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Unknown  |  1992-06-06  |  92.4 KB

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hex view
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|00001dd0| 20 6f 75 74 63 6f 6d 65 | 2c 20 61 6e 64 20 61 67 | outcome|, and ag|
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|00001e30| 6e 6a 75 72 79 20 72 65 | 68 61 62 69 6c 69 74 61 |njury re|habilita|
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|00001e50| 7d 0d 0a 24 4a 6f 75 72 | 6e 61 6c 7b 4a 41 4d 41 |}..$Jour|nal{JAMA|
|00001e60| 7d 0d 0a 24 56 6f 6c 75 | 6d 65 7b 32 36 30 7d 0d |}..$Volu|me{260}.|
|00001e70| 0a 24 50 61 67 65 7b 31 | 32 35 35 2d 31 32 35 38 |.$Page{1|255-1258|
|00001e80| 7d 0d 0a 24 44 61 74 65 | 7b 53 65 70 74 20 32 2c |}..$Date|{Sept 2,|
|00001e90| 20 31 39 38 38 7d 0d 0a | 24 59 42 56 6f 6c 7b 31 | 1988}..|$YBVol{1|
|00001ea0| 39 38 39 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |989 Year| Book of|
|00001eb0| 20 52 65 68 61 62 69 6c | 69 74 61 74 69 6f 6e 7d | Rehabil|itation}|
|00001ec0| 0d 0a 24 43 68 61 70 74 | 65 72 7b 34 2d 39 7d 0d |..$Chapt|er{4-9}.|
|00001ed0| 0a 24 59 42 45 64 69 74 | 6f 72 7b 44 72 73 2e 20 |.$YBEdit|or{Drs. |
|00001ee0| 4b 61 70 6c 61 6e 2c 20 | 46 72 61 6e 6b 2c 20 47 |Kaplan, |Frank, G|
|00001ef0| 6f 72 64 6f 6e 2c 20 4c | 69 65 62 65 72 6d 61 6e |ordon, L|ieberman|
|00001f00| 2c 20 4d 61 67 6e 75 73 | 6f 6e 2c 20 4d 6f 6c 6e |, Magnus|on, Moln|
|00001f10| 61 72 2c 20 50 61 79 74 | 6f 6e 2c 20 61 6e 64 20 |ar, Payt|on, and |
|00001f20| 53 61 72 6e 6f 7d 0d 0a | 24 54 61 62 6c 65 7b 54 |Sarno}..|$Table{T|
|00001f30| 61 62 6c 65 20 4f 6d 69 | 74 74 65 64 7d 0d 0a 24 |able Omi|tted}..$|
|00001f40| 43 6f 6d 6d 65 6e 74 61 | 74 6f 72 7b 4a 2e 53 2e |Commenta|tor{J.S.|
|00001f50| 20 4c 69 65 62 65 72 6d | 61 6e 2c 20 4d 2e 44 2e | Lieberm|an, M.D.|
|00001f60| 7d 0d 0a 0d 0a 43 6f 70 | 79 72 69 67 68 74 20 28 |}....Cop|yright (|
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|00001f80| 69 63 61 6c 20 50 75 62 | 6c 69 73 68 65 72 73 2c |ical Pub|lishers,|
|00001f90| 20 49 6e 63 2e 2c 20 31 | 39 38 39 0d 0a 0d 0a 31 | Inc., 1|989....1|
|00001fa0| 39 38 39 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |989 Year| Book of|
|00001fb0| 20 52 65 68 61 62 69 6c | 69 74 61 74 69 6f 6e 20 | Rehabil|itation |
|00001fc0| 28 52 29 0d 0a 0d 0a 43 | 68 61 70 74 65 72 20 34 |(R)....C|hapter 4|
|00001fd0| 2d 2d 4e 65 75 72 6f 6c | 6f 67 69 63 61 6c 20 52 |--Neurol|ogical R|
|00001fe0| 65 68 61 62 69 6c 69 74 | 61 74 69 6f 6e 0d 0a 0d |ehabilit|ation...|
|00001ff0| 0a 53 70 69 6e 61 6c 20 | 43 6f 72 64 20 49 6e 6a |.Spinal |Cord Inj|
|00002000| 75 72 79 20 61 6e 64 20 | 53 70 69 6e 65 0d 0a 0d |ury and |Spine...|
|00002010| 0a 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |.-------|--------|
|00002020| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002030| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002040| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002050| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002060| 2d 0d 0a 46 69 78 65 64 | 2d 20 76 73 2e 20 41 64 |-..Fixed|- vs. Ad|
