bluuebunny/crossref_metadata_2025 huggingface dataset:
Interspecific competition influences reproduction in spotted hyenas
Authors: Watts H. E. , Holekamp K. E.
Published: October 2008

Interspecific competition among carnivores is an important determinant of predator population dynamics, and it may also affect lower trophic levels. Whereas considerable research has focused on effects of interspecific competition on threatened carnivore populations, here we examine the effects of interspecific competition on the most abundant large carnivore in Africa, the spotted hyena Crocuta crocuta. Specifically, we compared two populations of spotted hyenas to examine the sources of variation in fitness, including effects of competition with lions Panthera leo. Hyenas living in Amboseli National Park and the Masai Mara National Reserve, Kenya, were monitored from 2003 to 2005 and 1988 to 1992, respectively. Females reproduced at significantly higher rates in Amboseli, due to shorter lactation periods, though neither juvenile survival nor litter size differed between populations. Differences in reproduction were estimated to result in 24% greater lifetime reproductive success among Amboseli than among Mara females. We then tested alternative ecological hypotheses to explain these differences in fitness measures between populations. We found little support for hypotheses suggesting that population differences were due to variation in prey availability or dispersion, or to intraspecific competition either within or between hyena groups. Our results were most consistent with the hypothesis that population differences were due to variation in interspecific competition with lions. Hyenas in Amboseli lived at lower lion density, enjoyed higher rates of food intake despite less abundant prey, and scavenged more food from lions than did Mara hyenas. Our results indicate that competition with lions operated primarily via food competition, rather than direct killing, to generate the fitness differences.
Rit signaling contributes to interferon‐γ‐induced dendritic retraction via p38 mitogen‐activated protein kinase activation
Authors: Andres Douglas A. , Shi Geng‐Xian , Bruun Donald , Barnhart Chris , Lein Pamela J.
Published: October 2008

The proinflammatory cytokine interferon‐γ (IFNγ) alters neuronal connectivity via selective regressive effects on dendrites but the signaling pathways that mediate this effect are poorly understood. We recently demonstrated that signaling by Rit, a member of the Ras family of GTPases, modulates dendritic growth in primary cultures of sympathetic and hippocampal neurons. In this study, we investigated a role for Rit signaling in IFNγ‐induced dendritic retraction. Expression of a dominant negative Rit mutant inhibited IFNγ‐induced dendritic retraction in cultured embryonic rat sympathetic and hippocampal neurons. In pheochromacytoma cells and hippocampal neurons, IFNγ caused rapid Rit activation as indicated by increased GTP binding to Rit. Silencing of Rit by RNA interference suppressed IFNγ‐elicited activation of p38 MAPK in pheochromacytoma cells, and pharmacological inhibition of p38 MAPK significantly attenuated the dendrite‐inhibiting effects of IFNγ in cultured sympathetic and hippocampal neurons without altering signal transducer and activator of transcription 1 activation. These observations identify Rit as a downstream target of IFNγ and suggest that a novel IFNγ‐Rit‐p38 signaling pathway contributes to dendritic retraction and may, therefore, represent a potential therapeutic target in diseases with a significant neuroinflammatory component.
Beyond Anemia: The Clinical Impact of the Physiologic Effects of Erythropoietin
Authors: Diskin Charles J. , Stokes Thomas J. , Dansby Linda M. , Radcliff Lautrec , Carter Thomas B.
Published: October 2008

Although we have known that oxygen tension affects erythrocyte production since the 19th century, we have only recently begun to understand many subtleties of erythropoietin (EPO) physiology. EPO administration has allowed hundreds of thousands of patients to avoid transfusions. With the beneficial effects so apparent a detailed understanding of the full clinical physiology of this plasma factor seemed less important. However, the unanticipated increase in mortality found in recent randomized studies is prompting a reassessment of this view. We will review what is known about the physiology of this plasma factor that, it is now clear, is more than just an erythrocyte production factor.
Hemodialysis Central Venous Catheters as a Source of Inflammation and Its Implications
Authors: Hung Adriana M. , Alp Ikizler T.
Published: October 2008

The mortality rate for end‐stage renal disease patients is six times higher than in the general population. Hemodialysis central venous catheter (CVC) utilization has increased by 50% between 1998 and 2004 and data from the United States Renal Data System suggest that 81% of the patients initiate hemodialysis through a CVC. There is evidence that the two observations are linked in both an obvious way (catheter‐related sepsis) as well as in a less obvious manner—chronic inflammation. Inflammation is highly prevalent in chronic hemodialysis (CHD) patients and is consistently associated with poor outcomes. Some of the most important consequences of inflammation in CHD include, but are not limited to, cardiovascular disease, uremic protein‐energy wasting, erythropoietin hyporesponsiveness, and increased hospitalization and death rates. Use of CVC has been long suspected to play a role in the inflammatory response in CHD patients. Recent studies have shown that the presence of CVCs is associated with higher levels of C‐reactive protein (CRP), lower serum albumin values, and lower hemoglobin values. Furthermore, there are data showing that CRP levels decrease following CVC removal. Accordingly, avoidance of CVC represents an effective strategy to limit the inflammatory response in CHD patients and potentially prevent its devastating consequences.
Pathophysiology and Management of Fluid and Electrolyte Disturbances in Patients on Chronic Dialysis with Severe Hyperglycemia
Authors: Tzamaloukas Antonios H. , Ing Todd S. , Siamopoulos Kostas C. , Raj Dominic S. C. , Elisaf Moses S. , Rohrscheib Mark , Murata Glen H.
Published: October 2008

