bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new cold autoagglutinin specificity: the third external loop of band 3
Authors: Janvier Daniel , Lam Yin , Galicier Lionel , Bierling Philippe 
Published: September 2009

BACKGROUND: Cold autoagglutinins (CAs) are almost always of immunoglobulin (Ig)M class and specific for carbohydrate antigens. We report a case of hemolytic anemia caused by a mixture of IgM and IgG cold agglutinins. Both agglutinins were specific for the third extracellular loop of band 3.CASE REPORT: The patient, a 46‐year‐old man with no medical history, was admitted for an acute, life‐threatening hemolytic anemia caused by a cold agglutinin. Improvement was obtained after plasmapheresis, red blood cell (RBC) transfusions, and steroid therapy. Recovery was complete and no etiology was found.STUDY DESIGN AND METHODS: Conventional serologic procedures and immunochemical methods were used.RESULTS: The patient's autoantibody was directed to an antigen equally expressed by adult and cord RBCs, resistant to papain, neuraminidase, and endo‐β‐galactosidase treatments. This pattern of reactivity excluded all known specificities of cold agglutinins. The antibody failed to react with RBCs treated by α‐chymotrypsin or pronase, suggesting that it may be directed to the third extracellular loop of band 3. Serum fractionation showed that the cold agglutinin was composed of IgM and IgG class antibodies. Antibody specificity was confirmed by blocking tests using murine monoclonal antibodies against band 3 and by immunoprecipitation.CONCLUSION: This is to our knowledge the first observation of a CA specific for band 3. The coexistence of IgM and IgG molecules, a very unusual feature for a CA, may be related to the peptidic nature of the target antigen.
Core temperature changes in resuspended red blood cells (RBCs) and pediatric RBCs removed from refrigerated storage
Authors: Perry Holly Elizabeth , Prasad Priyanka , Kirwan Susy , Huang Yuan Qing 
Published: September 2009

BACKGROUND: The 30‐minute rule, whereby intact red blood cell (RBC) products may be returned to stock if returned to 4°C storage within 30 minutes of issue, was established many years ago. It was based on observations that the core temperature of units of whole blood removed from storage temperatures of 1 to 6°C, and left at room temperature, would reach 10°C at between 45 minutes and 1 hour.STUDY DESIGN AND METHODS: Forty‐one units of RBCs resuspended leukoreduced and 8 units of pediatric RBCs resuspended leukoreduced were exposed to ambient temperature for periods of time between 0 and 60 minutes. Core temperatures of all units were measured at 1‐minute or 5‐minute intervals.RESULTS: Resuspended RBCs units reached a mean core temperature of 10°C at 15 minutes, 12.7°C at 30 minutes, and 15°C at 60 minutes. Pediatric RBCs reached a mean core temperature of 12.8°C at 15 minutes, 15.5°C at 30 minutes, and 17.8°C at 60 minutes.CONCLUSION: In view of our results, and the range of RBC products now available, it may be timely for blood services to review and reduce the 30‐minute rule.
Effects of anemia and blood transfusion in acute myocardial infarction in rats
Authors: Hu Houxiang , Xenocostas Anargyros , Chin‐Yee Ian , Lu Xiangru , Feng Qingping 
Published: September 2009

BACKGROUND: The optimal hemoglobin (Hb) level in acute myocardial infarction (MI) is unknown. The goal of this study was to determine the optimal Hb concentration in acute MI and whether transfusion of fresh blood to correct anemia reduces myocardial injury and improves outcome.STUDY DESIGN AND METHODS: Anemia was induced in rats by an iron‐deficient diet and phlebotomy. MI was induced by left coronary artery ligation. Some rats received transfusion of fresh blood. Survival, hemodynamic measurements, and infarct size were determined 24 hours after MI.RESULTS: Reduction of Hb to 80 to 90 and 70 to 80 g/L decreased 24‐hour survival after MI to 42 and 47%, respectively (p < 0.05). Infarct size was increased in both 70 to 80 and 80 to 90 g/L anemic groups compared to the normal Hb group (p < 0.05). Cardiac function was decreased in anemic groups after MI (p < 0.01). Transfusion of fresh blood to increase Hb from 80 to 90 g/L to 100 g/L decreased infarct size (p < 0.05) and improved cardiac function (p < 0.05), and a trend toward better survival (73%) was observed. Transfusion from 80 to 90 g/L Hb to 120 g/L Hb was associated with larger infarct size (p < 0.05), decreased cardiac function (p < 0.05), and no improvement in survival (47%, p = NS).CONCLUSION: Anemia increases infarct size and decreases cardiac function and survival in acute MI. Transfusion of anemic animals up to 100 g/L Hb with fresh blood reduces infarct size and improves cardiac function. However, transfusion to 120 g/L Hb did not demonstrate any additional benefit and was associated with larger infarcts.
Effect of packing density of hollow fibers on solute removal performances of dialyzers
Authors: YAMASHITA Akihiro C. , FUJITA Ryoichiro , TOMISAWA Narumi , JINBO Yoichi , YAMAMURA Masaru 
Published: September 2009

