31 results on '"Ruff ME"'
Search Results
2. Sleep Apnea and Vocal Cord Paralysis Secondary to Type I Chiari Malformation
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Fisher, Alexander Spock, Ruff Me, and Oakes Wj
- Subjects
business.industry ,Sleep apnea ,Apnea ,Airway obstruction ,Nasal congestion ,medicine.disease ,Obstructive sleep apnea ,Anesthesia ,Pediatrics, Perinatology and Child Health ,Medicine ,Vocal cord paralysis ,medicine.symptom ,business ,Syringomyelia ,Chiari malformation - Abstract
A previously healthy 13-year-old boy d boy wimyelo-myelo-dysplasia who had mild scoliosis was seen with complaints of nasal congestion, noisy nighttime breathing, and difficulty sleeping. Flattening of the inspiratory loop on the flow-volume curve was found on pulmonary function testing, suggesting a variable extrathoracic obstruction due to a laryngeal lesion. Bilateral abductor vocal cord paralysis and sleep apnea developed precipitously following general anesthesia. Further workup demonstrated a type-I Chiari malformation with syringomyelia. Brainstem abnormalities such as Chiari malformation with secondary tenth cranial nerve deficits should be considered in previously healthy children and adolescents with signs and symptoms of upper airway obstruction and apnea.
- Published
- 1987
3. 493 Suppression of the Late Cutaneous Response (LCR) by immunotherapy (IT)
- Author
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Fling, JA, primary, Ruff, ME, additional, Parker, WA, additional, Whisman, BA, additional, Martin, ME, additional, Moss, RB, additional, and Reid, MJ, additional
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- 1988
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4. Multi-Modal Pain Control in Ambulatory Hand Surgery.
- Author
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Harrison RK, DiMeo T, Klinefelter RD, Ruff ME, and Awan HM
- Subjects
- Acetaminophen therapeutic use, Adolescent, Adult, Aged, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Pain Measurement, Prospective Studies, Treatment Outcome, Young Adult, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Hand surgery, Ketorolac therapeutic use, Narcotics therapeutic use, Orthopedic Procedures methods, Pain Management methods, Pain, Postoperative drug therapy
- Abstract
We evaluated postoperative pain control and narcotic usage after thumb carpometacarpal (CMC) arthroplasty or open reduction and internal fixation (ORIF) of the distal radius in patients given opiates with or without other non-opiate medication using a specific dosing regimen. A prospective, randomized study of 79 patients undergoing elective CMC arthroplasty or ORIF of the distal radius evaluated postoperative pain in the first 5 postoperative days. Patients were divided into 4 groups: Group 1, oxycodone and acetaminophen PRN; Group 2, oxycodone and acetaminophen with specific dosing; Group 3, oxycodone, acetaminophen, and OxyContin with specific dosing; and Group 4, oxycodone, acetaminophen, and ketorolac with specific dosing. During the first 5 postoperative days, we recorded pain levels according to a numeric pain scale, opioid usage, and complications. Although differences in our data did not reach statistical significance, overall pain scores, opioid usage, and complication rates were less prevalent in the oxycodone, acetaminophen, and ketorolac group. Postoperative pain following ambulatory hand and wrist surgery under regional anesthesia was more effectively controlled with fewer complications using a combination of oxycodone, acetaminophen, and ketorolac with a specific dosing regimen., Competing Interests: Authors’ Disclosure Statement: The authors report no actual or potential conflict of interest in relation to this article.
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- 2018
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5. The Effect of Trigger Finger Injection Site on Injection-Related Pain.
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Rosenbaum YA, Benvenuti N, Yang J, Ruff ME, Awan HM, and Samora JB
- Subjects
- Dexamethasone administration & dosage, Disability Evaluation, Female, Humans, Male, Middle Aged, Prospective Studies, Visual Analog Scale, Glucocorticoids administration & dosage, Injections methods, Trigger Finger Disorder drug therapy
- Abstract
Background: Stenosing tenosynovitis, or trigger digit, is a common condition for which patients often seek relief. Corticosteroid injections have been shown to provide relief in many cases, and several different approaches for delivering the injection have been described in the literature. We compared patients' perception of pain following each of 3 accepted injection methods, namely, palmar proximal, palmar distal, and webspace approaches., Methods: We prospectively followed 38 patients with 39 symptomatic digits in this trial, with varying severities of trigger finger as graded by the Patel and Moradia classification. The patients were divided into 3 groups representing the 3 approaches without randomization, based upon the treating surgeons' preference. Disabilities of the Arm, Shoulder and Hand and visual analog scale (VAS) pain scores were calculated pre-injection and at 4-week and 8-week follow-up visits., Results: No statistically significant differences in age, sex, affected extremity, grade, or duration of symptoms were observed among the 3 approaches. No statistically significant differences in VAS score were found between the palmar proximal (mean = 6.6, SD = 2.6), palmar distal (mean = 6.0, SD = 2.8), and webspace (mean = 6.8, SD = 1.8) approaches., Conclusion: Our data suggest that injection approach does not affect patient pain perception scores or outcomes. We recommend that the technique that is most comfortable to the surgeon be utilized, with the understanding that one injection alone has a low likelihood of relieving symptoms.
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- 2018
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6. Current Trends in Treatment of Kienböck Disease: A Survey of Hand Surgeons.
