bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determination of the total protein and triglyceride content of human breast milk on the Synchron CX7 Delta analyser
Authors: Lynch P.L.M. , O'Kane M.J. , O'Donohoe J. , McCrea A. , Pearse J. , Wright A. 
Published: January 2004

Background: Premature babies have improved clinical outcomes when fed breast milk with a relatively high protein content. Since there was no convenient way of measuring the macronutrition of breast milk we used our routine laboratory pyrogallol red dye binding method for cerebrospinal fluid microprotein (MTP) and our routine method for serum triglyceride to determine the total protein and triglyceride content of human breast milk. Methods: The total protein contents of whole and defatted breast milk samples, randomly collected from 115 nursing mothers, analysed using a pyrogallol red dye binding assay on a Synchron CX7 Delta analyser were compared with the total protein contents determined by dry combustion analysis. Triglyceride concentrations, determined on the Synchron CX7 Delta analyser were compared with their respective creamatocrits. Results: Passing and Bablok regression analysis (95% confidence interval) gave the following regression equations: y = 5.98(5.48 to 6.56)x-1.32(-2.02 to -0.73) where y is whole milk MTP (g/L) and x is dry combustion analysis (g/100 g); y = 7.09 (6.54 to 7.78)x-2.44 (-3.46 to -1.67) where y is volume-corrected defatted milk MTP (g/L) and x is dry combustion analysis (g/100 g); y = 7.52 (6.86 to 8.24)x+0.90(-2.42 to 3.37) where y is whole milk triglyceride (mmol/L) and x is creamatocrit (%). Conclusion: The Synchron CX7 Delta total protein and triglyceride assays provide practical, rapid and reliable methods for the determination of the macronutrition in human milk.
An audit of biological monitoring of industrial lead workers by a UK laboratory over a 2-year period
Authors: Allen K.R. , Newton K.E. 
Published: January 2004

Background: Medical surveillance of workers in the lead industry is under the statutory control of the Control of Lead at Work Act (CLAW). Over the years the CLAW regulations have been updated with a reduction in the suspension concentration for blood lead and the introduction of an action limit. As a result of these changes, an audit of blood lead measurement together with an evaluation of haemoglobin and zinc protoporphyrin (ZPP) measurements, also requested as part of surveillance, is required. Methods: Results of measurements for blood lead, ZPP and haemoglobin in lead-exposed workers in 58 industries within the UK were collected over a 2-year period. Results: For male workers, 8.8% of blood lead results [range 1-88 µg/dL (0.05-4.25 µmol/L), median 29 µg/dL (1.4 µmol/L), n = 3010] were above the action limit and 5.6% above the suspension limit set by CLAW. For female workers, 1.9% of blood lead results [range 1-74 µg/dL (0.05-3.58 µmol/L), median 7 µg/dL (0.34 µmol/L), n = 161] were above the action limit. No significant correlation was found between blood lead and haemoglobin in the male workers (rs =-0.04, P = 0.024) and only a slight negative correlation for the female workers (rs =-0.25, P = 0.0016). ZPP showed an exponential relationship with blood lead in the male workers with a wide scatter of results. Conclusion: Haemoglobin and ZPP offer little towards the assessment of lead exposure in industrial workers. Blood lead in accordance with the CLAW regulations still offers the most appropriate means of industrial monitoring.
A new method of measuring the antioxidant activity of polyphenols using cumene hydroperoxide
Authors: Sugita Osamu , Ishizawa Nobuhito , Matsuto Takayuki , Okada Masahiko , Kayahara Norihiko 
Published: January 2004

Background: It is well known that polyphenols lower the risk of chronic diseases such as heart disease and cancer. We describe a new method using cumene hydroperoxide (CHP) to determine the antioxidant activity of polyphenols. CHP is considered to be a model reactive lipid peroxidation product. Methods: The method was based on two reactions: the reduction of a known concentration of CHP by polyphenols and the reaction of the remaining CHP with a methylene blue derivative (10-N-methylcarbamoyl-3,7 dimethylamino-10H-phenothiazine) in the presence of haemoglobin. Methylene blue was formed as a result of the two reactions and then measured by absorbance at 675 nm. We named this assay the 'cumene hydroperoxide/haemoglobin·methylene blue (CHP/Hb·MB) method'. We examined 13 polyphenols and nine compounds known to be antioxidants. Results: Among the 13 polyphenols, milicetin, with the largest number of hydroxyl groups, had the highest antioxidant activity, followed by cyanidin, pelargonidin and quercetin. It is suggested that the increase in the number of hydroxyl groups induced a higher antioxidant activity. Within-run coefficients of variation were 3.6% and 3.5% at the mean antioxidant activity of 50 µmol/L and 151 µmol/L, respectively. Conclusion: We conclude that this CHP/Hb·MB assay is capable of measuring the antioxidant activity of polyphenols.
Limitations of faecal elastase-1 and chymotrypsin as tests of exocrine pancreatic disease in adults
Authors: Brydon W.G. , Kingstone K. , Ghosh S. 
Published: January 2004

