bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resistance Exercise and Physical Performance in Adults Aged 60 to 83
Authors: Vincent Kevin R. , Braith Randy W. , Feldman Ross A. , Magyari Pete M. , Cutler Rachel B. , Persin Stephanie A. , Lennon Shannon L. , Md Abdel H. Gabr , Lowenthal David T. 
Published: March 2003

OBJECTIVES: This investigation examined the effect of 6 months of high‐ or low‐intensity resistance exercise on muscular strength and endurance and stair climbing ability in adults aged 60 to 83.DESIGN: A randomized controlled trial.SETTING: University of Florida Center for Exercise SciencePARTICIPANTS: Sixty‐two men and women completed the study protocol. Subjects were matched for strength and randomly assigned to a control (n = 16), low‐intensity (LEX, n = 24), or high‐intensity (HEX, n = 22) group.INTERVENTION: Six months of progressive, whole‐body resistance training. Subjects trained at 50% of their one‐repetition maximum (1RM) for 13 repetitions (LEX) or 80% of 1RM for eight repetitions (HEX) three times per week for 24 weeks using resistance machines. One set each of 12 exercises was performed.MEASUREMENTS: One‐repetition maximum was measured for eight different exercises. Muscular endurance was measured using leg press and chest press machines. Low back strength was measured using a lumbar extension machine. Stair climbing ability was assessed as the time to ascend one flight of stairs.RESULTS: 1RM significantly increased for all exercises tested for the HEX and LEX groups (P≤ .050). The increases in total strength (sum of all eight 1RMs) were 17.2% and 17.8% for the LEX and HEX groups, respectively. Muscular endurance improved by 79.2% and 105.0% for the leg press, and 75.5% and 68.0% for the chest press for the LEX and HEX groups, respectively. The time to ascend one flight of stairs significantly decreased for both the LEX and HEX groups (P≤ .050). Lumbar extension strength increased by 62.6% and 39.5% for the LEX and HEX groups, respectively.CONCLUSIONS: These data indicate that significant and similar improvements in strength, endurance, and stair climbing time can be obtained in older adults as a consequence of high‐ or low‐intensity resistance exercise training. These findings may have an effect on how resistance exercise is prescribed to older adults.
The Prevalence of Dementia in Older People in an Urban Population of Korea: The Seoul Study
Authors: Lee Dong Young , Lee Jung Hie , Ju Young‐Su , Kang Uk Lee MD , Kim Ki Woong , Jhoo Jin Hyeong , Yoon Jong Choul , Ha Jin , Woo Jong Inn 
Published: March 2003

OBJECTIVES: To estimate prevalence of dementia and its subtypes in older people in Seoul, a metropolitan area of Korea, and compare these findings with estimates reported for other populations.DESIGN: The study employed a two‐stage design for case identification. Initially, the Mini‐Mental State Examination in the Korean version (MMSE‐KC) of the Consortium to Establish a Registry for Alzeheimer's Disease (CERAD) assessment packet was administered to all participants. Two hundred seventeen persons sampled from three levels of performance on MMSE‐KC underwent the second‐stage clinical evaluation based on the Korean Version of the CERAD assessment packet.SETTING: The study was conducted in an urban community setting.PARTICIPANTS: Six hundred forty‐three persons aged 65 and over participated in the study.MEASUREMENTS: Dementia was defined using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic features of dementia.RESULTS: Dementia prevalence ranged from 2.6% in persons aged 65 to 69 to 32.6% in persons aged 85 and older. Age‐standardized prevalence was 8.2% for dementia, 5.4% for Alzheimer's disease, and 2.0% for vascular dementia. The prevalence estimates, which excluded very mild cases (clinical dementia rating index 0.5), were approximately 5.3% for dementia and 4.3% for Alzheimer's disease.CONCLUSION: The prevalence of dementia in older people in Seoul appears to be somewhat lower than in rural areas of Korea. Considering the difficulties involved in establishing a diagnostic threshold for dementia, actual differences in dementia prevalence between Asian populations are probably minimal.
Quality of Care of Nursing Home Residents Hospitalized With Heart Failure
Authors: Ahmed Ali , Weaver Michael T. , Allman Richard M. , DeLong James F. , Aronow Wilbert S. , Cmd  
Published: March 2003

