bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Blood Perfusion and Tissue Oxygenation in the Postischemic Transcutaneous pO2 Response
Authors: Slagsvold Carl-Erik , Stranden Einar , Rosén Leif , Kroese Andries J. 
Published: November 2007

The transcutaneous pO2 (TCpO2) response following release of tourniquet cuff occlusion is expressed as oxygen reappearance time (ORT) and oxygen recov ery index (ORI). In the present study the effects of blood perfusion and tissue oxygenation on ORT and ORI in healthy control subjects and two patient groups with peripheral arterial insufficiency were assessed. In control subjects, ORT reflects diffusion time for O2molecules from capil laries to the TCpO2sensor. In patients with claudication, ORT was prolonged probably because of delayed postischemic reperfusion and reduced tissue oxy genation. In patients with critical ischemia, prolonged ORT seems to be attributed more to reduced tissue oxygenation than to delayed postischemic reperfusion. ORI in control subjects and patients with claudication apparently depends more on capillary pO2than on magnitude and duration of the postischemic reper fusion. In patients with critical ischemia, ORI is more related to decreased O2delivery subsequent to reduced or absent reactive hyperemia response. In addition, increased O2extraction ("O2steal") and extensive countercur rent O2exchange during low flow states may reduce ORT and ORI in severely ischemic skin.
Hemostatic Abnormalities in Sneddon's Syndrome
Authors: Mayou Susan C. , Kovacs Iren B. , Ridler Colin D. , Kirby John D. 
Published: November 2007

Sneddon's syndrome is a rare condition comprising widespread livedo retucularis and multiple episodes of transient cerebral ischemia. Treatment to date has been empirical. The hemostatic/thrombotic status of 4 patients with Sneddon's syndrome was studied by a unique technique, hemostatometry, which measures primary hemostasis (shear-induced platelet plug formation), the over all coagulation, and thrombolysis (dislodgment of the hemostatic plugs) from nonanticoagulated blood. In all 4 patients, platelet reactivity, which shows itself in the initial phase of the hemostatic reaction, was enhanced. The overall hemostasis, in which the generation of thrombin by activated platelets plays the decisive role, was enhanced in 3 patients. Three of the 4 patients had hypercoagulation, and in 3, spontane ous thrombolysis was inhibited. Treatment was commenced with aspirin and nifedipine, and patients were monitored both clinically and by serial hemostatometry over two years. One patient had one further transient ischemic episode; the other 3 remained asymptomatic. Thus, the observed clinical improvement correlated with im provement of the hemostatic profile.
The Antihypertensive and Cardiac Hemodynamic Effects of Nebivolol
Authors: DeCrée J. , Van Rooy P. , Geukens H. , Haeverans K. , Verhaegen H. 
Published: November 2007

Acute, subacute, and chronic treatment with nebivolol, a novel β1-selective adrenergic antagonist, significantly lowered systolic and diastolic blood pressure and heart rate in patients with essential hypertension. No orthostatism and bradycardia were reported. A comparison between a normal control group and 23 hypertensive patients revealed that the ratio between the preejection period (PEP) and the left ventricular ejection time (LVET) of the systolic time inter vals (STI) was significantly increased in the hypertensive patients, owing to a prolongation of the PEPc (PEP corrected for heart rate). Treatment with ne bivolol 5 mg once a day significantly improved the PEP/LVET, in acute condi tions from 0.42 ± 0.023 to 0.39±0.018, after one month of treatment from 0.40 ± 0.013 to 0.36 ± 0.013 and after one year of treatment from 0.41 ± 0.012 to 0.36 ± 0.010, owing to a significant shortening of the PEP c. There was no correlation between changes of blood pressure and changes of STI. Diastolic dysfunction is an early finding in hypertension and may well be reflected in the prolongation of the PEPc. The improvement of left ventricu lar performance, as measured with STI, suggests that treatment with nebivolol may favorably influence the underlying diastolic dysfunction and be of therapeutic value for hypertensive patients with left ventricular damage.
Short- and Long-Term Comparative Study of Anistreplase Versus Streptokinase in Acute Myocardial Infarction
Authors: Silber Haim , Hausmann Michael J. , Katz Amos , Gilutz Harel , Zucker Nili , Ovsyshcher Ilya 
Published: November 2007

