bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wound healing following surgical and regenerative periodontal therapy
Authors: Susin Cristiano , Fiorini Tiago , Lee Jaebum , De Stefano Jamie A. , Dickinson Douglas P. , Wikesjö Ulf M. E. 
Published: April 2015

AbstractClinical studies have evaluated the effect of conventional periodontal surgical therapy. In general, although some clinical gain in tissue support may be attained, these therapies do not support regeneration of the periodontal attachment. Even though the biological possibility of periodontal regeneration has been demonstrated, the clinical application of this intrinsic potential appears difficult to harness; thus also conceptually most intriguing candidate protocols face clinical challenges. In this review, we explore the bioclinical principles, condiciones sine quibus non, that unleash the innate potential of the periodontium to achieve clinically meaningful periodontal regeneration (i.e. space‐provision, wound stability and conditions for primary intention healing). Moreover, limiting factors and detrimental practices that may compromise clinical and biological outcomes are reviewed, as is tissue management in clinical settings.
Periodontal plastic surgery
Authors: Zucchelli Giovanni , Mounssif Ilham 
Published: April 2015

AbstractThe aim of the present article is to summarize current knowledge in terms of the etiology, diagnosis, prognosis and surgical treatment of gingival recession. Whilst the main etiological factors (i.e. toothbrushing trauma and bacterial plaque) are well established, challenges still remain to be solved in the diagnostic, prognostic and classification processes of gingival recession, especially when the main reference parameter – the cemento–enamel junction – is no longer detectable on the affected tooth or when there is a slight loss of periodontal interdental attachment. Root coverage in single type gingival recession defects is a very predictable outcome following the use of various surgical techniques. The coronally advanced flap, with or without connective tissue grafting, is the technique of choice. The adjunctive use of connective tissue grafts improves the probability of achieving complete root coverage. Surgical coverage of multiple gingival recessions is also predictable with the coronally advanced flap and the coronally advanced flap plus the connective tissue graft, but no data are available indicating which, and how many, gingival recessions should be treated adjunctively with connective tissue grafting in order to limit patient morbidity and improve the esthetic outcome. None of the allograft materials currently available can be considered as a full substitute for the connective tissue graft, even if some recent results are encouraging. The need for future studies with patient‐based outcomes (i.e. esthetics and morbidity) as primary objectives is emphasized in this review.
Pre‐clinical in vivo models for the screening of bone biomaterials for oral/craniofacial indications: focus on small‐animal models
Authors: Stavropoulos Andreas , Sculean Anton , Bosshardt Dieter D. , Buser Daniel , Klinge Björn 
Published: April 2015

AbstractPreclinical in vivo experimental studies are performed for evaluating proof‐of‐principle concepts, safety and possible unwanted reactions of candidate bone biomaterials before proceeding to clinical testing. Specifically, models involving small animals have been developed for screening bone biomaterials for their potential to enhance bone formation. No single model can completely recreate the anatomic, physiologic, biomechanic and functional environment of the human mouth and jaws. Relevant aspects regarding physiology, anatomy, dimensions and handling are discussed in this paper to elucidate the advantages and disadvantages of small‐animal models. Model selection should be based not on the ‘expertise’ or capacities of the team, but rather on a scientifically solid rationale, and the animal model selected should reflect the question for which an answer is sought. The rationale for using heterotopic or orthotopic testing sites, and intraosseous, periosseous or extraskeletal defect models, is discussed. The paper also discusses the relevance of critical size defect modeling, with focus on calvarial defects in rodents. In addition, the rabbit sinus model and the capsule model in the rat mandible are presented and discussed in detail. All animal experiments should be designed with care and include sample‐size and study‐power calculations, thus allowing generation of meaningful data. Moreover, animal experiments are subject to ethical approval by the relevant authority. All procedures and the postoperative handling and care, including postoperative analgesics, should follow best practice.
Experience of anaesthesia nurses of perioperative communication in hip fracture patients with dementia
Authors: Krupic Ferid , Eisler Thomas , Sköldenberg Olof , Fatahi Nabi 
Published: April 2015

