bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Determinants of Private Medical Insurance Prevalence in England, 1997–2000
Authors: King Derek , Mossialos Elias 
Published: January 2005

Objective. The aim of this paper is to identify the factors that determine the prevalence of private medical insurance (PMI) in England.Data Sources/Study Setting. Secondary data sources are the British Household Panel Survey (BHPS) 1997–2000, Laing's Healthcare Market Review 1999–2000, the United Kingdom (U.K.) Department of Health's National Health Service Waiting Times Team, and the Work Force Statistics Branch of the Department of Health.Study Design. Logistic regression models for panel data were used to compare non‐PMI subscribers with individual subscribers and those with employer‐provided PMI.Data Collection/Extraction Methods. The BHPS data are collected by the Institute for Social and Economic Research at the University of Essex. Other data used were collected by Laing and Buisson and the U.K. Department of Health.Principal Findings. Individual PMI is more prevalent among the well‐educated and healthy. Income, age, sex, and political preference are key determinants of PMI prevalence for both individual and employer paid PMI. Individuals are also likely to reflect on information with regard to waiting times in deciding whether or not to purchase PMI cover. The withdrawal of the tax subsidy in 1997 to PMI subscribers over 60 years of age did not impact on their rate of withdrawal from PMI coverage relative to the rate among all PMI subscribers, but may have discouraged potential new subscribers.Conclusions. Current trends in the PMI market suggest that, over time, individually purchased PMI is likely to be partially displaced by PMI purchased as part of a company‐based plan. However, having PMI is linked to economic factors in both groups, suggesting a similar segment of the population valuing the responsiveness that PMI provides. Geographic factors relating to waiting times and supply‐side factors are associated with both individual and company‐based PMI. The withdrawal of the tax subsidy to individual subscribers older than age of 60 resulted in a significant decline in the demand for PMI. In particular, the number of new subscribers in this group declined substantially.
Editorials: L‐Carnitine Supplementation in Dialysis Patients: Does the Evidence Justify Its Use?
Authors: Steinman Theodore I. 
Published: January 2005

ABSTRACTBeginning January 1, 2003, the Centers for Medicare and Medicaid Services (CMS) initiated a national coverage determination for the use of levo‐carnitine (L‐carnitine) in end‐stage renal disease (ESRD) patients as a supplement for individuals defined as having a carnitine deficiency, accompanied by either erythropoietin (EPO)‐resistant anemia and/or symptomatic intradialytic hypotension. The CMS criteria established for use of this supplement is minimal because EPO‐resistant anemia and symptomatic intradialytic hypotension are never defined with any degree of scientific rigor. Even with the minimal criteria, CMS rejected 97% of the claims submitted over the first 6 months of the national coverage. Most importantly, scientific studies to justify use of the supplement do not exist. Based on limited scientific investigations, there appears to be no justification for the government paying for this supplement. A randomized, prospective, controlled study is needed to determine if there is any benefit from L‐carnitine supplementation. Pending appropriate scientific proof, I do not believe that we should continue to waste our limited ESRD resources on a treatment of unproven benefit.
Complications associated with cannula insertion techniques used for laparoscopy in standing horses
Authors: Desmaizières Louis‐Marie , Martinot Stephane , Lepage Olivier M. , Bareiss Emmanuel , Cadoré Jean‐Luc 
Published: January 2005

Objective—To report our experience and complications associated with different cannula insertion techniques for laparoscopy in standing horses.Study Design—Retrospective study.Sample Population—Forty horses that had laparoscopy for diagnostic or surgical purposes.Methods—After a physical examination, including rectal palpation, standing laparoscopy was performed in 40 sedated horses. Local anesthetic was injected at each site of cannula insertion in the left flank. Horses were divided into 5 groups: Pneumoperitoneum was induced before cannula insertion using a Verres needle (group 1,n = 3) or a 12‐g catheter (group 2,n = 14); the cannula was inserted before inducing a pneumoperitoneum (group 3,n = 9); the cannula was inserted under visual control, using an operating laparoscope (group 4,n = 2) or a Visiport Optical Trocar (group 5,n = 12). Horses were observed for 7 days.Results—Problems with insufflation or cannula insertion occurred in 12 horses: 6 had peritoneal detachment, 4 had a splenic puncture, and 2 had descending colon puncture. Eleven of these complications occurred in groups 1 to 3 and only 1 in groups 4 and 5.Conclusions—The Visiport optical device allows controlled insertion of the initial trocar, and thus avoided potential problems associated with “blind” cannula insertion techniques and was used effectively in horses that had feed withheld for 12 hours. This technique enables direct insertion of a cannula directly into the right flank.Clinical Relevance—Complications associated with initial cannula insertion in the paralumbar fossa, for laparoscopy, in standing horses can be minimized with the use of an optical cannula.
The effect of topical tripeptide‐copper complex on healing of ischemic open wounds
Authors: Canapp Sherman O. , Farese James P. , Schultz Gregory S. , Gowda Santosh , Ishak Anthony M. , Swaim Steven F. , Vangilder James , Lee‐Ambrose Linda , Martin Frank G. 
Published: January 2005

