bluuebunny/crossref_metadata_2025_split huggingface dataset:
Octreotide Scintigraphy in the Head and Neck
Authors: Bustillo A. , Telischi F. , Weed D. , Civantos F. , Angeli S. , Serafini A. , Whiteman M. 
Published: February 2004

AbstractObjectives/Hypothesis Octreotide is a somatostatin analogue that, when coupled to a radioisotope, produces a scintigraphic image of neuroendocrine tumors (NET) expressing somatostatin type 2 receptors (SSR 2). Octreotide scintigraphy (OS) may be useful in confirming the preoperative diagnosis of certain head and neck NET. Paragangliomas (PG), like many NET, have been found to have a high density of SSR 2 on the cell surfaces. Other NET of the head and neck include merkel cell carcinomas (MCC), medullary thyroid carcinomas (MTC), and esthesioneuroblastomas.Study Design A retrospective study that compared the results of OS with the histopathologic diagnosis in 74 patients with head and neck NET.Results Of the 60 patients undergoing evaluation for suspected paraganglioma, OS was correctly positive in 36 of the 37 patients with PG. OS was correctly negative in 19 of the 23 patients that did not exhibit PG. For PG, this yielded a sensitivity of 97% and a specificity of 82%. There were 14 patients in the nonparaganglioma group. OS detected or diagnosed all metastases in three patients with MTC, locoregional recurrences in two patients with esthesioneuroblastoma, an extrapituitary adenoma in one patient, and metastasis in two patients with MCC. It failed to detect a paraspinal metastasis in the third patient with MCC.Conclusion On the basis of this series of patients, OS appears to be a reliable test to detect PG and may be helpful in detecting primary and metastatic disease for NET.
Staging of Obstructive Sleep Apnea/Hypopnea Syndrome: A Guide to Appropriate Treatment
Authors: Friedman Michael , Ibrahim Hani , Joseph Ninos J. 
Published: February 2004

AbstractObjective Early studies by Friedman et al. have demonstrated the value of staging obstructive sleep apnea/hypopnea syndrome (OSAHS) patients for the prediction of success for uvulopalatopharyngoplasty (UPPP) on the basis of short‐term follow up. The goal of this study is to test the value of this staging system in a prospective study.Study Design This is a prospective study of two cohorts of patients: one was treated with the benefit of a clinical staging system and the other without.Methods Patients with symptoms of OSAHS were assessed by polysomnography and were staged according to a previously described staging system. The staging system is based on palate position, tonsil size, and body mass index (BMI). The control group was treated without the benefit of staging. All patients in the control group were treated with UPPP only. Patients in the experimental group were treated based on their clinical stage. Patients with stage I disease, regardless of the severity of disease, were treated with UPPP only. Selected patients with stage II and stage III disease were treated with UPPP in addition to a staged tongue‐base reduction using a radiofrequency technique (TBRF).Results Follow‐up at 6 months showed significant improvement compared with a group of patients treated without the benefit of a staging system. Successful treatment of patients with stage II disease improved from 37.9% to 74.0%. The overall success rate improved from 40% to 59.1%.Conclusion Clearly, patients with stage I disease had the best success rate, but a selective protocol based on clinical staging improves the overall success rate. In addition, it can eliminate as surgical candidates those patients with whom the procedure is likely to fail.
Hospital Use in the Treatment of Sleep Apnea
Authors: Petersen Erik J. , Reiter Evan R. 
Published: February 2004

