bluuebunny/crossref_metadata_2025_split huggingface dataset:
The German Haemovigilance System–reports of serious adverse transfusion reactions between 1997 and 2007
Authors: Keller‐Stanislawski B. , Lohmann A. , Günay S. , Heiden M. , Funk M. B. 
Published: September 2009

summary.Data of the German Haemovigilance System were collected from 1997 to 2007 and assessed on the basis of pre‐defined safety standards. Suspected cases of serious adverse reactions following transfusions reported to the Paul‐Ehrlich‐Institut were evaluated on the basis of national criteria, and the definitions of International Society of Blood Transfusion (ISBT) in compliance with defined causality criteria. The suspected cases were rated as confirmed and unconfirmed transfusion reactions. Assessment of causality took into consideration the clinical course of the adverse reaction and, if necessary, information about donation and manufacturing. Of the 5128 suspected serious adverse reactions, 1603 could be confirmed. Referring to the absolute figures, acute transfusion reactions (e.g. allergic reactions, hypotension and dyspnoea) were recorded most frequently, followed by transfusion‐related acute lung injury (TRALI), haemolytic reactions, transfusion‐related bacterial infections and virus infections. The majority of the 52 transfusion‐related fatalities (14 each) were due to TRALI and acute transfusion reactions (mostly severe allergic reactions). Referred to the blood products administered, immune TRALI cases and TRALI‐related fatal courses were most frequently reported after administration of fresh frozen plasma (FFP) (15/106 and 3.5/106 units, respectively), transfusion‐related bacterial infections after administration of platelet concentrates (7/106 units), acute haemolytic transfusion reactions after administration of red blood cell concentrates (2.3/106units) and acute transfusion reactions after administration of red blood cell or platelet concentrates (7.8/106 and 13/106 units, respectively). Despite the high safety standard required for blood products in Germany, there is still room for reducing the frequency of isolated cases of transfusion reactions by targeted action.
Validation of methodologies for quantifying isolated human islets: an islet cell resources study
Authors: Kissler H.J. , Niland J.C. , Olack B. , Ricordi C. , Hering B.J. , Naji A. , Kandeel F. , Oberholzer J. , Fernandez L. , Contreras J. , Stiller T. , Sowinski J. , Kaufman D.B. 
Published: August 2009

Kissler HJ, Niland JC, Olack B, Ricordi C, Hering B J, Naji A, Kandeel F, Oberholzer J, Fernandez L, Contreras J, Stiller T, Sowinski J, Kaufman DB. Validation of methodologies for quantifying isolated human islets: an islet cell resources study. Clin Transplant 2009 DOI: 10.1111/j.1399‐0012.2009.01052.x. © 2009 John Wiley & Sons A/S.Abstract:  Background:  Quantification of islet mass is a crucial criterion for defining the quality of the islet product ensuring a potent islet transplant when used as a therapeutic intervention for select patients with type I diabetes.Methods:  This multi‐center study involved all eight member institutions of the National Institutes of Health‐supported Islet Cell Resources Consortium. The study was designed to validate the standard counting procedure for quantifying isolated, dithizone‐stained human islets as a reliable methodology by ascertaining the accuracy, repeatability (intra‐observer variability), and intermediate precision (inter‐observer variability). The secondary aim of the study was to evaluate a new software‐assisted digital image analysis method as a supplement for islet quantification.Results:  The study demonstrated the accuracy, repeatability and intermediate precision of the standard counting procedure for isolated human islets. This study also demonstrated that software‐assisted digital image analysis as a supplemental method for islet quantification was more accurate and consistent than the standard manual counting method.Conclusions:  Standard counting procedures for enumerating isolated stained human islets is a valid methodology, but computer‐assisted digital image analysis assessment of islet mass has the added benefit of providing a permanent record of the isolated islet product being evaluated that improves quality assurance operations of current good manufacturing practice.
Symptomatic lymphoceles after kidney transplantation – multivariate analysis of risk factors and outcome after laparoscopic fenestration
Authors: Ulrich Frank , Niedzwiecki Sebastian , Fikatas Panos , Nebrig Maxim , Schmidt Sven C. , Kohler Sven , Weiss Sascha , Schumacher Guido , Pascher Andreas , Reinke Petra , Tullius Stefan G. , Pratschke Johann 
Published: August 2009