AbstractSolute removal performances of dialyzers are dependent not only on the solute permeabilities of the membrane but also on the module design. We have investigated how the packing density of hollow fiber (PDF) affects the solute removal performances. A series of 4 polyester polymer alloy membrane test dialyzers were assembled with varying PDFs of 29.6%, 35.3%, 44.1%, and 53.1%. Clearances (CL) were measured in vitro for creatinine (MW113), vitamin B12 (MW1355), and chymotrypsin (MW25300) with various QB=100 to 400 and QD=350 to 650 mL/min in the absence of net ultrafiltration. When QB was ≤300 mL/min, no significant changes were found in creatinine CL with the increase of PDF up to 35.3%. A slightly greater increase was found in CL when QB=400 mL/min. Clearances for vitamin B12, however, increased with the increase of PDF in the range of 29.6% to 35.3%. The effects of PDF on CL were greater with larger QB. More importantly, an abrupt increase of CL was found when PDF was increased from 44.1% to 53.1%. According to a rigorous mathematical model, this may be caused by the internal filtration, which is reverse ultrafiltration occurring in a dialyzer at any given time. No significant increase was found in chymotrypsin CL when the PDF was ≤35.3%, which suggested that CL for large molecules was strongly dependent on the solute permeability rather than the conditions of flow patterns. A very steep increase was also found in CL for chymotrypsin when the PDF was >44.1%, which was also considered to be due to the internal filtration. Packing density of hollow fiber can be optimized in terms of solute removal performances when the target solute and therapeutic conditions are specified.
Genetic and environmental effects and characteristics of Japanese end‐stage renal disease patients
Authors: OGATA Satoshi , YORIOKA Noriaki , GILBERTSON David T. , CHEN Shu‐Cheng , FOLEY Robert N. , COLLINS Allan J. 
Published: September 2009

AbstractFew studies of end‐stage renal disease (ESRD) investigate genetic and environmental effects simultaneously in one racial/ethnic group. United States Renal Data System data show racial differences in primary causes of ESRD, survival rates, and causes of death. Comparing these with Japanese Society for Dialysis Therapy data, survival rates appear better for Japanese than for US patients. To explore genetic and environmental differences, we investigated incident and prevalent ESRD patient characteristics. The United States Renal Data System and Japanese Society for Dialysis Therapy databases were analyzed between 1983 and 2002 for the following patient subsets: Americans excluding Asian Americans (n=1,153,974); Asian Americans excluding Japanese Americans (n=35,983); Hawaiian and non‐Hawaiian Japanese Americans by state, race, and Japanese surname (n=3932); native Japanese living in Japan (n=450,593). Japanese Americans tended to be older, male, have more diabetes and hypertension and less glomerulonephritis, and to die more often of heart failure than the other US groups. Adjusted mortality hazard ratios were 0.70 for non‐Japanese Asian Americans and 0.75 for Japanese Americans vs. non‐Asian Americans (1.00). Hawaiian Japanese patients tended to be older, with more diabetes and hypertension and less glomerulonephritis than the other Japanese groups; their survival rates improved after adjustment for rate of diabetes. Japanese American ESRD patients differ from Asian and non‐Asian Americans, and from native Japanese, despite similar genetic make‐ups. Both genetic and environmental factors may affect patient outcomes.
Spontaneous erythrocytosis in a patient on chronic hemodialysis
Authors: ADENIYI Muniru , SUN Yijuan , SERVILLA Karen S. , HARTSHORNE Michael F. , TZAMALOUKAS Antonios H. 
Published: September 2009

