bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of the patients with delaminated rotator cuff tear
Authors: Iwashita Satoshi , Hashiguchi Hiroshi , Okubo Atsushi , Yoneda Minoru , Takai Shinro 
Published: July 2018

Purpose: The purpose of this study was to analyze factors relating to delamination in full-thickness rotator cuff tears.
Methods: 126 patients with full-thickness rotator cuff tears treated by arthroscopic rotator cuff repair were the subjects of this study. There were 52 females and 74 males whose average age was 64.2 years. Fifty-three patients had history of trauma. The average duration of disorder was 29.5 weeks. Nineteen patients were diagnosed with diabetes. On types of the tears, small tear was observed in 59 patients, medium tear in 47 patients, large tear in 6 patients, and massive tear in 14 patients. The average size of tear was 1.98 cm. Delamination of the torn cuff was observed in 45 patients. Factors compared between the patients without delamination and those with delamination were as follows: gender and age of the patients, history of trauma, duration of disorder, diabetes, smoking, size and number of rotator cuff tears.
Results: The delamination rate of the smoking patients was significantly higher than non-smoking patients. The delamination rate of patients with more than two tendon tears was significantly higher than those with only one tendon tear. The average size of tear with delamination was significantly larger than that of tear without delamination. The other factors were not related to delamination.
Conclusions: This study suggests that smoking, size of tear and number of torn cuffs are associated with delamination. The progression of torn cuff, anatomical features and nicotine of smoking affect the causes of delaminated tear of rotator cuff.
Prävention und Behandlung von Antipsychotika-induzierten tardiven Dyskinesien
Authors: Erbe Sebastian 
Published: July 2018

ZusammenfassungTardive Dyskinesien (TD) sind immer noch häufige Langzeitfolgen einer Behandlung mit Antipsychotika. Sie sind meist irreversibel, mit einer geringeren Lebensqualität und kognitiven Defiziten assoziiert und ein Risikofaktor für erhöhte Sterblichkeit. Auch führen sie häufig zu einer weiteren Stigmatisierung der betroffenen Patienten. In der Behandlung von schweren psychiatrischen Krankheitsbildern sind Antipsychotika aber weiterhin nicht entbehrlich. Deshalb ist das Wissen insbesondere über die Prävention und die Risikofaktoren aber auch über die Behandlung von TD bei der Verordnung von Antipsychotika sehr wichtig. Die Behandlung von TD besteht in der Optimierung der antipsychotischen Pharmakotherapie. Des Weiteren können gezielte medikamentöse Behandlungen erfolgen. Hierbei kommt den sogenannten VMAT-2-Inhibitoren eine besondere Rolle zu. Die neuen VMAT-2-Inhibitoren sind in Deutschland noch nicht zugelassen. Weitere Medikamente zur Behandlung der TD sind unter anderem Clonazepam und Gingko biloba. Dieser Übersichtsartikel fasst die gegenwärtige Evidenz für die Behandlung von TD zusammen und versucht klinische Empfehlungen zur Prävention und Behandlung von TD zu formulieren.
Die ELDERLY-Studie: Design und Stichprobe einer Untersuchung zur ambulanten Psychotherapie von Alkoholkonsumstörungen bei älteren Erwachsenen
Authors: Behrendt Silke , Braun Barbara , Bühringer Gerhard 
Published: July 2018

Zusammenfassung
Ziel Über die ELDERLY-Studie zur Erprobung zweier ambulanter Kurzinterventionen (Einzelsetting) für Menschen im Alter 60+ mit DSM-5 Alkoholkonsumstörung (AKS) in Deutschland zu informieren.
Methoden Eine internationale, multizentrische, randomisiert-kontrollierte Studie ohne Medikamentengabe, mit einer Eingangs- und 4 Folgeuntersuchungen. Studienteilnehmer wurden zufallsbasiert einer Behandlungsvariante zugewiesen: 4 Sitzungen Motivierende Gesprächsführung (MET) oder 12 Sitzungen MET und Community Reinforcement Approach for Seniors (CRAS).
Ergebnisse N=203 Personen nahmen in Deutschland an der Studie teil (47,8% Frauen, Durchschnittsalter: 66,5 Jahre). Alle Schweregrade einer DSM-5 AKS waren vertreten (schwergradig: 32,5%). Die Intervention wurde von den Teilnehmern überwiegend positiv bewertet.
Schlussfolgerungen Ältere Menschen mit AKS sind einer ambulanten Kurzintervention gegenüber aufgeschlossen. Sie weisen nicht zwingend nur leichtgradige AKS auf.
Inherited Prethrombotic Disorders and Infectious Purpura
Authors: Westendorp Rudi G J , Reitsma Pieter H , Bertina Rogier M 
Published: July 2018

