bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rhabdomyolysis After Correction of Hyponatremia in Psychogenic Polydipsia Possibly Complicated by Ziprasidone
Authors: Zaidi Ali N 
Published: August 2005

OBJECTIVE: To report a case of rhabdomyolysis related to correction of hyponatremia secondary to psychogenic polydipsia, possibly complicated by the use of ziprasidone. CASE SUMMARY: A 50-year-old white man treated for 3 weeks with ziprasidone 40 mg twice daily for chronic paranoid schizophrenia was admitted to the intensive care unit after a witnessed generalized seizure. Marked hypotonic hyponatremia was present secondary to psychogenic polydipsia. After correction of hyponatremia with intravenous NaCl 0.9%, he developed a substantial elevation in the creatine kinase level without any evidence of muscle trauma, stiffness, or swelling or any signs of neuroleptic malignant syndrome. Renal failure or compartment syndrome did not complicate the clinical picture. DISCUSSION: It is well known that severe hyponatremia can cause neurologic complications such as stupor, seizures, and even coma. Hyponatremia from water intoxication (n = 28) and its correction with intravenous fluids (n = 2) may cause non-neurologic complications such as rhabdomyolysis. An explanation may lie within the calcium–sodium exchange mechanism across the skeletal myocyte or the failure of cell volume regulation secondary to extracellular hypo-osmolality. Neuroleptic medications have been linked to the development of rhabdomyolysis, with antipsychotics being the primary offenders. As of August 2005, there has been only one reported case of rhabdomyolysis related to correction of hyponatremia complicated by an atypical antipsychotic (clozapine). It is possible that ziprasidone, like clozapine, may enhance muscle cell permeability leading to rhabdomyolysis under similar conditions. CONCLUSIONS: Psychiatric patients treated with atypical antipsychotic medications should be closely monitored for rhabdomyolysis during correction of hyponatremia, thus permitting prompt therapy to limit its complications.
Argatroban Anticoagulation in Patients with Heparin-Induced Thrombocytopenia Requiring Renal Replacement Therapy
Authors: Reddy Bharathi V , Grossman Eric J , Trevino Sharon A , Hursting Marcie J , Murray Patrick T 
Published: August 2005

BACKGROUND: Argatroban, a direct thrombin inhibitor, is used for prophylaxis or treatment of thrombosis in heparin-induced thrombocytopenia (HIT). The recommended initial dose is 2 μg/kg/min (0.5 μg/kg/min in hepatic impairment), adjusted to achieve activated partial thromboplastin time (aPTT) values 1.5–3.0 times baseline. However, few argatroban-treated patients with HIT and renal failure requiring renal replacement therapy (RRT) have been described. OBJECTIVE: To evaluate the safety and efficacy of argatroban anticoagulation during RRT in patients with HIT. METHODS: We retrospectively reviewed records from 47 patients with HIT and renal failure requiring RRT who underwent 50 treatment courses with argatroban. Patients with HIT had received argatroban during prospective, multicenter studies. Outcomes, safety, and dosing information were summarized. RESULTS: In the multicenter experience, no patient died due to thrombosis and 2 (4%) patients developed new thrombosis while on argatroban. No adverse outcomes occurred during argatroban reexposure. Starting doses were typically 2 μg/kg/min in patients without hepatic impairment and <1.5 μg/kg/min in those with hepatic impairment. Median (range) infusion doses were 1.7 (0.2–2.8) and 0.7 (0.1–1.7) μg/kg/min, respectively, with associated median (range) aPTT ratios, relative to baseline, of 2.2 (1.6–3.6) and 2.0 (1.4–4.1), respectively. Major bleeding occurred in 3 (6%) of 50 treatment courses. CONCLUSIONS: Argatroban provides effective anticoagulation upon initial and repeated administration in patients with HIT and renal impairment requiring RRT, with an acceptably low bleeding risk. Current dosing recommendations are adequate for these patients.
Treating Pregnancy-Related Nausea and Vomiting with Ginger
Authors: Boone Sarah A , Shields Kelly M 
Published: August 2005

