bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reproducibility of Blood Pressure Variation in Older Ambulatory and Bedridden Subjects
Authors: Tsuchihashi Takuya , Kawakami Yasunobu , Imamura Tsuyoshi , Abe Isao 
Published: March 2003

OBJECTIVES: We investigated the influence of ambulation on the reproducibility of circadian blood pressure variation in older nursing home residents.DESIGN: Ambulatory blood pressure monitoring was performed twice in 37 older nursing home residents.SETTING: Nursing home in Japan.PARTICIPANTS: Subjects included 18 ambulatory nursing home residents who had no limitation on physical activity and 19 bedridden residents who did not participate in physical activity.MEASUREMENTS: Twenty‐four–hour, daytime, and nighttime blood pressure levels and their variability.RESULTS: The 24‐hour and daytime variability of systolic blood pressure (SBP) was significantly greater in ambulatory than in bedridden subjects, whereas nighttime variability was similar. Significant correlations in SBP averaged for the whole day, daytime, and nighttime were observed between the two examinations in ambulatory (r = .80–.83) and bedridden (r = .83–.91) subjects, but the variabilities of SBP for the whole day and during the daytime of the first measurement were correlated with those of the second measurement in bedridden (r = .67 and r = .47, respectively) but not in ambulatory (r = .39 and r = .28, respectively) subjects. Significant correlations were found between the nocturnal SBP changes at two occasions in both ambulatory (r = .50) and bedridden (r = .51) subjects, but the dipper versus nondipper profiles, defined as reduction in SBP of greater than 10% versus not, showed low reproducibility in ambulatory subjects; five ambulatory (28%) and one bedridden (5%) subjects showed divergent profiles between the two examinations.CONCLUSIONS: The reproducibility of blood pressure variation in nursing home residents is influenced by ambulation.
Diurnal, Week‐to‐Week, and Long‐Term Variation in Urine Deoxypyridinoline Cross‐Link Excretion in Healthy Older Women
Authors: Allain Theresa J. , Abraha Hagosa D. , Ouldred Emma L. , Ajmal Raheela , Buxton‐Thomas Muriel S. , Gray Beverley C. , Dnm  , Jackson Stephen H. D. , Blackburn Ann M. , Moniz Caje F. 
Published: March 2003

OBJECTIVES: To establish a reference range for morning and afternoon excretion of urinary deoxypyridinoline (DPD) in apparently healthy older women selected from a volunteer database. To assess the extent of diurnal variation and short and long‐term within‐subject longitudinal variation.DESIGN: Prospective, observational, cohort study.SETTING: Clinical Age Research Unit, King's College School of Medicine, London, United Kingdom.PARTICIPANTS: Forty‐two women aged 68 to 89 (median age 75) selected from a volunteer database.METHODS: Subjects completed an osteoporosis risk factor questionnaire and a physical examination and had a measurement of the broadband ultrasound attenuation and speed of sound of their right heel. Subjects provided six urine samples: morning and afternoon at baseline and 1 week and 60 weeks later for measurement of DPD.RESULTS: The mean baseline values for DPD of morning and afternoon samples were 7.2 nM/mM and 6.0 nM/mM creatinine, respectively. The majority of subjects showed diurnal variation, with mean afternoon values 15% lower than morning values (P < .0001 for afternoon vs morning values). The mean difference in DPD after 60 weeks was 1.67 nM/mM for morning and 1.34 nM/mM for afternoon creatinine. This difference was not significant. Some individuals displayed marked changes in DPD excretion with no change in health status or treatment. DPD excretion in a nonfasting afternoon sample showed similar characteristics to morning void samples in terms of scatter, week‐to‐week variation, and long‐term reproducibility.CONCLUSIONS: The study was set up to provide background data to assist the development of a clinical osteoporosis service for older women. Further studies are needed to determine whether these measurements predict fracture risk and respond to treatment changes in this age group.
Memantine (a N‐methyl‐d‐aspartate receptor antagonist) in the treatment of neuropathic pain after amputation or surgery: a randomized, double‐blinded, cross‐over study. (Danish Pain Research Center, University of Aarhus, Aarhus, Denmark) Anesth Analg 2000;91:960–966.
Authors: Nikolajsen Lone , Gottrup Hanne , Kristensen Anders G. D. , Jensen: Troels S. 
Published: March 2003

