bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age‐Related Differences in the Use of Guideline‐Recommended Medical and Interventional Therapies for Acute Coronary Syndromes: A Cohort Study
Authors: Schoenenberger Andreas W. , Radovanovic Dragana , Stauffer Jean‐Christophe , Windecker Stephan , Urban Philip , Eberli Franz R. , Stuck Andreas E. , Gutzwiller Felix , Erne Paul ,   for the Acute Myocardial Infarction in Switzerland Plus Investigators
Published: February 2008

OBJECTIVES: To compare the use of guideline‐recommended medical and interventional therapies in older and younger patients with acute coronary syndromes (ACSs).DESIGN: Prospective cohort study.SETTING: Fifty‐five hospitals in Switzerland.PARTICIPANTS: Eleven thousand nine hundred thirty‐two patients with ACS enrolled between March 1, 2001, and June 30, 2006. ACS definition included ST‐segment elevation myocardial infarction (STEMI), non‐ST‐segment elevation myocardial infarction (NSTEMI), and unstable angina pectoris (UA).MEASUREMENTS: Use of medical and interventional therapies was determined after exclusion of patients with contraindications and after adjustment for comorbidities. Multivariate logistic regression models were used to calculate odds ratios (ORs) per year increase in age.RESULTS: Elderly patients were less likely to receive acetylsalicylic acid (OR=0.976, 95% confidence interval (CI)=0.969–0.980) or beta‐blockers (OR=0.985, 95% CI=0.981–0.989). No age‐dependent difference was found for heparin use. Elderly patients with STEMI were less likely to receive percutaneous coronary intervention (PCI) or thrombolysis (OR=0.955, 95% CI=0.949–0.961). Elderly patients with NSTEMI or UA less often underwent PCI (OR=0.943, 95% CI=0.937–0.949).CONCLUSION: Elderly patients across the whole spectrum of ACS were less likely to receive guideline‐recommended therapies, even after adequate adjustment for comorbidities. Prognosis of elderly patients with ACS may be improved by increasing adherence to guideline‐recommended medical and interventional therapies.
High Blood Pressure, Hypertension, and High Pulse Pressure Are Associated with Poorer Cognitive Function in Persons Aged 60 and Older: The Third National Health and Nutrition Examination Survey
Authors: Obisesan Thomas Olabode , Obisesan Odunayo Abiodun , Martins Sayyida , Alamgir Laila , Bond Vernon , Maxwell Celia , Gillum Richard Frank 
Published: February 2008

OBJECTIVES: To test the hypothesis that hypertension, high blood pressure, and high pulse pressure (PP) are independently associated with lower cognitive function.DESIGN: Cross‐sectional study of persons examined in 1988 to 1994.SETTING: U.S. noninstitutionalized population.PARTICIPANTS: Six thousand one hundred sixty‐three men and women aged 60 and older who participated in the Third National Health and Nutrition Examination Survey (NHANES III).MEASUREMENTS: Measurements included blood pressure, short‐portable Mini‐Mental State Examination (sp‐MMSE), self‐reported history of hypertension, diagnosis, and treatment.RESULTS: In the initial bivariate analysis within age groups of 60 to 64, 65 to 69, and 70 to 74, optimal blood pressure (<120/80 mmHg) was associated with best cognitive performance; the severe hypertension group had the poorest performance in all age groups except the very old (≥80), where the pattern was reversed, showing poorest performance in the optimal blood pressure group and best in the group with moderate hypertension. This pattern changed slightly in multiple regression analyses modeling sp‐MMSE as the outcome variable. Higher stage of hypertension according to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and higher PP were associated with worse cognitive performance than normal blood pressure at ages 70 to 79 and 80 and older. No significant negative association was seen in subjects aged 60 to 69. Subjects with treated but uncontrolled hypertension had significantly lower sp‐MMSE scores than those without hypertension or with controlled hypertension after controlling for age, sex, ethnicity, income, and PP.CONCLUSION: At age 70 and older, high blood pressure, hypertension, and uncontrolled blood pressure are associated with poorer cognitive function than normal blood pressure. Optimal control of blood pressure may be useful in preserving neurocognitive loss as the population ages.
Inflammatory Biomarkers and Physical Function in Older, Obese Adults with Knee Pain and Self‐Reported Osteoarthritis After Intensive Weight‐Loss Therapy
Authors: Miller Gary D. , Nicklas Barbara J. , Loeser Richard F. 
Published: February 2008

