bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of laser power on microstructure and tribological performance of WC−10Co4Cr coating
Authors: Zhicheng Liu , Jiangzheng Shi , Chuang He , Fan Wang , Dejun Kong 
Published: April 2023

AbstractIn order to enhance wear resistance of cold work molds, WC−10Co4Cr coating was fabricated on Cr12MoV steel by laser cladding. The morphologies, chemical compositions, and phases of obtained coatings were analyzed using a scanning electron microscopy (SEM), energy disperse spectroscopy, and X−ray diffraction, respectively. The effect of laser power on the tribological performance was analyzed using a ball−on−plate friction machine, and the wear mechanism was also discussed. The results show that the WC−10Co4Cr coating is composed of WC and Co6W6C phases, and the average hardness of coating cross−sections fabricated at the laser power of 1200, 1500, and 1800 W was 1296, 1375, and 1262 HV0.5, respectively, in which that fabricated at the laser power of 1500 W is the highest among the three kinds of coatings. The average coefficients of friction of coatings fabricated at the laser power of 1200, 1500, and 1800 W are 0.61, 0.52, and 0.59, respectively; and the corresponding wear rates are 64.38, 35.38, and 123.92 μm3•N−1•mm−1, respectively, showing that the coating fabricated at the laser power of 1500 W has best friction reduction and wear resistance. The wear mechanism of WC−10Co4Cr coating is fatigue wear and abrasive wear, which is contributed to the increase of hard WC mass fraction.
Exploring the displacement induced changes in social convoys and support for older women in displacement (OWD) in Abuja, Nigeria
Authors: Ekoh Prince Chiagozie , Chukwuemeka Ejimakaraonye 
Published: April 2023

AbstractThe world is witnessing a dramatic increase in displaced persons in Africa, Asia, South America, and, most recently, Europe. Within this population of violence‐induced displacement are older women, a group that is mostly unseen because research and relief initiatives primarily target younger women and children. This study aimed to explore the changes in the convoys and support for older women in displacement (OWD). Qualitative data were collected from nine OWD using art‐based convoys of concentric circles and interviews. The collected data were analysed in themes, and findings revealed that while there has been intervention from formal organisations to fill the displacement‐induced support gap, supports are still limited, sporadic, not focused on the peculiar needs of OWD, not guided by any framework, and mainly material in design. The study concluded by recommending sustainable support to help OWD become empowered to cope effectively without aid.
Aleukaemic granulocytic sarcoma
Authors: Ifrah N , Saint‐Andre J P , Rousselet M C , Chretten M F , Fondimare A , Boasson M 
Published: April 2023

SummaryA case of aleukaemic granulocytic sarcoma with bone and lymph node involvement is reported in a young man. It was initially misdiagnosed as an eosinophilic granuloma. Death occurred 13 months later with evidence of leukaemia arising a few days before the end‐stage of the disease. A review of the literature shows that these rare tumours are difficult to identify and to treat.
Comparative evaluation of cefotaxime and cephamandole in the prevention of post‐operative infective complications following emergency abdominal surgery
Authors: Ridley P D , Sagar S 
Published: April 2023

SummaryIn previous published work we described 57 patients undergoing emergency abdominal surgery, prospectively randomised to receive either cefotaxime or cephamandole as a single‐antibiotic, three‐dose, peri‐operative prophylaxis against post‐operative infective complications. This earlier work suggested that cefotaxime might be more effective than cephamandole in preventing wound sepsis in emergency abdominal surgery.We describe here our findings in a further 63 patients undergoing emergency abdominal surgery who were similarly allocated into either a cefotaxime or cephamandole antibiotic group. Infective complications occurred in 12/32 (37 percent) of the cefotaxime group and 15/31 (48 per cent) of the cephamandole group. Wound infections occurred in 5/32 (16 per cent) of the cefotaxime group and 9/31 (29 per cent) of the cephamandole group. The organisms cultured and their sensitivities are discussed in detail.The total of 120 patients studied in the two series showed wound infection to occur in 13 per cent of the 62 patients receiving cefotaxime and 30 percent of the 58 patients receiving cephamandole. This difference reaches statistical significance (p<0.05). Possible mechanisms to explain this finding are discussed.Again we found the regime of 4 g of cefotaxime given peri‐operatively to be a simple, safe and effective single agent as prophylaxis for emergency abdominal surgery
Abdominal tuberculosis
Authors: Aston N O , De Costa A M 
Published: April 2023