SummaryPatients with severe meningococcal infection are characterized by extensive microvascular thrombosis, consumption coagulopathy and secondary hemorrhages. The contribution of the inherited prethrombotic disorders to the severity of the disease course is not established yet. Here, we report on the levels of protein C, protein S, antithrombin and the presence of the factor V Leiden mutation (R506Q) in 50 patients with meningococcal disease, as determined 6 to 58 months after hospital discharge. In addition, we recalled the parents of 16 deceased patients to screen for the mutation in factor V, an abnormality which results in resistance to activated protein C. Among the patients, the prevalence of the genetic risk factors for thrombosis was not higher than expected on the basis of their prevalence in the general population. Moreover, the prevalence of the factor V Leiden mutation was not increased among the parents of the deceased patients. The individual plasma levels of protein C, protein S, and antithrombin did not differ between the patients with or without severe purpura. The present data constitute circumstantial evidence that primary defects in the natural anticoagulant systems do not play a major role in the severity of the disease course. Screening of patients with infectious purpura for inherited thrombotic risk factors is therefore not indicated.
Cloning of the Rat Tissue Factor cDNA and Promoter: Identification of a Serum-response Region
Authors: Taby Olivier , Rosenfield Claire-Lise , Bogdanov Vladimir , Nemerson Yale , Taubman Mark B 
Published: July 2018

SummaryTissue factor (TF) initiates coagulation and its expression in vascular smooth muscle cells (VSMC) likely plays a role in the propagation of arterial thrombosis. We report cloning the cDNA and proximal promoter region of the rat TF gene. While maintaining the general structure and organization of the TF molecule, there is a surprising divergence (≈ 18%) between the derived amino acid sequences of the rat and mouse TF. In contrast, there is striking similarity (90%) in the 5’ untranslated regions. High levels of basal promoter activity were seen in rat VSMC with constructs containing 106 bp of sequence downstream from the putative transcription start site and 426 to 103 bp of upstream sequence. Deletion of the sequence from −103 to −79, containing a single SP1 site, removed virtually all of the basal and serum-induced activity. Removal of the NFkB site or two additional upstream SP1 sites had little effect on serum responsiveness. Removal of the 5’ untranslated region abolished most of the basal activity of the TF promoter, suggesting that its high degree of conservation may be due to the presence of transcriptional elements critical for TF expression in rodent VSMC.
Platelet Anti-Aggregating Activity and Tolerance of Clopidogrel in Atherosclerotic Patients
Authors: Boneu B , Destelle G ,   on behalf of the Study Group
Published: July 2018

SummaryThe anti-aggregating activity of five rising doses of clopidogrel has been compared to that of ticlopidine in atherosclerotic patients. The aim of this study was to determine the dose of clopidogrel which should be tested in a large scale clinical trial of secondary prevention of ischemic events in patients suffering from vascular manifestations of atherosclerosis [CAPRIE (Clopidogrel vs Aspirin in Patients at Risk of Ischemic Events) trial]. A multicenter study involving 9 haematological laboratories and 29 clinical centers was set up. One hundred and fifty ambulatory patients were randomized into one of the seven following groups: clopidogrel at doses of 10, 25, 50,75 or 100 mg OD, ticlopidine 250 mg BID or placebo. ADP and collagen-induced platelet aggregation tests were performed before starting treatment and after 7 and 28 days. Bleeding time was performed on days 0 and 28. Patients were seen on days 0, 7 and 28 to check the clinical and biological tolerability of the treatment. Clopidogrel exerted a dose-related inhibition of ADP-induced platelet aggregation and bleeding time prolongation. In the presence of ADP (5 \lM) this inhibition ranged between 29% and 44% in comparison to pretreatment values. The bleeding times were prolonged by 1.5 to 1.7 times. These effects were non significantly different from those produced by ticlopidine. The clinical tolerability was good or fair in 97.5% of the patients. No haematological adverse events were recorded. These results allowed the selection of 75 mg once a day to evaluate and compare the antithrombotic activity of clopidogrel to that of aspirin in the CAPRIE trial.
Dietary Vitamin and Stability of Oral Anticoagulation: Proposal of a Diet with Constant Vitamin K1 Content
Authors: Booth Sarah L , Charnley Jacqueline M , Sadowski James A , Saltzman Edward , Bovill Edwin G , Cushman Mary 
Published: July 2018

