bluuebunny/crossref_metadata_2025_split huggingface dataset:
CRITICAL CARE ISSUES FOR THE NEPHROLOGIST: Mechanical Ventilation in the Management of Acute Respiratory Distress Syndrome
Authors: Delong Peter , Murray James A. , Cook Christopher K. 
Published: December 2006

AbstractThe occurrence of acute respiratory distress syndrome (ARDS), is now common in intensive care units throughout the world. The diagnosis of ARDS is based on a definition that includes bilateral pulmonary infiltrates on chest radiographs, impaired oxygenation, and the absence of clinical evidence of elevated left atrial pressure. ARDS is the clinical result of a group of diverse processes, which range from physical or chemical injury, to extensive activation of innate inflammatory response. All these processes damage the integrity of the alveolar‐capillary barrier causing increased alveolar‐capillary permeability and an influx of protein‐rich fluid into the alveolar space. This alveolar flooding results in hypoxemia, inactivated surfactant, intrapulmonary shunt, and impaired alveolar ventilation. The treatment of acute respiratory distress syndrome is largely supportive in nature, keeping patients alive while allowing their lungs to heal, and minimizing further pulmonary insult. In 1994 the National Heart, Lung, and Blood Institute (NHLBI) established the ARDS Network for the conduct of clinical trials. This is a network, supported by the National Institutes of Health, that provided the infrastructure for well‐designed, multicenter, randomized trials of therapies for ARDS. The first study from this group in 2001 produced landmark data demonstrating mortality improvements in ARDS with particular mechanical ventilation strategies. Specifically, low tidal volume mechanical ventilation was demonstrated to reduce mortality by 22%. Other strategies such as high positive end expiratory pressure and prone positioning have not been shown to reduce mortality. Clinicians who are involved in the care of patients with ARDS should have a basic understanding of mechanical ventilation and the evidence guiding the mechanical ventilation strategies of these patients. Until further evidence is published, providers should adopt the use of a volume and pressure limited approach to mechanical ventilation.
The Classification of Procedure‐Related Complications—A Fresh Approach
Authors: Beathard Gerald A. , Urbanes Aris , Litchfield Terry 
Published: December 2006

AbstractAs with any type of medical procedure, endovascular procedures result in procedure‐related complications (PRCs). A PRC system as part of an outcome‐based practice monitoring strategy is essential. Such a program should have several features. It should be realistic, it should be standardized, it should have credibility, it must allow for comparisons with other physicians who are performing the same procedure, and it should be easily accomplished. Currently the only system in popular use is the system designed by the Society of Interventional Radiology (SIR). Definitions within this system are excessively broad and somewhat difficult to apply. This leads to inconsistencies. SIR indicates that their system is intended for use in publications of clinical research and may not be appropriate for use in routine clinical practice. There is a need for a system specifically aimed at and designed for day to day use by the practicing interventionalist whose work is not necessarily directed toward publication. We have described a system from the clinical applications viewpoint.
Vascular Access Outcomes and Medication Use: A USRDS Study
Authors: Yevzlin Alexander S. , Conley Emily L. , Sanchez Robert J. , Young Henry N. , Becker Bryan N. 
Published: December 2006

AbstractSeveral medications have been proposed to improve hemodialysis (HD) vascular access outcomes based on potentially favorable anticoagulant, antiplatelet, or pleiotropic properties. The purpose of this study was to evaluate the relationship between medication use and vascular access patency in a group of HD patients. We conducted a historical cohort study of the US Renal Data System Dialysis Mortality and Morbidity Wave II study to identify patients with an arteriovenous fistula (AVF), polytetrafluoroethylene (PTFE) graft, or a permanent catheter for vascular access. Cox regression analysis, adjusted for age, gender, race, history of coronary artery disease, peripheral vascular disease, or coronary artery bypass graft, was used to model the hazard ratio (HR) of permanent vascular access failure. Of the 2001 HD patients in the Wave II study, 901 (45%) were included in the analysis. PTFE graft patency was greater for males (HR, 0.73; 95% CI 0.53–1.00, p = 0.05) and for older individuals (HR, 0.99; 95% CI 0.98–1.00, p = 0.02). Treatment with antiplatelet medications, ticlopidine and dipyridamole (HR, 3.54; 95% CI 1.07–11.76; p = 0.04), or aspirin (HR, 2.49; 95% CI 1.31–4.73; p = 0.005) was associated with significantly worse AVF patency. Antiplatelet agents had a significant negative association with access patency in this cohort. In contrast to other published data, it was difficult to identify any beneficial effect of specific medications on access patency.
ASDM Clinical Case Focus: Persistent Left Superior Vena Cava: Diagnosis and Implications for the Interventional Nephrologist
Authors: Wasse Haimanot 
Published: December 2006