The mechanisms of fluid and solute abnormalities that should be considered in any patient with severe hyperglycemia include changes in the total amount of extracellular solute, osmotic diuresis, intake of water driven by thirst, and influences from associated conditions. The absence of osmotic diuresis distinguishes dialysis‐associated hyperglycemia (DH) from hyperglycemia with preserved renal function (HPRF). Mainly because of this absence, comparable degrees of hyperglycemia tend to produce less hypertonicity and less severe intracellular volume contraction in DH than in HPRF, while extracellular volume is expanded in DH but contracted in HPRF. Ketoacidosis can develop in both DH and HPRF. Among DH patients, hyperkalemia appears to be more frequent when ketoacidosis is present than when nonketotic hyperglycemia is present. Among HPRF patients, the frequency of hyperkalemia appears to be similar whether ketoacidosis or nonketotic hyperglycemia is present. Usually patients with severe DH have no symptoms or may exhibit a thirst. Infrequent clinical manifestations of DH include coma and seizures from hypertonicity or ketoacidosis and pulmonary edema from extracellular expansion. Insulin infusion is usually the only treatment required to correct the biochemical abnormalities and reverse the clinical manifestations of DH. Monitoring of the clinical manifestations and biochemical parameters during treatment of DH with insulin is needed to determine whether additional measures, such as administration of saline, free water, or potassium salts, as well as emergency hemodialysis (HD) are needed. Emergency HD carries the risk of excessively rapid decline in tonicity; its benefits in the treatment of DH have not been established.
Dialysis Research: Surface‐Area‐Normalized Kt/V: A Method of Rescaling Dialysis Dose to Body Surface Area—Implications for Different‐Size Patients by Gender
Authors: Daugirdas John T. , Depner Thomas A. , Greene Tom , Kuhlmann Martin K. , Levin Nathan W. , Chertow Glenn M. , Rocco Michael V.
Published: October 2008

Dialysis is measured as Kt/V, which scales the dose (Kt) to body water content (V). Scaling dialysis dose to body surface area (Sdub) has been advocated, but the implications of such rescaling have not been examined. We developed a method of rescaling measured Kt/V to Sdub and studied the effect of such alternative scaling on the minimum adequacy values that might then be applied in male and female patients of varying body size. We examined anthropometric estimates of V and S (Watson vs. Dubois estimates) in 1765 patients enrolled in the HEMO study after excluding patients with amputations. An S‐normalized target stdKt/V was defined, and an adequacy ratio (R) was computed for each patient as R = D/N where D = delivered stdKt/V (calculated using the Gotch–Leypoldt equation for stdKt/V) and N = the S‐normalized minimum target value. In the HEMO data set, we determined the extent to which baseline (prerandomization) stdKt/V values would have exceeded such an S‐based minimum target stdKt/V. The median Vwat:Sdub ratios were significantly higher in men (21.34) than in women (18.50). The average of these (20) was used to normalize the current suggested minimally adequate value (stdKt/V ≥ 2.0/week) to the S‐normalized target value (stdKt/S ≥ 40 L/M2), assuming that average modeled V = average anthropometric V. To achieve this S‐normalized target, the required single‐pool (sp) Kt/V was always higher in women than in men at any level of body size. For small patients (Vwat = 25L), required stdKt/V values were 2.05 and 2.21/week for men and women, respectively, corresponding to spKt/V values of 1.31 and 1.52/session. On the other hand, large (Vwat = 50L) male patients would need spKt/V values of only 1.0/session. Prerandomization baseline dialysis sessions in the HEMO study were found to meet such a new S‐based standard in almost all (766/773) men and in 885/992 women. An analysis of scaling dose to anthropometrically estimated liver size (L) showed similar gender ratios for Vwat:L and Vwat:Sdub, providing a potential physiologic explanation underpinning S‐based scaling. S‐based scaling of the dialysis dose would require considerably higher doses in small patients and in women, and would allow somewhat lower doses in larger male patients. Current dialysis practice would largely meet such an S‐based adequacy standard if the dose were normalized to a Vwat:Sdub ratio of 20.
Treatment Time, Chronic Inflammation, and Hemodynamic Stability: The Overlooked Parameters in Hemodialysis Quantification
Authors: Zsom Lajos , Zsom Marianna , Fulop Tibor , Flessner Michael F
Published: October 2008

Decades after the introduction of chronic maintenance hemodialysis, the optimal means of quantifying dialysis dose remains controversial. Differences of opinion in the international dialysis community lead to substantial diversity in everyday clinical practice. Several studies suggest that the well‐recognized international mortality differences in hemodialysis populations may result from these divergent approaches to dialysis care. One of the main areas of divergence is the different degree of reliance on dialysis clearance when prescribing dialysis. The “clearance approach” implies that treatment quality is primarily dependent on efficient removal of uremic toxins as estimated by dialytic urea clearance. Urea can be rapidly removed by high efficiency dialysis in a relatively short time. The main alternative to this strategy is the “time approach” based on the recognition that longer or more frequent dialysis provides benefits beyond increasing urea removal. Some of the putative benefits are more effective volume and blood pressure control, better maintenance of hemodynamic stability because of slower ultrafiltration and removal of uremic toxins that do not behave like urea. Recently, chronic inflammation has been proposed to be an important predictor of outcome in dialysis patients. Inflammatory markers are commonly elevated in chronic renal failure and levels of these seem to correlate with malnutrition, maintenance of residual renal function, and volume control. The relationships between dialysis clearance, treatment time, chronic inflammation, volume control, and hemodynamic stability are explored in this review. We propose that a better understanding of these complex relationships may provide opportunities for improving outcomes of maintenance hemodialysis patients.
Congenital Molluscum Contagiosum: Report of Four Cases and Review of the Literature
Authors: Connell Christopher O’ , Oranje Arnold , Van Gysel Dirk , Silverberg Nanette B.
Published: October 2008