SummaryCase reports cited in Medline or Biological Abstracts (1966-1996) were reviewed to evaluate the impact of vitamin K1 dietary intake on the stability of anticoagulant control in patients using coumarin derivatives. Reported nutrient-drug interactions cannot always be explained by the vitamin K1 content of the food items. However, metabolic data indicate that a consistent dietary intake of vitamin K is important to attain a daily equilibrium in vitamin K status. We report a diet that provides a stable intake of vitamin K1, equivalent to the current U.S. Recommended Dietary Allowance, using food composition data derived from high-performance liquid chromatography. Inconsistencies in the published literature indicate that prospective clinical studies should be undertaken to clarify the putative dietary vitamin K1-coumarin interaction. The dietary guidelines reported here may be used in such studies.
The Risk of Recurrent Venous Thromboembolism in Patients with and without Factor V Leiden
Authors: Eichinger Sabine , Pabinger Ingrid , Stümpfien Andreas , Hirschl Mirko , Bialonczyk Christine , Schneider Barbara , Mannhalter Christine , Minar Erich , Lechner Klaus , Kyrle Paul A 
Published: July 2018

SummaryThromboprophylaxis with oral anticoagulants up to six months is established in patients after a first venous thromboembolic event (VTE). The risk of recurrent VTE is still considerable thereafter, and it is uncertain whether some patients might benefit from extended anticoagulation. We performed a prospective, multicenter trial (4 thrombosis centers) and evaluated in 380 patients with a first or recurrent VTE (patients with a deficiency of antithrombin, protein C, protein S or plasminogen; cancer; or an antiphospholipid antibody syndrome were excluded) the risk of recurrence after discontinuation of secondary thromboprophylaxis with oral anticoagulants. It was the aim of the study to evaluate whether patients with factor V Leiden are at an increased risk of recurrent VTE. 112 (29.5%) patients were carriers of factor V Leiden (26.9% heterozygous, 2.6% homozygous). After a median observation time of 19.3 months the overall recurrence rate of VTE was 9.9%. Recurrent deep vein thrombosis and/or pulmonary embolism occurred in 26 of 268 patients without factor V Leiden (9.7%) and in 10 of 112 patients with factor V Leiden (8.9%). The probability of recurrent VTE two years after discontinuation of oral anticoagulants was 12.4% (95% Cl 7.8-17) in patients without factor V Leiden and was 10.6% (95% Cl 3.8-17.4) in carriers of the mutation. This difference was statistically not significant. Patients with factor V Leiden are not at a higher risk of recurrent VTE within two years after discontinuation of oral anticoagulants than patients without factor V Leiden. Balancing the risk of recurrent VTE and bleeding from oral. anticoagulants, patients with factor V Leiden are not likely to benefit from oral anticoagulant therapy extended beyond six months.
Molecular Weight Measurements of Low Molecular Weight Heparins by Gel Permeation Chromatography
Authors: Mulloy B , Gee C , Wheeler S F , Wait R , Gray E , Barrowcliffe T W 
Published: July 2018

SummaryThe molecular weight profiles of low molecular weight heparin samples have been measured by high-performance gel permeation chromatography using as calibrant the heparinase-degraded material (90/686) now established as the 1st International Reference Preparation (IRP) Low Molecular Weight Heparin for Molecular Weight Calibration. Use of the calibrant as a broad molecular weight standard is described and a calibration table provided based on data collected over several years in one laboratory.In order to confirm the assignment of degree of polymerisation to resolved oligosaccharide peaks in the calibrant, molecular weights of oligosaccharides fractionated from the 1st IRP were independently determined by fast atom bombardment mass spectrometry (FAB MS).The molecular weight distributions of commercial low molecular weight heparins have been characterized. Measurements of molecular weight parameters of heparin molecular weight standards from several sources provide comparisons between the molecular weight scales of this and other studies.
The Dietary Pigment Curcumin Reduces Endothelial Tissue Factor Gene Expression by Inhibiting Binding of AP-1 to the DNA and Activation of NF-κB
Authors: Bierhaus Angelika , Zhang Youming , Quehenberger Peter , Luther Thomas , Haase Michael , Müller Martin , Mackman Nigel , Ziegler Reinhard , Nawroth Peter P 
Published: July 2018

