bluuebunny/crossref_metadata_2025_split huggingface dataset:
Statin‐Associated Muscle‐Related Adverse Effects: A Case Series of 354 Patients
Authors: Cham Stephanie , Evans Marcella A. , Denenberg Julie O. , Golomb Beatrice A. 
Published: May 2010

Study Objective. To characterize the properties and natural history of 3–hydroxy‐3‐methylglutaryl coenzyme A reductase inhibitor (statin)‐associated muscle‐related adverse effects (MAEs).Design. Patient‐targeted postmarketing adverse‐effect surveillance approach coupling survey design with an open‐ended narrative.Setting. University‐affiliated health care system.Subjects. Three hundred fifty‐four patients (age range 34–86 yrs) who self‐reported muscle‐related problems associated with statin therapy.Measurements and Main Results. Patients with perceived statin‐associated MAEs completed a survey assessing statin drugs and dosages; characteristics of the MAEs; time course of onset, resolution, or recurrence; and impact on quality of life (QOL). Cases were assessed for putative drug adverse‐effect causality by using the Naranjo adverse drug reaction probability scale criteria and were evaluated for inclusion in groups for which mortality benefit with statins has been shown. Patients reported muscle pain (93%), fatigue (88%), and weakness (85%). Three hundred patients (85%) met literature criteria for probable or definite drug adverse‐effect causality. Ninety‐four percent of atorvastatin usages (240/255) generated MAEs versus 61% of lovastatin usages (38/62, p<0.0001). Higher potency statins reproduced MAEs in 100% of 39 rechallenges versus 73% (29/40) with lower potency rechallenges (p<0.01). Time course of onset after statin initiation varied (median 14 wks); some MAEs occurred after long‐term symptom‐free use. Recurrence with rechallenge had a significantly shorter latency to onset (median 2 wks). The MAEs adversely affected all assessed functional and QOL domains. Most patients with probable or definite MAEs were in categories for which available randomized controlled trial evidence shows no trend to all‐cause mortality benefit with statin therapy.Conclusion. This study complements available information on the properties and natural history of statin‐associated MAEs, affirming dose dependence and strong QOL impact. The data indicating a dose‐dependent relationship between MAE risk and recurrence suggest lower potency statins or discontinuation may bear consideration for ameliorating symptoms.
Use of Cytomegalovirus Intravenous Immune Globulin for the Adjunctive Treatment of Cytomegalovirus in Hematopoietic Stem Cell Transplant Recipients
Authors: Alexander Bryan T. , Hladnik Lindsay M. , Augustin Kristan M. , Casabar Ed , McKinnon Peggy S. , Reichley Richard M. , Ritchie David J. , Westervelt Peter , Dubberke Erik R. 
Published: May 2010

Study Objective. To describe the characteristics and clinical outcomes of hematopoietic stem cell transplant (HSCT) recipients who received adjunctive cytomegalovirus intravenous immune globulin (CMV‐IVIG) for probable or proven CMV disease.Design. Retrospective cohort study.Setting. Large, university‐affiliated, tertiary‐care medical center.Patients. Thirty‐five adult HSCT recipients who received at least one dose of CMV‐IVIG for adjunctive treatment of probable or proven CMV disease between January 1, 1999, and December 31, 2007.Measurements and Main Results. All‐cause mortality at hospital discharge was the primary outcome. All patients received an allogeneic HSCT. Twenty‐six patients (74%) had pneumonitis, nine (26%) had enteritis, and 29 (83%) had CMV viremia. All patients received concomitant antiviral therapy; 31 (89%) received ganciclovir, and 14 (40%) received foscarnet. All‐cause mortality at hospital discharge was 49% (17 patients). Patient characteristics associated with mortality included requiring intubation for CMV pneumonia (11 [79%] of 14 nonsurvivors vs 3 (25%) of 12 survivors, p=0.016) and earlier disease onset after HSCT (median 48 days for nonsurvivors vs 106 days for survivors, p<0.001). In the multivariate analysis, only requiring intubation for CMV pneumonia remained a significant risk factor for increased mortality. A low rate of adverse events was attributed to CMV‐IVIG, with mild hypertension (two patients [6%]) and erythema and chills (one patient [3%]) being the most common.Conclusion. The mortality rate in our study population was similar to previous reports in the literature and may be somewhat lower than rates reported with antiviral monotherapy. Our analysis suggests that factors associated with mortality include the need for intubation and, possibly, earlier onset of CMV disease after HSCT. Treatment with CMV‐IVIG appears to be well tolerated in HSCT recipients. These findings support further trials of CMV‐IVIG efficacy in this setting.
MRI for Definitive In Utero Diagnosis of Cleft Palate: A Useful Adjunct to Antenatal Care?
Authors: Descamps Marjanne J.L. , Golding Stephen J. , Sibley Jane , McIntyre Anthony , Alvey Christopher , Goodacre Timothy 
Published: May 2010