Abstract:  Molluscum contagiosum is a viral infection of the skin and mucous membranes that is caused by infection with the molluscum contagiosum virus. Molluscum contagiosum can be acquired from skin to skin contact which may be during play, in a swimming pool, or through sexual contact. Sexually acquired molluscum is rare in younger children, but becomes quite common during adolescence and young adulthood, after the sexual debut. It has been long known that the human papillomavirus, which causes genital warts, i.e., condyloma accuminatum, can be vertically transmitted through an infected genital tract. Children may not manifest condyloma lesions for a few years. The entity of congenital molluscum has been debated in the literature and only three cases of suspected congenital molluscum have been reported. We report on four more infants with congenital molluscum, two children with congenital lesions, and two children with onset of lesions at 6 weeks of age. Two children had single cutaneous lesions on the extremities and two had lesions of the scalp consistent with the site of cervical pressure. Congenital molluscum appears to be a more common entity than previously reported. Vertical transmission of molluscum should be considered for all infantile cases of molluscum.
Topical Tacrolimus in the Treatment of Lichen Planus in a Child
Authors: FORTINA ANNA BELLONI , GIULIONI ERIKA , TONIN ELENA
Published: October 2008

Abstract:  Lichen planus is a relatively common mucocutaneous disease in adult patients, but it is more rare in children. Topical corticosteroids are the first line of treatment in most pediatric patients with a localized classic form of lichen planus. We report the case of a child with cutaneous lichen planus who did not respond to topical steroids but showed complete resolution once switched to 0.03% tacrolimus ointment.
Presentation of Perianal Group A Streptococcal Infection as Irritability Among Children
Authors: SHOUVAL DROR S. , SCHURR DANI , NUSSINOVITCH MOSHE
Published: October 2008

Abstract:  We report on a series of 11 children with perianal Streptococcus group A infection who presented with intermittent episodes of irritability. Awareness and recognition of this disease by pediatricians and its early diagnosis by a rapid‐strep test will lead to appropriate treatment and prompt recovery.
A Further Case of Annular Lichenoid Dermatitis of Youth: Role of the Anti‐Hepatitis B Immunization?
Authors: SANS VERONIQUE , LEAUTE‐LABREZE CHRISTINE , VERGIER BEATRICE , TAIEB ALAIN
Published: October 2008

Letters to the Editor are welcomed for publication (subject to editing). Letters must be signed by all authors, typewritten double spaced, and must not exceed two pages of text including references. Two copies of all letters should be submitted along with one copy on disk. Letters should not duplicate material submitted or published in other journals. Prepublication proofs will not be provided.
Neutrophilic Dermatoses in Children
Authors: Berk David R. , Bayliss Susan J.
Published: October 2008

Abstract:  The neutrophilic dermatoses are rare disorders, especially in children, and are characterized by neutrophilic infiltrates in the skin and less commonly in extracutaneous tissue. The neutrophilic dermatoses share similar clinical appearances and associated conditions, including inflammatory bowel disease, malignancies, and medications. Overlap forms of disease demonstrating features of multiple neutrophilic dermatoses may be seen. The manuscript attempts to provide an up‐to‐date review of (i) classical neutrophilic dermatoses, focusing on distinctive features in children and (ii) neutrophilic dermatoses which may largely be pediatric or genodermatosis‐associated (Majeed, SAPHO [synovitis, severe acne, sterile palmoplantar pustulosis, hyperostosis, and osteitis] syndrome, PAPA (pyogenic sterile arthritis, pyoderma gangrenosum, and acne), PFAPA (periodic fever with aphthous stomatitis, pharyngitis, and cervical adenopathy), and other periodic fever syndromes, and congenital erosive and vesicular dermatosis healing with reticulated supple scarring).
Use of Suprathel® Dressing in a Young Infant with TEN
Authors: Pfurtscheller Klaus , Zobel Gerfried , Roedl Siegfried , Trop Marija
Published: October 2008

Abstract:  Toxic epidermal necrolysis and Stevens‐Johnson syndrome are potentially life‐threatening skin disorders. We report that a 3‐month‐old infant, a patient with toxic epidermal necrolysis, who in addition to a standard resuscitation protocol for burns received treatment with Suprathel® (PolyMedics Innovations GmbH, Filderstadt, Germany) and fatty gauze as topical wound dressings in the form of a whole body cover with complete recovery. This is the first case report of Suprathel® being used successfully in a baby with toxic epidermal necrolysis.
Methicillin‐Resistant Staphylococcus aureus Colonization in Children with Atopic Dermaitis
Authors: Suh Liza , Coffin Susan , Leckerman Kateri Heydon , Gelfand Joel M. , Honig Paul J. , Yan Albert C.
Published: October 2008