- Author
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Kolovich GP, Kalu CM, and Ruff ME
- Abstract
Background: The cause and treatment of Kienböck disease is controversial. No treatment algorithm has been accepted. We surveyed US hand surgeons to determine trends and attitudes regarding the treatment of Kienböck disease., Methods: An online questionnaire was created focusing on specific treatments of Kienböck disease. The survey included 6 questions regarding the cause of disease, preferred vascularized bone grafting (VBG) procedure, and treatment of stages I, II, IIIA, and IIIB. Respondents were also asked to specify their geographic location of practice and the approximate number of years in practice., Results: A total of 338 of the 2781 surgeons contacted completed the survey for a response rate of rate of 12%. The majority of respondents believe ulnar-negative variance alone contributes to the development of Kienböck disease. For treatment of a young ulnar-neutral male with stage I disease who had failed immobilization and nonsteroidal anti-inflammatory drugs, most hand surgeons chose distal radius core decompression. There was no preferred treatment among respondents for treatment of a young ulnar-neutral female with stage II disease. For treatment of a 40-year-old ulnar-negative male with stage IIIA disease, most hand surgeons chose a radial shortening osteotomy. The preferred treatment among respondents for treatment of stage IIIB disease is a proximal row carpectomy., Conclusions: Our study demonstrated that most hand surgeons believe ulnar-negative variance largely contributes to Kienböck disease and the most commonly preferred VBG technique utilizes the fourth and fifth extensor compartment arteries.
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- 2016
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7. Fixation of Metacarpal Shaft Fractures: Biomechanical Comparison of Intramedullary Nail Crossed K-Wires and Plate-Screw Constructs.
- Author
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Curtis BD, Fajolu O, Ruff ME, and Litsky AS
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- Biomechanical Phenomena, Bone Nails, Bone Plates, Bone Screws, Bone Wires, Equipment Failure Analysis methods, Fracture Fixation, Internal methods, Fracture Fixation, Intramedullary instrumentation, Fracture Fixation, Intramedullary methods, Humans, Materials Testing methods, Prosthesis Failure, Fracture Fixation, Internal instrumentation, Fractures, Bone surgery, Internal Fixators, Metacarpal Bones injuries, Metacarpal Bones surgery
- Abstract
Objectives: Metacarpal (MC) fractures are very common, accounting for 18% of all fractures distal to the elbow. Many MC fractures can be treated non-operatively; however, some are treated most effectively with surgical stabilization, for which there are multiple methods. It was postulated that plates would have a significantly higher (P < 0.05) load to failure than crossed K(XK)-wires and that intramedullary metacarpal nails (IMNs) and XK-wires would have equivalent load to failure., Methods: Mid-diaphyseal transverse fractures were created in 36 synthetic metacarpals and stabilized using nails, XK-wires or non-locking plates. Three-point bending was performed with continuous recording of load and displacement. Statistical analysis was performed using single factor ANOVA and Scheffe's test. Statistical significance was defined as P < 0.05., Results: Biomechanical testing revealed significant differences between groups in load-to-failure. Average load to failure was significantly greater in the plate (1669 ± 322 N) than the XK-wire (146 ± 56 N) or IMN (110 ± 43 N) groups. The loads to failure of the K-wires and nails were equivalent. Plates were 11 and 15 times stronger in three-point bending than the K-wires and nails, respectively. There was no statistically significant difference between strengths of the K-wires and nails., Conclusions: Although plates are the most stable means of fixation of midshaft metacarpal fractures, if minimally-invasive techniques are indicated, intramedullary nails may provide equivalent stability as commonly-used XK-wires. Although some studies have shown favorable clinical outcomes with IMNs, additional clinical correlation of these biomechanical results to fracture healing and outcomes is needed., (© 2015 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.)
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- 2015
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8. Rheumatoid nodules.
- Author
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Munns JJ and Ruff ME
- Subjects
- Evidence-Based Medicine, Female, Hand, Humans, Middle Aged, Rheumatoid Nodule surgery, Treatment Outcome, Rheumatoid Nodule therapy
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- 2014
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9. Outcomes after injury to the thumb ulnar collateral ligament--a systematic review.
- Author
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Samora JB, Harris JD, Griesser MJ, Ruff ME, and Awan HM
- Subjects
- Arthroplasty, Autografts, Humans, Collateral Ligaments injuries, Hand Injuries surgery
- Abstract
Objectives: Rupture of the ulnar collateral ligament (UCL) is a frequent injury of the hand. When untreated, this injury may lead to decreased pinch strength, pain, instability, and osteoarthritis. There is currently no consensus on treatment of acute or chronic UCL injuries. Our primary purpose was to compare nonoperative treatment with surgical repair and surgical reconstruction of thumb UCL injuries. A secondary purpose was to compare graft choice and surgical technique for reconstruction., Data Sources: A systematic review of multiple medical databases was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines with specific inclusion and exclusion criteria. Clinical outcome studies after nonoperative or operative treatment of thumb UCL injuries, with a minimum of 2 years mean follow-up, were included. Pain, range of motion, key-pinch strength, and stability testing were used as outcome measures., Main Results: Fourteen articles were included and analyzed (293 thumbs). All but 2 were level IV evidence. Mean Quality Appraisal Tool score was 13.1 (55% overall rating study methodological quality). Thirty-two thumbs were treated nonoperatively and 261 operatively. Mean subject age was 33.9 years. There were 200 acute injuries and 93 chronic injuries. Mean study follow-up was 42.8 months. Nonoperative treatment often failed, necessitating surgery. Acute UCL repair and autograft UCL reconstruction for chronic injury led to excellent clinical outcomes, without a significant difference between the 2 groups. After significant delay to treatment or even failed nonoperative treatment, excellent clinical outcomes can be achieved, without a difference between initially treating the injury surgically. Complications after surgery were rare., Conclusions: This review has demonstrated excellent clinical outcomes after surgical treatment of both acute and chronic UCL injury, without any significant difference between repair and reconstruction for acute and chronic injury, respectively.
