bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tobramycin as a Pharmacologic Tracer to Compare Airway Deposition from Nebulizers
Authors: Asmus Michael J. , Stewart Barbara A. , Milavetz Gary , Teresi Mary E. , Han Seung‐Ho , Wang Deli , Ahrens Richard C. 
Published: May 2004

Study Objective. To assess the utility of inhaled tobramycin as a pharmacologic tracer for comparing lung deposition from a prototypic breath‐actuated jet nebulizer connected to an electronic pressure sensor designed to coordinate nebulization with inspiration with that from a continuously operating standard jet nebulizer.Design. Prospective open‐label study.Setting. University‐affiliated research center.Subjects. Six healthy adult volunteers.Intervention. All subjects received inhaled tobramycin 80, 160, and 320 mg from each nebulizer during six visits, as well as oral tobramycin 32 mg at a seventh visit to confirm the absence of significant gastrointestinal absorption. During each visit, urine was collected before drug administration and in 12‐hour segments throughout the first 48 hours after administration.Measurements and Main Results. Lung deposition of tracer after each of the seven treatments was quantified by measuring urinary tobramycin excretion over 48 hours with use of an enzyme‐multiplied immunoassay technique. The ratio of tobramycin excreted after breath‐actuated nebulization to that after standard nebulization, normalized for dose, was used to compare lung deposition by the two devices. Urinary excretion of tobramycin was linear and proportional to dose for both nebulizers. For every 1 mg of tobramycin that the standard nebulizer deposited into the lungs, the breath‐actuated nebulizer deposited 1.22 mg (95% confidence interval 1.04–1.43).Conclusions. Tobramycin can be used as a pharmacologic tracer for comparison of relative airway deposition by nebulizers.
Serum Bactericidal Activity of Extended‐Release Clarithromycin Against Macrolide‐Resistant Strains of Streptococcus pneumoniae
Authors: Stein Gary E. , Schooley Sharon 
Published: May 2004

Study Objective. To investigate the serum bactericidal activity (SBA) over time of extended‐release clarithromycin against moderately resistant strains of Streptococcus pneumoniae.Design. Prospective, single‐dose pharmacodynamic study.Setting. University‐affiliated research center.Subjects. Eleven healthy male volunteers.Intervention. All volunteers received a single dose of extended‐release clarithromycin as two 500‐mg tablets, and blood samples were obtained at 0, 2, 6, 12, and 24 hours after administration of the dose.Measurements and Main Results. For each blood sample, a serum bactericidal titer (SBT) was determined against S. pneumoniae strains with minimum inhibitory concentrations (MICs) of 0.5, 1.0, 2.0, 4.0, and 8.0 μg/ml to clarithromycin. The median SBT was determined for each time period. The extended‐release formulation of clarithromycin exhibited SBA for 24 hours against pneumococcal strains with MICs of 0.5, 1.0, and 2.0 μg/ml. No SBA was observed against isolates with MICs of 4.0 or 8.0 μg/ml.Conclusion. The extended‐release formulation of clarithromycin, taken once/day, will provide SBA for 24 hours against strains of S. pneumoniae with MICs of 2.0 μg/ml or less.
Impact of a Critical Pathway on Acute Myocardial Infarction Quality Indicators
Authors: Bestul Megan B. , McCollum Marianne , Stringer Kathleen A. , Burchenal Jeb 
Published: May 2004

Study Objective. To determine the impact of a critical pathway on acute myocardial infarction (AMI) quality indicators.Design. Retrospective chart review.Setting. Large university hospital.Patients. One hundred seventy‐five patients who underwent primary percutaneous transluminal angioplasty for AMI (control group 89 patients, intervention group 86 patients).Measurements and Main Results. The medical records of the control group (1998–1999) were reviewed for door‐to‐balloon (DtB) time (the time between the patient's arrival at the emergency department and the first balloon inflation during a percutaneous transluminal coronary angioplasty procedure). Drug therapy prescribed at hospital discharge (aspirin, β‐blocker, angiotensin‐converting enzyme [ACE] inhibitor, and lipid‐lowering therapy) was also reviewed. The data collected for the control group were compared with the intervention group data (2000–2001). The impact of the pathway was evaluated using the Wilcoxon rank sum test, odds ratios (ORs), and χ2 tests. The DtB time was significantly lower in the intervention group versus the control group (91.5 vs 108 min, p<0.01), and fewer intervention patients exceeded the guidelines with a DtB time longer than 120 minutes (OR 0.38, p<0.01). In addition, the intervention group was more likely than the control group to be prescribed an ACE inhibitor (OR 3.7, p<0.01) or lipid‐lowering therapy (OR 3.7, p=0.02) at discharge. Aspirin and β‐blockers were not prescribed differently in the intervention versus control groups (aspirin 95.2% vs 96.2%, β‐blockers 93.5% vs 92.6%).Conclusion. These data suggest that in the current era of published treatment guidelines, implementation of a critical pathway can further improve AMI quality indicators and clinical care.
Evaluation of the US Oncology Network's Recommended Guidelines for Therapeutic Substitution with Darbepoetin alfa 200 μg Every 2 Weeks in Both Naïve Patients and Patients Switched from Epoetin alfa
Authors: Thames William A. , Smith Sandra L. , Scheifele Andrew C. , Yao Bin , Giffin Suzana A. , Alley Julie L. 
Published: May 2004