Abstract:  Children with atopic dermatitis are more frequently colonized with Staphylococcus aureus than children without atopic dermatitis. However, little epidemiological data exist regarding the prevalence of methicillin‐resistant S. aureus among children with atopic dermatitis. Recent studies have revealed an increasing prevalence of community‐associated methicillin‐resistant S. aureus among patients presenting to hospitals with serious bacterial infections, particularly those with cutaneous and soft tissue infections. As many atopic dermatitis patients are treated empirically with antibiotics for secondary skin infections, an understanding of the epidemiology of bacterial colonization and superinfection is essential for directing proper treatment in the atopic patient population. This study investigates the prevalence of risk factors for community‐associated, methicillin‐resistant S. aureus colonization among pediatric atopic dermatitis patients encountered at an academic pediatric dermatology clinic. An observational cross‐sectional study was conducted at the Children’s Hospital of Philadelphia in which 54 patients previously diagnosed with atopic dermatitis were enrolled. A detailed patient questionnaire, a complete cutaneous examination, and an evaluation of eczema severity according to the Eczema Area and Severity Index were completed at the time of enrollment. Bacterial cultures from the skin and nares were obtained to determine the frequency of colonization with either methicillin‐sensitive S. aureus or methicillin‐resistant S. aureus. Although most atopic dermatitis patients studied were colonized with S. aureus (43/54 [80%]), methicillin‐resistant S. aureus was isolated from only seven atopic dermatitis patients (7/43 [16%]). Patients colonized with S. aureus were more likely to be male, to have been previously hospitalized, to have used a topical calcineurin inhibitor in combination with a topical steroid, and less likely to have used topical antibiotics. Bivariable analysis, however, revealed that only previous hospitalization was independently associated with an increased risk of methicillin‐resistant S. aureus colonization. We observed that 80% of atopic dermatitis patients were colonized with S. aureus, and that of these patients, 16% of colonized patients were colonized with a methicillin‐resistant strain. Methicillin‐resistant S. aureus colonization was found to be significantly associated with previous hospitalization. Evidence also indicates that topical calcineurin inhibitors used in conjunction with topical steroids is associated with increased S. aureus colonization, while topical antibiotic use appears to decrease S. aureus colonization.
Streptococcus pyogenes and β‐lactam antibiotics
Authors: DEL GIUDICE PASCAL
Published: October 2008

Letters to the Editor are welcomed for publication (subject to editing). Letters must be signed by all authors, typewritten double spaced, and must not exceed two pages of text including references. Two copies of all letters should be submitted along with one copy on disk. Letters should not duplicate material submitted or published in other journals. Prepublication proofs will not be provided.
Haplotypic Variants in DRD2, ANKK1, TTC12, and NCAM1 are Associated With Comorbid Alcohol and Drug Dependence
Authors: Yang Bao‐Zhu , Kranzler Henry R. , Zhao Hongyu , Gruen Jeffrey R. , Luo Xingguang , Gelernter Joel
Published: October 2008

Background:  Each gene in the chromosome 11q23 cluster of NCAM1, TTC12, ANKK1, and DRD2 is functionally linked to dopamine in brain. Many association studies of DRD2 and substance dependence (SD), including alcohol dependence (AD) and drug dependence (DD), have been reported; the results have been inconsistent. Recent association studies have considered this cluster more comprehensively, examining the association of SD with several risk variants mapped to the other genes in the cluster. Because comorbid AD with DD (AD+DD) is common, we hypothesized that heterogeneity of the SD diagnoses studied might have contributed to the inconsistency of prior results.

Methods:  We conducted 2 separate association studies of AD+DD and AD without DD (AD‐only) in 1,090 European‐Americans using family‐based and case‐control designs and 43 single nucleotide polymorphisms mapped to this cluster. We used a generalized linear model and haplotype score tests for the case‐control sample, and the family‐based association test for the family sample.

Results:  For AD+DD, the risk regions centered on TTC12 exon 3 [optimal individual haplotype simulated p (poihs) = 0.000015], and another extended from ANKK1 exon 8 to DRD2^C957T (poihs = 0.0028), in both samples. NCAM1 exon 12 markers showed global significance in both designs, but were significant for specific haplotypes (poihs = 0.0029) only for the family sample. For AD‐only, NCAM1 intron 14 to 18 and the junction of ANKK1 and DRD2 were associated globally. Population stratification was excluded as the basis for these results. Linkage disequilibrium contrast tests supported selection at TTC12 exon 3 and ANKK1 exon 2.

Conclusions:  We conclude that variants in TTC12 exon 3, NCAM1 exon 12, and the two 3′‐ends of ANKK1 and DRD2 co‐regulate risk for comorbid AD and DD.
Age at First Drink and the First Incidence of Adult‐Onset DSM‐IV Alcohol Use Disorders
Authors: Dawson Deborah A. , Goldstein Risë B. , Patricia Chou S. , June Ruan W. , Grant Bridget F.
Published: October 2008

Background:  Existing studies of the association between age at first drink (AFD) and the risk of alcohol use disorders (AUD) suffer from inconsistent levels of control and designs that may inflate associations by failure to control for duration of exposure to risk.

Methods:  This study examined associations between AFD (ages <15 and 15–17 vs. 18+ years) and first incidence of DSM‐IV alcohol dependence, abuse, and specific AUD criteria over a 3‐year follow‐up in a longitudinal study of U.S. drinkers 18 years of age and older at baseline (n = 22,316), controlling for duration of exposure, family history, and a wide range of baseline and childhood risk factors.

