bluuebunny/crossref_metadata_2025_split huggingface dataset:
Muscle Strength Is a Poor Screening Test for Predicting Lower Extremity Injuries in Professional Male Soccer Players: A 2-Year Prospective Cohort Study
Authors: Bakken Arnhild , Targett Stephen , Bere Tone , Eirale Cristiano , Farooq Abdulaziz , Mosler Andrea B. , Tol Johannes L. , Whiteley Rod , Khan Karim M. , Bahr Roald 
Published: March 2018

Background: Lower extremity muscle strength tests are commonly used to screen for injury risk in professional soccer. However, there is limited evidence on the ability of such tests in predicting future injuries. Purpose: To examine the association between hip and thigh muscle strength and the risk of lower extremity injuries in professional male soccer players. Study Design: Case-control study; Level of evidence, 3. Methods: Professional male soccer players from 14 teams in Qatar underwent a comprehensive strength assessment at the beginning of the 2013/2014 and 2014/2015 seasons. Testing consisted of concentric and eccentric quadriceps and hamstring isokinetic peak torques, eccentric hip adduction and abduction forces, and bilateral isometric adductor force (squeeze test at 45°). Time-loss injuries and exposure in training and matches were registered prospectively by club medical staff throughout each season. Univariate and multivariate Cox regression analyses were used to calculate hazard ratios (HRs) with 95% CIs. Results: In total, 369 players completed all strength tests and had registered injury and exposure data. Of these, 206 players (55.8%) suffered 538 lower extremity injuries during the 2 seasons; acute muscle injuries were the most frequent. Of the 20 strength measures examined, greater quadriceps concentric peak torque at 300 deg/s (HR, 1.005 [95% CI, 1.00-1.01]; P = .037) was the only strength measure identified as significantly associated with a risk of lower extremity injuries in multivariate analysis. Greater quadriceps concentric peak torque at 60 deg/s (HR, 1.004 [95% CI, 1.00-1.01]; P = .026) was associated with the risk of overuse injuries, and greater bilateral adductor strength adjusted for body weight (HR, 0.75 [95% CI, 0.57-0.97; P = .032) was associated with a lower risk for any knee injury. Receiver operating characteristic curve analyses indicated poor predictive ability of the significant strength variables (area under the curve, 0.45-0.56). Conclusion: There was a weak association with the risk of lower extremity injuries for 2 strength variables: greater quadriceps concentric muscle strength at (1) high and (2) low speeds. These associations were too small to identify an “at-risk” player. Therefore, strength testing, as performed in the present study, cannot be recommended as a screening test to predict injuries in professional male soccer.
Biocompatibility and Functional Performance of a Polyethylene Glycol Acid-Grafted Cellulosic Membrane for Hemodialysis
Authors: Sirolli V. , Di Stante S. , Stuard S. , Di Liberato L. , Amoroso L. , Cappelli P. , Bonomini M. 
Published: March 2018

In order to improve the biochemical reactivity of the cellulose polymer, which is mainly attributed to the presence of surface hydroxyl groups, derivatized cellulosic membranes have been engineered replacing or masking some or all of the hydroxyl groups in the manufacturing process of the membrane. The present study was set up to analyze both biocompatibility and functional performance of two different derivatized cellulosic membranes (cellulose diacetate; polyethylene glycol, PEG, acid-grafted cellulose) as compared to a synthetic membrane (polymethylmethacrylate, PMMA). Cellulose diacetate is prepared by substituting hydroxyl groups with acetyl groups; PEG cellulose is obtained by grafting PEG chains onto the cellulosic polymer with a smaller amount of substitution than cellulose diacetate. While the three dialyzers provided similar urea and creatinine removal, the dialyzer containing cellulose diacetate showed a reduced ability to remove β2-microglobulin compared to that containing PEG cellulose or PMMA. A transient reduction in leukocyte count was observed for both derivatized cellulosic membranes. The neutrophil and monocyte counts throughout the entire dialysis session showed a closer parallelism with the cellular expression of the adhesive receptor CD15s (sialyl-Lewis x molecole) than with CD11b/CD18 expression. Platelet activation, as indicated by the percentage of cells expressing the activation markers CD62P (P-selectin) and CD63 (gp53), occurred with all membranes at 15 min of dialysis and also with PMMA at 30 min. An increased formation of platelet-neutrophil and platelet-monocyte coaggregates was found at 15 and 30 min during dialysis with cellulose diacetate and PMMA but not with PEG cellulose. Generally in concomitance with the increase in platelet-neutrophil coaggregates, an increased hydrogen peroxide production by neutrophils occurred. Our results indicate that derivatizing cellulose may represent a useful approach to improve the biocompatibility of the cellulose polymer, though some homeostatic reactions remain activated. Our results also indicate that there may be a great variability in the biocompatibility profile of derivatized cellulosic membranes which most likely stem from the different type of structural modification rather than from the degree of hydroxyl group replacement.
Tissue-Engineered Heart Valve Leaflets: An Effective Method for Seeding Autologous Cells on Scaffolds
Authors: Kim W.G. , Park J.K. , Park Y.N. , Hwang C.M. , Jo Y.H. , Min B.G. , Yoon C.J. , Lee T.-Y. 
Published: March 2018