AbstractAwareness and recognition of anatomic anomalies of the great vessels of the neck and chest are important for the interventional nephrologist, as central venous catheter placement is a common procedure. A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly (0.3–0.5% of the population), and can present difficulty during internal jugular or subclavian vein catheter insertion, as well as pose a diagnostic dilemma. In this report, two cases of PLSVC are described, and the clinical significance and diagnosis of PLSVC are reviewed.
Overutilization of Central Venous Catheters in Incident Hemodialysis Patients: Reasons and Potential Resolution Strategies
Authors: Lenz Oliver , Sadhu Sanghamitra , Fornoni Alessia , Asif Arif 
Published: December 2006

AbstractEven after adjusting for comorbidities, the outcomes in hemodialysis (HD) patients using a central venous catheter (CVC) as dialysis access are worse than in those with a permanent vascular access. In spite of this, nationwide data suggest that only about 25% of incident HD patients initiate dialysis with an arteriovenous fistula. We conducted a retrospective study to identify reasons and resolution strategies for CVC use in patients who initiated HD at an academic medical center with a well‐established chronic kidney disease (CKD) clinic and a dedicated vascular surgeon. Estimated glomerular filtration rate (eGFR) loss over time to record progression of patients to HD was also examined. The charts of 170 consecutive patients were reviewed. Ninety‐two percent were found to initiate HD using a CVC. Three factors explained 93% of all CVC in our cohort: absence of adequate predialysis care (45%), acute illness with failure to recover from an episode of acute renal failure (31%), and patient's failure to adhere to scheduled clinic or surgical appointments (17%). In addition, analyses of eGFR suggest that the velocity of GFR loss rather than a defined degree of renal function might be a better trigger for vascular access referral. We conclude that early referral, a close follow up of CKD patients who initiate dialysis due to acute illness, and patient education may have a positive impact to counteract overutilization of CVCs for dialysis. The rate in eGFR decline might also be used to calculate the referral time adequate for fistula creation.
Topical ketoprofen TDS patch versus diclofenac gel: efficacy and tolerability in benign sport related soft-tissue injuries
Authors: Esparza Francisco , Cobián César , Jiménez José Fernando , García-Cota Juan José , Sánchez Carlos , Maestro Antonio ,   the working group for the acute pain study of SETRADE (coordinated by Josep Borrell)
Published: December 2006

Objective:To compare the ketoprofen TDS patch with diclofenac gel in the treatment of traumatic acute pain in benign sport-related soft-tissue injuries.Design:7–14 treatment days, prospective, randomised, open study.Patients:Outpatients aged 18–70 years diagnosed for painful benign sport-related soft-tissue injury (sprains, strains and contusions within the prior 48 h), randomised to either ketoprofen patch 100 mg once daily (n = 114) or diclofenac gel 2–4 g three times daily (n = 109).Intervention:7–14 days of topical non-steroidal anti-inflammatory drugs treatment to assess the pain intensity changes (daily activities and spontaneous at rest) in a daily diary (100-mm Visual Analogue Scale (VAS)).Main outcome measurement:Pain intensity (VAS).Results:The ketoprofen patch was not inferior to diclofenac gel in reducing the baseline pain during daily activities (difference of –1.17 mm in favour of ketoprofen patch, 95% CI (–5.86 to 3.52), reducing to the baseline VAS 79%. Ketoprofen patch presented also a higher cure rate (64%) than diclofenac gel (46%) at day 7 (p = 0.004). Patient opinions about the treatment comfort (pharmaceutical shape, application and dosage) were also statistically higher for the ketoprofen patch (>80% of the patients rated as good or excellent the patch removal and skin adherence).Conclusion:Ketoprofen patches are effective and safe pain relievers for the treatment of sports injury pain with advantages compared with diclofenac gel.
Effect of maximal exercise on the short-term kinetics of zinc metabolism in sedentary men
Authors: Volpe Stella Lucia , Lowe Nicola M , Woodhouse Leslie R , King Janet C 
Published: December 2006

