bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cold agglutinin activity in 2 dogs
Authors: Rojas‐Temahuay Gabriela , Crain Sarah , Benson Catherine , Sharkey Leslie , Nothnagel Geneva 
Published: July 2014

AbstractA 5‐year‐old neutered male Mastiff and an 8‐year‐old spayed female Labrador Retriever were presented to the University of Minnesota Veterinary Medical Center. The Mastiff was presented for evaluation of lameness and pyoderma one month prior in Missouri, where he tested positive forEhrlichia canisby serumELISAtest, treated with doxycycline.PCRforEhrlichiasp, Anaplasmasp, Babesiasp, andBartonellasp,andPCRfor antigen receptor rearrangement were negative, serum protein electrophoresis (SPE) revealed polyclonal gammopathy, and mildly reactive lymphoid cells were seen cytologically. The Labrador presented with a proliferative rostral mandibular gingival mass and lipomas for further presurgical evaluation of cold agglutinin activity documented by a commercial laboratory 2 years earlier prior to removal of a gradeIImast cell tumor. This dog had a negativeSNAP4Dx, normalSPE, and persistently increased serumALPactivity and polyuria/polydipsia suggestive for hyperadrenocorticism. Both dogs had markedly agglutinatedRBCin theEDTAsamples that dispersed with warming, and normal plasma color. Cold agglutinin activity was demonstrated by direct saline agglutination testing using whole blood and washed erythrocytes demonstrating agglutination at 30°C, 25°C, 15°C, and 4°C, but not at 37°C.CBCresults (ADVIA2120i) from the Mastiff revealed no significant differences in theRBCresults obtained at room temperature (RT) and at 37°C; however, theRTrun demonstrated negative bias in neutrophil and platelet concentrations attributed to rapidRBCsettling. This uncommon hematologic condition may cause artifacts on the automated leukogram and platelet count, and may be subclinical for long periods.
A pilot external quality assurance study of transfusion screening for HIV, HCV and HBsAG in 12 African countries
Authors: Bloch E. M. , Shah A. , Kaidarova Z. , Laperche S. , Lefrere J.‐J. , van Hasselt J. , Zacharias P. , Murphy E. L. ,   the Anglophone Africa Transfusion Research Group
Published: July 2014

Background and ObjectivesSerologic screening for the major transfusion transmissible viruses (TTV) is critical to blood safety and has been widely implemented. However, actual performance as measured by proficiency testing has not been well studied in sub‐Saharan Africa. Therefore, we conducted an external quality assessment of laboratories engaged in transfusion screening in the region.Materials and MethodsBlinded test panels, each comprising 25 serum samples that were pedigreed for HIV, HBsAg, HCV and negative status, were sent to participating laboratories. The panels were tested using the laboratories' routine donor screening methods and conditions. Sensitivity and specificity were calculated, and multivariable analysis was used to compare performance against mode of testing, country and infrastructure.ResultsA total of 12 African countries and 44 laboratories participated in the study. The mean (range) sensitivities for HIV, HBsAg and HCV were 91·9% (14·3–100), 86·7% (42·9–100) and 90·1% (50–100), respectively. Mean specificities for HIV, HBsAg and HCV were 97·7%, 97% and 99·5%, respectively. After adjusting for country and infrastructure, rapid tests had significantly lower sensitivity than enzyme immunoassays for both HBsAg (P < 0·0001) and HCV (P < 0·05). Sensitivity also varied by country and selected infrastructure variables.ConclusionWhile specificity was high, sensitivity was more variable and deficient in a substantial number of testing laboratories. These findings underscore the importance of proficiency testing and quality control, particularly in Africa where TTV prevalence is high.
Neutrophil antibodies are clinically important
Authors: Fung Y. L. , Tung J. P. , Minchinton R. M. 
Published: July 2014