Background A precondition for the successful formation of tissue-engineered heart valves is the generation of a proper matrix on biodegradable scaffolds over a limited period of time. The aim of this study was to find an effective method of seeding autologous cells on these scaffolds to create a new matrix for heart valves. Methods Myofibroblasts and endothelial cells were isolated and cultured from an ovine artery. A synthetic biodegradable scaffold consisting of polyglycolic and polylactic acids was seeded first with the myofibroblasts, then coated with endothelial cells. Three different methods of myofibroblast seeding were compared: I) daily seeding of myofibroblasts (1×106) for ten days and culture for four days; II) seeding of myofibroblasts (1×107) and culture for 14 days with the use of a simple medium; III) seeding of myofibroblasts (1×107) with the use of a medium containing collagen and culture for 14 days. Light and electron microscopic analyses were perfomed. Results The group that used the medium containing collagen showed the best results in terms of seeding efficiency. Conclusion Seeding autologous cells with a medium containing collagen onto the scaffold showed the largest cell population and might generate the best matrix on the scaffold.
Heparin-Free DALI LDL-Apheresis in Hyperlipidemic Patients: Efficacy, Safety and Biocompatibility
Authors: Wendler T. , Lennertz A. , Heinemann O. , Duhr C. , Samtleben W. , Bosch T. 
Published: March 2018

Background and Aim of Study In routine DALI apheresis - the first technique for direct adsorption of lipoproteins from whole blood - heparin plus citrate (ACD-A) is used as anticoagulation regimen. However, recently several publications have warned of heparin-induced thrombocytopenia as a rare but potentially life-threatening complication of heparin administration (HIT type 2). The aim of the present study was therefore to test the efficacy and biocompatibility of DALI using a heparin-free anticoagulation regimen consisting exclusively of citrate. Methods Four symptomatic hypercholesterolemic patients on regular DALI apheresis were switched to the heparin-free protocol for two sessions each. Two of the patients were on oral anticoagulation using phenprocoumon. In the weekly sessions, 1.3 patient blood volumes were processed at a blood flow rate of 60 ml/min using ACD-A at a ratio of 1:20 (v/v) during adsorber priming and the session. Results Clinically, all sessions were essentially uneventful. Uncorrected lipoprotein reductions amounted to 65% for LDL-C, 62% for Lp(a), 53% for VLDL-C, 24% for HDL-C, 17% for triglycerides and 19% for fibrinogen. Cell counts remained virtually constant. No signs of hemolysis or clotting could be detected. Thromboplastin time (Quick) was slightly prolonged and partial thromboplastin time (PTT) moderately elevated in all patients. In constrast, whole blood coagulation time acc. to Lee-White and activated clotting times were increased only in orally anticoagulated patients. Biocompatibility in terms of complement, leukocyte and thrombocyte activation was excellent. Bradykinin activation was moderate peaking at 3038 pg/ml in the efferent line. Systemic thrombin-antithrombin complex (TAT) reflected perfect anticoagulation in orally anticoagulated patients and adequate anticoagulation in the patients without phenprocoumon. Conclusion In this pilot study, heparin-free DALI apheresis was safe and effective and may thus be performed in LDL-apheresis dependent patients who suffer from heparin intolerance.
Evaluation of Systemic Metal Diffusion after Spinal Pedicular Fixation with Titanium Alloy and Stainless Steel System: A 36-month Experimental Study in Sheep
Authors: Brayda-Bruno M. , Fini M. , Pierini G. , Giavaresi G. , Rocca M. , Giardino R. 
Published: March 2018