SummaryOver a four‐year period, 28 patients with abdominal tuberculosis were seen, of whom 24 were immigrants and 22 under 45 years. Emergency surgery was carried out in 10 patients; another 14 had elective laparotomy. The diagnosis was suspected pre‐operatively in 75 per cent of those having elective surgery and 10 per cent of those having emergency laparotomy. Perforated ileal strictures were found in 30 per cent of those with acute symptoms. Half of those with chronic disease had hyperplastic ileocaecal disease and half tuberculous peritonitis. Positive histology was obtained in 23 patients, but culture was positive in only four. The only death was of an elderly white man with a perforated ileal stricture. The four patients treated without surgery showed a rapid symptomatic response to antituberculous drugs.
Gastrointestinal malignancies as a complication of chronic myeloid leukaemia
Authors: Slade R , Thomas W E G 
Published: April 2023

SummaryA 70‐year‐old patient is presented who, after chemotherapy for chronic myeloid leukaemia, developed two separate gastrointestinal malignancies. His family history indicated a strong family tendency towards neoplasia, and it is speculated that this predisposition may have been potentiated by the chemotherapy or the leukaemic process itself. It is stressed that, in such cases of multiple malignancy, each condition should be treated on its own merits.
Multicentre, double‐blind comparison of terfenadine and cetirizine in patients with seasonal allergic rhinitis
Authors: Backhouse C I , Renton R , Fidler C , Rosenberg R M 
Published: April 2023

SummaryThis double‐blind, multicentre study was designed to compare the efficacy and tolerability of terfenadine 120 mg with cetirizine 10 mg, each taken once daily, in the treatment of seasonal allergic rhinitis. Two hundred and eighty‐five patients were recruited to the study by nine general practice centres in the south of England during the 1989 hay‐fever season.Symptom severity was assessed daily by the patient and before and after the one‐week treatment period by the investigator. At the second clinic visit both patient and investigator assessed the overall response to treatment.The two treatment groups were well matched for all demographic variables and baseline symptom scores. Improvement in all seven symptoms (nasal congestion, sneezing, rhinorrhoea, itching nose, itching eyes, watery eyes and red eyes) and overall response to treatment were similar in both treatment groups. Adverse events were mainly of mild to moderate severity and were reported by 14 patients on terfenadine and 21 patients treated with cetirizine (p=0.317).This study confirmed terfenadine's role as the treatment of choice in hayfever. A single 120 mg dose in the morning effectively reduced symptoms by 43 to 70 per cent of baseline values, with an acceptably low incidence of side effects. Cetirizine at a single dose of 10 mg displayed equal efficacy in controlling hayfever symptoms but, in common with other studies, had a significantly greater incidence of drowsiness (p=0.046).
A multicentre, long‐term evaluation of the safety and efficacy of ibuprofen syrup in children with juvenile chronic arthritis
Authors: Steans A , Manners P J , Robinson I G 
Published: April 2023

SummaryThe safety, efficacy and acceptability of ibuprofen syrup were assessed in a multicentre controlled open study in children with juvenile chronic arthritis. Forty‐six children aged 18 months to 13 years (mean 6.8 years) were studied. Dosage commenced at 10 mg/kg/day and increased to a maximum of 40 mg/kg/day depending on condition and individual disease control. Follow‐up assessments of disease severity, active joint count and any side effects were made at each clinic visit, usually monthly or as often as deemed necessary by the physician.Thirty‐nine children completed the minimum eight weeks treatment period, with average duration of treatment being eight months. Seven children did not complete the minimum required treatment period, of which four were lost to follow‐up or non‐compliant, two had suspected adverse reactions, and one had a taste complaint and nausea. Adverse reactions were predominantly gastrointestinal, but only one was severe enough for discontinuation from the study before the end of the protocol period. Two children had minimal benefit from treatment and were changed to other medication, 10 went into remission during the study period and four were lost to follow‐up. Twenty‐three children continued on ibuprofen syrup or tablets after the study period.This study demonstrates that ibuprofen is a well tolerated anti‐inflammatory agent for children with juvenile chronic arthritis, and that the syrup form is particularly useful for small children who may not be able to swallow tablets.
The body‐worn alarm in the treatment of childhood enuresis
Authors: Butler R J , Forsythe W I , Robertson J 
Published: April 2023

