bluuebunny/crossref_metadata_2025_split huggingface dataset:
The p67 laminin receptor identifies human erythroid progenitor and precursor cells and is functionally important for their bone marrow lodgment
Authors: Bonig Halvard , Chang Kai-Hsin , Nakamoto Betty , Papayannopoulou Thalia 
Published: April 2006

AbstractThe laminins are a group of extracellular matrix proteins with constitutive expression in all tissues, including bone marrow stroma. A functional role for the nonintegrin laminin receptor p67 has been described for cancer metastasis and lymphocyte trafficking. Expression of p67 was also reported for other subsets of mature leukocytes and for malignant hematopoietic or nonhematopoietic cells. We explored p67 expression on normal hematopoietic progenitor cells (HPCs) and its putative role in bone marrow retention of transplanted HPCs. We found p67 expression on a subset of primary human CD34+ cells coexpressing erythroid markers. Of importance, p67 recognizes early erythroid progenitors, since sorted p67+ cells were significantly enriched for burst-forming units–erythroid (BFU-Es) and depleted of colony-forming units–granulocyte/macrophage (CFU-GMs). Blockade of p67 binding of donor cells, using antifunctional antibody, reduced bone marrow homing of BFU-Es. These studies identify p67 as a novel phenotypic marker for erythroid HPCs of functional importance for lineage-specific homing/retention among adult transplanted HPCs.
Patients with quinine-induced immune thrombocytopenia have both “drug-dependent” and “drug-specific” antibodies
Authors: Bougie Daniel W. , Wilker Peter R. , Aster Richard H. 
Published: April 2006

AbstractImmune thrombocytopenia induced by quinine and many other drugs is caused by antibodies that bind to platelet membrane glycoproteins (GPs) only when the sensitizing drug is present in soluble form. In this disorder, drug promotes antibody binding to its target without linking covalently to either of the reacting macro-molecules by a mechanism that has not yet been defined. How drug provides the stimulus for production of such antibodies is also unknown. We studied 7 patients who experienced severe thrombocytopenia after ingestion of quinine. As expected, drug-dependent, platelet-reactive antibodies specific for GPIIb/IIIa or GPIb/IX were identified in each case. Unexpectedly, each of 6 patients with GPIIb/IIIa-specific antibodies was found to have a second antibody specific for drug alone that was not platelet reactive. Despite recognizing different targets, the 2 types of antibody were identical in requiring quinine or desmethoxy-quinine (cinchonidine) for reactivity and in failing to react with other structural analogues of quinine. On the basis of these findings and previous observations, a model is proposed to explain drug-dependent binding of antibodies to cellular targets. In addition to having implications for pathogenesis, drug-specific antibodies may provide a surrogate measure of drug sensitivity in patients with drug-induced immune cytopenia.
The Steap proteins are metalloreductases
Authors: Ohgami Robert S. , Campagna Dean R. , McDonald Alice , Fleming Mark D. 
Published: April 2006

AbstractIron and copper are essential for all organisms, assuming critical roles as cofactors in many enzymes. In eukaryotes, the transmembrane transport of these elements is a highly regulated process facilitated by the single electron reduction of each metal. Previously, we identified a mammalian ferrireductase, Steap3, critical for erythroid iron homeostasis. Now, through homology, expression, and functional studies, we characterize all 4 members of this protein family and demonstrate that 3 of them, Steap2, Steap3, and Steap4, are not only ferrireductases but also cupric reductases that stimulate cellular uptake of both iron and copper in vitro. Finally, the pattern of tissue expression and subcellular localization of these proteins suggest they are physiologically relevant cupric reductases and ferrireductases in vivo.
Lenalidomide therapy in myelofibrosis with myeloid metaplasia
Authors: Tefferi Ayalew , Cortes Jorge , Verstovsek Srdan , Mesa Ruben A. , Thomas Deborah , Lasho Terra L. , Hogan William J. , Litzow Mark R. , Allred Jacob B. , Jones Dan , Byrne Catriona , Zeldis Jerome B. , Ketterling Rhett P. , McClure Rebecca F. , Giles Francis , Kantarjian Hagop M. 
Published: April 2006

