bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-Dose Warfarin for Prevention of Symptomatic Thromboembolism after Orthopedic Surgery
Authors: Enyart Jeremy J , Jones Ronald J 
Published: May 2005

BACKGROUND: Warfarin dosing with a target international normalized ratio (INR) range of 1.5–2.5 has not been reported as adequate for venous thromboembolism (VTE) prophylaxis after total knee (TKR) and total hip replacement (THR) surgery. OBJECTIVE: To evaluate the rate of symptomatic VTE after TKR and THR surgery using a low-dose (INR 1.5–2.5) warfarin protocol started the evening before surgery compared with a literature cohort treated with enoxaparin. METHODS: TKR/THR patients treated with a 21-day low-dose warfarin protocol were followed via a consecutive observational design. Main outcome measures were symptomatic VTE and pulmonary embolism (PE), with major bleeds and death as secondary outcomes. Low-dose warfarin was compared with a literature cohort of patients treated with enoxaparin who received enoxaparin for a similar length of time and was evaluated for the same outcomes. Cohort event rates were derived as a weighted average using the DerSimonian model. RESULTS: VTE, PE, bleeds, and deaths in the low-dose warfarin group were 8 (1.04%), 4 (0.52%), 8 (1.04%), and 4 (0.52%), respectively. The cohort weighted average values were 35 (1.33%), 19 (0.72%), 65 (2.46%), and 18 (0.67%), respectively. Odds ratios for low-dose warfarin for VTE, PE, and VTE plus PE were 0.778 (95% CI 0.36 to 1.68), 0.717 (0.24 to 2.11), and 0.754 (0.41 to 1.42), respectively, all nonsignificant. Odds ratios for bleeds and death were 0.420 (0.20 to 0.87; p = 0.02) and 0.756 (0.26 to 2.24; NS), respectively. CONCLUSIONS: For this evaluation, low-dose warfarin was comparable to the enoxaparin cohort for development of VTE, PE, and VTE+PE. Incidences of bleeds in the enoxaparin cohort were significantly higher than in patients receiving low-dose warfarin.
Transporters and Their Impact on Drug Disposition
Authors: Beringer Paul M , Slaughter Richard L 
Published: May 2005

OBJECTIVE: To review the recent advances in knowledge about human transporters and their effect on drug disposition. DATA SOURCES: A MEDLINE search (1996–March 2005) was performed to identify pertinent literature on human transporters and their impact on drug disposition. Additional articles were identified from a manual search of the references of retrieved articles. STUDY SELECTION AND DATA EXTRACTION: Based on the identified studies, data were extracted on the impact of transporters on drug absorption, distribution, and elimination. DATA SYNTHESIS: The pharmacokinetic disposition of drugs is known to be influenced by metabolic enzymes, kidney function, and transporters. Recent research on human transporters has greatly advanced our understanding of their diversity and importance in drug disposition. In particular, members of the multidrug resistance family of transporters (MDR, MRP) are present in organs and tissues throughout the body and are known to significantly affect the absorption, distribution, and elimination of commonly prescribed drugs. A growing number of studies now demonstrate that alterations in transporter function as a result of drug interactions or genetic polymorphisms may explain a significant portion of the variability in treatment response for certain drugs. CONCLUSIONS: Human transporters contribute significantly to the pharmacokinetic disposition of drugs. Knowledge of substrates, inducers, and inhibitors of these transporters is necessary to ensure optimal patient outcomes.
Potential Effects of Jaw Tag Loss on Exploitation Estimates for Lake Erie Walleyes
Authors: Isermann Daniel A. , Knight Carey T. 
Published: May 2005

Abstract
We used mark–recapture data collected from 1992 to 1995 to evaluate the potential effects of jaw tag loss on exploitation (u) estimates for walleyes Sander vitreus migrating from Lake Erie into the Grand River, Ohio. Loss of small jaw tags (size 10) detected during tagging periods was less than 17%. The annual loss rate of small tags exceeded 49% during each of the 2 years in which they were used. We detected no loss of large tags (size 12) during tagging periods, and annual rates of large-tag loss ranged from 23% to 50%. Exploitation rates adjusted for tag loss ranged from 14% to 39%, and unadjusted estimates ranged from 7% to 20%. Failure to adjust for annual tag loss rates resulted in 25–59% underestimation of u; however, error rates may be inflated due to a lack of knowledge concerning temporal patterns in tag loss. Our findings indicate that jaw tag loss rates must be accounted for when estimating population parameters such as u from mark–recapture studies. Furthermore, if agency personnel are able to analyze large samples of harvested fish for tags, the use of internal tag types that typically exhibit higher retention rates than jaw tags could reduce tag loss and eliminate biases due to nonreporting.
Associations among Selection Logging History, Brook Trout, Macroinvertebrates, and Habitat in Northern Michigan Headwater Streams
Authors: VanDusen Peter J. , Huckins Casey J. F. , Flaspohler David J. 
Published: May 2005