|00002070| 6a 75 73 74 65 64 2d 44 | 6f 73 65 20 48 65 70 61 |justed-D|ose Hepa|
|00002080| 72 69 6e 20 69 6e 20 74 | 68 65 20 50 72 6f 70 68 |rin in t|he Proph|
|00002090| 79 6c 61 78 69 73 20 6f | 66 20 54 68 72 6f 6d 62 |ylaxis o|f Thromb|
|000020a0| 6f 65 6d 62 6f 6c 69 73 | 6d 20 69 6e 20 53 70 69 |oembolis|m in Spi|
|000020b0| 6e 61 6c 0d 0a 43 6f 72 | 64 20 49 6e 6a 75 72 79 |nal..Cor|d Injury|
|000020c0| 0d 0a 0d 0a 47 72 65 65 | 6e 20 44 3b 20 4c 65 65 |....Gree|n D; Lee|
|000020d0| 20 4d 59 3b 20 49 74 6f | 20 56 59 3b 20 43 6f 68 | MY; Ito| VY; Coh|
|000020e0| 6e 20 54 3b 20 50 72 65 | 73 73 20 4a 3b 20 46 69 |n T; Pre|ss J; Fi|
|000020f0| 6c 62 72 61 6e 64 74 20 | 50 52 3b 20 56 61 6e 64 |lbrandt |PR; Vand|
|00002100| 65 6e 42 65 72 67 20 57 | 43 3b 0d 0a 59 61 72 6b |enBerg W|C;..Yark|
|00002110| 6f 6e 79 20 47 4d 3b 20 | 4d 65 79 65 72 20 50 52 |ony GM; |Meyer PR|
|00002120| 20 4a 72 0d 0a 28 4e 6f | 72 74 68 77 65 73 74 65 | Jr..(No|rthweste|
|00002130| 72 6e 20 55 6e 69 76 3b | 20 52 65 68 61 62 69 6c |rn Univ;| Rehabil|
|00002140| 69 74 61 74 69 6f 6e 20 | 49 6e 73 74 20 6f 66 20 |itation |Inst of |
|00002150| 43 68 69 63 61 67 6f 29 | 0d 0a 4a 41 4d 41 20 32 |Chicago)|..JAMA 2|
|00002160| 36 30 3a 31 32 35 35 2d | 31 32 35 38 2c 20 53 65 |60:1255-|1258, Se|
|00002170| 70 74 20 32 2c 20 31 39 | 38 38 0d 0a 2d 2d 2d 2d |pt 2, 19|88..----|
|00002180| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002190| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000021a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000021b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000021c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 0d 0a |--------|----....|
|000021d0| 41 62 73 74 72 61 63 74 | 0d 0a 0d 0a 20 20 20 20 |Abstract|.... |
|000021e0| 20 41 64 6a 75 73 74 65 | 64 2d 64 6f 73 65 20 68 | Adjuste|d-dose h|
|000021f0| 65 70 61 72 69 6e 20 77 | 61 73 20 63 6f 6d 70 61 |eparin w|as compa|
|00002200| 72 65 64 20 77 69 74 68 | 20 74 68 65 20 73 74 61 |red with| the sta|
|00002210| 6e 64 61 72 64 20 66 69 | 78 65 64 20 6d 69 6e 69 |ndard fi|xed mini|
|00002220| 64 6f 73 65 20 72 65 67 | 69 6d 65 6e 0d 0a 69 6e |dose reg|imen..in|
|00002230| 20 61 20 70 72 6f 73 70 | 65 63 74 69 76 65 20 73 | a prosp|ective s|
|00002240| 74 75 64 79 20 6f 66 20 | 70 61 74 69 65 6e 74 73 |tudy of |patients|
|00002250| 20 61 64 6d 69 74 74 65 | 64 20 77 69 74 68 20 63 | admitte|d with c|
|00002260| 6f 6d 70 6c 65 74 65 20 | 6d 6f 74 6f 72 20 63 6f |omplete |motor co|
|00002270| 72 64 20 69 6e 6a 75 72 | 79 20 69 6e 0d 0a 74 68 |rd injur|y in..th|
|00002280| 65 20 70 61 73 74 20 37 | 32 20 68 6f 75 72 73 2e |e past 7|2 hours.|
|00002290| 20 20 54 68 65 20 66 69 | 78 65 64 2d 64 6f 73 65 | The fi|xed-dose|
|000022a0| 20 67 72 6f 75 70 20 72 | 65 63 65 69 76 65 64 20 | group r|eceived |
|000022b0| 35 2c 30 30 30 20 75 6e | 69 74 73 20 6f 66 20 68 |5,000 un|its of h|
|000022c0| 65 70 61 72 69 6e 0d 0a | 73 75 62 63 75 74 61 6e |eparin..|subcutan|
|000022d0| 65 6f 75 73 6c 79 20 65 | 76 65 72 79 20 31 32 20 |eously e|very 12 |
|000022e0| 68 6f 75 72 73 2e 20 20 | 54 68 65 20 6f 74 68 65 |hours. |The othe|
