagnostic factors were ascertained by stepwise logistic regression. Prostate-specific antigen concentration, digital rectal examination and significant terminal dribbling were the most powerful factors in the diagnosis of carcinoma of the prostate. When prostate-specific antigen concentration was considered in isolation, a value of 6.5 ng/ml appeared appropriate for referral. Age was not significant, perhaps due to the narrow patient age range. The significant diagnostic factors were built into an algorithm calculating the probability of carcinoma of the prostate. This algorithm, together with prostate-specific antigen concentration results and digital rectal examination findings, forms the basis of the referral guidelines and a subsequent prospective study.
Interprofessional learning
Authors: Parsell G , Bligh J 
Published: December 2008

Summary
Effective care in hospitals and in the community requires doctors, nurses and other healthcare professionals to work together to achieve the best possible outcomes for patients. In the UK, a shift in emphasis towards a primary care led service and recent changes to the ways in which healthcare is funded and organised, are profoundly affecting traditional patterns of working. Boundaries which define the roles and responsibilities of individual professions are becoming less clear and there is increasing overlap of knowledge and skills. The provision of effective patient care now depends much more on the individual practitioner's understanding of the need to collaborate within and between healthcare teams in community settings and the care provided in hospitals. This paper describes some of the ways in which those providing education and training for the professions are seeking to create opportunities for learners which will not only help them to understand the complexities of working in a multiprofessional healthcare environment, but also enable them to develop the skills and attitudes they need for interprofessional working. However, it is not yet established whether ‘learning together’ during basic training will result in better ‘working together’ in practice. Higher education institutions are understandably cautious about adopting new learning methods which make extra demands on decreasing resources. More studies are therefore needed to show whether interprofessional learning during basic education has an impact on future working practice.
Recognition and management of hypercholesterolaemia in patients awaiting elective coronary artery bypass grafting
Authors: Asimakopoulos G , Barlow C , Pillai R 
Published: December 2008

Summary
The recently published Scandinavian Simvastatin Survival Study showed that long-term treatment with simvastatin, in patients with ischaemic heart disease and serum cholesterol levels between 5.5 and 8.0 mmol/l, improved survival. The present study was conducted in order to evaluate whether patients with ischaemic heart disease awaiting coronary revascularisation are aware of their serum cholesterol levels and whether raised levels are being treated adequately. One hundred consecutive patients admitted from our waiting list for elective coronary artery bypass grafting, with or without valve replacement, were included in the study. The patients were asked whether they had a history of raised serum cholesterol and, if so, how this was being treated. Fasting serum cholesterol levels were subsequently taken in the morning before surgery. Forty-six patients gave a positive history of raised blood cholesterol levels; 25 of these were on cholesterol-lowering medication at the time of admission, 15 were on a lipid-lowering diet and six were not being treated. Thirty-one (67%) of these 46 patients had a serum cholesterol of more than 5.5 mmol/l, compared with 30 (56%) of the 54 patients without a positive history of hypercholesterolaemia, and 61% of the total 100 patients. These data suggest that an inadequate number of patients awaiting coronary artery bypass grafting are aware of their cholesterol status. The management of hypercholesterolaemia among these patients could be improved.
Advanced Trauma Life Support instructor training in the UK: an evaluation
Authors: Moss G D 
Published: December 2008

Summary
The paper reports on a questionnaire evaluation of the UK-based ATLS (Advanced Trauma Life Support) instructor course. The trainee instructors who responded were mainly at consultant grade with some senior registrars. The course was regarded as being very effective in achieving most of its objectives and in raising the confidence of postgraduate medical instructors, especially those lacking previous training in instructional methods. This is particularly so for practical skills training. The least effective areas of the course concern small group teaching and questioning techniques.
Occupational hydrocarbon exposure and nephrotoxicity: a cohort study and literature review
Authors: Pai P , Stevenson A , Mason H , Bell G M 
Published: December 2008

