bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insulin Action After Resistive Training in Insulin Resistant Older Men and Women
Authors: Ryan Alice S. , Hurlbut Diane E. , Lott Mary E. , Ivey Fred M. , Fleg Jerome , Hurley Ben F. , Goldberg Andrew P. 
Published: March 2003

OBJECTIVES: To determine the effects of resistive training (RT) on insulin action and assess the determinants of the changes in insulin action. DESIGN: Longitudinal study. SETTING: Outpatient setting. PARTICIPANTS: Eighteen older men and older postmenopausal women (65–74 years) with normal (6 men and 5 women) or impaired glucose tolerance (4 men and 3 women). INTERVENTION: Six months of progressive whole‐body RT. MEASUREMENTS: Upper and lower body strength was assessed by the one repetition maximum test. Total body fat and fat‐free mass (FFM) were determined by dual‐energy x‐ray absorptiometry before and after 6 months of RT. Insulin sensitivity was estimated from the relationship of glucose utilization (M) to the concentration of insulin (I) during the last 30 minutes of 3‐hour hyperinsulinemic‐euglycemic clamps (240 pmol·m−2·min−1) (M/I) before and after RT. RESULTS: RT significantly improved upper and lower‐body muscular strength (P < .005). FFM increased after RT in the entire group (P < .0l) with no significant change in body fat. Although the change in M was larger in men (13%) than women (3%), the difference was not significant. The change in M was a function of initial M (r=−0.53, P < .05). There was a trend (0.060 ± 0.006 vs 0.066 ± 0.006 μmol·kg−1·min−1/pmol/l, n = 18) for M/I to increase after RT in the combined group of men and women (P= .06). There were no significant relationships between changes in M or M/I with changes in body composition or strength. CONCLUSION: A 6‐month RT program tends to improve insulin action in insulin‐resistant older adults. These results suggest that RT may be useful in ameliorating insulin resistance that often occurs with physical inactivity, obesity, and loss of muscular strength in older insulin resistant men and women.
Effects of Resistance Training on Insulin‐Like Growth Factor and its Binding Proteins in Men and Women Aged 60 to 85
Authors: Borst Stephen E. , Vincent Kevin R. , Lowenthal David T. , Braith Randy W. 
Published: March 2003

OBJECTIVES: We have reported that resistance training (RT) elevates insulin‐like growth factor (IGF‐I) in healthy young adults. Our goals were to determine whether RT produces a similar effect in the healthy older persons and to determine the effects of low‐ versus high‐intensity RT on hormonal status.SETTING: Center for Exercise Science, University of Florida, Gainesville.PARTICIPANTS: Sixty‐two men and women (mean age = 68.1).INTERVENTION: A 6‐month, 3‐day/week program of low‐intensity RT (LEX), high‐intensity RT (HEX), or no exercise (CON).MEASUREMENTS: Before and after training, blood was drawn for hormone analysis. IGF‐I, IGF binding protein‐1 (IGFBP‐1), and IGFBP‐3 were measured at rest. Testosterone and cortisol were measured at rest and immediately after exercise.RESULTS: RT caused significant increases in 1‐repetition maximum (1RM) strength and peak oxygen consumption (V02peak), which we have reported separately. Currently, we report that RT had no effect on the resting serum concentrations of IGF‐I, IGFBP‐1, IGFBP‐3, testosterone, or cortisol. Acute resistance exercise caused no change in circulating testosterone in men or women but did cause a significant elevation of cortisol in the HEX group. This increase in cortisol was blunted as a result of training.CONCLUSIONS: We conclude that the increases in strength and endurance caused by RT were not mediated by increases in circulating IGF‐I, IGFBPs, or testosterone.
Good Deaths, Bad Deaths, and Preferences for the End of Life: A Qualitative Study of Geriatric Outpatients
Authors: Vig Elizabeth K. , Davenport Nathaniel A. , Pearlman Robert A. 
Published: March 2003