Background: The faecal enzymes elastase and chymotrypsin are a relatively inexpensive non-invasive means of investigating causes of malabsorption. However, such tests may be affected by enzyme degradation or faecal dilution. Methods: Faecal elastase-1 and chymotrypsin were measured in 225 patients in whom pancreatic disease was suspected, and the association between faecal free water and pH with these faecal enzymes was examined in subjects with normal pancreatic function. Results: The sensitivity of faecal elastase-1 and chymotrypsin for identifying exocrine pancreatic disease was 75% and 60%, respectively. Corresponding specificities for excluding disease were 95% and 97%. The positive predictive value for faecal elastase-1 increased from 58% to 92% when watery diarrhoea was excluded. Faecal elastase-1 (inversely) and chymotrypsin (directly) were significantly associated with percentage faecal free water content in subjects without pancreatic disease. Faecal elastase-1 was not related to faecal pH, whereas chymotrypsin was inversely related to pH. Conclusion: Faecal elastase-1 is a more sensitive test for exocrine pancreatic disease in adults but is affected by dilution in patients with watery diarrhoea. The value of faecal chymotrypsin is limited by intestinal degradation.
Long-term socio-economic impact of vestibular schwannoma for patients under observation and after surgery
Authors: Tos Tina , Caye-Thomasen Per , Stangerup Sven-Eric , Tos Mirko , Thomsen Jens 
Published: January 2004

This study describes and compares the long-term socio-economic impact for patients diagnosed with a vestibular schwannoma and either operated on or observed.A consecutive sample of patients diagnosed with vestibular schwannoma in Denmark and either operated on (748 patients) or observed by the wait-and-re-scan policy (272 patients) during the period 1976-2000 were studied retrospectively. The consequences of operation/diagnosis (andobservation) on vocational status, ability to handle daily chores and some psycho-social aspects were studied by means of a prospective postal questionnaire. Ninety-six per cent of the operated and 83 per cent of the observed patients answered the questionnaire. Overall, 34 per cent of operated patients resumed their daily activities within one to two months, and 76 per cent within four to six months. Patients operated on for a large tumour resumed their daily activities later than patients with a small tumour. Regardless of tumour size, employment was unchanged for the majority of observed and operated patients. The vocational consequences were significantly worse for operated patients with a large tumour, than for observed patients. However, no difference existed between the observed group and operated patients with a tumour below 20 mm in size. A change in vocational status was most frequent for assisting spouses, unskilled manual workers and the self-employed. The majority of both observed and operated patients experienced no change in their ability to handle daily chores. The changed ability of operated patients was worse than that of observed patients. Among various changes in their psycho-social well-being, decrease in social ability was the most frequent complaint in both groups, followed by increased fatigue, decreased concentration, increased irritability, depression and headache, decreased intellect and libido. Regardless of tumour size, the change in social ability, concentration and fatigue was worse for operatedpatients. Concerning headache, patients operated on for a large tumour were better off than observed patients and patients operated on fora small tumour. There was no difference between the operated and observed groups concerning irritability, intellect and libido.Deterioration of vocational status, ability to handle daily chores and several aspects of psycho-social well-being are reported both by patients operated on and observed for vestibular schwannoma. However, the negative changes were more frequent among the operated patients, although the differences were surprisingly modest, especially when comparing observed patients with patients operated on for a small tumour.
Paget-Schroetter syndrome
Authors: Khan S N , Stansby G 
Published: January 2004