|000022f0| 72 20 70 61 74 69 65 6e | 74 73 20 77 65 72 65 20 |r patien|ts were |
|00002300| 74 72 65 61 74 65 64 20 | 74 6f 20 6d 61 69 6e 74 |treated |to maint|
|00002310| 61 69 6e 20 61 6e 0d 0a | 61 63 74 69 76 61 74 65 |ain an..|activate|
|00002320| 64 20 70 61 72 74 69 61 | 6c 20 74 68 72 6f 6d 62 |d partia|l thromb|
|00002330| 6f 70 6c 61 73 74 69 6e | 20 74 69 6d 65 20 28 41 |oplastin| time (A|
|00002340| 50 54 54 29 20 69 6e 20 | 74 68 65 20 34 30 2d 73 |PTT) in |the 40-s|
|00002350| 65 63 6f 6e 64 20 72 61 | 6e 67 65 3b 20 74 68 65 |econd ra|nge; the|
|00002360| 20 6d 61 78 69 6d 61 6c | 0d 0a 64 6f 73 65 20 77 | maximal|..dose w|
|00002370| 61 73 20 31 35 2c 30 30 | 30 20 75 6e 69 74 73 20 |as 15,00|0 units |
|00002380| 65 76 65 72 79 20 31 32 | 20 68 6f 75 72 73 20 28 |every 12| hours (|
|00002390| 46 69 67 20 34 2d 32 29 | 2e 0d 0a 20 20 20 20 20 |Fig 4-2)|... |
|000023a0| 54 68 69 72 74 79 2d 66 | 69 76 65 20 70 61 74 69 |Thirty-f|ive pati|
|000023b0| 65 6e 74 73 20 77 65 72 | 65 20 72 61 6e 64 6f 6d |ents wer|e random|
|000023c0| 69 7a 65 64 20 74 6f 20 | 66 69 78 65 64 2d 64 6f |ized to |fixed-do|
|000023d0| 73 65 20 68 65 70 61 72 | 69 6e 2c 20 61 6e 64 20 |se hepar|in, and |
|000023e0| 34 30 20 74 6f 0d 0a 61 | 64 6a 75 73 74 65 64 2d |40 to..a|djusted-|
|000023f0| 64 6f 73 65 20 74 72 65 | 61 74 6d 65 6e 74 2e 20 |dose tre|atment. |
|00002400| 20 54 68 65 20 6c 61 74 | 74 65 72 20 70 61 74 69 | The lat|ter pati|
|00002410| 65 6e 74 73 20 72 65 63 | 65 69 76 65 64 20 73 69 |ents rec|eived si|
|00002420| 67 6e 69 66 69 63 61 6e | 74 6c 79 20 6d 6f 72 65 |gnifican|tly more|
|00002430| 0d 0a 68 65 70 61 72 69 | 6e 2e 20 20 54 68 69 72 |..hepari|n. Thir|
|00002440| 74 79 2d 6f 6e 65 20 70 | 65 72 63 65 6e 74 20 6f |ty-one p|ercent o|
|00002450| 66 20 74 68 65 20 66 69 | 78 65 64 2d 64 6f 73 65 |f the fi|xed-dose|
|00002460| 20 67 72 6f 75 70 20 61 | 6e 64 20 37 25 20 6f 66 | group a|nd 7% of|
|00002470| 20 74 68 65 20 61 64 6a | 75 73 74 65 64 2d 64 6f | the adj|usted-do|
|00002480| 73 65 0d 0a 67 72 6f 75 | 70 20 68 61 64 20 74 68 |se..grou|p had th|
|00002490| 72 6f 6d 62 6f 65 6d 62 | 6f 6c 69 73 6d 2e 20 20 |romboemb|olism. |
|000024a0| 4e 65 69 74 68 65 72 20 | 6f 66 20 74 68 65 20 6c |Neither |of the l|
|000024b0| 61 74 74 65 72 20 70 61 | 74 69 65 6e 74 73 20 68 |atter pa|tients h|
|000024c0| 61 64 20 72 65 61 63 68 | 65 64 20 74 68 65 0d 0a |ad reach|ed the..|
|000024d0| 74 61 72 67 65 74 20 41 | 50 54 54 2e 20 20 54 68 |target A|PTT. Th|
|000024e0| 72 65 65 20 70 61 74 69 | 65 6e 74 73 20 6f 6e 20 |ree pati|ents on |
|000024f0| 66 69 78 65 64 2d 64 6f | 73 65 20 68 65 70 61 72 |fixed-do|se hepar|
|00002500| 69 6e 20 68 61 64 20 6e | 6f 6e 66 61 74 61 6c 20 |in had n|onfatal |
|00002510| 70 75 6c 6d 6f 6e 61 72 | 79 0d 0a 65 6d 62 6f 6c |pulmonar|y..embol|
|00002520| 69 73 6d 2e 20 20 53 65 | 76 65 6e 20 70 61 74 69 |ism. Se|ven pati|
|00002530| 65 6e 74 73 20 69 6e 20 | 74 68 65 20 61 64 6a 75 |ents in |the adju|
|00002540| 73 74 65 64 2d 64 6f 73 | 65 20 67 72 6f 75 70 20 |sted-dos|e group |
|00002550| 77 65 72 65 20 77 69 74 | 68 64 72 61 77 6e 20 62 |were wit|hdrawn b|
|00002560| 65 63 61 75 73 65 20 6f | 66 0d 0a 62 6c 65 65 64 |ecause o|f..bleed|
