bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal assessment of thyroid function in pregnancy
Authors: Ekinci Elif I , Lu Zhong X , Sikaris Ken , Bittar Intissar , Cheong Karey Y , Lam Que , Crinis Nick , Houlihan Christine A 
Published: July 2013

Background Trimester-specific reference intervals (RIs) for thyroid function tests are lacking for Beckman Dxl 800 analysers. We aimed to establish RIs for thyroid stimulating hormone (TSH), free thyroxine (fT4) and to track intraindividual changes in thyroid function throughout pregnancy. Methods One hundred and thirty healthy women without antithyroid peroxidase antibodies were followed longitudinally. Thyroid function was determined at trimester-1 (T1): 9–13 weeks; trimester-2 (T2): 22–26 weeks; trimester-3 (T3): 35–39 weeks and postpartum (PP): 8–12 weeks. A subgroup ( n = 47) was used to track intraindividual changes using PP as non-pregnant state (baseline). Results For trimesters 1–3, TSH (median (2.5th, 5th, 95th and 97.5th percentile)) was 0.77 (0.03, 0.05, 2.33, 3.05), 1.17 (0.42, 0.47, 2.71, 3.36) and 1.35 (0.34, 0.42, 2.65, 2.83) mIU/L, respectively. Free T4 (mean (95%CI)) was 10.7 (5.9–15.5), 8.1 (4.9–11.3), 7.8 (4.5–11.0) pmol/L, respectively. In T2 and T3, 36% and 41% of the fT4 values, respectively, fell below the non-pregnancy lower normal limit. In the subgroup assessed for longitudinal changes, of the women with baseline TSH ⩽ median, 71–75% remained at or below the corresponding median for trimesters 1–3. Of the women with baseline fT4 ⩽ median, 69–81% also remained at or below the corresponding median for trimesters 1–3. High correlation was observed at different trimesters and baseline for TSH (Spearman’s r: 0.593–0.846, P < 0.001) and for fT4 ( r: 0.480–0.739, P < 0.001). Conclusions Use of trimester-specific RIs would prevent misclassification of thyroid function during pregnancy. In the majority of women, TSH and fT4 tracked on the same side of the median distribution, from a non-pregnant baseline, throughout pregnancy.
A diagnostic conundrum: heterophilic antibody interference in an adrenocorticotropic hormone immunoassay not detectable using a proprietary heterophile blocking reagent
Authors: Grasko Jonathan , Willliams Robin , Beilin Jonathan , Glendenning Paul , Fermoyle Soraya , Vasikaran Samuel 
Published: July 2013

Context Heterophilic antibodies are a well-described interferent but poorly appreciated and are often not a recognized problem affecting most immunoassays. We describe for the first time heterophilic antibodies interference affecting an adrenocorticotropic hormone (ACTH) assay in a patient with Cushing’s syndrome due to bilateral nodular adrenal hyperplasia. Case A 60-year-old retired female nurse underwent extensive invasive investigations, which were ultimately unnecessary, as a result of initial analytical interference in the ACTH assay, which could not be resolved using a proprietary heterophilic binding reagent. Results This case highlights the inherent difficulty of diagnosing Cushing’s syndrome and the large emphasis placed on laboratory tests. The consequence of not initially identifying interference in this patient’s laboratory test results led to unnecessary and costly investigations with potentially adverse outcomes. Conclusions Clinicians and the laboratory community need to be continuously vigilant and view laboratory results with caution when they are inconsistent with the clinical picture. This approach is paramount, especially at a time of increasing automation and ever-diminishing scientist involvement in sample processing.
Levodopa therapy in Parkinson’s disease: influence on liquid chromatographic tandem mass spectrometric-based measurements of plasma and urinary normetanephrine, metanephrine and methoxytyramine
Authors: Eisenhofer Graeme , Brown Sebastian , Peitzsch Mirko , Pelzel Daniela , Lattke Peter , Glöckner Stephan , Stell Anthony , Prejbisz Aleksander , Fassnacht Martin , Beuschlein Felix , Januszewicz Andrzej , Siegert Gabriele , Reichmann Heinz 
Published: July 2013

