bluuebunny/crossref_metadata_2025_split huggingface dataset:
Compression Therapy of Limb Edema Using Hydrostatic Pressure of Mercury
Authors: Palmer Arthur , Macchiaverna June , Braun Amy , Hendrix Ronald , Miller Albert J. 
Published: November 2007

A new apparatus for the treatment of edema of the extremities is described. The extremity is placed in a cylindrical vertical tank and isolated by a circum ferential synthetic rubber membrane. The equipment is programmed to create a mold of the extremity using a slurry of plastic granules from a reservoir. Mer cury is then pumped between the mold and the extremity, thereby exerting a pres sure gradient on the extremity equal to the hydrostatic pressure of the mercury column. A computerized program forms the mold and runs several compres sion cycles for each treatment session.Twelve patients were treated (8 upper extremities, 4 lower extremities) on a weekly or semiweekly basis. Progress was followed with computed axial tomog raphy scans, as well as measurements and photographs. Ten patients experienced significant immediate decrease in edema with each treatment. Wrapping or elas tic support was required to prevent the return of edema between treatments. No pain, skin injury, or other complication of treatment was noted.The apparatus can safely provide short-term, immediate, significant improve ment of extremity edema. Further studies will be necessary to determine long- term benefit.
The Simon Nitinol Filter: Evaluation by MR and Ultrasound
Authors: Kim Ducksoo , Edelman Robert R. , Margolin Chaim J. , Porter David H. , McArdle Colin R. , Schlam Bertrand W. , Gianturco Laurie E. , Siegel Jeffrey B. , Simon Morris 
Published: November 2007

In this prospective blinded study of inferior vena caval (IVC) patency, 18 patients underwent 25 duplex ultrasound (US) and magnetic resonance (MR) angiography examinations over an eight-month period following Simon nitinol filter placement. Clinical examination for lower extremity venous stasis and plain abdominal radiography were also performed. Twenty-three of 24 MR ex aminations and 11 of 24 US examinations were judged technically adequate by the blinded observers. One technically adequate US exam was false positive for intraluminal caval thrombus. Thirteen technically inadequate US examinations missed 3 complete caval occlusions and 2 partial occlusions. MR identified all patients with complete or partial caval occlusion. The authors conclude that duplex US reliably confirms IVC patency only when strict criteria for technical adequacy and interpretation are met (good visualization of filter and IVC above and below filter). MR, although expensive, more reliably identifies nonoccluding intraluminal thrombus and caval occlu sion. It should be the noninvasive study of choice in symptomatic patients with venous stasis and patients with recurrent pulmonary emboli.
Physical Manipulation of Subcutaneously Implanted Cardiac Muscle in Rat Increased Plasma Atrial Natriuretic Peptide Concentration
Authors: Gu Jiang , Daloisio Connie , D'Andrea Michael , Muralidharan S. , Yu Cheng-Zhi , Cichon Romuald 
Published: November 2007

To examine the effects of physical stretch on cardiac muscle endocrine activ ity, the authors transplanted whole neonatal hearts subcutaneously into the back and the ears of the correspondent mother (n=9). Seven days later, physical manipulation was applied on the implanted heart by stretching the skin and the subcutaneous tissue encasing the implanted cardiac muscle, for a period of five to ten minutes. Such manipulation was repeated approximately every seven days postoperatively for a total of two to four times for each rat. The plasma atrial natriuretic peptide (ANP) levels were measured by radioimmunoassay prior to and immediately following manipulation. Postmanipulation plasma ANP levels were found to increase from the premanipulation levels. At two weeks postimplant, the average increase was 290% with the highest single-speci men increase being nearly twelvefold. The increases observed at two and three weeks following implantation had Signed Rank Test p values of 0.015 and 0.042 respectively. The viability of the implanted hearts was confirmed by cell culture. Light microscopic immunocytochemistry detected ANP immunoreactivity in the implanted cardiocytes. The elevated plasma ANP concentration induced by the manipulation appeared to be correlated with the functional status of the im planted cardiocytes. In conclusion: (1) Subcutaneously transplanted neonatal myocardiocytes survived for at least three to four weeks while retaining the ability to produce ANP. (2) Physical manipulation of implanted heart induced ANP release. There fore, cardiac ANP production and release is indeed stimulated by physical stretching.
Critical Degree of Renal Arterial Stenosis That Causes Hypertension in Dogs
Authors: Imanishi Masahito , Akabane Satoshi , Takamiya Makoto , Kawamura Minoru , Matsushima Yohkazu , Kuramochi Morio , Omae Teruo 
Published: November 2007