AbstractWhile anemia is common in patients on chronic hemodialysis (HD), spontaneous erythrocytosis is rare and can be caused by either the same conditions causing erythrocytosis in the general population or any condition specific to chronic renal failure. We present a patient illustrating this latter circumstance. A 53‐year‐old man with diabetic nephropathy, with no known disease causing hypoxemia started HD in April 2001. Blood hemoglobin (Hgb) level was 13.7 ± 2.8 g/dL while his kidney function was normal (1993–1996) and after 1997, with the development of chronic kidney disease, decreased progressively to a low of 10.2 g/dL in March 2001 when erythropoietin (EPO) injections were started. Erythropoietin requirements progressively decreased because of rising Hgb. Erythropoietin was discontinued in mid‐2005. Blood hemoglobin continued to rise, however, to a high value of 17.6 g/dL in February 2006. At the same time, endogenous blood EPO level was 3.6 mIU/mL, a value consistent with primary polycythemia. White blood cell and platelet counts were normal. Several small renal cysts, including 1 complex cyst, were detected by ultrasonography and computer tomography in April 2006. He refused surgical treatment. He was treated with small phlebotomies (not returning the blood in the dialyzer at the end of dialysis) and monitoring of Hgb, which decreased toward the desired range. Repeated computer tomographic scans showed a slow increase in the size of the complex cyst and several other cysts. In late 2007 Hgb started rising again, and in February 2008, while the Hgb level was 16.4 g/dL, the endogenous serum EPO level was 726 mIU/mL (upper normal limit 31.5 mIU/mL). Intermittent phlebotomies were reinstituted. He subsequently developed multiple vascular catastrophes and expired from ischemic bowel disease in September 2008. Acquired cystic disease of the kidneys should be considered in HD patients who develop spontaneous erythrocytosis. The risks of acquired cystic disease include, in addition to the development of malignancy, vascular events from elevated Hgb.
Aicardi–Goutières syndrome presenting with haematemesis in infancy
Authors: Hall D , Rice GI , Akbar N , Meager A , Crow YJ , Lim MJ 
Published: September 2009

AbstractAicardi–Goutières syndrome is a genetic childhood encephalopathy characterized by basal ganglia calcification, chronic cerebrospinal lymphocytosis and elevated cerebrospinal fluid interferon‐alpha, mimicking acquired congenital viral infections. As more is discovered about the pathogenesis of Aicardi–Goutières, it is becoming evident that a dysfunction of the immune system is likely to be responsible for the disease phenotype. We describe a previously healthy 2‐month‐old female infant who presented with haematemesis and seizures and was subsequently diagnosed with Aicardi–Goutières syndrome. To our knowledge, this is the first documented case of Aicardi–Goutières syndrome presenting with haematemesis. The gastrointestinal tract is an area of high cell loss, revealing early signs of systemic inflammation and we postulate that a systemic proinflammatory milieu occurs in Aicardi–Goutières syndrome.Conclusion: Aicardi–Goutières syndrome can present with haematemesis, adding to the growing evidence that the Aicardi–Goutières syndrome spectrum encompasses an immune‐mediated multisystem involvement. Gastrointestinal inflammation should also be considered in these patients and treated appropriately.
Why do municipal issues rise on the federal policy agenda in Canada?
Authors: Young Robert , McCarthy Kelly 
Published: September 2009

Abstract: Under Prime Minister Paul Martin, the federal government developed a “cities and communities” agenda, with Ottawa prepared to be much more active about municipalities. The pendulum has swung back under the Harper government, which is far less inclined to intrude into this area of provincial jurisdiction. But these recent developments are not unique. The federal government was involved with the urban file in the 1970s through the Ministry of State for Urban Affairs, and there have been other historical instances of federal interest in municipalities. This article explores the factors that are associated with the place of municipalities and urban issues on the federal policy agenda. The time period covered is 1867–2005. The methodology is the one common to the agenda‐setting literature: cross‐correlation functions and lagged correlations. The authors think there may be three operative independent variables: rapid population growth in cities; restructuring of municipal systems by provincial governments; and financial stress. The analysis investigates the strength of each factor in placing urban issues on the national policy agenda. In the end, there is no single explanatory model to explain the rise of municipal issues on the agenda: history matters.Sommaire : Sous le régime du Premier ministre Paul Martin, le gouvernement fédéral d'Ottawa était disposéàêtre beaucoup plus actif auprès des municipalités en mettant au point un programme intitulé« Villes et collectivités ». Le pendule est revenu en arrière sous le gouvernement Harper, qui est beaucoup moins enclin à s'infiltrer dans ce domaine de compétence provinciale. Mais ces récents développements ne sont pas uniques en leur genre. Dans les années 1970, le gouvernement fédéral s'était investi dans les affaires urbaines par l'intermédiaire du département d'État chargé des Affaires urbaines, et il y a eu d'autres cas historiques d'un intérêt fédéral accordé aux municipalités. Le présent article examine les facteurs associés à l'importance qu'occupent les municipalités et les questions urbaines dans le programme de la politique fédérale. La période étudiée va de 1867 à 2005. La méthodologie est celle propre aux documents sur l'établissement de programmes : fonctions de corrélations croisées et corrélations retardées. Selon les auteurs, il pourrait y avoir trois variables indépendantes en jeu : une croissance rapide de la population dans les villes; la restructuration des systèmes municipaux par les gouvernements provinciaux; et le stress financier. L'analyse examine la force de chaque facteur pour placer les questions urbaines à l'ordre du jour de la politique nationale. Finalement, il n'existe pas de modèle unique pour expliquer la croissance des questions municipales à l'ordre du jour : c'est l'histoire qui compte.
Federal‐municipal relations in Canada: The changing organizational landscape
Authors: Stoney Christopher , Graham Katherine A.H. 
Published: September 2009