|00002570| 69 6e 67 20 63 6f 6d 70 | 6c 69 63 61 74 69 6f 6e |ing comp|lication|
|00002580| 73 2e 20 20 4e 6f 6e 65 | 20 6f 66 20 74 68 65 20 |s. None| of the |
|00002590| 66 69 78 65 64 20 64 6f | 73 65 20 72 65 63 69 70 |fixed do|se recip|
|000025a0| 69 65 6e 74 73 20 62 6c | 65 64 2e 0d 0a 20 20 20 |ients bl|ed... |
|000025b0| 20 20 43 6f 72 64 2d 69 | 6e 6a 75 72 65 64 20 70 | Cord-i|njured p|
|000025c0| 61 74 69 65 6e 74 73 20 | 77 68 6f 73 65 20 41 50 |atients |whose AP|
|000025d0| 54 54 20 69 73 20 70 72 | 6f 6c 6f 6e 67 65 64 20 |TT is pr|olonged |
|000025e0| 74 6f 20 31 2e 35 20 74 | 69 6d 65 73 20 63 6f 6e |to 1.5 t|imes con|
|000025f0| 74 72 6f 6c 20 77 69 6c | 6c 20 62 65 0d 0a 73 70 |trol wil|l be..sp|
|00002600| 61 72 65 64 20 74 68 72 | 6f 6d 62 6f 65 6d 62 6f |ared thr|omboembo|
|00002610| 6c 69 63 20 65 76 65 6e | 74 73 2c 20 62 75 74 20 |lic even|ts, but |
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|00002630| 6e 73 69 64 65 72 61 62 | 6c 65 20 72 69 73 6b 20 |nsiderab|le risk |
|00002640| 6f 66 20 62 6c 65 65 64 | 69 6e 67 2e 0d 0a 41 64 |of bleed|ing...Ad|
|00002650| 6a 75 73 74 65 64 2d 64 | 6f 73 65 20 68 65 70 61 |justed-d|ose hepa|
|00002660| 72 69 6e 20 69 73 20 75 | 73 65 64 20 69 6e 20 70 |rin is u|sed in p|
|00002670| 61 74 69 65 6e 74 73 20 | 77 69 74 68 20 6e 6f 20 |atients |with no |
|00002680| 74 72 61 75 6d 61 20 74 | 6f 20 6f 74 68 65 72 20 |trauma t|o other |
|00002690| 6f 72 67 61 6e 73 20 61 | 6e 64 0d 0a 74 69 73 73 |organs a|nd..tiss|
|000026a0| 75 65 73 2c 20 61 6e 64 | 20 66 69 78 65 64 2d 64 |ues, and| fixed-d|
|000026b0| 6f 73 65 20 74 72 65 61 | 74 6d 65 6e 74 20 69 73 |ose trea|tment is|
|000026c0| 20 75 73 65 64 20 69 6e | 20 6f 74 68 65 72 20 70 | used in| other p|
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|000026e0| 69 74 68 0d 0a 63 61 6c | 66 2d 63 6f 6d 70 72 65 |ith..cal|f-compre|
|000026f0| 73 73 69 6f 6e 20 62 6f | 6f 74 73 20 6f 72 20 73 |ssion bo|ots or s|
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|00002710| 74 2d 43 6f 6d 6d 65 6e | 74 0d 0a 0d 0a 20 20 20 |t-Commen|t.... |
|00002720| 20 20 54 68 65 20 75 73 | 65 20 6f 66 20 6c 6f 77 | The us|e of low|
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|00002760| 73 70 69 6e 61 6c 0d 0a | 63 6f 72 64 2d 69 6e 6a |spinal..|cord-inj|
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|000027d0| 61 6e 64 20 74 68 65 20 | 62 6c 65 65 64 69 6e 67 |and the |bleeding|
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|00002800| 20 74 68 65 0d 0a 75 73 | 65 20 6f 66 20 66 69 78 | the..us|e of fix|
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|00002830| 64 6f 73 65 20 68 65 70 | 61 72 69 6e 2e 20 20 54 |dose hep|arin. T|
|00002840| 68 65 20 72 65 73 75 6c | 74 73 20 61 72 65 20 6e |he resul|ts are n|
|00002850| 6f 74 0d 0a 74 6f 74 61 | 6c 6c 79 20 75 6e 65 78 |ot..tota|lly unex|
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|000036f0| 64 69 7a 65 64 20 62 65 | 64 73 20 61 6e 64 0d 0a |dized be|ds and..|
|00003700| 63 6f 6e 76 65 6e 74 69 | 6f 6e 61 6c 20 74 68 65 |conventi|onal the|