AbstractSelection logging is a dominant forest management technique in mixed‐hardwood forests of the Laurentian Great Lakes region, yet little is known about its potential effects on neighboring streams and their communities. We surveyed nine headwater streams of the Otter River watershed in Michigan's Upper Peninsula for which the adjacent forest had undergone selection logging in the previous 2 to 30 years to examine whether the abundance of brook troutSalvelinus fontinaliswas related to the logging history, stream habitat conditions, or aquatic macroinvertebrate composition. Mean abundances of age‐1 and older brook trout were estimated by electrofishing replicate 100‐m sections of each stream in 1999 and 2000. Aquatic macroinvertebrates were surveyed in 1999, and stream habitat was surveyed in 2000. Correlation models showed that brook trout density and biomass were substantially lower in streams bordering more recently logged forests. Brook trout abundance was also positively correlated with the relative combined abundance of the disturbance‐sensitive taxa Ephemeroptera, Plecoptera, and Trichoptera (EPT), which is an indicator of coldwater stream habitat quality. Streams in recently logged stands had substrates with higher fine sediment content and lower overall habitat quality as estimated by a multimetric habitat index. Neither brook trout density nor EPT was correlated with the abundance of fine sediments in the streams. Fine sediment abundance was negatively related to stream canopy cover. Volume of instream woody debris and other specific elements of instream habitat were not significantly correlated with years since logging, nor did they explain significant variation in biotic variables. Results from this chronological‐sequence comparison study suggest that selection logging alters stream habitat and influences associated stream communities, although the specific mechanistic linkages remain to be determined.
Patterns of Tobacco Use in the Early Epidemic Stages: Malawi and Zambia, 2000–2002
Authors: Pampel Fred C. 
Published: May 2005

Objectives. I examined demographic and socioeconomic patterns of tobacco use in 2 African nations in the early stages of epidemic. Methods. I used population-based data from the Demographic Health Surveys of men aged 15–59 years (N=5111) and women aged 15–49 years (N=20809) in Malawi (2000) and Zambia (2001/2002) and multinomial logistic regression models to examine tobacco use (nonsmoker, light cigarette smoker, heavy cigarette smoker, and user of other tobacco) as a function of age, residence, education, occupation, marital status, and religion. Results. Male tobacco users tend to be less educated, urban, household service or manual workers, formerly married, and non-Christian and non-Muslim. Although tobacco use is less common among women, it relates inversely to their education and occupational status. Tobacco users more often reported drinking, getting drunk, and, among men, paying for sex. Conclusions. Tobacco use patterns in 2 African nations at the early stages of epidemic suggest the need for public health officials to focus on disadvantaged groups to prevent the worldwide spread of tobacco.
Bacterial colonization on different suture materials—A potential risk for intraoral dentoalveolar surgery
Authors: Otten J.‐E. , Wiedmann‐Al‐Ahmad M. , Jahnke H. , Pelz K. 
Published: May 2005

