bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elective Intracoronary Micro-Stent II™ Implantation Without Quantitative Coronary Angiography or Intravascular Ultrasound Guidance and Without Subsequent Anticoagulation: Short- and Long-Term Results
Authors: Salachas Anastasios J. , Patsilinakos Sotirios P. , Tsilias Karmelos P. , Stefanou Ioannis , Margaris Nikolaos G. , Ifantis George P. , Kranidis Athanasios J. , Tavernarakis Antonios G. , Rokas Stylianos G. , Antonellis Ioannis 
Published: July 2008

Intracoronary stenting has been shown to reduce acute closure and restenosis rate in patients treated with coronary angioplasty. The use of high inflation pressures and intravascular ultrasound guidance allowed the substitution of anticoagulants with antiplatelet agents but increased the cost. The aim of this study was to investigate the effectiveness, safety, and long-term outcome of the elective implantation of a relatively new type of stent (Micro-Stent II™), without the use of quantitative coronary angiog raphy or intravascular ultrasound guidance and without subsequent anticoagulation. The study included 361 patients who underwent elective microstent implantation. Stent expansion was performed at 8 atm followed by higher inflation pressure at 14-20 atm. Heparin was given intraarterially only once immediately after the arterial sheath insertion. Ticlopidine was started at least 48 hours before the procedure and continued for 1 month while aspirin was continued indefinitely. All patients were followed up for 12.9 ±3.6 months. Short term outcome (first month): Stent implantation was successfully achieved in 361 of 366 patients (98.6%). Seven patients (1.9%) were excluded from the study and received anticoagulants because of a suboptimal result. In total, 423 stents were implanted. There was no subacute thrombosis, but acute vessel closure occurred in one patient (0.3%). Non-Q wave myocardial infarction occurred in six patients (1.7%), Q wave myocardial infarction occurred in one patient (0.3%), and only one death (0.3%) of nonischemic origin was reported. No major peripheral vascular complications were observed. Late results: Q or non-Q wave infarction occurred in 13 patients (3.6%), 26 patients (7.2%) underwent a repeat angioplasty, eight patients (2.2%) underwent coronary artery bypass grafting, and four patients (1.1%) died. Overall, 284 patients (78.7%) were free of symptoms, while 77 (21.3%) had recurrent coronary ischemia. In conclusion, Micro-Stent II™ implantation without quantitative coronary angiog raphy or intravascular ultrasound guidance and without anticoagulation was found to be effective, safe, and with good long-term outcome.
Combination of Calcium Channel Blockers and Beta Blockers for Patients with Exercise-Induced Angina Pectoris: A Double-Blind Parallel-Group Comparison of Different Classes of Calcium Channel Blockers
Authors: van der Vring J.A.F.M. , Daniëls M.C.G. , Holwerda N.J.H. , Withagen P.J.A.M. , Schelling A. , Cleophas T.J. , Hendriks M.G.C. 
Published: July 2008

The combination of calcium channel blockers and beta blockers is more effective for the treatment of exercise-induced angina pectoris than beta blocker monotherapy. Since ischemia in exercise-induced angina is essentially preceded by an increase in heart rate, calcium channel blockers with negative chronotropic property may perform better for this purpose than nonchronotropic compounds. A 335-patient, 10-week, double-blind, parallel-group comparison of amlodipine 5 and 10 mg, diltiazem XR 200 and 300 mg, and mibefradil 50 and 100 mg treatment added to baseline beta blocker treatment was performed. Exercise testing (ETT) was performed by bicycle ergometry. Although none of the calcium channel blockers improved duration of exercise or amount of workload, all of them significantly delayed onset of 1 mm ST segment depres sion on ETT (p<0.001 for any treatment versus baseline). In addition, mibefradil, both low- and high-dose treatment, produced the largest delays (low dose: different from diltiazem and amlodipine by 24.1 and 29.8 s, p<0.003 and <0.001, respectively; high (continued on next page) dose: different from diltiazem and amlodipine by 33.7 and 37.0 s, p<0.001 and <0.001, respectively). These effects were linearly correlated to the amount of rate pressure product (RPP) reduction. Serious symptoms of dizziness likewise occurred significantly more frequently with mibefradil (p<0.05) and led 19 patients taking mibefradil to withdraw from the trial. The authors conclude that calcium channel blockers with negative chronotropic property provide better delay of ischemia in patients with exercise-induced angina but that the concomitant risk of intolerable dizziness largely reduces this benefit.
Superficial Thrombophlebitis of the Legs: A Randomized, Controlled, Follow-up Study
Authors: Belcaro G. , Nicolaides A.N. , Errichi B.M. , Cesarone M.R. , De Sanctis M.T. , Incandela L. , Venniker R. , Belcaro G. 
Published: July 2008