Background Medication-related interferences with measurements of catecholamines and their metabolites represent important causes of false-positive results during diagnosis of phaeochromocytomas and paragangliomas (PPGLs). Such interferences are less troublesome with measurements by liquid chromatography with tandem mass-spectrometry (LC-MS/MS) than by other methods, but can still present problems for some drugs. Levodopa, the precursor for dopamine used in the treatment of Parkinson’s disease, represents one potentially interfering medication. Methods Plasma and urine samples, obtained from 20 Parkinsonian patients receiving levodopa, were analysed for concentrations of catecholamines and their O-methylated metabolites by LC-MS/MS. Results were compared with those from a group of 120 age-matched subjects and 18 patients with PPGLs. Results Plasma and urinary free and deconjugated (free + conjugated) methoxytyramine, as well as urinary dopamine, showed 22- to 148-fold higher ( P < 0.0001) concentrations in patients receiving levodopa than in the reference group. In contrast, plasma normetanephrine, urinary noradrenaline and urinary free and deconjugated normetanephrine concentrations were unaffected. Plasma free metanephrine, urinary adrenaline and urinary free and deconjugated metanephrine all showed higher ( P < 0.05) concentrations in Parkinsonian patients than the reference group, but this was only a problem for adrenaline. Similar to normetanephrine, plasma and urinary metanephrine remained below the 97.5 percentiles of the reference group in almost all Parkinsonian patients. Conclusions These data establish that although levodopa treatment confounds identification of PPGLs that produce dopamine, the therapy is not a problem for use of LC-MS/MS measurements of plasma and urinary normetanephrine and metanephrine to diagnose more commonly encountered PPGLs that produce noradrenaline or adrenaline.
Case Report: Remote monitoring using Spectrum Medical Live Vue allows improved response time and improved quality of care for patients on cardiopulmonary support
Authors: Fung K , Beck JR , Lopez HC , Mongero LB 
Published: July 2013

Clinician rounding on bedside extracorporeal membrane oxygenation (ECMO) is a common coverage practice at many centers across the USA. Occasionally, clinical issues or concerns may go unnoticed for a considerable period of time during the intervals of clinician rounds. We report a case utilizing the LiveVue (Spectrum Medical, Fort Mill, SC) remote monitoring for care of a patient on ECMO. A patient was placed on veno-arterial (VA) ECMO in our intensive care unit, using a Rotaflow centrifugal pump and a Quadrox D polymethylpentene (PMP) fiber oxygenator (both Maquet, Fairfield, NJ). Following ECMO initiation and stabilization, a two-hour rounding schedule was established for the covering perfusionist. On day two, shortly after the perfusionist had rounded, the ECMO flow began fluctuating between 0.1 and 2.1 L/min. A compliance alert (i.e. red flashing notification) was recognized by the perfusion team on a large screen monitor installed in the perfusion pump room. Immediate response from the perfusion team identified venous inflow obstruction due to cannula malposition. The pump revolutions per minute (rpm) and, thus, the resulting flow were temporarily reduced to prevent vessel intimal damage and the surgical team was summoned to reposition the venous cannula. Later in that ECMO run, a steady rise in pre-oxygenator pressure was noted by the perfusionist. This increasingly concerning event was able to be trended and monitored with the LiveVue from a remote location. After a few hours, a compliance alert was noticed again on the LiveVue screen in the pump room. The pre-oxygenator pressure increased by 150 mmHg and the circuit flow decreased by half. Again, the perfusionist response was immediate and an oxygenator change-out ensued. Once more, a potentially dangerous clinical scenario was avoided with continuous critical parameter remote monitoring using the LiveVue system.
Quantitative evaluation of the axonal degeneration of central motor neurons in chronic cerebral stroke with diffusion tensor imaging
Authors: Lai Can , Zhou Hai-Chun , Ma Xiao-Hui , Zhang Hong-Xi 
Published: July 2013

