bluuebunny/crossref_metadata_2025_split huggingface dataset:
Addressing viral hepatitis in the opiate substitution setting: An integrated nursing model of care
Authors: Fragomeli Vince , Weltman Martin 
Published: February 2015

AbstractDespite the availability of effective therapies for hepatitis C virus (HCV) and B virus (HBV), only a minority of infected patients receive treatment. In the general population, morbidity and mortality associated with chronic HCV is now successfully being addressed through the use of antiviral therapy. In Australia, an estimated 41% to 68% of people who inject drugs (PWID) are HCV positive, and between 28% and 59% of users are estimated to have been exposed to HBV. Although current treatment guidelines suggest that active drug use should not preclude people from HCV treatment, uptake of therapy thus far has been low. Patient, physician, social, and logistical‐related barriers contribute to the low uptake of HCV treatment among PWID. Traditional means of managing HCV infection—referral to secondary or tertiary health centers—historically has a poor track record in increasing therapy uptake among this population. The same is true for people with chronic HBV who inject drugs. Close to 50 000 Australians receive opioid substitution therapy (OST) through a range of services, including public and private clinics, thus this setting is an ideal target for identifying and treating people at risk for and already infected with HBV and HCV. Over the last 11 years, a nursing model of care initiated by a teaching hospital in Sydney, Australia that integrates viral hepatitis screening, assessment, and treatment into the OST setting has enhanced access to services among the marginalized injecting drug use population.
Comparison of Global Initiative for Chronic Obstructive Pulmonary Disease 2013 Classification and Body Mass Index, Airflow Obstruction, Dyspnea, and Exacerbations Index in Predicting Mortality and Exacerbations in Elderly Adults with Chronic Obstructive Pulmonary Disease
Authors: Chen Chiung‐Zuei , Ou Chih‐Ying , Yu Chun‐Hsiang , Yang Szu‐Chun , Chang Han‐Yu , Hsiue Tzuen‐Ren 
Published: February 2015

ObjectivesTo examine whether the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) 2013 revision offers greater predictive ability than the body mass index, airflow obstruction, dyspnea, and exacerbations (BODEx) index in elderly adults with chronic obstructive pulmonary disease (COPD).DesignProspective cohort study.SettingUniversity‐affiliated medical center.ParticipantsTaiwanese outpatients with COPD (N = 354).MeasurementsParticipants were classified as Group A (low risk with mild dyspnea), Group B (low risk with more‐severe dyspnea), Group C (high risk with mild dyspnea), and Group D (high risk with more‐severe dyspnea) for GOLD 2013 and from Quartile 1 (0–2 points) to 4 (7–9 points) for BODEx score. Ability to predict exacerbations and mortality was compared using logistic regression analysis with receiver operating characteristic (ROC) curve estimations and area under the ROC curve (AUC).ResultsMortality was 14.1% for GOLD Group A, 14.5% for Group B, 6.5% for Group C, and 35.8% for Group D and 15.2% for BODEx Quartile 1, 22.5% for Quartile 2, 28.1% for Quartile 3, and 79.2% for Quartile 4. Risk of exacerbation relative to Group A was 1.7 (95% confidence interval (CI) = 0.6–4.3) for Group B, 14.1 (95% CI = 4.6–43.2) for Group C, and 17.9 (95% CI = 7.6–42.0) for Group D. The AUC for the GOLD classification and BODEx index were 0.65 and 0.67 for mortality (P = .60) and 0.79 and 0.73 for exacerbation (P = .03).ConclusionThe GOLD 2013 classification performed well in identifying individuals at risk of exacerbations, and its predictive ability for exacerbations was better than that of the BODEx index, although the predictive ability for mortality in elderly adults with COPD was poor for both indices.
Bone shaft bending strength index is unaffected by exercise and unloading in mice
Authors: Wallace Ian J. , Gupta Shikha , Sankaran Jeyantt , Demes Brigitte , Judex Stefan 
Published: February 2015

