bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bone micro‐environment in prostate cancer: impact, treatment and implications for nursing practice
Authors: Drudge‐Coates Lawrence , Turner Bruce 
Published: June 2012

Prostate cancer is a substantial worldwide health care challenge. The disease is associated with detrimental effects on bone remodelling, mediated by the RANK/RANK ligand (RANKL) system. Androgen deprivation therapy (ADT) causes an imbalance in regular bone turnover, resulting in bone loss [cancer‐treatment‐induced bone loss (CTIBL)]. As prostate cancer progresses, bone metastases may develop, leading to a vicious cycle of increased bone turnover and tumour growth. In both cases, patients have reduced quality of life and an increased risk of fracture. However, data show that subcutaneous denosumab, a human monoclonal antibody that targets RANKL, is superior to the intravenous bisphosphonate zoledronic acid in delaying the onset of skeletal‐related events (SREs) and has a favourable safety profile in terms of nephrotoxicity and acute‐phase reactions.Urology nurse practitioners, as members of multidisciplinary teams, have an important role to play in assessing and helping to manage patients with bone‐related disease in prostate cancer. In this review, an overview of prostate‐cancer‐related bone disease is provided. Currently available pharmacological interventions for the different stages of the disease are discussed, and implications for urological nursing practice are suggested.
Fibrinogen concentrates in bleeding trauma patients
Authors: Meyer M. A. S. , Johansson P. I. 
Published: June 2012

Background  A balanced transfusion of red blood cells, fresh frozen plasma (FFP) and platelets are recommended for massively bleeding trauma patients. Fibrinogen concentrates could potentially lessen or replace the need for FFP and/or platelet transfusions.Aim  To provide a review of the literature covering the application of fibrinogen concentrates in trauma care.Methods  PubMed and Cochrane database search: fibrinogen and (concentrate or trauma), not congenital, published between 2000 and 2012.Results  Six papers were identified. None were randomized controlled trials. The main conclusion of these papers was that administration of fibrinogen sometimes together with prothrombin complex concentrate might improve haemostasis in trauma patients resuscitated with synthetic colloids. Data regarding the effect of fibrinogen concentrate together with a more physiological resuscitation fluid, i.e. FFP, or as the only intervention in bleeding trauma patients is lacking.Conclusions  Evidence for the use of fibrinogen concentrate to trauma patients with massive bleeding is sparse, of poor quality and confined to patients resuscitated with synthetic colloids. Well‐designed prospective, randomized, double‐blinded studies evaluating the effect of fibrinogen concentrate, as the only intervention, are urgently needed.
End‐to‐end electronic transfusion management in hospital practice
Authors: Murphy M. F. 
Published: June 2012

Background  Errors occur at all stages of the hospital transfusion process and the resulting morbidity and mortality are well documented. Recent initiatives in the UK and elsewhere to reduce transfusion errors have focussed on implementing recommended manual procedures for good practice, but have only been partially effective.Aims  Our approach was to ‘re‐engineer’ bedside and laboratory transfusion procedures.Materials and Methods  We implemented barcode patient identification, bedside handheld computers and electronically controlled blood fridges to simplify transfusion procedures and improve practice.Results  There was an improvement from 11.8% to 100% of staff following the process for correct pre‐transfusion bedside patient identification; no ABO incompatible red cell transfusions in 5 years; a reduction in wrong blood component transfused events from 1 in 27,523 to 1 in 67,935; reduced nursing (one nurse rather than 2 and half the time to administer blood) and laboratory workload; and more rapid delivery of urgently required red cell units to patients (from a median of 18 minutes to 45 seconds). The electronic system provided a simple mechanism for compliance with UK/EU regulatory requirements for the traceability of blood, and the documentation of transfusion and training. Feedback from both staff and patients was positive.Discussion  The project was taken through pilot stages between 2001 and 2006 through to its full implementation across the acute hospitals in Oxfordshire in 2006/07. Our group wrote a national specification for the electronic transfusion process, but the implementation elsewhere in the UK has been slow. There is the potential to introduce an additional module into the electronic transfusion process to provide ‘decision support’ for doctors ordering blood to minimise inappropriate use of blood as part of a patient blood management programme, and use the same ‘end‐to‐end electronic’ approach for other clinical procedures such as drug administration.Conclusion  The implementation of a hospital electronic transfusion management system was shown to provide improvement in transfusion practice and in the efficiency of the service.
Blood donation patterns and challenges in Southern Africa
Authors: Reddy R. 
Published: June 2012

