bluuebunny/crossref_metadata_2025_split huggingface dataset:
Volume of Ambulatory Care Visits and Patterns of Care for Patients Diagnosed with Plantar Fasciitis: A National Study of Medical Doctors
Authors: Riddle Daniel L. , Schappert Susan M. 
Published: January 2017

Background: Plantar fasciitis is a relatively common disorder of the foot, yet little is known about its prevalence, what types of physicians see patients with the disorder, or how, on a national scale, patients are typically managed. The purpose of this study was to generate national estimates of the volume of patient visits and characteristics of care given to patients diagnosed with plantar fasciitis by medical doctors. Methods: Data from the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS) for the years 1995–2000 were studied. These are multistage probability sample surveys of visits to office-based physicians (NAMCS) and visits to nonfederal, short-stay, and general hospitals (NHAMCS) to consult doctors of medicine and doctors of osteopathy. Sample data have been weighted to produce national estimates. Data describing the number of patient visits for plantar fasciitis and the characteristics of the care given during those visits were summarized using univariate analyses. Data were combined for the 6-year period to increase the reliability of the estimates, and figures are presented as annual averages. Results: Approximately 1 million patient visits per year were made to office-based physicians and hospital outpatient departments for the diagnosis and treatment of plantar fasciitis during 1995–2000. Approximately 62% of all visits were made to primary care practitioners, and 31% were made to orthopaedic surgeons. Patient visits for plantar fasciitis accounted for approximately 1% of all patient visits to orthopedic surgeons. Pain medication, including nonsteroidal anti-inflammatory drugs (NSAIDs), was the most frequently used intervention (47% of visits). Exercise counseling was cited at 26% of visits, and physical therapy was ordered or provided at 19% of visits. Conclusions: This research suggests that plantar fasciitis is a relatively common disorder that is seen by several physician specialties. The disorder is not managed in a consistent way. Rather, there appears to be a large amount of variation in the way that these patients are managed. These findings support the argument that additional research is needed to identify effective interventions for plantar fasciitis and to determine if physician specialty influences treatment outcome.
Change in Plantarflexion Strength after Complete Detachment and Reconstruction of the Achilles Tendon
Authors: Wagner Emilio , Gould John , Bilen Erkel , Fleisig Glenn S. , Wilk Kevin , Fowler Rachel 
Published: January 2017

Background: Chronic insertional tendinitis of the Achilles tendon is an overuse injury seen with increasing frequency because of an aging population and an increased interest in sports. We evaluated the change in plantarflexion strength in patients after our surgical technique for chronic insertional Achilles tendinitis. Methods: From our previous clinical series of detachment and reconstruction of the Achilles tendon for the treatment of insertional tendinitis, ten patients were evaluated with an average followup of 32.1 (range 18 to 52) months. The average age was 65.7 years. We developed a mathematical model to predict the difference in plantarflexion strength between a reconstructed ankle and a healthy contralateral one. Isokinetic testing at 60 degrees/second was performed, measuring plantarflexion peak torque, dorsiflexion peak torque, and total work. Results: Our mathematical model predicted a decrease of 4% in plantarflexion torque after the surgery. Isokinetic testing found no significant differences in plantarflexion torque, dorsiflexion torque, or total work between the operated and nonoperated ankles. Conclusions: Complete detachment and reconstruction of the Achilles tendon do not decrease the working capacity of the gastrocsoleus muscle.
Frequency and Effects of Intratendinous and Peritendinous Calcifications after Open Achilles Tendon Repair
Authors: Kraus Ralf , Stahl Jens-Peter , Meyer Christof , Pavlidis Theodorus , Alt Volker , Horas Uwe , Schnettler Reinhard 
Published: January 2017

Background: Although calcification of the Achilles tendon has been described by several authors, a detailed evaluation of its frequency and effects on clinical outcome has not been reported. The purposes of this work were to determine the frequency of calcifications in the Achilles tendon after open repair and their effects on clinical outcomes and to identify possible risk factors for postoperative calcification. Methods: Thirty-six patients with open Achilles tendon repair were evaluated at an average followup of 19 months. Evaluation included a self-assessment questionnaire concerning treatment outcomes, clinical examination, and radiographic and ultrasonographic examinations. Results: No patient had calcifications in the Achilles tendon area before surgery. Postoperatively, intratendinous or peritendinous calcifications, ranging in size from 3 mm to 37 mm, were found in 10 (28%) of the 36 patients. The development of calcifications was associated with chronic swelling, decreased range of motion of the ankle joint, and increase pain, especially with calcifications larger than 10 mm. No association was found between the development of calcifications and the surgical technique, suture materials, time from injury to surgery, or postoperative management, and no risk factors could be identified. Conclusions: Calcifications of the Achilles tendon appear to be frequent after open tendon repair and to have a negative effect on clinical outcome.
Bilateral Deficits in Postural Control following Lateral Ankle Sprain
Authors: Evans Todd , Hertel Jay , Sebastianelli Wayne 
Published: January 2017