BackgroundPerioperative care in hip fracture patients with dementia can be complex. There is currently little scientific evidence on how care should be undertaken.AimsThe aim of the study was to describe the experience of anaesthesia nurses of the difficulties that emerge in care situations and how communication with patients can be maintained in the perioperative setting of hip fracture surgery.MethodsIndividual interviews were conducted with ten anaesthesia nurses (5 men and 5 women). The interviews were carried out at a university hospital in Gothenburg (Sweden), and the data were analysed using qualitative content analysis.FindingsThree main response categories were discerned: ‘Communication’, ‘Dementia as a special issue’ and ‘Practical issues’. Dementia was viewed as one of the most difficult and shifting diseases an individual may suffer from. Time must be allocated to communicate clearly and patiently, to meticulously plan and carry out care while providing distinct information to enable patient participation. Establishing a mental bridgehead by confirming the patients' perceptions/feelings significantly reduced distress in a majority of the patients. A holistic and respectful approach was deemed mandatory at all times. Patients are sometimes dependent on recognition, so that small personal items brought close to the patient during surgery can calm the patient. State‐of‐the‐art analgesia and anxiolytic medications are mandatory.ConclusionsPerioperative problems can be overcome with patience, empathy and profound knowledge of how patients with dementia respond prior to surgery. Our results may serve as a source for future care and provide information about hospital settings for better perioperative care in patients with dementia.
Murine typhus in a liver transplant recipient: report of a first case
Authors: Phatharodom P. , Limsrichamrern S. , Kaewwinud J. , Chayakulkeeree M. 
Published: April 2015

AbstractZoonoses, especially rickettsial diseases, are rarely reported in solid organ transplant recipients. We report here a case of murine typhus in a 69‐year‐old liver transplant recipient, who presented with acute febrile illness 5 years post transplantation. Although receiving treatment with broad‐spectrum antibiotics, he was still febrile and developed progressive dyspnea. Laboratory results showed elevated transaminases and his chest radiograph revealed bilateral interstitial infiltration. The diagnosis of murine typhus was made by a 4‐fold rise in specific Rickettsia typhi antibody, using indirect immunofluorescent assay. He dramatically improved after treatment with doxycycline for 7 days. To our knowledge, this is the first case report of murine typhus in a liver transplant recipient.
Variation in vital signs resulting from blood component administration in adults
Authors: Gehrie Eric A. , Hendrickson Jeanne E. , Tormey Christopher A. 
Published: April 2015

BACKGROUNDAlthough vital signs are routinely recorded before and after every transfusion, there are few published data on how these variables vary with component administration. Thus, there is very little evidence available to support guidelines that are intended to differentiate “benign” changes in vital signs from transfusion reactions. The aim of this study was to evaluate the variation in vitals observed after transfusion.STUDY DESIGN AND METHODSRetrospective data were extracted from blood bank records for 3496 component infusions (red blood cells, n = 2359; platelets, n = 478; plasma, n = 659) over a 1‐year period. The following were collected: recipient pre‐ and posttransfusion vital signs (temperature, pulse rate, and blood pressure) and whether a transfusion reaction was reported.RESULTSTransfusion was associated with very mild median changes in temperature (approx. 0°C), pulse rate (<5 beats/min), or blood pressure (<5 mmHg) across all components. The transfusion reaction rate reported by clinical teams was 0.5%, but reported temperature changes indicated a higher reaction rate of 2.1% based on institutional criteria.CONCLUSIONSBlood transfusion is not associated with significant changes in recipient vital signs. Our data could be used to develop reference ranges for transfusion‐related vital signs. More than 75% of transfusion reactions may not be reported to the blood bank.
Biphenotypic B‐cell lymphoma in 2 cats
Authors: Granum Liana , Gorman Elena , Ruaux Craig , Vernau William 
Published: April 2015