SummaryTwo studies examined the effectiveness of the body‐worn alarm in out‐patient treatment of childhood nocturnal enuresis. The first involved 40 children, previously untreated by conditioning methods, treated with either the body‐worn alarm or the traditional pad and bell alarm. The second study compared the body‐worn alarm with modified dry‐bed training with 48 children previously resistant to treatment.Results of both studies indicated the body‐worn alarm was as effective as other methods in terms of the proportion of children successfully treated and was superior with respect to rapidity of response and consumer appeal. Such findings indicate that the body‐worn alarm could become the treatment of choice for nocturnal enuresis.
Disseminated intravascular coagulation and bacterial infections in the elderly
Authors: Anandadas J A , Banerjee A K 
Published: April 2023

SummaryAnticoagulant screening tests (prothrombin time, thrombin time, kaolin‐cephalin time and serum fibrinogen levels), platelet count and estimation of fibrinogen degradation products were carried out on 34 elderly patients with proven bacterial infections, 42 elderly patients with suspected bacterial infections and in 20 controls, to investigate the existence of a sub‐clinical form of disseminated intravascular coagulation.The prothrombin time was significantly prolonged in bacterial infections of the elderly and subclinical intravascular coagulation was not found to be a feature. The screening tests did not show any correlation with the outcome of the disease or the presence of septicaemia.
Comparison of the efficacy and long‐term tolerability of a combination of atenolol and nifedipine with atenolol alone in the treatment of hypertension
Authors: Mayhew S 
Published: April 2023

SummaryThis randomised, double‐blind crossover study in 30 hypertensive patients has demonstrated that the fixed combination of atenolol (50 mg) and nifedipine retard (20 mg) once daily lowered blood pressure to a significantly greater extent than atenolol (50 mg once daily) alone. In a follow‐up six‐month open tolerance study there was no evidence of tachyphylaxis, and treatment with the fixed combination was well tolerated. In selected hypertensive patients use of this fixed formulation may result in improved blood pressure control and benefit patient compliance.
Displaced boxers' fractures: a simple and effective method of external splintage
Authors: Maitra Asit , Sen Basav 
Published: April 2023

SummaryForty patients with fractures of the fifth metacarpal neck (boxers' fractures) having a volar angulation of 30° or more were treated by closed reduction and external immobilisation. A combination of malleable aluminium alloy splint and plaster of Paris cast was used. The results show a significant improvement in fracture angulation after reduction and at follow‐up (3/5 weeks) using this form of external splintage. There were no complications. Our results compare favourably with those of other recently published series. We advocate the use of this method of treatment for these fractures with significant volar angulation.
WHICH ANTIBIOTIC FOR SURGICAL NOSOCOMIAL INFECTION?
Authors: Chapman S T , Walsh T H 
Published: April 2023

SUMMARYNosocomial infection means hospital‐acquired infection. In this article we discuss treatment of nosocomial infections which relate to, or arise as a consequence of, general surgical procedures. Most such infections become apparent during the patient's stay in hospital, but some patients with nosocomial infection first present to their general practitioners after discharge and this group should not be overlooked.
PARADOXICAL EMBOLI IN ELDERLY PATIENTS
Authors: Vella M , McNabb R , Lewis R , Sulke N , Poston R , Lugon M 
Published: April 2023

SUMMARYWe report two elderly patients who each had a patent foramen ovale (PFO) and were considered to have had paradoxical emboli. In one patient the PFO was detected by contrast two‐dimensional echocardiography, whereas in the other it was demonstrated at post‐mortem examination. This is an unusual but treatable condition, particularly difficult to diagnose in older people and probably occurring more frequently than is generally suspected.1
RECURRENT ENDOMETRIAL ADENOCARCINOMA PRESENTING AS AN UMBILICAL METASTASIS (SISTER MARY JOSEPH'S NODULE)
Authors: Patel K S , Watkins R M 
Published: April 2023

SUMMARYA case of recurrent endometrial adenocarcinoma metastatic to the umbilicus is reported. The possible modes of spread, management and prognosis of this rare manifestation of visceral malignancy are discussed.
RUPTURED ABDOMINAL AORTIC ANEURYSM PRESENTING WITH ACUTE URINARY RETENTION
Authors: Scott HJ , Bearn PE , Scott RAP 
Published: April 2023