Ulrich F, Niedzwiecki S, Fikatas P, Nebrig M, Schmidt SC, Kohler S, Weiss S, Schumacher G, Pascher A, Reinke P, Tullius SG, Pratschke J. Symptomatic lymphoceles after kidney transplantation – multivariate analysis of risk factors and outcome after laparoscopic fenestration. Clin Transplant 2009 DOI: 10.1111/j.1399‐0012.2009.01073.x © 2009 John Wiley & Sons A/S.Abstract:  Lymphocele formation is a common complication after kidney transplantation, and laparoscopic surgery has become a widely accepted treatment option. The aim of this retrospective study was to analyze the risk factors of lymphocele development and to assess the treatment outcome after laparoscopic fenestration. We analyzed 426 renal allograft recipients operated between 2002 and 2006 receiving triple immunosuppression with calcineurin inhibitors. The incidence of lymphocele was 9.9%, while 24 (5.6%) patients with symptomatic lymphoceles required laparoscopic surgery. Serum creatinine at diagnosis was significantly higher in patients with lymphoceles treated surgically (3.2 ± 0.7 vs. 1.7 ± 0.6 mg/dL; p < 0.001). After successful laparoscopic intervention, creatinine concentrations recovered until discharge and were comparable to other patients (1.6 ± 0.5 vs. 1.5 ± 0.5 mg/dL; p = NS). While we observed a significant association of lymphocele formation with diabetes, tacrolimus therapy, and acute rejection in univariate testing, only diabetes remained a significant factor after multivariate analysis. Laparoscopic fenestration proved to be a safe and efficient method without any associated mortality and a low recurrence rate of 8.3% (n = 2). We conclude that diabetes is an independent risk factor for lymphocele development, and laparoscopic fenestration should be the treatment of choice for larger and symptomatic lymphoceles, as it is safe and offers a low recurrence rate.
Serum leptin and adiponectin levels correlate with severity of allergic rhinitis
Authors: Hsueh Kai‐Chung , Lin Ying‐Ju , Lin Hsiao Chuan , Lin Ching‐Yuang 
Published: August 2009

Hsueh K‐C, Lin Y‐J, Lin HC, Lin C‐Y. Serum leptin and adiponectin levels correlate with severity of allergic rhinitis. Pediatr Allergy Immunol 2010: 21: e155–e159. © 2009 John Wiley & Sons A/SThe aim of this study was to evaluate the roles of leptin and adiponectin, which are adipokines produced by adipose tissue, in childhood allergic rhinitis (AR), and their association with severity of AR, parameters of atopy and pro‐/anti‐inflammatory cytokines. Serum levels of leptin, adiponectin, mite allergen‐specific and total immunoglobulin E, eosinophil cationic protein (ECP), and pro‐ and anti‐inflammatory cytokines were analysed in 97 non‐asthmatic children presenting with persistent AR and in 64 controls. The nasal symptom scores and body mass index were evaluated at the time of blood collection. We found that patients had significantly higher serum levels of leptin and significantly lower serum levels of adiponectin than controls. Furthermore, multivariate logistic regression analysis revealed that leptin and adiponectin were significant predictive factors for AR. Serum levels of leptin and adiponectin were significantly correlated with nasal symptom scores. There was no correlation between levels of pro‐ and anti‐inflammatory cytokines and level of leptin or adiponectin. A significant negative correlation was observed between serum levels of adiponectin and ECP levels in AR children. Our findings suggest that serum leptin and adiponectin levels may serve as predictors of disease severity in childhood AR and both of them appear to be attractive candidates for unmasking or modulating AR.
Urinary nitric oxide excretion in infants with eczema
Authors: Devenney Irene , Norrman Gunilla , Forslund Tony , Fälth‐Magnusson Karin , Sundqvist Tommy 
Published: August 2009

Devenney I, Norrman G, Forslund T, Fälth‐Magnusson K, Sundqvist T. Urinary nitric oxide excretion in infants with eczema. Pediatr Allergy Immunol 2010: 21: e229–e234. © 2009 John Wiley & Sons A/SEczema is characterized by inflammation of the skin and is commonly associated with food allergy. It has been suggested that nitric oxide (NO) is an important player in eczema, food allergy and intestinal inflammation. The aim of this study was to assess the levels of urinary NO breakdown products in infants with eczema and the effect of eczema treatment on NO levels. Ninety‐four infants with eczema, 58 boys and 36 girls, with a mean age of 7.5 ± 5.2 months (mean ± s.d.) at inclusion were examined twice with an interval of 6 wk. The sum of nitrite and nitrate was measured colorimetrically in urinary samples from both visits and compared with clinical data concerning eczema severity, nutrition, gastrointestinal symptoms, asthma and skin prick positivity. The levels of NO products increased significantly from the first to the second visit: 289; 374 μm (median; IQR) vs. 457; 678 μm (median; IQR) (p < 0.001) in parallel with a significant improvement of the eczema. After eczema treatment consisting of skin care and elimination diet during the 6‐wk interval between evaluations, the NO levels approached the values previously found in healthy children. The results support previous studies indicating that the homeostasis of nitrogen radicals is disturbed in childhood eczema.
An evaluation of monitoring possibilities of argatroban using rotational thromboelastometry and activated partial thromboplastin time
Authors: ENGSTRÖM M. , RUNDGREN M. , SCHÖTT U. 
Published: August 2009