AbstractAnthropologists frequently use the shaft bending strength index to infer the physical activity levels of humans living in the past from their lower limb bone remains. This index is typically calculated as the ratio of bone shaft second moments of area about orthogonal principal axes (i.e. Imax/Imin). Individuals with high Imax/Imin values are inferred to have been very active, whereas individuals with low values are inferred to have been more sedentary. However, there is little direct evidence that activity has a causal and predictable effect on the shaft bending strength index. Here, we report the results of two experiments that were designed to test the model within which anthropologists commonly interpret the shaft bending strength index. In the first experiment, mice were treated daily with treadmill exercise for 1 month to simulate a high‐activity lifestyle. In the second experiment, in an attempt to simulate a low‐activity lifestyle, functional weight‐bearing was removed from the hindlimbs of mice for 1 month. Femoral mid‐shaft structure was determined with μCT. We found that while exercise resulted in significant enhancement of Imax and Imin compared with controls, it failed to significantly increase the Imax/Imin index. Similarly, stunted bone growth caused by unloading resulted in significantly diminished Imax and Imin compared with controls, but low activity did not lead to significantly decreased Imax/Imin compared with normal activity. Together, these results suggest that caution is required when the bone shaft bending strength index is used to reconstruct the activity levels of past humans.
Clinical, Magnetic Resonance Imaging, and Histopathologic Findings in 6 Dogs with Surgically resected Extraparenchymal Spinal Cord Hematomas
Authors: Hague D.W. , Joslyn S. , Bush W.W. , Glass E.N. , Durham A.C. 
Published: January 2015

BackgroundExtraparenchymal spinal cord hematoma has been described in veterinary medicine in association with neoplasia, intervertebral disk disease, and snake envenomation. There are rare reports of spontaneous extraparenchymal spinal cord hematoma formation with no known cause in human medicine. Multiple cases of spontaneous extraparenchymal spinal cord hematoma have not been described previously in veterinary medicine.ObjectivesTo describe the signalment, clinical findings, magnetic resonance imaging (MRI) features, and surgical outcomes in histopathologically confirmed extraparenchymal spinal cord hematomas in dogs with no identified underlying etiology.AnimalsSix dogs had MRI of the spinal cord, decompressive spinal surgery, and histopathologic confirmation of extraparenchymal spinal cord hematoma not associated with an underlying cause.MethodsMulti‐institutional retrospective study.ResultsSix patients had spontaneous extraparenchymal spinal cord hematoma formation. MRI showed normal signal within the spinal cord parenchyma in all patients. All hematomas had T2‐weighted hyperintensity and the majority (5/6) had no contrast enhancement. All dogs underwent surgical decompression and most patients (5/6) returned to normal or near normal neurologic function postoperatively. Follow‐up of the patients (ranging between 921 and 1,446 days) showed no progression of neurologic clinical signs or any conditions associated with increased bleeding tendency.Conclusions and Clinical ImportanceBefore surgery and histopathology confirming extraparenchymal hematoma, the primary differential in most cases was neoplasia, based on the MRI findings. This retrospective study reminds clinicians of the importance of the combination of advanced imaging combined with histopathologic diagnosis. The prognosis for spontaneous spinal cord extraparenchymal hematoma with surgical decompression appears to be favorable in most cases.
Effect of Synthetic Colloid Administration on Coagulation in Healthy Dogs and Dogs with Systemic Inflammation
Authors: Gauthier V. , Holowaychuk M.K. , Kerr C.L. , Bersenas A.M.E. , Darren Wood R. 
Published: January 2015

BackgroundSynthetic colloids are often used during fluid resuscitation and affect coagulation.ObjectiveTo compare the effects of an isotonic crystalloid and synthetic colloid on coagulation in healthy dogs and dogs with systemic inflammation.AnimalsSixteen adult purpose‐bred Beagles.MethodsRandomized, placebo‐controlled, blinded study. Dogs were randomized into one of two groups receiving fluid resuscitation with either 40 mL/kg IV 0.9% NaCl or tetrastarch after administration of lipopolysaccharide or an equal volume of placebo. After a 14‐day washout period, the study was repeated such that dogs received the opposite treatment (LPS or placebo) but the same resuscitation fluid. Blood samples were collected at 0, 1, 2, 4, and 24 hours for measurement of coagulation variables.ResultsAdministration of either fluid to healthy dogs and dogs with systemic inflammation resulted in similar increases in prothrombin time and activated clotting time. In comparison to saline administration, tetrastarch administration resulted in significantly decreased R (P = .017) in healthy dogs, as well as significantly increased activated partial thromboplastin time (P ≤ .016), CL30% (P ≤ .016), and K (P < .001) and significantly decreased platelet count (P = .019), α (P ≤ .001), MA (P < .001), and von Willebrand factor antigen (P < .001) and collagen binding activity (P ≤ .003) in both healthy dogs and dogs with systemic inflammation.Conclusions and Clinical ImportanceTetrastarch bolus administration to dogs with systemic inflammation resulted in a transient hypocoagulability characterized by a prolonged activated partial thromboplastin time, decreased clot formation speed and clot strength, and acquired type 1 von Willebrand disease.
Efficacy of Gamithromycin for the Treatment of Foals with Mild to Moderate Bronchopneumonia
Authors: Hildebrand F. , Venner M. , Giguère S. 
Published: January 2015

