bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arthroscopic Cartilage Indentation and Cartilage Lesions of Anterior Cruciate Ligament-Deficient Knees
Authors: Vasara Anna I. , Jurvelin Jukka S. , Peterson Lars , Kiviranta Ilkka 
Published: February 2005

Background The anterior cruciate ligament-deficient knee is prone to osteoarthritis and meniscus lesions. Very little, however, is known about the biomechanical properties of articular cartilage in anterior cruciate ligament-deficient knees. Purpose To evaluate biomechanical and macroscopical cartilage changes in the knee joint with respect to the time after anterior cruciate ligament rupture. Hypothesis Chronic anterior cruciate ligament deficiency induces cartilage softening. Study Design Cross-sectional study; Level of evidence, 3. Methods Cartilage stiffness of 50 patients undergoing anterior cruciate ligament reconstructive surgery because of symptomatic knee instability after chronic anterior cruciate ligament rupture was measured with an arthroscopic indenter device, and the number and size of cartilage lesions were evaluated. Results The cartilage stiffness did not correlate with time from trauma to surgery (r = 0.002, P =. 99), but the number of cartilage lesions in the knee increased when the time from the initial trauma to reconstructive surgery increased (r = 0.356, P =. 011). Indentation values measured on healthy-looking cartilage on damaged joint surfaces were lower than the values measured on healthy joint surfaces (P <. 01 on lateral femoral condyle and on tibial plateaus). Conclusions The number of cartilage lesions increases with increased time after initial trauma. The arthroscopic indenter device is able to detect cartilage softening as the early mechanical sign of degradation not yet visible to the eye.
Injuries among Competitive Snowboarders at the National Elite Level
Authors: Torjussen Joern , Bahr Roald 
Published: February 2005

Background Little is known about injury risk or the pattern of injuries among competitive snowboarders. Purpose To describe the incidence and pattern of injuries among female and male snowboard athletes at the highest national level. Study Design Descriptive epidemiology study Methods This study consists of 2 parts: prospective registration of injuries at snowboarding national cup events and the national championships during the 2002 season, as well as a retrospective interview of the participants during the national championships in March 2002. All injuries that resulted in missed participation were recorded. Exposure was recorded as the number of runs in all disciplines. Results In the prospective study, the competition incidence was 4.0 ± 0.7 injuries per 1000 runs (n = 32 injuries). Back (22%), knee (16%), and hand/wrist injuries (9%) were the most common. The incidence for the different disciplines was 14.2 ± 5.3 per 1000 runs for big jump, 6.1 ± 1.8 for snowboardcross, 3.1 ± 0.9 for halfpipe, and 1.9 ± 1.9 for giant slalom. The retrospective interview (n = 163 athletes, 83% response) revealed 84 acute time-loss injuries during the season; knee (16%), back (13%), head (13%), and hand/wrist injuries (12%) were the 4 most common injury types. The overall competition incidence was 3.4 ± 0.6 injuries per 1000 runs (6.6 ± 3.0 for big jump, 5.8 ± 1.7 for snowboardcross, 2.1 ± 0.7 for halfpipe, and 6.6 ± 4.7 for giant slalom). No injury was recorded in parallel slalom in either study. Conclusion The incidence of injuries is high among competitive snowboarders at the elite national level. The injury pattern is different from the panorama seen among less experienced athletes, with fewer wrist injuries and more knee injuries.
Opening Wedge Tibial Osteotomy: The 3-Triangle Method to Correct Axial Alignment and Tibial Slope
Authors: Noyes Frank R. , Goebel Steven X. , West John 
Published: February 2005