Background:
Rotational thrombelastometry/thrombelastography with ROTEM® and TEG® is becoming available bedside in an increasing number of intensive care units, where many patients with heparin‐induced thrombocytopenia (HIT) are treated. The study has been performed in an effort to find out whether ROTEM® could be an alternative to activated partial thromboplastin time (aPTT) when argatroban is used for anticoagulation.Methods:
Argatroban was added in vitro to a series of citrated whole‐blood samples from 10 healthy volunteers to obtain whole‐blood concentrations of 0, 0.125, 0.25, 0.5, 1.0, 2.0, 4.0 and 8.0 mg/l. ROTEM® and whole‐blood aPTT analyses were performed at each argatroban concentration. Correlation analyses were performed using the Spearman correlation analysis.Results:
There was a significant and strong correlation between argatroban concentrations and clotting time (CT in ROTEM® analysis with INTEM) (P<0.0001 and r=0.98). Also, the ROTEM® time to maximum clot formation velocity (MAXV‐t) appeared to have a very strong and highly significant correlation to argatroban concentrations (P<0.0001 and r=0.95). When we studied the correlation between aPTT and CT, we found a highly significant and strong correlation between these two analyses (P<0.0001 and r=0.97), especially so in the clinically relevant therapeutic range up to 100 s aPTT prolongation for HIT patients.Conclusion:
A significant and strong correlation was found between argatroban concentrations and several ROTEM® parameters. Rotational thrombelastometry/thrombelastography has a potential role in increasing the safety of argatroban anticoagulation in critically ill patients.
High or low current threshold for nerve stimulation for regional anaesthesia
Authors: STEINFELDT T. , GRAF J. , VASSILIOU T. , MORIN A. , FELDMANN K. , NIMPHIUS W. , DE ANDRES J. , WULF H. 
Published: August 2009

Background: The purpose of this study was to determine whether the application of high stimulation current thresholds (SCT) leads to a distant needle to nerve proximity (NNP) compared with low SCT during nerve localization for regional anaesthesia in pigs.Methods: A minimal motor response to the stimulation of femoral or brachial plexus nerves in 16 anaesthetized pigs was triggered either by a minimal SCT of a low (0.01–0.3 mA) or a high (0.8–1.0 mA) current in a random order. After eliciting a motor response with a predetermined SCT, synthetic resin was injected via the needle. After postmortem dissection of the injection site, the localization of the resin deposition was determined verifying the final position of the needle tip. Depending on the proximity of resin deposition to the nerve epineurium, the needle tip placement was considered either as a close or a distant NNP.Results: A total of 235 punctures were performed. Ninety‐one punctures were carried out with low SCT and 92 with a high SCT. Fifty‐two punctures served as a control (1.8–2.0 mA). All injectates following both high or low SCT were considered ‘close needle tip to nerve placement’, whereas 27 of 52 injectates of the control group appeared distant to nerve epineurium.Conclusion: Regardless of the applied SCT, i.e. high or low, all resin deposition was found adjacent to nerve epineurium. These findings suggest that high and low SCT result in equivalent needle tip localization in pigs.
Modafinil reduces patient‐reported tiredness after sedation/analgesia but does not improve patient psychomotor skills
Authors: GALVIN E. , BOESJES H. , HOL J. , UBBEN J. F. , KLEIN J. , VERBRUGGE S. J. C. 
Published: August 2009