BackgroundNeutrophils or polymorphonuclear neutrophils (PMNs) make up the largest proportion (45 – 70%) of circulating leukocytes and play a pivotal role in innate immunity. Thus, patients with low PMN counts (neutropenia) or defective PMN function are more likely to be overwhelmed by infection. PMN reactive antibodies can cause either allo‐ or auto‐immune neutropenias. In some transfusion‐related acute lung injury (TRALI) events, donor derived neutrophil reactive antibodies can cause inappropriate activation of neutrophils leading to collateral damage of the surrounding pulmonary microvasculature with potentially grave clinical consequences.Discussion & ConclusionClinical outcomes of TRALI and immune neutropenias demand rapid and precise diagnosis using reliable neutrophil serology. The ISBT Granulocyte Immunobiology Working Party brings together members working in diagnostic laboratories, research and clinical fields to enable strong and productive interactions, innovation and collaboration in granulocyte immunobiology, function and pathology.
Pathogen reduction technologies
Authors: Marks D. C. , Faddy H. M. , Johnson L. 
Published: July 2014

BackgroundIdeally, pathogen reduction technology (PRT) should provide proactive protection against emerging pathogens, reduce the need to introduce additional testing, minimize bacterial contamination and potentially replace processing steps such as gamma‐irradiation.Material and MethodsAvailable literature regarding technologies currently in use or under development for the treatment of labile blood components during processing was reviewed.ResultsThe INTERCEPT and Mirasol PRT systems are used widely in blood centres in Europe, Asia and the Middle East for the treatment of both platelets and plasma, whereas clinical trials of platelets treated using the THERAFLEX UV‐Platelets system are underway. In vitro data suggest that PRT treatment leads to some loss of platelet function. However, haemovigilance reports from countries where PRT‐treated platelets and plasma are transfused indicate no change in component usage, and indeed a reduction in transfusion‐related adverse events. Animal models are being used to elucidate mechanisms for these observed reductions. A second‐generation S‐303 system for red cells is also under development, as is a Mirasol PRT system for treatment of whole blood. Preliminary data indicate that these technologies may eventually become available.ConclusionThe challenge for blood services is to understand and rationalize the costs, risks and benefits of PRT compared with removing any tests or processes, whilst aiming to provide the highest level of blood safety. Ongoing post‐marketing surveillance and clinical trials are still required for all PRT systems.
Advances in granulocyte test methodologies
Authors: Matsuhashi M. , Tsuno N. H. , Iino J. , Nagura Y. , Okazaki H. , Santoso S. 
Published: July 2014

AbstractAlloantibodies to human neutrophil antigens (HNA) are involved in clinical conditions such as neonatal alloimmune neutropenia (NAN), autoimmune neutropenia (AIN) and transfusion‐related acute lung injury (TRALI). For the diagnosis of these conditions, the detection of the causative antibody is essential. Presently, the use of a combination of granulocyte agglutination assay (GAT) and granulocyte immunofluorescence test (GIFT) for the screening of granulocyte antibodies, followed by the determination of antibody specificity by the monoclonal antibody‐specific immobilization of granulocyte antigens (MAIGA) is recommended by the ISBT Working Party on Granulocyte Immunobiology. In Japan, the mixed‐passive hemagglutination (MPHA) assay, a method originally developed for the detection of anti‐platelet antibodies, was adapted for the testing of anti‐granulocyte antibodies. Although various technologies are available, presently, no one of the methods alone is able to detect all clinically relevant antibodies, thus their combination is important, and the development of new methodologies is desired. In this review, we describe the presently available classical methods for anti‐granulocyte antibody detection, including GIFT, GAT, MAIGA and MPHA, and also the new technologies, especially focusing on the advantages and problems of the different methods.
Assessment of administrative claims data for public health reporting of Salmonella in Tennessee
Authors: Marder Ellyn , Garman Katie , Jones Timothy F , Dunn John , Jones Stephen 
Published: July 2014