OBJECTIVE: To review literature assessing the safety and efficacy of the use of ginger to treat nausea and vomiting in pregnancy. DATA SOURCES: Iowa Drug Information Service (1966–September 2004), International Pharmaceutical Abstracts (1971–September 2004), MEDLINE (1966–September 2004), and EMBASE (1966–September 2004) were searched. Key terms included ginger, nausea, vomiting, emesis, and pregnancy. DATA SYNTHESIS: Studies evaluating the safety and efficacy of ginger in the management of nausea and vomiting in pregnancy were reviewed. Various doses and forms of ginger were used to treat women during their first and second trimesters of pregnancy. Ginger has been shown to improve the symptoms of nausea and vomiting compared with placebo in pregnant women. CONCLUSIONS: While data are insufficient to recommend ginger universally and there are concerns with product quality due to limited regulation of dietary supplements, ginger appears to be a fairly low-risk and effective treatment for nausea and vomiting associated with pregnancy. In low doses, this may be appropriate for patients not responding to traditional first-line therapies.
Eszopiclone for Insomnia
Authors: Melton Sarah T , Wood Jill M , Kirkwood Cynthia K 
Published: August 2005

Objective: To review the pharmacology, pharmacokinetics, efficacy data, and adverse effects of eszopiclone in the treatment of transient and chronic insomnia in adult and geriatric patients. Data Sources: A MEDLINE literature search (1966–May 2005) was conducted to retrieve articles and abstracts involving eszopiclone. The manufacturer of the drug provided a general summary of clinical data and abstracts of unpublished Phase III clinical trials. Study Selection and Data Extraction: All articles identified from the data sources were reviewed, and information deemed relevant was included for this review. Data Synthesis: Food and Drug Administration approval of eszopiclone was based on 6 double-blind, placebo-controlled trials. Five trials published in abstract or study form were reviewed. The sixth trial was not available for evaluation. An open-label continuation trial was also reviewed. All studies showed statistically significant improvements in sleep parameters in adult and elderly patients treated for insomnia with eszopiclone. CONCLUSIONS: The results of the 5 available double-blind, placebo-controlled studies (and 1 open-label, 6-month extension) showed that eszopiclone was safe and effective in the treatment of transient and chronic insomnia in adult and geriatric patients. Tolerance with long-term exposure (6 mo) and rebound insomnia were not observed. The results of the 6-month, open-label extension trial demonstrated that improvements in sleep parameters were sustained. Future studies comparing eszopiclone with other non benzodiazepine sedative–hypnotics (eg, zolpidem, zaleplon) are needed with cost data to clearly define the role of eszopiclone in the pharmacotherapy of chronic insomnia.
Involvement of Cholecystokininergic Systems in Anxiety-Induced Hyperalgesia in Male Rats: Behavioral and Biochemical Studies
Authors: Andre Judith , Zeau Brigitte , Pohl Michel , Cesselin, François , Benoliel, Jean-Jacques , Becker Chrystel 
Published: August 2005

Keeping in mind the increased pain complaints reported in anxious or depressive patients, our goal was to investigate in rats the consequences of an experimentally provoked state of anxiety/depression on pain behavior and on its underlying mechanisms. We therefore used a model of social defeat consisting of a 30 min protected confrontation followed by a 15 min physical confrontation, repeated during 4 d, that elicited symptoms close to those observed in humans with anxiety or depression. Indeed, 5 d later, animals subjected to social-defeat confrontation were characterized by a decrease of sweet-water consumption and of body weight, and a hyperactivity of the hypothalamic–pituitary–adrenal axis, suggesting that the social-defeat procedure induced a prolonged state of anxiety.Rats subjected to the social-defeat procedure showed an enhanced nociceptive behavior to the subcutaneous administration of formalin, 5 d after the last confrontation session. Because chronic treatment with the established anxiolytic chlordiazepoxide (10 mg · kg–1· d–1) prevented hyperalgesia, this strongly suggested that this experimental procedure might be a suitable animal model of “anxiety-induced hyperalgesia.” Hyperalgesia associated with anxiety not only was related to a significant increase of CCKLM [cholecystokinin (CCK)-like material] in frontal cortex microdialysates but also was prevented by a CCK-B receptor antagonist [4-[[2-[[3-(1H-indol-3-yl)-2-methyl-1-oxo-2[[(tricyclo[3.3[12,17]dec-2-yloxy)-carbonyl]amino]-propyl]amino]-1-phenyethyl]amino]-4-oxo-[R-(R*,R*)]-butanoateN-methyl-d-glucamine (CI-988)] (2 mg/kg), strongly supporting the involvement of central CCKergic systems in these phenomena. Finally, combined treatments with CI-988 and morphine completely suppressed pain-related behavior, supporting the idea that the association of both compounds might represent a new therapeutic approach to reduce the increase of pain complaints highly prevalent among anxious or depressive patients.
Lokalisierung mittels mengenbasierter nichtlinearer Filterung im Hyperraum (Localization Using Set-theoretic Nonlinear Filtering Methods)
Authors: Briechle Kai , Hanebeck Uwe D. 
Published: September 2005