The minimum degree of renal arterial stenosis needed to cause hypertension was identified by renal arterial angiography of anesthetized dogs. The effects of renal nerves and prostanoids on the critical stenosis were also examined. The left renal artery was constricted concentrically by a radiolucent con strictor device, and the stenosis of the artery was evaluated by cineangiography with the kidney either innervated or denervated. At this time, renal blood flow, renal perfusion pressure, and systemic blood pressure were serially monitored. In another group of dogs, renal venous and aortic blood samples were taken as the stenosis increased; these were assayed for prostaglandin E2 and plasma re nin activity. The same experiments were done again after treatment with a cyclooxygenase inhibitor, aspirin DL-lysine (54 mg/kg). With the kidney either innervated or denervated, systemic blood pressure began to increase when the stenosis was more than 70% of the diameter of the renal artery; the renal blood flow decreased when the stenosis was more than 75% of the diameter. Aspirin treatment attenuated the increase in blood pres sure but did not affect the autoregulation of the renal blood flow when stenosis was 70% or less. Prostaglandin E2 production increased in the stenotic kidney when the stenosis was more than 70%; aspirin inhibited prostaglandin synthesis and suppressed the stimulation of renin release. These results suggest that whether there is innervation or not, the critical degree of renal arterial stenosis that causes hypertension is more than about 70% of the diameter in the presence of renal prostaglandins; in their absence, the critical point above which hypertension occurs is 75% or more.
Suppurative Pericarditis
Authors: Folger Gordon M. 
Published: November 2007

Think of suppurative pericarditis in in stances of fever of unknown origin—it is a treatable disease if recognized before the terminal events. Suppurative pericarditis is still with us despite the wider use of antibiotics. These two recent cases serve to remind the prac titioner of the details of diagnosis and management of this persistent pediatric problem.
Blood Pressure Standards for Normal Children
Authors: Londe Sol 
Published: November 2007

Standards for auscultatory blood pressure determinations under office conditions in 120 three-year olds are given here, to supple ment standards published previously for children aged four through 15. Discussed also are suggested thresholds for diagnosing hypertension; improved methods of obtaining reliable pressure readings in three-year olds; and some relationships of blood pressure to weight and height.
Velopharyngeal Incompetence
Authors: Stool Sylvan E. , Graham William , Randall Peter 
Published: November 2007

Velopharyngeal incompetence (failure of the soft palate to affect closure of the nasopharynx) may result in hypernasal or unintelligible speech, chronic otitis media with secondary conductive hearing loss, or even pseudomental retardation. Such devastating consequences make early diagnosis mandatory. Here is an excellent ca se illustration, review of the literature, and a diagnostic checklist for office use.
Management of the Newborn with Imperforate Anus
Authors: Touloukian Robert J. , Pickett Lawrence K. 
Published: November 2007

The results of surgical care of 62 newborn infants with imperforate anus are summarized here in a 20-year retrospective study. Ninety per cent had anomalies in either formation of the urorectal septum or failure of posterior, "migration" of the rectum. The over-all mortality rate was 30 per cent, but most of the deaths were in untreated newborns having other severe congenital anomalies. Emphasis in diagnosis is placed on correlating physical findings with some abnormality during a specific phase of embryologic development. The value of upside-down lateral films of the pelvis in determining the initial treatment is de-emphasized. Roentgenograms of the chest, abdomen and lumbosacral spine, and intravenous pyelogram and cystogram, are important to detect the associated, anormalies. The over-all results of perineal anoplasty for a low perineal fistula or obvious perineal bulging are good, which indicates that this is the procedure of choice with such newborns. A combined abdominoperineal pull-through operation following a preliminary colortomy is recommended for infants with high imperforate anus. Eventual function may be satisfactory if there is close supervision of the postoperative patient throghout infancy and childhood to prevent chronic fecal impactions and secondary megacolon.
Home Oxygen Therapy
Authors: Sauve R.S. , McMillan D.D. , Mitchell I. , Creighton D. , Hindle N.W. , Young L. 
Published: November 2007

