bluuebunny/crossref_metadata_2025_split huggingface dataset:
PAROXYSMAL NOCTURNAL HIEMOGLOBINURIA : AN ACQUIRED DYSHÆMOPOIESIS
Authors: HIRSH J. , UNGAR B. , ROBINSON J. S. 
Published: September 2017

SummaryThe clinical and hæmatological features of three cases of paroxysmal nocturnal hæmoglobinuria are reported. Each patient developed a second hæmatological disorder requiring treatment in its own right. The first patient (Case I) developed severe bone‐marrow hypoplasia, the second (Case II) folic acid deficiency, and the third (Case III) iron deficiency. The severe bone‐marrow hypoplasia was accepted as a feature of paroxysmal nocturnal hæmoglobinuria. Folic acid deficiency was attributed to increased demands associated with a chronic hæmolytic process. Iron deficiency was attributed to inadequate replacement of hæmoglobin and hæmosiderin iron lost in the urine.In each case a considerable time elapsed before the correct diagnosis was made. Delay in diagnosis occurred in one case because the result of the acid‐serum test was initially negative, and in the other two cases because the correct diagnosis was not considered until later in the course of the disease.It is suggested that a diagnosis of paroxysmal nocturnal hæmoglobinuria should be considered in every case of refractory anæmia. As shown in our three cases, the diagnosis of paroxysmal nocturnal hæmoglobinuria cannot be excluded by the temporary absence of hæmoglobinuria or hæmosiderinuria, or by negative results in the acid‐serum test even on several occasions. The circumstances in which these diagnostic criteria may be absent are discussed.All three patients required blood transfusions to maintain their hæmoglobin value at a level compatible with a relatively normal existence. One patient (Case II) developed hæmolytic reactions to transfusions despite the use of carefully washed cells. The problem of these reactions was partly overcome by the adoption of a two‐stage transfusion régime. Additional measures were undertaken to treat complications, but these measures did not appear to influence the patients' transfusion requirements.The name “paroxysmal nocturnal hæmoglobinuria” is considered a little inappropriate, as it is descriptive of merely one prominent feature of the disease. Although paroxysmal nocturnal hæmoglobinuria defies accurate definition at present, it is suggested that it should be regarded as an acquired dyshæmatopoiesis of unknown ætiology, which is usually, but not invariably, accompanied by nocturnal hæmoglobinuria.
THE EXCRETION RATE OF TAMM‐HORSFALL URINARY MUCOPROTEIN IN NORMALS AND IN PATIENTS WITH RENAL DISEASE
Authors: MCKENZIE J. K. , PATEL R. , McQuEEN E. G. 
Published: September 2017

SummaryThe excretion rate of Tamm‐Horsfall urinary mucoprotein was estimated in 15 normal subjects and in 28 patients with renal disease. The method used for estimation was appraised and possible corrections for incomplete precipitation were formulated.Amongst normal subjects, the mean excretion rate of Tamm‐Horsfall mucoprotein was 1·83 mg. per hour per 1·73 sq. m. of body surface. “Corrected” to allow for loss by incomplete precipitation, the figure was 1·94 mg. per hour per 1·73 sq. m. There was no significant difference in excretion rates between males and females.In patients with renal disease, a correlation was observed between overall renal function, as assessed on the basis of creatinine clearance, and rate of Tamm‐Horsfall mucoprotein excretion.No evidence was observed in this series of relative increase in Tamm‐Horsfall mucoprotein excretion rate in pyelonephritis or in other conditions in which proteinuria was not a feature.Patients with gross proteinuria had at times a relatively high rate of excretion of Tamm‐Horsfall mucoprotein. In five nephrotic patients, variations in excretion rate of Tamm‐Horsfall mucoprotein, which was at times considerably raised above normal, were found to occur over a period of months, and these corresponded to variations in excretion rate of total protein. Experiments designed to increase the rate of excretion of serum proteins by increasing the filtered load gave inconclusive results with regard to their effect on Tamm‐Horsfall mucoprotein excretion.The possibility that agglutination of Tamm‐Horsfall mucoprotein with cast formation causes under certain circumstances intrarenal nephron obstruction is discussed.
FAMILIAL HYPERKALÆMIC PERIODIC PARALYSIS
Authors: ALLSOP JOHN L. , GOULSTON KERRY , JOHNSTON COLIN , KELLY DAVID , RAIL L. 
Published: September 2017