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|00003720| 61 72 6b 65 64 20 66 6f | 72 20 6c 61 72 67 65 72 |arked fo|r larger|
|00003730| 20 70 72 65 73 73 75 72 | 65 20 73 6f 72 65 73 2e | pressur|e sores.|
|00003740| 20 20 41 66 74 65 72 20 | 74 61 6b 69 6e 67 0d 0a | After |taking..|
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|00003800| 74 68 65 72 61 70 79 2e | 20 20 43 6f 6e 74 72 61 |therapy.| Contra|
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|00003890| 69 6e 61 72 79 20 74 72 | 61 63 74 20 69 6e 66 65 |inary tr|act infe|
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|000038b0| 72 6e 61 74 72 65 6d 69 | 61 2e 0d 0a 20 20 20 20 |rnatremi|a... |
|000038c0| 20 41 69 72 2d 66 6c 75 | 69 64 69 7a 65 64 20 62 | Air-flu|idized b|
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|00003970| 66 66 65 63 74 69 76 65 | 20 69 6e 20 73 75 62 67 |ffective| in subg|
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|000039a0| 73 70 6f 6e 73 65 20 69 | 73 0d 0a 67 72 65 61 74 |sponse i|s..great|
|000039b0| 65 73 74 2c 20 69 2e 65 | 2e 2c 20 70 61 74 69 65 |est, i.e|., patie|
|000039c0| 6e 74 73 20 77 69 74 68 | 20 6c 61 72 67 65 20 70 |nts with| large p|
|000039d0| 72 65 73 73 75 72 65 20 | 73 6f 72 65 73 20 61 6e |ressure |sores an|
|000039e0| 64 20 74 68 6f 73 65 20 | 75 6e 64 65 72 67 6f 69 |d those |undergoi|
|000039f0| 6e 67 0d 0a 6e 75 74 72 | 69 74 69 6f 6e 61 6c 20 |ng..nutr|itional |
|00003a00| 73 75 70 70 6f 72 74 2e | 0d 0a 0d 0a 50 6f 73 74 |support.|....Post|
|00003a10| 2d 43 6f 6d 6d 65 6e 74 | 0d 0a 0d 0a 20 20 20 20 |-Comment|.... |
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|00003a30| 72 6c 79 20 64 6f 63 75 | 6d 65 6e 74 73 20 74 68 |rly docu|ments th|
|00003a40| 65 20 65 66 66 65 63 74 | 69 76 65 6e 65 73 73 20 |e effect|iveness |
|00003a50| 6f 66 20 61 69 72 2d 66 | 6c 75 69 64 69 7a 65 64 |of air-f|luidized|
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|00003a70| 72 65 61 74 6d 65 6e 74 | 20 6f 66 20 70 72 65 73 |reatment| of pres|
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|00003a90| 61 6c 73 6f 20 64 6f 63 | 75 6d 65 6e 74 73 20 74 |also doc|uments t|
|00003aa0| 68 65 69 72 20 69 6e 63 | 72 65 61 73 65 64 20 65 |heir inc|reased e|
|00003ab0| 66 66 69 63 69 65 6e 63 | 79 0d 0a 63 6f 6d 70 61 |fficienc|y..compa|
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|00003ad0| 69 6f 6e 61 6c 20 74 68 | 65 72 61 70 79 2e 20 20 |ional th|erapy. |
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|00003b40| 70 65 75 74 69 63 20 64 | 65 76 69 63 65 2e 20 20 |peutic d|evice. |
|00003b50| 4f 75 74 63 6f 6d 65 0d | 0a 73 74 75 64 69 65 73 |Outcome.|.studies|
|00003b60| 20 73 75 63 68 20 61 73 | 20 74 68 69 73 20 77 69 | such as| this wi|
|00003b70| 6c 6c 20 63 65 72 74 61 | 69 6e 6c 79 20 62 65 20 |ll certa|inly be |
|00003b80| 68 65 6c 70 66 75 6c 20 | 69 6e 20 6a 75 73 74 69 |helpful |in justi|
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|00003ba0| 20 69 6e 20 74 68 65 0d | 0a 66 75 74 75 72 65 2e | in the.|.future.|
|00003bb0| 2d 2d 4a 2e 53 2e 20 4c | 69 65 62 65 72 6d 61 6e |--J.S. L|ieberman|
|00003bc0| 2c 20 4d 2e 44 2e 0d 0a | 24 55 6e 69 71 75 65 5f |, M.D...|$Unique_|