AbstractWe present results of 2 similarly designed but separate phase 2 studies involving single-agent lenalidomide (CC-5013, Revlimid) in a total of 68 patients with symptomatic myelofibrosis with myeloid metaplasia (MMM). Protocol treatment consisted of oral lenalidomide at 10 mg/d (5 mg/d if baseline platelet count < 100 × 109/L) for 3 to 4 months with a plan to continue treatment for either 3 or 24 additional months, in case of response. Overall response rates were 22% for anemia, 33% for splenomegaly, and 50% for thrombocytopenia. Response in anemia was deemed impressive in 8 patients whose hemoglobin level normalized from a baseline of either transfusion dependency or hemoglobin level lower than 100 g/L. Additional treatment effects in these patients included resolution of leukoerythroblastosis (4 patients), a decrease in medullary fibrosis and angiogenesis (2 patients), and del(5)(q13q33) cytogenetic remission accompanied by a reduction in JAK2V617F mutation burden (1 patient). Grade 3 or 4 adverse events included neutropenia (31%) and thrombocytopenia (19%). We conclude that lenalidomide engenders an intriguing treatment activity in a subset of patients with MMM that includes an unprecedented effect on peripheral blood and bone marrow abnormalities.
Are the “Life‐Support” Courses Updated? An Evaluation of Their Literature Base
Authors: Hack Jason B. , Wilkinson Heather L. 
Published: April 2006

Abstract
Background:
As a condition of employment, many physicians practicing in the United States are mandated to remain current in their certification of some or all of the life‐support courses. These courses reputedly set the standard of care by establishing nationally recognized paradigms of resuscitation. These courses' textbooks are revised and re‐released at regular intervals.
Objectives:
To determine whether the source data for these texts are vigorously updated with each revision and whether there is an obvious literature‐based impetus to release a new version.
Methods:
A comparison was made of the years of the references contained within the three most recent textbook editions of the advanced cardiac life support (ACLS), advanced trauma life support, basic life support, and pediatric advanced life support courses. The years of the references were tallied for each text, and these tallies were compared both within and between the courses. Data were divided into three groups: group 1, references published before the previous versions' release; group 2, references published after previous versions' release; group 3, references dated within three years of the texts' release.
Results:
There appears to be a large amount of overlap of group 1 data throughout most of the course texts; the number of references in group 2 and 3 varies greatly between and within these courses.
Conclusions:
With one exception (ACLS in 2003), the life‐support courses appear to be based on similar reference sets for the last 7 to 11 years. There may be a reason other than an availability of a critical mass of new information that prompts the release of a new edition of these life‐support courses.
Predictors of On‐call Specialist Response Times in California Emergency Departments
Authors: Mohanty Sarita A. , Washington Donna L. , Lambe Susan , Fink Arlene , Asch Steven M. 
Published: April 2006

Abstract
Objectives:
To assess waiting times in emergency departments (EDs) for on‐call specialist response and how these might vary by facility or neighborhood characteristics. Limited availability of on‐call specialists is thought to contribute to ED overcrowding.
Methods:
Direct observational data from a random sample of 1,798 patients visiting 30 California EDs during a six‐month period provided specialist waiting times. The authors used multivariate logistic regression and survival analysis to analyze predictors of time to on‐call specialists' telephone response.
Results:
Eighty‐six percent of on‐call specialists who were paged responded by telephone within 30 minutes. Ten percent of specialists did not respond at all. After controlling for the annual percentage of nonurgent ED patients at each facility, near closure status, and hospital ownership status, for every $10,000 increase in hospital zip code income, the odds of on‐call specialist response within 30 minutes increased by 123% (adjusted odds ratio = 2.23; 95% confidence interval = 1.24 to 4.02; p = 0.01).
Conclusions:
Although the majority of on‐call specialists met the federal recommendation of a 30‐minute response, those in poor neighborhoods were less likely to do so. One in ten on‐call specialists did not respond at all. State and federal policies should focus on making more funding available for on‐call specialist panels in poor areas.
Child Witnesses and Victims in Homes with Adult Intimate Partner Violence
Authors: Ernst Amy A. , Weiss Steven J. , Enright‐Smith Shannon 
Published: April 2006