Abstract
Moderne, leistungsfähige Verfahren zur Lokalisierung von Objekten haben in den letzten Jahren eine Vielzahl neuartiger technischer Anwendungen eröffnet. Die Mehrzahl dieser Lokalisierungsverfahren basiert auf Filterverfahren, mit welchen die Lage des zu lokalisierenden Objektes geschätzt wird. Dieser Artikel stellt ein neuartiges nichtlineares Filterverfahren vor, das die effiziente Behandlung nichtlinearer Filterprobleme ermöglicht. Es bietet sich damit für Lokalisierungsprobleme an, bei welchen mit herkömmlichen, linearisierenden Filterverfahren oft keine zufrieden stellenden Ergebnisse erzielt werden können. Die Leistungsfähigkeit des vorgestellten Verfahrens wird mit Anwendungen auf prototypische Lokalisierungsprobleme und einem Experiment zur Lokalisierung eines mobilen Roboters belegt.
Polynomiale Unterordnung und Dominanz rationaler Matrizen (Polynomial Subordination and Dominance of Rational Matrices)
Authors: Lampe Bernhard P. , Rosenwasser Efim N. 
Published: September 2005

Abstract
Beim Entwurf linearer Regelungssysteme im Frequenzbereich sind exakte (mathematische) Kürzungen gegenüber der Kompensation von Polen gegen Nullstellen zu unterscheiden. Die mathematischen Kürzungen müssen vorgenommen werden, da sonst real nicht existierende Bestandteile im Modell mitgeführt werden. Für Mehrgrößensysteme ist das eine komplizierte Aufgabe, zumal im Falle von durch Mess- oder Rundungsfehler verfälschten Modellen davon ausgegangen werden muss, dass Kürzungen erzwungen werden müssen. Die in diesem Artikel eingeführten Begriffe polynomialer Unterordnung und Dominanz erlauben es, solche Probleme einfacher zu lösen und verhelfen darüber hinaus zu einem tieferen Verständnis der Struktur von Mehrgrößen-Abtastsystemen, wie an einem Beispiel gezeigt wird.
Lower Limb Pain in a Preadolescent Population: Prognosis and Risk Factors for Chronicity—A Prospective 1- and 4-Year Follow-up Study
Authors: El-Metwally Ashraf , Salminen Jouko J. , Auvinen Anssi , Kautiainen Hannu , Mikkelsson Marja 
Published: September 2005

Objective. To determine the short-term and long-term prognosis of preadolescent lower limb pain and to assess factors that contribute to pain persistence at 1-year follow-up and pain recurrence at 4-year follow-up.
Methods. A 1- and 4-year follow-up was conducted of a population-based 10- and 12-year old cohort of schoolchildren with lower limb pain at baseline
Results. Of the baseline students with lower limb pain, 32% reported pain persistence at 1-year follow-up and 31% reported pain recurrence at 4-year follow-up. Vigorous exercise was the only statistically significant predictor of lower limb pain persistence at 1-year follow-up (odds ratio [OR]: 2.43; 95% confidence interval [CI]: 1.16–5.05), whereas at 4-year follow-up (at adolescence), hypermobility was predictive of pain recurrence (OR: 2.93; 95% CI: 1.13–7.70). Traumatic lower extremity pain had a 50% lower risk for pain recurrence compared with nontraumatic pain (OR: 0.48; 95% CI: 0.19–0.92).
Conclusion. Trauma-induced lower extremity pain in preadolescents has a favorable long-term natural course. Children’s involvement in vigorous exercise predicts short-term outcome of lower limb pain, whereas hypermobile children have a worse long-term prognosis.
Clinical and Demographic Factors Associated With Urinary Tract Infection in Young Febrile Infants
Authors: Zorc Joseph J. , Levine Deborah A. , Platt Shari L. , Dayan Peter S. , Macias Charles G. , Krief William , Schor Jeffrey , Bank David , Shaw Kathy N. , Kuppermann Nathan ,   for the Multicenter RSV-SBI Study Group of the Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics
Published: August 2005