Background Conventional magnetic resonance imaging (MRI) can only show the degeneration-induced morphological changes but fail to quantitatively reveal the degree and extent of the axonal damage of nerve fibers. Diffusion tensor imaging (DTI) has the ability to detect the diffusion of water molecules and thus suitable to the study of axonal degeneration of central motor neurons. Purpose To illustrate and quantitatively evaluate the axonal degeneration of central motor neurons in patients with chronic cerebral stroke. Material and Methods DTI and conventional MRI were carried out with 10 normal control subjects and 25 patients who suffered from chronic cerebral stroke in the region supplied by middle cerebral artery and had varying degrees of limb movement disorders (the mean time of onset was 2.5 months), to measure the fractional anisotropy (FA), volume ratio (VR), apparent diffusion coefficient (ADC), tensor eigenvalues (λ1, λ2, and λ3), and signal intensity (SI) on T2-weighted images, of the central motor fibers (pyramidal tract) in the plane of cerebral peduncle. Results from the ipsilateral side were compared with those from the contralateral side in the same patient and with those from normal control. Results The axonal degeneration of central motor neurons manifests in DTI as the decline of FA of the pyramidal tract and the reduction and distortion of the high signal area. While all the FA, VR, ADC, and λ1 in the ipsilateral side reduce on DTI, λ3 increases; the T2-weighted signals exhibit no significant differences among groups. Conclusion The changes and diffusions of water molecule associated with the axonal degeneration of central motor neurons after chronic cerebral stroke can be detected by DTI, which can directly quantitatively reflect the degree and extent of axonal degeneration of central motor neurons and can compensate the shortcomings of conventional MRI and diffusion-weighted imaging (DWI).
2D versus 3D roadmap for uterine artery catheterization: impact on several angiographic parameters
Authors: Maleux Geert , Michielsen Koen , Timmerman Dirk , Poppe Willy , Heye Sam , Vaninbroukx Johan , Bosmans Hilde 
Published: July 2013

Background Three-dimensional (3D) roadmap is a recently developed imaging technique used to guide diagnostic and interventional catheter-directed procedures and mainly evaluated for neurovascular procedures. Few data with regard to efficacy and radiation dose are currently available in literature. Purpose To evaluate the use of 3D roadmap technique as compared with the conventional two-dimensional (2D) roadmap for uterine artery catheterization and embolization during uterine fibroid embolization and assess the potential impact on radiation dose, contrast load, and total procedure time. Material and Methods In this prospective study, 40 patients were randomly assigned to the 2D or 3D roadmap technique for uterine artery catheterization. Demographic data, specifically the patient’s age, weight, height, pelvic circumference, and total uterine and fibroid volume were recorded. Exposure parameters, contrast load, and procedure time were recorded and organ doses for ovaries and uterus were calculated. Results Demographic data did not differ between the groups. Catheterization and embolization of both uterine arteries were feasible in all patients, although in one patient in the 3D group, a focal dissection of the proximal uterine artery occurred. No significant difference in estimated ovarian dose was found in the 3D versus 2D group ( P = 0.07). Total procedure time was shorter in the 2D group ( P = 0.01) and no difference in total contrast load was seen ( P = 0.17). Conclusion Both roadmap techniques are effective imaging-guided tools for uterine artery catheterization, without difference in terms of radiation exposure or contrast load. The total procedure time is shorter in the 2D group.
Radial MRI during free breathing in contrast-enhanced hepatobiliary phase imaging
Authors: Gomi Tatsuya , Nagamoto Masahashi , Hasegawa Makoto , Tabata Akiko , Iwasaki Mikiko , Ooka Minako , Murata Nozomu , Tsunoo Mika , Iizuka Yuo , Kohda Ehiichi , Shiraga Nobuyuki 
Published: July 2013

Background Use of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) for diagnosis of hepatic tumors has been previously reported. Fat-saturated 3D T1-weighted gradient echo sequence (TIGRE) imaging using a breath-hold technique is usually used for dynamic studies and hepatobiliary phase Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI). In cases where the patient has difficulty holding their breath, this scanning method can be difficult. Purpose To investigate the usefulness of a fat-saturated T1-weighted spin-echo (SE) sequence using a radial read-out (radial acquisition regime-SE, RADAR-SE) during free breathing for hepatobiliary phase Gd-EOB-DTPA-enhanced MRI. Material and Methods Images were acquired at 1.5 T. First, a phantom with diluted Gd-EOB-DTPA was scanned using the TIGRE sequence and the RADAR-SE sequence. Contrast ratios of the sequences were compared. Next, the hepatobiliary phase was imaged in 62 patients using the TIGRE sequence with breath-hold and the RADAR-SE during free breathing. Qualitative and quantitative evaluations were compared. Results In the phantom study, RADAR-SE had a higher contrast ratio than TIGRE. In the clinical study, artifacts were more conspicuous in RADAR-SE compared to TIGRE images in the qualitative evaluation. However, RADAR-SE images were equal to or better than TIGRE images in patients who had difficulty holding their breath. The signal intensity ratio of the liver was statistically higher using RADAR-SE than TIGRE. Conclusion RADAR-SE can be useful for hepatobiliary phase Gd-EOB-DTPA-enhanced MRI in patients who have difficulty holding their breath.
Providers’ lack of knowledge about herpes zoster in HIV-infected patients is among barriers to herpes zoster vaccination
Authors: Aziz M , Kessler H , Huhn G 
Published: July 2013