Objective To assess the use of fetal magnetic resonance imaging (MRI) in obtaining a definitive prenatal diagnosis of cleft palate. Design All expectant mothers with a sonographically diagnosed fetal cleft lip or a previously affected child with cleft palate were offered antenatal MRI at around 34 weeks' gestation. Images were interpreted by a consultant radiologist who was blinded to the ultrasound diagnosis. Two MRI readings were performed: one at the time of examination and one at the end of the study to elicit the radiologist's learning curve. MRI findings were correlated with the birth diagnosis. Setting Tertiary referral center for facial clefts—the Spires Cleft Centre, Oxford Children's Hospital, Oxford, United Kingdom. Participants Study participants included 49 pregnant women between 24 and 37 weeks' gestation, four with a family history of cleft posterior palate and 45 with a facial cleft on a 20-week ultrasound. Results The positive predictive value of fetal MRI for involvement of the palate was 96%, and the negative predictive value was 80%. The accuracy in predicting palatal clefting of four different MRI signs is discussed. The radiologist's interpretation skills significantly improved between the two MRI readings. Conclusions Fetal MRI enables us to predict accurately the extent of a cleft palate after an ultrasound diagnosis of cleft lip. With more accurate diagnosis of the severity of the cleft, we can counsel patients more precisely and plan postnatal management correctly.
Palatoplasty as the Technique of Choice for Prevention of Obstructive Sleep Apnea Secondary to Surgery for Velopharyngeal Insufficiency
Authors: Prada Madrid Jose Rolando , Nieto Luis Eduardo , Gomez Viviana , Echeverry Pilar , Tavera Maria Cristina , Oliveros Henry 
Published: May 2010

Objective The aim of this study is to compare patients treated with pharyngoplasty and those treated with palatoplasty for velopharyngeal insufficiency to establish what surgical procedure poses the highest risk for developing sleep apnea. The hypothesis tested in this study is that the incidence of obstructive sleep apnea syndrome associated with pharyngoplasty is greater than that associated with palatoplasty for velopharyngeal insufficiency. Subjects Twenty patients were taken from the Institution FISULAB. Design Observational cohort analytic study. Main Outcome Measures An overnight polysomnographic study was used to determine the incidence and severity of obstructive sleep apnea syndrome. Results The incidence of obstructive sleep apnea syndrome following pharyngoplasty was shown to be significantly higher than after palatoplasty. The apnea-hypopnea index, also called the respiratory disturbance index, was 12.7 in the pharyngoplasty group and 1.35 in the palatoplasty group ( p < .001). When obstructive sleep apnea syndrome was stratified into different levels of severity according to the values of respiratory disturbance index, there were noticeable differences between these two groups. In the palatoplasty group, one patient had mild obstructive sleep apnea syndrome. In the pharyngoplasty group, two patients had mild obstructive sleep apnea syndrome, one patient had moderate obstructive sleep apnea syndrome, and two patients had severe obstructive sleep apnea syndrome. Conclusions When comparing the apnea-hypopnea index (i.e., respiratory disturbance index) of patients treated for velopharyngeal insufficiency with palatoplasty versus pharyngoplasty, we observed an important difference between the groups, with the highest indices in the pharyngoplasty group.
A Modified Surgical Schedule for Primary Management of Cleft Lip and Palate in Developing Countries
Authors: Agrawal Karoon , Panda Kasinath 
Published: May 2010