Objective. Previous research has identified clinical predictors for urinary tract infection (UTI) to guide urine screening in febrile children &lt;24 months of age. These studies have been limited to single centers, and few have focused on young infants who may be most at risk for complications if a UTI is missed. The objective of this study was to identify clinical and demographic factors associated with UTI in febrile infants who are ≤60 days of age using a prospective multicenter cohort.Methods. We conducted a multicenter, prospective, cross-sectional study during consecutive bronchiolitis seasons. All febrile (≥38°C) infants who were ≤60 days of age and seen at any of 8 pediatric emergency departments from October through March 1999–2001 were eligible. Clinical appearance was evaluated using the Yale Observation Scale. UTI was defined as growth of a known bacterial pathogen from a catheterized specimen at a level of (1) ≥50000 cfu/mL or (2) ≥10000 cfu/mL in association with a positive dipstick test or urinalysis. We used bivariate tests and multiple logistic regression to identify demographic and clinical factors that were associated with the likelihood of UTI.Results. A total of 1025 (67%) of 1513 eligible patients were enrolled; 9.0% of enrolled infants received a diagnosis of UTI. Uncircumcised male infants had a higher rate of UTI (21.3%) compared with female (5.0%) and circumcised male (2.3%) infants. Infants with maximum recorded temperature of ≥39°C had a higher rate of UTI (16.3%) than other infants (7.2%). After multivariable adjustment, UTI was associated with being uncircumcised (odds ratio: 10.4; bias-corrected 95% confidence interval: 4.7–31.4) and maximum temperature (odds ratio: 2.4 per °C; 95% confidence interval: 1.5–3.6). Factors that were reported previously to be associated with risk for UTI in infants and toddlers, such as white race and ill appearance, were not significantly associated with risk for UTI in this cohort of young infants.Conclusions. Being uncircumcised and height of fever were associated with UTI in febrile infants who were ≤60 days of age. Uncircumcised male infants were at particularly high risk and may warrant a different approach to screening and management.
Preventable Adverse Events in Infants Hospitalized With Bronchiolitis
Authors: McBride Sarah C. , Chiang Vincent W. , Goldmann Donald A. , Landrigan Christopher P. 
Published: September 2005

Objective. To determine the incidence of preventable adverse events (AEs) and near misses (NMs) among infants hospitalized for bronchiolitis at a pediatric tertiary care hospital and the impact of these errors on hospital length of stay (LOS).Methods. We studied 143 infants with bronchiolitis, ages 0 to 12 months, admitted from December 2002 to April 2003. Using prospective chart review and staff reports, we captured medical errors and AEs. Each event was classified as a (1) preventable AE, (2) nonpreventable AE, (3) intercepted NM, (4) nonintercepted NM, or (5) error with little or no potential for harm.Results. Of 143 patients, 15 (10%) suffered an AE or NM. The incidence of preventable AEs was 10 per 100 admissions. We found a higher incidence of preventable AEs and NMs among critically ill patients (CIPs) compared with non-CIPs (68 vs 5 per 100 admissions, respectively), making the absolute risk of an AE or NM 14 times more likely in CIPs. Mean LOS was significantly longer for CIPs with at least 1 AE (9.1 ± 8.8 days) than for CIPs without AEs (2.9 ± 1.5 days). Mean LOS was not significantly different between non-CIPs who did (3.8 ± 2.6 days) and did not (4.2 ± 5.0 days) experience an AE.Conclusions. Preventable AEs occur frequently among patients admitted for bronchiolitis, especially those who are critically ill. CIPs who suffer AEs during their hospitalization have longer hospital LOSs. Future studies should investigate error-prevention strategies with a focus on those patients with severe disease.
Exercise With and Without an Insulin Pump Among Children and Adolescents With Type 1 Diabetes Mellitus
Authors: Admon Gil , Weinstein Yitzhak , Falk Bareket , Weintrob Naomi , Benzaquen Hadassa , Ofan Ragina , Fayman Gila , Zigel Levana , Constantini Naama , Phillip Moshe 
Published: September 2005