Evidence has accumulated that the N‐methyl‐d‐aspartate receptor system plays a role in continuous and stimulus‐evoked pain after nerve injury. The analgesic effect of memantine on a group of patients with chronic pain after surgery was examined in this randomized, double‐blinded, study. Nineteen patients randomly received either memantine or placebo in the first 5‐week treatment period. A washout period of 4 weeks was followed by another 5‐week treatment period of the opposite drug. The dosage of drug was increased from 5 to 20 mg/d. Pain was recorded daily, with the use of a 0‐10 numeric rating scale. Before and at the end of each treatment, pain and sensitivity were also assessed by using the McGill Pain Questionnaire, allodynia to touch, brush, and cold, wind‐up‐like pain, and thresholds to mechanical stimuli (pressure and von Frey hair). A total of 15 patients completed the study. There was no difference between memantine and placebo on any of the outcome measures. Conclude that memantine at a dosage of 20 mg/d does not reduce spontaneous or evoked pain in patients with nerve injury pain.Comment by Tat‐Leang Lee, M.D. The treatment of patients suffering from chronic neuropathic pain remains a clinical challenge, particularly in cases where opioid therapy fails to provide sufficient pain relief. Experimental data concerning the role of NMDA‐mediated processes in central sensitization and the effects of NMDA receptor antagonists in different models of neuropathic pain have been well established. Currently, clinically available NMDA antagonists have narrow therapeutic windows and are limited by psychomimetic and other side effects. There exists a need to improve on this therapeutic ratio. Potential methods include the use of more selective NMDA antagonists that modulate binding sites within the NMDA complex, using novel routes including central axis delivery, or in combination with drugs. Combinations of opioids and NMDA antagonists may hold the most promise. Recently, a 1:1 mixture of morphine with dexmethorphan hydrobromide allowed satisfactory pain relief in chronic pain patients at a significantly lower morphine dose.1 In this study, there were 3 patients who had morphine as part of their conventional treatment. Although specific data is not available, it would be interesting to know if memantine proved to be more effective in these patients.
The density of remaining nerve endings in human skin with and without postherpetic neuralgia after shingles. (Massachusetts General Hospital, Harvard Medical School, Boston, MA) Pain. 2001;92:139–145.
Authors: Oaklander Anne Louise 
Published: March 2003

Postherpetic neuralgia (PHN), which occurs in some patients after shingles, was used to investigate the neural determinants of chronic pain. Skin biopsies were obtained from 38 adults with or without PHN at least 3 months after healing of shingles on the torso. Vertical sections were immunolabeled against PGP9.5, a pan‐axonal marker, to measure the density of the remaining nerve endings in skin previously affected by shingles. Of 19 subjects without PHN, 17 had more than 670 neurites/mm2 skin surface area, and 18 of 19 subjects with PHN had 640 or fewer neurites/mm2. PHN may be a “phantom‐skin” pain associated with loss of nociceptors. The study implies that the absence of pain after shingles may require the preservation of a minimum density of primary nociceptive neurons, and that the density of epidermal innervation may provide an objective correlate for the presence or absence of PHN pain.Comment by Miles Day, M.D. This is a good article addressing one of the most difficult chronic pain syndromes to treat. As you know postherpetic neuralgia can be devastating to the patients secondary to the ongoing and sometimes incapacitating pain. This study does not attempt to explain the cause of postherpetic neuralgia. Instead it establishes objective criteria that implies the absence of pain after shingles may require preservation of a minimum density of primary nociceptor neurons and that this density may provide an objective correlate for the presence or absence of postherpetic neuralgia pain. If the implication made by the study is true, it raises a question as to whether or not skin biopsy should be preformed on all patients who have just experienced a case of herpes zoster to determine whether or not they are at risk for developing postherpetic neuralgia. Another question that may arise is whether or not we should empirically treat certain patients for potential postherpetic neuralgia if there neurite density falls below a certain established level. While the information from this study should not be used as a sole factor in determining whether or not a patient with a previous herpes zoster infection will develop postherpetic neuralgia it does add objective data to our armamentarium that can be used to try to prevent or treat the devastating pain caused by postherpetic neuralgia.
Botulinum toxin A and chronic back pain: a randomized, double‐blinded study. (Walter Reed Army Medical Center, Washington, DC) Neurology. 2001;56:1290–1293.
Authors: Foster Leslie , Clapp Larry , Erickson Marleigh , Jabbari Bahman 
Published: March 2003