Streptokinase is well established as an effective thrombolytic. Anistreplase, a new thrombolytic drug, is a complex of streptokinase and acylated human plas minogen that can be administered by intravenous bolus and activates plasmino gen at the clot site. Although both streptokinase and anistreplase are effected in treating myocardial infarction (MI), they have different pharmacologic proper ties. This study was designed to identify short- and long-term differences in their clinical effectiveness, safety in use, and survival rates in patients with acute MI. One hundred ten successive patients under seventy years of age admitted within three hours after onset of sustained chest pain suggestive of acute MI were randomized to receive either 30 units of anistreplase intravenously over five minutes or intravenous injection of 750,000 units of streptokinase over thirty to sixty minutes. Reperfusion was achieved in 34 of the 52 (65%) patients treated with anis treplase and in 41 of the 58 (71%) patients treated with streptokinase (p = NS). The two drugs were equally effective in preserving left ventricular ejection frac tion, which was found to be significantly better in patients with anterior wall MI who had achieved reperfusion than it was in those who did not (p < 0.02). One-month, twelve-month, and thirty-six-month survival rates were high (96% to 88%) with no significant difference between the two treatment groups. The authors conclude that the two drugs are equally effective thrombolytic agents but that anistreplase has the advantage that it can be administered as a bolus injection.
Coronary Angioplasty in Patients with Previous Coronary Artery Bypass Grafting
Authors: Unterberg Christina , Buchwald Arnd , Wiegand Volker , Kreuzer Heinrich 
Published: November 2007

Between 1982 and 1990, in 134 patients with prior coronary artery bypass grafting and recurrent angina, repeat coronary angiography and balloon angioplasty of stenoses in grafts or native arteries were attempted. Mean age of grafts was 45.6 months, range three days to twelve years. At the time of angioplasty, 6 patients had one-vessel-disease, 33 had two-vessel-disease, and 95 had three-vessel-disease. A total of 182 lesions were dilated: 55 venous grafts, 3 internal mammary artery grafts, and 124 native vessels. Forty-nine of 55 (89%) venous grafts could be successfully dilated, and in 3 internal mammary artery grafts, a stenosis reduction > 50% was achieved. In 65 of 88 (74%) grafted native arteries, dilation success was achieved. Twenty-seven of 36 (75%) patients with prior bypass surgery to other arteries had successful angioplasty of nongrafted native arteries. Three patients underwent emergency bypass surgery after dissection and acute occlusion: one of them died in cardiogenic shock secondary to acute myocardial infarction. The angiographic success rate in grafts was slightly higher than in native arteries (90% vs 74%). These data indicate that percutaneous transluminal coronary angioplasty in patients after bypass surgery is possible at a low risk (3%) and constitutes an effective therapy in symptomatic patients.
Homosexuality and the Pediatrician
Authors: Shearer Marshall 
Published: November 2007

Homosexuality is a psychiatric syn drome which begins in childhood. By rec ognizing some of the predisposing factors early, and then using his influence and knowledge to work towards their correc tion, the pediatrician can often play a ma jor role in preventing its development. Homosexuality must be looked upon as the illness which it is. It is not just a "different way of life."
The Kurdistani Cradle Story
Authors: Bloch Aaron 
Published: November 2007

Israeli immigrants from Iraq tie their infants into the Kurdistani cradle, a low wooden rocking bed, from birth until they are ready to walk. Movement is impossible. Is this a danger to children? What are the public health aspects of this custom? A pediatrician tells the fascinating story of his search for an swers to these and related questions. It is a classic example of the impact of modern preventive medicine upon traditional child-rear ing customs.
Medical Counseling of Parents of the Retarded
Authors: Solomons Gerald , Menolascino Frank J. 
Published: November 2007

Expansion in comprehensive programs for the chronically handicapped, and the multidisciplinary approach to evaluation, have produced problems in communica tion, not only among the professional dis ciplines concerned, but between the pro fessionals and the families seeking help. The time, expense and effort involved in the evaluation of a mentally retarded child can be largely wasted if the explanation to the parents is either inadequate or not understood. The initial interpretation in terview is particularly crucial to all fur ther treatment and habilitation attempts, and in this regard the "primary physician" is probably the most important individual the family will meet. Guidelines for counseling the parents of the retarded are outlined.
Chronic Paronychia in Children
Authors: Stone Orville J. , Mullins J. Fred 
Published: November 2007