The aim of the present study was to evaluate the effects of different treatment plans (compression only, early surgery, low-dose subcutaneous heparin [LDSH], low- molecular-weight heparin [LMWH], and oral anticoagulant [OC] treatment) in the management of superficial thrombophlebitis (STP), by considering efficacy and costs in a 6-month, randomized, follow-up trial. Patients with STP, with large varicose veins without any suspected/documented systemic disorder, were included. Criteria for inclusion were as follows: presence of varicose veins; venous incompetence (by duplex); a tender, indurated cord along a superficial vein; and redness and heat in the affected area. All patients were ambulatory. Exclusion criteria were obesity, cardiovascular or . neoplastic diseases, bone/joint disease, problems requiring immobilization, and age > 70 years. Patients with superficial thrombophlebitis without varicose veins and patients under treatment with drugs at referral were also excluded. Color duplex (CD) was used to detect concomitant deep vein thrombosis (DVT) and to evaluate the extension or reduction of STP at 3 and 6 months. Venography was not used. Of 562 patients included, 3.5% had had a recent DVT in the same limb affected by SVT and 2.1% in the contralateral limb. In six patients DVT was present in both limbs. These patients were treated with anticoagulants and excluded from the follow-up. After 3 and 6 months the incidence of STP extension was higher in the elastic compression and in the saphenous ligation groups (p < 0.05). There was no significant difference in DVT incidence at 3 months among the treatment groups. Stripping of the affected veins was associated with the lowest incidence of thrombus extension. The cost for compression alone was the lowest and the cost including LMWH was the highest. The average cost was 1,383 US$. However the highest social cost (lost working days, inactivity) was observed in subjects treated only with stockings.
Age-Related Progressive Brachial Artery Endothelial Dysfunction Precedes the Changed Carotid and Left Ventricular Geometry in Healthy Humans
Authors: Djuric Dragan , Popovic Zoran , Petrovic Jordan , Bojic Milovan , Djuric Dragan M. 
Published: July 2008

In this study the authors evaluated correlation between aging and brachial endothelial and vascular smooth muscle dysfunction, changes in carotid geometry, and left ventric ular remodeling. Vasomotor influences of brachial endothelium and brachial smooth muscle function to reactive hyperemia and nitroglycerin (400 μg, sublingual spray) were assessed by noninvasive ultrasound in 66 healthy subjects of different ages (20-82 years). Carotid intima-media thickness and left ventricular mass index were also assessed by ultrasound and compared with brachial hemodynamic parameters. All results were analyzed by linear regression analysis. The response of brachial artery diastolic diameter to reactive hyperemia decreased with aging (p < 0.0001). Also, the response of brachial artery diastolic diameter to nitro glycerin increased relative to aging (p < 0.004). Age-related correlations between increased carotid intima-media thickness and brachial artery diastolic diameter response to reactive hyperemia (p<0.01) as well as between increased carotid intima-media thickness and increased left ventricular mass index (p < 0.001) were found. However, there was no correlation between brachial artery diastolic diameter response to reactive hyperemia and increased left ventricular mass index (p > 0.05). The study showed that aging influences not only brachial endothelial vasomotor properties but also vascular and cardiac geometry. The authors believe that modern ther apeutic approach should take these results into consideration to establish new vasculo protective and cardioprotective strategies.
Rapid Changes in the Coagulant Proteins on Saphenous Vein Endothelium in Response to Arterial Flow
Authors: Turner Robert J. , Gosling Martin , Powell Janet T. , Golledge J. 
Published: July 2008