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- 2013
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10. Solitary enchondroma of the phalanx.
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Jacobson ME and Ruff ME
- Subjects
- Adult, Baseball injuries, Bone Neoplasms diagnostic imaging, Bone Neoplasms therapy, Casts, Surgical, Chondroma diagnostic imaging, Chondroma therapy, Combined Modality Therapy, Education, Medical, Continuing, Female, Follow-Up Studies, Fracture Healing physiology, Fractures, Bone diagnostic imaging, Fractures, Bone therapy, Fractures, Spontaneous diagnostic imaging, Fractures, Spontaneous therapy, Humans, Orthopedic Procedures methods, Radiography, Risk Assessment, Treatment Outcome, Bone Neoplasms pathology, Chondroma pathology, Finger Phalanges pathology, Fractures, Spontaneous pathology
- Published
- 2011
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11. A simple method for comparing microarray genotype data between brain and other tissues.
- Author
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Ruff ME and Pamphlett R
- Subjects
- Amyotrophic Lateral Sclerosis genetics, DNA genetics, Female, Gene Dosage genetics, Genotype, Humans, Loss of Heterozygosity genetics, Male, Middle Aged, Molecular Biology methods, Mosaicism, Software standards, User-Computer Interface, Brain Chemistry genetics, DNA analysis, Gene Expression Profiling methods, Oligonucleotide Array Sequence Analysis methods, Polymorphism, Single Nucleotide genetics, Software trends
- Abstract
A number of software packages are currently available to analyse the large amounts of single nucleotide polymorphism (SNP) data generated using microarrays. However, for less usual datasets, such as those involving DNA from different types of tissue in cases and controls, investigators need a program that can be tailored to their particular needs. The purpose of this study was to demonstrate a flexible method of analysing SNP data derived from Affymetrix 500K GeneChips without the need for an array-dedicated software package. SNP genotype calls from white cell and brain DNA samples from patients with amyotrophic lateral sclerosis and controls were imported into a Microsoft Access((R)) database and analysed in two ways. The first used database "queries" designed through the Access graphical user interface. The second involved scripts written with the Visual Basic software that is supplied with Access. Both the queries and scripts performed simple two-way comparisons as well as three-way comparisons between genotypes, which is vital when comparing genotypes in different tissues in cases and controls. A similar method could be used to compare copy number changes derived from SNP intensities between multiple datasets. This flexible method can easily be customised by the investigator and would be of use in comparing microarray SNP data between multiple datasets, in particular where somatic mosaicism was suspected.
- Published
- 2008
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12. Once-daily ciclesonide in children: efficacy and safety in asthma.
- Author
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Gelfand EW, Georgitis JW, Noonan M, and Ruff ME
- Subjects
- Albuterol therapeutic use, Bronchodilator Agents therapeutic use, Child, Child, Preschool, Dose-Response Relationship, Drug, Double-Blind Method, Drug Administration Schedule, Forced Expiratory Volume, Humans, Hydrocortisone blood, Hydrocortisone urine, Metered Dose Inhalers, Quality of Life, Severity of Illness Index, Treatment Outcome, Adrenal Cortex Hormones therapeutic use, Asthma drug therapy, Pregnenediones therapeutic use
- Abstract
Objective: To compare the efficacy and safety of once-daily inhaled ciclesonide 40 mug (CIC40), 80 mug (CIC80), and 160 mug (CIC160) with placebo in children with persistent asthma of all severities., Study Design: Overall, 1031 children age 4 to 11 years were randomized into 2 identical double-blinded, placebo-controlled, parallel group studies consisting of a run-in phase followed by 12 weeks of treatment. Both studies were designed to allow for a prespecified integrated analysis. The primary outcome variable was change in forced expiratory volume in 1 second (FEV(1)) percent predicted between baseline and study end; treatment comparisons were assessed using analysis of covariance. Additional endpoints included asthma symptom scores, daily albuterol use, and safety, including hypothalamic-pituitary-adrenal (HPA) axis function., Results: Baseline characteristics were comparable; 59.4% of patients had moderate asthma, and 24.1% had severe asthma. All ciclesonide doses were associated with greater improvements in baseline to week 12 FEV(1) percent predicted versus placebo (CIC40, 11.97; CIC80, 13.58, P <.05; CIC160, 14.17, P < .01). Significant improvements in asthma symptoms (P < .01) and reductions in albuterol use were reported. Ciclesonide was well tolerated with no effect on HPA axis function., Conclusions: In this integrated analysis, ciclesonide was effective and well tolerated in children with persistent asthma.
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- 2006
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13. Attention deficit disorder and stimulant use: an epidemic of modernity.