SummaryTwo cases of familial hyperkalæmic periodic paralysis (adynamia episodica hereditaria) are described. Attacks of weakness were precipitated in each case by the oral administration of potassium. Mild myotonia was present in one case, but striking in the other. The clinical, biochemical and electromyographic features of the patients are described. Some of the literature is reviewed.
HEREDITARY BLEEDING DISORDERS IN WESTERN AUSTRALIA
Authors: ROBERTSON J. H. 
Published: September 2017

SummaryThe clinical and laboratory findings are reviewed in 147 cases of hereditary bleeding disorders investigated in the years 1956 to 1963.There was an unexpectedly large number of hæmophiliacs (55) in the series, many of whom were very mildly affected. The importance of mild hæmophilia as a cause of unexpected surgical bleeding is noted.The findings in patients with von Willebrand's syndrome were very variable, and about a third had a formal bleeding time when first investigated. The difficulty in diagnosis and distinction from mild hæmophilia is discussed. Menorrhagia was found to be a very frequent presenting symptom in females with this condition.A family affected by hereditary thrombocytopenia is described. This was considered to be a variant of the von Willebrand syndrome.The Hicks‐Pitney test was evaluated and found to be reliable as a screening procedure in patients with less than 30% antihæmophilic globulin.
EXPERIMENTAL PATHOLOGY IN UNDERGRADUATE MEDICAL EDUCATION
Authors: HACKETT EARLE 
Published: September 2017

SummaryUndergraduate courses in pathology rely too much on morbid anatomy and histology, and need to be balanced with experimental work. A teaching method is described whereby a chosen group of medical students gains direct experience of experimental pathology in extracurricular time, and then reports its findings back to the main class. Suitable experiments are listed, and literature is cited in which details of others may be found. The value of this approach to teaching is discussed.
FATAL CARDIAC INFARCTION DUE TO PLATELET THROMBOSIS IN AN EIGHTEEN‐YEAR‐OLD YOUTH
Authors: MATZ L. R. , WURFEL L. J. , SCHWARTZ C. J. 
Published: September 2017

SummaryA case of coronary artery occlusion with cardiac infarction and aneurysm formation in a normocholesterolæmic youth, aged 18 years, is described. One of the occlusions was a recent platelet thrombus, and the other, a recanalizing occlusion, showed extensive foam cell formation, suggesting that this too was of platelet origin. In neither instance was there any demonstrable disease of the arterial wall.
Using blogs to explore the lived‐experience of life after stroke: “A journey of discovery I never wanted to take”
Authors: Thomas Caroline M. , Allison Rhoda , Latour Jos M. 
Published: September 2017

AbstractAimsTo explore the lived‐experiences of stroke survivors as expressed in blogs and to discover the role the blogs play in the writers’ lives.BackgroundStroke can be a devastating, life changing event. Previous qualitative studies tend to examine one aspect of life after stroke. As stroke often has multiple effects, it is necessary to look widely at its lived‐experience. New resources which can enable researchers to explore the lived‐experience of stroke are blogs.DesignPhenomenological exploration using an interpretive thematic analysis.MethodsThe Internet was searched for stroke survivors’ blogs (January–March 2016) using pre‐set criteria, seeking blogs with entries over an extended time (>1 year). Suitable blogs were identified and codes of meaning were identified and developed into categories, subthemes and themes.FindingsEight blogs were identified for analysis. Of the 40 categories, eight subthemes were assimilated; internal dialogue, emotions, transition, stroke effects, health care, “in the world”, relationships, rehabilitation. Two main themes were identified related to perspectives of lived‐experience; Internal relationship with “self” and External relationship with “the world”. Participants expressed loss and initially strove to regain their “old” lives, their focus being recovery and independence.ConclusionStroke survivors must transition from their previous life to a new and initially unwelcome way of being. Rehabilitation should respect this process and support stroke survivors as they undertake this individual journey.
Salidroside suppressing LPS‐induced myocardial injury by inhibiting ROS‐mediated PI3K/Akt/mTOR pathway in vitro and in vivo
Authors: Chen Lvyi , Liu Peng , Feng Xin , Ma Chunhua 
Published: September 2017