OBJECTIVES: Patient involvement in decision‐making has been advocated to improve the quality of life at the end of life. Although the size of the oldest segment of the population is growing, with greater numbers of older adults facing the end of life, little is known about their preferences for the end of life. This study aimed to explore the attitudes of older adults with medical illness about the end of life, and to investigate whether current values could be extended to end‐of‐life preferences.DESIGN: Descriptive study with interviews using open‐ and closed‐ended questions.SETTING: Patients attending two university‐affiliated geriatric clinics were interviewed in a private conference room near the clinic they attended or in their homes.PARTICIPANTS: Sixteen older men and women identified by their physicians as having nonterminal heart disease or cancer.MEASUREMENTS: The interview contained open‐ended questions such as: “What are the most important things in your life right now?” and “What would you consider a good/bad death?” The interview also contained closed‐ended questions about symptoms, quality of life, and health status. Additional questions elicited preferences for the end of life, such as location of death and the presence of others. The open‐ended questions were tape‐recorded, transcribed, and analyzed using qualitative methods. The closed‐ended questions were analyzed using descriptive statistics.RESULTS: Patients with heart disease and cancer provided similar responses. Participants' views about good deaths, bad deaths, and end‐of‐life scenarios were heterogeneous. Each participant voiced a unique combination of themes in describing good and bad deaths. Because each participant described a multifaceted view of a good death, for instance, no theme was mentioned by even half of the participants. Participants provided differing explanations for why given themes contributed to good deaths. Currently valued aspects of life were not easily translated into end‐of‐life preferences. For example, although the majority of participants identified their family as being important, many gave reasons why they did not want their family members present when they died.CONCLUSIONS: Because of the heterogeneity of views and the difficulty in inferring end‐of‐life preferences from current values, older adults should be asked not only questions about general values, but also specific questions about their end‐of‐life choices and the reasons for these choices. A thorough understanding of an individual's end‐of‐life preferences may help health professionals working with older adults develop patient‐centered care plans for the end of life.
Percentage of Body Fat and Body Mass Index Are Associated with Mobility Limitations in People Aged 70 and Older from NHANES III
Authors: Davison Kirsten Krahnstoever , Ford Earl S. , Cogswell Mary E. , Dietz William H. 
Published: March 2003

OBJECTIVES: To assess the association between functional limitations and body composition indices, including percentage of body fat, muscle mass, and body mass index (BMI).DESIGN: A cross‐sectional, population‐representative sample.SETTING: All noninstitutionalized people living in the United States (National Health and Nutrition Examination Survey). Data were collected between 1988 and 1994.PARTICIPANTS: One thousand five hundred twenty‐six women and 1,391 men aged 70 and older.MEASUREMENTS: Independent variables included BMI, muscle mass, and percentage of body fat; the latter two were assessed using predictive equations. The dependent variable, functional limitations, was defined as difficulty in performing at least three of five functional living tasks, such as carrying a 10‐pound bag of groceries.RESULTS: Women in the highest quintile for percentage of body fat and women with a BMI of 30 or greater were two times more likely to report functional limitations than women in the comparison groups. Similar, but weaker, relationships were found among men; men in the highest quintile for body fat and men with a BMI of 35 or greater were 1.5 times more likely to report limitations. Low muscle mass (sarcopenia) and sarcopenia in combination with high percentage of body fat (sarcopenic obesity) were not associated with a greater likelihood of reporting functional limitations.CONCLUSIONS: Prevention of excessive accumulation of body fat and maintenance of a BMI in the normal range may reduce the likelihood of functional limitations in old age.
Intraoperative loading attenuates nausea and vomiting of tramadol patient‐controlled analgesia. (Show‐Chwan Memorial Hospital, Changhua, Taiwan) Can J Anaesth 2000;47:968–973.
Authors: Pang Wei‐Wu , Mok Martin S. , Huang Shyuan , Hung Chih‐Peng , Huang: Min‐Ho 
Published: March 2003