Study Objective. To evaluate the efficacy of darbepoetin alfa 200 μg subcutaneously every 2 weeks after therapeutic substitution for epoetin alfa.Design. Retrospective multicenter chart review.Setting. Three US Oncology–affiliated outpatient sites.Patients. Three hundred thirty anemic patients with nonmyeloid malignancies, of whom 174 had been treated previously with epoetin alfa (switched group) and 156 had not been treated recently with epoetin alfa (naïve group).Interventions. Therapeutic substitution with darbepoetin alfa was started according to the US Oncology Pharmacy and Therapeutics Committee's recommended dosing guidelines: anemic patients with cancer received a starting dosage of darbepoetin alfa 200 μg every 2 weeks regardless of whether or not they had previously received epoetin alfa. Hematologic and darbepoetin alfa usage data were abstracted from consecutive medical records dated from May 2002–March 2003.Measurements and Main Results. Median exposure to darbepoetin alfa was 10 weeks (25th quartile 6 wks, 75th quartile 17 wks) and 10 weeks (25th quartile 5 wks, 75th quartile 18 wks) for the naïve and switched groups, respectively. The week before the switch to darbepoetin alfa, the 174 patients receiving epoetin alfa were administered the following weekly doses: less than 40,000 U (9%), 40,000 U (50%), or 45,000–90,000 U (41%). Mean hemoglobin level increased from baseline (wk 0) in both the naïve and switched groups. The proportion of patients receiving a red blood cell transfusion in the darbepoetin alfa treatment phase was low (15% in each group). No variation in transfusion rates was observed across weight categories in patients who received a fixed dosage of darbepoetin alfa. Darbepoetin alfa was well tolerated. A detailed usage algorithm was validated by these results and is being used in these three US Oncology–affiliated practices.Conclusion. A darbepoetin alfa starting dosage of 200 μg subcutaneously every 2 weeks administered according to US Oncology–recommended dosing guidelines is effective in treating chemotherapy‐induced anemia in both epoetin alfa–naïve patients and those switched from epoetin alfa.
Relationship Between Symptoms and Health‐Related Quality of Life in Patients Treated for Hypertension
Authors: Erickson Steven R. , Williams Brent C. , Gruppen Larry D. 
Published: May 2004

Study Objective. To determine the relationship between symptoms and health‐related quality of life (HRQOL) in patients receiving drug therapy for hypertension.Design. Cross‐sectional survey.Setting. Outpatient general medicine and university‐based hypertension clinics.Patients. All patients prescribed one or more antihypertensive drugs seen during a 6‐month period in the clinics.Intervention. Data were obtained from a mailed questionnaire and medical records.Measurements and Main Results. Symptoms were measured by a symptom count and total symptom distress. Two scores derived from the Short Form‐36 (SF‐36)—the Physical Component Summary (PCS) and the Mental Component Summary (MCS)—were used to assess HRQOL. Responses were received from 125 of 220 patients (56.8%). Mean ± SD values were 8.8 ± 7.8 for symptom count, 31.6 ± 46.2 for total symptom distress, 48.7 ± 9.3 for PCS, and 51.6 ± 10.1 for MCS. Higher symptom counts and symptom distress scores were strongly associated with lower HRQOL scores in multivariate models, with standardized coefficients from −0.62 to −0.41. These were greater in magnitude than any other predictor, including demographic information (age, sex, race, education level, income), disease variables (blood pressure, years of hypertension), and drug treatment (number of antihypertensive drugs and duration of regimen). Model‐adjusted R2 values were 0.22–0.41.Conclusion. Symptoms have a greater impact on HRQOL than patient characteristics, blood pressure, or drug‐related factors. Among patients receiving drug therapy for hypertension, detailed review of symptoms may yield important information for assessing and improving HRQOL.
Angiotensin‐Converting Enzyme Inhibitor Therapy in Patients with Heart Failure Enrolled in a Managed Care Organization: Effect on Costs and Probability of Hospitalization
Authors: Abarca Jacob , Malone Daniel C. , Armstrong Edward P. , Zachry Woodie M. 
Published: May 2004