Objective: To review current approaches to investigation and management of Paget-Schroetter syndrome (PSS). Methods: Relevant clinical studies and reports were searched for using MEDLINE and Embase databases and cross-referenced articles. Articles were extracted using keywords by the two authors independently. Principal findings: There is growing evidence of functional or positional anatomical defects, which lead to subtle intimal injury and a tendency for recurrence or poor outcome. Management of PSS remains controversial. Anticoagulation as a stand-alone treatment has lost favour. Active treatment with thrombolysis followed by consideration of thoracic decompression is recommended by most in the recent literature. Thrombolytic therapy appears to be a safe and efficacious method of establishing immediate patency of the axillary/subclavian vein. The timing and indications of decompression surgery are yet to be defined clearly. There are no randomized trials of treatment or management strategies in PSS. Conclusions: Treatment of PSS remains contentious. Most authors recommend active treatment with thrombolysis followed by thoracic decompression. Multicentre randomized trials are needed.
The clinical and histological effects of Dermagraft® in the healing of chronic venous leg ulcers
Authors: Krishnamoorthy Latha , Harding Keith , Griffiths David , Moore Keith , Leaper David , Poskitt Keith , Sibbald R Gary , Brassard Alain , Dolynchuk Kenneth , Adams Julian , Whyman Mark 
Published: January 2004

Objective: Pilot study to assess the safety and effectiveness of Dermagraft® when used in conjunction with multi-layer compression bandage therapy (Profore™) compared with multilayer compression only in the treatment of chronic venous leg ulcers. Design: Open-label, prospective, multicentre, randomized, controlled clinical trial. Methods: Patients aged at least 18 years with leg ulceration of venous aetiology were screened for inclusion in the trial. Patients with arterial disease (ankle brachial pressure index <0.7) and causes of ulceration other than venous disease were excluded. Patients were randomized into four groups. Three active treatment groups received Dermagraft® in combination with compression bandaging, Profore™: Group 1, 12 pieces of Dermagraft (one per week for 12 weeks); Group 2, four pieces of Dermagraft (Weeks 0, 1, 4, 8); Group 3, one piece of Dermagraft (Week 0). The control group was treated with compression bandaging alone (Group 4). The study was not powered to detect statistical differences in healing rates. Adverse events were reported according to national guidelines. There was no statistical analysis of adverse event data. Results: In all 53 patients were randomized, of whom 47 completed the study per protocol. At 12 weeks complete healing of the ulcer, analysed by 'intention-to-treat' (ITT) was 15% using Profore alone, 7% using single application Dermagraft and Profore (Group 3), compared with 38% using multiple applications of Dermagraft and Profore (Groups 1 and 2). At study discontinuation, the median percentage reduction in wound area was 81.4% for Group 1, 88.6% for Group 2, 59.4% for Group 3 and 78.1% for Group 4. No major safety issues were identified during the course of the study. Conclusions: The results of the pilot study indicate that four pieces of Dermagraft are the optimal application frequency to take forward to further clinical trials. Further studies are required to confirm these data, and these should be powered to detect whether there are statistical differences in healing rates and safety between different regimens.
Role of ambulatory venous pressure measurement in the assessment of venous disease
Authors: Dix F P , McCollum C N 
Published: January 2004

Objectives: The gold standard assessment of venous hypertension is ambulatory venous pressure (AVP). Aims of this study were to determine the relationship of AVP with clinical severity of venous disease and whether AVP accurately identifies sites of incompetence. Methods: 117 limbs (93 subjects) underwent classification of venous signs, duplex imaging and AVP measurement. Eleven limbs had no disease, 28 had varicose veins (VVs), 45 had chronic venous insufficiency, 15 had healed ulceration, and 18 had active ulceration. Results: Mean (standard error of the mean) pressure relief index (PRI) showed a step-wise decrease from 1794 (±317) in controls to 167 (±46) in active ulcers ( P <0.001, ANOVA). PRI correlated with clinical severity of venous disease (r = -0.60, P <0.01, Pearson). Superficial reflux alone was most common in VVs (60%), deep reflux in active ulceration (11%) and combined reflux in healed ulceration (93%). Tourniquet tests showed an increase in PRI only in combined reflux ( P <0.028, ANOVA). Conclusions: AVP correlates with skin condition but is inaccurate in identifying sites of incompetence.
Subfascial endoscopic perforator surgery using a soft trocar for varicose veins in the lower leg
Authors: Hirokawa Masayuki , Inoue Yoshinori , Iwai Takehisa 
Published: January 2004