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Ruff ME
- Subjects
- Adolescent, Attention Deficit Disorder with Hyperactivity ethnology, Child, Child, Preschool, Cultural Characteristics, Humans, Life Style, Social Environment, Attention Deficit Disorder with Hyperactivity drug therapy, Attention Deficit Disorder with Hyperactivity etiology, Central Nervous System Stimulants administration & dosage
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- 2005
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14. Efficacy and safety of dry powder fluticasone propionate in children with persistent asthma.
- Author
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LaForce CF, Pearlman DS, Ruff ME, Silvers WS, Weinstein SW, Clements DS, Brown A, Duke S, Harding SM, and House KW
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- Child, Child, Preschool, Double-Blind Method, Female, Fluticasone, Forced Expiratory Volume drug effects, Humans, Male, Powders, Therapeutic Equivalency, Androstadienes pharmacokinetics, Androstadienes therapeutic use, Anti-Asthmatic Agents pharmacokinetics, Anti-Asthmatic Agents therapeutic use, Asthma drug therapy
- Abstract
Background: Flovent Diskus is a powder formulation of the inhaled corticosteroid fluticasone propionate (FP) delivered via a breath-actuated, multidose inhaler., Objective: To determine the efficacy and safety of dry powder FP administered once or twice daily (200 microg per day) to children with persistent asthma., Methods: Twelve-week, randomized, double-blind, placebo-controlled, multicenter trial with a 52-week, open-label extension. Children aged 4 to 11 were required to have pulmonary function 50% to 85% of predicted values. The population was stratified for baseline therapy (inhaled corticosteroid/cromolyn or bronchodilators only). After a 2-week placebo run-in, 242 patients received dry powder FP 200 microg each morning, dry powder FP 100 microg BID, or placebo for 12 weeks; 192 were rerandomized to the QD or BID regimen for an additional 52 weeks of open-label treatment. Primary endpoints were mean changes in FEV1 and morning PEF recorded at clinic visits., Results: Both dry powder FP regimens significantly improved FEV1, evening PEF, and asthma symptoms at the double-blind phase endpoint (P < or = .017 compared with placebo). The BID regimen also significantly improved morning PEF and nighttime awakenings due to asthma (P < or = .005). Among patients previously treated with inhaled corticosteroids/cromolyn, improvements observed with the QD and BID regimens were similar. Patients switched from BID to open-label QD treatment showed additional improvements at week 52 generally comparable to patients who received the BID regimen during both phases. Fluticasone propionate was well tolerated for up to 64 weeks with few reports of drug-related adverse events or morning plasma cortisol abnormalities., Conclusions: Once daily dosing of dry powder FP 200 microg is an effective and convenient alternative for children whose asthma is controlled with a more frequent dosing regimen of inhaled corticosteroids.
- Published
- 2000
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15. Absence of growth retardation in children with perennial allergic rhinitis after one year of treatment with mometasone furoate aqueous nasal spray.
- Author
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Schenkel EJ, Skoner DP, Bronsky EA, Miller SD, Pearlman DS, Rooklin A, Rosen JP, Ruff ME, Vandewalker ML, Wanderer A, Damaraju CV, Nolop KB, and Mesarina-Wicki B
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- Administration, Intranasal, Anti-Inflammatory Agents adverse effects, Child, Double-Blind Method, Female, Glucocorticoids, Growth Disorders chemically induced, Humans, Male, Mometasone Furoate, Pregnadienediols adverse effects, Anti-Inflammatory Agents therapeutic use, Growth drug effects, Pregnadienediols therapeutic use, Rhinitis, Allergic, Perennial drug therapy
- Abstract
Objective: Intranasal corticosteroids are used widely for the treatment of allergic rhinitis because they are effective and well tolerated. However, their potential to suppress growth of pediatric subjects with allergic rhinitis continues to be a concern, particularly in light of reports of growth suppression after treatment with intranasal beclomethasone dipropionate or intranasal budesonide (see the article by Skoner et al in this month's issue). A 1-year study of prepubertal patients between 3 and 9 years of age with perennial allergic rhinitis was conducted to assess the effects on growth of mometasone furoate aqueous nasal spray (MFNS), a new once-daily (QD) intranasal corticosteroid with negligible bioavailability., Methods: This was a randomized, placebo-controlled, double-blind, multicenter study. Ninety-eight subjects were randomized to treatment with either MFNS 100 microg QD or placebo for 1 year. Each subject's height was required to be between the 5th and 95th percentile at baseline, and skeletal age at screening was required to be within 2 years of chronological age, as determined by left wrist x-rays. Washout periods for medications that affect either childhood growth or allergic rhinitis symptoms were established based on estimated period of effect, and these medications were prohibited during the study. However, short courses of either oral prednisone lasting no longer than 7 days or low-potency topical dermatologic corticosteroids lasting no longer than 10 days were permitted if necessary. Height was measured with a calibrated stadiometer at baseline and at 4, 8, 12, 26, 39, and 52 weeks, and the primary safety variable was the change in standing height. The rate of