bluuebunny/crossref_metadata_2025_split huggingface dataset:
Methamphetamine-Associated Burn Injuries: A Retrospective Analysis
Authors: Danks Roy R. , Wibbenmeyer Lucy A. , Faucher Lee D. , Sihler Kristen C. , Kealey G Patrick , Chang Phyllis , Amelon Marge , Lewis Robert W. 
Published: September 2004

Abstract
Methamphetamine production and use has increased dramatically during the past 10 years. Methamphetamine production requires combining hazardous and volatile chemicals that expose the manufacturer to burn injuries from explosions and chemical spills. We sought to review the epidemiology of burn injuries in a rural burn center secondary to the use of amphetamine or methamphetamine and/or the manufacture of methamphetamine. Review of the records of 507 patients who were admitted to our burn unit from December 1, 1998, to December 31, 2001, revealed 34 patients who were involved in the use of amphetamines or methamphetamines and/or the manufacture of methamphetamine. Thirty-one patients tested positive for either amphetamine (n = 2) or methamphetamine (n = 29) on routine admission urine drug screens. Twenty of these patients were involved in the manufacture of methamphetamines. Three additional patients were identified as methamphetamine manufacturers but tested negative for the use of methamphetamines. The mean age of the study population was 31.88 ± 7.65 years, with a male:female ratio of 10.3:1. The average burn size was 18.86 ± 20.72, with the majority secondary to flame (n = 26). Patient burn admission histories were vague, and the patient's involvement in the manufacture of methamphetamine was often only later confirmed by media, the fire marshal, family members, or the patient. Fifteen patients showed the usual withdrawal pattern of agitation and hypersomnolence, with seven patients requiring detoxification with benzodiazepines. Two were admitted acutely to the psychiatric ward for uncontrollable agitation. Eighteen patients were offered chemical dependency treatment, and two completed therapy. There was one mortality. The mean cost per person was $77,580 (range, $112–$426,386). The increasing use of and manufacture of methamphetamine presents new challenges for the burn team because these patients can become violent and frequently need assistance with detoxification. Routine drug screens are mandatory in identifying methamphetamine use to alert burn unit personnel to particular management problems and target individuals who may be receptive to drug rehabilitation.
Milk Bottle Burns
Authors: Ali Syed N. , O'toole Greg , Tyler Michael 
Published: September 2004

Abstract
In recent years numerous infants have been treated at Stoke Mandeville Hospital's Burns' Unit for scalds sustained in accidents that occurred during the preparation of warm milk. These were significant burns affecting young children with susceptibly thin skin that often resulted in the injured child requiring a long stay in hospital. Frequently, formal intravenous fluid resuscitation was required as was burn excision and skin grafting. We recommend the use of milk bottle warmer to avoid all the hazards associated with use of different techniques of warming milk bottle.
Endometrial ablation for von Willebrand disease‐related menorrhagia – experience with seven cases
Authors: Rubin G. , Wortman M. , Kouides P. A. 
Published: September 2004

Summary.  Background:  Endometrial ablation has recently gained popularity as a treatment of menorrhagia in the general population. In the von Willebrand disease (VWD) patient, intuitively, it would appear that the failure rate would be higher because of the underlying hypocoaguability increasing the likelihood for re‐bleeding. In a consecutive series of seven patients, we assessed the efficacy and safety of endometrial ablation in VWD‐related menorrhagia.Patients and methods:  We performed a retrospective analysis using chart review and a 21‐item questionnaire administered to seven (six type 1, one type 2A) women who underwent endometrial ablation between the years 1997 and 2001. Parameters assessed included operative complications, the development of abdominal pains, recurrence of menstrual bleeding post‐ablation and the change in the pre‐/post‐ablation quality of life (QOL). Three patients underwent endomyometrial resection and one each underwent rollerball, thermal, electrocautery and balloon ablation. All patients were pre‐treated with i.v. desmopressin (DDAVP) except the 2A patient who received Humate P. Mean age of the patient was 41 ± 6 years and follow‐up was for 45 months (range 31–73) post‐ablation.Results:  No significant perioperative bleeding complications were observed in any of the patients. All patients initially responded (two amenorrhoea, four hypomenorrhoea, one moderate improvement). In all patients, QOL assessed by 10 parameters improved significantly following the ablation procedure, regardless of the specific technique used. However, at the end of follow‐up, only one patient remained amenorrheic, one was hypomenorrheic, one had moderate improvement and four patients experienced recurrence of menorrhagia, three eventually requiring a hysterectomy at a median of 11 months post‐ablation.Conclusion:  Endometrial ablation appears to be a safe procedure that improves the QOL in patients with VWD‐related menorrhagia. However, its long‐term efficacy appears to be lower in VWD patients when compared with women with menorrhagia without VWD.
An examination of senior nursing roles: challenges for the NHS
Authors: Williams Angela , McGee Paula , Bates Lindsay 
Published: September 2004