OBJECTIVES: To describe the relationships between proinflammatory biomarkers and self‐reported and performance‐based physical function and to examine the effect of weight loss on these markers of inflammation.DESIGN: Randomized, longitudinal, clinical study comparing subjects eating an energy‐restricted diet and participating in exercise training with a control group.SETTING: Community‐base participants for the Physical Activity, Inflamation and Body Composition Trial.PARTICIPANTS: Eighty‐seven obese (body mass index (BMI) >30.0 kg/m2) adults aged 60 and older with knee pain and self‐report of osteoarthritis.MEASUREMENTS: Inflammatory biomarkers (interleukin 6 (IL‐6), tumor necrosis factor alpha (TNFα), C‐reactive protein, and soluble receptors for TNFα (sTNFR1 and sTNFR2)) and self‐reported (Western Ontario and McMaster University Osteoarthritis Index questionnaire) and performance‐based (6‐minute walk distance and stair climb time) measures of physical function at baseline and 6 months.RESULTS: Mean (standard error of the mean) weight loss was 8.7% (0.8%) in the intervention group, compared with 0.0% (0.7%) in the control group. sTNFR1 was significantly less in the intervention group than in the control group at 6 months. sTNFR1 and sTNFR2 predicted stair climb time at baseline. Change across the 6‐month intervention for sTNFR2 was an independent predictor for change in 6‐minute walk distance.CONCLUSION: These results indicate that an intensive weight‐loss intervention in older obese adults with knee pain can help improve inflammatory biomarkers and that changes in these concentrations showed associations with physical function.
MONITORING THE TRAUMA PATIENT
Authors: Jennings Paul B. 
Published: February 2008

SUMMARYPatient monitoring devices may be considered as extensions of the veterinary clinician's senses. Many of the parameters outlined above have been used for years, without the term “monitor” being used. In this report, several patient monitoring methods have been discussed, and their advantages weighed. It is hoped that judicious use of some of these monitoring methods may aid the veterinary clinician in diagnosis and treatment of his trauma patients.
METABOLIC MANAGEMENT OF THE HORSE WITH ACUTE ABDOMINAL CRISIS*
Authors: Donawick William J. 
Published: February 2008

SUMMARYThe horse with an abdominal crisis caused by acute gastro‐intestinal tract obstruction develops hypovolemia, hemoconcentration, electrolyte depletion, metabolic acidosis and shock. During preparation for operation, treatment with fluids, antibiotics and bicarbonate will impede metabolic imbalance. Stomach decompression may slow the passage of sodium, water and potassium to the gut lumen, reduce pain and minimize the risk of stomach rupture. Selected laboratory determinations and the monitoring of arterial and venous pressures will provide a measure of severity and serve as a guide to replacement therapy. In the post surgical period, vigilance must be directed towards potassium and bicarbonate imbalanc and adequate hydration.
SELECTED SURGICAL DISEASE STATES WHERE MICROBIOLOGICAL EVALUATION IS ESSENTIAL
Authors: Dixon Robert 
Published: February 2008

SUMMARYInfection caused by bacterial organisms constitutes an important problem in surgical practice. Bacteremia due to both Gram positive and Cram negative bacteria is often complicated by shock.Frequent antibiotic susceptibility tests and bacterial culture of blood, urine, body fluids, draining wounds or other sources of infection is an essential adjunct to the proper management of surgical infections which may lead to septic shock.In combination with current medical and surgical principles of septic shock therapy, two things may help to reverse the high mortality rate, making the diagnosis early enough and supporting the patient until the shock can be reversed.
EXPERIMENTAL ACUTE GASTRIC DILATATION AND VOLVULUS IN THE DOG: CHANGES IN BIOCHEMICAL PARAMETERS*
Authors: Wingfield Wayne E. , Cornelius Larry M. , DeYoung Donald W. 
Published: February 2008