Background: Although postural control deficits have been identified after lateral ankle sprains, objective and subjective comparisons of data before and after injury are limited. The purpose of this project was to prospectively assess and compare the changes in postural control and self-reported functional status in athletes who suffer acute lateral ankle sprains. We evaluated postural control and self-reported functional status before injury and at 1, 7, 14, 21, and 28 days after acute lateral ankle sprain. Methods: Postural control in single-limb stance and self-reported functional status were evaluated in 460 collegiate athletes during preseason examinations. Twenty-eight athletes suffered a lateral ankle sprain during the competitive season and participated in testing at 1, 7, 14, 21, and 28 days after injury. Results: Significant deficits in postural control were noted in both the injured and the uninjured ankles at 1 day after injury compared to the baseline measurements taken during the preseason examinations. Significant differences ( p < .05) also were noted between the uninjured and injured ankles at 1, 7, and 21 days after injury. Conclusions: After lateral ankle sprain, postural control deficits occur in the injured and uninjured ankles, suggesting a central impairment in neuromuscular control. Changes in self-reported functional status followed a trend of deficit and improvement that was similar to that shown by the postural control data taken after injury, but the two measures did not strongly correlate.
A Comparison of the Tolerability and Efficacy of Lovastatin 20 mg and Fluvastatin 20 mg in the Treatment of Primary Hypercholesterolemia
Authors: Berger Marc L. , Wilson Helene M. , Liss Charles L. 
Published: January 2017

Background: To compare the cholesterol-lowering potency of fluvastatin and lovastatin, a randomized, prospective. open-label parallel study was conducted in patients eligible for drug therapy by National Cholesterol Education Program guidelines. The study was conducted at eight centers in the United States. Methods and Results: Patients were required to follow a cholesterol-lowering diet and were withdrawn from all lipid-lowering agents for 4 weeks prior to study entry. Patients were randomized to receive lovastatin 20 mg or fluvastatin 20 mg daily for 6 weeks. The two treatment groups were comparable with respect to demographic and clinical characteristics. Baseline lipid levels in the two groups were comparable. Lovastatin was significantly more effective than fluvastatin in lowering total cholesterol (-19.5% vs-12.8%, P <.001) and low-density lipoprotein cholesterol (-27.6% vs-18.2%. P <.001). Changes in high-density lipoprotein and triglyceride levels were comparable in the two groups. The differences in cholesterol lowering were similar in the three strata of coronary heart disease risk factor status as defined by the second NCEP Adult Treatment Panel. Both treatments were well tolerated. Conclusions: Treatment of patients with combined hyperlipidemia and/or low high-density lipoprotein with combination low-dose simvastatin and niacin resulted in large reductions in total, low-density lipoprotein, and very low-density lipoprotein cholesterol and increases in HDL cholesterol. Although the combination was well tolerated in the current trial, its safety needs to be evaluated in larger trials of longer duration.
Atorvastatin, a New HMG-CoA Reductase Inhibitor as Monotherapy and Combined With Colestipol
Authors: Heinonen Therese M. , Schrott Helmut , McKenney James M. , Sniderman Allan D. , Broyles Frances E. , Zavoral James H. , Kivel Frances , Black Donald M. 
Published: January 2017