BackgroundGamithromycin is active in vitro against the bacterial agents most commonly associated with bronchopneumonia in older foals. However, the clinical efficacy and safety of this drug have not been investigated.HypothesisGamithromycin is effective for the treatment of bronchopneumonia in foals.AnimalsOne hundred and twenty‐one foals on a farm endemic for infections caused byRhodococcus equi.MethodsIn a controlled, randomized, and double blinded clinical trial, foals with ultrasonographic evidence of pulmonary abscesses (abscess score 8.0–20 cm) were randomly allocated in 3 treatment groups: (1) gamithromycin IM q7 days (n = 40); (2) azithromycin with rifampin, PO q24h (n = 40); or (3) no antimicrobial treatment (controls; n = 41). Physical examination and thoracic ultrasonography were performed by individuals unaware of treatment group assignment. Foals that worsened were removed from the study.ResultsThe proportion of foals that recovered without the need to be removed from the study was significantly higher for foals treated with gamithromycin (38 of 40) or azithromycin with rifampin (39 of 40) than for controls (32 of 41). Treatment with gamithromycin or with azithromycin‐rifampin resulted in a significantly faster decrease in the clinical score and abscess score compared to the controls. Adverse reactions characterized by colic (n = 18) and hind limb lameness (n = 14) were observed only in foals treated with gamithromycin.Conclusion and Clinical ImportanceGamithromycin was noninferior to azithromycin with rifampin for the treatment of bronchopneumonia in the study population but had a higher frequency of adverse reactions.
Complication Rates Associated with Transvenous Pacemaker Implantation in Dogs with High‐Grade Atrioventricular Block Performed During versus After Normal Business Hours
Authors: Ward J.L. , DeFrancesco T.C. , Tou S.P. , Atkins C.E. , Griffith E.H. , Keene B.W. 
Published: January 2015

BackgroundTransvenous pacemaker implantation in dogs is associated with a relatively high complication rate. At our institution, pacemaker implantation in dogs with high‐grade atrioventricular block (HG‐AVB) frequently is performed as an after‐hours emergency.HypothesisAmong dogs withHG‐AVB, the rate of major complications is higher when pacemakers are implanted after hours (AH) compared to during business hours (BH).AnimalsClient‐owned dogs withHG‐AVBthat underwent transvenous pacemaker implantation between January 2002 and December 2012 at the North Carolina State University Veterinary Teaching Hospital.MethodsRetrospective medical record review. Two‐year follow‐up was required for complications analysis.ResultsMajor complications occurred in 14/79 dogs (18%) and included lead dislodgement, lead or generator infection, lead or generator migration, and pacing failure. Incidence of major complications was significantly higherAH(10/36, 28%) compared toBH(4/43, 9%;P = .041), and all infectious complications occurredAH. Median survival time for all dogs was 27 months and did not differ betweenAHandBHgroups for either all‐cause (P = .70) or cardiac (P = .40) mortality.AHdogs were younger thanBHdogs (P = .010), but there were no other clinically relevant differences betweenBHandAHgroups in terms of demographic, clinical, or procedural variables.Conclusions and Clinical ImportanceAt our institution,AHtransvenous pacemaker placement is associated with a higher rate of major complications (especially infections) compared toBHplacement. This difference may be because of a variety of human factor differencesAHversusBH.
Nanoparticulate CpG Immunotherapy in RAO‐Affected Horses: Phase I and IIa Study
Authors: Klier J. , Lehmann B. , Fuchs S. , Reese S. , Hirschmann A. , Coester C. , Winter G. , Gehlen H. 
Published: January 2015