Abstract
In the USA, approximately 4% of the estimated 1 million Salmonella infections occurring annually are reported to public health. Administrative claims data from large health insurance companies capture disease-specific data which could potentially enhance public health surveillance. To determine the utility of medical claims data for public health reporting of Salmonella, we assessed medical claims data from BlueCross BlueShield of Tennessee (BCBST) members compared to Tennessee Department of Health (TDH) surveillance data. BCBST Salmonella cases diagnosed during 2007–2011 were matched to TDH Salmonella cases reported during the same time period. Matches and non-matches were validated using medical records. Of the 450 BCBST cases identified, 72% matched TDH cases. All culture-confirmed BCBST cases were reported to TDH. Non-matched BCBST cases included clinical diagnoses which were culture negative or not tested. Our findings indicate administrative claims data are not currently a viable mechanism for enhancing routine reporting of Salmonella infections.
Effectiveness and implementation of enhanced recovery after surgery programmes: a rapid evidence synthesis
Authors: Paton Fiona , Chambers Duncan , Wilson Paul , Eastwood Alison , Craig Dawn , Fox Dave , Jayne David , McGinnes Erika 
Published: July 2014

ObjectivesTo assess the evidence on the impact of enhanced recovery programmes for patients undergoing elective surgery in acute hospital settings in the UK.DesignRapid evidence synthesis. Eight databases were searched from 1990 to March 2013 without language restrictions. Relevant reports and guidelines, websites and reference lists of retrieved articles were scanned to identify additional studies. Systematic reviews, RCTs not included in the systematic reviews, economic evaluations and UK NHS cost analysis, implementation case studies and surveys of patient experience in a UK setting were eligible for inclusion.Primary and secondary outcome measuresWe assessed the impact of enhanced recovery programmes on health or cost-related outcomes, and assessed implementation case studies and patient experience in UK settings. Studies were quality assessed where appropriate using the Centre for Reviews and Dissemination Database of Abstracts of Reviews of Effects critical appraisal process.Results17 systematic reviews and 12 additional RCTs were included. Ten relevant economic evaluations were included. No cost analysis studies were identified. Most of the evidence focused on colorectal surgery. 14 innovation case studies and 15 implementation case studies undertaken in National Health Service settings described factors critical to the success of an enhanced recovery programme.Evidence for colorectal surgery suggests that enhanced recovery programmes may reduce hospital stays by 0.5–3.5 days compared with conventional care. There were no significant differences in reported readmission rates. Other surgical specialties showed greater variation in reductions in length of stay reflecting the limited evidence identified. Findings relating to other outcomes were hampered by a lack of robust evidence and poor reporting.ConclusionsThere is consistent, albeit limited, evidence that enhanced recovery programmes can reduce length of patient hospital stay without increasing readmission rates. The extent to which managers and clinicians considering implementing enhanced recovery programmes in UK settings can realise savings will depend on length of stay achieved under their existing care pathway.
A new patient information leaflet for Dermatology outpatients
Authors: Becker Katrin , whittam lindsay 
Published: July 2014

AbstractLack of provision of information was the single most common cause of poor performance in the 2008/2009 NHS Patient Survey Programme of trusts in the UK. Information leaflets have been shown to improve patient satisfaction with consultations.We introduced a new patient information leaflet about the scheduled consultation in a district hospital´s dermatology outpatient clinic. We then assessed in a small study its effect on the patients regarding helpfulness, preparation for and satisfaction with the out-patient consultation.Via the hospital´s booking office, leaflets were sent to all patients (n=32) due to attend two outpatient clinics, accompanied by a letter about the survey. After the consultation, patients were given a short anonymous questionnaire to complete.Of the 32 patients, 12 patients did not receive the leaflet, three did not attend their consultation, and two left before they were handed the questionnaire. We gave out 15 questionnaires, and received 15 responses (100%).46.9% of patients (n=15) answered the questionnaire. Of these 33.3% were new patients (n=5). 86.7% (n=13) found the leaflet helpful and 33% excellent (n=5). 86.7% felt well prepared for the consultation, 40% excellently (n=6). 86.7% were satisfied with the consultation, 73% rated their satisfaction as excellent (n=11). 60% of patients brought a list with their medication (n=9), 80% of the new patients (n=4). 13.3% of patients (n=2) wrote down questions prior to the consultation. Comments suggested the leaflet would be more useful for new patients.Patients scored highly for satisfaction with the consultation, whether or not they had received and information leaflet (we asked n=20 patients without leaflet). This short survey supports the idea that patients find it helpful to receive an information leaflet, and actively prepare by bringing a list of their medication, and thinking of questions.
Smoking cessation for hospital inpatients
Authors: Bickerstaffe Gary 
Published: July 2014