Objective—To evaluate the effects of topical glycyl‐L‐histidyl‐L‐lysine tripeptide‐copper complex (TCC; Iamin 2% Gel; Procyte Corporation, Redmond, WA) on healing in ischemic open wounds.Study Design—Experimental study.Sample Population—Twenty‐four adult male Sprague‐Dawley rats.Methods—Rats were divided into 3 groups: topical TCC, topical TCC vehicle (hydroxypropyl‐methylcellulose), and no treatment (control). Six‐mm‐diameter, full‐thickness wounds were created within an ischemic bipedicle skin flap on the dorsum of each rat. Each day, for 13 days, wound margins were traced, and the TCC and TCC vehicle groups were treated topically. Tracings were scanned, and wound perimeter and area were calculated. On days 6, 10, and 13, selected wounds were biopsied and analyzed for tumor necrosis factor α (TNF‐α) and matrix metalloproteinases (MMP) 2 and 9.Results—A significant decrease in wound area was seen in the TCC group, but not the vehicle group, when compared with the control group on days 3 to 5, 6 to 9, and 11 to 13 and when TCC was compared with TCC vehicle on days 3 and 9. On day 13, initial wound area had decreased by 64.5% in the TCC group, 45.6% in the vehicle group, and 28.2% in the control group. On days 6, 10, and 13, TCC‐treated wounds contained significantly lower concentrations of TNF‐α and MMP‐2 and MMP‐9 than control wounds.Conclusion—Topical TCC resulted in accelerated wound healing in ischemic open wounds.Clinical Relevance—Topical TCC is an effective stimulant of healing of ischemic open wounds in rats and may have an application for the treatment of chronic wounds in other species. Clinical evaluation of topical TCC is warranted.
Life‐threatening hemorrhage from enterotomies and anastomoses in 7 horses
Authors: Doyle Aimie J. , Freeman David E. , Rapp Hans , Murrell Jose A. Verocay , Wilkins Pamela A. 
Published: January 2005

Objective—To report our experience with horses that presumptively had severe intraluminal hemorrhage from enterotomy or anastomosis.Study Design—Clinical study.Animals—Six adult horses and 1 adult donkey.Methods—A retrospective study was conducted at the University of Illinois (April 1994 to December 2001) to determine the clinical course and outcome of horses with melena and/or anemia and evidence of life‐threatening hemorrhage from intestinal incisions. Medical records of all horses that had colic surgery were reviewed to determine the proportion of horses with this complication. In addition, horses that fit the same criteria identified in 3 other veterinary clinics were included.Results—Three horses (1.3%) of those that had enterotomy or anastomosis at the University of Illinois and 4 horses from other clinics had complications presumptively related to severe hemorrhage from these intestinal procedures. Melena became evident within 72 hours of surgery and lasted 12 to 96 hours. Six horses had an acute and severe drop in packed cell volume (PCV), increased heart rates, and other signs of acute hemorrhage, and 1 horse had signs of colic postoperatively. Horses were administered intravenous formalin (3 horses) and whole blood transfusions (4 horses). Repeat celiotomy was performed on 2 horses. In 1 of these horses, a bleeding artery was ligated in the edge of the original enterotomy, and, in the other, a 25‐cm‐diameter intraluminal blood clot was found occluding the pelvic flexure. A horse that had jejunocolostomy for cecal impaction was not treated for hemorrhagic shock but was euthanatized and necropsied. Necropsy revealed blood‐filled bowel from the jejunocolostomy to the anus. One of the remaining 6 horses died of enterocolitis and 5 survived to discharge.Conclusions—Hemorrhage from incisional edges, particularly in the large intestine, should be considered a rare but possibly fatal complication of enterotomy or anastomosis in horses.Clinical Relevance—To prevent fatal hemorrhage from incisional edges during enterotomy or anastomosis, large vessels should be ligated at the original surgery, and hemostatic effects of different closure techniques should be considered. No intraoperative or postoperative findings were useful to predict this complication, and response to supportive medical therapy was favorable.
Bone gentamicin concentration after intra‐articular injection or regional intravenous perfusion in the horse
Authors: Werner Laura A. , Hardy Joanne , Bertone Alicia L. 
Published: January 2005