AbstractThe purpose of the present study was to investigate the effect of salidroside (Sal) on myocardial injury in lipopolysaccharide (LPS)‐induced endotoxemic in vitro and in vivo. SD rats were randomly divided into five groups: control group, LPS group (15 mg/kg), LPS plus dexamethasone (2 mg/kg), LPS plus Sal groups with different Sal doses (20, 40 mg/kg). Hemodynamic measurement and haematoxylin and eosin staining were performed. Serum levels of creatine kinase (CK), lactate dehydrogenase, the activities of the antioxidant enzymes catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GSH‐px), glutathione, tumour necrosis factor‐α (TNF‐α), interleukin‐6 (IL‐6), and interleukin‐1β (IL‐1β) were measured after the rats were killed. iNOS, COX‐2, NF‐κB and PI3K/Akt/mTOR pathway proteins were detected by Western blot. In vitro, we evaluated the protective effect of Sal on rat embryonic heart‐derived myogenic cell line H9c2 induced by LPS. Reactive oxygen species (ROS) in H9c2 cells was measured by flow cytometry, and the activities of the antioxidant enzymes CAT, SOD, GSH‐px, glutathione‐S‐transferase, TNF‐α, IL‐6 and IL‐1β in cellular supernatant were measured. PI3K/Akt/mTOR signalling was examined by Western blot. As a result, Sal significantly attenuated the above indices. In addition, Sal exerts pronounced cardioprotective effect in rats subjected to LPS possibly through inhibiting the iNOS, COX‐2, NF‐κB and PI3K/Akt/mTOR pathway in vivo. Furthermore, the pharmacological effect of Sal associated with the ROS‐mediated PI3K/Akt/mTOR pathway was proved by the use of ROS scavenger, N‐acetyl‐l‐cysteine, in LPS‐stimulated H9C2 cells. Our results indicated that Sal could be a potential therapeutic agent for the treatment of cardiovascular disease.
Competence Creep Revisited
Authors: Garben Sacha 
Published: September 2017

AbstractHow is it that regardless of the reforms introduced by the Lisbon Treaty to better contain European integration in areas of core state powers, ‘competence creep’ can continue? What is the underlying cause? And why is it problematic? This article proposes answers to these questions through a systematic (re‐)conceptualization of the problem of ‘competence creep’, arguing that it results from the cross‐cutting governance that is the legal Leitmotif of European integration as well as from ‘two‐level games’ of national governments, and that it is problematic from the viewpoint of democratic legitimacy. However, it argues that the one form of competence creep that is most commonly understood as the core problem, and on which most reforms have focused, namely indirect legislation in areas of Member State competence, is actually the least worrying type of covert integration; negative and parallel integration, soft law and co‐ordination are all far more problematic.
The vasopressin system: new insights for patients with kidney diseases
Authors: Clark W. F. , Devuyst O. , Roussel R. 
Published: September 2017

AbstractPeople with chronic kidney disease (CKD) are at risk of severe outcomes, such as end‐stage renal disease or cardiovascular disease, and CKD is a globally increasing health burden with a high personal and economic cost. Despite major progresses in prevention and therapeutics in last decades, research is still needed to reverse this epidemic trend. The regulation of water balance and the state of activation of the vasopressin system have emerged as factors tightly associated with kidney health, in the general population but also in specific conditions; among them, various stages of CKD, diabetes and autosomal dominant polycystic kidney disease (ADPKD). Basic science findings and also epidemiological evidence have justified important efforts towards interventional studies supporting causality, and opening therapeutic avenues. On the basis of recent clinical data, the blockade of V2 vasopressin receptors using tolvaptan in patients with rapidly progressing ADPKD has been granted in several countries, and a long‐term randomized trial evaluating the effect of an increase in water intake in patients with CKD is on‐going.
Reconceptualising Hierarchies: The Disaggregation and Dispersion of Headquarters in Multinational Corporations
Authors: Nell Phillip C. , Kappen Philip , Laamanen Tomi 
Published: September 2017

AbstractIn this paper, we provide an introduction to the Special Issue entitled ‘Divide and Rule? The Emergence and Implications of Increasingly Disaggregated and Dispersed Headquarters Activities in Contemporary Firms’. The purpose is two‐fold. First, we propose a conceptualization of headquarters activities as a dynamic system in which activities can be distributed organizationally and spatially. We explicitly break with the dominant view of the prior research on ‘the headquarters’ as a single, identifiable unit in one specific location. Second, building on the manuscripts accepted for publication in this Special Issue, we outline research implications and put forward an agenda for research on the emergence and continuous management of disaggregated and dispersed headquarters systems.
Anin vitroinvestigation of MalaysianPhytophthora palmivoraisolates and pathogenicity study on oil palm
Authors: Mohamed Azni Intan Nur Ainni , Sundram Shamala , Ramachandran Vasagi , Abu Seman Idris 
Published: September 2017