AbstractThe clinical and pathologic features of biphenotypic B‐cell lymphoma in 2 cats are reported. Clinical presentation varied from multiple cutaneous masses identified on the thigh in one cat to signs of lethargy from acute hemorrhage due to neoplastic infiltration of one kidney in the other. Cytology and histopathology confirmed round cell neoplasia in both cats and immunochemical staining demonstrated expression of both B‐ and T‐lymphocyte markers by the neoplastic cells in both animals. InPCRanalysis of antigen receptor gene rearrangement, clonal rearrangement of B‐cell receptor genes and polyclonal T‐cell receptor gene rearrangement were demonstrated in both lymphomas. These findings were consistent with a diagnosis of B‐cell lymphoma with aberrant CD3 expression in both cases. Clinical progression of disease post diagnosis was rapid in both cats, suggesting a poor prognosis for this lymphoma type. Although bigenotypic receptor rearrangement of lymphoma cells appears relatively common, this is the first known report of actual biphenotypic lymphoma in cats.
Quality management in transfusion medicine: a race without finish
Authors: Strengers P. F. W. 
Published: April 2015

AbstractQuality management in transfusion medicine, used for the the purposes of compliance with regulations and guidelines involves all processes from the blood donation to the administration and follow up of the blood product, transfused to the patient. Correlated with control, prevention and failures, quality management will help in minimising failures and be the only instrument to guarantee the patient effective, safe and affordable blood products.
Engineering more efficient multipotent mesenchymal stromal (stem) cells for systemic delivery as cellular therapy
Authors: Moll G. , Le Blanc K. 
Published: April 2015

Multipotent mesenchymal stromal (stem) cells (MSCs) harbour great potential for regenerative and immunomodulatory therapies. A major drawback in MSC therapy appears to be the incomplete understanding of cell fate and function following systemic administration. We here summarize our knowledge on MSC interaction with human blood. Analysis of tissues following MSC therapy indicated limited long‐term engraftment. MSCs and other stromal cells trigger an innate immune attack, termed instant blood‐mediated inflammatory reaction (IBMIR), which has been shown to compromise the survival, engraftment and function of cellular therapeutics. MSCs express hemostatic regulators similar to those produced by endothelial cells, but display higher amounts of prothrombotic tissue factor on their surface, which triggers the IBMIR after blood exposure. This process is dependent on the cell dose, the choice of MSC donor, the cell passage number and cell handling before infusion. Freshly harvested, short‐term expanded bone marrow MSCs trigger only weak blood responses, while extended culture, freeze‐thawing, washing and resupsension in human AB plasma, and co‐culture with activated lymphocytes increases their prothrombotic profile. After MSC infusion to patients, we found increased formation of blood activation markers, but no formation of hyperfibrinolysis marker D‐dimer or acute phase reactants with the currently applied dose of 1–3 × 106 cells/kg, demonstrating product safety. We conclude, that currently applied doses of low‐passage clinical grade MSCs are safe and elicit only minor systemic effects, but higher cell doses, and particularly higher passage cells, should be handled with care. This deleterious reaction can compromise the survival, engraftment and function of these therapeutic cells.
Approach to managing platelet refractory patients
Authors: Lee C. , Ayob Y. 
Published: April 2015