SUMMARYRuptured abdominal aortic aneurysm classically presents with abdominal pain radiating to the back, a pulsatile abdominal mass and circulatory collapse. However, other symptoms may be the only presenting complaint. We report the case of a patient who presented with a history of acute retention of urine relieved by catheterisation, but who then developed clinical features more typical of abdominal aortic aneurysm rupture.
POLYARTERITIS NODOSA PRESENTING WITH HYPERTENSIVE ENCEPHALOPATHY
Authors: Vora J , Cooper J , Thomas J P 
Published: April 2023

SUMMARYPolyarteritis nodosa (PAN) is a rare cause of malignant hypertension.1 As far as we are aware, hypertensive encephalopathy has not been described in the literature as a presenting feature of PAN.
ACUTE GASTROENTERITIS: EFFECT ON NUTRITIONAL STATUS
Authors: Cunningham R , Parry C M , Harries A D , Beeching N J 
Published: April 2023

SUMMARYAnthropometric measurements were performed on admission and at four weeks post discharge on 25 adults referred to hospital with acute gastroenteritis. There was a significant change in weight (P <0.001) and mid‐arm circumference (P <0.05), but no change in skinfold thickness, arm muscle area or arm fat area. The results suggest that weight change during acute gastroenteritis is more a consequence of dehydration than of malnutrition.
PATIENT SATISFACTION IN AN URBAN ACCIDENT AND EMERGENCY DEPARTMENT
Authors: Maitra A , Chikhani C 
Published: April 2023

SUMMARYThe aim of this study was to assess patients' opinions about their experience of attending an urban Accident and Emergency department. They were given a questionnaire designed to demonstrate any shortcomings in the delivery of care which required corrective actions. Just over half (50.8%) the patients responded, 411 (95%) of whom recorded satisfaction with the outcome of their visit (P = 0.0001). There was significant correlation between patient satisfaction and waiting time to see the doctor (P = 0.003), the doctor's explanation about management (P = 0.02), and total time spent in the department (P = 0.01). A total of 120 patients (27.8%) did not receive any explanation from the nurse about what was going to happen, and 267 (61.6%) received no information about possible delay. These factors did not significantly influence patients' satisfaction with the outcome, but they need to be addressed as they will obviously lead to an improved service.
FINE NEEDLE ASPIRATION CYTOLOGY OF PALPABLE BREAST LESIONS
Authors: De Freitas R , Hamed H , Fentiman I 
Published: April 2023

SUMMARYFine needle aspiration cytology is a safe diagnostic technique for breast cancer and can identify certain benign lesions, which can be excised without affecting surrounding tissue. The combination of experienced operator and cytologist can yield high sensitivity and specificity, together with important prognostic information.
THE ACUTE PORPHYRIAS
Authors: Lip G Y H , McColl K E L , Moore M R 
Published: April 2023

SUMMARYThe porphyrias are a heterogeneous group of rare inborn errors of metabolism caused by inherited enzyme defects in the haem biosynthetic pathway, resulting in overproduction of porphyrins. The porphyrias can be distinguished biochemically but may be difficult to differentiate clinically. Considerable advances have been made in the understanding of the enzymology and molecular biology of the porphyrias. The acute attack of porphyria may be a life‐threatening condition, and an understanding of its many precipitating factors, clinical features and management is of importance in a disease with a significant mortality.
PLASMA VISCOSITY AND THE DIAGNOSIS OF GIANT CELL ARTERITIS
Authors: Orrell R W , Johnson M H 
Published: April 2023

SUMMARYThe level of plasma viscosity associated with the diagnosis of giant cell arteritis, and its use as a replacement for the erythrocyte sedimentation rate (ESR) is examined, by reviewing the records of 59 patients undergoing temporal artery biopsy. All patients with positive temporal artery biopsy had plasma viscosity above the upper limit of normal (1.72 mPa.s), range 1.88 to 2.28. There was a large group of patients with a possible diagnosis, supported by a raised plasma viscosity, who in the absence of a positive biopsy were not felt to have clinical disease requiring steroid treatment. The role of plasma viscosity appears to be similar to that of the ESR in the diagnosis of giant cell arteritis.
INAPPROPRIATE OUT‐PATIENT REFERRALS INCREASING?
Authors: Nunez D A 
Published: April 2023