Background: Early recovery of patients following sedation/analgesia and anesthesia is important in ambulatory practice. The aim of this study was to assess whether modafinil, used for the treatment of narcolepsy, improves recovery following sedation/analgesia.Methods: Patients scheduled for extracorporeal shock wave lithotripsy were randomly assigned to one of four groups. Two groups received a combination of fentanyl/midazolam with either modafinil or placebo. The remaining groups received remifentanil/propofol with either modafinil or placebo. Modafinil 200 mg was administered to the treatment group patients 1 h before sedation/analgesia. Groups were compared using the digital symbol substitution test (DSST), trail making test (TMT), observer scale of sedation and analgesia (OAA/S) and Aldrete score. Verbal rating scale (VRS) scores for secondary outcome variables e.g. energy, tiredness and dizziness were also recorded before and after treatment.Results: Sixty‐seven patients successfully completed the study. Groups received similar doses of sedation and analgesic drugs. No statistically significant difference was found for DSST between groups. No significant adverse effects occurred in relation to modafinil. No statistically significant difference between groups was identified for TMT, OAA/S and Aldrete scores. The mean VRS score for tiredness was lesser in the modafinil/fentanyl/midazolam group [1.3 (2.0)] compared with the placebo group [3.8 (2.5)], P=0.02. Such a difference was not found between the remifentanil/propofol groups [placebo 2.6 (2.2) vs. modafinil 3.1(2.7)], p>0.05. Dizziness was greater in the modafinil/remifentanil/propofol group 1.7 (2.0) vs. placebo 0.0 (0.5), p<0.05.Conclusion: Modafinil reduces patient‐reported tiredness after sedation/analgesia but does not improve recovery in terms of objective measures of patient psychomotor skills.
Comparison of desaturation and resaturation response times between transmission and reflectance pulse oximeters
Authors: CHOI S. J. , AHN H. J. , YANG M. K. , KIM C. S. , SIM W. S. , KIM J. A. , KANG J. G. , KIM J. K. , KANG J. Y. 
Published: August 2009

Background: In general, there is a response time between actual arterial hypoxemia and its detection by pulse oximeters. We compared the desaturation and resaturation response times between two types of pulse oximeters, transmission and reflectance pulse oximeters, to find out which oximeter has a more rapid response time.Methods: Thirty‐three ASA 1 or 2 patients were enrolled in this study. A transmission pulse oximeter was placed on the index finger and a reflectance pulse oximeter was placed on the forehead and monitored simultaneously. After the induction of general anesthesia without pre‐oxygenation, we waited until the oxygen saturation value of any of two pulse oximeters declined to 90%, and then mask ventilation was started with 100% oxygen. Oxygen saturation was recorded at an interval of 2 s during this time.Results: The desaturation response time of SpO2 to 95% after apnea was 82.0 s (interquartile range: 67.0–98.5 s) vs. 94.0 s (interquartile range: 84.0–106.5 s) (P<0.001) and SpO2 to 90% was 94.0 s (interquartile range: 75.5–109.5 s) vs. 100.0 s (interquartile range: 84.5–114.5 s) (P<0.001) in the reflectance and transmission oximeters, respectively. The resaturation response time from mask ventilation to 100% SpO2 was 23.2±5.6 vs. 28.9±7.6 s (P<0.001) in the reflectance and transmission oximeters, respectively.Conclusion: In clinical situations in which rapid changes in oxygen saturation are expected, we recommend the forehead reflectance pulse oximeter because it responds more quickly in detecting oxygen desaturation and resaturation compared with the transmission pulse oximeter.
Diagnosing acute lung injury in the critically ill: a national survey among critical care physicians
Authors: VLAAR A. P. J. , HONSELAAR W. B. , BINNEKADE J. M. , GROENEVELD A. B. , SPRONK P. E. , SCHULTZ M. J. , JUFFERMANS N. P. 
Published: August 2009

Background: Incidence reports on acute lung injury (ALI) vary widely. An insight into the diagnostic preferences of critical care physicians when diagnosing ALI may improve identification of the ALI patient population.Methods: Critical care physicians in the Netherlands were surveyed using vignettes involving hypothetical patients and a questionnaire. The vignettes varied in seven diagnostic determinants based on the North American European Consensus Conference and the lung injury score. Preferences were analyzed using a mixed‐effects logistic regression model and presented as an odds ratio (OR) with a 95% confidence interval.Results: From 243 surveys sent to 30 hospitals, 101 were returned (42%). ORs were as follows: chest X‐ray consistent with ALI: OR 1.7 (1.3–2.3), high positive end‐expiratory pressure (PEEP) (15 cmH2O): OR 5.0 (3.9–6.6), low pulmonary artery occlusion pressures (PAOP) (<18 mmHg): OR 4.7 (3.6–6.1), low compliance (30 ml/cmH2O): OR 0.7 (0.5–0.9), low PaO2/FiO2 (<250 mmHg): OR 9.2 (6.9–12.3), absence of heart failure: OR 1.2 (0.9–1.5), presence of a risk factor for ALI (sepsis): OR 1.0 (0.8–1.3). The questionnaire revealed that critical care physicians with an anesthesiology background differed from physicians with an internal medicine background with regard to hemodynamic variables when considering an ALI diagnosis (P<0.05).Conclusions: Dutch critical care physicians consider the PEEP level, but not the presence of a risk factor for ALI, as an important factor to diagnose ALI. Background specialty of critical care physicians influences diagnostic preferences and may account for variance in the reported incidence of ALI.
Electrical impedence tomography and heterogeneity of pulmonary perfusion and ventilation in porcine acute lung injury
Authors: FAGERBERG A. , SÖNDERGAARD S. , KARASON S. , ÅNEMAN A. 
Published: August 2009