This study investigated the efficacy of botulinum toxin A in chronic low back pain and associated disabilities. Thirty‐one consecutive patients with chronic low back pain who met the inclusion criteria were studied. Each patient's baseline level of pain and degree of disability was documented using the visual analogue scale (VAS) and the Oswestry Low Back Pain Ques‐ tionnaire (OLBPQ). The authors reevaluated the patients at 3 and 8 weeks (VAS) and 8 weeks (OLBPQ). At 3 weeks, 11 of the 15 patients who received botulinum toxin (73.3%) had> 50% pain relief versus 4 of 16 in the saline group. At weeks, 9 of 15 in the botulinum toxin group and 2 of 16 in the saline group had relief. Repeat OLPBPQ at 8 weeks showed improvement in 10 of 15 in the botulinum toxin group versus 3 of 16 in the saline group. No patient experienced side effects. Conclude that paravertebral administration of botulinum toxin A in patients with chronic low back pain relieved pain and improved function at 3 and 8 weeks after treatment.Comment by Miles Day, M.D. This study evaluates the use of botulinum toxin A in the treatment of myofascial pain in patients with chronic low back pain. It's conclusion is “Paravertebral administration of botulinum toxin A in patients with chronic low back pain relieved pain and impoved function at 3 and 8 weeks after treatment”. While the results of this study are promising I agree with the authors that the conclusion should be regarded with caution because the sample size of patients studied was small. My main criticism is in the selection criteria the authors use in this criteria. As stated in the study six of the patients had a history of disc disease and three had had discectomies five to eighteen years prior to the study. As we in the pain field know, continuing pain after previous surgery can be secondary to multiple causes including disc disease, epidural scaring, myofascial pain, and facet disease. These patients sometime have a hard time delineating the amount of pain that is being generated from each one of these potential causes of ongoing pain. The results of this study may have been better if the inclusion criteria eliminated patients with multiple pain generators and only included patients with myofacial pain.
Treatment of idiopathic trigeminal neuralgia: comparison of long‐term outcome after radiofrequency rhizotomy and microvascular decompression. (Heidelberg College of Medicine, Heidelberg, Germany) Neurosurgery. 2001;48:1261–1267.
Authors: Tronnier Volker M. , Rasche Dirk , Hamer Jürgen , Kienle Anna‐Lena , Kunze Stefan 
Published: March 2003