Abstract: Drawing on research that is part of the five‐year Major Collaborative Research Initiative project examining public policy in Canadian municipalities, this article provides an overview of the federal‐municipal machinery developed to facilitate urban policy and program development. The “federal‐municipal machinery” refers to the many programs and initiatives that have been used to structure federal‐municipal relations and influence urban policy and development. The research time frame begins with the period leading up to the creation of the Ministry of State for Urban Affairs, in 1971, and continues through four decades to include recent events of note such as the creation of the Prime Minister's Caucus Task Force on Urban Issues, the subsequent announcements of the New Deal, and the Gas Tax Fund for Canada's cities and communities. The authors begin with a discussion of why federal governments involve themselves in municipal and urban affairs and then provide an overview of their analysis by identifying patterns and trends in the evolution of federal‐municipal machinery. They then discuss the effectiveness of the machinery, over three periods, and conclude by considering the implications of their findings for the future of federal‐municipal relations in the context of the growing pressures facing urban Canada.Sommaire : Fondé sur la recherche entreprise sur cinq ans dans le cadre du projet intitulé«Grands travaux de recherche concertée» qui examine la politique gouvernementale dans les municipalités canadiennes, le présent article donne un aperçu de l'appareil fédéral‐municipal mis au point pour faciliter l'élaboration de programmes et de politiques dans le secteur urbain. L'«appareil fédéral‐municipal» fait référence aux nombreux programmes et initiatives qui ont servi à structurer les relations fédérales‐municipales et à influencer la politique d'urbanisme et son développement. Le cadre de référence de la recherche commence avec la période menant à la création du département d'État chargé des Affaires urbaines en 1971 et se poursuit sur quatre décennies pour inclure de récents événements remarquables, comme la création du Groupe de travail du caucus du premier ministre sur les affaires urbaines du Canada, les annonces subséquentes du Nouveau Pacte et du Fonds de la taxe sur l'essence pour les villes et collectivités du Canada. Les auteurs commencent par une discussion sur la raison pour laquelle les gouvernements fédéraux s'impliquent dans les affaires urbaines et municipales, puis ils présentent une vue d'ensemble de leur analyse en identifiant les modèles et les tendances dans l'évolution de l'appareil fédéral‐municipal. Enfin, ils discutent de l'efficacité de l'appareil sur trois périodes distinctes et concluent en examinant les implications de leurs résultats pour l'avenir des relations fédérales‐municipales dans le contexte des pressions croissantes auxquelles fait face le Canada urbain.
Evaluation of Pimobendan and N‐Terminal Probrain Natriuretic Peptide in the Treatment of Pulmonary Hypertension Secondary to Degenerative Mitral Valve Disease in Dogs
Authors: Atkinson K.J. , Fine D.M. , Thombs L.A. , Gorelick J.J. , Durham H.E. 
Published: September 2009