AbstractBud rot disease affecting oil palm in South American countries is reported to be caused byPhytophthora palmivora.P. palmivorais a local pathogen affecting various crops in Malaysia, and this finding caused an alarm, which prompted an investigation of pathogenicity using MalaysianP. palmivorato assess the potentials of this Oomycete to infect oil palm in Malaysia. A total of 11P. palmivoraisolates were obtained from cocoa and durian for the study. Leaf bioassays via artificial inoculation using 50,000 zoospores/ml and mycelial agar disc showed severe necrotic lesions on the infection spot of oil palm (DxP) spear leaves. Mild infection was observed in oil palm spear leaves of OxG hybrids indicating lower susceptibility againstP. palmivorainfection. Phylogenetic analysis using internal transcribed spacer (ITS) data revealed that Malaysian isolates were genetically similar to Colombian isolates supported by significant bootstrap values. The leaf bioassay results revealed that Malaysian oil palm materials are susceptible towards localP. palmivorainfection. The ColombianP. palmivoraisolates causing bud rot incidence may have evolved over a long period of time, undergone sequential genetic shift to become more virulent towards Colombian oil palm planting materials.
Novel assessment tool to detect breathing pattern disorder in patients with refractory asthma
Authors: Todd Sarah , Walsted Emil S. , Grillo Lizzie , Livingston Rebecca , Menzies‐Gow Andrew , Hull James H. 
Published: September 2017

ABSTRACTBackground and objectiveBreathing pattern disorder (BPD) can co‐exist with and mimic asthma, acting to amplify symptoms and confound assessment of disease control, resulting in inappropriate treatment escalation. The aim of this research was to report the utility of a novel breathing pattern assessment tool (BPAT) to detect BPD in treatment‐refractory asthma.MethodsAs a component of a multidisciplinary assessment, adult patients referred with treatment‐refractory asthma underwent respiratory physiotherapy assessment to diagnose BPD. Based on this assessment, patients were classified as having asthma, asthma + BPD or BPD alone. BPAT data were collected in addition to questionnaire data (Asthma Quality of Life Questionnaire (AQLQ) and Nijmegen Questionnaire (NQ)), pulmonary function and an assessment of exercise capacity.ResultsData were retrospectively analysed for 150 (female; 69%) patients, mean (SD) age of 43 (14) years; characterized as asthma‐only (n = 54, 36%), asthma + BPD (n = 63, 42%) and BPD‐only (n = 33, 22%). Of the total population, 113 (76%) had an NQ score ≥23, but of these only 68% had physiotherapy evidence of BPD. Exercise capacity and AQLQ were lower in the asthma + BPD group than in the asthma‐only group (P < 0.05), whilst lung function was similar between groups. Sensitivity analysis indicated that a BPAT score of ≥4 corresponded to a sensitivity of 0.92 and a specificity of 0.75 for diagnosis of BPD in this cohort.ConclusionBreathing pattern irregularities are highly prevalent in individuals referred with treatment‐refractory asthma and can be characterized using the BPAT. Further work is needed to determine inter‐observer and within‐subject variability and ensure the BPAT is a robust clinical tool.Watch the video abstract
Adherence to PI‐based 2nd‐line regimens in Cambodia is not simply a question of individual behaviour: the ANRS 12276 2PICAM study
Authors: Sagaon‐Teyssier Luis , Mmadi Mrenda Bakridine , Khol Vohith , Ferradini Laurent , Mam Sovatha , Ngin Sopheak , Mora Marion , Maradan Gwenaëlle , Vun Mean Chhi. , Ségéral Olivier , Nerrienet Eric , Saphonn Vonthanak , Spire Bruno 
Published: September 2017

AbstractObjectivesTo investigate whether adherence to antiretroviral treatment (ART) can be explained not only by individual factors but also by health care facilities' characteristics, among a sample of people living with HIV (PLWH) treated with PI‐based regimens in Cambodia.MethodsThe ANRS 12276 2PICAM cross‐sectional survey was conducted between February 2013 and April 2014 among PLWH followed up in 13 health care facilities. The 1316 patients in this analysis corresponded to 90% of the total number of adult patients treated with 2nd‐line PI‐based regimens in Cambodia in the study period. A variable indicating whether patients were non‐adherent (=1) or completely adherent (=0) was constructed. Health care facilities and individual characteristics were included in a two‐level logistic model to investigate their influence on patients' adherence to ART.ResultsA total of 17% of participants did not adhere to ART. Patients in health care facilities outside the capital Phnom Penh were six times more likely to be non‐adherent than those treated in health care facilities in the capital (OR: 6.15, 95% CI [1.47, 25.79]). Providing psychosocial care (provided by psychologist counsellors and/or full‐time coaches) was found to be a structural facilitator of adherence, as the probability of non‐adherence fell by 38.5% per each additional psychological worker present in health care facilities (OR: 0.62, 95% CI [0.43, 0.89]). Financial constraints were the main individual factor preventing adherence.ConclusionsOur results suggest that inefficiencies in health care delivery are detrimental to PLWH health and to the exceptional progress currently being made by Cambodia in response to HIV. Policy makers should focus on increasing the number of psychosocial workers, especially in areas outside the capital.
A blinded, randomized clinical trial evaluating the efficacy and safety of lokivetmab compared to ciclosporin in client‐owned dogs with atopic dermatitis
Authors: Moyaert Hilde , Van Brussel Leen , Borowski Stasia , Escalada Monica , Mahabir Sean P. , Walters Rodney R. , Stegemann Michael R. 
Published: September 2017