Objective:To examine the effect of acute exhaustive exercise versus rest on short-term zinc kinetics in men.Design:Crossover design, wherein all subjects were their own control.Setting:University setting, where subjects were free living.Participants:12 healthy, sedentary men, 25–35 years of age.Interventions:70Zn was infused 10 min after exercise or at rest. Plasma zinc concentrations were measured at baseline and 2, 5, 10, 15, 30, 45, 60, 75, 90 and 120 min after exercise or rest. Haematocrit was measured before and after exercise to assess changes in plasma volume.Main outcome measurements:Plasma zinc (primary), serum creatine kinase and serum cortisol concentrations (secondary).Results:Plasma zinc concentrations decreased (p<0.05) after exercise, with a mean (SD) nadir of 13.9% (4.1%) observed at 70 min after exercise. There were increases in the size of the rapidly exchangeable plasma zinc pool (Qa; from 3.1 (0.2) to 3.6 (0.2) mg; p<0.05) and the liver zinc pool (Qb; from 10.2 (0.6) to 11.4 (0.8) mg; p = 0.12).Conclusion:Exercise seems to cause a shift of plasma zinc into the interstitial fluid and liver after exercise, which may reflect the acute stress response of strenuous exercise.
A study on tinea gladiatorum in young wrestlers and dermatophyte contamination of wrestling mats from Sari, Iran
Authors: Hedayati Mohammad T , Afshar Parvaneh , Shokohi Tahereh , Aghili Reza 
Published: December 2006

Objective:To study the prevalence of tinea gladiatorum among young wrestlers and dermatophyte contamination of wrestling mats from Sari city, the capital of Mazandaran, a northern province of Iran.Design:324 wrestlers (aged 9–20 years) from 7 active clubs in Sari city were examined, and skin scrapings were obtained from 135 wrestlers suspected of having tinea gladiatorum. The scraped skin samples were evaluated with potassium hydroxide. Pleated carpet sterile fragments (5×5 cm) were used for to survey of wrestling mat contamination. Sabouraud’s dextrose agar with and without chloramphenicole and cyclohexamide was used to culture scrapings and wrestling mat samples. The dermatophytes were identified by routine laboratory techniques.Results:Our study showed that of the 324 wrestlers, 65 (20.1%) had tinea gladiatorum. Most lesions were on the trunk and head. All the wrestling mat samples were positive for dermatophytes.Trichophyton tonsuranswas isolated from all the scrapings and wrestling mat samples.Conclusion:Considering that several colonies ofT tonsuranswere isolated from all the wrestling mats and from wrestlers with tinea gladiatorum (as the only dermatophyte species) we think that the contamination of wrestling mats withT tonsuranshas a crucial role in the injection of wrestlers.
Difference in plantar pressure between the preferred and non-preferred feet in four soccer-related movements
Authors: Wong Pui-lam , Chamari Karim , Chaouachi Anis , Mao De Wei , Wisløff Ulrik , Hong Youlian 
Published: December 2006

Objective and participants:The present study measured the difference in plantar pressure between the preferred and non-preferred foot in four soccer-related movements in 15 male university soccer players (mean (SD) age 20.9 (1.3) years, mean (SD) height 173 (4) cm and mean (SD) weight 61.7 (3.6) kg).Design:To record plantar pressure distribution, players randomly wore three types of soccer shoes (classical 6-stud and 12-stud, and specially designed 12-stud) embedded with an insole pressure recorder device with 99 sensors, divided into 10 areas for analysis. Plantar pressure was recorded in five successful trials in each of the four soccer-related movements: running (at 3.3 m/s), sideward cutting, 45° cutting and landing from a vertical jump.Results:Plantar pressures of the preferred and non-preferred foot were different in 115 of 120 comparisons. The overall plantar pressure of the preferred foot was higher than that of the non-preferred foot. Specifically, in each of the four movements, higher pressure was found in the preferred foot during the take-off phase, whereas this was found in the non-preferred foot during the landing phase. This would suggest a tendency of the preferred foot for higher motion force and of the non-preferred foot for a greater role in body stabilisation.Conclusions:The data indicate that the preferred and non-preferred foot should be treated independently with regard to strength/power training to avoid unnecessary injuries. Different shoes/insoles and different muscular strengthening programmes are thus suggested for each of the soccer player’s feet.
Intermittent KoldBlue cryotherapy of 3×10 min changes mid-portion Achilles tendon microcirculation
Authors: Knobloch Karsten , Grasemann Ruth , Spies Marcus , Vogt Peter M 
Published: December 2006