growth was also calculated for each subject as the slope (linear regression) of the change in height from baseline using data from all visits of subjects who had at least 2 visits. Hypothalamic-pituitary-adrenocortical- (HPA)-axis function was assessed via cosyntropin stimulation testing at baseline and at 26 and 52 weeks. All analyses were based on all randomized subjects (intent-to-treat principle). The change from baseline in standing height was analyzed by a 2-way analysis of variance that extracted sources of variation attributable to treatment, center, and treatment-by-center interaction., Results: Demographic characteristics were similar at baseline. Eighty-two subjects completed the study (42 in the MFNS group and 40 in the placebo group), and 93% of subjects achieved at least 80% compliance with therapy. After 1 year of treatment, no suppression of growth was seen in subjects treated with MFNS, and mean standing heights were similar for both treatment groups at all time points. For the primary safety variable (change in height from baseline), both treatment groups were similar at all time points except for weeks 8 and 52. Subjects treated with MFNS had a slightly greater mean increase in height than subjects treated with placebo at these time points: the change in height was 6.95 cm versus 6.35 cm at the 1-year time point. However, the rate of growth (.018 cm/day) averaged for all time points over the course of the study was similar for both treatment groups. Additional analyses found that MFNS did not retard growth in any sex or age subgroup of subjects. The use of exogenous corticosteroids other than the study drug was also similar among the 2 treatment groups. Results from cosyntropin stimulation testing confirmed the absence of systemic effects of MFNS. The change from baseline in the difference between prestimulation and poststimulation levels was similar for both treatment groups after 1 year of treatment, with no evidence of HPA-axis suppression in MFNS-treated subjects at any time point. Incidences of treatment-related adverse events were similar for both treatment groups, with 16% of MFNS-treated subjects reporting adverse events, compared with 22% of placebo-treated subjects., Conclusions: (ABSTRACT TRUNCATED)
- Published
- 2000
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16. A dose-ranging study of mometasone furoate aqueous nasal spray in children with seasonal allergic rhinitis.
- Author
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Meltzer EO, Berger WE, Berkowitz RB, Bronsky EA, Dvorin DJ, Finn AF, Galant SP, Grossman J, Hampel FC, Ratner PH, Ruff ME, Schenkel EJ, Segal AT, Segall N, Stewart GE 2nd, Tripathy I, Skoner DP, Anolik R, Dockhorn RJ, van Bavel J, Mesarina-Wicki B, and Nolop K
- Subjects
- Administration, Intranasal, Anti-Inflammatory Agents pharmacokinetics, Child, Child, Preschool, Dose-Response Relationship, Drug, Double-Blind Method, Drug Tolerance, Female, Glucocorticoids, Humans, Male, Mometasone Furoate, Placebos, Pregnadienediols pharmacokinetics, Therapeutic Equivalency, Anti-Inflammatory Agents administration & dosage, Pregnadienediols administration & dosage, Rhinitis, Allergic, Seasonal drug therapy
- Abstract
Background: The efficacy and safety of mometasone furoate aqueous nasal spray (MFNS; Nasonex) 200 microg once daily for the treatment and prophylaxis of seasonal allergic rhinitis (SAR) and treatment of perennial rhinitis have been demonstrated in adults. However, the dose response of MFNS in pediatric patients has not yet been characterized., Objective: This study was conducted to determine the dose-response relationship of 3 different doses of MFNS in a pediatric population., Methods: This was a multicenter, double-blind, active- and placebo-controlled study of 679 children 6 to 11 years of age with histories of SAR and documented positive skin test responses. Patients were randomized to one of the following treatment groups for 4 weeks: MFNS 25 microgram once daily, MFNS 100 microgram once daily, MFNS 200 microgram once daily, beclomethasone dipropionate 84 microgram twice daily (168 microgram/day), or placebo. Physician evaluations were performed at days 4, 8, 15, and 29, and patient evaluations were analyzed for days 1 to 15 and 16 to 29., Results: The mean reduction from baseline in physician-evaluated total nasal symptom scores at day 8 (the primary efficacy variable) was significantly greater in the MFNS and beclomethasone dipropionate groups than in the placebo group (P =.02). No significant differences were observed among the 3 MFNS groups. However, as treatment continued, symptoms in patients treated with MFNS 100 or 200 microgram once daily continued to improve, whereas those treated with MFNS 25 microgram once daily demonstrated little further improvement. By day 29, MFNS 100 and 200 microgram once daily both were significantly more effective than MFNS 25 microgram once daily in relieving symptoms of SAR, but MFNS 200 microgram provided no additional benefit over MFNS 100 microgram. All doses of MFNS were well tolerated, and cosyntropin stimulation tests performed before and after treatment found no evidence of hypothalamic-pituitary-adrenal axis suppression., Conclusion: These results indicate that the most appropriate therapeutic dosage of MFNS in the treatment of SAR in children 6 to 11 years of age is 100 microgram once daily. In addition, MFNS at doses up to 200 microgram once daily for 4 weeks was well tolerated and had no detectable effects on hypothalamic-pituitary-adrenal axis function.
- Published
- 1999
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17. Escherichia coli septicemia in nonperforated appendicitis.