Healthy endothelium provides a nonthrombogenic surface. In this study the authors investigated the effect of arterial flow on the saphenous vein endothelial expression of proteins controlling thrombosis. Human saphenous vein segments, freshly excised from patients, were placed in a validated in vitro circuit with flow conditions shown to simulate arterial or venous circulations. In separate experiments, placement of an external polytetrafluoroethylene (PTFE) stent was used to differentiate the effects of pulsatile wall deformation and shear stress, while addition of drugs to the vein perfusate allowed study of the role of ion channels in transducing the response of the vein to arterial flow. Endothelial concentrations of thrombomodulin, nitric oxide synthase, tissue factor, and tissue plasminogen activator were assessed by quantitative immunohisto chemistry and Western blotting of endothelial cell lysates, in paired vein samples, in comparison to control proteins. Arterial flow conditions caused a rapid and significant reduction in the endothelial concentration of thrombomodulin: The immunostaining area decreased from 80.1 ± 7.0 to 48.3 ±5.0 and 32.9 ±3.0% at 45 and 90 minutes respectively, p = 0.01. These findings were confirmed by Western blotting. The reduction in thrombomodulin concentration was unaffected by eliminating vein wall deformation by placement of an external PTFE stent or by including the K+ channel blocker tetraethylammonium (TEA) in the vein perfusate. In contrast, thrombomodulin concentrations remained high when blockers of stretch-activated cation and calcium channels were included in the vein perfusate. The endothelial concentration of nitric oxide synthase increased after 90 minutes of arterial flow and this change was abolished when TEA was included in the vein perfusate. Arterial flow induced rapid changes in saphenous vein antithrombotic proteins. Different cation channels mediated the flow-induced changes in thrombomodulin and nitric oxide synthase.
Diagnosis of Pulmonary Embolism by Use of Urinary TNFα and its Soluble TNF Receptor I
Authors: Shenoy Sadashiv , Murawski Sandra , Divan Kishore , Cullin Julia , Mousa Shaker , Taheri Syde A. 
Published: July 2008

The purpose of this clinical study was to determine the concentration of soluble tumor necrosis factor in urine of patients with pulmonary embolism (PE), verses voluntary control individuals. Sixteen patients (ages 24 to 74 years) with diagnosis of PE, docu mented by ventilation perfusion scan or pulmonary angiogram, were the subjects of this study. Ten cc of urine was obtained from each patient and subjected to a solid-phase enzyme-linked immunosorbent assay thus determining the soluble tumor necrosis factor (TNF) receptor I (R I) and TNFα levels in these samples. In this pilot study of PE cases, a statistically significant elevation in urinary levels of TNFα and soluble TNF R I was demonstrated in PE patients. The average urinary soluble TNF R I in normal subjects was 1,029 pg/mL and in PE patients the average TNF R I was 3,734.4 pg/mL. The clinical diagnosis of PE is a challenging problem for the physician. Late diagnosis and delayed management of this condition could be associated with massive PE. Although pulmonary angiography is the gold standard for diagnosis of PE, it re quires expensive equipment, trained radiologists, and the patient could be at risk of sensitivity to contrast agents.
Editorial
Authors: Cornfeld David 
Published: July 2008

In his editorial for the first issue of Clinical Pediatrics, Irving J. Wolman, M.D. wrote "Clinical Pediatrics, here presented in its first issue, aims to bring to its readers, with promptness, accuracy and efficiency, knowledge concerning the care of infants and children." A contributor to that first issue with an article on bacterial upper respiratory infection in children, today takes on this challenge as Editor-in-Chief of Clinical Pediatrics. We take great pleasure in introducing the new Editor-in-Chief, David Cornfeld, M.D. A native of Philadelphia and a graduate of the University of Pennsylvania School of Medicine, Dr. Cornfeld comes to the journal with a distinguished career in pediatric medicine. He is presently Professor and Associate Chairman of the Department of Pediatrics at the University of Pennsylvania School of Medicine. He is certified by the American Board of Pediatrics and the American Board of Pediatric Nephrology and is a Fellow in the College of Physicians of Philadelphia and the American Academy of Pediatrics. His many other accomplishments, too numerous to mention here, all testify to his dedication to the practice of medicine and more particularly pediatric medicine. We at the publishing offices know Dr. Cornfeld as an editor who has brought with him a sense of vitality that we know will reflect in the journal. We know him, too, as an editor with whom we will work to publish a journal which we will be proud of. As did Janus, we look backward and forward at the same time. Backward to many productive years under the stewardship of Irving Wolman and forward to many more productive years being guided by David Cornfeld. To Dr. Cornfeld, we say we are happy you have joined us. The Publisher
A Clinical Score for Predicting The Level of Respiratory Care in Infants With Respiratory Distress Syndrome
Authors: Peckham George J. , Schulman Joseph , Pereira Gilberto R. , Shutack John G. 
Published: July 2008