Objective—To compare intra‐articular (IA) and bone gentamicin concentrations achieved after intra‐articular administration or regional intravenous perfusion (RIP).Study Design—Experimental study.Animals—Twelve healthy adult horses.Methods—Horses were assigned to 2 treatment groups (n = 6/group): Group 1, 1 g gentamicin administered simultaneously in both left and right metacarpophalangeal joints and group 2, 1 g gentamicin administered simultaneously in both left and right lateral palmar veins. Serum, synovial fluid, and bone biopsy specimens were collected. Gentamicin concentrations were determined by fluorescence polarization immunoassay. Bone, synovial fluid, and serum gentamicin concentrations were compared over time and between groups using 2‐way ANOVA. Significance of all tests were evaluated atP< .05.Results—IA metacarpophalangeal joint administration resulted in higher concentration of gentamicin in synovial fluid than RIP administration. Synovial fluid concentration remained above minimum inhibitory concentration (MIC) for common pathogens for over 24 hours with IA and RIP administration. Bone gentamicin concentration remained above MIC for 8 hours with both methods; there was no significant difference in gentamicin concentration in bone with either method. Neither IA nor RIP administration had a significant effect on serum concentration of gentamicin.Conclusions—In normal horses, there is no difference in bone gentamicin concentration obtained with IA or RIP administration.Clinical Relevance—Based on MIC for common equine pathogens, administration of gentamicin intra‐articularly or by regional intravenous perfusion should be useful for treatment of osteomyelitis.
Effect of fenoldopam on renal function after nephrotomy in normal dogs
Authors: Zimmerman‐Pope Nancy , Waldron Don R. , Barber Don L. , Forrester S. Dru , Wilcke Jeff R. , Marini Michele 
Published: January 2005

Objective— To evaluate effects of fenoldopam on renal function in normal dogs subjected to bisection nephrotomy. In addition, effects of bisection nephrotomy on renal function in normal dogs were evaluated.Study Design— Controlled, randomized, blinded experiment.Sample Population— Sixteen mixed‐breed adult dogs.Methods— Dogs were paired for sex, body weight, and approximate age and assigned to 1 of 2 groups: fenoldopam (F) or placebo (P). Baseline glomerular filtration rate (GFR) based on quantitative renal scintigraphy using 99mTc‐DTPA, blood urea nitrogen (BUN), serum creatinine (SCr), urinalysis, and urine culture were performed before surgery. Left nephrotomy was performed via median celiotomy. Group F dogs were administered intravenous (IV) fenoldopam (0.1 μg/kg/min) for 90 minutes, whereas group P dogs were administered an equivalent volume of saline (0.9 % NaCl) solution for 90 minutes. Temperature, heart rate, respiration, direct arterial blood pressure, and urine volume were recorded during anesthesia. Renal function was assessed by measuring SCr, BUN, and GFR at 1, 21, and 42 days after surgery.Results— There was no significant difference between groups in measured physiologic variables. No significant difference in GFR, BUN, or SCr between groups or between operated or control kidneys was detected.Conclusions— Bisection nephrotomy in normal dogs with renal arterial occlusion of 15 minutes and using a simple continuous capsular closure does not adversely affect renal function.Clinical Relevance— Bisection nephrotomy, as described in this study, does not decrease renal function; perioperative administration of renoprotective agents is not necessary in normal dogs.
Evaluation of a vessel‐sealing device for small intestinal resection and anastomosis in normal horses
Authors: Rumbaugh Marilyn L. , Burba Daniel J. , Natalini Claudio , Hosgood Giselle , Moore Rustin M. 
Published: January 2005