The diagnosis of platelet refractoriness is made when at least on two sequential occasions, a 10‐min to 1‐h post‐transfusion, the CCI is less than 5 × 109/l, using ABO‐identical fresh platelets of less than 72 h old. In practice, an increase in the patient's platelet counts of <10 × 109/l after the transfusion can be used. Refractoriness to platelet transfusion can be due to non‐immune and immune causes. Non‐immune causes include sepsis and disseminated intravascular coagulation. Twenty percent of cases have a combination of both immune and non‐immune causes. Immune causes include alloimmunization to human leukocyte antigen (HLA) and/or human platelet antigens(HPA). The pattern of refractoriness and clinical condition may assist in determining the cause. Patients who are likely to receive multiple platelet transfusion should have their post transfusion platelet count estimated. If refractoriness is suspected, HLA typing and antibody investigation should be done. While waiting for the test result and the supply of HLA matched platelets, ABO compatible platelets may be given. Doubling the dose or giving more frequent transfusion maybe necessary in non‐immune cases. Where patient's HLA type is known, an identical or closely identical platelet can be given. Another approach is by giving platelet from donors lacking HLA antigens that correspond to the recipient's alloantibodies. Crossmatched platelets can be given in the absence of typed HLA platelets. Approximately 20–25% cases may be due to platelet‐specific antibodies, and undetected HLA incompatibility, in which case, the patient can be given antigen negative platelet.
Safety and effectiveness of a Patient Blood Management Programme in surgical patients – the study design for a multicentre epidemiological non‐inferiority trial by the German PBM network
Authors: Meybohm P. , Fischer D. P. , Herrmann E. , Geisen C. , Müller M. M. , Seifried E. , Steinbicker A. U. , Weber C. F. , Zacharowski K. D. ,   the German PBM Network
Published: April 2015

BackgroundPatient blood management (PBM) concepts aim to identify patients with anemia and optimize their treatment including use of preoperative iron substitution, blood‐sparing techniques and adequate transfusion practice. PBM concepts thus have great potential to increase patient safety and clinical outcome. Nevertheless, up to now, structured PBM programmes have only been implemented in very few hospitals in Germany and safety data regarding clinical outcome parameters is rare.MethodsThe German PBM network was founded in January 2014 and joined by 24 hospitals different hospitals of varying sizes and levels of patient care. An evidence‐based PBM programme will be applied in these hospitals reforming the care of adult patients undergoing surgery, and data will be monitored prospectively. This PBM programme includes the following three main pillars: (1) preoperative optimization of hemoglobin levels in high‐risk patients suffering from anemia, (2) standardization of transfusion practice according to evidence‐based guidelines and (3) wide implementation of alternatives to transfusion of allogeneic red blood cell (RBC) concentrates including blood‐sparing techniques. Primary endpoints are the following composite endpoints: (1) in‐hospital myocardial infarction, (2) stroke, (3) acute renal failure, (4) death of any cause, (5) pneumonia and (6) sepsis until hospital discharge in patients before and after the implementation of the PBM programme.ConclusionsThis trial will determine whether the implementation of a PBM programme is safe and effective in terms of clinical outcome. Data will be compared to data prior to implementation of PBM in (the same?) 20 Germany hospitals.
Next‐generation sequencing: academic overkill or high‐resolution routine blood group genotyping?
Authors: Avent N. D. , Madgett T. E. , Halawani A. J. , Altayar M. A. , Kiernan M. , Reynolds A. J. , Li X. 
Published: April 2015

Blood group genotyping (BGG) has been in routine clinical practice ever since the molecular determination of blood groups was achieved, during the early to mid 1990s. These early methods were dependent on allele‐specific PCR to detect simple single nucleotide polymorphisms (SNPs) responsible for blood group expression. As our knowledge regarding the molecular background of blood groups advanced, so did the numbers of SNPs requiring detection which necessitated the switch from allele‐specific PCR to array‐based technology, notably slide and bead‐based approaches. All these methods thus described are totally dependent on the predefined genetic basis of each SNP. Hybrid blood group genes (as found in RH, ABO and MNS systems) are difficult to define by all of these aforementioned techniques. With the arrival of cheap next‐generation sequencing (NGS) approaches in the past 5 years, we have conducted long‐range PCR (LR‐PCR) coupled with NGS determination of the major blood group genes. By analysis of these data using an Ion Torrent Personal Genome Machine™ (PGM™), it is readily apparent that NGS can highly effectively be applied with high resolution to blood grouping at costs no more than current array‐based platforms. However, the complexity of the data obtained need careful filtering for effective clinical utilization, but provides useful insight on the evolution of blood groups and their environmental impacts which will be of undoubted value as an academic exercise, but of minimal cost (if any) to the original testing.
The new oral anticoagulants: clinical use and reversal agent development
Authors: Costin J. , Ansell J. , Bakhru S. , Laulicht B. , Steiner S. 
Published: April 2015