A scoring system was developed to predict the need for transferring infants with respiratory distress syndrome (RDS) from community hospitals to spe cialized respiratory care centers. five clinical and laboratory determinations (birthweight, clinical RDS score, FIO2, PCO2 and pH) recorded from 100 infants with RDS during one year were utilized in a score with values ranging from 0 to 10. Application of the score to 159 with RDS during the following year showed that: (1) 73 per cent of infants scoring ≤3 received only oxygen by hood; (2) 75 per cent of infants scoring 4-5 required continuous positive air way (CPAP); and (3) 87 per cent of scoring ≥6 needed me chanical ventilation (MV). Mean scores were significantly different (p < 0.02) for each type of respiratory therapy employed: oxygen by hood (2.30 ± 0.19 S.E.M.); CPAP (4.27 ± 0.16 S.EIM.); MV (6.72 ± 0.25 S.E.M.). The accuracy and simplicity of the score make it valuable for the physician in the community hospital to assist in deciding when to transfer a neonate with RDS for more intensive respiratory therapy.
Dystrophic Epidermolysis Bullosa
Authors: Burkhart Craig G. , Ruppert Elizabeth S. 
Published: July 2008

The three forms of dystrophic epidermolysis bullosa include the autosomal recessive form and two autosomal dominant variants, the Cockayne-Touraine and Pasini forms. Whereas all three forms are clinically characterized by milia, nail dystrophy, and scarring, the autosomal recessive form tends to be the most mutilating .with frequent mucosal lesions. The Pasini variant often has generalized blistering commonly associated with mucosal involvement but to a lesser degree. The Cockayne-Touraine variant is usually localized to the extremities and tends to be the mildest form of dystrophic epidermolysis bullosa. Ultrastructurally, the blister is located below the basal lamina in all three variants. The anchoring fibrils are either absent or hypoplastic in each condi tion. The autosomal recessive form alone also demonstrates dermal collageno lytic activity. The ultrastructural differentiation between the two forms of the dominant dystrophic epidermolysis bullosa depends on a quantitative rather than qualitative assessment of the anchoring fibrils.
Radiographic Findings and Etiologic Diagnosis in Ambulatory Childhood Pneumonias
Authors: McCarthy Paul L. , Spiesel Sydney Z. , Stashwick Carole A. , Ablow Ronald C. , Masters Stuart J. , Dolan Thomas F. 
Published: July 2008

The chest roqntgenograms of 128 consecutive ambulatory children with radiologic pneumonia were read independently and without clinical informa tion by a faculty general pediatrician (Ped), a pediatric radiologist (R-P) and a general radiologist (R-G). The films were classified as normal, indicative of a viral or bacterial process, or indeterminate. Readings were compared with re sults of viral titers and bacterial cultures. Agreement between any two observers in classifying films, measured by unweighted Kappa, while statistically significant (p < 0.001) for any pair, was low.There was no significant difference between the agreement scores of Ped/R- P, Ped/R-G, and R-P/R-G. Twenty-one patients had fourfold viral titer increases (N = 16) or positive bacterial cultures of blood or pulmonary aspirate (N = 5).'The sensitivity of viral readings for titer increases varied from 19% to 68% depending on observer type; the sensitivity of bacterial readings for positive bacterial cultures varied from 60% to 80%. The three observers agreed on a correct reading in only three children with viral and three with bacterial pneumonia. Because of poor observer agreement and appreciable false-negative errors when viral and bacterial readings were compared to titer increases and positive bacterial cultures, respectively, we conclude that radiographic findings are poor indicators of etiologic diagnosis in ambulatory childhood pneumonias and, of themselves, are an insufficient data base for making therapeutic decisions.
Reflections and observations: An interview with the UK's first Chief Government Social Researcher
Authors: Burnett Judith , Duncan Sue 
Published: July 2008

