bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tetra-arsenic tetra-sulfide for the treatment of acute promyelocytic leukemia: a pilot report
Authors: Lu Dao-Pei , Qiu Jing-Ying , Jiang Bin , Wang Qin , Liu Kai-Yan , Liu Yan-Rong , Chen Shan-Shan 
Published: October 2002

Abstract
In the past 6 years, we treated 129 patients who had acute promyelocytic leukemia (APL) with a new arsenic agent, oral tetra-arsenic tetra-sulfide (As4S4). Nineteen of the patients had newly diagnosed APL, 7 had first relapse, and 103 had hematologic complete remission (HCR). HCR was achieved in all patients with newly diagnosed APL and in all those with hematologic relapse. Of 16 patients with newly diagnosed disease and available cytogenetic and molecular analyses, 14 had cytogenetic and molecular complete remission (CR). Cytogenetic and molecular CR was also obtained in 5 of the 7 patients with hematologic relapse. In the HCR group, 35 of 44 patients positive for PML-RARα at baseline became negative. In the newly diagnosed group, estimated disease-free survival (DFS) rates for 1 and 3 years were 86.1% and 76.6%, respectively, with a median follow-up time of 13.5 months (range, 2-40 months). In the HCR group, DFS rates for 1 and 6 years were 96.7% and 87.4%, respectively, with a median follow-up of 23 months (range, 2-71 months). Treatment with As4S4 was well tolerated, with only moderate side effects, including asymptomatic prolongation of corrected QT interval, transient elevation in liver enzyme levels, rash, and mild gastrointestinal discomfort; neither myelosuppression nor appreciable long-term side effects occurred. Degeneration or apoptosis of APL promyelocytes was observed during As4S4therapy. Pharmacokinetic studies showed that the agent was absorbed rapidly. Most urinary arsenic excretion occurred within the first 24 hours. Both blood and urinary arsenic levels declined after discontinuation of As4S4. Our results show, for the first time, that As4S4 treatment alone is highly effective and safe in both remission induction and maintenance therapy in patients with APL, regardless of disease stage.
Application of a high‐resolution seismic investigation in a Greek coal mine
Authors: Tselentis G.‐Akis , Paraskevopoulos Paraskevas 
Published: October 2002

High‐resolution seismic methods were applied to map the detailed structure and thickness of the Domeniko coal basin (central Greece) and to search for lateral discontinuities, such as pinch‐outs and faults. Extensive tests were performed to optimize recording parameters and equipment. Reflection events which can be attributed to coal layers can be interpreted from depths of approximately 30 to 150 m on CDP stacked and inverted sections. Several low‐throw faults have been interpreted from the sections. Results obtained from the high‐resolution seismic reflection survey combined with drillhole information clearly revealed the 3‐D model of the coal field.Using geostatistical methods, the results of the high‐resolution reflection seismic survey were combined with the information from the borehole program to clearly reveal the 3‐D model of the basin.
Postmap migration of crosswell reflection seismic data
Authors: Byun Joongmoo , Rector III James W. , Nemeth Tamas 
Published: October 2002

Vertical seismic profiling/common depth point (VSP‐CDP) mapping is often preferred to crosswell migration when imaging crosswell seismic reflection data. The principal advantage of VSP‐CDP mapping is that it can be configured as a one‐to‐one operation between data in the acquisition domain and data in the image domain and therefore does not smear coherent noise such as tube waves, guided waves, and converted waves as crosswell migration could. However, unlike crosswell migration, VSP‐CDP mapping cannot collapse diffractions; therefore, the lateral resolution of reflection events suffers.We present a migration algorithm that is applied to the crosswell data after they have been mapped. By performing crosswell migration in two distinct steps—mapping followed by diffraction stacking—noise events can be identified and filtered in the mapped domain without smearing effects commonly associated with conventional crosswell migration operators. Tests on noise‐free synthetic crosswell data indicate that the two‐step migration yields results nearly identical with conventional crosswell migration.Our specific implementation of the two‐step migration algorithm maps the data using an estimate of the interwell velocity field and then performs diffraction stacking using a constant‐velocity assumption. The migrated results are confined to the mapped region to reduce edge effects commonly associated with conventional crosswell migration. Results from synthetic data indicate that the constant‐velocity assumption used for diffraction stacking is remarkably robust, even for models with large vertical velocity variation. It is, however, important that the data are mapped with the correct interwell velocity model. After applying postmap migration to two field data sets mapped by VSP‐CDP mapping, better fault resolution was achieved and the lateral resolution was improved significantly.
Sensitivity of the Tinetti Gait Assessment for detecting change in individuals with Parkinson’s disease
Authors: Behrman Andrea L , Light Kathye E , Miller Gloria M 
Published: October 2002