OBJECTIVES: To determine whether the quality of heart failure (HF) care of hospitalized nursing home (NH) residents is different from that of patients admitted from other locations.DESIGN: Retrospective chart review.SETTING: Nursing home residents discharged from hospitals.PARTICIPANTS: Medicare beneficiaries aged 65 and older.MEASUREMENTS: Subjects were discharged with a primary discharge diagnosis of HF in Alabama in 1994. They were categorized as having been admitted from a NH or other locations. Bivariate logistic regression analysis was used to estimate crude odds ratios (ORs) and 95% confidence intervals (CIs) for left ventricular function (LVF) evaluation and angiotensin‐converting enzyme (ACE) inhibitor use for NH residents relative to nonresidents. Multivariate generalized linear models were developed to determine independence of associations.RESULTS: Subjects (N = 1,067 years) had a mean age ± standard deviation of 79 ± 7.4, 60% were female, and 18% were African Americans. Fewer NH residents (n = 95) received LVF evaluation (39% vs 60%, P < .001) and ACE inhibitors (50% vs 72%, P = .111). NH residents had lower odds for LVF evaluation (OR = 0.42, 95% CI = 0.27–0.64). The odds for ACE inhibitor use, although of similar magnitude, did not reach statistical significance (OR = 0.40, 95% CI = 0.12–1.28). After adjustment of patient and care characteristics, admission from a NH was significantly associated with lower LVF evaluation (adjusted OR = 0.64, 95% CI = 0.49–0.82) but not with ACE inhibitor use (adjusted OR = 0.59, 95% CI = 0.16–2.14).CONCLUSIONS: Quality of HF care received by hospitalized NH residents was lower than that received by others. Further studies are needed to determine reasons for the lack of appropriate evaluation and treatment of NH patients with HF who are admitted to hospitals.
Survival to Late Dementia in Dutch Nursing Home Patients
Authors: Koopmans Raymond T. C. M. , Ekkerink John L. P. , Van Weel Chris 
Published: March 2003

OBJECTIVES:To investigate the determinants of survival to late dementia in Dutch nursing home patients. DESIGN:Observational analysis of a cohort of patients with a prospective follow‐up. SETTING:Psychogeriatric nursing home “Joachim en Anna” in Nijmegen, the Netherlands. PARTICIPANTS:Dementia patients from a psychogeriatric nursing home admitted between 1980 and 1989. MEASUREMENTS:All patients were followed until death. Age, sex, severity of dementia on admission, and type of dementia were analyzed as determinants of survival to late dementia. Late dementia was operationally defined as total impairment on 20 items of the functional status questionnaire. RESULTS:The mean disease duration of the study population was 7.0 years, with a wide range. Some died soon after dementia was diagnosed, whereas others lived for more than 25 years after onset of the disease. One hundred twenty‐six patients (14.2%) reached the phase of late dementia, most of whom were women (90%) with Alzheimer's disease (60%). For most of the patients, this phase lasted 1 year or less. Age, sex, type of dementia, and severity of dementia on admission all contributed significantly to predicting survival to late dementia. CONCLUSION:One of seven nursing home patients with dementia survived to late dementia. Nursing home physicians can use these findings to inform relatives about the prognosis. J Am Geriatr Soc 51:184–187, 2003.
Development and Validation of an Instrument to Predict Probability of Home Discharge from a Geriatric Convalescence Unit in Spain
Authors: Miralles Ramón , Sabartés Olga , Ferrer Montse , Esperanza Ascensión , Llorach Imma , García‐Palleiro Pedro , Cervera Antoni‐María 
Published: March 2003