Sue Duncan's civil service career spans thirty years; she has held posts in Communities and Local Government, the Department for Work and Pensions, the Cabinet Office and HM Treasury. While at the Cabinet Office, she worked in the Prime Minister's Strategy Unit and was Director of Policy Studies in the Centre for Management and Policy Studies, where she was responsible for good practice in policy making, research and evaluation and for evidence-based policy making. For much of her career she was in the Government Social Research (GSR) service, where she worked closely with senior civil servants and Ministers, providing research-based advice and policy analysis to inform government decision making. Her GSR career culminated in her appointment as the first ever Chief Government Social Researcher, responsible for the thousand or so social researchers working across government. Sue is an active player in the wider research community and has served on numerous committees in the academic, commercial and public sector. She was a Commissioner and a Fellow of the Market Research Society, a member of the Social Research Association and an Honorary Fellow of Cardiff University. She has written and lectured widely on policy, research, research utilization and evidence-based policy making and now works as an independent consultant. The interview which follows draws out the themes of Sue's presentation as part of the Plenary Panel, `Sociology, Politics and Public Policy in 21st Century Britain' given to the British Sociological Association Annual Conference 2007 at the University of East London. In the interview, Sue reflects upon the connections between research, politics, sociology, and policy making as well as her own role in taking forwards the Modernising Government agenda of the `New' Labour governments.
Morbidity survey of lower limb amputees
Authors: Stephen PJ , Hunter J. , Aitken Rcb 
Published: July 2008

A prospective study of morbidity among 55 lower limb amputees was carried out by multiprofessional teams in two rehabilitation units in Lothian. The aim of treatment was the restoration of independence rather than concentration solely on walking training, although this was important in that 90% of patients were fitted with a temporary artificial limb. The problems and progress of these patients varied, but 90% returned successfully to the community where they made moderate demands on community services. Important differences in professional assessment were noted. The physiotherapists judged that 73% of the patients studied were mobile without help prior to discharge, whereas nurses placed only 46% of the same group at this level of independence. The occupational therapist assessed more of the patients (68%) as fully independent in selfcare than the nurses (44%). This difference between what the patient can do when assessed in therapy and what he actually does when observed in the ward was resolved in case conferences. Forty of the 46 patients who survived for one year replied to a postal questionnaire. Of these, 29 reported independence in mobility indoors and 20 reported total independence in activities of daily living, indicating that as a group they had achieved the level of function predicted. Only two patients required institutional care; two patients (17% of those previously employed) had returned to work. Successful rehabilitation of patients with multiple problems requires a holistic approach. This study demonstrates the need for multiprofessional case discussions so that appropriate decisions on discharge and future management can be made.
A comparison of uniform patterned and eutrophic electrotherapies in a clinical procedure of rehabilitation of some movements in the arthritic hand
Authors: Kidd Geoffrey L , Oldham Jacqueline A , Stanley John K 
Published: July 2008

The relative effectiveness of two different electrotherapies for hand rehabilitation was measured in 18 patients with muscle atrophy associated with rheumatoid arthritis, three of whom acted as controls and receiving no electrotherapy during the course of the trial. Both forms of electrotherapy were applied for between one and three hours each day for ten weeks. In the first electrotherapy, the stimuli were presented in a uniform pattern at a frequency of 10 stimuli/second (10 Hz). The electrotherapy for comparison (eutrophic electrotherapy) reproduced as stimuli the natural action potential firing pattern of a fatigue resistant motor unit in the first dorsal interosseus (1 st DI) of a normal hand. Comparison was based on the relative improvement during and following 10 weeks of electrotherapy, with the two patterns of electrotherapy in seven different parameters of hand function: angular deviation at 1 st MCP joint in ulnar drift; hand grip strength; pulp-to-pulp pinch strength; key pinch strength; button-unbutton test; the maximal voluntary force 1 st DI could produce when acting isometrically; and in abduction, the endurance shown by 1 st DI in generating such force. In all the parameters measured, eutrophic elecrotherapy was seen to be significantly more effective than a uniform patterned electrotherapy of 10 Hz. The greatest comparative effect of eutrophic electrotherapy was seen on endurance in force generation by 1 st DI and on hand grip strength, and the least on the reduction of the angular deviation of ulnar drift.