Introduction In developing countries cleft lip and palate (CLP) patients arrive late, and there is a risk of drop out for functionally important palatoplasty after lip repair. Patients may be underweight, anemic, and prone to recurrent infections. Objective To repair cleft palate at an appropriate time and secondly to avoid the drop out after the first surgery. Protocol A new surgical protocol has been designed for patients with CLP in whom the cleft palate is first repaired at 6 to 9 months of age or whenever the patient presents at the clinic. The cleft lip is repaired 3 to 6 months after the first surgery. Patients and Results When cleft lip repair was performed before palate repair (conventional protocol group) in 89 patients with CLP, the median interval between first and second surgery was 290 days. However, when the modified protocol was followed in 330 patients over 13 years, the median interval was 193 days ( p < .0002). The reduction in the interval is statistically significant. In eight patients cleft palate fistula encountered after palatoplasty was repaired during cleft lip repair thus avoiding a third surgery. Conclusions The compliance for two surgeries in CLP has improved. Apart from achieving the main aim of the new protocol, a number of advantages were noticed. The palate repair was easier in the presence of an unrepaired cleft lip. The anterior palate repair was more dependable with reduced incidence of anterior palatal or alveolar fistula.
Formative Assessment of ARM-U: A Modular Intervention for Decreasing Risk Behaviors Among HIV-Positive and HIV-Negative Methamphetamine-Using MSM
Authors: Garfein Richard S , Metzner Mitcheal , Cuevas Jazmine , Bousman Chad A , Patterson Thomas 
Published: May 2010

Background:
Methamphetamine is a major contributor to HIV transmission among men who have sex with men (MSM). Recent studies show that up to one-third of methamphetamine-using MSM (MUMSM) inject the drug. We developed a behavioral intervention for MUMSM to decrease unprotected anal intercourse and increase awareness of parenteral HIV transmission risk. This 6-session (3 in-person, 3 by telephone) modular intervention was designed to be tailored to participants’ HIV (+/-) and injection drug user ([IDU] yes/no) status. We present results of formative research used to evaluate the content and to assess feasibility and acceptability of this individual-level HIV risk-reduction intervention.

Setting:
HIV research clinic in a high MSM and methamphetamine prevalence neighborhood.

Project:
Avoiding Risks from Methamphetamine-Use (ARM-U) is a brief toolbox intervention that allows counselors to select modules that suit a client’s individual risk profile and intervention needs employing motivational interviewing and cognitive behavioral theory. We evaluated the format and content of the intervention through focus groups and pre-testing of the entire intervention using volunteers from the target population stratified into four groups (HIV+/IDU, HIV-/IDU, HIV+/non-IDU, HIV-/non-IDU). Four individuals in each stratum were recruited to undergo the intervention and complete a satisfaction survey at the end of each in-person session.

Results:
In total, 25 MUMSM attended one of five focus groups. Participants thought all proposed intervention topics were important and could aid in reducing sexual risk behaviors among MUMSM. However, the neurocognitive effects of methamphetamine were reported to be a barrier to practicing safer sex, condom use negotiation or HIV status disclosure. Fifteen (94%) of 16 participants completed all 6 sessions and the satisfaction survey. On average, participants felt the intervention was useful for MUMSM, made them contemplate and move toward behavior change, and would recommend the program to their peers.