Background Although a change in tibial slope may occur during a medial opening wedge osteotomy, calculations have not been defined to address this problem. The authors investigated geometric factors important to correct axial alignment and tibial slope during osteotomy. Purpose To calculate, through 3-dimensional analysis of the proximal tibia, how the angle of the opening wedge along the anteromedial tibial cortex influences the tibial slope (sagittal plane) and valgus correction (coronal plane) during osteotomy, and to analyze the different radiographic methods reported in the literature to measure medial and lateral tibial slope. The authors postulated that differences in reported normal values of tibial slope in the sagittal plane were technique dependent. Study Design Descriptive laboratory study Methods The proximal anteromedial tibial cortex obliquity on magnetic resonance imaging was measured in 35 knees. Serial computed tomography images of the proximal tibia were digitized, allowing a series of virtual opening wedge osteotomies to be performed. Algebraic calculations defined the effect of an opening wedge osteotomy on the anteromedial tibial cortex opening wedge angle, sagittal tibial slope angle, and coronal valgus alignment. Results The anteromedial tibial cortex oblique angle at the medial osteotomy site was 45°± 6° and determined, along with the degrees of valgus correction, the degrees of the opening wedge angle in the oblique plane. The anterior osteotomy gap at the tibial tubercle was generally one half of the posteromedial gap to maintain the normal sagittal tibial slope. Every millimeter of gap error at the tibial tubercle resulted in approximately 2° of change in the tibial slope. The width of the buttress plate along the anteromedial tibial cortex was 2 to 3 mm less than the computed coronal valgus posteromedial osteotomy gap to achieve tibiofemoral valgus correction. Conclusions A series of measurements preoperatively and intraoperatively are required to obtain the desired correction of tibial slope and valgus alignment.
Biomechanics of Youth Windmill Softball Pitching
Authors: Werner Sherry L. , Guido John A. , McNeice Ryan P. , Richardson Jasper L. , Delude Neil A. , Stewart Gregory W. 
Published: February 2005

Background Limited research attention has been paid to the potentially harmful windmill softball pitch. No information is available regarding lower extremity kinetics in softball pitching. Hypothesis The stresses on the throwing arm of youth windmill pitchers are clinically significant and similar to those found for college softball pitchers. Study Design Descriptive laboratory study. Methods Three-dimensional, high-speed (240-Hz) video and stride foot force plate (1200 Hz) data were collected on fastballs from 53 youth softball pitchers. Kinematic parameters related to pitching mechanics and resultant kinetics on the throwing-arm elbow and shoulder joints were calculated. Kinetic parameters were compared to those reported for baseball pitchers. Results Elbow and shoulder joint loads were similar to those found for baseball pitchers and college softball pitchers. Shoulder distraction stress averaged 94% body weight for the youth pitchers. Stride foot ground reaction force patterns were not similar to those reported for baseball pitchers. Vertical and braking force components under the stride foot were in excess of body weight. Conclusions Excessive distraction stress and joint torques at the throwing-arm elbow and shoulder are similar to those found in baseball pitchers, which suggests that windmill softball pitchers are at risk for overuse injuries. Normative information regarding upper and lower extremity kinematics and kinetics for 12- to 19-year-old softball pitchers has been established.
Anterior Cruciate Ligament Injury in National Collegiate Athletic Association Basketball and Soccer: A 13-Year Review
Authors: Agel Julie , Arendt Elizabeth A. , Bershadsky Boris 
Published: February 2005

Background Female collegiate athletes have been reported to have a higher rate of anterior cruciate ligament injury compared to male collegiate athletes. This finding has spawned a branch of research focused on understanding and preventing this injury pattern. Purpose To determine if the trends reported in 1994 have continued. Study Type Descriptive epidemiology study. Methods The National Collegiate Athletic Association Injury Surveillance System database was reviewed for all data relating to men's and women's basketball and soccer anterior cruciate ligament injuries for 1990 to 2002. Results No significant difference was seen in basketball comparing frequency of contact versus noncontact injuries between men (70.1%) and women (75.7%). Male basketball players sustained 37 contact injuries and 78 noncontact injuries. Female basketball players sustained 100 contact injuries and 305 noncontact injuries. In soccer, there was a significant difference in frequency of injury for male (49.6%) and female (58.3%) athletes when comparing contact and noncontact injuries (χ2 = 4.1, P <. 05). Male soccer players sustained 72 contact injuries and 66 noncontact injuries. Female soccer players sustained 115 contact injuries and 161 noncontact injuries. The magnitude of the difference in injury rates between male and female basketball players (0.32-0.21, P =. 93) remained constant, whereas the magnitude of the difference in the rate of injuries between male and female soccer players (0.16-0.21, P =. 08) widened. Comparing injury within gender by sport, soccer players consistently sustained more anterior cruciate ligament injuries than did basketball players. The rate of anterior cruciate ligament injury for male soccer players was 0.11 compared to 0.08 for male basketball players (P =. 002). The rate of anterior cruciate ligament injury for female soccer players was 0.33 and for female basketball players was 0.29 (P =. 04). The rates for all anterior cruciate ligament injuries for women were statistically significantly higher (P <. 01) than the rates for all anterior cruciate ligament injuries for men, regardless of the sport. In soccer, the rate of all anterior cruciate ligament injuries across the 13 years for male soccer players significantly decreased (P =. 02), whereas it remained constant for female players. Conclusions In this sample, the rate of anterior cruciate ligament injury, regardless of mechanism of injury, continues to be significantly higher for female collegiate athletes than for male collegiate athletes in both soccer and basketball. Clinical Relevance Despite vast attention to the discrepancy between anterior cruciate ligament injury rates between men and women, these differences continue to exist in collegiate basketball and soccer players. Also demonstrated is that although the rate of injury for women is higher than for men, the actual rate of injury remains low and should not be a deterrent to participation in sports.
Identification and characterization of circulating human transitional B cells
Authors: Sims Gary P. , Ettinger Rachel , Shirota Yuko , Yarboro Cheryl H. , Illei Gabor G. , Lipsky Peter E. 
Published: February 2005