Background: The heterogeneity of pulmonary ventilation (V), perfusion (Q) and V/Q matching impairs gas exchange in an acute lung injury (ALI). This study investigated the feasibility of electrical impedance tomography (EIT) to assess the V/Q distribution and matching during an endotoxinaemic ALI in pigs.Methods: Mechanically ventilated, anaesthetised pigs (n=11, weight 30–36 kg) were studied during an infusion of endotoxin for 150 min. Impedance changes related to ventilation (ZV) and perfusion (ZQ) were monitored globally and bilaterally in four regions of interest (ROIs) of the EIT image. The distribution and ratio of ZV and ZQ were assessed. The alveolar–arterial oxygen difference, venous admixture, fractional alveolar dead space and functional residual capacity (FRC) were recorded, together with global and regional lung compliances and haemodynamic parameters. Values are mean±standard deviation (SD) and regression coefficients.Results: Endotoxinaemia increased the heterogeneity of ZQ but not ZV. Lung compliance progressively decreased with a ventral redistribution of ZV. A concomitant dorsal redistribution of ZQ resulted in mismatch of global (from ZV/ZQ 1.1±0.1 to 0.83±0.3) and notably dorsal (from ZV/ZQ 0.86±0.4 to 0.51±0.3) V and Q. Changes in global ZV/ZQ correlated with changes in the alveolar–arterial oxygen difference (r2=0.65, P<0.05), venous admixture (r2=0.66, P<0.05) and fractional alveolar dead space (r2=0.61, P<0.05). Decreased end‐expiratory ZV correlated with decreased FRC (r2=0.74, P<0.05).Conclusions: EIT can be used to assess the heterogeneity of regional pulmonary ventilation and perfusion and V/Q matching during endotoxinaemic ALI, identifying pivotal pathophysiological changes.
Impact of theCYP2D6genotype on post‐operative intravenous oxycodone analgesia
Authors: ZWISLER S. T. , ENGGAARD T. P. , MIKKELSEN S. , BROSEN K. , SINDRUP S. H. 
Published: August 2009

Background:Oxycodone is a semi‐synthetic opioid with a μ‐receptor agonist‐mediated effect in several pain conditions, including post‐operative pain. Oxycodone is metabolized to its active metabolite oxymorphone byO‐demethylation via the polymorphic CYP2D6. The aim of this study was to investigate whether CYP2D6 poor metabolizers (PMs) yield the same analgesia post‐operatively from intravenous oxycodone as extensive metabolizers (EMs).Methods:Two hundred and seventy patients undergoing primarily thyroid surgery or hysterectomy were included and followed for 24 h post‐operatively. TheCYP2D6genotype was blinded until study procedures had been completed for all patients. All patients received intravenous oxycodone as pain treatment for 24 h post‐operatively and morphine 5 mg was used as escape medication. A responder was characterized as a patient without the need for escape medication and a positive evaluation in a questionnaire 24 h post‐operatively.Results:Twenty‐four patients were PM (8.9%) and 246 were EM (91.1%). One PM (4.17%, CI=0.1–21.1) was a non‐responder and 42 EM (17.07%, CI=12.6–22.4) were non‐responders. The non‐responder rate did not differ between the two genotypes (P=0.14). There was no difference in the total consumption of oxycodone between the two genotypes (EM=14.7 mg, CI=13.0–16.4 and PM=13.0 mg, CI=8.9–17.0,P=0.42). The mean oxymorphone/oxycodone ratios were 0.0031 and 0.00081 in the EMs and PMs, respectively (P<0.0001).Conclusion:This study showed for the first time in patients that the oxymorphone formation depends on CYP2D6, but we found no difference in the post‐operative analgesic effect of intravenous oxycodone between the twoCYP2D6genotypes.