Thumb-sucking is the most frequent predisposing factor of chronic paronychia in children. There are two basic components in chronic paronychia. One is a pocket which holds moisture and allows the sur vival of many different organisms. The other is an anatomic deformity of round ing out and retraction of the posterior nail fold because of foreign material in the dermis. The dermal change with the subsequent rounding out and retraction assures the continuing presence of the pocket. Chronic monilial disease usually local izes at sites of pre-existing defects. Mo nilia contribute to the disease process by irritation on the surface and by penetra tion of debris into the dermis. This debris stimulates chronic inflammation which in turn often aggravates the original defect.
Pseudo-intestinal Obstruction
Authors: Ramanathan K. , Grossman A. 
Published: November 2007

Intestinal paralysis in the newborn without any demonstrable anatomic ab normality of the gastro-intestinal tract 1-3 is a disorder which closely resembles symptomatic aganglionosis, but the pres ence of normal ganglion cells and its association with low birth weight dis tinguishes one from the other. No satis factory explanation for the syndrome is available. This paper describes such a case.
Postrubella Thrombocytopenic Purpura
Authors: Staub Henry P. 
Published: November 2007

Just as after measles and chickenpox, ru bella in children may be followed by acute transitory thrombocytopenic purpura from bone marrow injury. All eight children here described made uneventful recoveries, and this is the usual pattern. Specific epidemiologic inquiries and per haps even serologic studies for rubella should be done when a child experiences an attack of acute thrombocytopenic pur pura with no obvious inciting cause.
The "Thumb Sign" in Children
Authors: Feingold Murray 
Published: November 2007

Protrusion of the thumb beyond the clenched fist is almost always found in chil dren with Marfan's syndrome. In a random pediatric population studied, 1.1 per cent of the whites and 2.7 per cent of the Negroes had this finding but not the syndrome. Hence the sign has limited value as a screening test. Because the sign is not present in homo cystinuria it may be clinically useful in dis tinguishing between this condition and Mar- fan's syndrome.
Office Examination of Palatopharyngeal Function
Authors: Bloomer H. Harlan , Wolski William 
Published: November 2007

A functional palatopharyngeal valve is es sential for the production of normal speech. Any malfunctioning of this valve, as indi cated by hypernasality, hyponasality, or im paired speech intelligibility, warrants careful examination and diagnosis. For a complete study of the palate and its associated tissues one needs a specialist, but simple procedures for identification of palatopharyngeal dysfunction can be car ried out by the physician in general practice. These procedures include evaluation of speech, visual examination of the palate and nasopharynx, digital palpation of the hard and soft palate, soft tissue x-ray films of the head, and the use of readily obtainable in struments such as a steel mirror, stethoscope, and spirometer. Patients who have inade quate palatopharyngeal function and abnor mal speech should be referred for special examination and treatment. This paper identifies some of the causes of palatopharyngeal dysfunction, describes the procedures which can be used in its detection, and suggests referral sources avail able for special consultation.
Congenital Cystic Adenomatoid Malformation of the Lung
Authors: Parodi-Hueck Luis , Densler James F. , Reed Richard C. , Poulos Peter , Shulman Murray W. 
Published: November 2007

A newborn infant with congenital cystic adenomatoid malformation of the lung was treated successfully by resection of the affected lobe. This case plus 39 others reported in the English literature are reviewed here. Early diagnosis and early resection of the involved lobe or lobes are important.
Cardiology Review : The Medical and Surgical Management of Patients with Congenital Heart Disease
Authors: Friedberg David Z. , Litwin S. Bert 
Published: November 2007

Today, techniques for diagnosis, medical preparation, and definitive surgical repair are available for most cardiac anomalies, if needed. These permit successful treatment and carry a low mortality. Such children can now be expected to lead normal and meaningful lives as contributors to society. When serious symptoms occur in infancy, as discussed herein, an emer gency exists and prompt diagnosis and treatment are mandatory for survival.
The Comparative Efficacy of Cephalexin and Sulfisoxazole in Acute Urinary Tract Infection in Children
Authors: Russo Raymond M. , Gururaj Vymutt J. , Laude Teresita A. , Rajkumar Solomon V. , Allen John E. 
Published: November 2007

