bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fate of Erythrocytes Containing Heinz Bodies in the Spleen and Liver of Dogs and Turkeys
Authors: Simpson Charles F. 
Published: January 2017

Similar phagocytic and digestive events involving erythrocytes containing Heinz bodies occured in Kupffer cells and splenic macrophages of the dog. The earliest stage was confinement of a nonhemolyzed red blood cell by the membrane of a phagocytic vacuole. Next, there was leaching of hemoglobin into the phagocytic vacuole, followed by fragmentation and loss of the erythrocytic membrane. A round phagocytic vacuole containing hemosiderin was the fate of phagocytized erythrocytes containing Heinz bodies. There were Heinz bodies in both the cytoplasm and nucleoplasm of turkey erythrocytes. Such erythrocytes occurred in phagocytic vacuoles of Kupffer cells and splenic macrophages and evolved through a process similar to that occurring in canine tissue, except that a single vacuole often contained one or more erythrocytes.
Using an innovative model of service delivery to identify children who are struggling in school
Authors: Missiuna Cheryl , Pollock Nancy , Campbell Wenonah , DeCola Cindy , Hecimovich Cathy , Sahagian Whalen Sandra , Siemon Jennifer , Song Kaiwen , Gaines Robin , Bennett Sheila , McCauley Dayle , Stewart Debra , Cairney John , Dix Leah , Camden Chantal 
Published: January 2017

Introduction School-age children with motor coordination challenges typically require formal referral for occupational therapy services and often experience lengthy wait times for one-to-one intervention. In a new service delivery model called Partnering for Change, therapists work collaboratively with educators in classrooms to observe, identify, and support children. This study describes children identified through a traditional referral process and compares them with children identified by occupational therapists through classroom observation and dynamic performance analysis. Methods Participants included 246 children enrolled in a 2-year evaluative study of the Partnering for Change service delivery. Parents completed a demographic questionnaire, the Developmental Coordination Disorder Questionnaire, and the Strengths and Difficulties Questionnaire. Children’s educators completed the Strengths and Difficulties Questionnaire and the School Function Assessment. Children completed the Movement Assessment Battery for Children. Results Children identified were significantly younger and more likely to be girls than those referred under the traditional model. Using observation and dynamic performance analysis, occupational therapists identified children who had equally marked difficulties as those who came from the waitlist. In the Partnering for Change model, waitlists for service were eliminated for all children. Conclusions Occupational therapists can identify children who are experiencing significant challenges participating at school without the need for standardized assessment, formal referrals, and waitlists.
Using Platelet-Rich Plasma to Promote Healing and Prevent Seroma Formation in Abdominoplasty Procedures
Authors: Jackson Robert F. 
Published: January 2017

Introduction: To evaluate the efficacy of platelet-rich plasma in promoting wound healing and preventing seroma formation, a 30-patient study was conducted between January 2001 and May 2003. The intent of the study was to evaluate the use of platelet-rich concentrate on patients undergoing either full abdominoplasty (4 patients) or crescent tuck abdominoplasty (miniabdominoplasty) surgery. This series of patients was contrasted with a 100-patient study with similar surgery accomplished between 1990 and 2000 and previously reported at the 17th International Congress of the French Society of Aesthetic Surgery and the 5th International Congress of the Society of Lipo-Plasty. In addition, during the 30-patient study, there were 6 patients studied who did not receive platelet-rich concentrate. Those 6 patients were also compared with the 30-patient platelet-concentrate group. Materials and Methods: The platelet concentrate was prepared from 54 mL of blood drawn from the patient at the time of surgery. The anticoagulated volume of 60 mL was processed using a uniquely designed centrifuge system manufactured by Harvest Technologies (Plymouth, Mass). The separation process yielded 10 mL of platelet-rich plasma (PRP). This volume was combined with 1 mL of calcium thrombin in a spray that was applied to the surgical site. The calcium thrombin was used to activate the platelets and fibrinogen to form fibrin chains in order to achieve an immediate hemostatic seal on the tissue beds. The calcium thrombin was prepared by adding 5 mL of 10% calcium chloride to 5000 units of bovine thrombin. Only 1 mL of this mixture was used in the procedure. Prior to the application of the platelet concentrate/calcium thrombin to the tissue beds, absolute hemostasis is accomplished and both beds are blotted as dry as possible. Both the top and bottom layer are sprayed with approximately 4.5 mL of platelet concentrate/calcium thrombin. The tissue layers were approximated and the skin surface rolled to express any fluid from the location of the sutures. Sutures were then placed and the remaining PRP/calcium thrombin mixture was sprayed along the suture line. The formal abdominoplasty was done without liposuction in the upper or epigastric area of the abdomen. The crescent tuck abdominoplasty used was the same as the previous 100-patient series. Results: No seromas were found in the 30 patients studied as compared with a 7% seroma rate in the previous 100-patient series and 2 out of 6 of the patients who had abdominoplasty during the same time as the 30-patient group developed seromas. Anecdotally, the wounds seemed to heal much more rapidly with more esthetically pleasing incisions. Discussion: The addition of platelet-rich plasma is now easily applied at the surgical site with a very easily usable technology that does not require expensive or complicated equipment. The application of platelet-rich plasma as a natural fibrin matrix delivers growth factors to the wound and seems to promote more rapid healing.
Liposhifting: Treatment of Postliposuction Irregularities, Updated
Authors: Saylan Ziya 
Published: January 2017