The purpose of this study was to evaluate the long‐term outcome of patients after either percutaneous trigeminal rhizotomy or microvascular decompression (MVD) for idiopathic trigeminal neuralgia at a single institution. Overall, the results of the study showed that there was a 50% risk of recurrence of pain 2 years after percutaneous radiofrequency rhizotomy. Conversely, 64% of the patients who underwent MVD remained completely pain free 20 years postoperatively. Patients without sensory impairment after MVD were pain free significantly longer than patients who experienced postoperatively hypesthesia or partial rhizotomy. Conclude that because it is curative and nondestructive, MVD is considered the treatment of choice for trigeminal neuralgia in otherwise healthy people. In this study, it was proved to be a more effective and long‐lasting procedure for patients with typical trigeminal neuralgia than radiofrequency rhizotomy. Patients without postoperative sensory deficit remained pain free significantly longer, which is a strong argument against the “trauma” hypothesis of this procedure.Comment by Ron Pawl, M.D. This paper is noteworthy in that comparing the follow‐up on 225 of 378 patients who underwent microvascular decompression (MVD) with 206 of 316 who underwent radiofrequency thermocoagulation (RFT), the RFT group stood a 50% risk of recurrent pain by 2 years after the procedure, whereas 64% of those undergoing MVD were pain‐free after 20 years. Furthermore, after MVD, those patients with no postoperative sensory deficit, measured with von Frey hairs, remained pain‐free longer than those with a sensory deficit. This latter finding flies in the face of the concept that to be effective, surgery for trigeminal neuralgia must damage the nerve. The whole concept of RF lesioning of the nerve is to damage it enough to deaden the trigger zone of the affected nerve branch. However, in this study it is noted that postoperative hypesthesia was only temporary after RF lesioning, which might well explain the high rate of pain recurrence in this series. Although the long‐term pain relief in the MVD group is excellent, it must be weighed against the complications. In the MVD group, there were 3 mortalities, diminished hearing in 5%, loss of hearing in 2.6%, facial paralysis in 4 patients, and tinnitus in 4 patients, none of which occurred in the RF group.
Transesophageal monitoring of aortic blood flow during nonemergent canine surgeries
Authors: Wall Piper L. , DVM PhD, DACVECC  , Rudison Maisha M. , Lazic Tatjana , DVM  , Reidesel Dean H. , DVM PhD  
Published: March 2003

AbstractObjective: To establish baseline values for descending thoracic aortic blood flow parameters as determined with a transesophageal combined M‐mode and pulsed Doppler ultrasound‐based monitoring method.Design: Preliminary observational study.Setting: University small animal teaching hospital.Animals: The study population consisted of anesthetized canine patients undergoing nonemergent surgeries. Prospectively set criteria for inclusion were adequate body size for placement of the esophageal probe and a nonemergent reason for surgery. The criterion for exclusion was recent trauma.Interventions: Placement of the transesophageal probe.Measurements and main results: Data was collected during 15 surgeries. Data from three dogs was excluded from data analysis (two recently hit by motor vehicles, one recently having undergone a total hip replacement). Each parameter was stable across time within each individual dog. The ranges of the descending thoracic aortic parameters across the 12 nonemergent cases were as follows: blood flow, 0.038–0.085 L min−1 kg−1; blood flow per beat, 0.31–0.84 mL kg−1; blood acceleration, 6–29 m s2−1; blood peak velocity, 38–105 m s−1; left ventricular ejection time interval 331–492 ms; and diameter, 0.30–0.93 mm kg−1.Conclusions: The range of descending thoracic aortic blood flow parameters encountered in this small group of dogs during nonemergent surgeries was broad; however, each parameter was quite stable across time with little change occurring in any dog during monitoring.
Phenotyping autologous red cells within 1 day after allogeneic blood transfusion by using immunomagnetic isolation of reticulocytes
Authors: Brun A. , Skadberg Ø. , Hervig T.A. , Sandberg S. 
Published: March 2003

Background: When a transfused patient develops multiple or weak blood group antibodies, posttransfusion phenotyping is useful in antibody identification. To perform a correct phenotyping after transfusion, isolation of autologous red cells is necessary. However, mature autologous red cells are impossible to separate from their donor counterparts. Since the proportion of autologous reticulocytes compared to donor reticulocytes increases rapidly after transfusion, selective isolation of reticulocytes provides autologous cells for antigen typing.Study Design and Methods: Extensive phenotyping was performed on red cells from 10 surgical patients before transfusion and on red cells and reticulocytes after the transfusion of 5 or more red cell units. Reticulocytes were isolated by using an antibody against the human transferrin receptor coupled to magnetic beads.Results: The data showed nearly full agreement between pretransfusion phenotyping of red cells and posttransfusion typing of reticulocytes. Correct phenotyping of transferred patients could be obtained 8 to 10 hours after transfusion using isolated reticulocytes.Conclusion: This method is helpful in selecting compatible blood when patients have developed antibodies and have an urgent need for further transfusions.
Changes in ABH antigen expression on red cells during in vivo aging: a flow cytometric analysis
Authors: Fibach E. , Sharon R. 
Published: March 2003