Summary
Hydrocarbon exposure has been shown to play an important role in the development of renal dysfunction in several occupational settings. In this study, renal screening was performed in a group of paint sprayers with exposure to hydrocarbon-based paints, recruited from a car manufacturing plant where personal protective equipment was widely used. The hydrocarbon exposure scores and various markers of renal injury were compared between these subjects and a group of paint sprayers from a previous study who did not use personal protective equipment regularly. Cumulative hydrocarbon exposure scores were calculated from a validated questionnaire. Serum creatinine, urinary total protein, albumin, transferrin, retinol-binding protein, and N-acetylglucosaminidase were evaluated, Both groups experienced heavy hydrocarbon exposure but sprayers who regularly used personal protective equipment had significantly reduced exposure scores due to improved skin and respiratory protection. A significant number of sprayers from both groups had elevated levels of serum creatinine. Interestingly, urinary N-acetylglucosaminidase activity, a marker of proximal tubular damage, was abnormal in a significant proportion of sprayers in the unprotected group but normal in those with improved protection.
Our results are in keeping with the hypothesis that hydrocarbon exposure through paint spraying may result in active proximal tubular damage which may be reduced by improvement of protection at the worksite. However, renal impairment independent of tubular injury may result from chronic paint exposure, even with improved protection.
Neurocysticercosis
Authors: Garg R K 
Published: December 2008

Summary
Neurocysticercosis is the most common parasitic disease of the central nervous system. Varied clinical manifestations occur, due to deposition of larvae of the parasite Taenia solium in cerebral parenchyma, meninges, spinal cord, muscles, eyes and skin. The diagnosis of neurocysticercosis can be made with a fairly high degree of accuracy with the help of computed tomography and magnetic resonance imaging. Serological tests and histopathological examination of subcutaneous nodules provide additional support in establishing the diagnosis. The anticysticercal drugs albendazole and praziquantel have been extensively used, and found to be effective for all types of neurocysticercosis. However, recently controversy has been raised about their safety, and long-term clinical usefulness. Preventive health measures, such as provision of safe drinking water and excretion disposal, still offer the best ways to manage this disease.
Common bile duct stenting for choledocholithiasis: a district general hospital experience
Authors: Bowrey D J , Fligelstone L J , Solomon A , Thomas G , Shandall A A 
Published: December 2008

Summary
The favoured treatment of common bile duct stones is endoscopic sphincterotomy and stone extraction. The management of those cases where duct clearance is not possible is controversial. At our institution it has been policy to insert an endoluminal stent. We report a retrospective review of the outcome of patients stented for common bile duct stones. The study population was 14 men and 22 women, with a median age of 73 years (range 23–89 years). Treatment-related morbidity was seen in nine patients (25%), comprising cholangitis (5), pancreatitis (3), and cholecystitis (1). Three of these patients died; all were over the age of 75 years and had been stented on a long-term basis. These data suggest that endobiliary stents can be employed with an acceptable complication rate. We suggest that patients under the age of 75 years be stented only as a temporising measure, but that patients over 75 years or those unfit on physiological grounds can be stented on a long-term basis as definitive treatment.
The potential role of soluble fibre in the treatment of hypercholesterolaemia
Authors: Coats A J S 
Published: December 2008

Summary
The three major modifiable coronary risk factors are smoking, hypertension, and hypercholesterolaemia. Serum cholesterol levels are above the desirable level of 5.2 mmol/l in 79% of men and 65% of women aged between 35 and 50 years and thus are an important target for intervention. In this paper, the role of nonpharmacological intervention with soluble fibre in treating mild to moderate primary hypercholesterolaemia is reviewed. Evidence from controlled studies shows that soluble fibre can be effective in lowering cholesterol by clinically significant amounts. It is stressed, however, that risk factors for coronary heart disease are interactive and attention is shifting to addressing multiple rather that individual factors.
Assessment and treatment of nutritional status in stroke patients
Authors: Gariballa S E , Sinclair A J 
Published: December 2008