OBJECTIVES: To develop and validate an instrument to predict probability of home discharge upon hospital admission.DESIGN: Prospective cohort study.SETTING: Geriatric convalescence unit (GCU) in Spain.PARTICIPANTS: Seven hundred eighty‐one patients aged 65 and older consecutively admitted to a GCU over a 4‐year period. The total sample was randomized and divided into two subgroups; the first (n = 575) was used to construct the predictive instrument (development subgroup) and the second (n = 206) for the validation process (validation subgroup).MEASUREMENTS: All patients were evaluated within the first 72 hours after admission. Age, sex, functional status before admission, diagnostic categories, functional status on admission, comorbidity, cognitive function, and social support were assessed.RESULTS: Logistic regression analysis identified three patient characteristics as independent predictors of home discharge in the development subgroup: higher scores on functional status at admission (Barthel index), normal Mini‐Mental State Examination scores, and lower scores on Social Familial Evaluation Scale. A scoring system ranging from 0 to 5 was constructed using these variables to predict probability of home discharge (PHD). Different PHD scores (0–1, 2, 3, 4, and 5) identified patients with different probabilities of returning home on discharge in the validation subgroup (36.5%, 53.6%, 60.8%, 83.3%, and 100%, respectively). PHD scores of 4 and 5 demonstrated substantially higher posttest than pretest probability, with moderate and high clinical effect value. Scores of 0 or 1 demonstrated substantially lower posttest than pretest probability.CONCLUSION: A PHD instrument may be useful in identifying patients most likely to be discharged to home from the GCU. Patients with low probability of home discharge may also be identified early.
The role of glutamate, calcium and magnesium in secondary brain injury
Authors: Leonard Susan E. , Kirby Rebecca 
Published: March 2003

AbstractObjective:To review the roles that glutamate, calcium and magnesium play in both normal brain function and in the events following traumatic brain injury.Human data synthesis:Elevated extracellular brain glutamate levels have been well documented in humans following traumatic brain injury. Therapies focusing on glutamate receptor antagonists have not yet been shown to have clinical effectiveness significant enough to outweigh the side effects. Newer strategies are currently being explored focusing on the many secondary cellular cascades interacting to culminate in cell injury and death.Veterinary data synthesis:Derangements in glutamate, calcium and magnesium have been well documented in animals following traumatic brain injury. Research studies using animal models other than small laboratory animals such as rats, mice and rabbits are very limited. Prospective veterinary clinical trials in dogs and cats are needed to determine the potential success that various therapeutic strategies might have in the field of small animal emergency and critical care medicine.Conclusions:Alterations in the levels of glutamate, calcium and magnesium play a critical role in secondary brain injury. The future development of clinically‐tolerated and effective antagonists of glutamate, glutamate receptors, and other downstream mediators has the potential to revolutionize the therapy of traumatic brain injured patients.
Hypericin as an inactivator of infectious viruses in blood components
Authors: Lavie G. , Mazur Y. , Lavie D. , Prince A. M. , Pascual D. , Liebes L. , Levin B. , Meruelo D. 
Published: March 2003