ABSTRACTAcute gastric dilatation and volvulus with dilatation were produced in 11 dogs anesthetized with halothane. Blood samples were taken during these procedures for biochemical analyses.Serum potassium did not change significantly during the experimental procedure, but there was a significant increase (p<0.05) after release of the dilatation with volvulus. Renal function was impaired with significant increases (p<0.05) in the serum concentration of urea nitrogen, phosphorus, and creatinine. Evidence of cellular damage was reflected by a significant elevation (P<0.05) in glutamic‐oxaloacetic transaminase activity. Serum glucose concentration increased significantly (P<0.05) during experimental gastric dilatation and dilatation with volvulus.
PATHOPHYSIOLOGICAL EFFECTS OF RENAL ALLOGRAFTS IN THE DOG
Authors: Gourley Ira M. , Parker Harold R. , Gribble David H. , Conzelman G. M. , Ishizaki G. 
Published: February 2008

SUMMARYSeven dogs with renal allografts were studied to: (1) determine the practicality of the procedure for the treatment of end stage kidney disease in small animal medicine, and (2) measure allograft function to permit evaluation of immunosuppressive drug dosage to prevent rejection.Infection (bacterial nephritis, pneumonia, pleuritis), drug toxicity (bone marrow depression, liver degeneration and/or necrosis), and rejection of the transplants were the consistent problems.No objective measurement which would permit accurate determination of immunosuppressive drug dosage was found.Polyuria in the transplanted animals was attributed to failure to develop the interstitial osmotic gradient essential for the allografts to respond to antidiuretic hormone. Polydipsia probably was compensation for the polyuria.The results would indicate that until a major immunological breakthrough occurs in tissue transplantation, the clinical placement of a renal allograft in the dog for long term function is not practical.Prolonged function of the renal allograft has been accomplished in the dog using immunosuppressive drugs, suggesting that the procedure can be utilized for the treatment of end stage renal disease in this animal.18Immunosuppressive drugs have inherent toxicities, of which bone marrow depression, liver and gastrointestinal tract damage are most notable.5,18,23Ideally, minimal immunosuppression is desired to avoid drug toxicity, maintain some degree of immune competence to reduce chances of serious, if not fatal infection, and yet allow the transplanted kidney to survive in a hostile immune environment.22There are no good measurements to determine the immunological status of patients on immunosuppressive therapy,22 consequently, such treatment is emperic; based on experimental and clinical experience. 13,18Although the dog is a common model for renal allograft investigations, 15,18 there is limited information in the veterinary literature 3.5.6,11,14 concerning the experience of veterinary clinicians and their attempts to maintain the renal homograft.This report summarizes the author's experiment with renal transplants in the dog.
COMPLICATIONS RELATED TO THE INSERTION OF A SUTURE TO RETRACT THE ARYTENOID CARTILAGE TO CORRECT LARYNGEAL HEMIPLEGIA IN THE HORSE
Authors: Raker Charles W. 
Published: February 2008

SUMMARYLaryngeal sacculectomy has proven to be a useful surgical procedure to correct respiratory distress caused by paralysis of the left recurrent laryngeal nerve. However, to improve the rate of recovery procedures for the insertion of a suture to retract the paralyzed arytenoid have been developed. This procedure was found to be accompanied by some serious complications such as a cough, delayed wound healing, regurgitation of food and aspiration pneumonia.To avoid these complications it is suggested that mersilene be used instead of lycra to suture the arytenoid to the cricoid as it is tolerated better by the horse. Tension upon the suture should be sufficient to stabilize the paralyzed arytenoid in a median position between adduction and abduction or one of slight abduction. Extreme care should be used when placing the suture to avoid invasion of the laryngeal airway.
A Comparison of Size of Kuntscher Nails with the Length and the Width of Femurs and Humeri in Dogs
Authors: Charles Knecht , Robinson W.C. , Roesel O.F. 
Published: February 2008

SUMMARYFemurs and humeri were measured from 79 mixed breed dogs and 15 radiographs. Width to length relationships were established and compared to available sizes of intramedullary Kuntscher nails. Analysis of the data presented and an awareness of the advantages and merits of Kuntscher nailing will, it is hoped, precipitate a renewal of efforts to make nails of appropriate lengths available for the dog.
CARDIOPULMONARY PHYSIOLOGY — AS IT RELATES TO THORACIC SURGERY
Authors: Hobson H. Phil 
Published: February 2008