Summary
Stroke illness imposes a heavy and costly work load on hospital and community care services, and life after stroke can be a miserable affair for stroke patients and their carers. Nutritional factors may have an important role in acute stroke and its outcome. From the limited amount of research undertaken it has been shown that a significant number of patients with stroke are undernourished on admission and their nutritional status deteriorates further as an in-patient. This is especially so for those who are most dependent, in whom undernutrition is also associated with increasing morbidity and mortality. There is some evidence that nutritional supplementation may improve nutritional status and reduce morbidity and mortality. However most clinically available nutrition screening instruments lack sensitivity and specificity, and abnormal nutritional indicators may simply reflect effects of age, functional disability, or severe underlying disease. Therefore, causal relationship cannot be assumed without a sufficiently powerful intervention study which adequately adjusts for the effects of non-nutritional factors, such as the number and severity of comorbid conditions on clinical outcome. Meanwhile, doctors, nurses and members of the multidisciplinary team looking after stroke patients should be made aware of the likely impact of poor nutritional status on clinical outcome.
Smoking and pursuit of thinness in schoolgirls in London and Ottawa
Authors: Crisp A H , Stavrakaki C , Halek C , Williams E , Sedgwick P , Kiossis I 
Published: December 2008

Summary
It has been proposed that teenage girls often smoke cigarettes to protect themselves from the impulse to binge eat, with its feared weight-gain consequences, particularly when other measures such as greater dietary restraint have failed. The present study looked at the relationship between body mass index and standardised questionnaire responses concerning smoking, alcohol consumption, moods, weight changes, attitudes to body weight and shape, dietary patterns and menstruation in 1936 British (London) and 832 Canadian (Ottawa) schoolgirls. Data analysis revealed links between cigarette smoking and body weight/shape concerns, and awareness by subjects of these links; there was also a tendency for smokers in these two populations to be overweight but not grossly obese. Smoking was also related at all ages to being postmenarchal. The London population in particular revealed an association between smoking and a weight loss of 7 kg or more at some stage since puberty. Smoking was also linked, in a minority, with regular vomiting undertaken as a further defence against weight gain when overeating had occurred. These associations existed alongside the major and predictable association found between alcohol consumption and smoking. Similarities between the British and Canadian schoolgirls were striking in respect of rank order of reasons given for smoking and consequences of giving it up. Since smoking amongst older women is reportedly associated with below-average body weight it may indeed be effective in helping to curb weight gain. Our study provided little evidence of association between smoking and generalised anxiety or social anxiety (in either population), or depression (in the British cohort). We suggest that any preventive psychological approach to teenage female smoking should include attention to weight gain anxiety and consequent pursuit of thinness.
Cutaneous sarcoidosis
Authors: Wilson N J E , King C M 
Published: December 2008

Summary
Sarcoidosis is a multi-organ granulomatous disorder of unknown cause. Skin sarcoidosis occurs in about 25% of patients with systemic disease and may also arise in isolation. A wide range of clinical presentations of cutaneous sarcoidosis is recognised. The diagnosis rests on the presence of non-caseating granulomas on skin biopsy and the exclusion of other granulomatous skin disease. The treatment and overall prognosis of cutaneous sarcoidosis is primarily dependent on the degree of systemic involvement. In patients with aggressive disease limited to the skin immunosuppressive therapy may be indicated.
Spontaneous haemothorax: a cause of sudden death in von Recklinghausen's disease
Authors: Griffiths A P , White J , Dawson A 
Published: December 2008

Summary
Vasculopathy is a relatively frequent but poorly recognised manifestation of von Recklinghausen's neurofibromatosis. One of its more dramatic presentations is as spontaneous haemothorax. Clinicians and pathologists should be aware of this syndrome as a cause of sudden death in patients with neurofibromatosis.
The best management for ‘crescendo biliary colic’ is urgent laparoscopic cholecystectomy
Authors: Robertson G S M , Wemyss-Holden S A , Maddern G J 
Published: December 2008

Summary
Gallbladder disease due to stones is well recognised as falling into two categories, presenting with either chronic symptoms or developing acute cholecystitis or other complications. We describe an intermediate group of 14 patients (11 women, three men, median age 31 years) presenting with 4–14 days of at least daily attacks of resolving biliary colic, who underwent early laparoscopic cholecystectomy within 24 hours of presentation. None had any evidence of acute inflammation, either at laparoscopy or on histology. Their surgery was straightforward with operating times ranging from 35-80 minutes and no complications. Patients with ‘crescendo biliary colic’ are often young women who can rarely afford invalidity. Rather than the current practice of analgesia for each attack and elective surgery weeks later, they are optimally managed by urgent laparoscopic cholecystectomy, preventing the development of complications and minimising the need for further medical involvement.
Abnormal liver function tests following inadvertent inhalation of volatile hydrocarbons
Authors: Pyatt J R , Gilmore I , Mullins P A 
Published: December 2008