Objective: To describe the use of a novel soft trocar to perform subfascial endoscopic perforator surgery (SEPS) in patients with varicose veins in the lower leg. Procedures: From January 1999 through March 2001, SEPS was performed in 14 patients (17 legs) with primary varicose veins (clinical classes 3-6) by using a soft trocar. The soft trocar is a Y-shaped polyvinyl chloride bag with two ports at one end and a flexible, sealing ring at the opposite end. The subfascial space was dissected with an endoscopic dissection cannula and expanded with a balloon. Carbon dioxide gas insufflation was applied, and the perforating veins were divided by using UltraShears inserted simultaneously with an endoscope through the second port of the trocar. Results: A mean of 4.7 ± 2.9 perforating veins per leg were divided. No wound complications occurred. Conclusion: Use of the soft trocar facilitates both visualization and manipulation during SEPS.
A comparison of health-related quality of life of patients with primary and recurrent varicose veins
Authors: Beresford T , Smith J J , Brown L , Greenhalgh R M , Davies A H 
Published: January 2004

Aim: To determine whether recurrent varicose veins affect patient quality of life. The health-related quality of life (HRQL) scores of patients with recurrent varicose veins were compared with those of patients presenting with primary varicose vein disease. Methods: HRQL among patients attending outpatient appointments for recurrent and primary varicose veins was measured using the Aberdeen Varicose Vein Questionnaire (AVVQ) and the Short Form-36 General Health Survey (SF-36). Results: Questionnaires were given to 211 patients (150 primary, 61 recurrent), and 194 (133 primary, 61 recurrent) completed them. For the AVVQ, patients with recurrent varicose veins had significantly worse symptom scores compared with those with primary disease (24.87 ± 12.28 vs 17.77 ± 9.68, Mann-Whitney, P <0.01). The SF-36 recorded significantly worse HRQL (Mann-Whitney, P <0.05) for patients with recurrent varicose veins compared with those with primary varicose veins in all but one of the eight domains (role limitation attributed to emotional problems, RE, P = 0.073). Conclusion: Varicose vein recurrence is associated with a significantly worse HRQL than is found among patients with primary varicose veins.
Compression sclerotherapy of anterolateral thigh primary varicose veins (lateral accessory saphenous varicose veins): a prospective five-year follow-up study
Authors: Jagtman B A , Tazelaar D J , De Leeuw J 
Published: January 2004

Aim: To determine the percentage of varicose vein recurrence after compression sclerotherapy of a specific primary varicose vein, the anterolateral thigh vein (lateral accessory saphenous vein), without saphenofemoral junction (SFJ) incompetence at yearly intervals in a long-term follow-up study, and to investigate factors influencing recurrence. Patients and methods: Of 117 patients recruited, 11 were lost to follow up; therefore 106 patients were evaluated: 97 women, mean age 42 years (range 21-72) and nine men, mean age 47 years (range 21-67). If SFJ incompetence was present, surgical ligation of the junction was performed. Primary varicose veins were treated with compression sclerotherapy using polidocanol. A total of 111 limbs were studied. Results: Recurrent varicose veins were found after six months in 6% of cases, after one year in 18% (cumulative percentage), after two years in 28%, after three years in 36%, after four years in 46%and after five years in 54%. No differences could be detected between the recurrence group and the group without recurrence regarding length of varicose veins, amount of polidocanol used, number of injections, circumference of the leg or age of the patient. The varicose vein diameter was significantly larger in the recurrence group. Conclusions: Compression sclerotherapy with polidocanol of the anterolateral thigh vein (lateral accessory saphenous vein) without SFJ incompetence results in a high recurrence rate. Recurrence depends only on the vessel diameter, and not on the length of the varicose vein, amount of sclerosant used or patient age.
Calf exercise in the seated position using a new dynamic biped device increases femoral vein peak velocity up to eight-fold
Authors: Caruana M F , Brightwell R E , Huguet E L , Whitear P , Hodgkinson D W , Osman I S 
Published: January 2004