BACKGROUND: Hypericin is a potent virucidal agent with activity against a broad range of enveloped viruses and retroviruses. The effective virucidal activity emanates from a combination of photodynamic and lipophilic properties. Hypericin binds cell membranes (and, by inference, virus membranes) and crosslinks virus capsid proteins. This action results in a loss of infectivity and an inability to retrieve the reverse transcriptase enzymatic activity from the virion.STUDY DESIGN AND METHODS: Since hypericin is devoid of adverse action in most blood components and blood analyses, it is investigated as an additive with potential to inactivate infective viruses in blood components intended for transfusion.RESULTS: Complete inactivation of 10(6) tissue culture‐infective doses of human immunodeficiency virus was obtained in whole blood and in diluted packed red cells after illumination with fluorescent light for 1 hour. Loss of viral infectivity to cultured CEM cells has been monitored by use of a detection assay for human immunodeficiency virus p55 in enzyme‐linked immunosorbent assay and cytopathic assays. In physiologic media, hypericin interacts with albumin and lipoproteins, retaining the virucidal activity in bound form. The molecule is negatively charged and forms organic and inorganic monobasic salts (ion pairs) in physiologic pH. Various ion pairs differ in virucidal efficacy.CONCLUSION: The apparent transfusibility of hypericin, taken together with the efficacy of the virucidal activity, the broad range of enveloped viruses affected, and the absence of adverse effects on stored red cells, may render hypericin useful for inactivation of infectious viruses in red cells.
Contribution of polymerase chain reaction and radioimmunoprecipitation assay in the confirmation of human T‐lymphotropic virus infection in French blood donors
Authors: Defer C. , Coste J. , Descamps F. , Voisin S. , Lemaire J.‐M. , Maniez M. , Couroucé A.‐M. ,   Retrovirus Study Group of the French Society of Blood Transfusion
Published: March 2003

BACKGROUND: To verify the criteria for human T‐lymphotropic virus (HTLV) seropositivity in Western blot (WB) proposed by the Retrovirus Study Group of the French Society of Blood Transfusion, 186 blood donations that were repeatedly reactive in HTLV enzyme‐linked immunosorbent assay, selected according to their WB pattern, were tested by polymerase chain reaction (PCR) and radioimmunoprecipitation assay (RIPA).STUDY DESIGN AND METHODS: In two commercially available WBs, 12 samples were confirmed as positive (rgp21+p19+p24) and 174 were interpreted as indeterminate (one or two reactivities to these proteins). The primer pairs used for the PCR allowed the amplification of type I (HTLV‐I) or type II (HTLV‐II) (or both) sequences. The RIPA was performed with two 35S‐labeled cell lines: HTLV‐I infected HUT 102/B2 and HTLV‐II‐infected MoT.RESULTS: Of the 12 positive samples, 11 were classified as HTLV‐I‐positive and one as HTLV‐II‐positive. Among the 174 indeterminate samples, three (WB pattern: rgp21+, p19+, p24‐) were HTLV‐I positive in PCR (one of them was positive in RIPA also); the other 171 were HTLV negative.CONCLUSION: In the study of a population in which 97 percent of HTLV infections are due to HTLV‐I, these data support the three‐protein criteria (rgp21, p19, and p24) for a positive blot reading. No HTLV infection was observed when rgp21 did not react. Consequently, p19 and/or p24 band patterns represent false reactivity and do not require PCR or RIPA confirmation. To discriminate between false‐ and true‐positive results in the absence of MTA‐1 or K55 reactivity, PCR and/or RIPA is required only when rgp21 reactivity is associated with one gag band (p19 or p24).
Isoimmune neonatal neutropenia caused by Fc gamma RIIIb antibodies in a Spanish child
Authors: Puig N. , De Haas M. , Kleijer M. , Montoro J.A. , Perez A. , Villalba J.V. , Gomez I. , von dem Borne A.E. 
Published: March 2003