SummaryThe natural occurring pigment curcumin, a major component of the spice tumeric, has been described to have antioxidative, antitumorpro moting, anti-thrombotic and anti-inflammatory properties. It appears, that the pleiotropic effects of curcumin are at least partly due to inhibi tion of the transcription factors NF-κB and AP-1. This study investi gates the effect of curcumin on the TNFa induced expression of endo thelial Tissue Factor (TF), the central mediator of coagulation known to be controlled by AP-1 and NF-κ When bovine aortic endothelial cells (B AEC) were preincubated in the presence of curcumin, TNFα induced TF gene transcription and expression were reduced. Transient transfec tion studies with TF-promoter plasmids revealed that both, NF-κ and AP-1 dependent TF expression, were reduced by curcumin action. The observed inhibitions were due to distinct mechanisms. Curcumininhib ited TNFa induced kBa degradation and the nuclear import of NF-κB. In contrast, inhibition of AP-1 was due to a direct interaction of curcu min with AP-1-binding to its DNA binding motif. Thus, curcumin inhibits NF-κB and AP-1 by two different mechanisms and reduces expression of endothelial genes controlled by both transcription factors in vitro.
Factor V Leiden Is Associated with Repeated and Recurrent Unexplained Fetal Losses
Authors: Grandone Elvira , Margaglione Maurizio , Colaizzo Donatella , d'Addedda Marina , Cappucci Giuseppe , Vecchione Gennaro , Sciannamé Natale , Pavone G , Di Minno G 
Published: July 2018

SummaryActivated protein C resistance (APCR) is responsible for most cases of familial thrombosis. The factor V missense mutation Arg506>Gln (FV Leiden) has been recognized as the commonest cause of this condition. Recently, it has been suggested that APCR is associated with second trimester fetal loss. We investigated the distribution of FV Leiden in a sample (n = 43) of Caucasian women with a history of two or more unexplained fetal losses. A group (n = 118) of parous women with uneventful pregnancies from the same ethnical background served as control. We found the mutation in 7 cases (16.28%) and 5 controls (4.24%; p = 0.011). A statistically significant difference between women with only early fetal loss vs those with late events (p = 0.04) was observed. Our data demonstrate a strong association between FV Leiden and fetal loss. Furthermore, they indicate that late events are more common in these patients.
High Prevalence of Elevated Factor VIII Levels in Patients Referred for Thrombophilia Screening: Role of Increased Synthesis and Relationship to the Acute Phase Reaction
Authors: O’Donnell J , Tuddenham E G D , Manning R , Kemball-Cook G , Johnson D , Laffan M 
Published: July 2018

SummaryA recent report from the Leiden Thrombophilia Survey identified high factor VIII activity levels as an independent risk factor for venous thromboembolism in a population survey. As the study measure for factor VIII was a one-stage coagulation assay, and since markers for the acute phase reaction were not assessed, it remained uncertain whether the increase was due to a constitutional increased rate of synthesis, to circulating activated factor VIII, or to an acute phase response.We added factor VIII activity assay (FVIII:C), factor VIII antigen (FVIILAg), vWF antigen (vWF:Ag), ABO blood group, fibrinogen and C-reactive protein to our routine thrombophilia screen of patients referred because of unexplained thromboembolism.Elevated FVIILC (>1.5 iu/ml) emerged as the single commonest abnormality detected in 25.4% of a group of 260 such patients.FVIILC and FVIILAg were highly correlated (p = 0.003), showing that this represented a true increase in FVIII. In 4 of 46 patients this was clearly attributable to an acute phase reaction. Eleven others showed minor elevation of ESR and one of CRP. Neither FVIILC or FVIII:Ag showed significant correlation with fibrinogen, ESR or C-reactive protein by non parametric analysis.Although there was an excess of patients with B blood group (known to be associated with FVIILC levels which are -15% higher than those in blood group 0), this could not account for the marked elevation of factor VIII observed in these patients.We conclude that factor VIII activity assay should be a routine part of thrombophilia screening. We are investigating the cause of the increased synthesis, initially by means of family studies and linkage analysis with polymorphic markers of the FVIII locus. We postulate that it may be constitutive in some cases and in others an abnormal or exaggerated response to inflammatory stimuli.
Effect of Fixed Minidose Warfarin, Conventional Dose Warfarin and Aspirin on INR and Prothrombin Fragment 1 + 2 in Patients with Atrial Fibrillation
Authors: Koefoed B G , Feddersen C , Gulløv A L , Petersen P 
Published: July 2018