Forty-four oxygen-dependent infants were discharged home in oxygen from an NICU during an 8-year period. Survivors were followed for 3 years. The infants' discharge diagnoses were bronchopulmonary dysplasia (BPD) (39), sleep apnea (2), and congenital cardiac defects (3). The five infants who had diagnoses other than BPD all died, but 34 of 39 infants with BPD survived. Supplemental oxygen was discontinued at a mean age of 13.4 months. The infants with BPD experienced health, growth, nutritional, neurodevelopmental and sensory problems that necessitated frequent rehospitalizations and utilization of a variety of medical and support services.
Inborn Errors of Metabolism
Authors: Giugliani Roberto , Dutra-Filho Carlos S. , Barth Maria L. , Dutra Janice C. , Wajner Moacir , Wannmacher Clovis M. D. , Montagner Lenir T. 
Published: November 2007

We estimated the sensitivity of a screening procedure (SP) for inborn errors of metabolism (IEM) in 566 referred, high-risk patients. The 143 (25.3% of the total sample) patients with initial abnormal results in at least one screening test (ST) were recalled for further investigations. An IEM was diagnosed in 40.6 percent of the 106 patients who came for reevaluation. In 114 of the remaining 423 patients who had normal initial ST, an IEM was still suspected on basis of clinical, radiological, and/or laboratory findings and was confirmed in 30 of such patients (5.3% of the total sample and 7.1% of the patients with normal results in the SP). The sensitivity of the SP was estimated maximally as 67.4 percent and the efficiency as 80.4 percent. Twenty-five of the 30 cases undetected with the SP were patients with sphingolipidoses. The simple inclusion of thin-layer chromatography of urinary oligosaccharides in the SP should allow the detection of at least one half of these cases, increasing its sensitivity by 14.1 percent and its efficiency by 4.6 percent. In at least 7.1 percent of patients with an initial normal ST, an IEM was detected. These would have remained undiagnosed if the limitations of the SP employed had not been fully understood.
Enterobacter Cloacae Bacteremia in Children: A Review of 30 Cases in 12 Years
Authors: Bonadio William A. , Margolis David , Tovar Mauricio 
Published: November 2007

A review was performed of the 30 cases of pediatric Enterobacter cloacae (EBC) bacteremia which occurred at our institution during a 12-year period. These 30 cases represented 88% of all cases in which EBC was isolated by blood culture (four other instances were considered contaminants); the rate of isolation of this organism relative to all positive blood cultures was 0.6%. There were 14 patients <12 months of age, with 10 <2 months of age. Infection was nosocomially-acquired in 17 cases. At the time the positive blood culture was obtained, 5 patients were afebrile, and 8 patients (five immunocompromised) had been receiving parenteral antibiotic therapy to which the organism exhibited in-vitro sensitivity for at least 24 hours. EBC was a constituent of polymicrobial bacteremia in 6 cases; in 5 instances the associated organisms were also gram-negative bacteria. There were a total of 33 underlying medical conditions or foci of infection associated with EBC bacteremia identified in 27 patients, the most common of which were immune-deficiency state (17) and gastrointestinal tract lesions (6). There were 3 patients who died. EBC bacteremia is a relatively rare pediatric infection. It is commonly nosocomially-acquired, and afflicts children who are younger-aged or compromised by underlying medical problems.
The Effect of Beta Blockade on Stress-Induced Cognitive Dysfunction in Adolescents
Authors: Faigel Harris C. 
Published: November 2007

Test anxiety is severely disabling to students whose fear of examinations causes cognitive dysfunction that paralyzes their thinking the way stage fright impairs actors ability to act. In studies using subjective evaluations among actors and musicians, beta-blockade relieved stage fright and has been used informally to treat test anxiety in students without objective measures of effectiveness. The Scholastic Aptitude Test (SAT) was chosen as an objective test instrument to confirm the effect of beta-blockade on test anxiety and performance. Thirty-two high school students who had already taken the SAT before enrolling in this study and who had stress-induced cognitive dysfunction on exams were given 40 mg of propranolol one hour before they retook those tests. Mean SAT scores with beta-blockade were 130 points higher than on the initial SAT done before entering the study without medication (p=<.01). A single dose of propranolol immediately before the SAT permitted improved performance in students prone to cognitive dysfunction due to test anxiety.
Accidental Intravenous Administration of Semi-Elemental Formula in an Infant
Authors: Lopez Garcia Maria José , Monrabal Ignacio Sorribes , Fernandez-Delgado Cerda Rafael 
Published: November 2007