Objective: To determine the Tinetti Gait Assessment’s sensitivity for detecting changes in verbally instructed gait in patients with Parkinson’s disease. Design: Two-group comparison study with sample of convenience. Setting: Motor Behavior Lab, Department of Physical Therapy, University of Florida. Subjects: Twenty community-dwelling, elderly adults: 10 with moderately disabling Parkinson’s disease (PD) recruited from local Parkinson Support Groups and 10 gender and age-matched adults without PD recruited from the local community. Main outcome measures: Tinetti Gait Assessment (TGA) overall scores. All subjects were assessed while walking under ”ve verbally instructed conditions: (1) usual walking, (2) swing arms, (3) take large steps, (4) walk fast, (5) count aloud. Results: A 2 x 5 analysis of variance (group x instructional set) was performed. The PD group scored less than the control group on the TGA regardless of the instructed walking conditions ( p < 0.05), however, there was no signi”cant difference in the TGA scores across conditions. The effect size of the instructional set measured by the TGA was greatest for the swing arms condition, though small at 0.25. Conclusion: The TGA is not sensitive for detecting change in the gait impairments observed in moderately disabling PD and, therefore, is not adequate as an assessment to establish short-term goals, guide treatment, or assess the effects of intervention for clients with PD.
Hypnotic imagery as a treatment for phantom limb pain: two case reports and a review
Authors: Oakley David A , Whitman Lionel Gracey , Halligan Peter W 
Published: October 2002

Objective: To provide a theoretical background, to review existing literature and to present new case material relevant to the treatment of phantom limb pain using hypnotic imagery. Method: This paper presents two new case reports involving the use of hypnotic imagery procedures in the alleviation of phantom limb pain and reviews 10 previous clinical studies which have involved a similar approach. The earlier studies were identified by electronic and manual searches of the relevant literature. Results: Two main treatment strategies can be identified: (1) ipsative/ imagery-based approaches and (2) movement/imagery-based approaches. A common finding is the need to treat the phantom limb as a fireal’ body part, to accept its existence as a valid mental representation and to avoid treating the amputation stump as the sole source of the phantom pain sensations. Conclusion: Hypnotic procedures appear to be a useful adjunct to established strategies for the treatment of phantom limb pain and would repay further, more systematic, investigation. Suggestions are provided as to the factors which should be considered for a more systematic research programme.
Intramuscular neurolysis with alcohol to treat post-stroke finger fiexor spasticity
Authors: Kong K H , Chua K SG 
Published: October 2002

Objective: To evaluate the effectiveness of intramuscular neurolysis with alcohol for the treatment of finger fiexor spasticity in individuals with stroke. Design: Case series. Setting: Outpatient clinic of a tertiary rehabilitation facility. Subjects: Thirty patients with a mean age of 60.2 years and post-stroke duration of 8.3 months with finger fiexor spasticity. Interventions: Intramuscular neurolysis or motor point blocks of the finger fiexors of the hemiplegic upper extremity with 50% ethyl alcohol. Main outcome measures: The severity of spasticity as measured by the Modified Ashworth Scale (MAS) and the passive range of motion of the proximal interphalangeal joints of the second to fifth digits. Results: The mean baseline MAS score was 4.0 ± 0.5 and this improved to 2.0 ± 0.6, 2.2 ± 0.6 and 2.6 ± 0.6 at four weeks, three months and six months post neurolysis respectively. The gains in range of motion were 18.5 ± 6.7, 17.5 ± 6.4 and 14.9 ± 4.8 degrees at four weeks, three months and six months post neurolysis respectively. These improvements were statistically significant ( p < 0.05). Two subjects developed temporary dysesthetic pain of the forearm and palm. Conclusion: Intramuscular neurolysis with alcohol provides good relief of finger fiexor spasticity in hemiplegic individuals.
Zoledronic acid versus pamidronate as palliative therapy in cancer patients: A Canadian time and motion analysis
Authors: Dranitsaris George , Castel Liana D , Baladi Jean Francois , Schulman Kevin A 
Published: October 2002