Study Objective. To evaluate the effect of angiotensin‐converting enzyme (ACE) inhibitor therapy on risk of hospitalization and resource utilization in patients with heart failure enrolled in a managed care organization.Design. Retrospective medical and pharmacy claims analysis.Patients. One thousand five hundred seventy‐three patients with heart failure enrolled in a managed care organization.Measurements and Main Results. Medical and pharmacy claims from January 1, 1997‐December 31, 1999, from a managed care organization covering approximately 350,000 individuals were analyzed. Patients aged 35 years or older with a diagnostic code for heart failure and 18 months of continuous eligibility were selected. From this group (1573 patients), two cohorts were selected based on exposure to an ACE inhibitor. Dependent variables of interest were all‐cause hospitalization and total direct medical costs during the 12‐month study period. A logistic regression model and an ordinary least‐squares model adjusting for patient demographics, comorbidities, and concomitant drug therapy were used to analyze the risk of all‐cause hospitalization and total direct medical costs, respectively. Therapy with an ACE inhibitor for 180 days was associated with a decreased risk of all‐cause hospitalization (odds ratio 0.65, p<0.0001) and lower total costs (mean $2397, p<0.001) compared with no ACE inhibitor therapy.Conclusion. In patients with a diagnosis of heart failure, exposure to ACE inhibitor therapy is associated with fewer hospitalizations and lower total costs than no ACE inhibitor exposure.
Photopatternable Reflective Films Produced by Nanolayer Extrusion
Authors: Tangirala R. , Baer E. , Hiltner A. , Weder C. 
Published: May 2004

AbstractNovel patternable, light‐reflecting multilayer polymer films are presented. The investigated elements comprise 1024 nanolayers of two different, transparent polymers in strictly alternating fashion. Polymers with different refractive indices were employed and the individual layer thickness was controlled between 50 and 200 nm; as a result the investigated films exhibit pronounced optical interference effects. Different photoreactive additives were integrated into the multilayer films, rendering the optical characteristics of these elements tunable. One approach relied on the use of photoreactive blends of poly(methyl methacrylate) (PMMA) and up to 25 wt.‐% of trans‐cinnamic acid (CA) or trans‐methyl cinnamate (MC). Upon exposure to ultraviolet (UV) radiation, CA and MC undergo dimerization through 2+2 cycloaddition, leading to a significant decrease of the blend's refractive index. As a result, the reflectivity of the multilayer films based on these photoreactive blends changes considerably upon photoreaction. The second approach was based on the use of blends of PMMA and 2‐(2′‐benzoylphenyl)benzoxazole (BzPO), a ‘caged’ photoluminescent dye. This benzoyl ester of 2‐(2′‐hydroxyphenyl)benzoxazole (HPBO) is not photoluminescent, but upon exposure to appropriate UV radiation, the ester bond is cleaved, and the photoluminescent HPBO is quantitatively restored. Thus, using conventional photolithographic techniques, reflective multilayer films were patterned with photoluminescent designs.
Randomized study of the safety and clinical utility of rotational angiography versus standard angiography in the diagnosis of coronary artery disease
Authors: Maddux James T. , Wink Onno , Messenger John C. , Groves Bertron M. , Liao Robert , Strzelczyk Jodi , Chen Shiuh‐Yung , Carroll John D. 
Published: May 2004