AbstractMurine B-cell development begins in bone marrow and results in the generation of immature transitional B cells that transit to the spleen to complete their maturation. It remains unclear whether the same developmental pathway takes place in humans. Using markers characteristic of human bone marrow immature B cells, we have identified a population of circulating human B cells with a phenotype most similar to mouse transitional type I (T1) B cells, although these human counterparts express CD5. These cells die rapidly in culture, and B-cell activation factor member of the tumor necrosis factor (TNF) family (BAFF) does not effect their survival regardless of B-cell receptor (BCR) stimulation. In contrast, bone marrow stromal cells or interleukin-4 (IL-4) significantly enhanced their survival. In the presence of T-cell signals provided by IL-4 or CD40 ligation, BCR stimulation can induce progression into cell cycle. Interestingly, circulating B cells that phenotypically and functionally resemble murine T2 B cells are found in cord blood and adult peripheral blood, suggesting that B-cell maturation may not be restricted to the spleen. Notably, increased proportions of T1 B cells were found in blood of patients with systemic lupus erythematosus (SLE), although bone marrow production and selection appeared to be normal.
Late mortality in survivors of autologous hematopoietic-cell transplantation: report from the Bone Marrow Transplant Survivor Study
Authors: Bhatia Smita , Robison Leslie L. , Francisco Liton , Carter Andrea , Liu Yan , Grant Marcia , Baker K. Scott , Fung Henry , Gurney James G. , McGlave Philip B. , Nademanee Auayporn , Ramsay Norma K. C. , Stein Anthony , Weisdorf Daniel J. , Forman Stephen J. 
Published: February 2005

Abstract
We assessed late mortality in 854 individuals who had survived 2 or more years after autologous hematopoietic cell transplantation (HCT) for hematologic malignancies. Median age at HCT was 36.5 years, and median length of follow-up was 7.6 years. Overall survival was 68.8% ± 1.8% at 10 years, and the cohort was at a 13-fold increased risk for late death (standardized mortality ratio [SMR] = 13.0) when compared with the general population. Mortality rates approached those of the general population after 10 years among patients at standard risk for relapse at HCT (SMR = 1.1) and in patients undergoing transplantation for acute myeloid leukemia (AML; SMR = 0.9). Relapse of primary disease (56%) and subsequent malignancies (25%) were leading causes of late death. Relapse-related mortality was increased among patients with Hodgkin disease (HD; relative risk [RR] = 3.6), non-Hodgkin lymphoma (NHL; RR = 2.1), and acute lymphoblastic leukemia (ALL; RR = 6.5). Total body irradiation (RR = 0.6) provided a protective effect. Nonrelapse-related mortality was increased after carmustine (RR = 2.3) and with use of peripheral blood stem cells (RR = 2.4). Survivors were more likely to report difficulty in holding jobs (RR = 9.4) and in obtaining health (RR = 7.7) or life insurance (RR = 8.4) when compared with siblings. Although mortality rates approach that of the general population after 10 years in certain subgroups, long-term survivors of autologous HCT continue to face challenges affecting their health and well-being.
Perils of paradigm: Complexity, policy design, and the Endocrine Disruptor Screening Program
Authors: Vogel Jason M 
Published: February 2005