Pamidronate was an important advance in the palliative treatment of patients with cancer. However, pamidronate must be infused over at least 2 hours in most patients. Zoledronic acid represents the next-generation bisphosphonate with a potential for improved efficacy in the palliative care setting. One important advantage of zoledronic acid is that it can be administered over a 15-minute infusion. To measure the overall efficiency of zoledronic acid as compared with pamidronate in the outpatient setting, a USA microcosting model was adapted to Canadian inputs. Time and motion data were collected from six patients being treated with zoledronic acid or pamidronate in three USA outpatient cancer clinics. Resource use and time impact on outpatient clinical staff were reanalyzed using Canadian cost estimates. This included the evaluation of fixed, variable, and labour costs obtained from Canadian sources. The manufacturer provided drug costs. The base case analysis assumed a 5300-ft2 out-patient chemotherapy clinic with eight infusion chairs designated for bisphosphonate administration in the province of Ontario. Mean treatment times in the original USA data collected were 2 hours, 52 minutes for pamidro-nate, and 1 hour, 6 minutes for zoledronic acid (a difference of 1 hour, 46 minutes). In the Canadian version of the microcosting model, the overall treatment cost was Can$673 for pamidronate and Can$682 for zoledronic acid (2001 Canadian dollars). Findings suggest that the shorter zoledronic acid infusion time would allow an additional 27 bisphosphonate patients to be treated per day. Alternatively, approximately one additional hour of chair time could be made available with each zoledonic acid infusion. Sensitivity analyses revealed that (a) the base case results were consistent when geographic region was varied, and (b) the shorter the infusion time for zoledronic acid relative to pamidronate, the lesser the cost difference and more patients could be treated daily. In conclusion, zoledronic acid may enhance the overall efficiency of outpatient chemotherapy clinics by reducing patient waiting time for bisphosphonate administration. These benefits would be obtained at an incremental cost of Can$9 per infusion.
Symptoms in individuals with small cutaneous veins
Authors: Kröger K , Ose C , Rudofsky G , Roesener J , Hirche H 
Published: October 2002

The clinical relevance of small cutaneous veins (SCV) is still being discussed. In the Duesseldorf/Essen civil servants study, the prevalence of SCV and the individual symptoms and age-dependent changes were analysed. This cross-sectional study recruited 9935 employees; 9100 could be finally evaluated for this analysis. All volunteers were asked to fill out the questionnaire and were clinically examined. Primarily the clinical findings were documented, adapted to the Basel Study and later modified according to the CEAP classification: (a) class 0 - no visible or palpable clinical signs of venous disease, (b) class 1 - small cutaneous veins, (c) class 1 - reticular veins, (d) class 2 - varicose veins. In all, 64% of the volunteers had no signs of venous disease (class 0: age 41 10 years); 10% had small cutaneous veins (class 1: age 44 10 years). SCV was more frequent in females (25%) than in males (6%). Only 5% of those with SCV had already consulted a physician. A striking result was that individuals with SCV generally complained about more leg symptoms, of which ‘leg swelling’ and ‘muscle cramps during the night’ were the most frequent. ‘Continual leg swelling’ was reported by 24% of individuals with SCV as opposed to 10% of those without. ‘Leg cramps’ and ‘restless legs’ also were more often documented in individuals with SCV (29% vs 22% and 10% vs 7%). These findings were all statistically significant (p 0.001). After adjusting for age and sex, though, there were few or no differences between groups (leg swelling: odds ratio (OR) 1.3; 95% confidence interval (95% CI) 1.1-1.6 and cramps: OR 1.1; 95% CI 0.9-1.3). A gender separate estimation of the rates showed that females suffer more often from any symptom. Regarding ‘leg cramps’, ‘restless legs’ and ‘itching’, the OR were not different for females and males. For ‘leg swelling’ the age-adjusted OR were significant for women (OR 1.4; 95% CI 1.1-1.7) compared with men (OR 1.1; 95% CI 0.7-2). Individuals with SCV seem to have more symptoms compared with healthy people. However, this analysis shows that age and sex are the most relevant explanations for these symptoms.
Intramuscular Droperidol versus Intramuscular Dimenhydrinate for the Treatment of Acute Peripheral Vertigo in the Emergency Department: A Randomized Clinical Trial
Authors: Irving Carol , Richman Peter , Kaiafas Costas , Eskin Barnet , Allegra John 
Published: October 2002

