bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uterine Perforation During Surgical Abortion: A Review of Diagnosis, Management and Prevention
Authors: Pridmore Brian R. , Chambers Dennis G. 
Published: March 2008

Summary:We analysed results of 13,907 women who underwent termination of pregnancy over a 6‐year period in a public day‐surgery clinic in South Australia to determine possible risk factors and preventive measures for known perforation of the uterus in surgical abortion. The perforation rate in the first trimester was 6 in 12,040 (0.05%) and in the second trimester (13–20 weeks), 6 in 1,867 (0.32%). Previous gynaecological surgery had been performed in 11 of 12 (92%) women sustaining perforation and was the main risk factor identified. No second trimester perforations occurred in the 2 years following identification of the risk factor and the introduction of precautionary protocols, and there was only 1 first trimester perforation. The overall reduction in perforation rate was from 0.13% to 0.02% (p=0.022). We conclude that previous gynaecological surgery including termination of pregnancy, lower segment Caesarean section and the large loop excision of transformation zone of the cervix (LLETZ) procedure, which may have resulted in scarring of the internal cervical os is a previously unreported risk factor for tearing of the internal os leading to perforation of the uterus during subsequent surgical abortion procedures. Dilatation of the cervix particularly for these ‘at risk’ procedures should be predominantly passive by the use of oral prostaglandins such as misoprostol and osmotic dilators.
Giant Myoma and Erythrocytosis Syndrome
Authors: Özsaran A. Aydm , Itil Ismail Mete , Terek Coşan , Kazand Mert , Dikmen Yilmaz 
Published: March 2008

Summary:The objective of this study is to discuss the myomatous erythrocytosis syndrome in a patient with a giant subserous uterine myoma. She presented with plethora and an abdominal mass. After venesection of 4 units of blood, the preoperative haematocrit value of 53.3% and haemoglobin value of 17.5 g/dL had decreased to 48.6% and 16.8 g/dL levels, respectively. After the operative extraction of the giant subserous myoma with attached uterus weighing 14.2 kg, the haematocrit and the haemoglobin values had regressed to 40.3% and 14.3 g/dL levels, respectively. The findings indicated that the giant subserous myoma was the cause of the myomatous erythrocytosis syndrome in this patient.
NSF: WHAT WE KNOW AND WHAT WE NEED TO KNOW: Nephrogenic Systemic Fibrosis: Early Recognition and Treatment
Authors: Knopp Eleanor A. , Cowper Shawn E. 
Published: March 2008

AbstractNephrogenic systemic fibrosis (NSF) is a progressive, debilitating, and emotionally distressing disease that can affect patients with renal dysfunction. Prevention, early recognition and early treatment are essential to limiting its impact. The most significant risk factors for developing NSF are chronic or significant acute kidney disease (usually necessitating dialysis) and the administration of gadolinium‐containing contrast agents (GCCA). Early symptoms include swelling, redness, pruritus, and pain in the limbs, sometimes with muscle weakness. Early signs are edema, erythema, and occasionally palpable warmth of the involved extremities; there may be florid scleral telangiectasia resembling conjunctivitis. We must redouble our efforts to avoid the administration of GCCA to patients with renal insufficiency. The most effective treatment for NSF to date is maximization of renal function via medical therapy or transplantation. There are data to support a beneficial effect from extracorporeal photopheresis, and all patients can gain from physical therapy.
NSF: WHAT WE KNOW AND WHAT WE NEED TO KNOW: Nephrogenic Systemic Fibrosis: Recommendations for Gadolinium‐Based Contrast Use in Patients with Kidney Disease
Authors: Perazella Mark A. , Reilly Robert F. 
Published: March 2008

AbstractNephrogenic systemic fibrosis is a systemic disorder characterized by widespread tissue fibrosis. Gadolinium‐based contrast (GBC) was recently noted as a possible trigger for this disease. The vast majority of cases occur in patients with ESRD receiving hemodialysis or peritoneal dialysis. However, approximately 10% of cases develop in patients with AKI (many requiring dialysis), advanced CKD stage 4, and CKD stage 5 not receiving renal replacement therapy. Recommendations to guide the use of GBC in patients with underlying kidney disease are presented. These clinical practice guidelines should be individualized and considered in consultation with the ordering physician, radiologist, and nephrologist.
NSF: WHAT WE KNOW AND WHAT WE NEED TO KNOW: Tissue Deposition of Gadolinium and Development of NSF: A Convergence of Factors
Authors: Perazella Mark A. 
Published: March 2008