Summary• Wellhouse NHS Trust moved its inpatient services to the new Barnet General Hospital in 1997 and merged with Chase Farm Hospital NHS Trust in 1999.• To assist with the trust's management of resulting changes in care provision, a short project was conducted to examine the nursing services provided by ward managers (20) and senior nurses (27), that is nurses who undertake specialist/advanced nursing practice.• The project also aimed to present the views of the stakeholders (66) with regard to nursing in the trust and nurse‐led services. The project involved two stages of data collection – focus groups and postal questionnaires.• The project provided a great deal of information about the nursing service within the trust: a profile of the senior nurses, roles and responsibilities, skills and competencies, training and development, and support needs for their roles.• The findings considered a number of issues: (i) employment – diversity of grading for posts; (ii) work roles – conflicts in role composition; (iii) stakeholders – perspectives of stakeholders on nursing.• It is anticipated that the findings are not unique to the one trust and that they will contribute to the development of new clinical career pathways for senior nurses within the trust.
Mothers’ expressed emotion towards children with and without intellectual disabilities
Authors: Beck A. , Daley D. , Hastings R. P. , Stevenson J. 
Published: September 2004

AbstractObjectives  To identify factors associated with maternal expressed emotion (EE) towards their child with intellectual disability (ID).Design and method  A total of 33 mothers who had a child with ID and at least one child without disabilities between the ages of 4 and 14 years participated in the study. Mothers completed self‐assessment questionnaires which addressed their sense of parenting competence, beliefs about child‐rearing practices, and their reports of behavioural and emotional problems of their child with ID. Telephone interviews were conducted to assess maternal EE towards the child with ID and towards a sibling using the Five Minute Speech Sample (FMSS; Magana et al. 1986), and also to assess the adaptive behaviour of the child with ID using the Vineland Adaptive Behaviour Scale (VABS; Sparrow et al. 1984).Results  Mothers with high EE towards their child with ID were more satisfied with their parenting ability, and their children had more behaviour problems. Analysis of differential maternal parenting, through comparisons of EE towards their two children, showed that mothers were more negative towards their child with ID for all domains of the FMSS except dissatisfaction.Conclusions  A small number of factors associated with maternal EE towards children with ID were identified. Differences in maternal EE towards their child with ID and their other child suggest that EE is child‐driven rather than a general maternal characteristic. Implications of the data for future research are discussed.
Prevention of unintentional injury to people with intellectual disability: a review of the evidence
Authors: Sherrard J. , Ozanne‐Smith J. , Staines C. 
Published: September 2004