Summary
The use of aerosols containing volatile hydrocarbons in conditions of poor ventilation can result in accidental overexposure which can cause central nervous system effects and hepatic injury. We present a case in which inadvertent usage of an adhesive spray used to make greeting cards resulted in vague neurological symptoms and abnormal liver function tests both of which fully resolved on discontinuation.
DISSIPATIVE ENTROPY AND GLOBAL SMOOTH SOLUTIONS IN RADIATION HYDRODYNAMICS AND MAGNETOHYDRODYNAMICS
Authors: ROHDE CHRISTIAN , YONG WEN-AN 
Published: December 2008

The equations of ideal radiation magnetohydrodynamics (RMHD) serve as a fundamental mathematical model in many astrophysical applications. It is well known that radiation can have a damping effect on solutions of associated initial-boundary-value problems. In other words, singular solutions like shocks can be prohibited. In this paper, we consider discrete-ordinate approximations of the RMHD-system for general equations of state. If the magnetic fields are absent (i.e. if we consider radiation hydrodynamics), we prove the existence of global-in-time classical solutions for the Cauchy problem in one space dimension under an appropriate smallness condition on the inital data. We also show that counterparts of the compressive shock waves for the full RHD case and counterparts of the slow and fast MHD shock waves for the full RMHD-system can have structures in the presence of radiation if the amplitude is sufficiently small. Moreover, a new entropy function for the RMHD-system is presented.
AN EXPLORATORY VIEW OF EMERGING RELATIONSHIP BETWEEN CORPORATE SOCIAL AND FINANCIAL PERFORMANCE IN CANADA
Authors: MAY PETER , KHARE ANSHUMAN 
Published: December 2008

This study uses primary research methods to determine whether a corporate social performance (CSP)–corporate financial performance (CFP) relationship exists within the Canadian context through examination of publicly-traded Canadian-based companies.The empirical findings demonstrate a positive CSR–CFP relationship, typically with CFP preceding CSP (although this does not preclude a relationship in the other direction) when using accounting-based measures of financial performance and as applied to the Top 1000 firms in Canada as ranked by profitability. This positive relationship was not confirmed when compared to the Top 500 companies ranked by profitability (i.e., with the "bottom 500" removed). In addition, the positive relationship did not occur with respect to market-based measures of financial performance (i.e., share performance).In addition, the study noted two possible issues that may have influenced the findings although the extent of such influences (if they exist) is not known. The first of these relates to a predilection amongst the CSR-rankings towards firms with high profitability. Almost all of the top-ranked CSR leaders are from the Top 500 firms in Canada as ranked by profitability and nearly three-quarters are from the Top 100. The second issue is the potential bias of the CSR-ranking methods themselves. This may have resulted in the inclusion of some firms with more questionable reputations in the rankings as well as the lack of continuity from year to year of CSR-leaders amongst the three rankings examined.This exploratory study sets the stage for more detailed analyses within a Canadian context in the future.
When Did Herod the Great Reign?
Authors: Steinmann Andrew 
Published: December 2008

AbstractFor about 100 years there has been a consensus among scholars that Herod the Great reigned from 37 to 4 BCE. However, there have been several challenges to this consensus over the past four decades, the most notable being the objection raised by W.E. Filmer. This paper argues that Herod most likely reigned from late 39 BCE to early 1 BCE, and that this reconstruction of his reign can account for all of the surviving historical references to the events of Herod's reign more logically than the current consensus can. Moreover, the reconstruction of Herod's reign proposed in this paper accounts for all of the datable evidence relating to Herod's reign, whereas the current consensus is unable to explain some of the evidence that it dismisses as ancient errors or that it simply ignores.