BackgroundRecurrent airway obstruction (RAO), an asthma‐like disease, is 1 of the most common allergic diseases in horses in the northern hemisphere. Hypersensitivity reactions to environmental antigens cause an allergic inflammatory response in the equine airways. Cytosine‐phosphate‐guanosine‐oligodeoxynucleotides (CpG‐ODN) are known to direct the immune system toward a Th1‐pathway, and away from the pro‐allergic Th2‐line (Th2/Th1‐shift). Gelatin nanoparticles (GNPs) are biocompatible and biodegradable immunological inert drug delivery systems that protect CpG‐ODN against nuclease degeneration. Preliminary studies on the inhalation of GNP‐bound CpG‐ODN in RAO‐affected horses have shown promising results.ObjectivesThe aim of this study was to evaluate the clinical and immunological effects of GNP‐bound CpG‐ODN in a double‐blinded, placebo‐controlled, prospective, randomized clinical trial and to verify a sustained effect post‐treatment.Animals and MethodsTwenty‐four RAO‐affected horses received 1 inhalation every 2 days for 5 consecutive administrations. Horses were examined for clinical, endoscopic, cytological, and blood biochemical variables before the inhalation regimen (I), immediately afterwards (II), and 4 weeks post‐treatment (III).ResultsAt time points I and II, administration of treatment rather than placebo corresponded to a statistically significant decrease in respiratory effort, nasal discharge, tracheal secretion, and viscosity, AaDO2 and neutrophil percentage, and an increase in arterial oxygen pressure.Conclusion and Clinical ImportanceAdministration of a GNP‐bound CpG‐ODN formulation caused a potent and persistent effect on allergic and inflammatory‐induced clinical variables in RAO‐affected horses. This treatment, therefore, provides an innovative, promising, and well‐tolerated strategy beyond conventional symptomatic long‐term therapy and could serve as a model for asthma treatment in humans.
Insulin‐Like Growth Factor—Phosphatidylinositol 3 Kinase Signaling in Canine Cortisol‐Secreting Adrenocortical Tumors
Authors: Kool M.M.J. , Galac S. , van der Helm N. , Corradini S. , Kooistra H.S. , Mol J.A. 
Published: January 2015

BackgroundHypercortisolism is a common endocrine disorder in dogs, caused by a cortisol‐secreting adrenocortical tumor (AT) in approximately 15% of cases. In adrenocortical carcinomas of humans, activation of the phosphatidylinositol 3 kinase (PI3K) signaling pathway by insulin‐like growth factor (IGF) signaling represents a promising therapeutic target.ObjectivesTo investigate the involvement of PI3K signaling in the pathogenesis of ATs in dogs and to identify pathway components that may hold promise as future therapeutic targets or as prognostic markers.AnimalsAnalyses were performed on 36 canine cortisol‐secreting ATs (11 adenomas and 25 carcinomas) and 15 normal adrenal glands of dogs.MethodsmRNA expression analysis was performed for PI3K target genes, PI3K inhibitor phosphatase and tensin homolog (PTEN), IGFs, IGF receptors, IGF binding proteins and epidermal growth factor receptors. Mutation analysis was performed on genes encoding PTEN and PI3K catalytic subunit (PIK3CA).ResultsTarget gene expression indicated PI3K activation in carcinomas, but not in adenomas. No amino acid‐changing mutations were detected in PTEN or PIK3CA and no significant alterations in IGF‐II or IGFR1 expression were detected. In carcinomas, ERBB2 expression tended to be higher than in normal adrenal glands, and higher expression of inhibitor of differentiation 1 and 2 (ID1 and ID2) was detected in carcinomas with recurrence within 2.5 years after adrenalectomy.Conclusions and Clinical ImportanceBased on these results, ERBB2 might be a promising therapeutic target in ATs in dogs, whereas ID1 and 2 might be valuable as prognostic markers and therapeutic targets.
Cardiac Troponin I as Compared to Troponin T for the Detection of Myocardial Damage in Horses
Authors: Van Der Vekens N. , Decloedt A. , Ven S. , De Clercq D. , van Loon G. 
Published: January 2015

BackgroundDifferent cardiac troponin I (cTnI) assays give different results. Only 1 manufacturer has marketed troponin T (cTnT) assays. Therefore, cTnT often is preferred for detection of myocardial infarction in human patients. Studies of cTnT in horses are limited.ObjectivesTo compare a cTnI and a high‐sensitive cTnT assay (hs‐cTnT) in horses.AnimalsCardiac troponin I and cTnT were determined in 35 healthy horses (group 1), 23 horses suspected to have primary myocardial damage (group 2a), and 41 horses with secondary myocardial damage caused by structural heart disease (group 2b).MethodsAll cTnI samples were analyzed at laboratory A (limit of detection [LOD]: 0.03 ng/mL), whereas cTnT samples were analyzed at 2 laboratories with the same hs‐cTnT assay (laboratory B, LOD: 10.0 pg/mL; laboratory C, LOD: 4.0 pg/mL).ResultsThe median cTnI concentration in group 2a (0.90 ng/mL; range, 0.03–58.27 ng/mL) was significantly higher (P < .001) than in group 1 (0.03 ng/mL; range, 0.03–0.09 ng/mL) or group 2b (0.05 ng/mL; range, 0.03–30.92 ng/mL), and the optimal cut‐off for detection of primary myocardial damage was 0.095 ng/mL (sensitivity: 90.5%, specificity: 100%). Using an LOD of 10.0 pg/mL for all cTnT samples, a cut‐off value of 10.5 pg/mL was found, but sensitivity was low (42.9%). When only samples analyzed at laboratory C (n = 58) were included, a cut‐off of 6.6 pg/mL was found (sensitivity: 81%, specificity: 100%).Conclusions and Clinical ImportanceDespite large quantitative differences, cTnI and cTnT are both useful for detection of myocardial damage in horses.
Randomized Phase III Trial of Piroxicam in Combination with Mitoxantrone or Carboplatin for First‐Line Treatment of Urogenital Tract Transitional Cell Carcinoma in Dogs
Authors: Allstadt S.D. , Rodriguez C.O. , Boostrom B. , Rebhun R.B. , Skorupski K.A. 
Published: January 2015