AbstractThe Endocrine Disruptor Screening Program (EDSP), mandated by the United States Congress in the Food Quality Protection Act of 1996, attempts to protect public health from adverse endocrine effects of synthetic chemical compounds by establishing a new testing regime. But the complexities and uncertainties of endocrine disruption and its broader regulatory and social context all but ensure the failure of this policy. This article addresses the issues facing EDSP comprehensively and in detail, in order to move beyond the current regulatory paradigm and foster discourse on a positive role for scientists in support of EDSP's end goal: to protect public health.
An immunocompromised BALB/c mouse model for respiratory syncytial virus infection
Authors: Kong Xiaoyuan , Hellermann Gary R , Patton Geoff , Kumar Mukesh , Behera Aruna , Randall Timothy S , Zhang Jian , Lockey Richard F , Mohapatra Shyam S 
Published: February 2005

Abstract
Background
Respiratory syncytial virus (RSV) infection causes bronchiolitis in infants and children, which can be fatal, especially in immunocompromised patients. The BALB/c mouse, currently used as a model for studying RSV immunopathology, is semi-permissive to the virus. A mouse model that more closely mimics human RSV infection is needed. Since immunocompromised conditions increase risk of RSV infection, the possibility of enhancing RSV infection in the BALB/c mouse by pretreatment with cyclophosphamide was examined in this study. BALB/c mice were treated with cyclophosphamide (CYP) and five days later, they were infected with RSV intranasally. Pulmonary RSV titers, inflammation and airway hyperresponsiveness were measured five days after infection.

Results
CYP-treated mice show higher RSV titers in their lungs of than the untreated mice. Also, a decreased percentage of macrophages and an increased number of lymphocytes and neutrophils were present in the BAL of CYP-treated mice compared to controls. The CYP-treated group also exhibited augmented bronchoalveolar and interstitial pulmonary inflammation. The increased RSV infection in CYP-treated mice was accompanied by elevated expression of IL-10, IL-12 and IFN-γ mRNAs and proteins compared to controls. Examination of CYP-treated mice before RSV infection showed that CYP treatment significantly decreased both IFN-γ and IL-12 expression.

Conclusions
These results demonstrate that CYP-treated BALB/c mice provide a better model for studying RSV immunopathology and that decreased production of IL-12 and IFN-γ are important determinants of susceptibility to RSV infection.
Acute Seizures Due to a Probable Interaction between Valproic Acid and Meropenem
Authors: Coves-Orts Francisco Javier , Borrás-Blasco Joaquín , Navarro-Ruiz Andrés , Murcia-López Ana , Palacios-Ortega Francisco 
Published: February 2005

OBJECTIVE:To report a probable interaction between meropenem and valproic acid that resulted in the development of epileptic seizures.CASE SUMMARY:A 21-year-old woman presented to our emergency department because of a new-onset, generalized tonic—clonic seizure and was admitted to the intensive care unit. Treatment with valproic acid 1000 mg as a continuous intravenous infusion over 24 hours was initiated. On day 6, the serum concentration of valproic acid was 52.5 μg/mL. On day 13, treatment with intravenous meropenem 1 g 3 times daily was started. On day 15, when the patient was afebrile, numerous myoclonic episodes occurred involving her arms and face; the serum concentration of valproic acid at that time was 42 μg/mL. The valproic acid dose was increased to 2880 mg. Two days later, a generalized tonic—clonic seizure occurred despite the increased dosage, and the plasma concentration of valproic acid fell to 7 μg/mL. The valproic acid dose was increased the following day to 3600 mg; however, the serum concentrations remained <10 μg/mL. On day 19, based on the results of a blood culture and the suspicion of an interaction between meropenem and valproic acid, meropenem therapy was suspended. The serum concentration of valproic acid was 52.4 μg/mL on day 27. Three days later, the patient was asymptomatic and was discharged.DISCUSSION:Coadministration of valproic acid and other drugs that are metabolized by the hepatic cytochrome P450 isoenzyme system can lead to clinically relevant interactions by induction or inhibition of enzymes in shared metabolic pathways. In view of studies in experimental models, the interaction between carbapenem antibiotics and valproic acid is at least possible. Use of the Naranjo probability scale indicated a probable relationship between acute seizures and a meropenem—valproic acid interaction in this patient.CONCLUSIONS:This case report provides strong evidence for an interaction between valproic acid and meropenem. Clinicians should be aware of this potential interaction that may be associated with a serious adverse effect as the result of the decrease of the valproic acid serum concentrations.
Effect of Cotherapy Reduction on Tolerability of Epilepsy Add-On Therapy: A Randomized Controlled Trial
Authors: Naritoku Dean K , Hulihan Joseph F , Schwarzman Lesley Kraut , Kamin Marc , Olson William H 
Published: February 2005