AbstractObjectives Evaluate hospital use for treatment of sleep apnea.Study Design Retrospective database review.Materials and Methods The 1998 to 2000 National Inpatient Sample (NIS) was searched for admissions with a diagnosis of sleep apnea. Records were examined for demographics, diagnoses, procedures, and complications. Data were analyzed to identify factors affecting length of stay (LOS) and charges.Results There were 5,864 (0.03% NIS) admissions for sleep apnea. The sleep apnea group had lower mean age (43.1 vs. 47.2 years), higher percentages of males (71.6% vs. 41.0%) and African Americans (18.7% vs. 13.7%), and higher rates of obesity, hypertension, and anatomic airway diagnoses than the NIS population. Of sleep apnea group adults, 77.1% underwent a mean 2.3 procedures, whereas of those patients under 18 years of age, 60.8% underwent a mean of 1.2 procedures. Tracheotomy and procedures for hypopharyngeal airway compromise were used infrequently. Within the sleep apnea group, there were significant differences in LOS and charges on the basis of age, sex, race, payment method, procedures, and number of secondary diagnoses (all P < .05). Patients over 18 admitted for other diagnoses, but with secondary diagnosis of sleep apnea, had longer LOS (5.38 vs. 4.95 days) and higher charges ($16,562 vs. $13,928) than patients without sleep apnea.Conclusions Hospital use for sleep apnea remains largely for surgical treatment of the disease. Procedures directed at hypopharyngeal obstruction are seldom used. Multiple factors including patient age, number of secondary diagnoses, and procedures affect LOS and charges. The presence of sleep apnea also increases charges and LOS in patients admitted for other diagnoses.
Effectiveness of Laser‐Assisted Myringotomy for Otitis Media in Children
Authors: Cotter Cheryl S. , Kosko James R. 
Published: February 2004

AbstractObjective To evaluate the effectiveness of OtoScan CO2 laser‐assisted myringotomy (OtoLAM ESC/Sharplan) for acute otitis media and chronic otitis media with effusion (COME) in children.Study Design Retrospective review of 47 children with refractory acute otitis media (RAOM) or COME more than 3 months in duration in a pediatric otolaryngology practice.Methods Laser‐assisted myringotomy was performed on 47 patients (79 ears) using the OtoLAM device. There were 28 children (ages 0.50–3 years) with RAOM and 19 children (ages 0.58–15 years) with COME.Results A total of 57.4% of procedures were considered treatment failures. Failures occurred in 53.6% of patients with RAOM on average ±SD 3.89 ± 2.16 weeks after the procedure and in 63.2% of patients with COME on average ±SD 7.25 ± 5.57 weeks after the procedure. Age, sex, microorganism isolated, myringotomy size, wattage, and laterality did not predict outcome. Ventilation tube insertion was performed in 27 (57.4%) patients. Two patients have persistent tympanic membrane perforations at 2 years.Conclusions Laser‐assisted myringotomy in children with RAOM and COME was associated with a high incidence of recurrence or persistence of disease and with perforation of the tympanic membrane. Recommendations for use of the OtoLAM should include discussion of high failure rates and the strong likelihood of subsequent ventilation tube insertion. The OtoLAM remains an option for office‐based ventilation of the middle ear for families and patients where general anesthesia is a concern.
Silent Functional Magnetic Resonance Imaging (fMRI) of Tonotopicity and Stimulus Intensity Coding in Human Primary Auditory Cortex
Authors: Yetkin F. Zerrin , Roland Peter S. , Christensen William F. , Purdy Phillip D. 
Published: February 2004

AbstractObjectives The aims of this study were to determine the feasibility of obtaining auditory cortex activation evoked by pure tones presented at threshold and suprathreshold hearing levels, to evaluate tonotopicity of the primary auditory cortex, and to determine the effect of stimulus intensity on auditory cortex activation using silent functional magnetic resonance imaging (fMRI).Methods Sixteen subjects with normal hearing underwent silent fMRI. An audiometer was used to deliver pure tones of 1,000, 2,000, and 4,000 Hz to the left ear. Two levels of acoustic stimulation were used: 1) threshold, hearing level determined in the scanner room and 2) suprathreshold, 70 dB hearing loss (HL). Tonotopicity and stimulus intensity coding was assessed on the basis of the location, extent, and amount of the auditory cortex activation.Results The localization of activation moved to more medial and posterior regions of the primary auditory cortex as the frequency of the pure tone increased. Compared with a threshold stimulus, a suprathreshold stimulus evoked the same regions with increased spatial extent. The average increase in the right auditory cortex activation in response to suprathreshold stimulus was 57% at 1,000, 51% at 2,000, and 45% at 4,000 Hz compared with that activated by the threshold stimulus.Conclusions Silent fMRI can be used to evaluate auditory cortex activation using low‐intensity stimuli. The level of stimulus intensity increases the amount of auditory cortex activation and influences the fMRI mapping of the tonotopic organization of the primary auditory cortex.
Supporting Cells As a Target of Cisplatin‐Induced Inner Ear Damage: Therapeutic Implications
Authors: Ramírez‐Camacho Rafael , García‐Berrocal José Ramón , Buján Julia , Martín‐Marero Alejandro , Trinidad Almudena 
Published: February 2004