Results:  After adjusting for all risk factors, the incidence of dependence was increased for AFD < 15 years (OR = 1.38) and for women only with AFD at ages 15 to 17 (OR = 1.54). The incidence of abuse was increased at AFD <15 and 15 to 17 years (OR = 1.52 and 1.30, respectively). Most dependence criteria showed significant associations with AFD, but hazardous drinking and continued drinking despite interpersonal problems were the only abuse criteria to do so. All associations were nonsignificant after controlling for volume of consumption, except that AFD at all ages <18 combined was associated with a reduced likelihood of impaired control, and AFD at ages 15 to 17 was associated with lower odds of drinking more/longer than intended among heavy‐volume drinkers. In a population of low‐risk drinkers that excluded those with positive family histories, personality disorders, and childhood risk factors, there were strong associations between early AFD (<18) and the incidence of dependence (OR = 3.79) and continued drinking despite physical/psychological problems (OR = 2.71), but no association with incidence of abuse.

Conclusions:  There is a robust association between AFD and the risk of AUD that appears to reflect willful rather than uncontrolled heavy drinking, consistent with misuse governed by poor decision‐making and/or reward‐processing skills associated with impaired executive cognitive function (ECF). Additional research is needed to determine causality in the role of impaired ECF, including longitudinal studies with samples of low‐risk adolescents.
Which Patients Benefit the Most from a Geriatrician's Care? Consensus Among Directors of Geriatrics Academic Programs
Authors: Warshaw Gregg A. , Bragg Elizabeth J. , Fried Linda P. , Hall William J.
Published: October 2008

Given the anticipated limited availability of geriatricians for the foreseeable future, how should the geriatrician's specialized clinical skills be deployed to optimally benefit the health of our aging population? Directors of geriatrics academic programs (DGAPs) at all 145 U.S. allopathic and osteopathic medical schools were asked this question as part of a winter 2007 on‐line survey. The DGAPs were to indicate the types of patients who would most benefit from a geriatrician's services in three practice situations: primary care, consultations, and care in the hospital. The survey response rate was 74.5%. There was high consensus among the DGAPs on the benefits of having a geriatrician care for the most complex and vulnerable older adults in primary care and hospital settings. There was slightly less consensus as to when geriatrics consultations are beneficial. The patient subsets that were viewed as benefiting the most from geriatrician care were aged 85 and older, frailty, geriatric syndromes, severe functional impairment, and complexity. The results of this survey suggest that, because of the predicted shortage of geriatricians, the DGAPs would target geriatricians to work with the most vulnerable older adults. These findings offer the beginning of a consensus statement as to the role of geriatricians in the continuum of American medical care.
Counting platelets in platelet concentrates on hematology analyzers: a multicenter comparative study
Authors: Van Der Meer Pieter F. , Dijkstra‐Tiekstra Margriet J. , Mahon Anne , De Wildt‐Eggen Janny
Published: October 2008

BACKGROUND: Hematology analyzers are designed to count whole blood samples, but are also used by blood centers to perform quality control on blood components. In platelet (PLT) concentrates, the number of PLTs is approximately fivefold higher and red blood cells are absent, causing variable PLT counting results. It was our aim to compare currently used hematology analyzers for counting PLTs in PLT concentrates using fixed human PLTs.

STUDY DESIGN AND METHODS: PLT samples were fixed, diluted into seven concentration levels (plus one blank), aliquoted, and shipped to 68 centers. Evaluable data were obtained for 89 hematology analyzers. All samples were counted six times, and results were reported to the coordinating center. The overall group mean was calculated, and the percentage deviation from this mean was calculated for each analyzer.

RESULTS: At PLT levels relevant for blood centers, 750 × 109 to 2000 × 109 per L, analyzers gave results that were between 35 percent lower and 16 percent higher than the overall group mean. Within a group of analyzers, results were comparable with coefficient of variations usually below 10 percent, indicating that the observed differences were caused by instrument characteristics. A smaller study with fresh, unfixed PLT samples showed that analyzers behaved similarly for fixed and fresh PLTs.

CONCLUSION: With a wide array of currently used hematology analyzers, a marked difference was determined for the PLT counts of fixed human‐based identical samples provided to 68 laboratories by a centralized facility. A gold standard method is needed to allow for more valid interlaboratory comparisons between hematology analyzers.
Donor platelets stored for at least 3 days can elicit activation marker expression by the recipient's blood mononuclear cells: an in vitro study
Authors: Cognasse Fabrice , Hamzeh‐Cognasse Hind , Lafarge Sandrine , Acquart Sophie , Chavarin Patricia , Courbil Rémi , Fabrigli Patrick , Garraud Olivier
Published: October 2008

BACKGROUND: Recent studies have demonstrated that infused platelets (PLTs) can promote inflammation. The objective of this study was to evaluate the impact of storage of transfusion‐grade PLTs on the peripheral blood mononuclear cells (PBMNCs) of the recipient.

STUDY DESIGN AND METHODS: An in vitro cell model system was established to measure the degree of activation of donor PLTs during 5 days of their storage and then to measure immune cell activation by detecting marker expression in coculture experiments.

RESULTS: The level of soluble CD62p increased significantly by Day 3, and membrane expression of CD62p increased significantly from Day 2, indicating some degree of PLT activation over time during storage (p < 0.05). Donor PLTs and PBMNC subsets (monocytes, B cells, and T cells) from recipients were cocultured for 48 hours. The number of PLT‐PBMNC subset doublets detected by flow cytometry was correlated with the PLT storage time after Day 3 (p < 0.05), indicating consistent binding of PLTs to PBMNCs. The results of these experiments showed that there was a consistent and significant increase in expression of conventional activation markers of T cells, B cells, and monocytes compared with appropriate controls (p < 0.05 to <0.01).