Abstract
Objectives:
To determine demographics of children in homes to which police are called for intimate‐partner violence (IPV) and to compare the relative risk of perpetrator versus victim for those who, as children, witnessed or were victims of IPV and sexual assault.
Methods:
Data from Resources, Inc. Victim Assistance Unit yearly intake statistics for 2004 were accessed. In this city with a population of approximately 500,000 people, police will call for an on‐site advocate intervention (a trained social worker) at their own discretion for the adult or child victims of IPV and for children witnessing IPV. The social worker collects data on victims, perpetrators of IPV, and child witnesses or victims at all police calls for IPV. Comparisons were made by using chi‐square, relative risks (RRs), and 95% confidence intervals (95% CI).
Results:
Police and advocates visited 2,038 homes for IPV calls; 2,617 children were in these homes. Of these children, 1,904 (76%) witnessed IPV, and 698 (27%) were victims themselves. Adult victims (31%) and perpetrators (41%) had high rates of having witnessed IPV when they were children. Perpetrators were more likely than victims to have witnessed IPV as a child (RR, 1.56; 95% CI = 1.37 to 1.78) and to have been a victim of IPV as a child (RR, 1.71; 95% CI = 1.49 to 1.96).
Conclusions:
In this study population, 76% of IPV households include children, and one third of these children also are victims of IPV. Perpetrators often were victims and witnesses of IPV when they were children. This suggests that a history of childhood IPV is common for perpetrators of IPV. Development of and research on interventions for child witnesses or victims of IPV is needed.
Does Functional Decline Prompt Emergency Department Visits and Admission in Older Patients?
Authors: Wilber Scott T. , Blanda Michelle , Gerson Lowell W. 
Published: April 2006

Abstract
Background:
Older patients may visit the emergency department (ED) when their illness affects their function.
Objectives:
To quantify the function of older ED patients, to assess whether functional decline (FD) had occurred, and to determine whether function contributes to the ED visit and hospital admission.
Methods:
The authors performed an institutional review board–approved, prospective, cross‐sectional study in a community teaching hospital ED. Eligible patients were older than 74 years of age, with an illness at least 48 hours old. Patients from a nursing facility and those without a proxy who were unable or unwilling to complete the questions were excluded. The Older Americans Resources and Services Questionnaire, which tests seven instrumental activities of daily living (IADL) and seven physical ADLs (PADL), was used. Data are presented as means or proportions with 95% confidence intervals (95% CI), and comparisons as 95% CI for the difference between proportions.
Results:
The authors enrolled 90 patients (mean age, 81.6 yr [SD ± 4.9], 40% male). Dependence in at least one IADL was reported by 68% (95% CI = 57% to 77%), and in at least one PADL by 61% (95% CI = 50% to 71%). Functional decline was reported by 74% (95% CI = 64% to 83%). Two thirds of those with IADL decline and three quarters of those with PADL decline said that this contributed to their ED visit. Seventy‐seven percent with, and 63% without, IADL decline were admitted (14% difference, 95% CI =−6.1% to 33%). Seventy‐nine percent with and 61% without PADL decline were admitted (18% difference, 95% CI =−1.4% to 38%).
Conclusions:
Functional decline is common in older ED patients and contributes to ED visits in older patients; its role in admission is unclear.
National Study on Emergency Department Visits for Transient Ischemic Attack, 1992–2001
Authors: Edlow Jonathan A. , Kim Sunghye , Pelletier Andrea J. , Camargo Carlos A. 
Published: April 2006

Abstract
Objectives:
To describe the epidemiology of U.S. emergency department (ED) visits for transient ischemic attack (TIA) and to measure rates of antiplatelet medication use, neuroimaging, and hospitalization during a ten‐year time period.
Methods:
The authors obtained data from the 1992–2001 National Hospital Ambulatory Medical Care Survey. TIA cases were identified by having ICD‐9 code 435.
Results:
From 1992 to 2001, there were 769 cases, representing 2,969,000 ED visits for TIA. The population rate of 1.1 ED visits per 1,000 U.S. population (95% CI = 0.92 to 1.30) was stable over time. TIA was diagnosed in 0.3% of all ED visits. Physicians administered aspirin and other antiplatelet agents to a small percentage of patients, and 42% of TIA patients (95% CI = 29% to 55%) received no medications at all in the ED. Too few data points existed to measure a statistically valid trend over time. Physicians performed computed tomography scanning in 56% (95% CI = 45% to 66%) of cases and performed magnetic resonance imaging (MRI) in < 5% of cases, and there was a trend toward increased imaging over time. Admission rates did not increase during the ten‐year period, with 54% (95% CI = 42% to 67%) admitted. Regional differences were noted, however, with the highest admission rate found in the Northeast (68%).
Conclusions:
Between 1992 and 2001, the population rate of ED visits for TIA was stable, as were admission rates (54%). Antiplatelet medications appear to be underutilized and to be discordant with published guidelines. Neuroimaging increased significantly. These findings may reflect the limited evidence base for the guidelines, educational deficits, or other barriers to guideline implementation.
Laser‐assisted Anesthesia Reduces the Pain of Venous Cannulation in Children and Adults: A Randomized Controlled Trial
Authors: Singer Adam J. , Weeks Robert , Regev Ran 
Published: April 2006