Introduction: Developing countries face significant challenges in collecting sufficient blood to meet the demands from patients. Southern African countries have implemented many initiatives to recruit and retain sufficient voluntary blood donors and the success has been varied in different countries.Objective: To analyse blood donor patterns and challenges in the 14 Southern African countries and assess progress made in attaining a 100% voluntary donor base as well as collecting sufficient blood as per the WHO recommendations for developing countries.Results: A literature review showed that between 2004 and 2008 very little progress has been made with regard to improving the number of blood donations per 1000 population and increasing the number of voluntary non‐remunerated blood donors. When factors such as age, disease burden and poverty are factored in, the donor potential in these countries is low.Discussion: Collecting sufficient, safe blood from voluntary blood donors continues to be a major challenge for many developing countries and co‐ordinated efforts, with assistance from external organizations, is required.
TTID risk in the Latin America and Caribbean: recommendations to improve safety
Authors: Rojo J. , Arroyo A. 
Published: June 2012

Transfusion‐Transmitted Diseases (TTD) have been a persistent risk since the onset of transfusion medicine. In Latin America and the Caribbean countries (LACC), prevention of TTD requires special and different care in comparison with the in United States and European countries, due to the still persistent high prevalence of replacement donors, specific geographic location, topography, and climate, genetic and cultural and socio‐economic status of the population. These factors result in different distribution patterns of the infections, which together with the migration have changed the donor profile. According to the Pan American Health Organization (PAHO) reports, the screening of HIV, HBV, HCV and T. pallidum has increased in LACC since 2005, significantly reducing the risk of transmission. However these results have not yet reached the established aim in 1998, of analyzing 100% of blood units for these pathogens.The strategies recommended for the LACC should be based on the following points: a) the establishment of national blood transfusion services, b) blood collection from volunteer donors, c) high quality monitoring of TTD and emerging transfusion‐transmitted infections (ETTI) in all blood units, d) implementation of effective quality assurance systems and e) the rational use of blood components and alternatives to transfusion.
Quality management of blood collection
Authors: Strengers P. F. W. 
Published: June 2012

The objective of the quality management in the blood transfusion service is the continuous improvement of the quality of the processes and the products related to the blood donation of the blood donors, the production of the blood components and the transfusion of the blood products to the recipients. The efficacy, the safety and the efficiency of the blood transfusion processes requires that the personnel is educated and trained, that processes are described in standard operating procedures and that these procedures are followed up. When the concept of quality and the improvement of quality is in the mind of all working in the field of blood transfusion medicine, the quality of the blood transfusion service will go upwards, the donors will feel themselves respectfully treated and rewarded, the blood products will become more efficacious and safe, and the patients will receive the best products available.Quality management of blood collection implies the processes on donor recruitment, donor handling and donor vigilance, and the process of donation and screening. For all processes in blood collection, quality indicators should be defined and these data should be monitored, collated, analysed, reported and used in order to improve the quality of the processes.
Management of acquired coagulopathies in ITU
Authors: Thomas D. 
Published: June 2012

Acquiured coagulopathies are releatively frequent in an intensive care setting. In the majority of situations knowledge of the presenting disease process can help address treatment strategies.Often laborotary tests are either unhelpful or due to delay in reporting the results of such tests, the urgent situation has become worse with time and the clinical scenario will have changed.There is also a possibility when dealing with unstable patients that anxiety on behalf of the clinician may result in unwarrented use of blood components.A logical and calm approach supported by point of care testing can result in more appropriate use of blood components.
A nation‐wide fetal RHD screening programme for targeted antenatal and postnatal anti‐D
Authors: de Haas M. , van der Ploeg C. P. B. , Scheffer P. G. , Verlinden D. A. , Hirschberg H. , Abbink F. , van der Schoot C. E. 
Published: June 2012

In the Netherlands, since 1 July 2011, both antenatal anti‐D immunoprophylaxis (1000 IU in the 30th week of gestation) and postnatal prophylaxis (1000 IU) is administered to only those women for whom a fetal RHD typing, performed in week 27 of pregnancy, predicts the presence of a D‐positive child. The fetal RHD screening is part of the antenatal Screening Programme for Infectious diseases and Erythrocyte immunisation (PSIE), offered to all pregnant women early in pregnancy at their first antenatal visit, preferably before 12 weeks of gestation.Currently, the compliance to the fetal RHD screening programme and the performance of the fetal RHD typing test is evaluated in a nation‐wide study. At the start of the programme, it was determined that the number of false negative test results should be below 0·25%.In the first seven months after introduction of the fetal RHD screening programme, the number of false‐negative results was below the critical threshold and the number of false positives around 1·1%. The compliance to the programme was in this period >95%.Our first analysis confirms that, in a centralised setting, it is possible to guide both antenatal and postnatal anti‐D immunoprophylaxis by fetal RHD screening in maternal blood obtained at 27 week of gestation. The current analysis, however, is based on the cord blood samples received by Sanquin only. A longer period of nation‐wide evaluation of the fetal RHD screening programme, including all (also locally typed) cord blood serology results obtained in a one‐year time period, will provide insight in the robustness of the fetal RHD screening programme.
Blood transfusion and the social contract
Authors: Franklin I. M. 
Published: June 2012