Sixty adult patients scheduled for elective abdominal surgery were enrolled into this prospective, randomized, double‐blinded study. The patients were anesthetized in a similar manner. At the beginning of wound closure, the patients were randomly allocated to receive tramadol (Group 1) or normal saline (Group 2). Pain control and adverse effect assessments were done in the PACU and every 6 h for 48 h post drug by an independent observer. The loading dose was 290 ± 45 mg in Group 1 and 315 ± 148 mg in Group 2. In PACU, more nausea and vomiting both in terms of incidence and severity were observed in patients with postoperative loading than in those with intraoperative loading of tramadol. Conclude that administering the loading dose of tramadol during surgery decreases the nausea and vomiting associated with a high dose of tramadol and improves the quality of tramadol PCA in the relief of postoperative pain.Comment by Lian‐Kah Ti, M.D. The clinical application and conclusions of this study have to be questioned. It was not surprising that a loading dose of tramadol could effectively be given intraoperatively. What was surprising was that the authors chose not to give any analgesics either preoperatively or intraoperatively for relatively major surgery in an older population, potentially risking morbidity. Indeed, analgesics were withheld in the control group until the patients were extubated, awake, responsive, and complained of pain. Another source of concern was the large loading dose used. Based on their own experience, the authors gave doses of 300 mg of tramadol, which far exceeded the maximum recommended single dose of 100 mg as stated in the manufacturer's instruction for use. The authors did not report any intraoperative hemodynamic consequences from the loading dose, although they noted that the amount of isoflurane required was decreased. The authors concluded that the decreased nausea and vomiting seen in the patients receiving tramadol intraoperatively resulted from the patients being anesthetized at the point when peak plasma levels were achieved. An alternative explanation could be that the patients in the control group had greater postoperative pain (initial VAS of 5.9), and that pain itself resulted in the increased nausea and vomiting. Therefore, the value of this study is doubtful.
Glycogen metabolism in stored granulocytes
Authors: Lane T. A. , Lamkin G. E. 
Published: March 2003

Optimal function of transfused granulocytes (PMNs) requires adequate glycogen metabolism. Previous studies in our laboratory suggested that stored PMNs had decreased glycogen. We report here the glycogen content and chemotaxis of stored PMNs, and the ability of fresh and stored PMNs to use glycogen as the fuel source for chemotaxis. PMNs were prepared from 8 fresh units of blood drawn into citrate‐phosphate‐dextrose‐ adenine, suspended at 2 or 8 × 107 PMN per ml in autologous plasma with or without 15 mM sodium bicarbonate, and stored at 22 to 24°C in transfer packs for 48 hours. Glycogen was measured on resting PMNs, and after challenge with opsonized zymosan and F‐Met‐Leu‐ Phe (FMLP). The chemotaxis of fresh and stored PMNs was measured in the presence or absence of extracellular glucose.Fresh PMNs contained 10.3 ± 0.5 (mean ± SEM) μg of glycogen per 106 PMN. Glycogen decreased by 4.2 ± 0.9 μg per 106 PMN after challenge with opsonized zymosan and by 1.1 ± 0.6 μg per 106 PMN after FMLP. After 48 hours of storage, neutrophil glycogen increased by 18 percent, except in units stored at a concentration of PMN of 8 × 107 per ml without sodium bicarbonate. In PMNs from these units stored without bicarbonate, glycogen decreased by 9 percent (p < .05), and there was a 19 and 55 percent decrease in the ability of PMN from these units to metabolize glycogen after exposure to opsonized zymosan and FMLP, respectively (p < 0.05). In addition, in PMNs from units stored at a concentration of PMN of 8 × 107 per ml without bicarbonate, there was a 47 and 70 percent decrease in chemotaxis at 24 and 48 hours, respectively (p < 0.05). The chemotaxis of PMNs from all units was decreased, when measured in the absence of glucose (fresh PMNs, 10.3% decrease in chemotaxis without glucose; 24 hours storage 24 ± 2% decrease; 48 hours storage, 32 ± 3% decrease).We conclude that 1) storage of PMNs for 24 hours is accompanied by increased glycogen content, except in units stored at high concentration; 2) glycogenolysis stimulated by phagocytosis or a chemotactic stimulus is attenuated after storage; and 3) chemotaxis of PMNs suspended in glucose‐free medium is also somewhat decreased after storage. From these data, we also conclude that the functional and metabolic changes which accompany storage of PMNs, either at low or high cell concentration, are not due to insufficient glycogen stores and that, while defective glycogenolysis may slightly impair the chemotaxis of stored PMNs, it is not the major cause of impaired chemotaxis in PMNs after storage.
A simple method for preparing neocyte‐enriched leukocyte‐ poor blood for transfusion‐dependent patients
Authors: Hogan V. A. , Blanchette V. S. , Rock G. 
Published: March 2003