Continuous enteral nutrition (CEN) has some advantages in pediatrics when compared with total parenteral nutrition, namely, its greater feasibility and more physiologic approach to infant nutrition. The two types of nutrition are not substitutes for each other. Rather, they are complementary and can even be interassociated, thus allowing an earlier reintroduction of enteral nutrition and a decrease in the secondary effects of total parenteral nutrition.1 Like other techniques, CEN needs special care and attention, as well as some training; to guarantee the results. Continuous-perfusion systems capable of supplying exactly programmed enteral food may be similar to those used for intravenous infusion and used for the same patient. Catheters are easy to differentiate by checking their location in the child, but if the connections between infusion syringe and catheter are wide apart and the contents appear alike (lipid solution and milk), there may be mistakes and problems. We have recently had the apportunity to see one of these rare complications in an infant who inadvertently received, through a scalp vein, 10 mL of semi-ele mental formula, which was being delivered through continuous enteral administration.
Pollen evidence from tropical Australia for the onset of an ENSO-dominated climate at c. 4000 BP
Authors: Shulmeister James , Lees Brian G. 
Published: November 2007

The Holocene climatic history of tropical northern Australia is re-examined using the recently published pollen record from Groote Eylandt to corroborate and refine previous climatic inter pretations. We identify a four-stage Holocene comprising: (1) a continuous increase in effective precipitation (EP) from the beginning of the Holocene to about 5000 BP; (2) a mid-Holocene EP maximum from about 5000 to about 4000 BP; (3) a marked decline in EP somewhere between 4000-3500 Bp; and (4) an EP recovery in the last <2000 years. The mid-Holocene EP maximum is 1000 years later than Holocene EP maxima from temperate Southern Australia and suggests that the records are decoupled at this time. We focus on pollen evidence of environmental change at c. 4000 BP, which marks a break between a continuously ameliorating (increasing EP) climate but with small mean variation in the earlier Holocene and a steady (no directional trend) but highly variable later Holocene. We believe that this break represents the first evidence from the monsoonal lowlands of northern Australia for the onset of 'modern' ENSO-dominated ocean-atmosphere interactions in the Holocene. A simple conceptual model of trans-Pacific teleconnections is presented to explain this onset and as an hypothesis for testing.
Beneficial Effects of Vitamin E Treatment in Acute Myocardial Infarction
Authors: Sethi Rajat , Takeda Nobuakira , Nagano Makoto , Dhalla Naranjan S. 
Published: November 2007

Background: Vitamin E (Vit E), an antioxidant, is considered to prolong survival in patients and animals after myocardial infarction. Because myocardial infarction is associated with arrhythmia and heart dysfunction, this study tested the hypothesis that early treatment with Vit E reduces mortality because of its protective effects against arrhythmia and cardiac dysfunction induced by acute myocardial infarction. Methods: Rats were randomly divided into 4 groups: sham control, myocardial infarcted, Vit E-treated sham control, and Vit E-treated infarcted animals. Myocardial infarction was induced by ligation of the left anterior descending coronary artery. Treated animals received Vit E (25 mg/kg/d) through a gastric tube beginning 1 hour after the coronary occlusion, whereas control rats received tap water. Results: Electrocardiograms (lead II) at 1, 3, 7, and 21 days after coronary occlusion in the untreated animals showed ST-segment elevation, abnormal Q waves, premature ventricular complex (PVC), and QTc prolongation. Conversely, Vit E-treated rats showed attenuated ST-segment changes, fewer abnormal Q waves, and decreased incidence of PVC after coro nary occlusion. Total mortality was reduced from 38% to 16%, whereas the infarct size was decreased from 44.2% to 22.3% in infarcted rats treated with Vit E. The depression in left ventricular function as well as elevation of malondialdehyde content and conjugated diene formation in the 21-day infarcted rat hearts were prevented by Vit E treatment. Conclusion: These results indicate that Vit E may exert beneficial effects on the heart by reducing oxidative stress in acute myocardial infarction.
Cardiovascular Dysfunction in Hypercholesterolemia Associated With Enhanced Formation of ATI-Receptor and of Eicosanoids
Authors: Schwemmer Michael , Sommer Olaf , Koeckerbauer Reinhold , Bassenge Eberhard 
Published: November 2007