Summary Identification of perceptions about herpes zoster (HZ) disease, vaccine effectiveness and safety, and vaccine recommendations may impact immunization practices of physicians for HIV-infected patients. A survey was used to quantify knowledge of HZ as well as determine physician immunization perceptions and practices. There were 272/1700 respondents (16%). Correct answers for the incidence of varicella zoster virus (VZV) infection in adults and incidence of HZ in HIV-infected patients were recorded by 14% and 10% of providers, respectively. Providers reported poor knowledge of the incidence of disease recurrence in HIV-infected patients (41% correct), potency of HZ vaccine (47.5% correct) and mechanism of protection against reactivation of VZV (66% correct). Most (88%) agreed that HZ was a serious disease, and 73% believed that the burden of disease made vaccination important. A majority (75%) did not vaccinate HIV patients with HZ vaccine regardless of antiretroviral therapy status. Barriers to administration included safety concerns, concern that vaccine would not prevent HZ, risk of HZ dissemination, reimbursement issues and lack of Infectious Diseases Society of America (IDSA) guidelines. Only 38% of providers agreed that CDC guidelines were clear and 50% believed that clinical trials were needed prior to use of HZ vaccine in HIV-infected patients. Education about HZ is needed among HIV providers. Providers perceived vaccination as important, but data on vaccine safety and clear guidance from the CDC on this issue are lacking.
Factors affecting antiretroviral therapy adherence among HIV-positive pregnant and postpartum women: an adapted systematic review
Authors: Vitalis D 
Published: July 2013

Summary Adherence to antiretroviral therapy (ART) is crucial for effective treatment, but can be quite complex. Non-adherence can adversely affect treatment outcomes. Although many studies have been done on adherence in the general population, few have included HIV-positive pregnant and postpartum women in resource-constrained settings. This review assessed the evidence on adherence among these groups of women. A systematic search of databases was completed between June and July 2011. Both qualitative and quantitative studies were included. Eighteen studies from a total of 6622 satisfied the inclusion criteria that included inter alia facilitators and barriers to adherence. This review highlighted that there is still no consensus on the definition and measurement of adherence; also multiple factors can affect a woman's ability to adhere to ART. Some of the barriers and facilitators identified were similar in both the type of study (qualitative and quantitative) and among the various countries. Findings indicated that the few studies in this population are conducted primarily in resource-rich settings. Such paucity of information warrants urgent attention; thus targeted research is needed to provide insight on adherence within this population.
Use of the UriSwab collection device for testing of Chlamydia trachomatis and Neisseria gonorrhoeae: implications for a postal testing service
Authors: McNicol J , Debattista J 
Published: July 2013

Summary In order to demonstrate the reliability of UriSwab, a trial was conducted using urine samples that had previously returned a detected result for Chlamydia trachomatis and/or Neisseria gonorrhoeae. Urine specimens (115 samples) were received from sexual health clinics and tested using the Roche Cobas 4800 CT/NG method. Concurrently, the urine samples were pipetted directly on to the sponge applicator of the UriSwab, simulating micturition, and the urine harvested from the UriSwab was tested using the Roche Cobas 4800 method. Of the 87 standard urine specimens that were C. trachomatis detected, 85 (98%) were also detected in the corresponding UriSwab specimen (sensitivity 97.7%, specificity 95.7%). Of the 34 standard specimens that were N. gonorrhoeae detected, 33 (97%) were also detected in the corresponding UriSwab specimen (sensitivity 97.1%, specificity 100%). The performance of the UriSwab in this trial was comparable with the testing of neat first-catch urine specimens for both C. trachomatis and N. gonorrhoeae.
Use of the Alcohol Use Disorders Identification Test (AUDIT) to determine the prevalence of alcohol misuse among HIV-infected individuals
Authors: Surah S , Kieran J , O'Dea S , Shiel C , Raffee S , Mulcahy F , Keenan E , Lyons F 
Published: July 2013