Introduction: The most common complication after a liposuction is the residual (leftover) fat and hollows. Postliposuction irregularities have been commonly corrected with autologous fat injections, but without any long-term results. In the procedure described below, the fat is shifted under the skin from the surrounding tissues into the hollow without any suctioning, air contact, or injecting. Materials and Methods: The procedure is performed in the following stages: (1) marking the skin while the patient is standing; (2) local anesthestizing of the skin; (3) tumescent technique; (4) loosening the fat with a Becker cannula; (5) shifting; and (6) fixation of the shifted fat. Results: This technique has been applied to 82 patients over a period of 7 years. The rate of satisfaction was 88% (72 patients). Some cases with large imperfections had to be liposhifted more than once (5 cases, 14%). In 8 cases (9.8%), the results were not that satisfactory, and 2 cases (2.4%) did not respond to this treatment. The most common complication was hematoma due to fat loosening (5 cases, 6%). Discussion: Liposhifting is a very promising method for the elimination of larger irregularities on the skin and the underlying tissue caused by liposuction. It is only helpful in the extremities and in the abdominal wall. It is safe because any contamination of the fat transplant via air contact is avoided; it is practical because it does not need any special training or instruments. The irregularities due to liposuction still remain a main problem of the process.
Pronounced Metabolic Response to Modest Theophylline Overdose
Authors: Hagley Michael T. , Traeger Sheldon M. , Schuckman Hugh 
Published: January 2017

OBJECTIVE: To describe a patient who developed significant metabolic abnormalities in response to a low-level theophylline ingestion. CASE SUMMARY: An 18-year-old man was examined after ingesting theophylline 3 g in a suicide attempt. Although his peak theophylline concentration was 157 μmol/L (28.2 μg/mL), it was associated with significant leukocytosis, hypokalemia, hypomagnesemia, hypophosphatemia, hyperglycemia, and lactic acidosis. These abnormalities have been previously associated with theophylline intoxication, but only in conjunction with much higher peak concentrations of theophylline. CONCLUSIONS: Significant metabolic abnormalities can occur with suicidal ingestion of relatively small amounts of theophylline. The presence of these abnormalities should be sought in theophylline overdoses. In the proper clinical circumstances, such abnormalities should raise suspicion of covert theophylline ingestion.
Prevention of Anaphylactoid Reactions in High-Risk Patients Receiving Radiographic Contrast Media
Authors: Wittbrodt Eric T. , Spinler Sarah A. 
Published: January 2017