|00003bd0| 49 44 7b 59 52 42 30 38 | 38 30 34 7d 0d 0a 24 54 |ID{YRB08|804}..$T|
|00003be0| 69 74 6c 65 7b 4e 65 72 | 76 65 20 47 6c 75 63 6f |itle{Ner|ve Gluco|
|00003bf0| 73 65 2c 20 46 72 75 63 | 74 6f 73 65 2c 20 53 6f |se, Fruc|tose, So|
|00003c00| 72 62 69 74 6f 6c 2c 20 | 6d 79 6f 2d 49 6e 6f 73 |rbitol, |myo-Inos|
|00003c10| 69 74 6f 6c 2c 20 61 6e | 64 20 46 69 62 65 72 20 |itol, an|d Fiber |
|00003c20| 44 65 67 65 6e 65 72 61 | 74 69 6f 6e 20 61 6e 64 |Degenera|tion and|
|00003c30| 20 52 65 67 65 6e 65 72 | 61 74 69 6f 6e 20 69 6e | Regener|ation in|
|00003c40| 20 44 69 61 62 65 74 69 | 63 20 4e 65 75 72 6f 70 | Diabeti|c Neurop|
|00003c50| 61 74 68 79 7d 0d 0a 24 | 41 75 74 68 6f 72 7b 44 |athy}..$|Author{D|
|00003c60| 79 63 6b 2c 20 50 4a 0d | 0a 5a 69 6d 6d 65 72 6d |yck, PJ.|.Zimmerm|
|00003c70| 61 6e 2c 20 42 52 0d 0a | 56 69 6c 65 6e 2c 20 54 |an, BR..|Vilen, T|
|00003c80| 48 0d 0a 4d 69 6e 6e 65 | 72 61 74 68 2c 20 53 52 |H..Minne|rath, SR|
|00003c90| 0d 0a 4b 61 72 6e 65 73 | 2c 20 4a 4c 0d 0a 59 61 |..Karnes|, JL..Ya|
|00003ca0| 6f 2c 20 4a 4b 0d 0a 50 | 6f 64 75 73 6c 6f 2c 20 |o, JK..P|oduslo, |
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|00003cc0| 6e 7b 4d 61 79 6f 20 43 | 6c 69 6e 69 63 2c 20 4d |n{Mayo C|linic, M|
|00003cd0| 61 79 6f 20 46 6f 75 6e | 64 2c 20 52 6f 63 68 65 |ayo Foun|d, Roche|
|00003ce0| 73 74 65 72 2c 20 4d 69 | 6e 6e 7d 0d 0a 24 53 75 |ster, Mi|nn}..$Su|
|00003cf0| 62 6a 65 63 74 7b 53 6f | 72 62 69 74 6f 6c 20 6e |bject{So|rbitol n|
|00003d00| 65 72 76 65 2c 20 69 6e | 20 64 69 61 62 65 74 69 |erve, in| diabeti|
|00003d10| 63 20 6e 65 75 72 6f 70 | 61 74 68 79 3b 0d 0a 4e |c neurop|athy;..N|
|00003d20| 65 75 72 6f 70 61 74 68 | 79 20 64 69 61 62 65 74 |europath|y diabet|
|00003d30| 69 63 20 6e 65 72 76 65 | 20 67 6c 75 63 6f 73 65 |ic nerve| glucose|
|00003d40| 2c 20 66 72 75 63 74 6f | 73 65 2c 20 73 6f 72 62 |, fructo|se, sorb|
|00003d50| 69 74 6f 6c 2c 20 61 6e | 64 20 6d 79 6f 2d 69 6e |itol, an|d myo-in|
|00003d60| 6f 73 69 74 6f 6c 20 69 | 6e 3b 0d 0a 4e 65 72 76 |ositol i|n;..Nerv|
|00003d70| 65 20 67 6c 75 63 6f 73 | 65 2c 20 66 72 75 63 74 |e glucos|e, fruct|
|00003d80| 6f 73 65 2c 20 73 6f 72 | 62 69 74 6f 6c 2c 20 61 |ose, sor|bitol, a|
|00003d90| 6e 64 20 6e 65 75 72 6f | 70 61 74 68 79 3b 0d 0a |nd neuro|pathy;..|
|00003da0| 4d 79 6f 65 6c 65 63 74 | 72 69 63 20 6d 79 6f 2d |Myoelect|ric myo-|
|00003db0| 49 6e 6f 73 69 74 6f 6c | 20 69 6e 20 64 69 61 62 |Inositol| in diab|
|00003dc0| 65 74 69 63 20 6e 65 75 | 72 6f 70 61 74 68 79 3b |etic neu|ropathy;|
|00003dd0| 0d 0a 47 6c 75 63 6f 73 | 65 20 6e 65 72 76 65 2c |..Glucos|e nerve,|
|00003de0| 20 41 6e 20 64 69 61 62 | 65 74 69 63 20 6e 65 75 | An diab|etic neu|
|00003df0| 72 6f 70 61 74 68 79 3b | 0d 0a 46 72 75 63 74 6f |ropathy;|..Fructo|
|00003e00| 73 65 20 6e 65 72 76 65 | 2c 20 69 6e 20 64 69 61 |se nerve|, in dia|
|00003e10| 62 65 74 69 63 20 6e 65 | 75 72 6f 70 61 74 68 79 |betic ne|uropathy|
|00003e20| 7d 0d 0a 24 4a 6f 75 72 | 6e 61 6c 7b 4e 20 45 6e |}..$Jour|nal{N En|
|00003e30| 67 6c 20 4a 20 4d 65 64 | 7d 0d 0a 24 56 6f 6c 75 |gl J Med|}..$Volu|
|00003e40| 6d 65 7b 33 31 39 7d 0d | 0a 24 50 61 67 65 7b 35 |me{319}.|.$Page{5|