Lessons Learned:
Based on our formative research, we revised the ARM-U intervention to emphasize pre-planning to avoid combining methamphetamine use and sex or develop strategies to avoid sex risk following methamphetamine use. We also increased emphasis on referrals for care and other requested services. Future efficacy trials are needed to evaluate the intervention’s ability to reduce HIV-associated risk behaviors.
Electric dipole strength distribution below the E1 giant resonance in N = 82 nuclei
Authors: Guliyev Ekber , Kuliev Ali , Guner Mehmet 
Published: May 2010

AbstractIn this study quasiparticle random-phase approximation with the translational invariant Hamiltonian using deformed mean field potential has been conducted to describe electric dipole excitations in 136Xe, 138Ba, 140Ce, 142Nd, 144Sm and 146Gd isotones. The distribution of the calculated E1 strength shows a resonance like structure at energies between 6–8 MeV exhausting up to 1% of the isovector electric dipole Energy Weighted Sum Rule and in some aspects nicely confirms the experimental data. It has been shown that the main part of E1 strength, observed below the threshold in these nuclei may be interpreted as main fragments of the Pygmy Dipole resonance. The agreement between calculated mean excitation energies as well as summed B(E1) value of the 1− excitations and the available experimental data is quite good. The calculations indicate the presence of a few prominent positive parity 1+ States in heavy N = 82 isotones in the energy interval 6–8 MeV which shows not all dipole excitations were of electric character in this energy range.
Seasonal fluctuations of the nematode communities in a hop garden soil
Authors: Renčo M. , Lišková M. , Čerevková A. 
Published: May 2010

Abstract
A study on the seasonal fluctuation of nematode population was conducted during three vegetation periods (2005 – 2007), at 20 and 40 cm soil depth, from May to October, in a hop garden at Nemšová (Slovak Republic). The seasonal fluctuation of the nematode population was related to temperature and rainfall. At 20 cm soil depth of each year, the largest nematode population was recorded in July, and the smallest from July to October. At 40 cm soil depth, nematode abundance was not significantly different between the years 2006 and 2007. In general, at the same depth, a decrease of nematode abundance was observed from May to October. The soil nematode community was rich in bacteriovorous nematodes, especially in the top 20 cm soil. The genus Rhabditis was the eudominant taxon at both soil depths. This genus with the genera Cephalobus, Heterodera, Merlinius and Aglenchus represented the 50 % of the total nematode population at 20 cm soil depth and with the genera Cephalobus, Helicotylenchus, Heterodera and Merlinius represented the 52 % of total nematodes abundance at 40 cm depth.
Application of Novel Inertial Technique to Compare the Kinematics and Kinetics of the Legs in the Soccer Instep Kick
Authors: Meamarbashi Abbas , Hossaini S. 
Published: May 2010

Application of Novel Inertial Technique to Compare the Kinematics and Kinetics of the Legs in the Soccer Instep Kick
The kinematic and kinetic parameters of dominant and non-dominant legs examined with a new technology on 15 male, university soccer players in the field. A sensor module with special configuration of accelerometers placement, connected to a data logger, which attached to the shank and thigh, was applied to execute four instep kicks in the field. The angular velocity, linear velocity, angular acceleration and Z-axis linear acceleration (p<0.005) of the shank in dominant and non-dominant leg before impact were: 1970 ± 210, 1648 ± 300 °/s; 14.9 ± 3.0, 12.4 ± 2.6 m/s; 586.4 ± 121.9, 498.2 ± 160.4 rad/s2; 5.7 ± 1.7 and 4.0 ± 0.9 gravity, respectively. The leg swing time, force (X) (p<0.001), torque, angular momentum, angular power and angular impulse (p<0.05) of the shank, for dominant and non-dominant leg, before impact were: 271 ± 48 vs. 263 ± 62 msec; 172.4 ± 46.6 vs. 68.7 ± 47.1 N; 133.2 ± 29.8 vs. 111.8 ± 34.9 N.m.; 5.3 ± 1.1 vs. 4.1 ± 1.0 kg.m2/s; 2443 ± 666 vs. 1660 ± 790.1 W; 4.0 ± 0.9 vs. 3.3 ± 1.2 N.s., respectively. Even though there was lower shank angular velocity of the dominant leg compared with reported professional players, similar shape and gradient of the kicking pattern were found in the curves.
Physiological Background of Muscular Pain During Skiing and Delayed Muscle Soreness after Skiing
Authors: Klimek Andrzej 
Published: May 2010