Aims To present a rational approach to delivering a safe and effective blood supply.Methods Literature searching, reflective learning, peer group discussion.Results To provide a consistent blood supply system, there is much to learn from the rigour of philosophy. The organic development of blood safety practices has led to some inconsistencies. It is essential to consider all of those involved in the process, including donors and recipients but particularly those who may be damaged by, for example, a transfusion‐transmitted infection.Conclusion Current practices, at least in some countries, have evolved and use a mixture of philosophical approaches. A new way is recommended.
Platelets have a role as immune cells
Authors: Semple J. W. 
Published: June 2012

Abstract: Platelets are the primary cellular mediators of hemostasis and this function intimately acquaints them with a variety of inflammatory processes. For example, when aggregated on damaged vessel walls, activated platelets can secrete and express many pro‐ and anti‐inflammatory molecules that attract and capture circulating leukocytes and focus them on inflamed tissue. Platelets secrete several chemokines and cytokines that affect local innate immune responses by, for example, attracting neutrophils to sites of inflammation. In addition, platelets may directly regulate adaptive humoral immune responses via their expression and secretion of CD40/CD40L molecules. These studies have also suggested that platelets represent an important linkage between inflammation and thrombosis. Platelets also avidly bind to microorganisms and do so by expression of Toll‐like receptors. It appears that platelets may act as circulating sentinel cells that first encounter blood borne infectious products for presentation and activation of innate immune responses. This lecture will highlight several attributes of platelets that draw them into the realm of immunity and will discuss how platelets may be responsible for directly and indirectly controlling immune functions.
Characteristics of achalasia subtypes in untreated Chinese patients: A high‐resolution manometry study
Authors: Min Min , Peng Li Hua , Yang Yun Sheng , Hou Xiao Hua , Guo Rong Bin , Wang Wei Feng , Sun Gang , Wang Xiao Xiao 
Published: June 2012

ObjectiveTo evaluate and compare the clinical characteristics, manometric results and treatment outcomes of different subtypes of achalasia in untreated Chinese patients using high‐resolution esophageal manometry.MethodsA total of 75 achalasia patients and 34 healthy controls were enrolled in the study, and three achalasia subtypes were determined based on the Chicago classification. Clinical characteristics, manometric and treatment outcomes were compared.ResultsIn all, 25 patients were classified as type I, 46 as type II and 4 as type III. The mean overall length of lower esophageal sphincter (LES) in type III was significantly longer than those in the controls and type I patients (P < 0.05), and abdominal LES length was significantly longer in type III than those in controls, type I and type II patients. All subtypes of achalasia had higher resting and residual LES pressures than those found in healthy controls (P < 0.05). Resting upper esophageal sphincter (UES) pressure in type III patients was significantly lower than those in healthy controls and type I patients, whereas types I and II patients had higher residual UES pressures compared with healthy controls (P < 0.05). Type II patients had a better response to the treatment than type I and III patients.ConclusionsType II is more common in untreated Chinese achalasia patients, and type II patients had better treatment outcomes than other types of patients. Large‐sample multicenter trials are necessary in the future.
Central/Peripheral Fat Mass Ratio Is Associated With Increased Risk of Hypertension in HIV‐Infected Patients
Authors: Freitas Paula , Carvalho Davide , Santos Ana Cristina , Madureira António José , Xerinda Sandra , Martinez Esteban , Pereira Jorge , Sarmento António , Medina José Luís 
Published: June 2012

J Clin Hypertens (Greenwich). 2012; 14:593–600. © 2012 Wiley Periodicals, Inc.The data on the risk of hypertension in human immunodeficiency virus (HIV)–infected patients, particularly in those with lipodystrophy, are controversial. The authors assessed the impact of lipodystrophy on hypertension in a cohort of HIV‐infected adults receiving combination antiretroviral therapy. This was a cross‐sectional study in which lipodystrophy (clinically and fat mass ratio [FMR]–defined), blood pressure, and body composition (dual‐energy x‐ray absorptiometry and computed tomography) were evaluated in 368 HIV adults. The prevalence of hypertension in HIV patients with or without clinically or FMR‐defined lipodystrophy was similar (with clinical lipodystrophy 35.3% vs without 32.9%, not significant; with FMR lipodystrophy 41.7% vs without 32.2%, not significant). When HIV‐infected patients were classified into 4 categories of fat distribution (based on the presence or absence of lipoatrophy and abdominal prominence), isolated lipoatrophy was not significantly associated with hypertension, but patients with isolated central fat accumulation and mixed forms of lipodystrophy had a significantly higher prevalence of hypertension. Hypertensive HIV patients had significantly higher total fat, central, and central/peripheral fat mass ratio than normotensive ones. After adjustment for age, sex, smoking, and body mass index, hypertension remains significantly associated with central/peripheral fat mass ratio (odds ratio, 1.258; 95% confidence interval, 1.008–1.569). Hypertension was not more prevalent in lipodystrophic HIV‐infected patients, but was significantly associated with central/peripheral fat mass ratio.
Novel Method for Evaluating
In Vitro
Activity of Anidulafungin in Combination with Amphotericin B or Azoles
Authors: Teixeira-Santos R. , Rocha R. , Moreira-Rosário A. , Monteiro-Soares M. , Cantón E. , Rodrigues A. G. , Pina-Vaz C. 
Published: June 2012