Recent treatment for patients with thalassemia and chronic anemia involves transfusion of young red cells (YRBCs) or “neocytes.” We developed a technique enabling YRBCs to be separated based on their buoyant density in autologous plasma during centrifugation. Following this procedure, measurement of pyruvate kinase (PK), an age‐dependent red cell enzyme, showed neocyte enrichment in the top one‐third of the RBC layer corresponding to a mean of 47.5 percent of the total PK present in the unfractionated unit. To provide a neocyte transfusion preparation with an acceptable hemoglobin content, the top one‐third fraction from each of three bags of blood was pooled. Leukocytes were removed from this “neocyte unit” by an initial sedimentation with 6 percent hydroxyethyl starch (HES) followed by filtration through a filter (IG 500, Imugard). This process resulted in removal of 99.3 ± 0.5 percent (mean ± SD) of the leukocytes with a mean RBC recovery of 89.5 ± 5.5 percent and a final hemoglobin content of 53.4 ± 2.3 g. Tests for plasma‐free hemoglobin and HES in the supernatant of the final transfusion product gave acceptable mean values of 28 mg per dl and 3.0 mg per ml. Autologous mean RBC survival of Cr51 ‐labeled YRBC fractions was 41.8 ± 2.9 days (n=5).This technique yields neocyte enrichment superior to that achieved using a cell processor (model 2991, IBM) and has the added advantage of being less costly to prepare ($45.00 [1984] U.S. per YRBC unit as compared to an estimated $135.00 [1984] U.S., IBM) and more economical in terms of blood use.
Granulocyte transfusions: efficacy in treating fungal infections in neutropenic patients following bone marrow transplantation
Authors: Bhatia S. , McCullough J. , Perry E.H. , Clay M. , Ramsay N.K. , Neglia J.P. 
Published: March 2003

Background: A retrospective study was conducted to evaluate the efficacy of granulocyte transfusions in neutropenic patients with fungal infections following bone marrow transplantation.Study Design and Methods: Systemic fungal infection was detected in 87 patients during the first 100 days following bone marrow transplantation; 50 received granulocytes in addition to appropriate antifungal agents. The median age was 17 years in the transfused patients (range, 1.5–57) and 35 years in the nontransfused patients (range, 0.8–50). Granulocyte transfusions were given on a daily to twice‐daily basis. To evaluate their responses, patients were categorized by infection type (candidal [n = 38] vs. noncandidal [n = 49]) and site (fungemia alone [n = 30] vs. invasive infection [n = 57]). Resolution of infection was defined as the resolution of signs and symptoms and negative cultures and/or histopathology.Results: No benefit of granulocyte transfusions could be shown in the resolution of infection in patients with either invasive noncandidal infection (29% in the transfused patients vs. 23% in the nontransfused patients, p > 0.1) or candidal sepsis (56% vs. 50%, p > 0.1). Among patients with delayed marrow recovery, no difference was seen in the resolution of infection in the transfused (25.9%) and nontransfused (50%) patients (p > 0.1); nor was any difference between the transfused and nontransfused patients evident in the duration of febrile episode associated with the fungal infection. Granulocyte transfusions were well tolerated, with the only complications being fever in 12 patients (24%), chills in 10 (20%), and respiratory distress in 2 (4%). Despite attempts to stratify by infection type, invasiveness, and marrow recovery, it was not possible to show any benefit of granulocyte transfusions in this group.Conclusions: It is likely that only through a prospective randomized trial can the question of the efficacy of granulocyte transfusions in treating fungal infections be conclusively answered.
Fatal disseminated intravascular coagulation and pulmonary thrombosis following blood transfusion in a patient with severe autoimmune hemolytic anemia and human immunodeficiency virus infection
Authors: Bilgrami S. , Cable R. , Pisciotto P. , Rowland F. , Greenberg B. 
Published: March 2003

Background: Autoimmune hemolytic anemia (AIHA) has rarely been reported in association with human immunodeficiency (HIV) infection and never as a presenting manifestation. Similarly, disseminated intravascular coagulation (DIC) is a very infrequent complication of HIV infection.Case Report: An unusual patient is described who at the time of presentation with severe AIHA was found to be HIV positive. Shortly thereafter, he developed DIC, pulmonary thrombi, and right heart failure that proved fatal, in spite of intensive supportive measures.Conclusion: Although the etiology of the DIC and pulmonary thrombi could not be established, they are most likely related to aggressive transfusion therapy, with associated intravascular hemolysis.
Inactivation of lipid‐enveloped and non‐lipid‐enveloped model viruses in normal human plasma by crosslinked starch‐iodine
Authors: Highsmith F.A. , Xue H. , Caple M. , Walthall B. , Drohan W.N. , Shanbrom E. 
Published: March 2003

