bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acromegaly surgery in Manchester revisited – The impact of reducing surgeon numbers and the 2010 consensus guidelines for disease remission
Authors: Wang Yi Yuen , Higham Claire , Kearney Tara , Davis Julian R.E. , Trainer Peter , Gnanalingham Kanna K. 
Published: August 2011

SummaryIntroduction  Surgical remission rates for acromegaly vary and are dependent on the tumour morphology, biochemical definition of disease remission and surgical expertise. A previous report from the Manchester region in 1998 reported an overall surgical remission rate of 27% using accepted criteria for biochemical remission at the time. The establishment of the 2010 Consensus guidelines further tightens biochemical criteria for remission. This report aims to assess the impact of establishing a specialist pituitary surgery service in Manchester in 2005, with reduced surgeon numbers on the remission rates for acromegaly surgery.Methods  Patients with acromegaly undergoing first time endoscopic transsphenoidal surgery between 2005 and 2010 were studied. Surgery was performed by a single surgeon. Review of a prospectively collected acromegaly surgery database was performed with documentation of pre‐ and postoperative biochemical tests [oral glucose tolerance test (oGTT) and IGF‐1], as well as clinical, pathological and radiological data. Definition of disease remission was according to the 2010 Consensus criteria (GH nadir <0·4 μg/l following an oGTT and normalized population matched IGF‐1).Results  There were 43 consecutive patients with acromegaly, with 13 (30%) microadenomas and 12 (28%) invasive adenomas. Overall, surgical remission was achieved in 29 (67%) patients. The remission rates were similar between micro (77%), macro (63%) and giant (67%) adenomas. There were nonsignificant trends towards higher remission rates for noninvasive tumours compared with invasive tumours (74%vs 50%) and for patients with a preoperative GH nadir <10 μg/l (73%vs 54%) and IGF‐1 standard deviation score <15 (72%vs 54%).Conclusions  Remission rates for acromegaly surgery have improved following establishment of a specialist surgical service, with a reduction in surgeon numbers. Endoscopic trans‐sphenoidal surgery remains an effective first‐line treatment for achieving biochemical remission in acromegaly, despite the introduction of the more stringent 2010 consensus guidelines.
Full‐length visfatin levels are associated with inflammation in women with polycystic ovary syndrome
Authors: Lajunen Taina K. , Purhonen Anna‐Kaisa , Haapea Marianne , Ruokonen Aimo , Puukka Katri , Hartikainen Anna‐Liisa , Savolainen Markku J. , Morin‐Papunen Laure , Tapanainen Juha S. , Franks Stephen , Järvelin Marjo‐Riitta , Herzig Karl‐Heinz 
Published: August 2011

Eur J Clin Invest 2012; 42 (3): 321–328AbstractBackground  Polycystic ovary syndrome (PCOS) is the most common gynaecological endocrinopathy characterized by oligomenorrhea, amenorrhoea, clinical and/or biochemical hyperandrogenism and polycystic ovaries. Abdominal deposition of excess body fat and metabolic diseases like insulin resistance and compensatory hyperinsulinemia are commonly observed in PCOS subjects. It has been suggested that visfatin is an adipokine secreted from the abdominal fat influencing glucose metabolism and might therefore contribute to the metabolic disturbances in PCOS.Materials and methods  We measured circulating full‐length visfatin levels with a specific enzyme immunoassay (AdipoGen Inc, Incheon, South‐Korea) in 57 women with self‐reported symptoms of PCOS (hirsutism and/or oligomenorrhea) and ultrasound confirmed polycystic ovaries, and in 57 controls from the Northern Finland 1966 Birth Cohort and explored its association with metabolic and inflammatory parameters.Results  Polycystic ovary syndrome cases had higher body mass index (BMI) (25·7 vs. 24·1 kg/m2) and waist circumference (83·2 vs. 78·8 cm) compared to controls, yet there was no difference in plasma visfatin levels between them. In contrast, visfatin significantly correlated with C‐reactive protein (CRP) in the control group and with white blood cell count (WBC) in both groups. In linear regression analysis, adjusted for PCOS, smoking, socioeconomic status, BMI or waist circumference, serum lipids and markers of glucose metabolism and hormone status, only WBC remained significantly associated with plasma visfatin levels.Conclusion  Our results suggest that circulating visfatin levels correlate with WBC and CRP but are not associated with PCOS, obesity or metabolic markers, suggesting that visfatin may act as a proinflammatory cytokine.
The clinical presentation and surgical treatment of verrucous dermatitis lesions in a draught horse
Authors: Poore Luke A. B. , Else Rod W. , Licka Theresia L. 
Published: August 2011