AbstractBackground Recent research evidence shows that people with intellectual disability (ID) have double the unintentional injury risk of the general population and the risk is further increased in the presence of psychopathology and epilepsy. The pattern of injury and the circumstances surrounding an injury event in those with ID have some similarity with that of young children in the general population. Interventions to prevent injuries are an important health priority in this vulnerable population. This paper reviews evidence from injury prevention studies for people with ID and also considers the relevance of general population injury interventions for this population.Method Information regarding injury prevention in both ID and general populations was identified using online systems and consultation with research and public health organizations.Results Few published studies were identified addressing the issue of injury prevention for those with ID. Possible injury prevention strategies appropriate for the major causes of injury in the ID population were identified from the general population literature. While many environmental injury prevention strategies for young children in the general population are applicable to the population with ID, some may require design modification to ensure effectiveness. Other promising approaches include improved information for parents/carers, primary care physician counselling, and home visits by well‐informed and motivated professionals. There may be injury prevention benefit from improved management of psychopathology and epilepsy.Conclusions The issue of injury prevention for those with ID has not been addressed to the extent that the magnitude of the problem requires. Injury prevention programmes trialling a variety of evidence‐based approaches and strategies are needed to protect the quality of life for the ID population and their families.
Cross‐cultural working in community learning disabilities services: clinical issues, dilemmas and tensions
Authors: Summers S. J. , Jones J. 
Published: September 2004

AbstractBackground  People with learning disabilities from minority ethnic communities face many layers of disadvantage. Providing services that are culturally appropriate and sensitive can be difficult.Method  Through the use of clinical examples the issues, tensions and dilemmas raised for a community learning disabilities team in attempting to provide culturally sensitive services in an increasingly multicultural environment are discussed. Ways in which good practice can be more closely achieved are debated.Conclusions  Conflicts between the principal service values of individuality, choice, promotion of mental health and normalization, whilst also respecting the beliefs and values of other religions and cultures, can raise tensions and dilemmas for learning disabilities services. The importance of sensitive and appropriate service configuration, sharing of good practice, and good staff training are emphasized.
Cutaneous manifestations associated with antiphospholipid antibodies
Authors: Diógenes Maria José Nogueira , Diógenes Pedro Coelho N. , De Morais Carneiro Raquel Maia , Neto Carlos C. Ribeiro , Duarte Fernando B. , Holanda Rosangela R. A. 
Published: September 2004

AbstractBackground  Primary Antiphospholipid Antibody Syndrome (PAAS) is characterized by detection of antiphospholipid antibodies associated with venous or arterial thrombosis and/or miscarriages by patients with no other associated disease such as systemic lupus erythematosus (SLE). Primary Antiphospholipid Antibody Syndrome has many clinical manifestations of which dermatological ones are probably the most common. The purpose of this study was to determine the frequency of each cutaneous lesion, describing clinical features essential for diagnosis, in patients with Antiphospholipid Antibody Syndrome (AAS) attending Walter Cantídio University Hospital.Methods  Sixty patients with clinical findings suggestive of AAS were screened, and submitted for clinical and laboratory evaluations including lupus anticoagulant (KCT), anticardiolipin antibodies (IgG and IgM: ELISA), routine laboratory tests and screening tests for possible associated conditions.Results  Twenty‐five cases of primary and 14 cases of secondary AAS were diagnosed by clinical and laboratory evidences. Persistent elevated antiphospholipid antibodies without history of thromboembolic events or miscarriages were demonstrated in 21 patients. Forty percent of the patients with AAS had a cutaneous feature as the major complaint. These were dermographism (15), acrocyanosis (13), urticaria (9), diffuse alopecia (9), livedo reticularis (seven), Raynaud's phenomenon (three), purpura (two), ulcers and necrosis (four), nodules (four), pterygium ungueum (one) and subungual hemorrhage (one).Conclusions  Dermatological complaints are very frequent in patients with AAS and may be the first clue to the syndrome. Therefore a careful history and detailed physical examination are essential to diagnose AAS. All dermatologists should investigate the possibility of AAS when facing cutaneous findings related to venous or arterial thrombosis or microthrombosis.
Alpha‐1‐antitrypsin deficiency associated with panniculitis treated with plasma exchange therapy
Authors: De Oliveira Priscila , Paz‐Melgar Libania , Takahashi Maria Denise F. , Nico Marcello Menta S. , Rivitti Evandro A. , Mendrone Alfredo , Tatsui Nelson H. 
Published: September 2004