AbstractPeople who smoke make up a significant number of those admitted to hospital (NICE 2014). Being admitted to hospital can present a unique opportunity to attempt to stop smoking. Many smokers find quitting very difficult (Rigotti et al 2007), in large part due to them living and working in environments that contain many cues and triggers associated with nicotine consumption and smoking behaviours. Hospitals generally do not contain such environmental prompts to smoke. In the community, smokers have access to numerous types of support including GP's, pharmacies and Stop Smoking Services (SSS). Once admitted to hospital access to such support is significantly diminished. Given that many patients may be highly motivated to attempt to stop smoking due to heightened concerns about their health and being in an environment not associated with their smoking habits, it seems prudent to ensure there is access to all the levels of smoking cessation support available outside of the hospital. Not providing such support neglects implementing an evidence based, cost-effective health intervention in a major health setting (NICE 2014). A SSS pathway was designed that enabled existing hospital healthcare staff to be trained to identify patients that smoke, ask if the patient is considering quitting or abstaining whilst in hospital. If motivated to quit or abstain, to complete an assessment. This being based around dependence to nicotine and motivation to quit. Access to all available stop smoking medications should be included. Medication should only be provided alongside some level of motivational support up to discharge. Training core staff was felt to be the best option. They are available outside of office hours and access hospital systems such as pharmacy more readily than satellite staff.On discharge the patient is 'handed over' to SSS for continued contact and support once at home. Over 200 staff are trained to complete the assessment and support inpatients to stop or abstain. Approximately 30-35 referrals are made to the local SSS each month, the quit rate at 4 weeks averaging around 40-45%. Most referrals are seen from cardiology and respiratory. All hospital departments should identify staff to be trained to offer cessation support to their patients .
Efficacy of the jet injector in local anaesthesia for small wound sutures: a randomised clinical trial compared with the needle infiltration technique
Authors: Saghi Bijan , Momeni Mehdi , Saeedi Morteza , Ghane Mohammadreza 
Published: July 2014

BackgroundDespite advances in the application of needle free devices in medical procedure, there is a paucity of knowledge on the efficacy of the jet injector for suturing skin wounds.AimsOur study aimed to compare the severity of pain and time to initiation of anaesthesia between two methods of local anaesthesia for skin suturing of small facial wounds.MethodsWe conducted a double blind randomised clinical trial between December 2012 and February 2013 at a university hospital in Tehran, Iran. 53 patients with small facial wounds needing skin closure with sutures were assigned to either the jet injection group or the needle infiltration group. Pain severity after administration of local anaesthesia and during the stitching procedure, and time to initiation of skin numbness were evaluated.ResultsMean pain score during the anaesthetic procedure was 1.1±1 in the jet injector group compared with 4.4±1.4 in the needle infiltration group (p<0.0001). Moreover, time to initiation of local numbness was significantly longer in the jet injection group than in the needle infiltration group (p<0.0001). Nevertheless, suture procedure related pain scores did not differ significantly between the two groups (p>0.05).ConclusionsThe jet injector is an effective device in reducing the pain of the anaesthetic procedure for small facial wounds. However, the remarkably lower pain should be evaluated in light of other parameters, including acceptance and preference of the newly introduced technique.Trial registration NoIRCT201201308872N3.
Second opinion in breast pathology: policy, practice and perception
Authors: Geller Berta M , Nelson Heidi D , Carney Patricia A , Weaver Donald L , Onega Tracy , Allison Kimberly H , Frederick Paul D , Tosteson Anna N A , Elmore Joann G 
Published: July 2014