AbstractObjectives/Hypothesis Cisplatin induces adverse effects such as ototoxicity and nephrotoxicity. Unexplained hearing improvement in sudden deafness and fluctuating hearing loss suggests the presence of some mechanisms other than the primary lesion of the outer hair cell. The authors' aim was to study the functional and morphological lesions induced in the cochlea of the rat after cisplatin injection.Study Design Prospective experimental morphological and functional study.Methods Forty‐eight Wistar rats were given intraperitoneal injections of 5 mg/kg cisplatin. After short‐, medium‐, and long‐term survival, animals were studied by means of auditory brainstem response testing and scanning electronic microscopy.Results An increased hearing loss was observed in animals with long‐term survival compared with animals with short‐term survival after a single dose of cisplatin. These findings correlated with a more intense injury of the supporting cells, continuing with the late deterioration of the hair cells.Conclusion The study suggested that the initial damage of the supporting cells could be responsible for the late injury of the hair cells. This hypothesis was supported by the late increase in hearing loss after a single dose of cisplatin, emphasizing the role of the supporting cells in the cochlear changes induced by cisplatin.
Westminster Women: The Politics of Presence
Authors: Lovenduski Joni , Norris Pippa 
Published: February 2004

The entry of the 1997 cohort of Labour women into public life offers a test case of whether, and under what conditions, women politicians have the capacity to ‘make a substantive difference’. We outlines the theory of the politics of presence and discuss how to operationalise this in a testable model. We, use the British Representation Study survey of 1,000 national politicians (including parliamentary candidates and elected Members of Parliament) conducted in the 2001 general election. The analysis centres on the impact of gender on five scales measuring attitudes and values on issues that commonly divide British party politics. Once we control for party, there are no significant differences among women and men politicians across the value scales concerning the free market economy, Europe, and moral traditionalism. Yet on the values most directly related to women's interests – namely the affirmative action and the gender equality scales – women and men politicians differ significantly within each party, even after controlling for other common social background variables that explain attitudes, such as their age, education, and income. The conclusion considers why these findings matter for the composition of parliament, the public policy agenda and for women's roles as political leaders.
Alienation in the patient role: source of ambivalence and humor in comic get well cards
Authors: Bologh Roslyn Wallach 
Published: February 2004

Summary The humorous themes of over 300 comic get well cards are analyzed to reveal sources of tension or strain in the patient role. The author uses a model of alienation as a way of categorizing these themes. Corresponding to the four aspects of alienated labor as specified by Marx, alienation in the patient role is divided into the following four aspects: alienation from medical providers (domination and indifference), alienation of self from body (powerlessness or impotence), alienation from treatment (meaninglessness), alienation from responsibilities (self‐estrangement). Each of these categories gets further broken down into sub‐categories reflecting the specific sources of ambivalence and humor expressed in the comic get well cards.Using Merton's scheme of social structure and anomie, the author develops the logical possibilities in the patient role: compliant patient,‘problem’patient, malingerer, fatalist and rebel. These categories refer to the consequences of either accepting or rejecting the goal of getting well and the (alienating) means as indicated above required by the American system of medical care. Most of the humor of the get well cards falls primarily under the category that characterizes the‘problem’patient: accepting the goal of getting well but rejecting or ridiculing the alienating means.
Categorization in accident departments: ‘good’ patients, ‘bad’ patients and ‘children’
Authors: Dingwall Robert , Murray Topsy 
Published: February 2004