Abstract
Objectives:
Application of topical anesthetics before intravenous (IV) cannulation is effective yet limited by delayed transdermal absorption. The authors evaluated a handheld laser device to enhance topical anesthetic absorption by ablating the stratum corneum, the major barrier to drug absorption through the skin. The hypothesis was that laser‐assisted anesthesia would reduce the pain of IV cannulation in emergency department (ED) patients.
Methods:
This was a blinded, randomized, controlled trial. ED patients aged 1 year and older requiring nonemergent IV cannulation were included. Patients were randomized to pretreatment of the skin with laser or sham laser, and standardized venous cannulation was performed on the dorsum of the patients' hands or antecubital fossa. In the experimental group, the area over the target vein was pretreated with a lightweight, portable Er:YAG unit, with a fluence of 3.5 J/cm2, a pulse width of 600 microseconds, and a spot diameter of 6 mm. Lidocaine 4% cream was applied to the area immediately after laser application. Five minutes later, the cream was wiped off and a trained nurse inserted an IV catheter. In the control group, a sham laser and lidocaine were used. Pain of laser application and IV cannulation was recorded on age‐appropriate pain scales; presence of infection or abnormal pigmentation was determined at one week. Pain of cannulation was compared using parametric and nonparametric tests.
Results:
Sixty‐one patients were randomized to laser (30) and sham (31) pretreatment. Mean (± SD) age was 27 (± 21) years, 49% were female, and one half were children younger than 18 years. The mean pain of IV cannulation was significantly less (mean difference, 28.3 mm; 95% confidence interval = 17.9 to 38.7) in patients pretreated with the laser (10.0 mm; 95% confidence interval = 4.4 to 15.6) than with sham laser (38.3 mm; 95% confidence interval = 29.3 to 42.2). The difference in children was also significant. Application of the laser was painless in most patients. No patient developed infection or abnormal pigmentation.
Conclusions:
Pretreatment of the skin with a laser device followed by a five‐minute topical lidocaine 4% application reduces the pain of IV cannulation in ED adult and pediatric patients.
The Effect of a Commercially Available Burn‐cooling Blanket on Core Body Temperatures in Volunteers
Authors: Singer Adam J. , Freidman Brenda , Modi Prachi , Soroff Harry H. 
Published: April 2006

Abstract
Background:
Cooling of burns is one of the oldest therapies, yet there are concerns that excessive cooling may result in hypothermia.
Objectives:
To determine the effects of surface cooling with a commercially available cooling blanket on the core temperatures of volunteers and to test the ability of the cooling blanket to reduce water evaporation from plastic containers. The null hypothesis was that rectal temperatures would not be reduced by surface cooling and that the cooling blanket would reduce evaporative water loss.
Methods:
This was a prospective, noncomparative, interventional study. Ten healthy adult volunteers were recruited. Subjects were completely unclothed, and their entire body (excluding the head) was circumferentially wrapped with a commercially available gel‐soaked cooling blanket at room temperature. A rectal temperature probe was inserted, and continuous monitoring of vital signs was performed during a 30‐minute period. In addition, six plastic containers were filled with 50 mL of room‐temperature water, half of which were covered with the cooling blanket. The amount of water remaining within the containers was measured at hourly intervals over four hours.
Results:
The subjects' mean age was 38 years; 50% were female. There were no significant changes in core body temperatures over time in any of the study subjects. Mean (95% confidence intervals [CI]) core temperatures at the beginning and at the end of the study period were 37.2°C (95% CI = 37.0°C to 37.4°C) and 37.3°C (95% CI = 37.1°C to 37.5°C), respectively. Water evaporation in the blanket‐covered containers was less than in the uncovered containers.
Conclusions:
The authors conclude that covering healthy volunteers with a room temperature burn‐cooling blanket for 30 minutes does not result in hypothermia and that the cooling blanket reduces evaporative water loss.
Chemoembolization for Liver Metastases from Medullary Thyroid Carcinoma
Authors: Fromigué J. , De Baere T. , Baudin E. , Dromain C. , Leboulleux S. , Schlumberger M. 
Published: April 2006