SUMMARYA study was undertaken to determine if inappropriate general practitioner out‐patient referrals have increased. Out‐patients referred to an otolaryngology unit in north‐east England were analysed. Patient, diagnosis, waiting time and outcome of consultation details of new attenders for a two‐month period in 1981 and 1989 were compared. New out‐patient attenders without evidence of otolaryngological disease, who required no treatment, investigation or follow‐up, were defined as inappropriate referrals.A total of 2200 new attendances were studied, 819 in 1981 and 1381 in 1989. In all, 125 referrals (15%; 95% confidence interval, 12–18%) in 1981 and 180 patients (13%; 11–15%) in 1989 were inappropriate. There was no increase in the proportion of inappropriate referrals.
RHINOCEREBRAL MUCORMYCOSIS DIABETES MELLITUS AND ADRENOGENITAL SYNDROME
Authors: Weinberg J R , Smith A , Langley K , Gwavava N J 
Published: April 2023

SUMMARYA case of rhinocerebral mucormycosis in a diabetic is described. The case is unusual as the mucormycosis developed in the absence of ketoacidosis and because the patient had concomitant adrenogenital syndrome.
ENDOTHELIAL DYSFUNCTION AND CARDIOVASCULAR DISEASE: THE PROMISE OF BLOCKING THE RENIN‐ANGIOTENSIN SYSTEM
Authors: Erhardt LR 
Published: April 2023

SUMMARYAs a crucial regulator of vascular function the endothelium balances a complex range of actions. Accordingly, damage to the endothelium often precedes the development of clinically manifest vascular disease. This review surveys our current understanding of risk factors involved in causing endothelial damage and the effects of lifestyle changes and pharmacotherapy on the endothelium. Our developing understanding of the intricacies of endothelial function and the effects of risk factors may aid in optimising cardiovascular prevention as well as therapy.
DEFICIT IN MOTOR PERFORMANCE CORRELATES WITH CHANGED CORTICOSPINAL EXCITABILITY IN PATIENTS WITH CHRONIC FATIGUE SYNDROME
Authors: Davey NJ , Puri BK , Main J , Nowicky AV , Zaman R 
Published: April 2023

SUMMARYChronic fatigue syndrome (CFS) is characterised by fatigue and musculosketetal pain, the severity of which is variable. Simple reaction times (SRTs) and movement times (SMTs) are slowed in CFS. Our objective is to correlate the day‐to‐day changes in symptomatology with any change in SRT, SMT or corticospinal excitability. Ten CFS patients were tested on two occasions up to two years apart. Motor evoked potentials (MEPs) to transcranial magnetic stimulation (TMS) of the motor cortex were recorded from the thenar muscles. Threshold TMS strength to evoke MEPs was measured to index corticospinal excitability. SRTs and SMTs were measured. The percentage change in both SRTs and SMTs between the two test sessions correlated with the percentage change in corticospinal excitability assessed according to threshold TMS intensity required to produce MEPs. This study provides evidence that changing motor deficits in CFS have a neurophysiological basis. The slowness of SRTs supports the notion of a deficit in motor preparatory areas of the brain.
MAKING PROGRESS IN STABLE PATIENTS POST STROKE OR TRANSIENT ISCHAEMIC ATTACK: IMPLICATIONS FOR GENERAL PRACTICE
Authors: Jackson G 
Published: April 2023

SUMMARYStroke is a major cause of morbidity and mortality. Those who survive have a one in six chance of a further stroke in the ensuing five years. The perindopril protection against recurrent stroke study (PROGRESS) is the first specific trial to address whether blood pressure lowering in hypertensive or non‐hypertensive patients with a history of stroke or transient ischaemic attack (TIA) would reduce subsequent cerebrovascular and cardiovascular events. Results show that treatment based on perindopril significantly reduces stroke (28%), cardiovascular events (26%) and heart failure (26%). Stable patients post stroke should be considered for perindopril, and indapamide if possible, along with other evidence based risk reduction treatments (e.g. aspirin, statins). Therapy can be initiated and monitored either from hospital outpatients or general practice or both in co‐operation.