AbstractChildren form a significant proportion of accident services’ clientele but have received relatively little attention in the growing ethnographic literature on such organizations. This paper uses data from observation and interviews in four English accident departments to review Jeffery's influential analysis of medical staffs categorization of patients. After pointing to certain logical difficulties with this account, it is argued that an analysis of the way children are treated allows for these to be remedied by the development of a more sophisticated model of professional decision‐making. The paper concludes with a discussion of the way in which the categorization rests on the practical contingencies of accident work and the social organization of emergency work. Attention is drawn to the variation between high‐prestige units in teaching hosp pitals and lower‐status units in general hospitals and the way this limits the ability of the former to identify conditions like child abuse or neglect.
Problems in the conceptual framework of patient satisfaction research: an empirical exploration
Authors: Fitzpatrick Ray , Hopkins Anthony 
Published: February 2004

AbstractSurvey research into patient satisfaction has been responsible for developing a number of related concepts concerning the ways in which patients evaluate the health care that they receive. Recently doubts have been expressed as to the adequacy of this approach for understanding how patients anticipate and respond to medical encounters. This paper reports a study of patients attending neurological outpatient clinics. The results suggest that the conceptual framework deriving from patient satisfaction research provides only partial and sometimes misleading insights into the perspectives of the patients studied. The paper concludes that patients’ varying concerns with regard to their illness need to be more directly considered in explaining different responses to medical consultations. This approach enables a more sensitive evaluation of health care from the patient's point of view.
The identification and provision of care for the terminally ill at home by ‘family’ members
Authors: Hunt Maura 
Published: February 2004

AbstractAudio‐recordings of naturally occurring conversations over a three‐month period between five nurses in a Symptom Control Team and fifty four terminally ill cancer patients and their relatives in their own homes form the focus of this study. The SCT nurses specialised in the care of the dying but did not carry out ‘hands on’ nursing which was given by community nurses. The SCT nurses carried out their work through ‘talk’. The main aim of the study is therefore, through analysis of the audio‐recordings, to determine how conversational interactions are used by nurses, patients and relatives in dealing with the process of dying. The aspect of the study discussed in this paper deals with the process at first home visits whereby the nurses, patients and relatives establish ‘family’ memberships and determine eligible sources of help in relation to expected sets of rights and obligations.
Side effects of psychiatric treatment: a qualitative study of issues associated with a random allocation research study
Authors: Anthony Philip , Lancashire Stuart , Creed Francis 
Published: February 2004

AbstractA random allocation study of the effectiveness of day hospital treatment for acute psychiatric illness was carried out in two district general hospitals. During the study it became apparent that in one hospital numerous patients being randomised to the day hospital failed to become established in treatment. In depth interviews were carried out with the day hospital staff in an attempt to elicit the reasons for this. It became clear that staff perceptions of the role of the day hospital is a potential source of bias in this type of study. A case study of one patient who was transferred from day to inpatient treatment during the study illustrates the dynamics of this bias. The paper demonstrates, once again, the value of concurrent qualitative research while performing a randomised controlled trial. In this particular case the qualitative interview indicates the reasons why the results of randomised controlled trials at one centre cannot necessarily be generalised to other centres.
Possibly abusive, often benign, and always necessary. On power and domination in medical practice
Authors: Måseide Per 
Published: February 2004

AbstractIn the medical sociological literature that focuses on medical practice, the doctor‐patient relationship is usually described in terms such as relationship asymmetry, cognitive conflicts and professional dominance. The unfortunate consequences of the doctor's power over the patient are stressed in a common criticism of the dominating biomedical perspective of modern medicine. As an alternative, more social psychological models have been promoted. In this paper it is argued that these social psychological perspectives represent an understanding of the nature and role of power in medicine that is insufficient and inadequate; an alternative perspective is therefore supported which conceives of power as necessary and constitutive for adequate medical practice.
Coping with parents
Authors: Brossat Sylvia , Pinell Patrice 
Published: February 2004