It is known that titanium alloys cause more extensive local metallosis due to fretting corrosion than stainless steel implants. The aim of the present study was to investigate possible systemic metal releases (Ti, Al, V, Cr, Ni) in sheep where L4–L5 were implanted with titanium alloy (Ti6Al4V, ASTM F 136) and stainless steel (AISI 316 L). 16 sheep were used: 8 were implanted with Ti6Al4V and 8 with stainless steel. At 6, 12, 24 and 36 months, the following examinations were performed: histology, atomic absorption spectrophotometry (AAS) and scanning electron microscopy (SEM), on liver, lung, kidney, brain, spleen and lumbo-aortic lymph nodes. Hair, urine and arteria blood samples were also analysed by AAS before implantation and at sacrifices. A histologic and ultrastructural study was performed on peri-implant tissues, too. Particular attention was paid to avoid contamination from dissection instruments or use of containers. In basal and in samples at 6 and 12 months, no metals were found in blood, urine, hair or other target tissues of the animals implanted with either Ti6Al4V or stainless steel. Regarding Al, V, Co and Ni, negative results in all tissues and body fluids were obtained also at 24 and 36 months. On the contrary, Ti traces were found in lumbo-aortic lymph nodes and lungs of one sheep only (10 and 30 ng/g, respectively) at 24 months. At 36 months, a systemic diffusion of Ti was observed in all tissues of both sheep instrumented with Ti6AI4V (2-16.5 ng/g), except for body fluids and hair. Metal research in target tissues by light and SEM micro-probe analysis provided negative results. Current data suggest that the amount of Ti found in organs after stable pedicular fixation is extremely low and not biologically available. This observation would lead us to exclude the hypothesis of any toxic reaction and such a release seems to be due to the passive diffusion through lymphatic fluids. Additional studies are needed to confirm if this long-term release of Ti particles might cause tissue damage.
A semi-automatic algorithm for reducing the time spent on routine follow-up of cardioverter defibrillators
Authors: Boriani G. , Biffi M. , Renzi R. , Capestro F. , Pierantozzi A. , Sgarbi E. , Scarfó S. , Alboni P. , Migani L. , Sallusti L. , Frabetti L. , Branzi A. 
Published: March 2018

Background The routine follow-up of cardioverter defibrillators (CD) is a time-consuming procedure. Aim of the Study and Methods The present study was a prospective randomized cross-over evaluation on the clinical usefulness of a specific semi-automatic software algorithm (Quick Check) for CD follow-up, available in CPI Guidant systems (CD and programmer). Time-saving, while ensuring all the required data and patient safety, was evaluated in a large group of patients (105), recruited in different centers. In the same session and under a physician's supervision all patients underwent a follow-up with the aid of Quick Check or a standard follow-up, in a randomized sequence. Each patient served as his own control. Results In the overall population of 105 patients, the time spent for follow-up was reduced by Quick Check from 186±105 sec to 106±67 sec (p<0.0001) (43% reduction). The reduction in time spent for follow-up with Quick Check was the same (43% reduction) in patients with detected episodes (n=38) (from 241±144 sec to 138±95 sec (p<0.0001)) and in patients without detected episodes (n=67) (from 154±52 sec to 88±34 sec (p<0.0001)). No adverse events or deletion of potentially useful data was detected by the supervising physician. Conclusions Use of a specific software algorithm for routine follow-up of implanted CDs allows a significant shortening of the time spent on routine follow-up, thus reducing costs. The supervision of a physician is a guarantee of patient safety.
Cardiomyoplasty: Long-term results in ischemic cardiomyopathy
Authors: Driever R. , Bugenhagen R. , Fuchs S. , Minale C. , Vetter H.O. 
Published: March 2018