BACKGROUND: FcγRIIIB deficiency is a rare defect in which neutrophils do not express FcγRIIIB and therefore the individuals with this defect have an NA null phenotype. Soluble Fc gamma RIII in plasma is severely decreased and almost undetectable. During pregnancy, FcγRIIIB deficiency may cause the formation of maternal FcγRIIIB antibodies, which leads to an isoimmune neonatal neutropenia. The first known case of isoimmune neonatal neutropenia caused by these antibodies in a Spanish child was identified. CASE REPORT: A newborn infant was severely affected by omphalitis; analysis of his blood showed an absolute neutropenia, but he responded well on intravenous immunoglobulin therapy. The maternal antiserum reacted strongly with all tested FcγRIIIB‐positive neutrophils. A family study showed that the infant's mother, one of the mother's sisters, and her mother were FcγRIIIB deficient. No neutrophil antibodies were found in the plasma from these other FcγRIIIB‐negative women, although both had had numerous pregnancies. The three women were healthy, but one had recurrent otitis. DNA analysis of the family showed the absence of both FcγRIIIB genes in the three FcγRIIIB‐negative women. The father of the child and all the children of the FcγRIIIB gene‐deficient women were shown to lack one of the FcγRIIIB genes.CONCLUSION: A new case of isoimmune neonatal neutropenia caused by anti‐FcγRIIIB is identified. The family study indicates that the FcγRIIIB deficiency is a hereditary genetic defect. In accordance with the location of FcγRIIIB on chromosome 1, an autosomal pattern of inheritance of the FcγRIIIB‐deficient allele was observed.
Posttransfusion purpura following bone marrow transplantation
Authors: Evenson D.A. , Stroncek D.F. , Pulkrabek S. , Perry E.H. , Radford J. , Miller J.S. , Verfaillie C. 
Published: March 2003

BACKGROUND: Thrombocytopenia is a major cause of morbidity and hospital expense following bone marrow transplantation. Platelet transfusions in these patients are frequently complicated by the recipient's development of antibodies to HLA class I antigens. When these patients become refractory to the transfusion of HLA‐matched platelets, the recipient's platelet antigen phenotype must be determined, to ensure that donor platelets will be phenotypically compatible. Cases of alloimmunization to HPA‐1a and HPA‐1b resulting in refractoriness to transfused platelets and the subsequent development of a posttransfusion purpura‐like syndrome are reported. CASE REPORTS: In the first case, a 43‐year‐old woman with Stage IV infiltrating ductal breast cancer presented to the hospital for a transplant of autologous peripheral blood stem cells. After the transplant, her platelet count remained less than 10 × 109 per L, despite daily platelet transfusions, including HLA‐matched platelets. Fourteen days following the transplant, her serum was found to contain anti‐HPA‐1a. Initially, the patient was refractory to the transfusion of HPA‐1a‐negative platelets, but after treatment with intravenous immunoglobulin, she had transient increases in posttransfusion platelet counts. She was also treated with a staphylococcal protein A immunoadsorption column and has not had any such subsequent refractoriness. Her genotype has been found, by use of allele‐specific oligonucleotide hybridization with white cell DNA, to be HPA‐1b/1b. The second case involved a 32‐year‐old woman with chronic myelogenous leukemia who received an unrelated‐donor marrow transplant. Three years later, her CML recurred, and she was treated with interferon‐alpha. Four months afterward, she experienced interferon‐alpha‐induced thrombocytopenia and the interferon therapy was discontinued. She received 12 platelet transfusions in 20 days, but none was effective. Antibodies specific for HLA antigens and HPA‐1b were detected, and three HLA‐matched, HPA‐1b‐negative apheresis platelet components were given, but without effect. Two days after treatment with methylprednisolone (1 g intravenously) and prednisone (2 mg/kg/day orally), her platelet count was 26 × 109 per L, and after 8 more days, it was 102 × 109 per L, without further transfusions. She was found to be homozygous for HPA‐1a (HPA‐1a/1a).CONCLUSION: Anti‐HPA‐ 1a and anti‐HPA‐1b can cause refractoriness to platelet transfusions in bone marrow transplant patients. Testing for platelet‐specific antibodies should be considered in all patients who are refractory to HLA‐matched platelets.
Frequency and functional relevance of genetic threonine145/methionine145 dimorphism in platelet glycoprotein Ibα in an Italian population
Authors: Mazzucato M. , Pradella P. , Angelis V. de , Steffan A. , Marco L. de 
Published: March 2003