Background: In hypercholesterolemia with or without atherosclerosis cardiovascular dys function and altered signalling of angiotensin (Ang II), nitric oxide (NO), or prostanoids are intimately related to enhanced oxidant stress and concomitant changes in gene expression. We analyzed cardiac angiotensin receptor (AT1) expression and metabolism of Ang II, eicosanoids, and NO in hypercholesterolemic animals. Methods: Guinea pigs were fed a 1% cholesterol diet for 8 weeks (Chol). Hemodynamics were analyzed in Langendorff hearts. Spectrophotometric determination of plasma lipids and radioimmunological detection of eicosanoids/cyclic guanosine monophosphate (cGMP). Ac tivities of NO synthase III (NOS-III) or angiotensin converting enzyme (ACE) were deter mined by enzymatic assays. AT1 receptor density was assessed by radioligand binding assay. NOS-III mRNAs were quantitated by reverse transcription polymerase chain reaction. Results: Hypercholesterolemia was associated with fatty degeneration of the liver and pro found myocardial and coronary (e.g., endothelial) dysfunction. In Chol Langendorff hearts we observed significant increases in coronary flow (26.0 ± 1.0 vs. 17.5 ± 0.5 mL/min/g tissue) but diminished coronary responses to bradykinin (Bk, 250 ng bolus) or adenosine (Ado, 250 μg bolus) (ΔCPPBk/Ado: 5 ± 0.5 vs. 7.2 ± 1/0.9 ± 0. 1 vs. 1.9 ± 0.3 cm2 (area under the curve)). AT1 receptor expression was significantly increased in Chol hearts (72 ± 6.8 vs. 45 ± 5.6 fmol/mg protein), whereas marked suppression of cardiac activities of ACE (1.96 ± 0.34 vs. 4.90 ± 0.20 nmol/min/mg tissue) and of the entire cardiac nitric oxide-cGMP axis (e.g., NOS-III activity: 1.9 ± 0.4 vs. 3.1 ± 0.1 pmol/min/mg tissue; NOS-III mRNA: 0.82 ± 0.16 vs. 1.20 ± 0.12 arbitrary units; cGMP release: 0.41 ± 0.02 vs. 0.54 ± 0.04 pmol/min/g tissue) were shown in Chol. Finally, cardiac release of eicosanoids prostacyclin (PGI2) and throm boxane (TxA2) were significantly enhanced (0.48 ± 0.05 vs. 0.38 ± 0.05 and 0.60 ± 0.10 vs. 0.24 ± 0. 10 ng/min/g tissue, respectively). Enhanced cardiac PGI2 release and suppression of cGMP synthesis in Chol were even more pronounced on stimulation with Bk (38.2 ± 3.0 vs. 28.2 ± 2.0 ng/min/g tissue and 1.9 ± 0.3 vs. 3.0 ± 0.3 pmol/min/g tissue, respectively). Conclusions: Altered angiotensin-mediated signal transduction probably related to aug mented eicosanoid formation does not compensate for the limited endogenous NO production and for cardiovascular dysfunction in hypercholesterolemic guinea pigs. In this context, changes in redox-sensitive regulation of gene expression (ATI receptor, NOS-III—caused by enhanced oxidant stress—coutd play a pivotal role.
Use of Lipid-Lowering Drugs With Acute Myocardial Infarction Patients: An Examination of Physician Prescribing Behaviors
Authors: Khan Mubina , Mukkamala Aruna , Taylor D. Kay , Espinosa Aimee , Duff Jenny 
Published: November 2007

Background : Clinical trials have shown that the use of lipid-lowering agents in postmyocar dial infarction (MI) patients reduces rates of subsequent coronary events, reduces coronary artery bypass surgery rates, and improves survival. Physician decisions to prescribe lipid- lowering drugs is influenced by a number of patient factors, including age, medical history, and serum cholesterol levels. The purpose of this study was to examine physician behaviors in prescribing lipid-lowering therapy in patients after acute MI. Methods and Results: A retrospective study was conducted at a local community-based hospital. A total of 129 patients with validated acute MI, hospitalized between January 1996 and December 1996, was included in the study sample. Variables abstracted included patient age, sex, race, primary diagnosis, medical history, lipid-lowering interventions of the discharge plan, and other discharge instructions regarding smoking cessation, activity, and dietary modification. Descriptive analysis was performed. The study showed that only 7 sub jects (8.8%) were discharged on lipid-lowcring drugs. Several patients who did not undergo therapy had either a low-density lipoprotein concentration of < 130 (n = 13), a high-density lipoprotcin concentration of >50 (n = 6), or were on hormone replacement therapy (n = 3). Dietary modification was advised in 100% of subjects (n = 54) for whom the data were included in the charts. Conclusions: The results of this descriptive study suggests that lipid-lowering drugs are being utilized at low rates in the secondary prevention of acute MI. However, additional risk-lowering factors may play a role in the decision to discharge without drugs. Because of potential side effects associated with their use, a prudent path appears to be the norm in prescription of lipid-lowering drug therapy for MI patients.