AbstractBackground  Alpha‐1‐antitrypsin is the principal serum protease inhibitor. In addition to the well‐recognized association with early‐onset emphysema and cirrhosis, alpha‐1‐antitrypsin deficiency may be associated with panniculitis. The treatment of this type of panniculitis presents a significant challenge. Previous attempts using immunosuppressive, anti‐inflammatory, and cytotoxic drugs have shown variable results.Aim  To report a case of alpha‐1‐antitrypsin deficiency‐associated panniculitis treated with plasma exchange therapy.Methods  A 23‐year‐old patient developed painful red nodules on her thighs and buttocks with spontaneous ulceration and discharge of oily fluid. A skin biopsy specimen showed septal and lobular panniculitis. The serum alpha‐1‐antitrypsin level was 22 mg/dL. She was treated with plasma exchange therapy.Results  Treatment of this patient with plasma exchange therapy led to the control of the cutaneous lesions.Conclusions  Plasma exchange therapy represents an alternative treatment which restores serum and tissue alpha‐1‐antitrypsin levels. This method is proposed because of its clinical benefits and greater availability.
Awareness of, knowledge of and attitudes to nonmelanoma skin cancer (NMSC) and actinic keratosis (AK) among physicians
Authors: Halpern Allan C. , Hanson Laura J. 
Published: September 2004

AbstractBackground  Nonmelanoma skin cancer (NMSC) is the most common type of cancer that affects the Caucasian population. Approximately 80% of NMSCs are basal cell carcinoma (BCC) and 20% are squamous cell carcinoma (SCC). Actinic keratosis (AK) is a precancerous lesion that may develop into SCC.Methods  A market research survey was conducted in which dermatologists and primary care physicians (PCPs) were randomly selected from seven countries (USA, Australia, UK, Italy, France, Germany and Spain). Their knowledge of nonmelanoma skin cancer and their current clinical practice were assessed.Results  In total, 2100 physicians took part in the survey. They had practised medicine for between 1 and 30 years and saw at least 30 patients in a typical week. The majority of dermatologists (97%) were familiar with BCC and AK, and treated each condition with a minimum of referrals. PCPs were more familiar with BCC (90%) than with AK (74%). Of the PCPs that were aware of BCC, only 31% treated the condition, and of those aware of AK, 40% treated the condition. Surgery was the most common choice of treatment for BCC. The most popular treatment choice for AK lesions was cryotherapy. Eighty to 100% of physicians reported that they discussed skin cancer prevention with their patients. A much lower number of physicians (ranging from 5 to 37%) provided educational material to patients. Overall, PCPs in the two countries that have a high incidence of NMSC (USA and Australia) were more familiar with BCC and AK and more likely to treat each condition than PCPs in Europe. All physicians rated BCC as a more serious condition than AK. Facial lesions were considered more serious than lesions on the head or trunk for both conditions.Conclusions  As the burden of disease and the number of patients seeking treatment for NMSC increase, dermatologists are well placed to lead educational initiatives for PCPs and provide educational material for patients. This would increase awareness of AK and BCC and could improve early diagnosis.
Penile self‐injections: an unusual act
Authors: Al‐Mutairi Nawaf , Sharma Ashok K. , Zaki Amr , Nour‐Eldin Osama , Joshi Arun 
Published: September 2004