Objectives— To compare arterial bursting pressure after vessel closure using a vessel‐sealing device (LigaSure Atlas Laparoscopic Sealer/Divider Instrument; Valleylab, Boulder, CO), a ligate‐and‐divide stapling device (LDS), and 2‐0 polydioxanone suture. To evaluate the LigaSure Atlas as a method for ligation of the mesenteric vasculature during small intestinal resection in normal horses.Study Design— Experimental study.Animals— Part A: jejunal segments from 19 horses. Part B: 6 horses, aged 1 to 18 years, weighing 330 to 509 kg.Methods— Part A: Jejunal segments with mesenteric vessels were collected from 19 horses. After closure by 1 of 3 methods (LigaSure Atlas, LDS, 2‐0 polydioxanone) arteries were cannulated, and bursting pressure was measured by incrementally increasing intraluminal pressure until failure. Part B: Six horses had jejunal resection and anastomosis using a vessel‐sealing device (LigaSure Atlas) to provide hemostasis of the mesenteric vasculature. Horses were monitored clinically for 4 weeks.Results— Part A: Mean ± SEM bursting pressure after 2‐0 polydioxanone ligation (1,014.50 ± 279.05 mm Hg) was significantly greater than mean bursting pressure after LigaSure (554.25 ± 228.79 mm Hg), which was significantly greater than the mean bursting pressure after LDS (373.25 ± 183.69). Part B: No major operative or postoperative hemorrhage occurred after application of the LigaSure Atlas for sealing and transecting mesenteric vasculature during small intestinal resection in normal horses.Conclusions— The LigaSure Atlas appears to be a safe method for hemostasis of the mesenteric vasculature during small intestinal resection in normal horses.Clinical Relevance— Benefits of the LigaSure Atlas vessel‐sealing device include reduced time required to provide hemostasis, acceptable arterial bursting pressure, no remaining foreign material, and no risk for ligature slippage. In our experience, use of the LigaSure Atlas during small intestinal resection and anastomosis in horses is safe for ligation of vessels less than or equal to 7‐mm diameter.
An ex vivo mechanical evaluation of single versus double semitubular plate fixation of a transverse distal‐third scapular osteotomy in the dog
Authors: Mair Jacqueline J. , Belkoff Stephen M. , Boudrieau Randy J. 
Published: January 2005

Objective—To compare single versus double semitubular plate fixation for scapular body fractures.Study Design—Ex vivo mechanical study.Sample Population—Eighteen paired cadaveric canine scapulae.Methods—Transverse scapular body osteotomies were created in the distal third of 18 pairs of scapulae. One scapula of each pair was repaired with a single plate, whereas the contralateral scapula was repaired with 2 plates. Initial strength and stiffness of the constructs were measured in 10 pairs of scapulae. Eight pairs of scapulae underwent cyclic loading and then were subjected to failure testing.Results—Double‐plate fixation was significantly stronger (3,899 ± 632 N) but not stiffer (614 ± 130 N/mm) than the single‐plate fixation (3,238 ± 935 N and 537 ± 202 N/mm, respectively). Cyclic loading variables were not significantly different between the 2 methods of fixation. After cyclic loading, double‐plate fixation was significantly stronger (2,916 ± 618 N) than single‐plate fixation (2,347 ± 495 N). There was no significant difference (P= .11) in stiffness between double‐ versus single‐plate fixations: 734 ± 247 N/mm and 595 ± 139 N/mm, respectively.Conclusions—Double‐plate fixation was generally stronger and stiffer than single‐plate fixation. Because all constructs failed at loads that greatly exceeded those estimated to occur clinically, any difference between the 2 methods of fixation probably is not clinically relevant.Clinical Relevance—Single‐plate fixation may be of sufficient strength for fixation of scapular body fractures.
Validation of the Bech–Rafaelsen Melancholia Scale and the Hamilton Depression Scale in patients with major depression; is the total score a valid measure of illness severity?
Authors: Licht R. W. , Qvitzau S. , Allerup P. , Bech P. 
Published: January 2005

Objective:  Evaluation of antidepressant drug efficacy requires adequate rating scales for measuring the severity of depression. However, to measure the illness severity by such a total score, the scale needs to fulfil criteria of unidimensionality. On this background, we aimed at comparing the unidimensionality of the Bech–Rafaelsen Melancholia Scale (MES) and the 17‐item Hamilton Depression Rating Scale (HAM‐D17).Method:  A total of 1629 patients aged between 18 and 65 years with a major depressive episode were treated openly with sertraline at a fixed oral dose of 50 mg daily during 4 weeks. The HAM‐D17 and the MES were applied at baseline and at weeks 2 and 4. Unidimensionality was tested with Mokken and Rasch analysis.Results:  Unidimensionality of the HAM‐D17 could not be confirmed. However, the 6‐item Hamilton Depression Subscale (HAM‐D6), was accepted by the Rasch analysis both at baseline and after 2 and 4 weeks of therapy. For the MES (as well as for the HAM‐D6), a Loevinger coefficient of homogeneity above 0.40 (suggesting acceptance) was found at week 4.Conclusion:  The HAM‐D6 and the MES did fulfil criteria for unidimensionality while the HAM‐D17 did not. Therefore, the extended use of the HAM‐D17 in drug trials may be questioned.
Randomized double blind comparison of olanzapine vs. clozapine on subjective well‐being and clinical outcome in patients with schizophrenia
Authors: Naber D. , Riedel M. , Klimke A. , Vorbach E.‐U. , Lambert M. , Kühn K.‐U. , Bender S. , Bandelow B. , Lemmer W. , Moritz S. , Dittmann R. W. 
Published: January 2005