AbstractIn this in vivo and in vitro study on resorbable (Monocryl®) and nonresorbable (Deknalon®) monofilament sutures used in intraoral dentoalveolar surgery the bacterial colonization was compared. For the in vivo study the sutures were applied in 11 patients during dental surgery. Eight days postoperative the sutures were removed and the adhered bacteria were isolated and identified by biochemistry, morphology, antibiotic susceptibility, and gaschromatography. The colonization was studied by scanning electron microscopy. Aerobic and anaerobic bacteria were isolated in nearly equal colony‐forming units (cfu) on each suture. In comparison with Monocryl® about 15% more aerobic and anaerobic strains were isolated on Deknalon®. Regarding the pathogens only, about three times more anaerobic strains were isolated on both sutures in total. Additionally, more pathogens were found on Deknalon® than on Monocryl® (aerobic >40%, anaerobic >25%). The variety of bacteria correspond with purulent infections, not with normal oral flora. Intraindividual comparisons of cfu showed differences in dependence of the patient as described for subgingivale plaques. For the in vitro study the sutures were incubated with Streptococcus intermedius and Prevotella intermedia for 0.5 h. Scanning electron microscopy was performed to examine qualitatively the level of bacterial adherence. After 0.5 h the bacteria adhered very well. The colonization rate of Streptococcus intermedius on both sutures was similar. Coccoid bacteria within biofilms were seen. The growth of Prevotella intermedia was much better on Deknalon® than on Monocryl®. The risk of bacteremia at the time of suture removal is discussed. © 2005 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2005
Antibiotic prophylaxis in “clean” surgical procedures
Authors: Strachan Colin 
Published: May 2005

AbstractThe incidence of infection for clean surgical procedures should be less than 2%. The majority of infections are exogenous fromStaphylococcus aureus.These exogenous sources of bacteria include the ward, the theater environment, medical personnel, bed linen, and other infected patients. Endogenous infections may arise from the patient's own nose and skin; and although the majority of bacteria are staphylococcal, gram‐negative intestinal bacteria may colonize the skin around the perineum and are, therefore, important pathogens in hip replacement and aortobifemoral grafts. Methods of reducing exogenous infection include theater discipline, ultra clean air, surgical scrub, and isolating infected patients on the ward. Endogenous infections may be minimized by avoiding prolonged preoperative hospital stay, careful shaving only around the incision, and skin preparation with iodophors or chlorhexidine in alcohol. There is no place for antibiotic prophylaxis in clean surgical operations, provided the patient has a normal defense mechanism and provided a foreign body is not being implanted into bone or the circulation. Because of the morbidity and potential mortality of infected implants, antibiotics should be used in clean prosthetic surgery.
Prevention of sepsis in gastroesophageal surgery
Authors: Muscroft T. J. , Deane S. A. 
Published: May 2005

AbstractSepsis is a common complication of gastric operations, particularly in hypochlorhydric patients such as those with gastroesophageal carcinoma, gastric ulcer, or if revision gastric surgery is required for bile gastritis. By contrast, the risks of sepsis are small for patients with a duodenal ulcer having a proximal gastric vagotomy. The risks of endogenous sepsis are determined by the preoperative bacterial flora of the stomach. High preoperative bacterial counts are rare if the fasting pH is less than 4.0, hence cimetidine therapy given immediately before operation could increase the risk of endogenous sepsis. Systemic antimicrobial prophylaxis with a broad‐spectrum cephalosporin or penicillin is advised for all patients receiving cimetidine before operation, for all patients requiring gastric resection or revision gastric operations, and for any others in whom the preoperative gastric pH is 4.0 or more.
Clinical trials of antimicrobials in surgery
Authors: Watts James K. , McDonald Peter J. , Woods Pamela J. 
Published: May 2005

AbstractMany clinical trials of antimicrobials to prevent surgical infection are poorly designed and may, therefore, indicate policies that are misleading. This paper provides guidelines for trial design including statistical planning and analysis.Satisfactory trials have been carried out in most branches of surgery, but there is still a need to define patients at special risk of infection and to design trials within these groups. There is also a need to perform trials to validate current practice and to establish the cheapest, least toxic, and most effective antimicrobial regimens.Well‐designed trials require little analysis, but the results of a poorly planned trial cannot be retrieved even by statistical methods.
A rational approach to antibiotic prophylaxis in surgery
Authors: Keighley M. R. B. 
Published: May 2005

AbstractAntibiotic prophylaxis should be used a) where the risk of infection is high; b) where bacterial contamination is high; where contamination is infrequent but the consequences of infection are high; and c) where contamination is infrequent but the host is compromised. Careful attention should be given the selection of an appropriate agent for the given circumstance. Timing and route of administration are also important factors.
The effect of cholestasis on hepatic clearance of bacteria
Authors: Cardoso Valdemar , Pimenta Amadeu , Correia da Fonseca J. , Rodrigues J. Sousa , Vaz Maria José Machado 
Published: May 2005