ABSTRACT

A combination of drugs possessing different targets has been used as salvage therapy, although without scientific support.
In vitro
studies validating such combinations are scarce, and the methodology is very laborious and time-consuming. This study proposes a flow cytometric (FC) protocol as an alternative to evaluate the effect of the combination of anidulafungin (AND) with amphotericin B (AMB) and azoles (fluconazole and voriconazole), tested upon 39 and 36
Candida
strains, respectively. The concentration assayed in the combination was 0.5× MIC of each drug. The membrane potential marker DiBAC
4
(3) [Bis-(1,3-dibutylbarbituric acid) trimethine oxonol] was used for AND-AMB, and the metabolic marker FUN-1 was used for AND-azoles. Drug interaction was determined by calculating a staining index (SI): the sum of the percentage of depolarized cells (DC) after treatment with drug combinations divided by the DC of the drug alone, and the sum of the mean intensity of fluorescence (MIF) displayed by cells treated with drug combinations divided by the MIF of the drug alone for FUN-1. An SI of <1 means antagonism, an SI between 1 and 4 means no interaction, and an SI of >4 means synergism. The combination of AND and AMB by FC and checkerboard was synergistic for 46 and 43% of isolates and antagonistic for 5 and 8%, respectively. For the combination of AND and azoles, it was synergistic for 36% and antagonistic for 3% by FC and synergistic for 44% and antagonistic for 3% by checkerboard. When the FC method was compared to the gold standard checkerboard method, the agreement was 0.91 (95% confidence interval [95% CI] of 0.88 to 0.94), sensitivity was 0.88 (95% CI of 0.73 to 0.95), and specificity was 0.95 (95% CI of 0.84 to 1). Thus, FC is a rapid and reliable method (<2 h) to assess the effect of antifungal combinations.
First Report of an Extensively Drug-Resistant VIM-2 Metallo-β-Lactamase-Producing Brevundimonas diminuta Clinical Isolate
Authors: Almuzara Marisa N. , Barberis Claudia M. , Rodríguez Carlos H. , Famiglietti Angela M. R. , Ramirez Maria S. , Vay Carlos A. 
Published: June 2012

ABSTRACTIn the literature, only threeBrevundimonas diminutaenvironmental isolates carrying metallo-β-lactamase genes were recently published. However, so far, noB. diminutaclinical isolates carrying these carbapenem resistance genes have been described. Here we report the first VIM-2 metallo-β-lactamase-producingB. diminutaclinical isolate obtained from an immunocompromised patient.
THE CHARACTERISTICS OF GRBs WITH PRESENCE OF HIGH ENERGY COMPONENT IN THEIR SPECTRA
Authors: ARKHANGELSKAJA IRENE V. 
Published: June 2012

The properties of GRBs with presence of high energy emission in spectra are discussed. The temporal profiles of part of events are similar in various energy bands in prompt phase (as for GRB 080528, GRB 021008) but during some events extended high energy emission was detected (for example, GRB 090902B). For other part of GRBs temporal profiles are quite different in various energy bands during prompt phase (as for GRB 050525B), but for some such events extended high energy emission was observed too – for example, GRB 080514B. Moreover, high energy precursors were registered for several GRBs: some photons in energy band 30 MeV - 30 GeV were detected by AGILE during GRB 080514B. The shape of energy spectra of GRBs with presence of high energy emission can follows the Band model (or power law or broken power law) up to some tens or hundreds of MeV (as for GRB 021008) or contains additional high energy power law component (for example, GRB 050525B and GRB 090902B). Following this criteria it is possible to separate two main subclasses of GRBs with high energy emission. Both types of GRBs observed since CGRO mission beginning. The analysis of their energy spectra has shown that the break between additional high energy component and Band (or power law or broken power law) component was in energy region 2-200 MeV. Both types can have got extended high energy emission including component with E > 500 MeV for some events and low energy precursors. The special features of second class of GRBs by the results of preliminary data analysis are the absence of hard to soft evolution in the low energy band and (or) presence of the high energy precursors for some events.