OBJECTIVE: To review various pretreatment regimens for the prophylaxis of anaphylactoid reactions to radiographic contrast media (RCM) in high-risk patients. The proposed etiologies and risk factors for such reactions are also reviewed. DATA SOURCES: A MEDLINE search of the English-language literature was used to identify pertinent human studies and reviews. STUDY SELECTION: All studies comparing pretreatment regimens for anaphylactoid reactions to RCM were reviewed as well as studies comparing the incidence of anaphylactoid reactions between lower and higher osmolar RCM. DATA SYNTHESIS: The two types of reactions to RCM are the dose-independent, unpredictable anaphylactoid (pseudoallergic or idiosyncratic) reactions and the dose-dependent, predictable physicochemical (intrinsic, nonidiosyncratic) reactions. Prophylaxis of the former type is targeted at stemming the effects of certain chemical mediators, primarily histamine. The use of lower osmolar RCM is associated with a lower incidence of anaphylactoid reactions compared with higher osmolar RCM, but is significantly more expensive. Risk factors for such reactions are a history of previous anaphylactoid reaction to RCM, asthma, and reaction to skin allergens or penicillin. Discontinuation of any beta-blockers before the procedure is suggested. Pretesting patients with a small amount of RCM has little predictive value for an anaphylactoid reaction. Various pretreatment prophylactic regimens have been studied. Almost all included a corticosteroid to target the inflammatory response and a histamine1 (H1)-antagonist to blunt the effects of histamine. In some clinical trials, ephedrine was added for bronchodilation and cimetidine for its antagonism at the histamine2-receptor. The few controlled clinical trials that have been performed show the combination of prednisone and diphenhydramine to be most beneficial in preventing anaphylactoid reactions to RCM. The addition of ephedrine or cimetidine to a pretreatment regimen remains controversial. CONCLUSIONS: More controlled clinical studies comparing various pretreatment regimens for high-risk patients need to be performed, especially in patients receiving lower osmolar RCM. Recommendations for high-risk patients who must receive RCM include use of a lower osmolar agent, pretreatment with a corticosteroid and an H1-antagonist, discontinuation of beta-blockers if the patient is taking any, and bedside availability of appropriate medications and equipment to treat anaphylaxis.
Monitoring Warfarin Therapy with the International Normalized Ratio
Authors: Howard Patricia A. 
Published: January 2017

OBJECTIVE: To report a case of suboptimal warfarin monitoring. CASE SUMMARY: A patient with a history of rheumatic heart disease and a mechanical mitral valve was admitted to the local hospital complaining of left-sided weakness. At the time, she was receiving warfarin 5 mg/d. Upon admission her prothrombin time (PT) was 15 s. An initial computed tomography (CT) scan of the head was negative. On the basis of the initial findings, it was unclear whether the symptoms were caused by a cerebrovascular accident (CVA). The patient was transferred to the University Medical Center for a more thorough evaluation. The diagnosis of CVA was confirmed by a repeat CT scan seven days after the event. On the basis of the information obtained from the local hospital, it was determined that the initial PT of 15 s converted to an International Normalized Ratio (INR) of 1.5, which is below the recommended range for patients with mechanical heart valves. Prior to discharge, the warfarin dosage was increased to obtain an INR in the recommended range of 2.5–3.5. DISCUSSION: This case illustrates the problems that exist with the current system of PT reporting and the potential advantages of using the INR. Variations in the sensitivity of the thromboplastin reagents used to perform the PT may result in misinterpretation of the level of anticoagulation and errors in warfarin dosage adjustments. The potential for suboptimal anticoagulation is greatly increased in patients, such as the one reported here, who are having PTs performed by multiple laboratories. CONCLUSIONS: To maximize efficacy and minimize the risk of bleeding complications, warfarin therapy must be individualized and closely monitored. Standardization of PT monitoring through the use of the INR would significantly reduce the potential for suboptimal anticoagulation associated with the traditional system of reporting.
Recommended Treatment for Urinary Tract Infection in Pregnancy
Authors: Vercaigne Lavern M. , Zhanel George G. 
Published: January 2017

OBJECTIVE: To establish and recommend a therapeutic regimen for the treatment of urinary tract infection (UTI) in pregnancy based on the published studies. DATA SOURCES: An English-language literature search employing MEDLINE, Index Medicus, and bibliographic reviews of the references obtained were searched (key terms: urinary tract infection, UTI, pregnancy, bacteriuria). STUDY SELECTION AND DATA EXTRACTION: All identified human studies dealing with bacteriuria or UTI in pregnancy were analyzed. DATA SYNTHFSIS: Limited data are available regarding the appropriate antibiotic management of UTI in pregnancy. Single-dose cure rates with amoxicillin are approximately 80 percent. Trimethoprim/sulfamethoxazole provides cure rates of greater than 80 percent. Cephalosporins and nitrofurantoin produce variable results. CONCLUSIONS: We recommend separating pregnant subjects with UTI into two groups. Those with asymptomatic bacteriuria can be treated with a single dose of an antimicrobial to which the organism is susceptible. For those with symptomatic UTI, we recommend amoxicillin 500 mg tid for three days. Urine cultures should be repeated seven days following therapy to assess cure or failure. Well-designed studies need to be performed, comparing single-dose and three-day therapy for UTI in pregnancy.
Use of Antifungal Therapy in Hospitalized Patients II. Results after the Marketing of Fluconazole
Authors: Grasela Thaddeus H. , Pasko Mary T. , Goodwin S. Diane , Walawander Cynthia A. , Blackwelder Nicole , Bruder-Holt Rebecca J. 
Published: January 2017