AbstractNormal dogs and dogs with experimental cholestasis were inoculated intravenously withEscherichia coli.A study of the curves for bacterial blood clearance and bacterial appearance in the bile followed. In the normal dogs, bacteria rapidly disappeared from the blood; no bacteria were detected in the bile of these animals. In the jaundiced dogs, not only did the bacteria disappear from the blood less rapidly, but also appeared in the bile almost simultaneously. The different possible mechanisms for this activity are discussed. The results obtained may lead to a better understanding of the great incidence of infection in cases of biliary obstruction.
Wounds of the portal venous system
Authors: Stone H. Harlan , Fabian Timothy C. , Turkleson Margaret L. 
Published: May 2005

AbstractDuring a 23‐year interval, 83 patients with wounds of the portal and/or superior mesenteric veins underwent emergency laparotomy. Six (7%) of the injuries were due to blunt trauma, while penetrating wounds accounted for the remaining 77 (93%). With one exception, associated organ injuries were routinely present and involved 120 other major vascular structures in 59 (71%) of the patients. Five patients with both portal and superior mesenteric vein injury and 3 others with isolated portal venous injury exsanguinated before repair could be accomplished.Lateral phleborrhaphy gave survival in 24 of 34 patients so treated. End‐to‐end reanastomosis of the portal vein was successful in only 1 of 3 patients on whom it was attempted, while the single portacaval shunt led to a metabolic death. Of the initial 17 patients having vein ligation as a desperation measure, there were 7 survivors. Subsequent immediate application of this technique whenever lateral repair was impossible or impractical was successful in 17 of 20 so managed.Death resulted from hemorrhagic shock (20), its attendant coagulopathy (7), or renal failure (2) in 29 patients. Two deaths were the result of failure to over‐transfuse appropriately when portal venous ligation or thrombosis with its attendant splanchnic sequestration led to significant peripheral hypovolemia. The overall mortality rate was 41%, with individual mortality rates of 46% and 27% for the portal and superior mesenteric veins, respectively. There was no survival if both veins had been injured.
Recurrent laryngeal nerve anastomosis following thyroid surgery
Authors: Ezaki Haruo , Ushio Hiroki , Harada Yasuo , Takeichi Nobuo 
Published: May 2005

AbstractEnd‐to‐end anastomosis of the recurrent laryngeal nerve had been abandoned because movement of the vocal cords could not be restored because of misdirected regeneration. However, the authors discovered that, although vocal cord movement could not be restored, phonation was better in those in whom the recurrent laryngeal nerve was anastomosed than in those in whom it had been left in the severed state. Hoarseness improves after nerve anastomosis because it prevents vocal cord atrophy and the vocal cord gap is smaller. End‐to‐end anastomosis of the recurrent laryngeal nerve is, therefore, considered to be of value.
Diagnosis of acute pancreatitis using the amylase‐creatinine clearance ratio and radionuclide hepatobiliary and pancreas imaging
Authors: Orda Ruben , Orda Sara , Baron Jack , Wiznitzer Theodor 
Published: May 2005

AbstractAmylase‐creatinine clearance ratio and radionuclide hepatobiliary and pancreas imaging were used together as noninvasive screening procedures in 24 patients suspected of having acute pancreatitis. An increased amylase‐creatinine clearance ratio, normal filling of the gallbladder demonstrated by the radionuclide study, and decreased uptake of the radionuclide in the pancreas scan were helpful in reaching the diagnosis of acute pancreatitis.
An appraisal of transcatheter arterial embolization combined with transcatheter arterial infusion of chemotherapeutic agent for hepatic malignancies
Authors: Okamura Jun , Horikawa Shinichi , Fujiyama Takeo , Monden Morito , Kambayashi Junichi , Sikujara Osman , Sakurai Masami , Kuroda Chikazumi , Nakamura Hironobu , Kosaki Goro 
Published: May 2005

AbstractTranscatheter arterial embolization (TAE) combined with transcatheter arterial infusion (TAI) was done in 58 patients with unresectable hepatic malignancies. The actuarial 1‐year survival rate of the patients was 56.2%. Elective hepatic resection was performed on 10 patients following these procedures. These patients are all doing well. Complete tumor necrosis was demonstrated in 5 of these 10 patients by pathohistological studies on resected specimens from 1 to 11 months after surgery. These tumors were solitary, small (less than 4 cm in diameter), encapsulated, and located deeply inside the liver, being supplied by a single artery. In the other 5 patients, tumor cells in the main tumor and/or in daughter nodules were viable. We conclude that TAE combined with TAI was justified for treatment of hepatic malignancies in selected cases.
Laboratory and clinical evaluation of a membrane oxygenator with secondary flows in the blood channels
Authors: Karlson Karl E. , Massimino Ronald J. , Singh Arun K. , Cooper George N. 
Published: May 2005