AbstractThis study evaluates the safety and clinical utility of rotational angiography in the diagnosis of coronary artery disease. High‐speed rotational angiography is a newly available angiographic modality that gives a dynamic multiple‐angle perspective of the coronary tree during a single contrast injection. We prospectively randomized 56 patients referred for diagnostic coronary angiography to either standard or rotational angiography. Contrast and radiation utilization were compared between the two groups. The number of additional cine acquisitions needed was used to determine adequacy of the diagnostic study protocol. Rotational angiography was successfully completed in all subjects. There was a 33% reduction in contrast utilization in the rotational group as compared to the standard group (35.6 ± 12.6 vs. 52.8 ± 10.7 ml, respectively; P < 0.0001). Additionally, there was a 28% reduction in total radiation exposure in the rotational group as compared to the standard group (39.0 ± 18.5 vs. 53.9 ± 23.4 Gycm2, respectively; P = 0.01). Total whole‐body radiation exposure to the primary operator was 144 mrem with rotational angiography and 170 mrem with standard angiography. Procedure time tended to be shorter for rotational angiography (353.9 ± 146.7 vs. 396.8 ± 165.8 s; P = 0.3). Rotational coronary angiography can be rapidly performed in any patient and provides a significant reduction in contrast and radiation utilization while at the same time providing adequate angiographic data to complement or replace standard coronary angiography in the evaluation of coronary artery disease. Catheter Cardiovasc Interv 2004;62:167–174. © 2004 Wiley‐Liss, Inc.
Vascular complications following coronary intervention correlate with long‐term cardiac events
Authors: Kuchulakanti Pramod K. , Satler Lowell F. , Suddath William O. , Pichard Augusto D. , Kent Kenneth M. , Pakala Rajbabu , Canos Daniel A. , Pinnow Ellen E. , Rha Seung‐Woon , Waksman Ron 
Published: May 2004

AbstractWe aimed to study the consequences and late outcomes of patients who experienced peripheral vascular complications (PVCs) following percutaneous coronary interventions (PCI). A retrospective analysis of the medical records of 10,669 patients who underwent PCI and experienced PVC between 1995 and 2002 was conducted. One thousand ninety‐six patients (10.27% of the study cohort) had PVC post‐PCI. After PCI, patients with PVC had higher rates of in‐hospital complications (P < 0.001) when compared to patients without PVC, including Q‐wave myocardial infarction (MI; 1.2% vs. 0.3%), coronary artery bypass grafting (CABG; 3.8% vs. 0.6%), and death (4.0% vs. 1.0%). At 1‐year follow‐up, late complications of MI (37.4% vs. 25.4%), non‐Q‐wave MI (34.9% vs. 22.7%), death (12.9% vs. 5.9%), and CABG (5.7% vs. 4.5%) were higher (< 0.001) in patients with PVC compared to those without. Multivariate analysis identified PVC as a significant predictor of 1‐year mortality (P = 0.045). This study underscores the need to make diligent efforts to minimize PVC and follow up these patients for future coronary events. Cardiovasc Interv 2004;62:181–185. © 2004 Wiley‐Liss, Inc.
Complication with an embolic protection device during carotid angioplasty
Authors: Cardaioli Paolo , Giordan Massimo , Panfili Marco , Chioin Raffaello 
Published: May 2004

AbstractA case of carotid artery stenting with an AngioGuard cerebral protection device is described in a patient with tight internal carotid stenosis. Deployment of AngioGuard induced sudden severe vasospasm, with subsequent minor stroke. According to our observations, AngioGuard may cause a vasospastic response with adverse neurologic effects. Catheter Cardiovasc Interv 2004;62:234–236. © 2004 Wiley‐Liss, Inc.
Influence of hot pressing on the microstructure and fracture toughness of two pressable dental glass–ceramics
Authors: Albakry Mohammad , Guazzato Massimiliano , Swain Michael Vincent 
Published: May 2004

AbstractEmpress 1 and Empress 2 are well‐known pressable all‐ceramic dental materials that have generated substantial interest for many clinicians and patients. These two materials are reputed to benefit from heat pressing during the laboratory fabrication procedures, leading to better crystal distribution within a glass matrix, and hence an improved strength. The present study aimed to evaluate the effect of heat pressing on fracture toughness, microstructural features, and porosity. Results showed that Empress 1 had similar fracture toughness values before the pressing procedure, after it, and after the repressing procedure. The microstructural features were also similar among these specimens, but a more uniform distribution of leucite crystals was observed following the pressing and repressing procedures. Empress 2 demonstrated two different fracture toughness values. This was associated with the alignment of lithium disilicate crystals that occurred after the pressing and repressing procedures, which led to different indentation induced crack lengths, depending upon whether cracks propagated parallel to or perpendicular to the aligned crystals, the former having lower toughness than those that propagated in the perpendicular direction. Porosity, in terms of both the size and number of pores, was found to decrease after the pressing and repressing procedures for both materials. Repressing resulted in significant growth of the lithium disilicate crystals in Empress 2, but there was no change for the leucite crystals in Empress 1. The change in the lithium disilicate crystals' size did not have a noticeable effect on the fracture toughness of Empress 2. It was concluded that heat pressing did not significantly affect the fracture toughness of Empress 1, but resulted in two different values for Empress 2. It also decreased the size and number of pores for both materials, which could contribute to the strength improvement found after heat pressing, which has been reported in previous studies. © 2004 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 71B: 99–107, 2004
Infraciliature and myoneme system ofCampanella umbellaria(Protozoa, Ciliophora, Peritrichida)
Authors: Shi Xinlu , Warren Alan , Yu Yuhe , Shen Yunfen 
Published: May 2004