Summary The aim of the paper is to evaluate alcohol misuse among an inner city adult HIV clinic population with AUDIT (Alcohol Use Disorders Identification Test). A cross-sectional HIV outpatient clinic analysis between 28 February 2011 and 11 March 2011 was carried out. AUDIT, demographic and clinical data were collected. Univariate analysis was performed to look for the associations between variables. Backward stepwise multivariate analyses were performed on significant variables from the univariate analysis to assess for predictors of alcohol dependence. In total, 111 patients were included (60% uptake of clinic attendees); 66% were men and 26% were hepatitis C virus (HCV) co-infected. The median AUDIT score was 5 (within normal range). Thirty-four ‘AUDIT positive’ cases were identified: five (4.5%) indicated consumption of hazardous levels of alcohol; 21 (19%) indicated harmful levels of alcohol; and eight (7%) were likely alcohol dependent. Younger age (<40 years old) was significantly associated with AUDIT positivity ( P = 0.006). On multivariate analysis younger age ( P = 0.045, odds ratio 13.8) and lower level of education ( P = 0.006, odds ratio 6.7) were predictive of scores indicative of alcohol dependence (AUDIT ≥20). In conclusion, younger age and lower educational levels were associated with scores consistent with alcohol dependence. AUDIT was well tolerated and easy to administer in this outpatient HIV clinic population.
Human papillomavirus genotypes in genital warts in Latin America: a cross-sectional study in Bogota, Colombia
Authors: Hernandez-Suarez G , Pineros M , Vargas J C , Orjuela L , Hernandez F , Peroza C , Torres D , Escobar A , Perez G 
Published: July 2013

Summary Epidemiological studies on benign lesions related to human papillomavirus (HPV) infection are scarce in Latin America. We enrolled 342 consecutive patients with lesions suspected of being genital warts (GW). All patients underwent confirmatory biopsy and GP5+/GP6+/− Reverse Line Blot HPV testing on frozen tissue. In 261 (81%) cases, the diagnosis was confirmed by histopathology and HPV was detected in 90.6% of men and 87.7% of women. HPV 6 was by far the most common type in both women (62%) and men (56%), followed by HPV 11 (∼20%). Co-infection with these two types occurred in 7% and 12% of women and men, respectively. HPV16 ranked third in prevalence, with 16% of patients testing positive. Twenty-five percent of cases tested positive for multiple HPV genotypes. Although HPV 6 and HPV 11 were the main types detected and no differences between men and women were observed, we found HPV 11 contributed more to GW aetiology compared with previous reports, showing a variability of HPV type distribution in GW across populations. This information is valuable baseline data in Latin America for future estimations of the burden of GW in men and women and shows the potential benefit obtainable by prophylactic vaccination against HPV types 6 and 11.
The 2012 International Union against Sexually Transmitted Infections European Collaborative Clinical Group report on the diagnosis and management of Neisseria gonorrhoeae infections in Europe
Authors: Brooks B , Patel R ,   The European Collaborative Clinical Group (ECCG)
Published: July 2013

Summary The European Collaborative Clinical Group (ECCG) was inaugurated at the 26th International Union against Sexually Transmitted Infections (IUSTI) Congress in Riga, Latvia 2011. The ECCG is a network of over 100 sexually transmitted infection specialists who have come together to conduct questionnaire-based research across the European region. It is expected that this work will focus and direct guideline development. A central core group of the ECCG has also been established who are responsible for identifying suitable survey questions that will be carried out but only after approval by the full ECCG Board. The ECCG aims to conduct a maximum of two projects per year which will be presented at the annual regional congresses and published as appropriate.
A trial of questionnaire administration modalities for measures of sexual risk behaviour in the uniformed services of Peru
Authors: Anastario M , Chun H , Soto E , Montano S 
Published: July 2013

Summary Modalities of questionnaire administration may affect data quality, particularly when conducting Biological and Behavioral Surveillance Surveys (BBSS) of uniformed personnel. We aimed to examine differences in administration, reporting and data quality across several common modalities of administration for BBSS endeavors. Prior to a large-scale BBSS endeavor with the uniformed services of Peru, we pilot tested three modes of questionnaire administration among personnel engaged in internal combat: face-to-face interview (FFI), self-administered paper-based interview (SAPI), and audio computer-assisted self-interview (ACASI). Individuals who took the survey using ACASI were less likely to have missing data on measures of sexual risk and alcohol abuse and were more likely to report sexual risk behaviours and symptoms of alcohol abuse; however, more individuals took the survey using SAPI given inadequate time to devote to sitting through an entire FFI or ACASI. Sexually transmitted infections did not vary significantly across modes of questionnaire administration. While more logistically complicated for BBSS efforts in resource-constrained settings, we recommend the use of ACASI in collecting BBSS data from uniformed personnel if conditions are permissible.