Warfarin has been the centre of oral anticoagulant therapy for over 60 years. Recent development of new oral anticoagulants (NOACs) has provided a safe and effective alternative for stroke prevention in patients with atrial fibrillation and for prevention of venous thromboembolism. Determination of their use in acute coronary syndrome has been hampered by increases in bleeding events in most large trials, especially when used with antiplatelet therapy. NOACs have equal or superior efficacy and safety profiles compared to warfarin, fewer drug interactions; no dietary restrictions; predictable responses that eliminates monitoring; a rapid onset eliminates bridging with parenteral anticoagulants; and a potential reduction in mortality in patients with atrial fibrillation. There are reports of bleeding events and deaths associated with NOACs. Haemorrhage associated with dabigatran and warfarin were the most common safety issues for anticoagulants reported to the United States Food and Drug Administration in 2012. The lack of a NOAC reversal agent is a significant clinical concern for many physicians. Current reversal agents for unfractionated heparin, low molecular weight heparins and warfarin are less than optimal, and there are no effective reversal agents for NOACs. Development programs for anticoagulant reversal of the NOACs have three approaches: multiple coagulation factor replacement, large molecules (recombinant antibodies or altered coagulation factors) that either bind to or substitute for the coagulation factor while the anticoagulant itself is either being excreted or metabolized, and a small molecule specifically designed to bind to the NOACs and heparins and prevent them from binding to the coagulation factor targets.
Molecular tools for investigating immunohaematology problems
Authors: Peyrard T. 
Published: April 2015

Blood types are classically determined by haemagglutination methods. However, several backgrounds represent limitations for serological techniques, which may be overcome by molecular testing, for example blood typing in recently transfused patients or in case of a positive IgG direct antiglobulin test when indirect antiglobulin testing is required for antisera. A multitude of molecular tools are available and can be separated in five groups: low‐throughput tests, medium‐ to high‐throughput assays, genomic DNA sequencing, high‐throughput DNA sequencing devices and other specialized techniques. The low‐throughput tests especially include PCR‐restriction fragment length polymorphism (RFLP) and manual allele‐specific PCR techniques. The medium‐to high‐throughput systems, mainly real‐time PCR, microarray DNA chips and mass spectrometry, allow for the testing of multiple different SNPs. The so‐called ‘next‐generation sequencing’ technologies can analyse 10 Mb to 1000 Gb per run. Their implementation in transfusion medicine is currently developed by a few teams worldwide, and they may become a major investigating tool in the next future. Standard genomic DNA sequencing may be used when genotyping assays are unavailable or when screening for common mutations by genotyping devices is inconclusive. Specialized techniques, reserved for complex cases or research, are performed after messenger RNA extraction, followed by reverse transcription into complementary DNA, which may be directly sequenced or cloned with plasmid vectors for single‐allele sequencing. Finally, electronic databases are also very helpful tools in molecular immunohaematology, for example the resources from the National Center for Biotechnology Information (NCBI), Rhesus Base and the ISBT Website of the Working Party on Red Cell Immunogenetics and Blood Group Terminology.
Simple deterministic model of the hydraulic buffer effect in septic tanks
Authors: Forquet Nicolas , Dufresne Matthieu 
Published: April 2015

AbstractSeptic tanks are widely used in on‐site wastewater treatment systems. In addition to anaerobic pretreatment, hydraulic buffering is one of the roles attributed to septic tanks. However, there is still no tool for assessing it, especially in dynamic conditions. For gravity fed‐system, it could help both researchers and system designers. This technical note reports a simple mechanistic model based on the assumption of flow transition between the septic tank and the outflow pipe. The only parameter of this model was calibrated using computational fluid dynamics (CFD) modeling for a wide range of discharge rates. The resulting model highlights that a septic tank plays a hydraulic buffer role when faced with sudden and large discharge flow, but this role tends to disappear when input hydrographs are smoother. In those cases, there is an observable lag between the input hydrograph and outflow hydrograph.