AbstractGadolinium‐based contrast (GBC) exposure has recently been linked to the development of nephrogenic systemic fibrosis (NSF) in patients with underlying kidney disease and may in fact be the previously unrecognized trigger for the fibrosing process. As NSF is fairly rare in this patient population, a number of permissive factors are likely required for GBC exposure to initiate fibrosis. Advanced kidney disease is an absolute requirement whereas vascular injury and an inflammatory state, and a mix of co‐factors including increased serum phosphate and calcium concentrations and iron overload further enhance risk. The combination of these events allows excess circulating gadolinium, which dissociates from its chelate to leak out of vessels and deposit in tissues. Free or bound tissue gadolinium, a rare earth metal of the lanthanoid series, promotes fibrosis via either direct binding to the collagen helix or, once the metal has been engulfed by macrophages, through the production of free oxygen radicals, cytokines, and other profibrotic factors that attract circulating fibrocytes to tissues. These fibrocytes then differentiate into fibroblast‐like spindle cells that produce connective tissue matrix and other angiogenic and growth factors that further enhance tissue fibrosis. Direct gadolinium activation of transglutaminases on these tissue fibroblast‐like cells may also promote fibrosis.
NSF: WHAT WE KNOW AND WHAT WE NEED TO KNOW: Nephrogenic Systemic Fibrosis and Gadolinium‐Based Contrast: Medico‐Legal Implications
Authors: Houck Cara M. , Pristave Robert J. , Kannensohn Kimberly J. 
Published: March 2008

AbstractThe epidemiologic link between exposure to gadolinium‐based contrast (GBC) agents and the development of nephrogenic systemic fibrosis (NSF) in patients with moderate to severe end‐stage renal disease (ESRD) has caused concern among physicians, particularly radiologists and nephrologists. The concerns of manufacturers of GBC agents and the U.S. Food and Drug Administration (FDA) have led to the publication of product label warnings and a Public Health Advisory. As more cases of NSF associated with GBC agent exposure have surfaced, manufacturers and physicians have become increasingly concerned about the potential for litigation. To date, litigation has been directed primarily at manufacturers of GBC agents and has focused on package warnings. Thus, physicians should stay abreast of FDA warnings, keep an open line of communication with manufacturers of GBC agents, and review package warnings.
NSF: WHAT WE KNOW AND WHAT WE NEED TO KNOW: Treatment of Nephrogenic Systemic Fibrosis: Limited Options but Hope for the Future
Authors: Linfert Douglas R. , Schell Jane O. , Fine Derek M. 
Published: March 2008

AbstractNephrogenic systemic fibrosis has now been linked to gadolinium‐based contrast exposure in those with compromised kidney function. When present, symptoms can be quite devastating for the patient including severe pain and immobility. Unfortunately there is a lack of a universally effective therapy at this time and the literature, reviewed in this article, is comprised of primarily case reports and small case series allowing few conclusions to be drawn. It is widely recognized that supportive management with physical therapy and aggressive pain management is essential. Resolution of renal function in acute kidney injury appears to attenuate disease in most cases and transplantation has been associated with variable success. Therapies with anecdotal benefit include extracorporeal photopheresis and intravenous sodium thiosulfate. Other interventions have shown limited success. As the mechanism becomes more readily understood, it is hoped that targeted therapy might prove more effective than currently available remedies. In all likelihood prevention will prove to be most effective in avoiding this devastating complication.
NSF: WHAT WE KNOW AND WHAT WE NEED TO KNOW: Nephrogenic Systemic Fibrosis Risk: Is There a Difference between Gadolinium‐Based Contrast Agents?
Authors: Penfield Jeffrey G. , Reilly Robert F. 
Published: March 2008