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Ruff ME, Friedland IR, and Hickey SM
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- Adolescent, Anti-Bacterial Agents therapeutic use, Appendectomy, Appendicitis therapy, Bacteremia blood, Child, Combined Modality Therapy, Escherichia coli Infections blood, Humans, Incidence, Male, Preoperative Care, Retrospective Studies, Rupture, Spontaneous, Appendicitis epidemiology, Appendicitis microbiology, Bacteremia complications, Escherichia coli Infections complications
- Abstract
Objective: To determine the association between nonperforated appendicitis and Escherichia coli septicemia, and the frequency with which blood cultures are obtained in the clinical setting of appendicitis., Design: Three case reports of E coli septicemia and nonperforated appendicitis and a retrospective survey., Setting: Children's Medical Center, Dallas, Tex, a primary care and tertiary referral center., Patients: All children admitted in a 2-year period with a diagnosis of appendicitis., Interventions: None., Results: Preoperative blood cultures were obtained in 20 (21%) of 96 patients with histologic evidence of appendicitis. Fifty percent of the patients had gross or microscopic evidence of appendiceal perforation. Twelve (25%) of the 48 patients with perforated appendicitis had blood cultures obtained before the initiation of antimicrobial therapy, and in two of these patients (17%) the results were positive. Blood cultures were drawn before antibiotic therapy in four (8%) of the 48 patients with nonperforated appendicitis, and in two of these the results were positive. The blood culture isolates (coagulase-negative Staphylococcus and E coli) were the same in both groups., Conclusions: Nonperforated appendicitis and septicemia may be more common than formerly appreciated. Only a prospective study can determine the true incidence of septicemia in children with perforated or nonperforated appendicitis.
- Published
- 1994
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18. Quantification of error in measurement of radial inclination angle and radial-carpal distance.
- Author
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DiBenedetto MR, Lubbers LM, Ruff ME, Nappi JF, and Coleman CR
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- Anthropometry, Carpal Bones diagnostic imaging, Humans, Radiography, Radius diagnostic imaging, Carpal Bones anatomy & histology, Radius anatomy & histology
- Abstract
Posteroanterior wrist radiographs of eight patients were evaluated by eight orthopedists. Radial inclination angle and radial-carpal distance were measured by use of a standardized technique. The standard deviation for radial inclination angle was 2 degrees. The standard deviation for radial-carpal distance was 1 mm. The measured rotational variation of radial inclination and radial-carpal distance is 1 degree and 1 mm, respectively, through a 10-degree arc of supination and pronation.
- Published
- 1991
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19. Radiological case of the month. Neonatal appendicitis with perforation.
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Ruff ME, Southgate WM, and Wood BP
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- Appendicitis pathology, Appendicitis surgery, Diagnosis, Differential, Humans, Infant, Newborn, Intestinal Perforation pathology, Intestinal Perforation surgery, Male, Radiography, Rupture, Spontaneous, Appendicitis diagnostic imaging, Intestinal Perforation diagnostic imaging
- Published
- 1991
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20. Antimicrobial drug suspensions: a blind comparison of taste of fourteen common pediatric drugs.
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Ruff ME, Schotik DA, Bass JW, and Vincent JM
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- Adult, Humans, Single-Blind Method, Smell, Suspensions, Anti-Infective Agents administration & dosage, Taste
- Abstract
Children of preschool age most often receive medications in liquid form, and smell and taste are major determinants in achieving compliance. We compared smell, taste and other characteristics of 14 commonly prescribed antimicrobial suspensions in a blind test in 30 adult volunteers to determine whether there was a difference in their acceptability. A significant difference was observed with cephalosporins ranking highest and penicillins ranking lowest. Our findings support anecdotal observations and claims often made by parents that cephalosporin antimicrobial suspensions taste good and are readily accepted by children and that penicillin suspensions have an unpleasant taste and aftertaste and are poorly accepted. Other drugs had intermediate scores. Of the two erythromycin suspensions evaluated, Ilosone tested superior to Erythromycin ES.
- Published
- 1991
21. Impetigo. Current etiology and comparison of penicillin, erythromycin, and cephalexin therapies.
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Demidovich CW, Wittler RR, Ruff ME, Bass JW, and Browning WC
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- Adolescent, Child, Child, Preschool, Female, Humans, Impetigo microbiology, Infant, Male, Microbial Sensitivity Tests, Random Allocation, Streptococcal Infections drug therapy, Cephalexin therapeutic use, Erythromycin therapeutic use, Impetigo drug therapy, Penicillins therapeutic use, Staphylococcal Infections drug therapy
- Abstract
We attempted to determine the causative bacterial pathogens of impetigo in children in our area, to compare the effectiveness of three frequently used oral antimicrobial treatment regimens, and to correlate the antimicrobial sensitivity of the bacterial isolates with clinical responses to treatment. Seventy-three children with impetigo were randomly assigned to receive penicillin V potassium or cephalexin monohydrate, both administered in dosages of 40 to 50 mg/kg per day, or erythromycin estolate administered in a dosage of 30 to 40 mg/kg per day. All drugs were given in three divided doses for 10 days. Treatment failure was defined as persistence of lesions 8 to 10 days after initiation of drug therapy as determined by examiners blinded to the treatment therapies. Forty-five (62%) cultures showed Staphylococcus aureus only, 14 (19%) showed S aureus and group A beta-hemolytic streptococci, six (8%) showed group A beta-hemolytic streptococci only, and eight (11%) showed no growth or other organisms. Treatment failure occurred in six (24%) of 25 patients treated with penicillin V, one (4%) of 25 patients treated with erythromycin estolate, and no patients treated with cephalexin. We conclude that S aureus is the most common cause of impetigo in children in our study population, that cephalexin is the most effective treatment, that erythromycin estolate is nearly equally effective and may be preferred on a cost-effectiveness basis, and that penicillin V is inadequate for treatment of this infection.