BackgroundReported response rates of transitional cell carcinoma (TCC) in dogs to piroxicam in combination with either mitoxantrone or carboplatin are similar; however, it is unknown whether either drug might provide superior duration of response.Hypothesis/ObjectivesTo determine if the progression‐free interval (PFI) of dogs withTCCtreated with mitoxantrone and piroxicam was different than that of dogs receiving carboplatin and piroxicam. The hypothesis was that the efficacy of mitoxantrone is no different from carboplatin.AnimalsFifty dogs withTCCwithout azotemia.MethodsProspective open‐label phaseIIIrandomized study. Either mitoxantrone or carboplatin was administered every 3 weeks concurrently with piroxicam with restaging at 6‐week intervals. Twenty‐four dogs received carboplatin and 26 received mitoxantrone.ResultsResponse was not different between groups (P = .56). None of the dogs showed complete response. In the mitoxantrone group, there were 2 (8%) partial responses (PR) and 18 (69%) dogs with stable disease (SD). In the carboplatin group, there were 3PR(13%) and 13 (54%) dogs withSD. ThePFIwas not significantly different between groups (mitoxantrone = 106 days; carboplatin = 73.5 days;P = .62; hazard ratio 0.86; 95% confidence interval 0.47–1.56). Dogs with prostatic involvement experienced a shorter survival (median, 109 days) compared to dogs with urethral, trigonal, or apically located tumors; this difference was significant (median 300, 190, and 645 days, respectively;P = .005).Conclusions and Clinical ImportanceThis study did not detect a different in outcome in dogs withTCCtreated with either mitoxantrone or carboplatin in combination with piroxicam.
Evaluation and Diagnostic Potential of Serum Ghrelin in Feline Hypersomatotropism and Diabetes Mellitus
Authors: Jensen K.B. , Forcada Y. , Church D.B. , Niessen S.J.M. 
Published: January 2015

BackgroundGhrelin is a growth hormone secretagogue. It is a potent regulator of energy homeostasis. Ghrelin concentration is down‐regulated in humans with hypersomatotropism (HS) and increases after successful treatment. Additionally, ghrelin secretion seems impaired in human diabetes mellitus (DM).HypothesisSerum ghrelin concentration is down‐regulated in cats with HS‐induced DM (HSDM) compared to healthy control cats or cats with DM unrelated to HS and increases after radiotherapy.AnimalsCats with DM (n = 20) and with HSDM (n = 32), 13 of which underwent radiotherapy (RT‐group); age‐matched controls (n = 20).MethodsRetrospective cross‐sectional study. Analytical performance of a serum total ghrelin ELISA was assessed and validated for use in cats. Differences in serum ghrelin, fructosamine, IGF‐1 and insulin were evaluated.ResultsGhrelin was significantly higher (P < .001) in control cats (mean ± SD: 12.9 ± 6.8 ng/mL) compared to HSDM‐ (7.9 ± 3.3 ng/mL) and DM‐cats (6.7 ± 2.3 ng/mL), although not different between the HSDM‐ and DM‐cats. After RT ghrelin increased significantly (P = .003) in HSDM‐cats undergoing RT (from 6.6 ± 1.9 ng/mL to 9.0 ± 2.2 ng/mL) and the after RT ghrelin concentrations of HSDM cats were no longer significantly different from the serum ghrelin concentration of control cats. Serum IGF‐1 did not significantly change in HSDM‐cats after RT, despite significant decreases in fructosamine and insulin dose.Conclusion and Clinical ImportanceGhrelin appears suppressed in cats with DM and HSDM, although increases after RT in HSDM, suggesting possible presence of a direct or indirect negative feedback system between growth hormone and ghrelin. Serum ghrelin might therefore represent a marker of treatment effect.