SUMMARYThe supplying of oxygen to tissues, and the removal of gaseous wastes are quickly compromised once the chest has been surgically invaded. Of necessity the expansion of the lungs becomes one of a positive rather than a negative pressure process. Abnormal positioning of lobes of the lungs to facilitate exposure for surgery, reduced rate of respiration, atelectasis due to underinflation as well as diseased areas aggrevate the situation.Return of vascular flow to the heart is impaired by loss of negative pressure in the chest cavity. Blood flow through the pulmonary vasculature is impaired by anything that adds resistence. Life itself is very dependent on the delicate balance between hydrostatic and osmotic pressures within the pulmonary capillaries in order for there to be adequate oxygenization.Retention of CO2 or undersupply of oxygen to tissues contribute to an acidotic state. This acidosis can accelerate a viscious shock cycle if not controlled.Body temperature must not be allowed to drop excessively without careful monitoring of all vital parameters. Motility of cillia along the respiratory tree is slowed by drop in temperature. Phagacytosis within the alveoli undoubtedly diminishes as the temperature drops or the tissues become dehydrated.The heart and respiratory rates are controlled by many autonomic mechanisms which, if interrupted, may need to be compensated for and which must be returned to body control at the end of surgery.The chest is not an area which should be entered with fear but with much respect for its contents and their functions. The surgeon should keep this well in mind and should thus enter the chest as though it were his own.
Circumcostal Gastropexy in the Dog A Preliminary Study
Authors: FALLAH A. M. , LUMB W. V. , NELSON A. W. , FRANDSON R. D. , WITHROW S. J. 
Published: February 2008

Gastric dilatation‐volvulus (GDV) is a disease which causes many fatalities among large deep‐chested dogs. Despite several different surgical techniques used currently, recurrence is high among dogs that survive the first episode of GDV. Circumcostal gastropexy is a new surgical technique which utilizes a muscular flap of the ventral pyloric antrum to anchor the stomach to the costochondral junction of one of the last four ribs. The gastric lumen is not entered.This operation was performed on nine clinically normal dogs. A strong adhesion was created without altering the stomach's physiologic function and with minimal anatomic displacement. The technique has the advantage of being easy, safe, and fast (15 min). These results suggest that this operation will have great potential in preventing recurrence.
A Comparison of Two Surgical Approaches to the Equine Femoropatellar Joint for the Treatment of Osteochondritis Dissecans
Authors: TROTTER GAYLE W. , McILWRAITH C. WAYNE , NORRDIN ROBERT W. 
Published: February 2008

The femoropatellar joints of four mature, clinically normal horses were surgically entered by a craniolateral or a lateral approach. Visualization of intra‐articular structures was documented for each approach. Horses were euthanized 21, 42, and 63 days after surgery. Joint healing was evaluated clinically, and the joints were subjected to gross pathological and histopathological examination. Healing was by first intention following arthrotomy in six limbs. Skin dehiscence occurred in two limbs with healing by second intention. Subcutaneous seromas developed which resulted in peri‐incisional swelling in seven limbs. The lateral approach to the femoropatellar joint provided greater exposure of the lateral femoral trochlear ridge and articular surface of the patella.Surgery was performed on nine joints of seven clinical patients with osteochondritis dissecans. The craniolateral approach was used on four joints, and the lateral approach was used on five joints. Skin dehiscence occurred following four arthrotomies. Location of the lesion was concluded to be the main criterion for selection of the surgical approach.
Arthrodesis of the Distal Intertarsal and Tarsometatarsal Joints in the Horse
Authors: BARBER SPENCER M. 
Published: February 2008

Arthrodesis created by destruction of the articular surfaces of the distal intertarsal and tarsometatarsal joints by repeated insertion of a drill was studied in one limb of each of nine horses. Postoperatively, the horses were housed in box stalls for 8 weeks and then confined to a paddock for 19 weeks. Clinical and radiographic evaluations were performed prior to surgery, immediately following surgery, and at 2,4, 6, 8,10,12,16, 20, and 27 weeks following surgery. There was a statistically significant positive correlation between decreasing degree of lameness and increasing radiographic evidence of bony fusion; fusion of the distal intertarsal and tarsometatarsal joints was present in five horses 27 weeks after surgery. The horses lost weight during the first 8 weeks after surgery. Flexion of the treated tarsal joints was decreased significantly at the end of the experiment.Complications encountered included fracture of the third tarsal bone (five horses), instability of the tarsus (four horses), septic arthritis (three horses), and diarrhea (four horses).Arthrodesis, with this method of surgical drilling of the distal intertarsal and tarsometatarsal joints, is not recommended because of severe pain, prolonged convalescence, and high incidence of complications.
Use of Isobutyl‐Cyanoacrylate Adhesive in Osteosynthesis A Preliminary Study
Authors: WALKER A. M. , TOMLINSON J. L. 
Published: February 2008