CONCLUSION: The results of this study indicate that, from Day 3 onward, activation markers are consistently expressed on PLTs. From these results, we conclude that activated PLTs may affect PBMNC interactions in recipients.
Fibrin glue for refractory hemorrhagic cystitis after unrelated marrow, cord blood, and haploidentical hematopoietic stem cell transplantation
Authors: Tirindelli Maria Cristina , Flammia Gerardo , Sergi Federico , Cerretti Raffaella , Cudillo Laura , Picardi Alessandra , Postorino Massimiliano , Annibali Ombretta , Greco Rosa , Avvisati Giuseppe , Arcese William
Published: October 2008

BACKGROUND: Patients undergoing hematopoietic stem cell transplant (HSCT) are particularly exposed to the risk of developing hemorrhagic cystitis (HC), which is characterized by symptoms ranging from macroscopic hematuria to renal failure. Although HC significantly affects the quality of life and in a few cases becomes intractable leading to patient death, its therapeutic management has not been established. Fibrin glue (FG), a hemostatic agent derived from human plasma, has been largely employed in different surgical settings including urologic procedures.

STUDY DESIGN AND METHODS: In this pilot study we used FG to treat refractory HC. During cystoscopy, bladder distension was maintained at a constant pressure of 12 mmHg by a carbon dioxide insufflator. An endoscopic applicator allowed spraying FG on the bleeding and raw surfaces of bladder mucosa.

RESULTS: Five of 221 patients undergoing an HSCT developed a very severe, refractory HC and have been treated with endoscopic FG. The treatment was successful in 3 patients; the response was partial in 1 patient and transient in the last one, whose clinical course was severely complicated by acute graft‐versus‐host disease and multiple organ failure.

CONCLUSIONS: FG therapy is a feasible procedure and this pilot study suggests that it may be an effective treatment for refractory HC. Its application could be considered also in Grade 1 or 2 HC to prevent progression of damaged mucosa. The use of FG for HC should be prospectively investigated in terms of therapeutic efficacy, transfusion support, length of hospitalization, quality of life, and costs.
Expression levels of CD47, CD35, CD55, and CD59 on red blood cells and signal‐regulatory protein‐α,β on monocytes from patients with warm autoimmune hemolytic anemia
Authors: Barros Melca M.O. , Yamamoto Mihoko , Figueiredo Maria S. , Cançado Rodolfo , Kimura Elisa Y.S. , Langhi Dante M. , Chiattone Carlos S. , Bordin Jose O.
Published: October 2008

BACKGROUND:Animal models have shown that CD47‐deficient mice develop severe autoimmune hemolytic anemia (AIHA) because the binding of red blood cell (RBC) CD47 to signal‐regulatory protein (SIRP‐α) on macrophages contributes to the inhibition of phagocytosis. In contrast, complement‐inhibitory proteins such as CD35, CD55, and CD59 may protect RBCs against the lysis by complement.

STUDY DESIGN AND METHODS:With the use of flow cytometric analyses, the expression of CD47, CD35, CD55, and CD59 on RBCs and of SIRP‐α,β on peripheral monocytes of 36 patients with warm AIHA (wAIHA; 23 with active wAIHA, 13 with wAIHA in remission) and 20 healthy subjects was evaluated.

RESULTS:The mean fluorescence intensities (MFIs) of the expression of CD47, CD35, CD55, and SIRP‐α,β of active wAIHA patients, wAIHA in remission, and healthy subjects were not statistically different. Patients with active wAIHA showed significantly lower CD59 expression on RBCs than healthy individuals (MFI, 512.5 ± 59.6 vs. 553.7 ± 36.6; p = 0.009), while the CD59 expression in patients with wAIHA in remission was not significantly different from that of healthy controls (MFI, 538.4 ± 48.3 vs. 553.7 ± 36.6; p > 0.05). The expression of CD59 on RBCs of 3 patients who died from the wAIHA was lower than that seen on RBCs of healthy controls (MFI, 433.6 ± 69.6 vs. 553.74 ± 36.6; p = 0.0001).

CONCLUSIONS:Our data show that the expression of CD47 on RBCs and SIRP‐α,β on monocytes of patients with wAIHA is not different from that seen in healthy individuals. In addition, we detected that patients with active wAIHA present low expression of CD59 and normal expression of CD35 and CD55 on their RBCs. Complement‐regulatory proteins may play an important role in protecting RBC destruction through the activation of complement.
Long‐term deficits in health‐related quality of life after recovery from thrombotic thrombocytopenic purpura
Authors: Lewis Qurana F. , Lanneau Marion S. , Mathias Susan D. , Terrell Deirdra R. , Vesely Sara K. , George James N.
Published: October 2008

BACKGROUND: After recovery from thrombotic thrombocytopenic purpura (TTP), patients commonly describe persistent problems with memory, concentration, and endurance.

STUDY DESIGN AND METHODS: The Oklahoma TTP‐HUS Registry, an inception cohort of 364 patients, January 1, 1989, through June 30, 2007, has annually evaluated health‐related quality‐of‐life since 1998 with the Short Form (SF)‐36, a widely used questionnaire that assesses eight domains of physical and mental health.