AimsTo assess the laboratory policies, pathologists’ clinical practice and perceptions about the value of second opinions for breast pathology cases among pathologists practising in the USA.MethodsCross-sectional data were collected from 252 pathologists who interpret breast specimens in eight states using a web-based survey. Descriptive statistics were used to characterise findings.ResultsMost participants had >10 years of experience interpreting breast specimens (64%), were not affiliated with academic centres (73%) and were not considered experts by their peers (79%). Laboratory policies mandating second opinions varied by diagnosis: invasive cancer 65%; ductal carcinoma in situ (DCIS) 56%; atypical ductal hyperplasia 36% and other benign cases 33%. 81% obtained second opinions in the absence of policies. Participants believed they improve diagnostic accuracy (96%) and protect from malpractice suits (83%), and were easy to obtain, did not take too much time and did not make them look less adequate. The most common (60%) approach to resolving differences between the first and second opinion is to ask for a third opinion, followed by reaching a consensus.ConclusionsLaboratory-based second opinion policies vary for breast pathology but are most common for invasive cancer and DCIS cases. Pathologists have favourable attitudes towards second opinions, adhere to policies and obtain them even when policies are absent. Those without a formal policy may benefit from supportive clinical practices and systems that help obtain second opinions.
An evaluation of commissioning arrangements for intrauterine and subdermal contraception services from general practitioners in London, UK
Authors: Ma Richard , Brown Eleanor 
Published: July 2014

ObjectivesGeneral practitioners (GPs) in the UK may be commissioned to provide long-acting reversible contraception (LARC), which may have a role in reducing rates of abortion and unintended pregnancies. Primary care trusts (PCTs) in England had commissioning arrangements with GPs to provide LARC but little is known about such contractual arrangements. We studied the commissioning arrangements in some London PCTs to evaluate the cost and clinical governance of these contracts.MethodsWe requested commissioning contract specifications and activities for intrauterine contraception (IUC) and subdermal implants (SDI) from responsible officers in each PCT in London relating to activities in three financial years, namely 2009/2010 to 2011/2012. We evaluated each contract using a structure, process and outcome approach.ResultsHalf (15/31) the PCTs responded and submitted 20 contracts used to commission their GPs to provide IUC, SDI or a combination of these with testing for sexually transmitted infections. The information regarding service activity was inadequate and inconsistent so had to be abandoned. Information from 20 contracts suggested there was a variation in clinical governance and quality assurance mechanisms; there was also a range in the reimbursement for IUC insertion (£77.50 to £105.00), SDI insertion (£25.00 to £81.31) and SDI removal (£30.00 to £100.00) at 2011 prices.ConclusionIt was not clear from non-responders if these PCTs had a service in place. Of those that did commission IUC and SDI services, some specifications were lacking in detail regarding aspects of clinical governance. New commissioners should make explicit references to quality and safety criteria as poor-quality specifications can give rise to serious untoward incidents and litigation.
Patellar ligament rupture in the dog: repair methods and patient outcomes in 43 cases
Authors: Das S. , Thorne R. , Lorenz N. D. , Clarke S. P. , Madden M. , Langley‐Hobbs S. J. , Perry K. L. , Burton N. J. , Moores A. L. , Mosley J. R. 
Published: July 2014

The medical records of dogs receiving surgery for unilateral patellar ligament rupture between 1999 and 2012 at 12 multidisciplinary referral centres were reviewed. Forty‐three cases were identified; 26 were traumatic in origin; almost one‐third were iatrogenic, of which over three‐quarters occurred as a complication following surgical stabilisation of patellar luxation. Treatment involved primary reapposition of the ligament (36 cases). The repair was protected by circumpatellar and/or transpatellar loop(s) of orthopaedic wire, nylon, polypropylene or polydioxanone suture (34 cases). Wire loops were more likely to require surgical removal compared with loops of other materials (P=0.0014). The stifle joint was immobilised postoperatively by the applications of a transarticular external skeletal fixator (taESF) in 17 cases and by external coaptation (EC) in 8 cases; in 18 cases, no postoperative joint immobilisation was provided. Complications specific to the method of immobilisation occurred in seven of the cases with taESF and six of the cases with EC. Revision surgery to address failure of repair was required in five cases. Outcome was classified as acceptable or good in over three‐quarters of the cases (31/40) and poor in less than a quarter (9/40). These data highlight patellar ligament rupture as a complication of surgical stabilisation of patellar luxation.