Physiological Background of Muscular Pain During Skiing and Delayed Muscle Soreness after Skiing
During intensive skiing, at each turn, in particular towards the end of the turning steering phase, eccentric work of the lower limb muscles occurs (predominantly of the quadriceps femoris), which is the direct cause of damage within muscle cells. A few or more than ten hours after intensive physical effort the symptoms of delayed onset muscle soreness may appear, which is mainly a result of the micro-damage within the myocytes.
The following procedure can be proposed for prevention of muscle soreness for skiers: around a week before first day of skiing in the season, skiers should perform a series of intensive physical exercises involving eccentric contractions, thus inducing delayed muscular soreness. The exercises may involve for example: downhill running, preferably down a steep slope, running down stairs, deep knee bend jumps, deep knee bend jumps over an obstacle, jumping to the ground from a certain height, sit-ups on one or both feet, etc. The exercises should lead considerable local fatigue, in particular of the lower limb muscles, so that muscle soreness occurs on the second day, in particular in the frontal part of the thighs. After approximately two days the pain will alleviate, while after a week the strength of the muscles will return to its pre-exercise condition. This should considerably reduce, or even remove, delayed muscle soreness after skiing, which will not only help skiers use their time more effectively but will also be crucial to the skiers' safety.
Localization of cervical and cervicomedullary stimulation leads for pain treatment using median nerve somatosensory evoked potential collision testing
Authors: Balzer Jeffrey R. , Tomycz Nestor D. , Crammond Donald J. , Habeych Miguel , Thirumala Parthasarathy D. , Urgo Louisa , Moossy John J. 
Published: May 2010

Object
Spinal cord stimulation (SCS) is being currently used to treat medically refractory pain syndromes involving the face, trunk, and extremities. Unlike thoracic SCS surgery, during which patients can be awakened from conscious sedation to confirm good lead placement, safe placement of paddle leads in the cervical spine has required general anesthesia. Using intraoperative neurophysiological monitoring, which is routinely performed during these cases at the authors' institution, the authors developed an electrophysiological technique to intraoperatively lateralize lead placement in the cervical epidural space.

Methods
Data from 44 patients undergoing median and tibial nerve somatosensory evoked potential (SSEP) monitoring during cervical laminectomy or hemilaminectomy for placement or replacement of dorsal column stimulators were retrospectively reviewed. Paddle leads were positioned laterally or just off midline and parallel to the axis of the cervical spinal cord to effectively treat what was most commonly a predominant unilateral pain syndrome. During SSEP recording, the spinal cord stimulator was activated at 1.0 V and increased in increments of 1.0 V to a maximum of 6.0 V. A unilateral reduction or abolishment of SSEP amplitude was regarded as an indicator of lateralized placement of the stimulator. A bilateral diminutive effect on SSEPs was interpreted as a midline or near midline lead placement.

Results
Epidural stimulation abolished or significantly reduced SSEP amplitudes in all patients undergoing placement for a unilateral pain syndrome. In 15 patients, electrodes were repositioned intraoperatively to achieve the most robust SSEP amplitude reduction or abolishment using the lowest epidural stimulation intensity. In all cases in which a significant unilateral reduction in SSEP was observed, the patient reported postoperative sensory alterations in target locations predicted by intraoperative SSEP changes. Placement of cervical spinal cord stimulators for bilateral pain syndromes often resulted in bilateral but asymmetrical SSEP changes. In no cases were significant SSEP changes, other than those induced using the device to directly stimulate the dorsal surface of the spinal cord, observed. No case of new postoperative neurological deficit was observed.

Conclusions
Somatosensory evoked potentials can be used safely and successfully for predicting the lateralization of cervical spinal cord stimulator placement. Moreover, they can also intraoperatively alert the surgical team to inadvertent displacement of a lead during anchoring. Further studies are needed to determine whether apart from assisting with proper lateralization, SSEP collision testing may help to optimize electrode positioning and improve pain control outcomes.