AbstractVerrucous pastern dermatitis is a progressive inflammatory skin disease commonly involving the palmar or plantar aspects of the pasterns of horses. There are no reports of successful surgical treatment for multifocal circumscribed verrucous masses in the chronic stages of verrucous pastern dermatitis. A combination of sharp dissection and electrocautery was used to resect numerous multifocal circumscribed verrucous masses from the distal hindlimb of an 11‐year‐old gelding draught horse. There was no evidence of significant regrowth or complications at a 24 month postoperative examination.
Alternatives to Human Blood and Blood Resources
Authors: Prowse C.V. 
Published: August 2011

AbstractBiotechnology is increasingly providing alternatives to established transfusion products, with the promise of freedom from infectivity and unlimited supply. Such products must demonstrate a safety and efficacy at least as great as current products, and thereafter an improved cost‐benefit ratio. Alternatives to established products may be categorised as:

Alternatives made from blood donations.
Substitutes (acting by distinct mechanisms).
Recombinant analogs.
Cellular therapies (including gene therapy).

This overview covers the current status in each of these categories, and likely trends in the near future. Recombinant therapeutic proteins are already established in certain indications, and are likely to be extended to a wider range of applications as the methods for bulk production are improved. Alternative products from donated blood should find niche indications, especially for acute therapy, but cellular therapy is unlikely to be widely implemented on this timescale, except as an adjunct in life‐threatening indications. Substitutes are perhaps the most interesting category and are expected to have a major impact, particularly through the use of “poietins” to stimulate endogenous production of circulating cell populations.
Circulatory Effects of Whole Blood, Packed Red Cells, Albumin, Starch, and Crystalloids in Resuscitation of Shock and Acute Critical Illness
Authors: Shoemaker W.C. , Wo C.C.J. 
Published: August 2011

AbstractCirculatory deficiencies and the effectiveness of transfusion and fluid therapy may be evaluated by invasive and noninvasive monitoring after high risk surgery, hemorrhage, trauma, and sepsis in the ED, OR, and ICU. Earlier recognition and therapy of circulatory problems in emergency and critically ill patients to achieve optimal goals empirically defined by the survivors' patterns is recommended to improve outcome. WB, Prbc, and colloids markedly and statistically significantly improved pressure, flow, and tissue perfusion and best achieved these goals. Noninvasive monitoring may be used in the ED and OR shortly after admission to identify circulatory deficiencies and to titrate therapy, or they may be used initially as the front‐end of subsequent invasive monitoring.
Gene and Cell Transfer for Specific Immunotherapy
Authors: Brenner M.K. , Heslop H.E. , Rooney C.M. 
Published: August 2011

AbstractThe realisation that human tumor cells may express and process tumor specific and tumor associated antigens has increased interest in immunotherapeutic approaches to cancer treatment. This interest has been coupled with a burgeoning ability to genetically modify tumor cells and components of the immune system, in an effort to maximize the anti‐neoplastic response. In a number of settings, gene modified tumor vaccines, cytotoxic T cells and dendritic cells are producing both immunomodulation and clinically evident benefits. Continued exploration of this approach seems well justified.
Cord Blood Banking and Transplant in Europe
Authors: Gluckman E. , Rocha V. , Chastang C. ,   Eurocord
Published: August 2011