RESULTS: A total of 128 patients were eligible for this study (age ≥ 18 years, alive in January 1998 without prior relapse, survival and no relapse ≥1 year after recovery, no overt disability or additional disorders); 118 (92%) completed the SF‐36. At their initial assessment, these patients had significantly worse functioning and well‐being than the US population for all domains (p < 0.05). Forty‐nine patients who had their initial assessment more than 2 years after recovery had better scores for three domains than 69 patients who had their initial assessment 2 years or less after recovery (p < 0.05). Among these 69 patients, there was no difference between subgroups: 1) idiopathic versus other categories of TTP, 2) the presence or absence of severe ADAMTS13 deficiency, 3) the presence or absence of severe neurologic abnormalities during the episode of TTP, and 4) less than 10 or 10 or more plasma exchange treatments required to achieve remission (p > 0.05). Analysis of serial assessments in 72 (61%) of the 118 patients who had two or more assessments within 5 years of recovery and no intervening relapses demonstrated no significant improvement in any of the domains.

CONCLUSION: After recovery from TTP, patients may have persistent cognitive and physical difficulties.
Modulation of the Sinus Rate during Ventricular Fibrillation
Authors: WASMUND STEPHEN L. , PAI RAKESH K. , FREEDMAN ROGER A. , ABEDIN MOEEN , DACCARETT MARCOS , SEGERSON NATHAN M. , ZAITSEV ALEXEY V. , HAMDAN MOHAMED H.
Published: October 2008

Background:
During supraventricular and ventricular tachycardia, the arterial baroreflex predominates with minimal contribution from the cardiopulmonary reflex. To our knowledge, the role of the arterial baroreflex gain (BRG) during and immediately following termination of ventricular fibrillation (VF) has not been characterized.

Objective:
We hypothesized that (1) arterial BRG correlated with sinus node cycle length (SNCL) changes during VF, and that (2) the greater the arterial BRG, the greater the blood pressure (BP) recovery following successful defibrillation.

Methods:
Arterial BRG was assessed in 18 patients referred for the implantation of a defibrillator incorporating an atrial lead. The average SNCL was measured during the 5 seconds prior to VF induction and the last 5 seconds during VF before defibrillation. Percent SNCL change (%ΔSNCL) was determined. Arterial BP recovery was calculated as the difference in mean BP following defibrillation compared to during VF.

Results:
Arterial BRG ranged between –3 and 18 ms/mmHg. During VF, SNCL shortened in 11 patients (group A, mean %ΔSNCL =–15%), and surprisingly lengthened in seven patients (group B, mean %ΔSNCL = 5%). There was no correlation between %ΔSNCL and arterial BRG. In fact, arterial BRG in group A was lower when compared with group B (P = 0.075). Similarly, there was no correlation between arterial BRG and BP recovery.

Conclusions:
We found no correlation between arterial BRG and %ΔSNCL during VF, or BP recovery following defibrillation. Our findings of SNCL lengthening in 7 of 18 patients suggest that in some patients, arterial BRG plays a minor role during VF with a greater contribution from the cardiopulmonary BRG.
One‐Year Outcomes with the TAXUS Liberté Stent in the Real World: The TAXUS OLYMPIA Registry (Phase I)
Authors: AHMED WAQAR HABIB , ZAMBAHARI ROBAAYAH , AL‐RASHDAN IBRAHIM , AL NAEEMI ABDULLAH , SAEED FUAD A. , MASCIOLI STEPHEN
Published: October 2008

Background: The TAXUS OLYMPIA registry is a prospective, postapproval registry collecting clinical outcomes data on patients receiving the TAXUS Liberté paclitaxel‐eluting stent during routine interventional cardiology practice.

Methods: Between February and July 2005, 529 patients receiving the TAXUS Liberté stent at 16 centers in the Middle East, South/Central America, and Asia/Pacific regions were enrolled in Phase I of OLYMPIA. The primary end‐point was TAXUS Liberté stent‐related cardiac events (cardiac death, MI, and revascularization) at 30 days postimplant. Additional clinical assessment was conducted at 6 and 12 months. OLYMPIA phases II and III are in clinical follow‐up and will be reported separately.

Results: One‐year clinical follow‐up is available for 98% of patients. Complex patients and lesions were prevalent, including: 50% diabetes mellitus, 49% multivessel disease, 30% multiple stenting, 48% AHA/ACC type B2/C lesions, 19% long lesions (>26 mm), and 40% small vessels (≤2.75 mm). At 1 year, the cardiac event rate was 4.1%, including 1.5% cardiac death, 1.5% MI, and 2.3% target vessel revascularization (TVR). The TAXUS Liberté stent‐related cardiac event rate was 3.7% at 1 year. Stent thrombosis (ST) occurred in 1.7% of patients, with three cases occurring >30 days postprocedure. One‐year cardiac event rates among complex subpopulations (diabetics 5.0%, multiple stents 3.8%, long lesions 3.1%, and small vessels 2.9%) were comparable to the overall study population.