|00003e50| 34 32 2d 35 34 38 7d 0d | 0a 24 44 61 74 65 7b 53 |42-548}.|.$Date{S|
|00003e60| 65 70 74 20 31 2c 20 31 | 39 38 38 7d 0d 0a 24 59 |ept 1, 1|988}..$Y|
|00003e70| 42 56 6f 6c 7b 31 39 38 | 39 20 59 65 61 72 20 42 |BVol{198|9 Year B|
|00003e80| 6f 6f 6b 20 6f 66 20 52 | 65 68 61 62 69 6c 69 74 |ook of R|ehabilit|
|00003e90| 61 74 69 6f 6e 7d 0d 0a | 24 43 68 61 70 74 65 72 |ation}..|$Chapter|
|00003ea0| 7b 35 2d 39 7d 0d 0a 24 | 59 42 45 64 69 74 6f 72 |{5-9}..$|YBEditor|
|00003eb0| 7b 44 72 73 2e 20 4b 61 | 70 6c 61 6e 2c 20 46 72 |{Drs. Ka|plan, Fr|
|00003ec0| 61 6e 6b 2c 20 47 6f 72 | 64 6f 6e 2c 20 4c 69 65 |ank, Gor|don, Lie|
|00003ed0| 62 65 72 6d 61 6e 2c 20 | 4d 61 67 6e 75 73 6f 6e |berman, |Magnuson|
|00003ee0| 2c 20 4d 6f 6c 6e 61 72 | 2c 20 50 61 79 74 6f 6e |, Molnar|, Payton|
|00003ef0| 2c 20 61 6e 64 20 53 61 | 72 6e 6f 7d 0d 0a 24 54 |, and Sa|rno}..$T|
|00003f00| 61 62 6c 65 7b 7d 0d 0a | 24 43 6f 6d 6d 65 6e 74 |able{}..|$Comment|
|00003f10| 61 74 6f 72 7b 7d 0d 0a | 0d 0a 43 6f 70 79 72 69 |ator{}..|..Copyri|
|00003f20| 67 68 74 20 28 63 29 20 | 59 65 61 72 20 42 6f 6f |ght (c) |Year Boo|
|00003f30| 6b 20 4d 65 64 69 63 61 | 6c 20 50 75 62 6c 69 73 |k Medica|l Publis|
|00003f40| 68 65 72 73 2c 20 49 6e | 63 2e 2c 20 31 39 38 39 |hers, In|c., 1989|
|00003f50| 0d 0a 0d 0a 31 39 38 39 | 20 59 65 61 72 20 42 6f |....1989| Year Bo|
|00003f60| 6f 6b 20 6f 66 20 52 65 | 68 61 62 69 6c 69 74 61 |ok of Re|habilita|
|00003f70| 74 69 6f 6e 20 28 52 29 | 0d 0a 0d 0a 43 68 61 70 |tion (R)|....Chap|
|00003f80| 74 65 72 20 35 2d 2d 4d | 75 73 63 75 6c 6f 73 6b |ter 5--M|usculosk|
|00003f90| 65 6c 65 74 61 6c 20 46 | 75 6e 63 74 69 6f 6e 20 |eletal F|unction |
|00003fa0| 61 6e 64 20 50 61 69 6e | 0d 0a 0d 0a 2d 2d 2d 2d |and Pain|....----|
|00003fb0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003fc0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003fd0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003fe0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003ff0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 4e 65 |--------|----..Ne|
|00004000| 72 76 65 20 47 6c 75 63 | 6f 73 65 2c 20 46 72 75 |rve Gluc|ose, Fru|
|00004010| 63 74 6f 73 65 2c 20 53 | 6f 72 62 69 74 6f 6c 2c |ctose, S|orbitol,|
|00004020| 20 6d 79 6f 2d 49 6e 6f | 73 69 74 6f 6c 2c 20 61 | myo-Ino|sitol, a|
|00004030| 6e 64 20 46 69 62 65 72 | 20 44 65 67 65 6e 65 72 |nd Fiber| Degener|
|00004040| 61 74 69 6f 6e 20 61 6e | 64 0d 0a 52 65 67 65 6e |ation an|d..Regen|
|00004050| 65 72 61 74 69 6f 6e 20 | 69 6e 20 44 69 61 62 65 |eration |in Diabe|
|00004060| 74 69 63 20 4e 65 75 72 | 6f 70 61 74 68 79 0d 0a |tic Neur|opathy..|
|00004070| 0d 0a 44 79 63 6b 20 50 | 4a 3b 20 5a 69 6d 6d 65 |..Dyck P|J; Zimme|
|00004080| 72 6d 61 6e 20 42 52 3b | 20 56 69 6c 65 6e 20 54 |rman BR;| Vilen T|
|00004090| 48 3b 20 4d 69 6e 6e 65 | 72 61 74 68 20 53 52 3b |H; Minne|rath SR;|
|000040a0| 20 4b 61 72 6e 65 73 20 | 4a 4c 3b 20 59 61 6f 20 | Karnes |JL; Yao |
|000040b0| 4a 4b 3b 20 50 6f 64 75 | 73 6c 6f 20 4a 46 0d 0a |JK; Podu|slo JF..|
|000040c0| 28 4d 61 79 6f 20 43 6c | 69 6e 69 63 2c 20 4d 61 |(Mayo Cl|inic, Ma|