BackgroundLokivetmab is an injectable anti‐canine‐IL‐31 monoclonal antibody to treat clinical manifestations of atopic dermatitis (AD) in dogs.Hypothesis/ObjectivesTo characterize the efficacy and safety of lokivetmab, and to demonstrate its noninferiority to ciclosporin under field conditions.AnimalsDogs with chronic AD (n = 274) were enrolled from 40 practices in Belgium, The Netherlands, France and Germany.MethodsAnimals were randomized (1:1) to oral ciclosporin (5 mg/kg/once daily) or monthly injectable lokivetmab (1–3.3 mg/kg) for three months. Eighty one animals that successfully completed the comparative phase were enrolled in a continuation phase receiving lokivetmab for an additional six months. Owners assessed pruritus on a Visual Analog Scale, skin lesions were assessed by veterinary investigators with a Canine AD Extent and Severity Index (CADESI‐03) scale.ResultsLokivetmab was noninferior to ciclosporin for pruritus reduction on Day 28 (51.90% versus 43.72%). For Day 28 CADESI‐03 percentage reduction, noninferiority of lokivetmab (54.17) versus ciclosporin (56.86%) was not achieved. At none of the time points were mean CADESI‐03 scores significantly different between groups. Continued efficacy towards pruritus and lesions was demonstrated in the continuation phase where 76.3% of animals (n = 45) were assessed as ‘normal’ for pruritus at study end. No abnormal health events associated with lokivetmab were observed during the initial three month phase (142 dogs) or during the subsequent six month phase (81 dogs).Conclusions and clinical importanceLokivetmab at a minimum monthly dose of 1 mg/kg provided quick onset (within one day) of a lasting effect in reducing pruritus and skin lesions with a good safety profile.
Correction of antebrachial angulation‐rotation deformities in dogs with oblique plane inclined osteotomies
Authors: Franklin Samuel P. , Dover Ryan K. , Andrade Natalia , Rosselli Desiree , M. Clarke Kevin 
Published: September 2017

AbstractObjectiveTo describe oblique plane inclined osteotomies and report preliminary data on outcomes in dogs treated for antebrachial angulation‐rotation deformities.Study designRetrospective clinical study.AnimalsSix antebrachii from 5 dogs.MethodsRecords of dogs with antebrachial angulation‐rotation deformities treated with oblique plane inclined osteotomies were reviewed. Postoperative frontal, sagittal, and transverse plane alignments were assessed subjectively, and alignment in the frontal and sagittal planes was quantified on radiographs. Outcomes were classified based on owner's and veterinarian's evaluation as full, acceptable, and unacceptable function. Complications were classified as minor, major, or catastrophic.ResultsLimb alignment was subjectively considered excellent in 1 case, good in 3 cases, and fair in 2 cases. Osseous union was achieved in all cases (mean 10.5 weeks; range, 6‐13 weeks). Outcomes were assessed by the veterinarian as return to full function in 5 cases and acceptable function in 1 case at the final in‐hospital follow‐up (mean 44 weeks; range, 6‐124 weeks). All owners classified their dogs as returning to full function at the final phone/email interview (mean 107 weeks; range, 72‐153 weeks). Implants were removed due to infection or irritation in 3/6 limbs, while the other 3 limbs had minor dermatitis secondary to postoperative external coaptation. No catastrophic complications occurred.ConclusionOblique plane inclined osteotomies led to a successful outcome in all 6 limbs, but the technique can be challenging and does not always lead to optimal alignment. Future refinement of this technique could focus on the development of patient‐specific osteotomy guides to improve accuracy and precision.