Objective: The emergency department (ED) treatment of acute peripheral vertigo (APV) has not been well studied. The purpose of this study was to determine the efficacy of intramuscular (IM) droperidol vs IM dimenhydrinate, in the treatment of ED patients with APV. Methods: The study was a randomized, double‐blinded clinical trial, performed at a suburban, teaching ED. A convenience sample of adult patients with symptoms and signs consistent with rigid diagnostic criteria for APV were randomized to one of two treatment groups. Patients more than 65 years of age were excluded to reduce the likelihood of diagnostic misclassification. Demographic and historical features were recorded on a standardized data form. Patients recorded their initial level (t0) of discomfort on a 10‐centimeter (cm) visual analog scale (VAS). Treatment group 1 received 2.5 mg droperidol IM, while treatment group 2 received 50 mg dimenhydrinate IM. After 30 minutes (t30), patients again recorded the severity of their symptoms on the VAS. Chi‐square, t‐tests, and Mann‐Whitney were used for statistical comparison as appropriate. All tests were two‐tailed, with alpha set at 0.05. Primary outcome parameters were the mean change in VAS score from t0 to t30, and the percentage of patients in each treatment group who felt well enough to go home after t30 without further ED intervention. Results: There were 20 patients in the droperidol group and 20 in the dimenhydrinate group. The two groups were similar with respect to mean age (40 ± 13 years droperidol vs. 42 ± 13 years dimenhydrinate; p = 0.6), female sex (60% vs. 50%; p = 0.7), and mean median duration of symptoms [3 (interquartile range 2‐12) vs 9 (interquartile range 2‐30) hours; p = 0.2]. Mean initial t0 VAS scores were 7.2 ± 2.3 and 7.8 ± 1.9 (p = 0.47). Both treatment groups had mean reductions in VAS scores at t30 of 3.3 [95% confidence interval (95% CI) = 2.3 to 4.3]. At t30, 42% of patients in the droperidol group and 45% of patients in the dimenhydrinate group felt well enough to go home without further ED intervention. Conclusions: The authors found no difference between the therapeutic efficacies of IM droperidol and dimenhydrinate for the treatment of acute peripheral vertigo.
Factors Influencing Admission among Children with a Traumatic Brain Injury
Authors: McCarthy Melissa Lee , Serpi Tracey , Kufera Joseph A. , Demeter Lori A. , Paidas Charles 
Published: October 2002

Abstract Objectives: To describe the epidemiology of traumatic brain injury (TBI) among children in Maryland and to examine factors that influence hospital admission. Methods: Statewide mortality, hospital discharge, and ambulatory care data were used to identify all TBI‐related emergency department (ED) visits, hospitalizations, and deaths that occurred in 1998 to children aged 0‐19 years according to the Centers for Disease Control and Prevention's standard case definition and protocol. Inpatient admission was modeled as a function of patient, injury, and hospital characteristics. Results: The overall incidence of pediatric TBI (i.e., ED visits, hospitalizations, and deaths) in 1998 was 670/100,000. After controlling for injury severity and other factors, uninsured children were 40% less likely to be hospitalized (95% CI = 0.43 to 0.82) and children with Medicaid were 90% more likely to be hospitalized (95% CI = 1.42 to 2.54) than were those with private insurance. The presence of a major associated injury significantly influenced the likelihood of hospitalization, especially among children with a minor (OR = 8.8) to moderate (OR = 11.6) TBI. Children who presented to a trauma center hospital were significantly more likely to be hospitalized than children treated at a non‐trauma center hospital, although this varied depending on income (OR = 1.8 for high versus low) and hospital volume (OR = 2.6 for a small hospital and OR = 29.0 for a large hospital). Conclusions: After adjusting for TBI severity and the presence of associated injuries, significant differences in hospitalization rates may exist among different patient subgroups and hospitals for children who sustain TBIs.
Diagnostic Errors
Authors: Kuhn Gloria J. 
Published: October 2002