Objective:  This randomized double‐blind multicenter trial evaluated the effects of olanzapine vs. clozapine on subjective well‐being, quality of life (QOL) and clinical outcome.Method:  The primary objective was to demonstrate non‐inferiority of olanzapine, mean dosage 16.2 ± 4.8 (5–25 mg/day) vs. clozapine, mean dosage 209 ± 91 (100–400 mg/day) regarding improvement on the ‘Subjective Well‐Being under Neuroleptic Treatment’ (SWN) Scale after 26 treatment weeks in 114 patients with schizophrenia. Secondary outcome parameters included: Munich QOL Dimension List (MLDL), Positive and Negative Symptom Scale (PANSS), Clinical Global Impression (CGI).Results:  SWN scores improved significantly in both groups, olanzapine was non‐inferior to clozapine (group difference 3.2 points in favor of olanzapine; 95% CI: 4.2;10.5). MLDL‐satisfaction, PANSS and CGI‐S improved similarly, olanzapine yielded a higher CGI Therapeutic Index. Individual SWN and PANSS changes correlated only moderately (r = −0.45).Conclusion:  Olanzapine was non‐inferior to clozapine. The lack of a marked correlation between PANSS and SWN improvements indicates that patients and psychiatrists perceive treatment differently.
Pregnancy Outcome in Recurrent Aborters is Not Influenced by Chlamydia IgA and/or G
Authors: Sugiura‐Ogasawara Mayumi , Ozaki Yasuhiko , Nakanishi Tamao , Kumamoto Yoshiaki , Suzumori Kaoru 
Published: January 2005

Problem:  It is unclear whether chlamydia infection influences the miscarriage rate and immunological factors in patients with recurrent miscarriage.Method of study:  Chlamydia DNA, IgA and IgG to Chlamydia trachomatis, natural killer cell activity, complement 3 (C3), C4, hemolytic complement, antinuclear antibodies, antiphospholipid antibodies, prolactin, activated partial thromboplastin time, prothrombin time and fibrinogen were examined in 504 patients with a history of two or more consecutive first‐trimester miscarriages. Subsequent pregnancy outcomes were compared between cases with and without antibodies to C. trachomatis.Results:  Totals of 10 of 30 and 48 of 201 patients receiving no medication miscarried subsequently with and without chlamydia infection. Chlamydia IgA and/or IgG were associated with a high level of C3 but not other immunological and coagulatory parameters.Conclusion:  Antibodies to C. trachomatis do not influence subsequent pregnancy outcome in patients with a history of recurrent miscarriage.
Gonadotropin‐releasing Hormone Agonist Administration Affects the Thymopoiesis in Adult Female Rats Independently on Gonadal Hormone Production
Authors: Leposavić Gordana , Pekić Sandra , Kosec Duško 
Published: January 2005

Problem:  In addition to having an indirect effect on the T‐cell development by controlling the production of ovarian steroids, an accumulating body of evidence suggest that GnRH analogue (GnRH‐A) administration may exert a thymopoietic regulatory effect that is not mediated by ovarian hormones.Method of study:  In non‐ovariectomized (non‐OVX) and OVX adult female AO rats treated s.c. with GnRH‐A or saline (controls), over 14 days, were estimated the thymic cellularity and thymocyte expression of CD4/CD8/TCRαβ by stereological analysis and three‐color flow cytometry, respectively.Results:  GnRH‐A in both groups of rats diminished the thymic cellularity. In non‐OVX rats GnRH‐A increased the relative numbers of immature cells (CD4‐8‐TCRαβ−, CD4‐8‐TCRαβlow and CD4+8‐TCRαβlow), and reduced those of positively selected CD4+8+TCRαβhigh and mature (CD4‐8+TCRαβhigh, CD4+8‐TCRαβhigh) cells, suggesting decelerated expression of TCRαβ followed by less efficient positive selection and further maturation of the selected cells. Differently, in OVX rats GnRH‐A decreased the percentage of immature (CD4‐8‐TCRαβ−, CD4+8+ TCRαβ−) cells and increased those of all TCRαβhigh subsets, suggesting an increased rate of early thymocyte differentiation, more efficient positive selection and further maturation of the selected cells.Conclusions:  The effect of GnRH‐A administration is affected by the presence of ovarian steroids.