Background: Atorvastatin, a new HMG-CoA reductase inhibitor in clinical development has demonstrated an acceptable safety profile and marked cholesterol and triglyceride reduction at doses ranging from 10-80 mg/day. Since bile acid sequestering resins are often used in combination with HMGRIs to enhance cholesterol reduction, this trial was conducted to explore the use of atorvastatin alone and combined with colestipol in patients with primary hyperlipidemia. Methods and Results: One hundred six patients with low-density lipoprotein (LDL) cholesterol > 4.1 mM/L (160 mg/dL) and plasma triglycerides < 3.9 mM/L (350 mg/dL) were randomized to treatment consisting of 20 g/day colestipol, 10 mg/day atorvastatin, or 10 mg/day atorvastatin plus 20 g/day colestipol for 12 weeks. Percent change from baseline in lipid variables was measured. The atorvastatin group showed a significant reduction in LDL cholesterol of 35% after 12 weeks. Combination therapy provided an additional 10% reduction in LDL cholesterol over that observed for atorvastatin alone. Twenty-one percent of all patients in the atorvastatin monotherapy group experienced associated adverse events compared with 60% in the combination therapy group. Ninety percent of atorvastatin monotherapy patients were compliant at every visit compared with 75% receiving combination therapy. Conclusions: Although the combination of atorvastatin plus colestipol was more effective in lowering LDL cholesterol than atorvastatin alone, atorvastatin 10 mg/day monotherapy provided a better safety profile and improved patient compliance. which may result in improved long-term cholesterol control. Conclusions: Although the combination of atorvastatin plus colestipol was more effective in lowering LDL cholesterol than atorvastatin alone, atorvastatin 10 mg/day monotherapy provided a better safety profile and improved patient compliance. which may result in improved long-term cholesterol control.
Protective Effects of Ranolazine on Ventricular Fibrillation Induced by Activation of the ATP-Dependent Potassium Channel in the Rabbit Heart
Authors: Gralinski Michael R. , Chi Liguo , Park James L. , Friedrichs Gregory S. , Tanhehco Elaine J. , McCormack James G. , Lucchesi Benedict R. 
Published: January 2017

Background: The authors studied the antifibrillatory effects of the adenosine-triphosphate (ATP)-sparing metabolic modulator ranolazine in a rabbit isolated heart model in which ventricular fibrillation occurs under conditions of hypoxia/reoxygenation in the presence of the ATP-dependent potassium channel opener pinacidil. Methods and Results: Ten minutes after ranolazine or vehicle administration, addition of pinacidil (1.25 μM) to the buffer was followed by a 12-minute hypoxic period and 40 minutes of reoxygenation. At a reduced concentration of ranolazine (10 μM ), ventricular fibrillation occurred in 60% of the hearts. compared to 89% in the control group ( P = NS). In contrast, only three of nine hearts (33%) treated with 20 μM ranolazine developed ventricular fibrillation ( P <.05 vs vehicle). Hemodynamic parameters including coronary perfusion pressure, left ventricular developed pressure, and ±dP/dt were not affected by the presence of ranolazine in the perfusion medium. Ranolazine did not prevent or modify the negative inotropic or coronary vasodilator actions of pinacidil, suggesting a mechanism of action independent of potassium channel antagonism. Conclusions: Ranolazine significantly reduced the incidence of ventricular fibrillation in the hypoxic/reoxygenated heart exposed to the ATP-dependent potassium channel opener, pinacidil. The reported ability of ranolazine to prevent the decrease in cellular ATP during periods of a reduced oxygen supply may account for its observed antifibrillatory action. By maintaining intracellular ATP, ranolazine may modulate or prevent further opening of the ATP-dependent potassium channel in response to hypoxia and/or pinacidil.
Evidence of Na Current Contribution to the Transient Outward Current in Cardiac Ventricular Myocytes
Authors: Boutjdir Mohamed , Zhang Zhi-Hao , Huang Boyu , Stergiopoulos Nicholas , El-Sherif Nabil 
Published: January 2017