OBJECTIVE: To evaluatethe prescribing patternsof antifungal agents in the hospital setting after the introduction of fluconazole, a new broad-spectrum bis-triazole antifungal agent. Also comparedare the prescribing patterns of antifungal agents prior to (phase I) and following (phase II) fluconazole marketing. DESIGN: A prospective cohort of hospitalized patients prescribed topical or systemic antifungal agents. Data were collected from December 1990 to April 1991. SETTING: Fifty-seven hospitals ranging in size from 100 to more than 500 beds. Sixty-three percentare affiliated with medical schools. PATIENTS: Participating pharmacists consecutively identified 15 patients receiving systemic antifungal therapy and 5 patients receiving topical antifungal therapy. INTERVENTIONS: Observational data on patient antifungal therapy, risk factors for fungal infections, comorbidities, concurrent medications, and culture data were collected. MEASURES: Differences in prescribing patterns before and after the marketing of fluconazole were assessed using t-tests and chi-square tests. RESULTS: Of 818 patients studied, 615 (75.2 percent) received systemic antifungal therapy. Five hundred forty-six patients received a single antifungal agent; 348 (63.7 percent) received fluconazole, 105 (19.2 percent) received ketoconazole, 92 (16.8 percent) received amphotericin B, and 1 (0.2 percent) received flucytosine. Sixty-nine patients received two or more systemic agents either concurrently or consecutively. The use of parenteral amphotericin B, alone or in combination with flucytosine and/or an azole, declined from 56.8 percent in the phase I study to 24.2 percent in the current study. The use of parenteral therapy also declined from 56.8 to 40.2 percent. Ketoconazole was used in more than 90 percent of the oral and esophageal infections in the phase I study, but its use declined to only 33 percent in this study. Fluconazole was used most frequently across all sites of presumed or documented infections, with the exception of fungemia. Of the presumed or proven systemic or blood infections, amphotericin B was used alone or in combination in 48.4 percent of the patients and fluconazole was used exclusively in 39.0 percent of the patients. Fluconazole was used more often than amphotericin B (22 vs. 3 patients, respectively) for prophylaxis of systemic infections. The overall use of antifungal prophylaxis also increased from the phase I (9.5 percent) to phase II (13.7 percent). CONCLUSIONS: The introduction of fluconazole had a major impact on the prescribing patterns of antifungal therapy. Although amphotericin B remained the preferred agent for treatment of suspected or proven systemic, central nervous system, or blood infections, use of fluconazole for these indications approached nearly 40 percent. Further studies are needed to address the role of fluconazole in the prophylaxis and treatment of systemic mycoses.
Mice with a deficiency in CLEC-2 are protected against deep vein thrombosis
Authors: Payne Holly , Ponomaryov Tatyana , Watson Steve P. , Brill Alexander 
Published: January 2017

Key PointsAbsence of CLEC-2 abrogates venous thrombosis. Podoplanin expression is upregulated in the vessel wall and correlates with the degree of thrombosis.
Assessment of circulating tumor cells and serum markers for progression-free survival prediction in metastatic breast cancer: a prospective observational study
Authors: Bidard François-Clément , Hajage David , Bachelot Thomas , Delaloge Suzette , Brain Etienne , Campone Mario , Cottu Paul , Beuzeboc Philippe , Rolland Emilie , Mathiot Claire , Pierga Jean-Yves 
Published: January 2017

Abstract
Introduction
Circulating tumor cells (CTC) have been recently proposed as a new dynamic blood marker whose positivity at baseline is a prognostic factor and whose changes under treatment are correlated with progression-free survival (PFS) in metastatic breast cancer patients. However, serum marker levels are also used for the same purpose, and no clear comparison has been reported to date.

Methods
The IC 2006-04 enrolled prospectively 267 metastatic breast cancer patients treated by first line chemotherapy and confirmed that CTC levels are an independent prognostic factor for PFS and overall survival (OS). A secondary pre-planned endpoint was to compare prospectively the positivity rates and the value of CTC (CellSearch®), of serum tumor markers (carcinoembryonic antigen (CEA), cancer antigen 15.3 (CA 15-3), CYFRA 21-1), and of serum non-tumor markers (lactate deshydrogenase (LDH), alkaline phosphatase (ALP)) at baseline and under treatment for PFS prediction, independently from the other known prognostic factors, using univariate analyses and concordance indexes.