Introduction Cardiomyoplasty was introduced into clinical practice in 1985 by Alain Carpentier. Since then, the procedure has been performed on more than 400 patients worldwide. The latissimus dorsi muscle is prepared maintaining the vascular supply, then the muscle flap is wrapped around the heart and connected to a cardiomyostimulator. The muscle is later stimulated synchronously with ventricular systole to augment the cardiac contractility. Methods To evaluate the long-term outcome of cardiomyoplasty, we investigated 3 patients electively undergoing this procedure in our hospital. All of these patients (2 male, 1 female) had severe chronic heart failure which did not respond to optimal medical treatment. The mean follow-up time was 42 months (range 24 - 60). All patients showed symptoms corresponding to NYHA class III, and one patient intermittently showed class IV despite conventional medical therapy. Patients were evaluated at 6-month intervals for 2 years with right heart catheterization, radionuclide scans, echocardiography, as well as questionnaires for assessing quality of life. Results There was no operative mortality. One patient experienced sudden death 2 years after operation. There were no significant changes in hemodynamic variables at 6, 12 or 24 months after surgery, respectively. Left ventricular ejection fraction increased from 20.0 (9.2 to 40.0 ± 7.1 % (p = 0.05) 1 year after operation. Considerable improvement of symptoms was seen in all, and 1 patient returned to work. NYHA-class decreased from 3.1 to 2.0 (p = 0.02). Conclusions Following cardiomyoplasty, patients may exhibit impressive clinical improvement with less striking changes of objective hemodynamic parameters. Thus, in our patients, dynamic cardiomyoplasty improves quality of life. We do not consider this treatment to be an alternative to heart transplantation. It does, however, provide a therapeutic option for patients for whom transplantation is contraindicated.
Phosphatemic Control during Acute Renal Failure: Intermittent Hemodialysis versus Continuous Hemodiafiltration
Authors: Tan H.K. , Bellomo R. , M'Pisi D.A. , Ronco C. 
Published: March 2018

Background Achieving “adequacy of dialysis” includes the maintenance of normal serum phosphate concentrations and is an important therapeutic goal in the treatment of acute renal failure (ARF). It is unknown whether this goal is best achieved with intermittent or continuous renal replacement therapy. Methods We compared the effects of continuous veno-venous hemodiafiltration (CVVHDF) and intermittent hemodialysis (IHD) on serum phosphate concentrations using daily morning blood tests in 88 consecutive intensive care patients half of which were treated with IHD and half with CRRT. Results Mean patient age was 54 ± 14 years for IHD and 60 ± 14 years for CVVHDF (NS). However, patients who received CVVHDF were more critically ill (mean APACHE II scores: 24.4 ± 5.1 for IHD vs. 29.2 ± 5.7 for CVVHDF, p<0.003). Before treatment, the serum phosphate concentration was 2.04 ± 0.16 mmoll L for IHD and 1.96 ± 0.17 mmoll L for CVVHDF (NS), with abnormal values in 79.4% of IHD patients and in 64.8% of CVVHDF patients (NS). During treatment, CVVHDF induced a greater reduction in serum phosphate (p=0.02) during the first 48 hours and conferred superior subsequent control of hyperphosphatemia (achieved in 64.6% of observations during CVVHDF vs. 41.8% during IHD; p<0.0001). The serum phosphate concentration was also more likely to be within the normal range during CVVHDF (55.3% vs.36.2%; p<0.0001). There was a trend toward more frequent hypophosphatemia (9.3% vs. 5.6%; P<0.1) during CVVHDF. Conclusions Abnormal serum phosphate concentrations are frequent in ARF patients before and during renal replacement, however, normalization of phosphatemia is achieved more frequently with CVVHDF.
Standard 19mm St Jude aortic valves in patients with body surface less than 1.7m2
Authors: Renzulli A. , De Feo M. , De Santo L.S. , Corte A. Della , Dialetto G. , Cotrufo M. 
Published: March 2018

Although new models of bileaflet valves with improved orifice have been devised, aortic valve replacement with 19mm prostheses still raises concerns about long term effects of residual transprosthetic gradient. We reviewed our experience with 19 mm standard model St Jude prostheses in 68 patients operated on between January 1983 and December 1995. Clinical late assessment was performed to evaluate the incidence of valve related complications. Postoperative echocardiography was performed to evaluate hemodynamic performance of the prostheses. Mean body surface area was 1.66±0.14m2. Late postoperative peak gradient was 53.85±7.16 mmHg; mean gradient was 34.80±5.55 mm Hg; effective orifice area was 1.93±0.05 cm2. Thirteen-year actuarial survival has been 90.89 ± 0.6%; thirteen-year freedom from embolism 89.41 ± 0.7% and freedom from hemorrhage 98.25 ± 0.02%. No case of prosthetic endocarditis, thrombosis, or reoperation was observed during follow-up.
Design and analysis of coupling methods for modular endoprosthetic systems as an alternative to the conical coupling
Authors: Polmans R.P.J. , Grootenboer H.J. , Koops H. Schraffordt , Veth R.P.H. , van Horn J.R. , Verkerke G.J. 
Published: March 2018