Background: To study the transient outward current (Ito) investigators often use sodium-free external solution to minimize the possible contamination of Ito by sodium current. Removal of extracellular sodium creates reversal of sodium gradient and thus possibly contributing to Ito mainly at positive potentials. Methods and Results: To address this issue, whole-cell Ito was recorded in sodium-free choline chloride and cobalt solutions, from rat ventricular myocytes known to exhibit a prominent Ito. Depolarizing pulse to 40 mV from-100 mV holding potential every 10 seconds elicited a fast activating and time-dependent inactivating components. The activation of Ito was fast and complete within 10 ms at 40 mV. and the decay was rapid over the first 100 ms of the pulse and slower thereafter. External superfusion of the cell with 50 μM tetrodotoxin reversibly reduced Ito amplitude by 25% from 1.47 ± 0.2 to 1.1 ± 0.3 nA ( P <.04, n = 9). When sea anemone toxin (ATXII), known to selectively enhance INa by causing a delay in the inactivation gate, is applied to the cell, Ito amplitude increased in a time-and dose-dependent manner (EC50 = 86.4 nM). ATXII (100 nM) dramatically increased Itoamplitude at all voltages between-20 and 60 mV (from 1.51 ± 0.4 to 3.35 ± 0.8 nA at 40 mV, P <.003, n = 12). Superfusion of cells with 5 mM 4-AP resulted in 82% reduction in Ito amplitude at 40 mV (from 1.95 ± 0.5 to 0.37 ± 0.2 nA, P <.02, n = 8). Addition of ATXII to 4-AP containing solution increased peak Ito by 965% (from 0.37 ± 0.2 to 3.95 ± 0.9, n = 8, P <.0003). However, in 11 other cells, addition of tetrodotoxin (50 μM) to the ATXII-containing solution blocked ATXII-induced outward current (from 3.51 ± 0.64 nA to 1.60 ± 0.17 nA. P <.05). The conductance (GIto) was calculated by dividing peak Ito by (Vm-EK), with an EK of-75 mV. GIto was increased at all voltages (greater than-40 mV). Normalized GIto was fitted by Boltzmann equation and ATXII did not significantly modify V0.5 and k (from-20.5 ± 3.9 to-17.0 ± 3.5 mV for V0.5. and 12.2 ± 2.6 to 13.4 ± 2.1 mV for k. n = 4). Also, atropine (1 μM) did not have any significant effect on Ito (from 1.92 ± 0.15 nA to 1.85 ± 0.25 nA, n = 5). Conclusions: The results showed that, in sodium-free external solution, Ito is tetrodotoxin but not atropine sensitive. ATXII-induced Ito increase is 4-aminopyddine insensitive but tetrodotoxin sensitive. These data suggest that outward Na current due to reversal of Na gradient in the absence of external No contributes to Ito. Caution must be taken when studying kinetics and pharmacology of Ito in external sodium-free solutions.
Effects of Various Modalities of Oral Furosemide Administration in Mild or Severe Congestive Heart Failure
Authors: Cohen Natan , Dishi Victor , Zaidenstein Ronit , Soback Stefan , Weissgarten Joshua , Averbukh Zhan , Gips Marina , Blatt Alex , Berman Silvia , Modai David 
Published: January 2017

Background: This study evaluated the optimal formulation (tablet vs solution) and frequency (once vs twice daily) of maintenance oral furosemide in compensated congestive heart failure (CHF). Methods and Results: Eighteen patients with mild (group 1) and 18 with severe (group 2) CHF were studied. On 2 consecutive days each patient's individual fixed oral furosemide daily dosage was administered in tablet or solution in a crossover design. In an additional study. 14 patients with severe CHF received the daily dosage in tablet or solution form in two divided doses. Pharmacokinetic data were obtained in six randomly allocated patients of each group, during the once daily administration periods of either formulation. Twenty-four-hour urinary sodium and 12-hour volume were significantly greater in group 1 following furosemide solution versus tablets. In group 2, all parameters were comparable in response to single identical doses in tablets or solution. as well as to once versus twice daily administration of either formulation. These results coincided with a higher Cmax and a shorter tmax following solution. Conclusions: A once-daily oral furosemide solution is more effective than the same dosage in tablet form in patients with mild, but not those with severe, CHF. In patients with severe CHF. the natriuretic and diuretic effects are similar whether oral furosemide in tablet or solution is administered in a once or twice daily schedule.
Vasodilation Effects and Action Mechanisms of TMB-8 on Basilar Artery in Rabbits
Authors: Xiao Jigao , Liu Shirley X. L. , Chen Zhou , Chiou George C. Y. 
Published: January 2017