Background: During aging of red cells they undergo a multitude of physical and chemical changes.Study Design and Methods: Age‐dependent changes in the expression of ABH major blood group antigens on red cells were studied in a two‐variable flow cytometric analysis. The expression of the antigens was measured after staining with fluorescence antibodies (for A and B) or lectin (for H). Cell age was related to size as measured by forward light scattering. Aging senescent cells are smaller and have low forward light scattering properties.Results: The results indicated that, within a given population, the A and/or B and H antigens decreased with the decrease in forward light scattering (i.e., increase in age), but A and B antigen expression decreased to a greater extent than did H.Conclusion: During aging, red cells lose the antigens of the major blood groups, but the degree of this loss is related to the fact that these antigens are located on the cell surface.
Multiple unconfirmed‐reactive screening tests for viral antibodies among blood donors
Authors: Buffington J. , Shapiro C.N. , Holman R.C. , Strine T.W. , Grossman B.J. , Williams A.E. , Alter M.J. , Schonberger L.B. 
Published: March 2003

BACKGROUND: In December 1991, the United States Food and Drug Administration received reports of blood donations with unconfirmed reactivity on screening tests for antibodies to human immunodeficiency virus, human T‐lymphotropic virus type I, and hepatitis C virus (HCV). Of 91 donors with these test results, 57 (63%) reported a recent influenza vaccination.STUDY DESIGN AND METHODS: To determine the extent of unconfirmed reactivity, the time at which it began, and its association or nonassociation with specific manufacturers' tests, a nationwide survey of blood centers was conducted. A case‐donation was defined as a blood donation that was repeatedly reactive, but not confirmed positive, on at least two of the three tests from May 1990 through December 1991.RESULTS: Among 14 million donations screened by 110 centers, 582 case‐donations were identified. An increase in case‐ donations was evident in the fall of 1990 (2.8/100,000 donations). In 1991, rates increased from 0.9 per 100,000 donations in the first quarter to 1.3, 3.2, and 19.7 in subsequent quarters. A significantly higher rate of case‐donations was observed among donations tested with one of the two available anti‐HCV screening tests (8.0 vs. 1.2/100,000 donations; risk ratio = 6.8; 95% CI = 5.4–8.5).CONCLUSION: Although unconfirmed reactivity on multiple screening tests appeared to be seasonal, its documentation prior to the availability of influenza vaccine in 1991 and higher rates among donations tested with one manufacturer's anti‐HCV test indicated that test‐specific factors were also involved.
Modification of glutathione content in platelet concentrates by the use of acivicin
Authors: Burch P.T. , Aman M. , Burch J.W. 
Published: March 2003

BACKGROUND: Intracellular glutathione declines progressively in platelet concentrates stored for transfusion, but little is known about the nature of this process.STUDY DESIGN AND METHODS: Acivicin, an irreversible inhibitor of gamma‐glutamyl transpeptidase, was used to determine the fate of glutathione lost from platelets during storage. Glutathione, cysteinylglycine, cysteine, and their disulfides were measured by high‐performance liquid chromatography.RESULTS: In control and acivicin‐treated platelet concentrates, intracellular glutathione declined progressively during 7 days' storage, with half‐disappearance times of 2.12 ± 0.22 and 2.13 ± 0.23 days, respectively. No glutathione accumulated accumulated in the medium of control concentrates. In concentrates treated with acivicin, glutathione accumulated in plasma to a level equal to 150 percent of that present in platelets and plasma on Day 1 of storage, which suggested a net synthesis of glutathione during storage. The sum of glutathione, cysteinylglycine, and cysteine in plasma was not different in control and acivicin‐treated concentrates; however, plasma from control concentrates contained significantly higher amounts of cysteinylglycine and cysteine. Treatment of concentrates with acivicin had a small favorable effect on plasma lactate dehydrogenase, beta‐thromboglobulin, and beta‐N‐acetylglucosaminidase during storage.CONCLUSION: The loss of glutathione from platelets during their storage as concentrates for transfusion is due to its egress into the suspending medium and catabolism by gamma‐glutamyl transpeptidase.