- Published
- 1990
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22. Doppler mapping in hypothenar syndrome: an alternative to angiography.
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DiBenedetto MR, Nappi JF, Ruff ME, and Lubbers LM
- Subjects
- Adult, Hand Injuries diagnosis, Humans, Male, Thrombosis etiology, Hand Injuries complications, Thrombosis diagnosis, Ulna blood supply, Ultrasonography
- Abstract
Four patients with hypothenar hammer syndrome were evaluated preoperatively with Doppler mapping and angiography. Both tests documented ulnar artery occlusion. In one patient, the proximal extent of thrombosis could not be identified by angiography. In all cases Doppler mapping accurately documented the extent of occlusion as confirmed by surgical exploration. Doppler mapping is a noninvasive alternative to angiography in the evaluation of hypothenar hammer syndrome.
- Published
- 1989
- Full Text
- View/download PDF
23. Acute thoracic kyphosis in Gaucher's disease. A case report.
- Author
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Ruff ME, Weis LD, and Kean JR
- Subjects
- Acute Disease, Bone Transplantation, Casts, Surgical, Child, Female, Fractures, Spontaneous surgery, Humans, Kyphosis diagnostic imaging, Kyphosis surgery, Radiography, Spinal Fusion, Thoracic Vertebrae diagnostic imaging, Thoracic Vertebrae surgery, Fractures, Spontaneous complications, Gaucher Disease complications, Kyphosis etiology
- Published
- 1984
- Full Text
- View/download PDF
24. Treatment of subtrochanteric fractures with a sliding screw-plate device.
- Author
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Ruff ME and Lubbers LM
- Subjects
- Adult, Fracture Fixation, Intramedullary instrumentation, Hip Fractures diagnostic imaging, Humans, Ossification, Heterotopic, Postoperative Complications epidemiology, Radiography, Thrombophlebitis epidemiology, Urinary Tract Infections epidemiology, Bone Plates, Bone Screws, Fracture Fixation, Intramedullary methods, Hip Fractures surgery
- Abstract
In a series of 45 subtrochanteric fractures treated with a sliding screw-plate device, union was achieved in 43 patients (95.3%). Most were Seinsheimer Type II C (9), Type IIIA (12), and Type V (18). Fractures were stabilized in a valgus position (average, 140 degrees), with primary medial displacement of the femoral shaft (25 patients). Radiographic analysis of the degree of postoperative impaction of the fragments correlated with the fracture pattern. Fractures with medial cortical comminution such as Type IIIA and Type V were the most unstable, with an average of 10.8 and 8.0 mm axial impaction, respectively, and were at the greatest risk of complication. The sliding screw-plate device is a reliable method of achieving union in subtrochanteric fractures.
- Published
- 1986
- Full Text
- View/download PDF
25. Suppression of the late cutaneous response by immunotherapy.
- Author
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Fling JA, Ruff ME, Parker WA, Whisman BA, Martin ME, Moss RB, and Reid MJ
- Subjects
- Adolescent, Adult, Aged, Allergens administration & dosage, Allergens immunology, Antibody Specificity, Double-Blind Method, Female, Humans, Hypersensitivity, Delayed therapy, Hypersensitivity, Immediate therapy, Immunoglobulin G classification, Male, Middle Aged, Plant Extracts administration & dosage, Plant Extracts immunology, Prospective Studies, Rhinitis, Allergic, Seasonal immunology, Rhinitis, Allergic, Seasonal therapy, Trees immunology, Desensitization, Immunologic, Hypersensitivity, Delayed immunology, Intradermal Tests, Skin Tests
- Abstract
In a prospective, double-blind, placebo-controlled study, we examined the effect of mountain cedar (MC) immunotherapy on the MC-induced late cutaneous response (LCR). Fourteen MC-sensitive patients were intradermally skin tested before and after immunotherapy with MC extract. We measured the size of the wheal at 15 minutes and the area of tissue swelling at 6 hours. Patients were matched by the size of the LCR and started receiving either MC immunotherapy or placebo immunotherapy. MC-specific immunoglobulins (MC sIgG, MC sIgG1, MC sIgG4, and MC sIgE) were measured by ELISA. Symptom-medication scores (SMSs) were recorded on a daily basis during the MC season and tabulated at the end of the study. Comparison of the 14 paired patients revealed no significant differences between MC-treated and placebo-treated groups in preimmunotherapy MC sIgG1 and SIgG4. However, when MC immunotherapy was compared to placebo immunotherapy, patients receiving MC immunotherapy developed significantly higher MC sIgG1 (p less than 0.04) and MC sIgG4 (p less than 0.01) after immunotherapy. Patients receiving MC immunotherapy also demonstrated significantly greater suppression of the LCR after immunotherapy (p less than 0.005) with the postimmunotherapy LCR correlating significantly with both MC sIgG4 (rs = 0.715; p = 0.008) and cumulative dose of MC received (rs = 0.808; p = 0.004). MC sIgE was similar in both groups after immunotherapy. The reduction in SMSs in the MC-treated group did not reach significance, nor was there a correlation of SMSs with MC sIgE, sIgG, sIgG1, or sIgG4.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1989