AbstractThe number of cord blood transplants has been increasing very quickly with more than 250 cases reported to Eurocord Registry and more than 500 patients transplanted via the New York Cord Blood Bank. Cord blood transplants have been performed either with related or unrelated cord blood. Several cord blood banks established a group called Netcord whose goal is the standardization of the procedures, the organization of internal audits for accreditation and qualification, and the communication and exchange by internet of donor search on an international basis. More than 15000 units of frozen cord blood are currently available and this number is increasing rapidly worldwide. Analysis of the clinical results has shown that related cord blood transplants give better results than unrelated cord blood transplants. Factors associated with better survival in related and unrelated cord blood transplants were lower age, diagnosis, with better results in inborn errors and in good risk children with acute leukemia. A larger number of nucleated cells in the transplant and the recipient being negative for CMV serology were also favourable risk factors for survival. Engraftment was improved with higher numbers of cells and HLA identity. Graft versus Host disease was reduced when compared to transplants of adult allogeneic bone marrow or peripheral blood progenitor cells. HLA disparities did not influence GVH; the only factor associated with increased GVH was positive CMV serology in the recipient. This study shows that cord blood is an alternative source of hematopoietic stem cells for allogeneic transplantation in children and in some adults. HLA disparity is not a limiting factor but the number of cells infused is important; currently the use of a number of nucleated cells inferior to lx107/kg is not recommended. Several questions remain including the criteria of choice of the donor, the indications in children and in adults, the comparison of cord blood transplants to other sources of hematopoietic stem cells and the role of growth factors and expansion for improving the speed of engraftment.
Post‐Transfusion Hepatitis: Current Risks and Causes
Authors: Holland P.V. 
Published: August 2011

AbstractViral hepatitis which follows transfusions (post‐transfusion hepatitis) may be due to those transfusions, i.e., transfusion‐transmitted hepatitis (TTH), or may be incident to the reason for the transfusion and, thus, may be transfusion‐associated, but not transfusion‐transmitted. The current risks of TTH, today, are extremely small, but are still due, primarily, to the hepatitis B virus (HBV) and the hepatitis C virus (HCV), the latter, formerly being known as “non‐A, non‐B hepatitis.” The residual, now, of TTH which is non‐A, non‐B, and non‐C is extremely small and may be due to a variety of agents. Using volunteer (unpaid), repeat, blood donors, who are carefully screened for hepatitis risk factors and then tested for evidence of HBV infection, the risk of HBV being transmitted by a transfusion today is in the order of 1 per 63,000 units of blood. For transfusion‐transmitted HCV, with the same repeat, volunteer (unpaid) donors, careful screening and a sensitive assay for anti‐HCV, the risk is in the order of 1 in 125,000 units. These risks of HBV and HCV due to transfusions are so small that other means of acquiring these viruses should be sought when patients develop hepatitis following blood transfusions. However, efforts to further reduce the current risks of HBV and HCV transmission by transfusions should continue; these include restricting transfusions to those which are necessary or appropriate, utilizing alternatives to transfusion, employing novel assays to detect viral nucleic acids, and, finally, implementing various microbial inactivation techniques on blood, blood components and plasma derivatives.
HTLV Testing in Blood Transfusion
Authors: Couroucé A‐M. , Pillonel J. , Lemaire J‐M. , Saura C. 
Published: August 2011

AbstractTo improve the safety of the blood supply, HTLV screening of blood donations became mandatory in different countries.In Japan and in Europe, the majority of HTLV‐infected donors are HTLV‐I whereas in the USA more than half of them are HTLV‐II‐positive.The prevalence of HTLV‐infected donors is low in European Countries as is the rate of seroconversion. Consequently, to test donors only once would have a high efficiency. This procedure is already in use in certain countries.Furthermore, if the use of leucodepleted cell concentrates is generalized, the policies for HTLV screening will still be further modified.
Inactivation of Viruses, Bacteria, Protozoa, and Leukocytes in Platelet Concentrates
Authors: Corash L. 
Published: August 2011