AbstractNephrogenic systemic fibrosis (NSF) is a disabling and potentially fatal disease that has been associated with gadolinium‐based contrast (GBC) agents. There are five GBC agents approved for use in the United States and another four approved in Europe. The proposed cause of NSF is release of free Gd3+ into tissues in patients with decreased renal function. The number of associated cases and the potential to release free gadolinium is not equal between these agents. Gadodiamide has the largest number of reported cases of NSF followed by gadopentetate dimeglumine and gadoversetamide. The market share of these agents may contribute to the number of reported cases. The pharmokinetics of gadodiamide and gadoversetamide indicate that these two agents are more likely to release free Gd3+ than other GBC agents. Gadoteridol and gadoterate meglumine have a cyclic structure, making them less likely to release free Gd3+, and there is only a single reported case of NSF associated with gadoteridol use alone. Further research into individual agents is needed.
Guidelines for Venous Access in Patients with Chronic Kidney Disease
Authors: Hoggard Jeffrey , Saad Theodore , Schon Don , Vesely Thomas M. , Royer Tim 
Published: March 2008

AbstractAt the time of hemodialysis vascular access evaluation, many chronic kidney disease patients already have iatrogenic injury to their veins which impedes the surgical construction of an arteriovenous fistula (AVF). Achieving the important goal of a greater prevalence of arteriovenous fistulae in the US hemodialysis population will require identification of those patients prior to reaching end‐stage renal disease and an educational and procedural system for preserving their veins.
From Anemia Trials to Clinical Practice: Understanding the Risks and Benefits When Setting Goals for Therapy
Authors: Coyne Daniel W. 
Published: March 2008

AbstractManagement of anemia in chronic kidney disease (CKD) and dialysis patients with erythropoiesis stimulating agents continues to be an area of debate. Recent US Food and Drug Administration documents indicate that Normal Hematocrit Study (NHS) completed in 1996 had more patients (1265 vs. 1233) and showed significantly increased deaths or myocardial infarctions (p = 0.01; risk ratio: 1.28; 95% CI: 1.06–1.56) rather than the indeterminate evidence of harm (risk ratio: 1.30; 95% CI: 0.9–1.9) reported in the 1998 publication. This review places the NHS study results in context with the other three major anemia trials, which, together, contain ∼70% of all patients reported in trials using active therapy in both arms and examining a hemoglobin target >12 g/dl in CKD and dialysis. The potential impact of the ongoing TREAT trial, with its unique design characteristics, is also reviewed. This review outlines the known risks and benefits of various anemia targets based on these completed trials to better inform physicians about the realistic goals from anemia treatment.
Peritoneal Membrane Structural and Functional Changes during Peritoneal Dialysis
Authors: Goffin Eric 
Published: March 2008

AbstractPeritoneal dialysis is now utilized as a renal replacement therapy modality in a substantial percentage of patients with end‐stage renal disease, with excellent short‐term patient and technique survival rates. However, the potential complications associated with longer‐term therapy, such as ultrafiltration failure or encapsulating peritoneal sclerosis, have led to raise some concern about peritoneal dialysis as an adequate mode of treatment of end‐stage renal disease in the long term. In the last decade, a substantial amount of information has been gathered on the characteristics of the peritoneal membrane at the onset of peritoneal dialysis, and on the anatomical and pathophysiologic changes that occur with long‐term peritoneal dialysis. I will review this subject with a special focus on the various strategies that can help protect the peritoneal membrane during peritoneal dialysis so as to allow peritoneal dialysis to succeed as a long‐term dialysis modality.
Editorials: Niacin and Related Compounds for Treating Hyperphosphatemia in Dialysis Patients
Authors: Berns Jeffrey S. 
Published: March 2008

AbstractRecent experimental and clinical studies suggest the possible utility of niacin (nicotinic acid, vitamin B3) and its metabolite nicotinamide as a means of lowering phosphate levels in dialysis patients via direct inhibition of the Na‐Pi‐2b sodium‐dependent phosphate co‐transporter in the GI tract. While the possibility of taking just one or two pills a day, which do not have to be taken with meals, is very attractive, caution is warranted before moving forward with niacin and related compounds for lowering phosphate levels in dialysis patients until it is certain that they are effective, well tolerated, and safe for treatment of chronic hyperphosphatemia.
Thoracic Spinal Cord Stimulation for Post‐Ablation Cardiac Pain in a Patient with Permanent Pacemaker
Authors: Hoelzer Bryan C. , Burgher Abram H. , Huntoon Marc A. 
Published: March 2008