Background: 8-(N,N'-diethylamino)-n-octyl-3,4.5-trimethoxybenzoate (TMB-8) is a potent Ca2+-antagonist that can prevent/treat ischemic stroke and inhibit the contractility of smooth, skeletal. and cardiac muscles. Further studies are warranted to elucidate the efficacy of TMB-8 on rabbit basilar artery preparation and its action mechanisms on vascular smooth muscle cell cultures. Methods and Results: Effects of TMB-8 on the contractility of rabbit's basilar artery in vitro and those on intracellular free Ca2+ concentrations. [Ca2+]i, were studies with isolated organ bath and Fura-2 methods. Histamine-induced concentration-response curves were shifted by TMB-8 in a mixed manner whereas those of norepinephrine and KCI were shifted in a non-competitive manner. In the presence of nifedipine or in a Ca2+-free medium, 2,5-di(tert-butyl)-1,4-benzohydroquinone (BHQ) (10 μM) induced an immediate transient contraction in rabbit basilar artery, whereas ryanodine showed a slow, weak. sustained contraction, followed by a weak, sustained relaxation. TMB-8 (30 μM) significantly inhibited these contractions of BHQ and ryanodine. Further, aminophylline enhanced the inhibitory action of TMB-8 on vasocontractions. suggesting that TMB-8's inhibitory actions may be related to the increase of cAMP level. The muscle contraction induced by BHQ was enhanced by pretreatment of the artery ring with TMB-8 for 15 minutes and then TMB-8 was rinsed out. These results indicate that TMB-8 pretreatment can increase Ca2+ sequestration into sarcoplasmic reticulum. which leads to a larger subsequent Ca2+ release by BHQ. KCI-induced increase of [Ca2+]i in vascular smooth muscle cells was reduced when the cells were bathed in the medium containing nifedipine. TMB-8 made further reduction on KCI-induced [Ca2+]i increase in nifedipine-containing solution, which had already blocked the voltage-operated Ca2+ entry. Conclusion: These results indicate that (a) TMB-8 can enhance Ca2+ sequestration into sarcoplasmic reticulum, which leads to a larger amount of Ca2+ that can be released by BHQ; (b) TMB-8 can inhibit KCI-induced muscle contraction caused by the reduction of [Ca2+]i through saturation of Ca2+ inside the sarcoplasmic reticulum rather than a direct blockade of Ca2+-influx at cell membrane site; and (c) TMB-8 increases cAMP, which enhances Ca2+ uptake into the sarcoplasmic reticulum.
The Effects of an Ambulatory Collaborative Practice Model on Process and Outcome of Care for Bipolar Disorder
Authors: Shea Nancy M. , McBride Linda , Gavin Christopher , Bauer Mark S. 
Published: January 2017

BACKGROUND: Bipolar disorder is a chronic mental illness that affects 1% of the population. Persons with bipolar disorder have substantial rehabilitative potential although research has shown that such mood disorders are undertreated. OBJECTIVES: The objective was to determine the effect of a high-intensity collaborative practice ambulatory program on process and outcome of care: specifically, patient satisfaction, intensity of medication treatment, and the amount and patterns of service use. STUDY DESIGN: The Bipolar Disorders Program was structured for easy patient access by assigning clinical nurse specialists as primary caregivers to each patient supported by psychiatrist backup. The first 76 patients enrolled in the Bipolar Disorders Program who completed 6 months served as the sample. A quasiexperimental study was used. A mirror image design was used where relevant measurements before admission to the Bipolar Disorders Program were compared with data during the first 6 months of enrollment. RESULTS: Patients showed significant increases in satisfaction with care, increases in intensity of medication treatment, and trends toward decreases in neuroleptic exposure. Annualized service use data revealed significant decreases in emergency department use, psychiatric triage use, and psychiatric hospitalization days. CONCLUSIONS: These data indicated that high-intensity ambulatory treatment for bipolar disorder may have increased both treatment intensity and patient satisfaction and decreased use of costly mental health services.
Social Support, Stress, and Depression among Battered Women in the Judicial Setting
Authors: Constantino Rose E. , Bricker Patricia L. 
Published: January 2017

BACKGROUND: Violence has become a major health problem. Battered women have increasingly entered the health care system for treatment ofphysical injuries, stressrelated illnesses, and psychiatric disorders. OBJECTIVES: This study sought to measure the levels of social support, stress, and depression and to evaluate the relationship among these variables in battered women who were seeking a 'protection from abuse" order. STUDY DESIGN: A descriptive cobort design was used. RESULTS: The battered women exhibited high levels of stress and moderate-severe degrees of depression. The women werefound to experience suicidal ideation and disturbances in sleep and nutrition. Relationships among the variables revealed an inverse relationship between social support and stress as well as between social support and depression, suggesting that social support may modulate the negative effects of abuse. Younger women had higher levels of stress and lower social support, which may be reflective of a limited repertoire of coping strategies and an underdeveloped support system. CONCLUSIONS: Social support interventions may be beneficial to battered women, particularly young women.