AbstractDespite the increased safety of blood achieved through continued improvements in donor testing, concern remains about the safety of blood components. Transfusion of cellular components has been implicated in transmission of viral, bacterial, and protozoan diseases[l]. While it is commonly recognized that hepatitis B virus (HBV), hepatitis C virus (HCV), cytomegalovirus (CMV), and the retroviruses, such as human immunodeficiency virus (HIV) and the human lymphotrophic viruses (HTLV) can be transmitted through cellular components, other pathogens are emerging as potentially significant transfusion‐associated infectious agents. For example, transmission of protozoan infections due to trypanosomes[2–4] and babesia have been reported[5]. In addition to viral and protozoal infectious agents, bacterial contamination of platelet concentrates continues to be reported[6, 7]; and may be an under reported transfusion complication[8]. More importantly, new infectious agents may periodically enter the donor population before they can be definitively identified and tested for to maintain consistent safety of the blood supply. The paradigm for this possibility is the HIV pandemic which erupted in 1979. During the past decade a number of methods to inactivate infectious pathogens in blood components, including platelets, have been developed. This technology is now entering the clinical trial phase.
Immunomodulatory Effects of Allogeneic Blood Transfusions: Clinical Manifestations and Mechanisms
Authors: Blajchman M.A. 
Published: August 2011

AbstractRecognition that allogeneic transfusion associated immunomodulation can increase morbidity in allogeneically transfused individuals has become a major concern for those involved in transfusion medicine. However, whether allogeneic blood transfusions predispose recipients to increased risk for cancer recurrence or to bacterial infections is still unproven. In contrast, data from studies in experimental animal models suggest that allogeneic blood transfusion associated immunomodulation is an immunologically mediated biological effect which is associated primarily with the infusion of allogeneic leukocytes. Moreover, the available experimental animal data suggest that pre‐storage leukoreduction, as opposed to post‐storage leukodepletion, is effective in ameliorating this tumor growth‐enhancing effect of allogeneic blood. While considerable data have accumulated in an attempt to unravel the mechanism of the immunomodulatory effect of allogeneic blood transfusions, the precise mechanism of this effect has not yet been elucidated.
Donor Leukocyte Transfusions for Treatment of Leukemic Relapse after Bone Marrow Transplantation
Authors: Kolb H‐J. ,   EBMT Immunology and Chronic Leukemia Working Parties
Published: August 2011

AbstractAllogeneic bone marrow transplantation is an effective treatment of leukemia. Intensive chemo‐ and radiotherapy used for conditioning and T‐cells of the graft contribute to the control of leukemia. Animal experiments indicate that transfusion of lymphocytes from the marrow donor convert into complete chimerism without producing graft‐versus‐host disease, if delayed for two months or more. Transfusion of donor leukocytes (DLT) after marrow transplantation has induced lasting remissions in the majority of patients with chronic myelogenous leukemia (CML) in hematological or cytogenetic relapse, some patients with acute myeloid leukemia (AML), myelodysplastic syndromes (MDS), transformed phase CML and multiple myeloma (MMY). The mechanism of the graft‐versus‐leukemia reaction is discussed.
Suicide Gene Transduced T‐cells for the Regulation of the Graft‐versus‐Leukemia Effect
Authors: Bonini C. , Ciceri F. , Marktel S. , Bordignon C. 
Published: August 2011

AbstractIn allogeneic marrow transplantation (BMT), donor lymphocytes play a central therapeutic role in both graft‐versus‐leukemia and immune reconstitution. However, their use is limited by the risk of severe graft‐vs‐host disease (GvHD). Different strategies have been investigated to obtain all the benefits derived from donor lymphocytes while avoiding the risk of GvHD. In the first pilot study, infusions of donor lymphocytes transduced with the Herpes Simplex virus thymidine kinase (HSV‐tk) suicide resulted in anti‐tumor activity in 50% of patients. Acute GvHD could be effectively controlled by ganciclovir‐ induced elimination of the transduced cells. If these results will be confirmed in larger studies, genetic manipulation of donor lymphocytes will increase efficacy and safety of allogeneic marrow transplantation.
Antenatal Genotyping of the Blood Groups of the Fetus
Authors: Avent N.D. 
Published: August 2011