▪ AbstractBackground:  Spinal cord stimulation (SCS) is increasingly utilized for inoperable, intractable chest pain because of ischemia. Because patients with ischemic heart disease commonly have permanent cardiac pacemakers (PPM) or automated implantable cardio‐defibrillators (AICD), concurrent use of SCS and PPM or AICD may grow. Interference between SCS and PPM or AICD devices is potentially dangerous and has been previously reported.Case report:  A 51‐year‐old woman who underwent multiple catheter‐based cardiac ablations for a variety of tachy‐atrial arrhythmias. These procedures included atrioventricular node destruction, which left her PPM‐dependent (third degree heart block with an intrinsic heart rate in the 30s). During the course of her cardiac treatment, she developed chest pain which was not amenable to cardiac intervention and was refractory to medical management. The patient was evaluated for consideration of SCS and ultimately underwent implantation. Procedures evaluating SCS–PPM compatibility were followed and are described. Immediately after SCS implantation and at 6 months follow‐up, the patient experienced improved pain relief.Discussion:  Others have reported SCS implantation in patients with PPM. This is the first report to describe safe and effective use of an Advanced Bionics® SCS in a patient with a Guidant® PPM. In addition, we speculate that this patient's cardiac pain may have been other than ischemic in origin. As such, this case may represent a unique clinical scenario. Despite many cases series and case reports demonstrating safety of concurrent SCS and PPM or AICD, the complexity of these technologies requires continued demonstration of device compatibility in novel contexts. ▪
Fibromyalgia: Harmonizing Science with Clinical Practice Considerations
Authors: Perrot Serge , Dickenson Anthony H. , Bennett Robert M. 
Published: March 2008

▪ AbstractThis review summarizes the present and emerging knowledge base on the pathophysiology, diagnosis, and management of fibromyalgia.Epidemiology:  Fibromyalgia is the most common chronic pain syndrome encountered in general medicine and rheumatology. Historically, contemporary concepts of fibromyalgia have evolved in terms of its clinical description and parallel advances in the understanding of its pathophysiology.Pathophysiology:  A generally accepted paradigm postulates that fibromyalgia is the clinical expression of a rheumatologic disorder in which the associated pain is driven primarily by central sensitization and possibly through changes in several neuronal systems but not necessarily reliant on peripheral processes.Management:  Several agents, including serotonin‐norepinephrine reuptake inhibitors (ie, duloxetine and milnacipran), opioids (ie, tramadol), and the α2‐δ ligand pregabalin, which recently received U.S. regulatory approval for the treatment of fibromyalgia, have been evaluated in clinical trials, demonstrating benefit in terms of pain reduction and improvement in core symptoms (ie, fatigue and sleep disturbance). The European League Against Rheumatism has developed updated guidelines for the management of fibromyalgia. ▪
Performance evaluation of the new fully automated human immunodeficiency virus antigen‐antibody combination assay designed for blood screening
Authors: Sickinger Eva , Jonas Gesa , Yem Alex W. , Goller Andreas , Stieler Myriam , Brennan Catherine , Hausmann Michael , Schochetman Gerald , Devare Sushil G. , Hunt Jeffery C. , Kapprell Hans‐Peter , Bryant Jane D. 
Published: March 2008

BACKGROUND: Before the introduction of human immunodeficiency virus (HIV) combination assays, serologic diagnosis of HIV infection was performed with assays that detected either antibodies or p24 antigen. Owing to the capability to detect the early appearance of p24 antigen, combination assays that are designed for simultaneous detection of antibodies and antigen can significantly reduce the diagnostic window.STUDY DESIGN AND METHODS: Specificity and sensitivity of a commercially available HIV antigen‐antibody combination assay (Abbott PRISM; assay is not licensed by the FDA for use in the United States) were evaluated in a multicenter study by testing volunteer blood donors, hospitalized patients, seroconversion panels, and p24 antigen and HIV antibody subtype panels. Performance data were compared to a commercially available HIV combination assay and the PRISM HIV O Plus assay.RESULTS: Apparent specificity of 99.95 percent was observed in the donor population for the PRISM HIV antigen‐antibody combination assay, and better seroconversion sensitivity was demonstrated compared with another combination assay and the PRISM HIV O Plus assay. Analytical HIV antigen detection sensitivity averaged 33 pg per mL on the Agence Française de Sécurité Sanitaire des Produits de Santé (AFSSAPS) panel. Furthermore, comparable antigen sensitivity was demonstrated for 32 HIV‐1 group M subtype and group O panels. The PRISM HIV combination assay detected all HIV‐1 group M and O and HIV‐2 antibody–positive specimens evaluated.CONCLUSIONS: The PRISM HIV antigen‐antibody combination assay demonstrated a significant reduction of the window period for diagnosis of HIV infection. The assay demonstrated enhanced specificity and sensitivity along with broad subtype detection. The assay performance represents the “state‐of‐the art” technology for serologic blood screening of HIV infection.
Mannose‐binding lectin is involved in multiple organ dysfunction syndrome after cardiac surgery: effects of blood transfusions
Authors: Bilgin Yavuz M. , Brand Anneke , Berger Stefan P. , Daha Mohamed R. , Roos Anja 
Published: March 2008