AbstractA microporous membrane oxygenator which has transverse furrows on the membrane surface has been used in 50 clinical cardiopulmonary bypass procedures for coronary revascularization. The transverse furrows on the membrane, together with intermittent rapid pulsatile reversal of the blood flow in the blood film, produce secondary flows in the film and increase exposure of desaturated blood to the membrane. Venous drainage flows into a plastic reservoir, from which it is pumped through the oxygenator and integral heat exchanger into the aorta of the patient. Perfusions were carried out with hemodilution and moderate hypothermia. The oxygenator was ventilated with oxygen. In experimental perfusions using calves, the oxygen transfer was as high as 371 ml/min. During the clinical perfusions, arterial oxygen saturation was always 98% or higher. The mean arterial carbon dioxide tension was 41 mm Hg at a mean O2 flow of 1.4 L/min. The mean arterial pH was 7.40. The oxygenator puiser which created the secondary flows in the blood film was operated at a rate of between 90 and 255 pulses per minute. Pressure drop across the oxygenator averaged 18 mm Hg. Oxygen tension in the arterial blood could be regulated with the pulser rate, greater pulser rates being associated with larger oxygen transfer. Carbon dioxide transfer was best regulated by changes in gas flow rate. The oxygenator functioned well and was safe and reliable during these 50 perfusions.
Cost of nosocomial infections: Analysis of 512 digestive surgery patients
Authors: Fabry J. , Meynet R. , Joron M. T. , Sepetjan M. , Lambert D. C. , Guillet R. 
Published: May 2005

AbstractThe present report of 512 consecutive patients hospitalized for common digestive surgery assesses the medical outcome of nosocomial infection (NI) using Center for Disease Control criteria. Medical and social costs were evaluated for the hospitalization period and for the 6 months following. Estimate of cost directly due to NI represents 6.8% of total expenditures for the entire group of 512 patients.
Sepsis and asepsis in large bowel cancer surgery
Authors: Hughes E. S. R. , McDermott F. T. , Polglase A. L. , Johnson W. R. , Pihl E. A. 
Published: May 2005

AbstractA patient undergoing surgery for carcinoma of the large bowel has 2 hurdles to negotiate before claiming a cure. The first is postoperative complications and the second, recurrence of the tumor. Recurrence of the tumor will occur almost always within the first 5 years. Postoperative complications are mainly related to infection. Infection on its own is rarely responsible for the death of the patient, but by damaging the vascular endothelium may predispose to arterial or venous thrombosis. More commonly, sublethal sepsis is the cause of considerable morbidity whether within the abdominal wound or the intraperitoneal cavity. One or more of 3 basically different methods are employed to control infection in large bowel surgery: (1) reduction in the number of microorganisms in the large bowel; (2) reduction in the number of microorganisms contaminating the wound, whether within or without the peritoneal cavity; and (3) destruction of microorganisms contaminating the wound.The authors have relied on reducing the number of microorganisms contaminating the wound by strict attention to wound protection and aseptic surgery, and the destruction of microorganisms that actually reach the wound. To this end, excellent results with antibiotics have been obtained by combining meticulous aseptic surgery with the use of cefazolin and metronidazole administered a short time prior to surgery.
Experiences with intestinal antisepsis
Authors: Cohn Isidore , Bornside George H. 
Published: May 2005

AbstractFrom 1955 through 1964, the authors were actively engaged in experimental and clinical studies concerned with intestinal antisepsis, a form of antimicrobial prophylaxis used by the surgeon to lower the high rate of infectious complications following colorectal operations. Controversy has existed regarding the protective action of antibacterial agents and whether such a regimen has significant advantage over simple mechanical cleansing. Animal studies and clinical trials of 50 drugs, drug combinations, and drug dosage schedules are cited in support of intestinal antisepsis. Kanamycin was selected as the intestinal antiseptic of choice on the basis of studies in 967 patients.