- Full Text
- View/download PDF
26. Phenytoin-induced IgA depression.
- Author
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Ruff ME, Pincus LG, and Sampson HA
- Subjects
- Adolescent, Child, Child, Preschool, Depression, Chemical, Humans, Immunoglobulin G analysis, Immunoglobulin M analysis, Infant, Phenytoin blood, Seizures drug therapy, Anticonvulsants adverse effects, Immunoglobulin A analysis, Phenytoin adverse effects
- Abstract
In a survey of 1011 pediatric patients with seizure disorders, 93 children (9.2%) were found to have depressed serum IgA concentrations when compared with age-matched controls; 27 of these values were less than 0.1 g/L (less than 10 mg/dL). Two thirds (64/93) of these patients were being treated with phenytoin, and ten had been previously treated with phenytoin. No relationship between IgA deficiency and serum phenytoin concentration nor use of other anticonvulsant medications was found. The prevalence of phenytoin-induced IgA depression was similar in patients with "primary" or "secondary" seizure disorders. Approximately 40% of the patients with low serum IgA concentrations had mild to moderate depression of serum IgG and/or IgM concentrations when compared with age-matched controls.
- Published
- 1987
- Full Text
- View/download PDF
27. Sunflower oil is not allergenic to sunflower seed-sensitive patients.
- Author
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Halsey AB, Martin ME, Ruff ME, Jacobs FO, and Jacobs RL
- Subjects
- Adult, Anaphylaxis, Female, Humans, Immunoglobulin E immunology, Sunflower Oil, Food Hypersensitivity immunology, Helianthus immunology, Plant Oils immunology, Seeds immunology
- Abstract
The allergenicity of edible oils derived from sunflower seeds was investigated in two patients with anaphylactic sensitivity to sunflower seeds. Specific IgE-mediated hypersensitivity to sunflower seed was demonstrated by history, prick skin tests, positive passive transfer skin test, and RAST. Specific IgE directed toward sunflower oil, refined or cold pressed, could not be conclusively demonstrated. The Prausnitz-Küstner reaction with sunflower oils performed with one patient's serum was negative. Although the cold-pressed sunflower oil was found to contain a minute amount of protein, open challenge with the derivative oils resulted in no immediate or delayed reaction in the two patients studied. Sunflower oil ingestion in these patients who were highly sensitive to the parent material proved safe. Nonallergenicity of derivative products needs to be proven for each case.
- Published
- 1986
- Full Text
- View/download PDF
28. Severe combined immunodeficiency (SCID) with natural killer (NK) cell predominance.
- Author
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Buckley RH, Gard S, Haynes BF, Sindel LJ, Davis K, Sampson HA, Ruff ME, and Koren HS
- Subjects
- Acute Disease, Bone Marrow Transplantation, Female, Flow Cytometry, Humans, Immunologic Deficiency Syndromes therapy, Infant, Infant, Newborn, Killer Cells, Natural classification, Leukocyte Count, Phenotype, Time Factors, Immunologic Deficiency Syndromes immunology, Killer Cells, Natural immunology
- Published
- 1983
29. Protective effect of beta-adrenergic blockade and hypothermia on myocardial ultrastructure.
- Author
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Ruff ME, Karayannacos PE, Baba N, Kakos GS, Vasko JS, Williams TE, and Kilman JW
- Subjects
- Animals, Cardiopulmonary Bypass, Coronary Disease drug therapy, Dogs, Female, Heart Arrest drug therapy, Male, Perfusion, Statistics as Topic, Adrenergic beta-Antagonists therapeutic use, Hypothermia, Induced, Myocardium ultrastructure
- Published
- 1980
- Full Text
- View/download PDF
30. Sleep apnea and vocal cord paralysis secondary to type I Chiari malformation.
- Author
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Ruff ME, Oakes WJ, Fisher SR, and Spock A
- Subjects
- Adolescent, Humans, Male, Arnold-Chiari Malformation complications, Sleep Apnea Syndromes etiology, Vocal Cord Paralysis etiology
- Abstract
A previously healthy 13-year-old boy without myelodysplasia who had mild scoliosis was seen with complaints of nasal congestion, noisy nighttime breathing, and difficulty sleeping. Flattening of the inspiratory loop on the flow-volume curve was found on pulmonary function testing, suggesting a variable extrathoracic obstruction due to a laryngeal lesion. Bilateral abductor vocal cord paralysis and sleep apnea developed precipitously following general anesthesia. Further workup demonstrated a type-I Chiari malformation with syringomyelia. Brainstem abnormalities such as Chiari malformation with secondary tenth cranial nerve deficits should be considered in previously healthy children and adolescents with signs and symptoms of upper airway obstruction and apnea.
- Published
- 1987
31. Selective hindfoot arthrodesis in rheumatoid arthritis.
- Author
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Ruff ME and Turner RH
- Abstract
Rheumatoid arthritis that involves the hindfoot is disabling because it affects the patient's ability to walk. Fifteen patients with ankle pain who demonstrated isolated hindfoot arthritis clinically and radiographically underwent 19 selective hindfoot arthrodeses. At followup averaging 3 ½ years, results were rated good in 16, fair in four, and none were rated poor. Selective hindfoot fusion is effective in relieving pain and restoring the foot to ambulatory status., (Copyright 2013, SLACK Incorporated.)
- Published
- 1984
- Full Text
- View/download PDF
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