BACKGROUND: Serum levels of mannose‐binding lectin (MBL), a recognition molecule of the lectin pathway of complement, are highly variable, based on genetic variation. After cardiac surgery, extracorporeal circulation and ischemia‐reperfusion injury initiate a systemic inflammatory response, which can evolve to multiple organ dysfunction syndrome (MODS). Preoperative transfusions of allogeneic white blood cells (WBCs) contribute to infectious and inflammatory complications. This study investigates the role of MBL in relation to blood transfusions and complications after cardiac surgery.STUDY DESIGN AND METHODS: In cardiac surgery patients who participated in a randomized trial comparing leukoreduced with buffy coat–depleted red blood cell (RBC) transfusions, circulating MBL was measured pre‐ and postoperatively by enzyme‐linked immunosorbent assay (ELISA). Data were related to the incidence of complications and to the transfusions the patients received.RESULTS: Patients with high preoperative serum MBL levels (>400 ng/mL) show a significant (52 ± 12%) decrease of serum MBL postoperatively, whereas patients with low serum MBL levels (≤400 ng/mL) show a significant increase of serum MBL levels after surgery (140 ± 106%), which was further enhanced by fresh‐frozen plasma (FFP) transfusions. MBL levels were not associated with infections, sepsis, or death. Patients with MBL deficiency (MBL ≤ 80 ng/mL) were protected against development of MODS (p = 0.016), whereas FFP transfusion abolished this protection (p = 0.048).CONCLUSION: Cardiac surgery is associated with MBL consumption, independent of the transfusion of allogeneic WBCs. Patients with MBL deficiency develop no MODS, unless they have been transfused with FFP, which is associated with MBL reconstitution. Therefore, sustained MBL deficiency may be a favorable status for patients undergoing cardiac surgery.
Development of a novel assay to evaluate the functional potential of umbilical cord blood progenitors
Authors: Reems Jo‐Anna , Hall Karen M. , Gebru Luladay H. , Taber Greta , Rich Ivan N. 
Published: March 2008

BACKGROUND: Although the colony‐forming cell (CFC) assay provides the most relevant information regarding the functional potential of progenitors in a unit of umbilical cord blood (UCB), technical challenges associated with this assay have made it difficult to standardize the assay among testing laboratories. The purpose of this study was to assess the reproducibility of a newly developed functional assay (HALO SPC‐QC [HALO], HemoGenix, Inc.). This test is based on the principle that cellular proliferation responses to cytokine stimuli are proportional to intracellular ATP levels from progeny cells generated in culture from progenitors.STUDY DESIGN AND METHODS: Results of the HALO assay were evaluated at two geographically distinct sites with matched aliquots from 12 different UCB units.RESULTS: A significant correlation between the two sites for total nucleated cell counts was observed (r = 0.98, p < 0.001). Similarly, a strong correlation between HALO results from both sites was observed (r = 0.94, p < 0.001). Also, despite using different methods at each site for the CFC assay, results from the two sites correlated (r = 0.79, p = 0.002). A good correlation between the CFC and HALO assays (r = 0.73, p < 0.005), however, was only observed at the site with the same cytokine cocktail for both the CFC and the HALO assays.CONCLUSION: These results support the notion that the HALO assay is a reasonable approach for measuring the functional potential of hematopoietic progenitors in UCB. Moreover, because the final readout for the HALO assay is instrument based, unlike the CFC assay, which requires a subjective enumeration of colonies, the HALO assay may be more amenable to standardization.