Modular endoprostheses are often used in bone tumor management. However, the conical coupling that connects the various modules has several shortcomings. As an alternative, four new couplings have been developed. To find out if they have sufficient strength and show no movement during loading, each coupling was analysed using the finite element method. Bolt force and friction coefficient was varied to examine their influence. From the analysis it was concluded that coupling B, a dovetail coupling, meets all requirements and is the best alternative to the conical coupling. Sensitivity to bolt force and friction coefficient is very limited.
Daily Dialysis Kt/V and Flexible Schedules: Is it Possible to Control Efficiency, When and How?
Authors: Piccoli G.B. , Calderini M. , Bechis F. , Pacitti A. , Vischi M. , Iacuzzo C. , Mezza E. , Gai M. , Anania P. , Iadarola A.M. , Buniva C. , Jeantet A. , Segoloni G. 
Published: March 2018

Background Daily hemodialysis is a promising treatment schedule but uniform criteria for defining efficiency are lacking. Methods On our daily dialysis (DD) schedule, duration is flexible (2–3 hours, patients are free to add up to 30min/session), Qb 250–350 mL/min; dialyser 1.6–1.8 m2. Study was performed on 12 pts on DD for ≥2 months, with ≥4 Kt/V on subsequent days, tested in the same laboratory. Goal: To evaluate variability and identify a simple method for weekly calculation, Kt/V was assessed for 133 sessions. Results On flexible DD, variability of Kt/V-session is high (relative error 4.9%-22%). On flexible schedules, within the time range chosen (2–3 hours) variability of average hourly Kt/V is lower (standard deviation: min (0.014; max (0.052 hour, relative error 4.9%-10%) allowing calculation of weekly Kt/V (averaging 3 sessions: relative error <6%) suitable for clinical practice. Conclusions Flexible schedules, allowing patients to increase treatment time, are an interesting clinical option, but a challenge for Kt/V assessment.
Ash Split Cath® in Geriatric Dialyzed Patients
Authors: Conz P.A. , Catalano C. , Rizzioli E. , Normanno M. , Fabbian F. , Preciso G. 
Published: March 2018

Vascular access is the essential step in performing hemodialysis in uremic patients. In the absence of a permanent and utilizable native arterio-venous fistula, the use of a tunnelled catheter makes dialysis therapy possible. The Ash Split Cath, a recently introduced chronic hemodialysis catheter, was inserted in five patients (7.1 % of our prevalent dialysis population) because of repeated venous thrombosis in three patients and a poor venous tree in two. The mean age of patients was 78 years ± 7. The average blood flow rate was 250 ± 50 ml/minute and the mean venous pressure 140mm Hg ± 35. Recirculation determined by low flux technique was less than 2 %. KT/V calculated 3 months after the catheter placement was 1.2 ± 0.02. During the follow-up we did not document any infection of the exit site or related to the catheter. This device is simple to place, gives adequate dialysis treatment and is useful in geriatric dialyzed patients in whom the arterio-venous fistula can no longer be used.
Pressure Drops in Cannulas for Hemodialysis
Authors: Polaschegg H.D. 
Published: March 2018

Pressure drops in cannulas for hemodialysis have been measured in vitro in both flow directions for five different viscosities and up to 600 mL/min flow. Cannula dimensions were 15, 16 and 17 gauge and 15, 20 and 25 mm nominal length. The measurements were taken at room temperature with glycerin solutions as test fluid. Results The pressure drops can be described by a second order function but not by the Hagen-Poiseuille law even when corrected for inlet and outlet effects as described by Bernoulli's law. Pressure drops depend on flow direction. Back-eyes and cannula tips have no influence on the pressure drop. Pressure drops and especially flow direction asymmetry are influenced by the hydraulic design of the connection piece between cannula and tubing. The results can be used for prediction of pressure drops in cannulas allowing better use of pressures already measured in the extracorporeal circuit of hemodialysis machines.