Isobutyl 2‐cyanoacrylate was used to reattach partial‐thickness cortical bone fragments from the femur in rabbits. Stability, apposition, callus formation, and inflammation around the fragments were evaluated at 2, 4, 8, and 12 weeks.All glued bone fragments were stable, compared with 85% of controls. Good apposition was achieved in 95% of the glued bone fragments, compared with 19% of the controls. Analysis of the mean scores for callus formation revealed a significant difference only in the 8 week survival group.Bony union was noted in 20 of 21 of the glued fragments. No evidence of inflammation was seen around the glue, and viable bone was seen adjacent to the adhesive in many sections. In control legs, 13 fragments had healed by osseous union, two by fibrous union, and in six the chip had resorbed.
Comminuted First Phalanx Fractures in 30 Horses: Surgical vs. Nonsurgical Treatments
Authors: MARKEL MARK D. , RICHARDSON DEAN W. , NUNAMAKER DAVID M. 
Published: February 2008

Comminuted first phalanx fractures were diagnosed in 30 horses. One leg was involved in each horse. Five horses were presented with open fractures. Nine horses had a portion of intact cortex (strut) extending from the proximal to distal joint. Ten horses were euthanized, including one with an open fracture, without treatment. The remaining 20 horses were treated by open reduction with a neutralization plate (8 horses, including one with an open fracture), open reduction with lag screw fixation (3 horses), lag screw fixation through stab incisions (2 horses), external coaptation with a cast (3 horses), and external skeletal fixation using a weight supporting shoe (4 horses, including 3 with open fractures).Thirteen horses were euthanized following treatment because of persistent infection (9), chronic lameness (2), and third metacarpal bone fractures (2). Seven horses survived longer than 1 year after treatment. Six were lame and used as breeding animals, and one horse went on to race successfully. All four horses with open fractures that were treated were subsequently euthanized.Significantly more horses with an intact strut of bone survived after treatment (4 of 7 [57%]) when compared to horses without an intact strut of bone that were treated (3 of 13 [23%]) (p < 0.05).Invasive surgical approaches used for the repair of comminuted first phalanx fractures in this study were associated with an unacceptable infection rate (55%). Techniques involving less trauma to the compromised soft tissue around the fracture should afford a better chance for a successful outcome.
Reactivity of Equine Palmar Digital Arteries and Veins to Vasodilating Agents
Authors: BAXTER GARY M. , TACKETT RANDALL L. , MOORE JAMES N. 
Published: February 2008

Palmar digital arteries and veins removed surgically from healthy horses under general anesthesia were cut into 4 mm vascular rings, suspended in tissue baths, and attached to force displacement transducers for continuous measurement of vascular tension. In vitro vascular responses were determined for acetylcholine, acepromazine, isoxsuprine hydrochloride (isoxsuprine), prostaglandin E2 (PGE2), and prostaglandin I2 (prostacyclin). After preconstriction with norepinephrine hydrochloride (norepinephrine), or prostaglandin F2 alpha (PGF2 alpha), the concentrations needed to produce 50% maximum relaxation (EC50) and the maximum percentage of relaxation were determined for each drug.Acetylcholine was the most potent arterial vasodilator (smallest EC50 value) and PGE2 was the least potent. Prostacyclin was the least potent venodilator (highest EC50 value); there were no differences between acetylcholine, acepromazine, isoxsuprine, and PGE2. Isoxsuprine produced greater arterial relaxation than all other agents. Isoxsuprine and acepromazine produced significantly greater venous relaxation than did acetylcholine and PGE2. Prostacyclin produced minimal vasodilation of arteries or veins. Acepromazine and isoxsuprine relaxed the veins significantly more than the arteries. When PGF2 alpha was used instead of norepinephrine to preconstrict the arteries and veins, the potency and effectiveness of acepromazine and isoxsuprine to produce vasodilation were significantly decreased. Results indicate that acepromazine and isoxsuprine can relax the equine digital vasculature but their effectiveness varies depending on the origin of the constriction.