AbstractAntenatal genotyping of the fetus is now in widespread use as an aid to the clinical management in cases where there is the potential of haemolytic disease of the newborn occurring. The rapid diagnosis of an antigen‐negative fetus will preclude the requirement for further, potentially risky invasive procedures being performed, whilst the determination of an antigen‐positive fetus allows the potential of intensifying obstetric care for this pregnancy. Molecular genotyping is a major clinical application which has led from the determination of the molecular bases of blood group antigens expressed, most of which have been defined at the level of the gene. All assays used are dependent on the Polymerase Chain Reaction amplification of fetal DNA derived from either amniotic fluid or chorionic villi. Recent work has explored the potential of utilising fetal cells found to be present in maternal peripheral blood as a source of nucleic acid for prenatal diagnosis. Using non‐invasive methods will preclude exposing mother and fetus to the potential hazards of invasive methods (amniocentesis, chorionic villus sampling and cordocentesis) which include miscarriage, fetal malformations and further maternal alloimmunisation.
Monitoring of Oxygen Delivery in Cardiac and Vascular Surgery
Authors: Spahn D.R. 
Published: August 2011

AbstractMonitoring the adequacy of oxygen (02) delivery is of paramount significance in the perioperative period of surgical patients undergoing cardiac and major vascular surgery. These patients are at considerable risk for ischemic perioperative complications due to a high incidence of coronary artery disease. Monitoring the adequacy of global 02 delivery is based on observing stability of haemodynamics, absence of elevated lactate levels and preservation of 02 consumption. Monitoring the adequacy of regional 02 delivery focuses on the coronary, cerebral, splanchnic and renal circulation. Myocardial ischemia can be detected relatively easily by continuous ECG monitoring of leads II and V5 and in selected cases by transesophageal echocardiography. There are relatively few monitoring modalities clinically available at the present time to reliably assess adequacy of 02 delivery in the cerebral, splanchnic and renal circulation. Expecting relatively low intra‐ and postoperative haemoglobin levels per se does not necessarily mandate greatly exaggerated monitoring. However, continuous ECG monitoring of leads II and V5, invasive blood pressure measurement, determination of hourly urine production may be indicated in most patients. In high risk patients extended monitoring with a pulmonary artery catheter and transesophageal echocardiography may be indicated. Most important, however, is the clinical surveillance by an experienced physician integrating the information of all applied monitoring modalities who realises early alterations indicating (potentially) compromised 02 delivery.
EBV Specific CTL: A Model for Immune Therapy
Authors: Rooney C.M. , Heslop H.E. , Brenner M.K. 
Published: August 2011

AbstractWe have been generating Epstein‐Barr virus specific cytotoxic T cells for patients at high risk of developing EBV driven lymphoma. To discover the fate of the cells in vivo, we first marked them genetically, using a retroviral vector. Our results in 51 patients show that the approach is safe, that the CTL persist for several years and that they are able to mediate anti‐viral and anti‐tumor effects. We are now studying other virally‐linked malignancies to discover whether a similar approach will be of therapeutic value.
Interactions between Science, Government and Media on Selection and Testing of Donors
Authors: Sazama K. 
Published: August 2011

AbstractThe international media attention to “bad blood” has fueled governmental action in countries around the world. Donor selection criteria continue to expand, focusing most recently on the possibility of exclusion due to intranasal cocaine use and, in the US, due to incarceration for more than 72 hours. As newer methods of testing evolve, more deferrals will occur due to improved testing. An emerging area of concern is the non‐standardized notification of donors who are ineligible to donate and lack of a centralized listing of such deferred donors. Because of the consequences to recipients, improvements in both donor questioning and testing are necessary. Further studies are needed to understand and improve these processes.
Blood Collection and the Labile Blood Components: What should the Regulators ask for?
Authors: Maniatis A. , Adamides E. 
Published: August 2011

AbstractEfforts to promote the quality and safety of blood collection are underway in most European Union (EU) member states but the level of quality management continues to differ significantly not only between countries but also among Blood Collection Establishments (BCE's) within a country.The European Commission has asked for blood safety and self‐sufficiency in the Community and has initiated action in this direction. What is sought is harmonization of practices in the transfusion chain but such cannot be accomplished solely through recommendations and directives given the sociocultural and economic differences among EU member states. Active support for the development of common standards and a common quality system as well as an inspection and accreditation system would certainly help. The goal of self‐sufficiency should certainly be emphasized but may be difficult to achieve, given the unpredictability of factors that may affect demand and supply. Through bipartisan initiatives however, between the USA and EU, consensus regarding the issue of blood safety, could be reached.