A 42‐year‐old healthy Thai male presented with a 1‐week history of painful swelling of the penis following self‐injection of two tablets of vitamin A dissolved in 10 mL of tap water with an unsterilized syringe, in order to achieve a more prolonged erection for sexual intercourse, on a friend's advice. He injected himself all around the penile shaft “just under the skin.” Eight hours after injection, the penis started to become progressively swollen and painful, but it was a further 2 days before he presented to our clinic. He denied a history of any urinary obstructive or irritative symptoms. There was no history of genital ulceration or urethral discharge or any similar acts of self‐injection in the past.Physical examination revealed a markedly edematous, erythematous, and tender penis with multiple yellowish pus discharge points and small superficial ulcerations all around the shaft. The scrotum also showed mild edema and tenderness. There was tender bilateral inguinal lymphadenopathy. The patient was febrile (temperature, 39 °C) and was admitted. Complete blood count revealed a raised white blood cell count of 19.1 × 109/L. Urinalysis was normal. Ultrasonography of the genitalia revealed soft tissue thickening and multiple small collections of pus in the subcutaneous penile tissue; the corpora cavernosa and corpus spongiosum were normal. The patient declined urethrography.Cultures of blood and urine were sterile. Pus culture revealed Staphylococcus aureus. Microscopic examination of the discharge did not show any granular material. A biopsy was deferred at this stage considering the pyogenic nature of the patient's presentation. Parenteral antimicrobials, including ceftazidime, gentamicin, and metronidazole, were started. The patient's temperature rapidly fell to normal and, over a period of 10 days, the pus discharge points and pain and swelling of the penis resolved (Fig. 1) and the inguinal lymphadenopathy subsided. The patient was discharged with advice for regular follow‐up for any late sequelae. The patient refused to undergo psychiatric evaluation and counseling.Edema and induration of the penis after 10 days of therapy. Resolving superficial erosions are also seenimage
Epidemiology of Kaposi's sarcoma in patients with acquired immunodeficiency syndrome in São Paulo, Brazil
Authors: Yoshioka Márcia Cristina Naomi , Alchorne Mauricio Mota de Avelar , Porro Adriana Maria , Tomimori‐Yamashita Jane 
Published: September 2004

AbstractBackground  Kaposi's sarcoma (KS) is the most frequent neoplasm in patients with acquired immunodeficiency syndrome (AIDS). Although many studies on KS epidemiology have been performed in other countries, few have been carried out in Brazil despite the high incidence of AIDS.Methods  One hundred and seven KS patients seen in São Paulo, Brazil, between August 1995 and November 1998 were studied. The patients were followed for 1 year with assessment of the immunologic status, improvement of the lesions, treatment, and causes of death at the end of this period.Results  KS occurred mainly in men (94.4%) with a mean age of 37 years, and 25.2% of these patients were found to be human immunodeficiency virus (HIV) seropositive through KS. HIV was acquired mainly through homosexual contact. The patients presented an average of 15.9 KS lesions at the first visit and the mean duration of KS lesions before the first visit was 15.5 months. The clinical presentation was predominantly papules and plaques, and 33.6% presented with mucosal and/or visceral disease. KS affected mainly the lower limbs. The mean time since the diagnosis of HIV infection was 42.4 months. The CD4+ cell count was lower than 200 cell/mm3 in 60.8% of patients, but patients with a complete response showed an improvement in immune status after 1 year. Patients who did not show progression received a protease inhibitor as part of highly active antiretroviral therapy (HAART). Patients treated exclusively with HAART presented a complete response (61.6%), partial response (23%) or progression (15.4%) of KS.Conclusions  An improvement in immune status and the use of HAART were the most important prognostic features.
Cutaneous hyalohyphomycosis caused by Paecilomyces lilacinus: report of three cases and review of the literature
Authors: Hall Virginia C. , Goyal Sanjiva , Davis Mark D. P. , Walsh John S. 
Published: September 2004

AbstractCutaneous infection with Paecilomyces lilacinus is encountered worldwide, with most infections occurring either iatrogenically or in immunocompromised hosts. We report three cases of cutaneous hyalohyphomycosis caused by P. lilacinus, one of which occurred in an immunocompetent individual. In addition, we review the 17 cases previously reported in the literature. Although this infection can be difficult to treat, most cases are not fatal. Most cases responded well to systemic azole antifungal agents, either alone or in association with surgical excision of the lesion. Paecilomyces species are saprophytic fungi found in soil and decaying organic matter. Infection in humans is rare, but when it occurs treatment is often difficult. We report three cases of cutaneous hyalohyphomycosis caused by P. lilacinus and review the 17 previously reported cases in which the clinical history and response to therapy were described.