AbstractThe infraciliature and myoneme system ofCampanella umbellariawere revealed using the protargol impregnation technique. The main characteristics of the infraciliature are the peristomial ciliary rows (haplokinety and polykineties), which make four and a half turns around the peristomial disc before plunging into the infundibulum, and the aboral infraciliature, which is made up of the aboral ciliary wreath (trochal band) and the scopula. The myoneme system is composed of: 1) longitudinal fibers, which include 60–84 (mean 72.3) short longitudinal fibers, 40–56 (mean 45.8) medium‐length longitudinal fibers, and numerous long longitudinal fibers; and 2) circular fibers, which include 8–12 (mean 9.3) peristomial ring fibers, linking fibers, support fibers, and peristomial disc fibers. The various fibers inC. umbellariaare interconnected to form a single myoneme system that may act as a cell skeleton as well as providing the mechanism by which the zooid contracts and relaxes. J. Morphol. 261:43–51, 2004. © 2004 Wiley‐Liss, Inc.
The spermatozoon of Eurasian murine rodents: Its morphological diversity and evolution
Authors: Breed William G. 
Published: May 2004

AbstractThe murine rodents are the most speciose subfamily of mammals. Here the morphology of the spermatozoon, as determined by scanning and transmission electron microscopy of representative species from four Eurasian clades, is described. Much interspecific variability in all components of the spermatozoon was found to occur, although most species have a bilaterally flattened sperm head with a single apical hook of variable length and orientation. Ultrastructural observations indicate that this apical hook invariably contains a nuclear projection as well as a large extension of the subacrosomal cytoskeleton, as a perforatorium rostrally, and a complex asymmetrical acrosomal extension. These spermatozoa also have relatively long tails that are attached to the lower concave surface of the sperm head. Uniquely, in species in the Apodemus clade, the apical hook is orientated caudally. In a few species a highly derived sperm head morphotype that does not contain an apical hook is present. These sperm heads vary in morphology from being globular in two species of Bandicota, to bilaterally flattened and paddle‐shaped in Tokudaia and Micromys. In spermatozoa of the latter two genera the subacrosomal cytoskeleton, which is less extensive than in species with a hooked sperm head, forms an apical extension, but that is not the case in Bandicota. In all species where the sperm head lacks an apical hook the acrosome is more symmetrical. The sperm tail is much shorter in these species, with attachment to the head occurring on the ventral surface in Tokudaia and basal in Micromys and the two species of Bandicota. As the sperm head morphotype with a complex apical hook is present in all the major clades of murine rodents, it is likely to be a plesiomorphic character within each of these clades, with the nonhooked sperm heads, which vary greatly in structure between species of the different lineages, probably being independently derived. The ultrastructural organization of the sperm head of Bandicota, but not those of Micromys or Tokudaia, suggest divergence in some of the morphological events associated with sperm–egg interaction at the time of fertilization. J. Morphol. 261:52–69, 2004. © 2004 Wiley‐Liss, Inc.
Radiation‐Grafted Polymerization from a Gas Phase to Form Polymeric Layers on Metal Surfaces
Authors: Tsetlin Boris L. , Golubev Vladimir N. , Khokhlov Alexei R. , Dementjev Alexei P. , Maslakov Konstantin I. , Tsetlin Mikhail B. , Kalita Vasiliy I. 
Published: May 2004

AbstractSummary: Experimentally it is shown that, under irradiation in an atmosphere of non‐saturated vinylidene chloride vapors, a polymeric layer is formed on the surface of oxidized titanium samples. The thickness of this layer increases with the increase of thickness of the oxide film. Such a dependence corresponds to the current understanding of the mechanism of formation and migration of the active excited centers that initiate grafted polymerization.Wide range XPS spectra of oxidized titanium samples after PVDC grafting from a gas phase.imageWide range XPS spectra of oxidized titanium samples after PVDC grafting from a gas phase.