Background. The use of insulin pumps is becoming a popular technique for insulin delivery among patients with type 1 diabetes mellitus (T1DM), but there is no consensus regarding the guidelines for proper pump use during exercise.
Objective. To investigate the physiologic responses and risk of hypoglycemia among children and adolescents with T1DM when exercising with the pump on (PO) (50% of the basal rate) or pump off (PF).
Methods. Ten subjects with T1DM (6 female subjects and 4 male subjects), 10 to 19 years of age, performed prolonged exercise (40–45 minutes) on a cycle ergometer ∼2 hours after a standard breakfast and an insulin (Lispro) bolus. Complex carbohydrates (20 g) were provided before and after the exercise. Each patient exercised once with PO and once with PF, in a randomized, crossover (single-blind) manner. During exercise and 45 minutes of recovery, subjects were monitored for cardiorespiratory, metabolic, and hormonal responses. Blood glucose concentrations were recorded for 24 hours after exercise, with a continuous glucose monitoring system, to document late hypoglycemic events.
Results. During exercise, blood glucose concentrations decreased by 59 ± 58 mg/dL (mean ± SD: 29 ± 24%) with PF and by 74 ± 51 mg/dL (35.5 ± 18%) with PO (not significant). No significant differences were found in cortisol, growth hormone, or noradrenaline levels between PO and PF. There were no differences in cardiorespiratory parameters, blood lactate concentrations, or free fatty acids concentrations between pump modes. Hypoglycemic events during exercise were asymptomatic and occurred for 2 subjects with PO and 2 with PF. Nine subjects had late hypoglycemia after PO, compared with 6 after PF (not significant).
Conclusions. We found no advantage for subjects with either PO or PF during exercise, and we noted that late hypoglycemia was more common than hypoglycemia during exercise. However, PO was associated with a trend of increased risk for late hypoglycemia. We recommend that the pump be removed or turned off during prolonged exercise and that blood glucose concentrations be monitored for several hours after exercise, regardless of the pump mode.
A Randomized Clinical Trial of the Management of Esophageal Coins in Children
Authors: Waltzman Mark L. , Baskin Marc , Wypij David , Mooney David , Jones Dwight , Fleisher Gary 
Published: September 2005

Context. Children frequently ingest coins. When lodged in the esophagus, the coin may cause complications and must either be removed or observed to pass spontaneously.Objectives. (1) To compare relatively immediate endoscopic removal to a period of observation followed by removal when necessary and (2) to evaluate the relationship between select clinical features and spontaneous passage.Design/Setting. Randomized, prospective study of children &lt;21 years old who presented to an emergency department with esophageal coins in the esophagus. Exclusion criteria were (1) history of tracheal or esophageal surgery, (2) showing symptoms, or (3) swallowing the coin &gt;24 hours earlier. Children were randomized to either endoscopic removal (surgery) or admission for observation, with repeat radiographs ∼16 hours after the initial image.Outcome Measures. Proportion of patients requiring endoscopic removal, length of hospital stay, and the number of complications observed.Results. Among 168 children who presented with esophageal coins lodged in the esophagus, 81 were eligible. Of those eligible, 60 enrolled, 20 refused consent, and 1 was not approached. In the observation group, 23 of 30 (77%) children required endoscopy compared with 21 of 30 (70%) in the surgical group. Total hospital length of stay was longer in the randomized-to-observation group compared with the randomized-to-surgery group (mean: 19.4 [SD: ±8.0] hours vs 10.7 [SD: ±7.1] hours, respectively). There were no complications in either group. Spontaneous passage occurred at similar rates in both groups (23% vs 30%). Spontaneous passage was more likely in older patients (66 vs 46 months) and male patients (odds ratio: 3.7; 95% confidence interval: 0.98–13.99) and more likely to occur when the coin was in the distal one third of the esophagus (56% vs 27% [95% confidence interval: 1.07–5.57]).Conclusions. Because 25% to 30% of esophageal coins in children will pass spontaneously without complications, treatment of these patients may reasonably include a period of observation, in the range of 8 to 16 hours, particularly among older children and those with distally located coins.