|000040d0| 79 6f 20 46 6f 75 6e 64 | 2c 20 52 6f 63 68 65 73 |yo Found|, Roches|
|000040e0| 74 65 72 2c 20 4d 69 6e | 6e 29 0d 0a 4e 20 45 6e |ter, Min|n)..N En|
|000040f0| 67 6c 20 4a 20 4d 65 64 | 20 33 31 39 3a 35 34 32 |gl J Med| 319:542|
|00004100| 2d 35 34 38 2c 20 53 65 | 70 74 20 31 2c 20 31 39 |-548, Se|pt 1, 19|
|00004110| 38 38 0d 0a 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |88..----|--------|
|00004120| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004130| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004140| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004150| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004160| 2d 2d 2d 2d 0d 0a 0d 0a | 41 62 73 74 72 61 63 74 |----....|Abstract|
|00004170| 0d 0a 0d 0a 20 20 20 20 | 20 54 68 65 20 64 65 76 |.... | The dev|
|00004180| 65 6c 6f 70 6d 65 6e 74 | 20 6f 66 20 64 69 61 62 |elopment| of diab|
|00004190| 65 74 69 63 20 70 6f 6c | 79 6e 65 75 72 6f 70 61 |etic pol|yneuropa|
|000041a0| 74 68 79 20 69 73 20 6e | 6f 74 20 77 65 6c 6c 20 |thy is n|ot well |
|000041b0| 75 6e 64 65 72 73 74 6f | 6f 64 2e 0d 0a 44 65 63 |understo|od...Dec|
|000041c0| 72 65 61 73 65 73 20 69 | 6e 20 6d 79 6f 2d 69 6e |reases i|n myo-in|
|000041d0| 6f 73 69 74 6f 6c 20 6c | 65 76 65 6c 73 20 61 6e |ositol l|evels an|
|000041e0| 64 20 69 6e 63 72 65 61 | 73 65 73 20 69 6e 20 73 |d increa|ses in s|
|000041f0| 6f 72 62 69 74 6f 6c 20 | 6c 65 76 65 6c 73 20 68 |orbitol |levels h|
|00004200| 61 76 65 20 62 65 65 6e | 0d 0a 68 79 70 6f 74 68 |ave been|..hypoth|
|00004210| 65 73 69 7a 65 64 20 74 | 6f 20 62 65 20 69 6e 76 |esized t|o be inv|
|00004220| 6f 6c 76 65 64 2e 20 20 | 54 68 65 20 6c 65 76 65 |olved. |The leve|
|00004230| 6c 73 20 6f 66 20 67 6c | 75 63 6f 73 65 2c 20 66 |ls of gl|ucose, f|
|00004240| 72 75 63 74 6f 73 65 2c | 20 73 6f 72 62 69 74 6f |ructose,| sorbito|
|00004250| 6c 20 61 6e 64 0d 0a 6d | 79 6f 2d 69 6e 6f 73 69 |l and..m|yo-inosi|
|00004260| 74 6f 6c 20 69 6e 20 73 | 75 72 61 6c 20 6e 65 72 |tol in s|ural ner|
|00004270| 76 65 20 65 6e 64 6f 6e | 65 75 72 69 75 6d 20 77 |ve endon|eurium w|
|00004280| 65 72 65 20 6d 65 61 73 | 75 72 65 64 20 69 6e 20 |ere meas|ured in |
|00004290| 32 31 20 64 69 61 62 65 | 74 69 63 20 70 61 74 69 |21 diabe|tic pati|
|000042a0| 65 6e 74 73 0d 0a 77 69 | 74 68 20 6e 65 75 72 6f |ents..wi|th neuro|
|000042b0| 70 61 74 68 79 2c 20 34 | 20 64 69 61 62 65 74 69 |pathy, 4| diabeti|
|000042c0| 63 20 70 61 74 69 65 6e | 74 73 20 77 69 74 68 6f |c patien|ts witho|
|000042d0| 75 74 20 6e 65 75 72 6f | 70 61 74 68 79 2c 20 61 |ut neuro|pathy, a|
|000042e0| 6e 64 20 31 31 20 63 6f | 6e 74 72 6f 6c 73 20 61 |nd 11 co|ntrols a|
|000042f0| 6e 64 0d 0a 77 65 72 65 | 20 63 6f 6d 70 61 72 65 |nd..were| compare|
|00004300| 64 20 77 69 74 68 20 63 | 6c 69 6e 69 63 61 6c 2c |d with c|linical,|
|00004310| 20 6e 65 75 72 6f 70 61 | 74 68 6f 6c 6f 67 69 63 | neuropa|thologic|
|00004320| 20 61 6e 64 20 6d 6f 72 | 70 68 6f 6d 65 74 72 69 | and mor|phometri|
|00004330| 63 20 6e 65 72 76 65 20 | 70 61 72 61 6d 65 74 65 |c nerve |paramete|
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