Background and objective: Lower limb deep venous thrombosis is a common condition with a recognized morbidity and mortality. Hitherto known as a complication in hospitalized patients, anecdotal media reports and scientific trials have raised the profile of the same condition in association with air travel. Although probably multifactorial in aetiology, venous stasis is considered an important and correctable risk factor in the pathogenesis of deep venous thrombosis. The aim of this study was to assess the effectiveness of exercising the calf muscle blood pump in increasing venous blood flow using a new dynamic alternating inflatable biped device (Lymgym™, Lymgym Ltd, UK) which has been designed to be used by air passengers. Methods: Doppler ultrasound was used to assess peak flow velocity in the superficial femoral vein in 30 lower limbs of 15 healthy volunteers with no history of venous disease. Measurements of peak flow velocity were taken at rest in the seated 'coach position' and during calf muscle pump exercises with the device. Results: Peak blood flow velocity was eight-fold higher ( P < 0.0001, Wilcoxon signed rank test) during exercise with the device than at rest. Conclusions: These results show that use of the dynamic alternating biped device (Lymgym™) effectively reduces venous stasis when used in the seated position as defined by measurements of peak venous blood flow. These results provide the scientific justification for further studies assessing the value of this device in reducing the risk of travel-related thrombosis.
Symptoms, clinical disability scores and reflux in complicated and uncomplicated primary varicose veins
Authors: Saarinen J , Heikkinen M , Suominen V , Virkkunen J , Zeitlin R , Rasku K , Saaristo R , Vainio J , Nordback I , Salenius J-P 
Published: January 2004

Objective: To evaluate the role of subjective symptoms, grade of disability and axial reflux in superficial veins in different clinical stages of varicose veins (VVs). Methods: A total of 172 legs with primary venous insufficiency from 126 patients were studied. The examination involved evaluation of the CEAP clinical class and clinical disability score (CDS), recording of any symptoms of varicose disease, and a hand-held Doppler (HHD) examination of the superficial veins. Colour-flow duplex imaging (CFDI) was also performed in 22% of the legs. Results: The rate of insufficiency of the great saphenous vein (GSV) was 83% in complicated legs (C4-6), and 68% in uncomplicated legs (C2-3), ( P > 0.05). There was a difference between complicated and uncomplicated legs in the insufficiency of the whole GSV [C4-6: n = 18 (39%) versus C2-3: n = 12 (12%), P < 0.005]. Sensation of pain was noted in 68% of the legs in class C1, 60% of those in class C2-3 and 81% of those in class C4-6. Sensation of oedema was recorded in 70% of the legs in class C1, 65% of those in class C2-3 and 86% of those in class C4-6, respectively. CDS classes 2-3 were significantly more frequent among complicated legs (C4-6: 54% versus C2-3 12%, P < 0.005). Conclusions: Leg symptoms are frequent throughout classes C1-6. Their clinical usefulness is therefore limited. CDS parallels well with the clinical classification. In complicated disease the whole saphenous vein is more frequently insufficient.
Inflammation parallels severity of chronic venous insufficiency
Authors: Labropoulos N , Leder D M , Kang S S , Mansour M A , Baker W H 
Published: January 2004

Objective: This study was designed to assess the haemodynamic flow changes in patients with chronic venous insufficiency (CVI). Methods: Duplex scanning was used to evaluate prospectively the flow characteristics in the lower limb circulation and the number of enlarged lymph nodes in the groin of normal subjects, patients with CVI classes 2, 4, 5 and 6, and patients with acute cellulitis. Phasicity and continuous flow patterns were assessed in the venous system, while the arterial system was evaluated for tri-phasic flow, absence of flow reversal and absence of flow reversal with hyperaemic flow (increased peak systolic and end diastolic velocities). Additionally, the number and size of the groin lymph nodes around the saphenofemoral junction were recorded. Results: Patients with more severe class 4-6 CVI demonstrated an increased prevalence of abnormal flow patterns within the venous system of the leg compared to the normal phasic flow pattern seen in the absence of disease ( P < 0.001). Within the arterial system, significant changes were also observed in all three arteries studied in the legs of patients with class 4-6 CVI ( P < 0.001). For both the arterial and venous systems, no difference was noted between control limbs vs class 2 diseases or class 4-6 diseases vs cellulitis. With respect to the evaluation of inguinal lymph nodes, patients with class 2 disease were approximately four times as likely to have positive lymph nodes, and patients with more severe CVI were approximately 13 times as likely to have significant lymph nodes present. Conclusions: This study demonstrated that patients with more advanced stages of CVI had arterial and venous flow increases similar to those seen in an acute inflammatory condition such as cellulitis. These changes were most pronounced in the perforating and subcutaneous vessels in the leg.