SummaryThe efficacy of conventional dose adjusted oral anticoagulation for stroke prevention in patients with non-valvular atrial fibrillation is well- documented but not considered ideal as primary antithrombotic treatment in elderly patients. The antithrombotic effect of fixed minidose warfarin 1.25 mg/day alone or in combination with aspirin 300 mg/day, of conventional dose adjusted warfarin (INR 2.0-3.0), and of aspirin 300 mg/day have been investigated in outpatients with chronic nonvalvular atrial fibrillation in the second Copenhagen Atrial Fibrillation, Aspirin and Anticoagulant Therapy Study (AFASAK 2). In order to investigate the effect on the coagulation system of the treatments, the International Normalized Ratio of the prothrombin time (INR) and prothrombin fragment 1 + 2 (F1 +2) were monitored at baseline and after three months of treatment in 100 patients consecutively included in the trial. At baseline no differences in INR and F1+2 between the four treatment groups were present. After three months of therapy the level of INR increased significantly from baseline in patients receiving warfarin in any dose and the level of F1+2 decreased significantly by combined minidose warfarin-aspirin and by dose adjusted warfarin. When comparing the changes over time in FI +2 (three-month value minus baseline value) during therapy with fixed minidose warfarin, combined minidose warfarin-aspirin and aspirin alone no significant difference between the groups was found. In conclusion, INR was changed by all three warfarin regimens but only dose adjusted warfarin (INR 2.0-3.0) had a marked effect on F1+2.
Autoantibodies to Phospholipids and to the Coagulation Proteins in AIDS
Authors: Abuaf N , Laperche S , Rajoely B , Carsique R , Deschamps A , Rouquette A M , Barthet C , Khaled Z , Marbot C , Saab N , Rozen J , Girard P M , Rozenbaum W 
Published: July 2018

SummaryIn HIV-1 infection, an increased prevalence of anticardiolipin autoantibodies (aCL) and lupus anticoagulant (LA) has been described. In order to see if these antibodies are isolated or, like in autoimmune diseases, associated with hematological disorders and with antibodies to other phospholipids and to proteins of coagulation, we investigated 3 groups of patients: 1. 342 HIV-1 infected patients, 2. 145 control patients including 61 systemic lupus erythematosus (SLE) patients, 58 patients with a connective tissue disease, 15 patients with stroke, 11 patients with syphilis and 3.100 blood donors. In HIV-1 infection antiprothrombin (aPrT) antibodies were present in 25% of patients, the prevalence of antiphosphatidylcholine antibodies (aPC) (50%) was almost as high as aCL (64%), and 39% had both antibodies. Absorption on liposomes of the latter revealed an heterogeneous mixture of aCL and aPC or cross-reacting antibodies. In contrast with SLE, anti-β2-glycoprotein I (4%), LA (1%), biological false positive test for syphilis (0.3%), thrombosis (p <0.001) were uncommon. In HIV-1 infection, antiphospholipid antibodies do not associate with features linked to them in SLE or syphilis.
Fibrinogen Heterogeneity in Homozygous Plasminogen Deficiency Type I: Further Evidence that Plasmin Is not Involved in Formation of LMW- and LMW’-Fibrinogen
Authors: Dempfle Carl-Erik , Pfitzner Susanne A , Schott Dorothee , Niessen Karl-Heinz , Heene Dieter L 
Published: July 2018

SummaryHuman plasma fibrinogen is heterogeneous in SDS-polyacrylamide gel electrophoresis and other methods for separation of proteins by molecular size. A high molecular weight fraction (HMW-fibrinogen, 340 kD) contributes approximately 50% of total fibrinogen antigen. Low molecular weight fibrinogen (LMW-fibrinogen, 300 kD) adds another 40%. The residual amount is LMW’-fibrinogen with a molecular weight of 280 kD, and a small amount of very high molecular weight fibrinogen (Fib420), the product of alternative splicing of the Aa-chain genetic information, resulting in an extended A?-chain C-terminus. Fibrinogen was detected by specific immunostaining of nonreduced SDS-PAGE gel immunoblots with antibodies against fibrinopeptide A. Using densitometric scans of the immunoblots we found a ratio of HMW-, LMW- and LMW’-fibrinogen in a patient with homozygous plasminogen deficiency that was similar to the ratio found in immunoblots of plasma from healthy blood donors. Treatment with plasminogen concentrate resulted in a slight decrease of the proportion of HMW-fibrinogen, followed by an increase to 78%. The LMW’- fibrinogen band gained intensity initially, increasing to 11.9% of fibrinogen antigen 6 h after starting plasminogen infusion, but then dropped to levels below detection limit of the immunoblotting assay. LMW-fibrinogen remained constant during the initial 72 h of plasminogen treatment, then dropping to values in the range of 22-25% afterwards. The proportion of HMW-, LMW-, and LMW’-fibrinogen.again reached the initial levels two weeks after starting treatment with plasminogen concentrate. We conclude that plasminogen is not involved in the limited proteolysis leading to formation of LMW-fibrinogen and LMW’-fibrinogen in the absence of a generalized fibrinolytic condition. Fibrinolytic activation may lead to the formation of fibrinogen degradation product X, which appears in a similar position as LMW’- fibrinogen in SDS-PAGE.