A double blind, comparative study of the efficacy of cephalexin versus sulfis oxazole was conducted on 100 children with initial episodes of urinary tract infections. The overall bacteriologic and clinical cure rates were comparable for both antimicrobials. Children treated with cephalexin had a clinical cure rate of 86 per cent and a bacterial cure rate of 84 per cent, while those given sulfisoxazole were found to have rates of 82 and 92 per cent respectively. However, cephalexin was noted to have a rather high rate of failure in the therapy of Proteus mirabilis infections (4/8), casting some doubt on its use in urinary infections caused by this organism. Untoward effects associated with either medication were minimal.
Alveolar Hypoventilation and Cor Pulmonale Associated with Chronic Airway Obstruction in Infants with Down Syndrome
Authors: Levine O. Robert , Simpser Moises 
Published: November 2007

Four infants with Down syndrome developed cor pulmonale and heart failure in association with chronic upper airway obstruction. Features of the sleep apnea syndrome were conspicuous; namely, noisy breathing with retraction, cyanosis and frequent apnea during sleep, and daytime lethargy and somnolence. The clinical picture masqueraded as cyanotic congenital heart disease. Arterial blood gas anal yses revealed alveolar hypoventilation, especially during sleep. The nature of the obstructive element was variable. Adenoidectomy provided partial relief in one patient, and tonsillectomy and adenoidectomy resulted in temporary improvement in two others. Three patients were markedly benefitted by tracheostomy. Func tional inspiratory pharyngeal closure was demonstrated fluorographically in one patient. Infants with Down syndrome may be predisposed to upper airway obstruction by virtue of hypoplasia of facial and oropharyngeal structures and generalized hypotonia. Additional obstructive elements may be contributed by hypertrophied lymphoid tissue, excessive secretions, and glossoptosis. Removal of the obstructive element is helpful, but functional obstruction may only be relieved by tracheos tomy.
Cholestasis in Infancy
Authors: Watson Susan , Giacoia George P. 
Published: November 2007

The natural history of cholestatic syndromes in infancy remains largely unclarified for lack of sufficient data. Newborn and premature infants are particularly vulnerable to cholestasis because of immaturities in bile-forming mechanisms. Until recently, two broad categories of etiologic factors have been thought to be associated with cholestasis in early infancy: mechanical obstruction (almost always extrahepatic), and hepatocellular damage (the "neonatal hepatitis" group). Although in both groups specific etiologic factors have been identified, the majority of cases are currently of unknown etiology. Problems in differential diagnosis are reviewed. In the neonatal period, laboratory screening procedures usually do not uncover cholestatic liver disease until the infants become icteric. It is important to note that patients with liver dysfunction may remain anicteric or become anicteric while cholestasis persists. It is, therefore, important that biochemical markers of cholestasis other than conjugated bilirubin be found.
The Effectiveness of Health Education on Home Use of Ipecac
Authors: Dershewitz Robert A. , Posner Michael K. , Paichel Walter 
Published: November 2007

It is widely recommended by pediatricians that syrup of ipecac for secondary prevention of poisoning be kept in homes where there are young children. To evaluate the efficacy of this recommendation we measured mother's gain in knowledge of how to use ipecac safely at home. The study population (n = 78) were primarily middle class mothers bringing their 9-month- old infants to one pediatrician at a health maintenance organization for a well-baby visit. The pediatrician delivered health education on poisonings. A before-after study design was used. The highly significant (p < 0.001) gain in knowledge demonstrates that parents can learn to use ipecac safely at home. The practitioner should limit safety counseling to selected areas most problematic at each age level, and within each topic, should concentrate on the most salient points.
Chest Pain in Pediatric Patients Presenting to a Cardiac Clinic
Authors: Fyfe Derek A. , Moodie Douglas S. 
Published: November 2007