Background:Neovascularisation and microcirculatory changes have been reported in Achilles tendinopathy. Cryotherapy and compression, as part of a rest, ice, compression and elevation regimen, are shown to decrease pain and improve function. However, the microcirculatory changes following a given dosage of cryotherapy on mid-portion Achilles tendon remain unclear.Study design:Prospective clinical cohort study, level of evidence 2.Methods:30 people (12 males, 33 (SD 12) years, body mass index 25.6 (5.3) kg/m2) were included in the cohort. 3×10 min KoldBlue ankle-cooling bandages were applied and microcirculation of Achilles tendon mid-portion was real-time and continuously assessed using a laser-Doppler-spectrophotometry system (O2C, Germany).Results:Superficial capillary blood flow was reduced from 42 to 6, 5 and 3 relative units (rU) in the first, second and third cryotherapy periods, respectively (−65%, p = 0.001), with no significant capillary hyperaemia. Deep capillary tendon blood flow was reduced from 180 to 82, 53 and 52 rU (−71%, p = 0.001) within 6–9 min of application without hyperaemia. Superficial tendon oxygen saturation dropped significantly from 43% to 26%, 18% and 11% (p = 0.001) after repetitive cryotherapy, with persisting increase of tendon oxygenation during rewarming (51%, 49% and 54%, p = 0.077) up to 27% of the baseline level. At 8 mm tendon depth, cryotherapy preserved local oxygenation. Relative postcapillary venous tendon filling pressures were favourably reduced from 41 (11) to 31, 28 and 26 rU (−36%, p = 0.001) superficially and from 56 (11) to 45, 46 and 48 rU (−18%, p = 0.001) in deep capillary blood flow during cryotherapy, facilitating capillary venous clearance.Conclusion:Intermittent cryotherapy of 3×10 min significantly decreases local Achilles tendon mid-portion capillary blood flow by 71%. Within 2 min of rewarming, tendon oxygen saturation is re-established following cryotherapy. Postcapillary venous filling pressures are reduced during cryotherapy, favouring capillary venous outflow of the healthy Achilles tendon.
Distal tears of the hamstring muscles: review of the literature and our results of surgical treatment
Authors: Lempainen Lasse , Sarimo Janne , Mattila Kimmo , Heikkilä Jouni , Orava Sakari 
Published: December 2006

Background:Hamstring strains are among the most frequent injuries in sports, especially in events requiring sprinting and running. Distal tears of the hamstring muscles requiring surgical treatment are scarcely reported in the literature.Objective:To evaluate the results of surgical treatment for distal hamstring tears.Design:A case series of 18 operatively treated distal hamstring muscle tears combined with a review of previously published cases in the English literature. Retrospective study; level of evidence 4.Setting:Mehiläinen Sports Trauma Research Center, Mehiläinen Hospital and Sports Clinic, Turku, Finland.Patients:Between 1992 and 2005, a total of 18 athletes with a distal hamstring tear were operated at our centre.Main outcome measurements:At follow-up, the patients were asked about possible symptoms (pain, weakness, stiffness) and their return to the pre-injury level of sport.Results:The final results were rated excellent in 13 cases, good in 1 case, fair in 3 cases and poor in 1 case. 14 of the 18 patients were able to return to their former level of sport after an average of 4 months (range 2–6 months).Conclusions:Surgical treatment seems to be beneficial in distal hamstring tears in selected cases.
Influence of vibration on delayed onset of muscle soreness following eccentric exercise
Authors: Bakhtiary Amir H , Safavi-Farokhi Ziaeddin , Aminian-Far Atefeh 
Published: December 2006