BACKGROUND: Adverse effects are the most common cause for failure of an antiepileptic drug (AED), especially when an AED is added to existing therapy. With the increased drug load, it may not be possible to titrate the newly added AED to effective doses. Reducing the dosage of AED cotherapy as the new drug is introduced may improve tolerability. OBJECTIVE: To evaluate reduction of AED cotherapy as a strategy to improve tolerability and patient retention when a new AED is added to existing therapy. METHODS: In a 20-week, randomized, open-label study, topiramate was initiated as add-on therapy in adults and adolescents (⩾12 y of age) with inadequately controlled partial-onset seizures. Patients were randomized to receive treatment in which adverse events could be managed by adjustments in AED cotherapy (flex-dose group) or treatment in which AED cotherapy dosages remained fixed (fixed-dose group). Topiramate could be adjusted as needed in both groups. In the flex-dose group, patients exited randomized treatment when topiramate was discontinued. In the fixed-dose group, patients exited when AED cotherapy was reduced due to adverse events or when topiramate was discontinued. The primary study outcome was the percentage of patients exiting randomized treatment due to adverse events. RESULTS: The flex-dose group comprised 297 patients; 302 patients were in the fixed-dose group. Significantly fewer patients in the flex-dose group exited the study due to adverse events (16% vs 23% in the fixed-dose group; p = 0.02). In the flex-dose group, 10% (17 of 168) of patients discontinued topiramate due to adverse events after AED cotherapy was reduced versus 22% (29 of 129) when AED cotherapy was not reduced. CONCLUSIONS: Reduction of AED cotherapy is a useful strategy to improve tolerability and retention when topiramate is initiated as adjunctive therapy.
Assessment of Risks Related to Medicine Dispensing by Nonprofessionals in Colombia: Clinical Case Simulations
Authors: Vacca Claudia , Orozco José , Figueras Albert , Capellà Dolors 
Published: February 2005

BACKGROUND: Appropriate dispensing is one of the steps for rational drug use, so it is generally advised that the dispenser should have relevant and updated knowledge, skills, and attitudes. OBJECTIVE: To assess pharmacies and nonprofessional employees' (NEs) skills and knowledge, as well as their response to several specific case simulations in Bogotá, Colombia. METHODS: A descriptive cross-sectional study was performed on a random sample of 371 pharmacies in Bogotá. Information from each pharmacy was obtained using 2 approaches: (1) direct interview to collect data on organizational aspects of the store and characteristics of NEs, and (2) simulation (both by direct interview and by telephone) to assess dispensing responses in 6 simulated clinical cases. RESULTS: More than half of the simulated clinical situations resulted in inappropriate dispensing (direct simulations 57%; telephone simulations 55%). The proportion of correct answers to theoretical questions regarding a specific therapeutic problem during interviews was higher than the response when a simulation presented that same case and a dispensing act was expected. The educational background of the NEs included in the study points to a specific problem: two-thirds of the individuals selling medicines had completed only secondary-level education and only 2% of the sample had a pharmacist as technical director. Continuing education courses were either directly organized by drug manufacturers (one-third of the courses attended by pharmacists) or sponsored by them (more than an additional one-third). CONCLUSIONS: NEs should be considered part of the therapeutic chain and, if appropriately updated or instructed, could play a very important role in the always difficult promotion of rational drug use. Public health institutions and universities should be more actively involved in the provision of independent, unbiased, and essential information on common therapeutic problems, safety concerns, and new drug prescription restrictions.