Abstract
Background: Medullary thyroid carcinoma (MTC) is a well-differentiated neuroendocrine tumor. Distant metastases are the main cause of cancer-related death. Systemic chemotherapy produces only rare tumor responses. Somatostatin analogs and other available modalities are poorly effective to control symptoms.
Aims: The aim of our study was to evaluate the impact of liver transarterial chemoembolization (TACE) in MTC patients with predominant and progressive liver metastases.
Patients and Methods: Twelve MTC patients underwent 18 TACE courses (mean, 1.5; range, 1–2). Response evaluation criteria in solid tumors were used to evaluate tumor responses. Symptomatic responses were defined by more than a 25% decrease of symptoms intensity.
Results: Partial radiological tumor response was obtained in five patients (42%) with a median duration of 17 months (mean, 19; range, 15–28 months), stabilization in five (42%) with a median duration of 24 months (mean, 24; range, 4–39 months), and progression in the remaining two (16%). The five partial tumor responses were observed in the nine patients with less than 30% liver involvement. Clinical response was observed in two of the five patients with diarrhea. Carcinoembryonic antigen did not appear to be a useful marker in this setting. Significant grade 3–4 toxicity was observed in one patient who had a major tumor necrosis after TACE.
Conclusion: TACE should be considered for treating MTC patients with progressive and predominant liver metastasis, and preferably at an early stage during the course of metastatic disease.
Urine Steroid Hormone Profile Analysis in Cytochrome P450 Oxidoreductase Deficiency: Implication for the Backdoor Pathway to Dihydrotestosterone
Authors: Homma Keiko , Hasegawa Tomonobu , Nagai Toshiro , Adachi Masanori , Horikawa Reiko , Fujiwara Ikuma , Tajima Toshihiro , Takeda Ryoujun , Fukami Maki , Ogata Tsutomu 
Published: April 2006

Abstract
Context: Although the “backdoor” pathway to dihydrotestosterone has been postulated in the fetal-to-early-infantile period of patients with cytochrome P450 oxidoreductase deficiency (PORD), clinical data in support of this pathway remain limited.
Objective: The objective of this study was to obtain clinical evidence for the presence of the backdoor pathway in PORD.
Setting: This was a collaboration study between laboratories and hospitals.
Subjects: Twenty-two Japanese patients with molecularly confirmed PORD and 1763 control subjects participated in this study.
Intervention: Urine steroid profile analysis was performed by gas chromatography/mass spectrometry. In five patients and 776 control subjects, urine samples were obtained before 12 months of age.
Main Outcome Measure: The main outcome measure was identification of a urine steroid(s) indicating the backdoor pathway.
Results: In the PORD patients, pregnanediol, pregnanetriolone, and pregnanetriol were obviously elevated, and the urine steroid ratios reflecting CYP17A1 and CYP21A2 activities were decreased throughout the examined ages. Furthermore, etiocholanolone and 11-hydroxyandrosterone, which should originate almost exclusively from androstenedione in the conventional “frontdoor” pathway, were grossly normal or somewhat decreased since early infancy, whereas androsterone, which can be derived not only from androstenedione and dihydrotestosterone in the conventional frontdoor pathway but also from 5α-pregnane-3α,17α-diol-20-one in the backdoor pathway, was increased during early infancy and remained grossly normal thereafter. Thus, the androsterone to etiocholanolone ratio was increased during early infancy and remained grossly normal thereafter. 5α-Pregnane-3α,17α-diol-20-one was elevated throughout the examined ages.
Conclusions: The increased androsterone excretion during early infancy, as compared with the etiocholanolone and 11-hydroxyandrosterone excretions in the same period, suggests the presence of the backdoor pathway in PORD.