Delayed onset muscle soreness (DOMS), which may occur after eccentric exercise, may cause some reduction in ability in sport activities. For this reason, several studies have been designed on preventing and controlling DOMS. As vibration training (VT) may improve muscle performance, we designed this study to investigate the effect of VT on controlling and preventing DOMS after eccentric exercise.Methods:Fifty healthy non-athletic volunteers were assigned randomly into two experimental, VT (n = 25) and non-VT (n = 25) groups. A vibrator was used to apply 50 Hz vibration on the left and right quadriceps, hamstring and calf muscles for 1 min in the VT group, while no vibration was applied in the non-VT group. Then, both groups walked downhill on a 10° declined treadmill at a speed of 4 km/hour. The measurements included the isometric maximum voluntary contraction force (IMVC) of left and right quadriceps muscles, pressure pain threshold (PPT) 5, 10 and 15 cm above the patella and mid-line of the calf muscles of both lower limbs before and the day after treadmill walking. After 24 hours, the serum levels of creatine-kinase (CK), and DOMS level by visual analogue scale were measured.Results:The results showed decreased IMVC force (P = 0.006), reduced PPT (P = 0.0001) and significantly increased mean of DOMS and CK levels in the non-VT group, compared to the VT group (P = 0.001).Conclusion:A comparison by experimental groups indicates that VT before eccentric exercise may prevent and control DOMS. Further studies should be undertaken to ascertain the stability and effectiveness of VT in athletics.
Effect of off-road competitive motocross race on plasma oxidative stress and damage markers
Authors: Ascensão António , Ferreira Rita , Marques Franklim , Oliveira Eduardo , Azevedo Victor , Soares José , Magalhães José 
Published: December 2006

Aim:To analyse the effect of an off-road motocross heat on plasma levels of oxidative stress and damage, blood leucocyte counts and urine catecholamine concentration.Methods:Plasma contents of total, reduced and oxidised (GSSG) glutathione, %GSSG, malondialdehyde (MDA), protein carbonyl and sulphydryl groups, total antioxidant status (TAS), uric acid, and blood neutrophil and lymphocyte counts were evaluated in 10 male top-level riders before, immediately after (0 h) and 1 h after a simulated competitive motocross race. 24-h urine adrenaline, noradrenaline and dopamine concentrations were also measured.Results:The motocross heat resulted in an increase in plasma oxidative stress and damage (p<0.05). This was shown by a significant increase in %GSSG, TAS, MDA and carbonyls, and by a decrease in sulphydryl groups after the race. There was a significant increase in both plasma uric acid and urine catecholamine concentration after the race (p<0.05). Blood neutrophil counts increased at 0 and 1 h after exercise (p<0.05). Lymphocyte count increased from baseline to 0 h, although it decreased from baseline and 0 to 1 h after exercise (p<0.05).Conclusion:The data reinforce the marked metabolic and hormonal demands imposed by motocross, resulting in a condition of enhanced plasma oxidative stress and damage.
The “bench-presser’s shoulder”: an overuse insertional tendinopathy of the pectoralis minor muscle
Authors: Bhatia Deepak N , de Beer Joe F , van Rooyen Karin S , Lam Francis , du Toit Donald F 
Published: December 2006

Background:Tendinopathies of the rotator cuff muscles, biceps tendon and pectoralis major muscle are common causes of shoulder pain in athletes. Overuse insertional tendinopathy of pectoralis minor is a previously undescribed cause of shoulder pain in weightlifters/sportsmen.Objectives:To describe the clinical features, diagnostic tests and results of an overuse insertional tendinopathy of the pectoralis minor muscle. To also present a new technique of ultrasonographic evaluation and injection of the pectoralis minor muscle/tendon based on use of standard anatomical landmarks (subscapularis, coracoid process and axillary artery) as stepwise reference points for ultrasonographic orientation.Methods:Between 2005 and 2006, seven sportsmen presenting with this condition were diagnosed and treated at the Cape Shoulder Institute, Cape Town, South Africa.Results:In five patients, the initiating and aggravating factor was performance of the bench-press exercise (hence the term “bench-presser’s shoulder”). Medial juxta-coracoid tenderness, a painful active-contraction test and bench-press manoeuvre, and decrease in pain after ultrasound-guided injection of a local anaesthetic agent into the enthesis, in the absence of any other clinically/radiologically apparent pathology, were diagnostic of pectoralis minor insertional tendinopathy. All seven patients were successfully treated with a single ultrasound-guided injection of a corticosteroid into the enthesis of pectoralis minor followed by a period of rest and stretching exercises.Conclusions:This study describes the clinical features and management of pectoralis minor insertional tendinopathy, secondary to the bench-press type of weightlifting. A new pain site-based classification of shoulder pathology in weightlifters is suggested.