Background:Pimobendan is a positive inotrope and vasodilator that may be useful in the treatment of pulmonary hypertension (PHT) secondary to degenerative mitral valve disease.Hypothesis:Pimobendan decreases the severity of PHT measured echocardiographically and improves quality‐of‐life scores. Changes in N‐terminal probrain natriuretic peptide (NT‐proBNP) concentrations will reflect improvement in severity of PHT.Animals:Ten client‐owned dogs with peak tricuspid regurgitant flow velocity (TRFV) ≥3.5 m/s.Methods:Prospective short‐term, double‐blinded, crossover design, with a long‐term, open‐label component. Short term, dogs were randomly allocated to receive either placebo or pimobendan (0.18–0.3 mg/kg PO q12 h) for 14 days. After a 1‐week washout, they received the alternative treatment for 14 days, followed by pimobendan open‐label for 8 weeks.Results:Short‐term comparison: peak TRFV decreased in all dogs on pimobendan compared with placebo from a median of 4.40 (range, 3.2–5.6) to 3.75 (range, 2.4–4.8) m/s (P< .0001). NT‐proBNP concentration decreased after treatment with pimobendan from a median of 2,143 (range, 450–3,981) to 1,329 (range, 123–2,411) pmol/L (P= .0009). All dogs improved their quality‐of‐life score (P= .006). In the long‐term comparisons, peak TRFV decreased in all dogs from a median of 4.28 (range, 3.5–5.7) to 3.52 (range, 2.4–5.0) m/s (P< .0001). No significant changes in NT‐proBNP or quality‐of‐life scores were detected.Conclusions and Clinical Importance:Pimobendan lowered severity of measurable PHT, improved quality‐of‐life scores, and decreased NT‐proBNP concentrations short‐term. Long term, only the reduction in TRFV was maintained.
Randomized Controlled Study Investigating Viral Suppression and Serological Response following Pre-S1/Pre-S2/S Vaccine Therapy Combined with Lamivudine Treatment in HBeAg-Positive Patients with Chronic Hepatitis B
Authors: Hoa Pham Thi Le , Huy Nguyen Tien , Thu Le The , Nga Cao Ngoc , Nakao Kazuhiko , Eguchi Katsumi , Chi Nguyen Huu , Hoang Bui Huu , Hirayama Kenji 
Published: September 2009

ABSTRACT
The aim of the current study was to evaluate viral suppression following combined treatment with an S/pre-S1/pre-S2 vaccine and lamivudine in patients with chronic hepatitis B. We established a randomized, controlled clinical trial to compare the responses of three different treatment groups: those receiving vaccine monotherapy, lamivudine monotherapy, or combination treatment. Viral response was evaluated via hepatitis B virus (HBV) DNA suppression using different levels of classification. Seroconversion was evaluated via HBeAg loss, HBeAg seroconversion, HBsAg loss, and anti-HBs response. We found that the group receiving combination treatment demonstrated a significant increase in viral suppression over that for the lamivudine or vaccine monotherapy group, although the HBeAg seroconversion rate was not different. This enhanced suppression effect in the combination group was reversed after the discontinuation of vaccine treatment, suggesting that booster doses are required for a sustained viral response. Anti-HBs was detected in 55/120 vaccine recipients, but only 3 patients demonstrated HBsAg loss, indicating that the vaccine-induced anti-HBs was unable to completely neutralize HBsAg in the serum. At the study end point, anti-HBs responders showed significantly higher HBeAg seroconversion rates, greater suppression of HBV DNA levels, and a lower median reduction in HBV DNA levels than those of anti-HBs nonresponders. Our results suggest that combined treatment with the vaccine and lamivudine was significantly more effective than lamivudine monotherapy in the short term and was especially successful in producing viral suppression and an enhanced anti-HBs antibody response.
In Vitro Activities of Piperaquine, Lumefantrine, and Dihydroartemisinin in Kenyan
Plasmodium falciparum
Isolates and Polymorphisms in
p
fcrt
and
p
fmdr1
Authors: Mwai Leah , Kiara Steven M. , Abdirahman Abdi , Pole Lewa , Rippert Anja , Diriye Abdi , Bull Pete , Marsh Kevin , Borrmann Steffen , Nzila Alexis 
Published: September 2009

ABSTRACT

We have analyzed the in vitro chemosensitivity profiles of 115 Kenyan isolates for chloroquine (CQ), piperaquine, lumefantrine (LM), and dihydroartemisinin in association with polymorphisms in
pfcrt
at codon 76 and
pfmdr
1
at codon 86, as well as with variations of the copy number of
pfmdr
1
. The median drug concentrations that inhibit 50% of parasite growth (IC
50
s) were 41 nM (interquartile range [IQR], 18 to 73 nM), 50 nM (IQR, 29 to 96 nM), 32 nM (IQR, 17 to 46 nM), and 2 nM (IQR, 1 to 3 nM) for CQ, LM, piperaquine, and dihydroartemisinin, respectively. The activity of CQ correlated inversely with that of LM (
r
2
= −0.26;
P
= 0.02). Interestingly, parasites for which LM IC
50
s were higher were wild type for
pfcrt
-76
and
pfmdr
1
-
86
. All isolates had one
pfmdr
1
copy. Thus, the decrease in LM activity is associated with the selection of wild-type
pfcrt
-
76
and
pfmdr
1
-
86
parasites, a feature that accounts for the inverse relationship between CQ and LM. Therefore, the use of LM-artemether is likely to lead to the selection of more CQ-susceptible parasites.