Background: Threonine145/methionine145 dimorphism in platelet glycoprotein (GP) Ibα defines the human platelet antigen (HPA)‐2 system that has been implicated in refractoriness to HLA‐matched platelet transfusion and in neonatal immune thrombocytopenic purpura.Study Design and Methods: The occurrence of this amino acid dimorphism was investigated in 379 Italian blood donors by studying their genomic DNA. Two oligonucleotide primers, Ibα‐3 (5′‐GGACGTCTCCTTCAACCGGC‐3′) and Ibα‐4 (5′‐GCTTTGGTGGGGAACTTGAC‐3′), were used in a polymerase chain reaction to generate a 591‐base pair fragment that was digested with the restriction enzyme Acy I. To investigate whether this dimorphism is involved in the binding of von Willebrand factor (vWF) to GPlb, the binding of vWF to the GPlb/IX complex was measured in two Met145/Met145 and two Thr145/Thr145 subjects.Results: The genotypic frequencies are 78.9% for Thr/Thr, 19.8% for Thr/Met), and 1.3% for Met/Met; the allelic frequencies are 88.8% for Thr145 and 11.2% for Met145. Estimates for binding of subunit molecules per platelet at saturation and inhibition constant in mol per L, respectively, follow. In the presence of ristocetin (0.5 mg/mL), they are 11,460 ± 2,040 and 1.26 ± 0.44 × 10−8 for normals and 11,230 ± 2,330 and 1.29 ± 0.48 × 10−8 for patients. In the presence of botrocetin (2.5 μg/mL), they are 64,260 ± 7,760 and 2.99 ± 0.96 × 10−8 for normals and 65,770 ± 11,570 and 2.47 ± 0.22 × 10−8 for patients. Platelet aggregation responses obtained using platelet‐rich plasma from donors with Met145/Met145 or Thr145/Thr145 genotype were within normal limits.Conclusion: Genotypic and phenotypic frequencies in the HPA‐2 system in this population are consistent with those reported among the white population. Furthermore, the HPA‐2 system is not involved in the binding of vWF to GPlb.
The effect of recombinant human erythropoietin on the efficacy of autologous blood donation in patients with low hematocrits: a multicenter, randomized, double‐blind, controlled trial
Authors: Price T. H. , Goodnough L. T. , Vogler W. R. , Sacher R. A. , Hellman R. M. , Johnston M. F.M. , Bolgiano D. C. , Abels R. I. 
Published: March 2003

Background: This randomized controlled study was undertaken to determine the effect of recombinant human erythropoietin (rHuEPO) on erythropoiesis, autologous blood collection, and allogeneic transfusion risk in elective surgery patients with low baseline hematocrits.Study Design and Methods: Patients (n = 204) with low baseline hematocrits (< or = 39%), scheduled for orthopedic surgery within 25 to 35 days, were seen every 3 to 4 days for 21 days. At each visit, 450 mL of blood was collected if the hematocrit was > or = 33 percent, and rHuEPO (600 U/kg) or placebo was administered intravenously.Results: One hundred seventy‐three patients were evaluable. The number of autologous units collected from the rHuEPO and control groups, respectively, was 4.5 ± 1.0 and 3.0 ± 1.1 (p < 0.001), and marrow production of red cells increased by 668 ± 222 and 353 ± 155 mL over and above baseline production (p < 0.05). Allogeneic blood transfusion was required by 31 percent of control and 20 percent of rHuEPO patients (p = 0.09). Excluding 8 patients who received > 6 units, 29 percent of control and 14 percent of rHuEPO patients required allogeneic blood (p = 0.015). Logistic regression modeling determined that the risk of allogeneic transfusion was reduced by rHuEPO (p = 0.025).Conclusion: The use of rHuEPO stimulates erythropoiesis, permits the storage of more autologous blood, and reduces allogeneic transfusion risk in patients with low hematocrits who are undergoing elective orthopedic surgery. Additional studies are necessary to determine the optimal schedules of rHuEPO administration and autologous blood collection as well as the cost‐effectiveness of this strategy.