AbstractThis paper accounts for the birth of a disease‐related consumers’ association, bringing together parents of children who are patients on a specialist paediatric ward and are subjected to parenteral nutrition at home. We attempt to show how the analysis of the production of technological‐medical innovation permitting the transfer of care from hospital to home elucidates the process leading up to the birth of the group. We interpret this process as a two‐phase development in the ward: the introductory stage, in which social innovations go hand in hand with the technological invention, bringing about a reshuffling of layman‐professional relationships; and the restructuring stage, starting when the former phase is re‐defined and designated as anarchic, and in which the old structure re‐emerges. We argue that the setting up of a parents’ association is a reaction to the re‐establishment of order following a period of order undone.
The uneasy fate of nursing home residents: an organisational‐interaction perspective
Authors: Wiener Carolyn L. , Kayser‐Jones Jeanie 
Published: February 2004

AbstractThis paper examines the macrosociological and organisational conditions which impinge on those who are most directly involved in decisions about nursing home patients: kin, physicians and nursing staff. Focus is on the organisational‐interaction interplay, through use of an ‘illness trajectory’ framework. This analysis sheds light on the differing effect of external and internal conditions on members of each group and on the work they are called upon to do in the care of nursing home patients. All of the actors are caught in a downward spiral: under the impact of the conditions described in this paper, kin, physicians and nursing staff come to accept their powerlessness to affect change; gradual diminution of expectations ensues, leading to an acceptance of a lower standard of care. This, in turn, has serious implications when patients develop an acute illness.
Theorising class, health and lifestyles: can Bourdieu help us?
Authors: Williams Simon J. 
Published: February 2004

AbstractWhat is the relationship between class, health and life‐styles, and to what extent does health‐related knowledge influence subsequent behaviour? These issues have been a source of considerable debate for medical sociologists and others concerned with promoting ‘healthier’ life‐styles over the years. Yet despite a wealth of empirical material, there has been little attempt to theorise this relationship between class, health and lifestyles and the associated issues of structure and agency, accounts and action it raises. This paper attempts to rectify this lacuna through a critical discussion of the work of Pierre Bourdieu, and its relevance to the class, health and life‐styles debate. In particular, attention is paid to Bourdieu's analysis of the logic of practice, his concepts of habitus and bodily hexis, and the search for social distinction in the construction of (health‐related) life‐styles. The paper concludes with a critical commentary on these issues and the relative merits of Bourdieu's analysis for the sociology of health and illness. It is argued that despite certain limitations regarding issues of agency and ‘choice’, Bourdieu's analysis does indeed shed important light on the health and lifestyles debate, and that further bridge‐building exercises of this nature between mainstream theory and the sociology of health and illness are both necessary and fruitful.
Bringing back the body without the blame?: the experience of ill and disabled people at work
Authors: Pinder Ruth 
Published: February 2004

AbstractThis paper tussles with the policy question, that of integrating people with arthritis into employment, in terras of a dialectic between trouble and trust. It suggests that disability theorists' emphasis on the ‘social model of disability’ as the definitive explanation for disabled people's unfavourable position in the labour market is limited without an understanding of the body as a set of relationships linking self and outer world together. For disabled people, longterm illness in a public domain such as work may profoundly disrupt expectations about biographical and social integrity, and normative order. Using an indepth qualitative approach, this paper focuses on the differing employment experiences of two informants disabled by rheumatoid arthritis. Their accounts illustrate some tensions between the breakdown of trust, its constitution as trouble, and attempts to restore ‘business as usual’ in the workplace. The wider social and cultural significance of illness in the workplace, and the need to adopt a more discriminating approach to ‘discrimination’ are discussed.