Conclusions: In conclusion, this first report of real‐world experience with the TAXUS Liberté stent demonstrates the safety and clinical utility of this stent in the broader spectrum of coronary disease treated in everyday practice.
Neoliberal Reform and Health Dilemmas
Authors: Foley Ellen E.
Published: October 2008

In this article, I trace the links among neoliberalism, regional ecological decline, and the dynamics of therapeutic processes in rural Senegal. By focusing on illness management in a small rural community, the article explores how economic reform is mediated by existing social structures, and how household social organization in turn influences therapeutic decision making. The illness episodes relayed here demonstrate how the acute economic and social crisis facing the Ganjool region becomes written on the bodies of young men, and how the fault lines of gender and generation shape illness experiences. These narratives also illuminate the tremendous discrepancy between the lived realities of sickness and death, and the idealized models of health participation and empowerment envisioned by the state. Rather than “neoliberal subjects” who behave as rational economic actors, men and women coping with illness are social beings embedded in fields of power characterized by highly stratified household social relations.
Templated Grain Growth of <001> Textured PMN‐28PT Using SrTiO3 Templates
Authors: Brosnan Kristen H. , Poterala Stephen F. , Meyer Richard J. , Misture Scott , Messing Gary L.
Published: October 2008

Highly textured PMN‐28PT (0.72Pb(Mg1/3Nb2/3)O3–0.28PbTiO3) ceramics were produced by templated grain growth on <001> oriented platelet‐shaped SrTiO3 template particles with an aspect ratio of 10–15. The templates were aligned in PMN‐28PT matrix powder via tape casting and fired in an O2–PbO atmosphere at 1150°C for up to 15 h. This resulted in textured ceramics with a 40 micrometer grain size and without residual templates. The volume fraction of textured material ( f ) and the orientation parameter (r) were quantified by fitting X‐ray diffraction rocking curve data to the March–Dollase equation. Processing conditions were optimized to achieve the best possible values of f and r for the chosen templates and matrix powder. A texture fraction of at least 81 vol% and an orientation parameter of 0.2 were achieved when all random matrix grains were consumed (a perfect textured ceramic would show a texture fraction of 100 vol% and an orientation parameter of 0).
Methanol–Water System for Solvothermal Synthesis of YVO4:Eu with High Photoluminescent Intensity
Authors: Kaowphong Sulawan , Nakashima Kouichi , Petrykin Valery , Thongtem Somchai , Kakihana Masato
Published: October 2008

A methanol–water mixed solvent was used as a reaction medium for the preparation of Eu3+‐doped YVO4 phosphor materials. These were synthesized by a solvothermal method at 150°–300°C using a 10 vol% solution of water in methanol as the reaction medium followed by calcination at 1000°–1200°C. The phase composition and optical properties of the products were characterized by X‐ray diffraction, scanning electron microscope, and photoluminescence spectroscopy. The powders obtained were composed of spherical particles ∼0.5 μm in size, with an internal structure that was different for samples prepared under subcritical and supercritical conditions of methanol. After the calcination, the powders obtained at 240°–300°C retained the initial raspberry‐like morphology, whereas the morphology of samples prepared at 150°–210°C changed significantly due to noticeable sintering. The fluorescence intensity exhibited by the prepared samples was higher than the fluorescence intensity shown by one of the best commercial YVO4:Eu phosphors having a large particle size.
Spray Pyrolysis of Fe3O4–BaTiO3 Composite Particles
Authors: Adachi Tomoyuki , Wakiya Naoki , Sakamoto Naonori , Sakurai Osamu , Shinozaki Kazuo , Suzuki Hisao
Published: October 2008

Fe3O4–BaTiO3 composite particles were successfully prepared by ultrasonic spray pyrolysis. A mixture of iron(III) nitrate, barium acetate and titanium tetrachloride aqueous solution were atomized into the mist, and the mist was dried and pyrolyzed in N2 (90%) and H2 (10%) atmosphere. Fe3O4–BaTiO3 composite particle was obtained between 900° and 950°C while the coexistence of FeO was detected at 1000°C. Transmission electron microscope observation revealed that the composite particle is consisted of nanocrystalline having primary particle size of 35 nm. Lattice parameter of the Fe3O4–BaTiO3 nanocomposite particle was 0.8404 nm that is larger than that of pure Fe3O4. Coercivity of the nanocomposite particle (390 Oe) was much larger than that of pure Fe3O4 (140 Oe). These results suggest that slight diffusion of Ba into Fe3O4 occurred.
The Effect of Electric Field on Pressure Filtration of Ceramic Suspensions
Authors: Hirata Yoshihiro , Uchima Hiroyuki , Tanaka Yosuke , Matsunaga Naoki
Published: October 2008

The consolidation behavior of Al2O3 and indium tin oxide (ITO, 90% In2O3–10% SnO2) particles 150–200 nm in size was examined using a pressure filtration apparatus at a constant compressive rate under an electric field. The relation of applied pressure (ΔPt) with volume of dehydrated filtrate (Vf) was compared with the established filtration theory (theory I) for a well‐dispersed suspension and the newly developed filtration theory (theory II) for a flocculated suspension. The experimental results without polyelectrolyte dispersant deviated from theory I when ΔPt exceeded a critical pressure (ΔPtc). This deviation is associated with the phase transition from a dispersed suspension to a flocculated suspension at ΔPtc. A good agreement was shown between the developed theory II and experimental results after the phase transition. When a dispersant (polyacrylic ammonium, PAA) was added to alumina, ITO, or Al2O3–ITO mixed powder suspensions, the consolidation behavior of the particles was controlled by the dissociation and amounts of adsorbed and free PAA. The addition of a large amount of highly charged PAA enhanced the repulsive interaction between PAA‐adsorbed particles, and the consolidation behavior was explained by theory I. The adsorption of neutral PAA on the particles reduced the repulsive interaction, and the consolidation behavior was well explained by theory II. The phase transition from dispersed to flocculated suspension was very sensitive to the electric field during the pressure filtration. The ΔPtc for the suspension with and without PAA decreased drastically when a low electric field was applied. The final packing density of the flocculated particles was greatly increased by the application of a weak electric field. However, the dense structure under high pressure was relaxed to a low‐density structure when the stored elastic strain energy was released.