Time trends in reported prevalence of kidney stones in the United States: 1976–199411.See Editorial by Goldfarb, p. 1951.

Time trends in reported prevalence of kidney stones in the United States: 1976–1994.BackgroundA body of evidence establishes that the occurrence of kidney stone disease has increased in some communities of industrialized countries. Information on recent temporal trends in the United States is lacking and population-based data on epidemiologic patterns are limited.Study objective was to determine whether kidney stone disease prevalence increased in the United States over a 20-year period and the influence of region, race/ethnicity, and gender on stone disease risk.MethodsWe measured the prevalence of kidney stone disease history from the United States National Health and Nutrition Examination Survey (II and III), population-based, cross-sectional studies, involving 15,364 adult United States residents in 1976 to 1980 and 16,115 adult United States residents in 1988 to 1994.ResultsDisease prevalence among 20- to 74-year-old United States residents was greater in 1988 to 1994 than in 1976 to 1980 (5.2% vs. 3.8%, P < 0.05), greater in males than females, and increased with age in each time period. Among 1988 to 1994 adults, non-Hispanic African Americans had reduced risk of disease compared to non-Hispanic Caucasians (1.7% vs. 5.9%, P < 0.05), and Mexican Americans (1.7% vs. 2.6%, P < 0.05). Also, age-adjusted prevalence was highest in the South (6.6%) and lowest in the West (3.3%). Findings were consistent across gender and multivariate adjusted odds ratios for stone disease history, including all demographic variables, as well as diuretic use, tea or coffee consumption, and dietary intake of calcium, protein, and fat did not materially change the results.ConclusionPrevalence of kidney stone disease history in the United States population increased between 1980 and 1994. A history of stone disease was strongly associated with race/ethnicity and region of residence

Enhancing Anticoagulation Monitoring and Therapy in Patients Undergoing Microvascular Reconstruction in Maxillofacial Surgery: A Prospective Observational Trial

Background: In reconstructive surgery, loss of a microvascular free flap due to perfusion disorders, especially thrombosis, is a serious complication. In recent years, viscoelastic testing (VET) has become increasingly important in point-of-care (POC) anticoagulation monitoring. This paper describes a protocol for enhanced anticoagulation monitoring during maxillofacial flap surgery. Objective: The aim of the study will be to evaluate, in a controlled setting, the predictive value of POC devices for the type of flap perfusion disorders due to thrombosis or bleeding. VET, Platelet monitoring (PM) and standard laboratory tests (SLT) are comparatively examined. Methods/Design: This study is an investigator-initiated prospective trial in 100 patients undergoing maxillofacial surgery. Patients who undergo reconstructive surgery using microvascular-free flaps will be consecutively enrolled in the study. All patients provide blood samples for VET, PM and SLT at defined time points. The primary outcome is defined as free flap loss during the hospital stay. Statistical analyses will be performed using t-tests, including the Bonferroni adjustment for multiple comparisons. Discussion: This study will help clarify whether VET can improve individualized patient care in reconstruction surgery. A better understanding of coagulation in relation to flap perfusion disorders may allow real-time adaption of antithrombotic strategies and potentially prevent flap complications

The characteristics of millisecond pulsar emission: I. Spectra, pulse shapes and the beaming fraction

We have monitored a large sample of millisecond pulsars using the 100-m Effelsberg radio telescope in order to compare their radio emission properties to the slowly rotating population. With some notable exceptions, our findings suggest that the two groups of objects share many common properties. A comparison of the spectral indices between samples of normal and millisecond pulsars demonstrates that millisecond pulsar spectra are not significantly different from those of normal pulsars. There is evidence, however, that millisecond pulsars are slightly less luminous and less efficient radio emitters compared to normal pulsars. We confirm recent suggestions that a diversity exists among the luminosities of millisecond pulsars with the isolated millisecond pulsars being less luminous than the binary millisecond pulsars. There are indications that old millisecond pulsars exhibit somewhat flatter spectra than the presumably younger ones. We present evidence that millisecond pulsar profiles are only marginally more complex than those found among the normal pulsar population. Moreover, the development of the profiles with frequency is rather slow, suggesting very compact magnetospheres. The profile development seems to anti-correlate with the companion mass and the spin period, again suggesting that the amount of mass transfer in a binary system might directly influence the emission properties. The angular radius of radio beams of millisecond pulsars does not follow the scaling predicted from a canonical pulsar model which is applicable for normal pulsars. Instead they are systematically smaller. The smaller inferred luminosity and narrower emission beams will need to be considered in future calculations of the birth-rate of the Galactic population.Comment: 40 pages, 14 figures, accepted for publication in Ap

The characteristics of millisecond pulsar emission: II. Polarimetry

We have made polarimetric monitoring observations of millisecond pulsars visible from the northern hemisphere at 1410 MHz. Their emission properties are compared with those of normal pulsars. Although we demonstrated in paper I that millisecond pulsars exhibit the same flux density spectra and similar profile complexity, our results presented here suggest that millisecond pulsar profiles do not comply with the predictions of classification schemes based on ``normal'' pulsars. The frequency development of a large number of millisecond pulsar profiles is abnormal when compared with the development seen for normal pulsars. Moreover, the polarization characteristics suggest that millisecond-pulsar magnetospheres might not simply represent scaled versions of the magnetospheres of normal pulsars, supporting results of paper I. However, phenomena such as mode-changing activity in both intensity and polarization are recognized here for the first time (e.g., J1730--2304). This suggests that while the basic emission mechanism remains insensitive to rotational period, the conditions that, according to the canonical pulsar model, regulate the radio emission, might be satisfied at different regions in millisecond pulsar magnetospheres. At least three types of model have been proposed to describe the millisecond pulsar magnetospheres. A comparison of the predictions of these models with the observations suggests that individual cases are better explained by different processes. However, we show that millisecond pulsars can be grouped according to common emission properties, a grouping that awaits verification from future multifrequency observations.Comment: 38 pages, 8 figures, accepted for publication in ApJ, (see astro-ph/9801177 for paper I