AbstractOne of the most complex and challenging tasks facing physicians is the need to make a diagnosis. Recent research has focused attention on medical errors alleged to have resulted in increased patient morbidity and mortality. A number of authorities have suggested methods to track and prevent errors. Most have dealt with systems' changes and fail‐safe methods to prevent medication errors and commission of errors during treatment. Few have addressed methods to find and prevent diagnostic errors. Unless diagnostic error is either avoided or corrected early, fail‐safe methods to prevent medication and treatment errors will ultimately fail to improve patient outcome. American medical literature, particularly postmortem studies, have documented diagnostic error since at least 1912. European literature shows the problem is worldwide. The limits of human memory and errors in both observation and processing of information during problem solving contribute to the commission of errors. The purpose of this article is to examine the thinking patterns and cognitive errors that can result in diagnostic error, and suggest instructional strategies that can be used to alert residents and attending physicians to these potential problems so they can be avoided.
Attitudes of Law Enforcement Officers Regarding Automated External Defibrillators
Authors: Groh William J. , Lowe Miriam R. , Overgaard Amanda D. , Neal Jeanie M. , Fishburn W. Craig , Zipes Douglas P. 
Published: October 2002

Abstract Objective: To assess the knowledge and attitudes of law enforcement officers regarding treating out‐of‐hospital cardiac arrest (OHCA) and using automated external defibrillators (AEDs). Methods: This was a survey conducted among officers serving Marion County, Indiana. Results: Of 1,130 surveys distributed, 929 (82.2%) were returned. Among these officers, 603 (66.4%) were certified in cardiopulmonary resuscitation (CPR) and 103 (11.3%) had received AED training. Most officers had limited knowledge regarding OHCA. A 100‐point knowledge score (mean ± SD: 31.9 ± 14.3) was higher in officers who had performed CPR while on duty [35.0, 95% confidence interval (95% CI) = 32.9 to 37.2, p = 0.005] and who were AED‐trained (40.8, 95% CI = 38.0 to 43.6, p < 0.001). Of the respondents, 367 (40.1%) believed that AED usage by local law enforcement was needed, and 323 (35.6%) stated that they would feel comfortable using an AED if trained. A 100‐point attitude score (mean ± SD: 32.1 ± 21.0) was higher in officers who had CPR certification (38.2, 95% CI = 35.6 to 40.8), who had performed CPR while on duty (40.6, 95% CI = 37.7 to 43.5), who were AED‐trained (39.5, 95% CI = 35.6 to 43.4), and who had improved OHCA knowledge (+3.8 per 10 points knowledge score, 95% CI = 3.0 to 4.7), p < 0.001, all significant factors. Conclusions: Limited knowledge and negative attitudes of law enforcement officers regarding their involvement in treating OHCA and using AEDs are commonly present. These factors could result in barriers that negatively impact law enforcement AED programs.
Thrombolysis Candidates for the Treatment of Stroke at an Emergency Department in Japan
Authors: Yamaguchi Keiji , Hori Shingo , Nogawa Shigeru , Tanahashi Norio , Fukuuchi Yasuo , Aikawa Naoki 
Published: October 2002

Abstract Objectives: To study the proportion and characteristics of potential candidates for the intravenous administration of tissue plasminogen activator (IV‐tPA) among patients with cerebral infarction in a Japanese emergency department (ED). Methods: A retrospective observational study was performed using patients who had been transported by ambulance between August 1988 and April 2000 to an urban ED of a university hospital located in the Tokyo metropolitan area. Potential candidates for IV‐tPA were identified using the criteria of the National Institute of Neurological Disorders and Stroke (NINDS) study. Results: Of all 30,064 patients transported by ambulance, 526 were diagnosed as having cerebral infarction. Among them, 190 patients arrived at the ED within two hours of symptom onset (early ED arrivers). In comparison of their demographics with late ED arrivers (n = 319), atrial fibrillation, male gender, and consciousness disturbance were related with early ED arrivers, while aging and diabetes were related with late ED arrivers. As to the stroke subtype, patients with an embolic infarction accounted for 76.8% among early ED arrivers. Application of exclusion criteria identified 114 patients, who were suitable for the thrombolysis treatment, indicating that the proportion of potential IV‐tPA candidates was 21.7% among all cerebral infarction patients and 0.38% among all ED patients. Conclusions: The number of potential IV‐tPA candidates among patients transported to the ED by ambulance in Japan was substantial, where the proportion of embolic infarction cases was extremely high.