Records of 67 pediatric patients with a primary complaint of chest pain were reviewed to determine the frequency of associated cardiac disease. Only four of 67 (6%) had chest pain associated with cardiac diseases that usually cause chest pain. Fifty-seven (85%) patients had chest pain in which no clear cause could be determined. Of these 57, 20 patients also had isolated congenital cardiac anomalies, i.e., atrial septal defect. A causal relationship of these lesions to the chest pain could not be established. Thirty-four of the 37 patients with chest pain and no cardiac abnormalities were evaluated by telephone at a mean of 13 months after their clinic assessment. Twenty-nine of the 34 were either asymptomatic or had reduced symptoms. There was no correlation between duration of symptoms prior to their clinical study and the persistence of chest pain at follow-up. From this study, we conclude that chest pain in pediatric patients is infrequently due to cardiac disease even when associated with previously unsuspected, isolated congenital cardiac lesions. Idiopathic chest pain tends to be self-limited.
The Effect of the Tylenol Scare on Parent's Use of Over-the-counter Drugs
Authors: Dershewitz Robert A. , Levin Gerald S. 
Published: November 2007

We administered a questionnaire to determine changes in parental use and administration of over-the-counter (OTC) drugs after cyanide-laced Extra-Strength Tylenol capsules caused the deaths of at least seven people in Illinois in 1982. Three hundred area parents were studied and divided into three equally sized groups on the basis of economic, educational, and professional criteria. After the Tylenol murders, all groups became anxious about the safety of OTC drugs, but intergroup differences were highly significant (p = 0.001). Attitude changes, however, did not necessarily precipitate a change in behavior. Similar percentages of each of the groups who claimed to be adversely affected by the Tylenol scare gave OTC drugs as before.
Nonparametric Methods
Authors: Brown George W. , Hayden Gregory F. 
Published: November 2007

In clinical research, "samples" are studied in order to get ideas about the characteristics of the larger populations from which the samples are taken. Population characteristics are called parameters (the population mean and standard deviation are examples). Parametric statistical methods are those that require estimates of parameters and assumptions about the source populations. Familiar examples of parametric methods are the t test, analysis of variance, and Pearson's correlation coefficient. Nonparametric (NP) methods do not require estimates of population parameters. These methods are sometimes called "distribution-free" because the samples of interest can be evaluated without concern for the shape (distribution) of the values in the populations providing the samples. NP methods also are called "ranking" or "ordering" tests, because the relative size or order of the observations may be evaluated, rather than requiring actual measurements. More than 30% of the research reports that appeared between July 1982 and June 1983, in four pediatric journals, employed at least one nonparametric method. The commonly used tests were chi-square, the Fisher exact test, and various "ranking" methods. An alphabetical list of common nonparametric tests is presented, with brief comments about each. Tables are presented, arranged by types of observations, so that the nature of the data guides the user to the method that might be used.
Reliability of Plasma Creatinine Measurement in Infants and Children
Authors: Clermont Marie Jose , Brion Luc P. , Schwartz George J. 
Published: November 2007

Plasma creatinine (Pcr, mg/dl) is often used to estimate glomerular filtration rate (GFR) in children. To establish whether the clinician can rely on the commonly used methods for measuring Pcr, the authors analyzed data from their own modified Technicon Autoanalyzer reference method and compared them to those obtained simultaneously from a Beckman Astra 8 kinetic Jaffe technique or a Technicon continuous flow Jaffe endpoint SMAC method. The SMAC method consistently overestimated Pcr by 0.1 mg/dl, whereas the kinetic method resulted in a large spread around the reference values. Neither laboratory gave consistent results for Pcr below 0.55, the normal range for infants and young children. The SMAC technique tended to underestimate GFR by 20 to 30 percent, whereas the kinetic method resulted in a great deal of scatter (only 37% of the measurements fell within ±25% of the values for GFR obtained by the reference method). The results suggest that the subtraction of 0.1 mg/dl from the Pcr measured on the SMAC system would give a value similar to that obtained with the reference method. This correction would permit the use of an estimate of GFR from kL/Pcr, where L is body length in cm and k is a constant (equalling 0.45 in term infants, 0.55 in children, and 0.7 in adolescent boys). The kinetic method requires repetitive determinations of Pcr before any firm conclusions can be drawn about GFR because of the scatter. The reliability of the clinician's laboratory can be tested by sending half the plasma to the laboratory on one day and the other half the next; the values should usually differ by <0.1 mg/dl or <15 percent, otherwise another laboratory should be consulted. It is suggested that both the kinetic and SMAC methods may lead to inaccuracies in the measurement of Pcr and therefore in the estimation of GFR in children from kL/Pcr.