Results
A total of 90% of the patients had at least one elevated blood marker. Blood markers were correlated with poor performance status, high number of metastatic sites and with each other. In particular, CYFRA 21-1, a marker usually used in lung cancer, was elevated in 65% of patients. A total of 86% of patients had either CA 15-3 and/or CYFRA 21-1 elevated at baseline. Each serum marker was associated, when elevated at baseline, with a significantly shorter PFS. Serum marker changes during treatment, assessed either between baseline and week 3 or between baseline and weeks 6 to 9, were significantly associated with PFS, as reported for CTC. Concordance indexes comparison showed no clear superiority of any of the serum marker or CTC for PFS prediction.

Conclusions
For the purpose of PFS prediction by measuring blood marker changes during treatment, currently available blood-derived markers (CTC and serum markers) had globally similar performances. Besides CEA and CA 15-3, CYFRA 21-1 is commonly elevated in metastatic breast cancer and has a strong prognostic value.
Structural modeling defines transmembrane residues in ADAM17 that are crucial for Rhbdf2–ADAM17-dependent proteolysis
Authors: Li Xue , Maretzky Thorsten , Perez-Aguilar Jose Manuel , Monette Sébastien , Weskamp Gisela , Le Gall Sylvain , Beutler Bruce , Weinstein Harel , Blobel Carl P. 
Published: January 2017

ABSTRACT
A disintegrin and metalloproteinase 17 (ADAM17) controls the release of the pro-inflammatory cytokine tumor necrosis factor α (TNFα, also known as TNF) and is crucial for protecting the skin and intestinal barrier by proteolytic activation of epidermal growth factor receptor (EGFR) ligands. The seven-membrane-spanning protein called inactive rhomboid 2 (Rhbdf2; also known as iRhom2) is required for ADAM17-dependent TNFα shedding and crosstalk with the EGFR, and a point mutation (known as sinecure, sin) in the first transmembrane domain (TMD) of Rhbdf2 (Rhbdf2sin) blocks TNFα shedding, yet little is known about the underlying mechanism. Here, we used a structure–function analysis informed by structural modeling to evaluate the interaction between the TMD of ADAM17 and the first TMD of Rhbdf2, and the role of this interaction in Rhbdf2–ADAM17-dependent shedding. Moreover, we show that double mutant mice that are homozygous for Rhbdf2sin/sin and lack Rhbdf1 closely resemble Rhbdf1/2−/− double knockout mice, highlighting the severe functional impact of the Rhbdf2sin/sin mutation on ADAM17 during mouse development. Taken together, these findings provide new mechanistic and conceptual insights into the critical role of the TMDs of ADAM17 and Rhbdf2 in the regulation of the ADAM17 and EGFR, and ADAM17 and TNFα signaling pathways.
Alterations in the balance of tubulin glycylation and glutamylation in photoreceptors leads to retinal degeneration
Authors: Bosch Grau Montserrat , Masson Christel , Gadadhar Sudarshan , Rocha Cecilia , Tort Olivia , Marques Sousa Patricia , Vacher Sophie , Bieche Ivan , Janke Carsten 
Published: January 2017

ABSTRACT
Tubulin is subject to a wide variety of posttranslational modifications, which, as part of the tubulin code, are involved in the regulation of microtubule functions. Glycylation has so far predominantly been found in motile cilia and flagella, and absence of this modification leads to ciliary disassembly. Here, we demonstrate that the correct functioning of connecting cilia of photoreceptors, which are non-motile sensory cilia, is also dependent on glycylation. In contrast to many other tissues, only one glycylase, TTLL3, is expressed in retina. Ttll3−/− mice lack glycylation in photoreceptors, which results in shortening of connecting cilia and slow retinal degeneration. Moreover, absence of glycylation results in increased levels of tubulin glutamylation in photoreceptors, and inversely, the hyperglutamylation observed in the Purkinje cell degeneration (pcd) mouse abolishes glycylation. This suggests that both posttranslational modifications compete for modification sites, and that unbalancing the glutamylation–glycylation equilibrium on axonemes of connecting cilia, regardless of the enzymatic mechanism, invariably leads to retinal degeneration.