Background: The purpose of this study was to evaluate an iodine‐based method of activating potentially harmful viruses that might be found in normal human plasma.Study Design and Methods: A procedure has been developed for inactivating lipid‐enveloped and non‐lipid‐enveloped model viruses in normal human plasma by using iodine complexed to crosslinked potato starch. The established conditions are an iodine concentration of 1.05 mg per mL and 60 minutes' incubation.Results: Under these conditions, inactivation of more than 9 log10 of vesicular stomatitis virus, a lipid‐enveloped virus, and more than 7 log10 of encephalomyocarditis virus, a non‐lipid‐enveloped virus, was achieved, with minimal losses of biologic activity of selected plasma proteins. Under these conditions, 70 percent of factor VIII activity, 77 percent of factor IX activity, and 100 percent of protein C activity in the plasma were retained.Conclusion: Crosslinked starch‐iodine may be useful in the inactivation of viruses in single‐donor plasma units and in pooled human plasma before fractionation.
Blood collections by community blood centers, 1988 through 1992
Authors: Forbes J.M. , Laurie M.L. 
Published: March 2003

BACKGROUND: The provision of a safe and sufficient supply of blood is critical to patient care.STUDY DESIGN AND METHODS: A survey was conducted of the blood collection activity of the 189 community blood centers operating in the United States from 1988 through 1992. Data were analyzed by source of the donation (allogeneic or autologous), by center's collection volume, and by geographic region. Total collection figures were compared to historical blood collection activity since 1970.RESULTS: A total of 12.31 million units of blood were collected in 1992, an increase of 2.6 percent over the total number of units collected in 1988. For the 5‐year period (1988–1992), total collections increased at a compound annual growth rate of 0.6 percent. The collection of allogeneic blood units declined by 0.2 percent annually, while that of autologous units increased by 23.2 percent annually. Autologous blood units accounted for 5.7 percent of total collections in 1992. Nationally, 48 units were collected per 1000 people in 1992, although substantial geographic variation (range, 38–64 units/1000) was observed across nine US census regions.CONCLUSION: The data from this study provide evidence that the total supply of blood grew more slowly from 1988 through 1992 than in the years before 1988.
Abnormal neutrophil phenotype and neutrophil FcRIII deficiency corrected by bone marrow transplantation
Authors: Minchinton R.M. , de Haas M. , von dem Borne AE , Kleijer M. , Roberts A.W. , Gillett E.A. 
Published: March 2003

BACKGROUND: Neutrophils from a patient in first remission of acute myeloid leukemia were found to lack NA1 and NA2 alloantigens. This NA null phenotype was converted to the normal phenotype of NA1, NB2 by the transplantation of bone marrow from an HLA‐identical sibling. To investigate the inherited or acquired nature of this rare phenotype, a combination of conventional neutrophil serology and recently developed restriction fragment length polymorphism (RFLP) and polymerase chain reaction (PCR) assays was used.STUDY DESIGN AND METHODS: Diagnosis, remission, and posttransplant patient peripheral blood samples were used for neutrophil phenotyping by granulocyte agglutination and immunofluorescence tests. The presence and dose of the gene for neutrophil Fc gamma RIIIb (Fc gamma RIIIB) were tested for with RFLP and Southern analysis and PCR‐based RFLP tests. Plasma levels of circulating soluble Fc gamma RIII (sFc gamma RIII) were measured with radioimmunoassay. The sibling bone marrow donor and the patient's parents were also studied.RESULTS: RFLP analysis of DNA obtained from the patient at the time of diagnosis showed that she lacked the Fc gamma RIIIB gene for neutrophil Fc gamma RIII (i.e., Fc gamma RIIIb), but that, in DNA prepared from posttransplant samples, the Fc gamma RIIIB gene was present. Quantitation of plasma levels of soluble FcRIII (sFcRIII) demonstrated a complete absence of sFcRIII in the patient's pretransplant plasma. However, 20 units of sFcRIII were detected in the patient's plasma by 160 days after graft. Hair samples from the patient provided sufficient nonhematopoietic, genomic DNA to confirm that her genotype was NA0NA0. DNA prepared from lymphocytes of both parents and the sibling marrow donor was used to quantitate their Fc gamma RIIIB gene dose. The mother and brother had only one Fc gamma RIIIB gene each, while the father apparently had a normal complement of two Fc gamma RIIIB genes.CONCLUSION: In this case, an inherited absence of Fc gamma RIIIB gene in a patient with acute myeloid leukemia was unintentionally corrected by the transplantation of bone marrow from a sibling donor who himself carried only one Fc gamma RIIIB gene.