bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of universal leukodepletion of the blood supply on hemovigilance reports of posttransfusion purpura and transfusion‐associated graft‐versus‐host disease
Authors: Williamson Lorna M. , Stainsby Dorothy , Jones Hilary , Love Elizabeth , Chapman Catherine E. , Navarrete Cristina , Lucas Geoff , Beatty Cynthia , Casbard Angela , Cohen Hannah ,   the Serious Hazards of Transfusion Steering Group
Published: June 2007

BACKGROUND: The pathogenesis of posttransfusion purpura (PTP) and transfusion‐associated graft‐versus‐host disease (TA‐GVHD) involves patient exposure to donor platelets (PLTs) and T lymphocytes, respectively, which are removed during blood component leukodepletion (LD).STUDY DESIGN AND METHODS: Reports of PTP and TA‐GVHD to the UK hemovigilance scheme Serious Hazards of Transfusion (SHOT) from 1996 to 2005 were compared before and after implementation of universal LD during 1999.RESULTS: There were 45 reports of PTP, with a mean of 10.3 per year before universal LD and 2.3 per year afterward (p  < 0.001). All patients had received red cells, but before universal LD, only 1 of 31 (3%) cases had also received PLTs, compared to 8 of 14 (57%) afterward (p  < 0.001). Thirty‐four cases (76%) had human platelet antigen (HPA)‐1a antibodies, whereas 11 had antibodies to other HPA specificities, only 1 of which occurred after LD. Two cases reported before LD also had heparin‐dependent PLT antibodies. There were 13 reports of TA‐GVHD, all fatal, of which only 2 cases of undiagnosed immunodeficiency met current UK criteria for irradiated components. Eight others had one or more risk factors: B‐cell malignancy (6), steroids (1), fresh blood (1), and donor‐recipient HLA haplotype share (4). Eleven cases were due to non‐LD and 2 to LD components (p  < 0.001). No cases have been reported since 2001. In an additional 405 cases, nonirradiated components were transfused in error to high‐risk recipients, mainly on fludarabine, but none developed TA‐GVHD.CONCLUSIONS: These findings suggest that universal LD has further reduced the already low risk of TA‐GVHD in immunocompetent recipients and has altered the profile of PTP cases.
Nonfatal intravascular hemolysis in a pediatric patient after transfusion of a platelet unit with high‐titer anti‐A
Authors: Harris Shealynn B. , Josephson Cassandra D. , Kost Christine B. , Hillyer Christopher D. 
Published: June 2007

BACKGROUND: In the pediatric population, hemolysis after out‐of‐group platelet (PLT) transfusion is a potentially fatal event that is thought to be underrecognized. Group A patients transfused with group O single‐donor PLTs (SDPs) with “high‐titer” anti‐A are at greatest risk for hemolysis.STUDY DESIGN AND METHODS: A clinical and serologic evaluation of a pediatric patient with hemolysis of initially unknown etiology was conducted. Retrospective testing for anti‐A titer of an admission sample and a transfused group O SDP was performed.RESULTS: The group A patient (previously group O) was found to have a history of engrafted major ABO‐mismatched hematopoietic peripheral blood progenitor cell transplant (HPBPCT). Immune‐mediated intravascular hemolysis with a delayed presentation was determined. Testing identified passive anti‐A in the patient's plasma and high‐titer anti‐A (IgG 4096, IgM 256) in the group O SDP unit.CONCLUSION: Hemolysis after out‐of‐group SDP transfusion may be delayed in presentation and, thus, clinically unrecognized. When evaluating these cases, the limitations of routine type and screen for detection of passive anti‐A must be considered. Group A individuals with a history of engrafted major ABO‐mismatched HPBPCT potentially have increased susceptibility to hemolysis from group O SDP transfusion due to their lack of tissue and soluble A antigen.
Single Chamber Atrial Pacing: A Realistic Option in Sinus Node Disease: A Long‐Term Follow‐up Study of 213 Patients
Authors: HÖIJER CARL J. , HÖGLUND PETER , SCHÜLLER HANS , BRANDT JOHAN 
Published: June 2007

Background:

Despite several decades of experience with atrial pacing, many centers do not apply this mode to any greater extent, mainly because of concerns for the development of future atrioventricular (AV) block or atrial fibrillation. Recent studies have emphasized possible negative effects of right ventricular stimulation, even when AV‐synchrony is preserved, and have thus given rise to renewed interest in single chamber atrial pacing for sinus node disease.
Methods:

This study presents the results of up to 19 years' follow‐up of 213 patients with sinus node disease treated with atrial pacing with respect to survival and causes of death, development of atrial fibrillation and AV block, and total mode survival. Patients were divided into two groups: with or without associated atrial tachyarrhythmias at the time of implant. Results are given for all patients and for the two groups separately.
Results:

The mean follow‐up time was 10.1 years. The survival of the entire group was lower after 10 years than that of an age and gender‐matched general Swedish population. This was caused by patients with the brady‐tachy syndrome (BT) having a significantly higher mortality rate than controls, whereas those with bradycardia only (B) had survival comparable to the general population. Permanent atrial fibrillation (AF) developed in 20% of patients and was significantly more common in patients with BT. The majority of patients with AF (78%) no longer needed any pacing, i.e., did not require ventricular stimulation due to slow ventricular rate. The annual incidence of high grade AV block was 1.8%. If patients with preexisting bundle branch block were excluded, the incidence was 1.6%. No fatal episode of AV block was seen. The overall mode survival at the end of follow‐up was 75%, with 155 patients still with atrial pacemakers.
Conclusion:

Atrial pacing is a safe and reliable mode of pacing in patients with sinus node disease, even in the very long‐term.
Bradypacing: Indications and Management Challenges in Nigeria
Authors: THOMAS M.O , OKE D.A , OGUNLEYE E.O , ADEYANJU F.A 
Published: June 2007

Background:

Permanent pacemaker implantation is a life‐saving procedure that is performed worldwide. There is paucity of reports on pacemaker surgery in Nigeria. The aims of the study were to determine the indications for pacemaker insertion, the demographic distribution of the patients requiring it, the electrocardiographic (ECG) changes, and the management challenges in Nigeria.
Materials and Method:

One hundred consecutive patients who had pacemaker insertion done by our team from 1999 were included in the study. The patients' biodata, indications for pacemaker insertion, ECG changes, and the treatment profile were recorded.
Results:

There was female preponderance (93.0%) among the patients studied. Third‐degree heart block was the indication in 86.0% of the patients and most patients did well with single lead ventricular pacing which is generally cheaper than the dual chamber pacing.
Conclusion:

The majority of bradyarrhythmia patients in this environment can be maintained on single lead ventricular pacemaker.
Early Detection of Regional Myocardial Dysfunction in Paced Children With Congenital Complete Atrioventricular Block
Authors: TUZCU VOLKAN , BODTKE JIMMY P , BEST THOMAS H 
Published: June 2007

Background:

Right ventricular apical pacing leads to global left ventricular dysfunction. Assessment of regional myocardial function may allow for earlier detection of pacing‐induced myocardial remodeling. The aim of this study was to evaluate regional myocardial function in paced children with congenital complete atrioventricular block (CCAVB).
Methods:

We investigated regional myocardial function using strain echocardiography and tissue velocity imaging in 10 paced children with CCAVB and in 14 age‐matched healthy children. Echocardiograms of the paced children were obtained during intrinsic junctional rhythm.
Results:

All patients had normal biventricular size and global function. The time from R wave to peak regional strain rate and the time from R wave to peak regional myocardial tissue velocity were measured in nine segments. The differences between maximum and minimum values were used as a measure of contraction delay (dSR and dTV). Study group patients had significantly higher dSR and dTV values compared to the control group. Mean peak strain rates and peak tissue velocities obtained from same segments were significantly decreased in the study group compared to the control group. Regional dysfunction was more prominent in the areas of ventricular pacing. No significant correlation is found between the duration of pacing (2.5–18 years) and dSR, dTV, mean peak strain rates, or mean peak tissue velocities.
Conclusion:

Pacing leads to regional myocardial dysfunction that can be detected with strain echocardiography and tissue velocity imaging during intrinsic junctional rhythm in children with CCAVB. Pacing‐induced regional myocardial remodeling does not seem to progress with long‐term right ventricular pacing in children with CCAVB.
Cardiac Autonomic Modulation Evaluated by Heart Interval Variability is Unaltered but Subtly Widespread in the Indeterminate Chagas' Disease
Authors: CORREIA DALMO , JUNQUEIRA LUIZ FERNANDO , MOLINA RODRIGO JULIANO , PRATA ALUÍZIO 
Published: June 2007

Background:Cardiac autonomic function in the indeterminate chronic form of Chagas' disease deserves better clearing‐up and understanding, since the existing findings are scarce and controversial. This work analyzed the short‐term heart interval variability in order to verify the cardiac autonomic modulation in indeterminate Chagas' disease subjects examined in a Brazilian endemic area.Methods:Variability in time and frequency domain of 5‐minute electrocardiogram (ECG) series of R‐R intervals in supine and active standing positions were obtained from 18 age‐, gender‐, body mass index‐, lifestyle‐, and physical activity‐matched chagasics and 18 control healthy subjects examined in Água Comprida city, MG, Brazil. Mann‐Whitney test was used for analysis of the data and spread of the individual indices in both groups.Results:The median of the all variability indices in the chagasic group were statistically similar (P= 0.17–0.87) to that in the control group. A wide dispersion of the almost all individual indices values, ranging from normal to variably reduced or increased ones, was noted in the majority of the chagasics in relation to the control interquartile range, in both postural positions.Conclusion:As a group, indeterminate Chagas' disease subjects showed unaltered short‐term heart interval variability. Individual somewhat widespread of majority of time‐ and frequency‐domain indices, from depressed to exacerbated ones appears to exist. This conforms to a variable cardiac autonomic modulation in this form of disease, suggesting that the majority of chagasics has no lesions, and a minority has subtle lesions of the efferent innervation‐sinus node complex.
Heart Rate Turbulence After Short Runs of Nonsustained Ventricular Tachycardia in Chronic Heart Failure
Authors: FLEVARI PANAYOTA , GEORGIADOU PANAGIOTA , LEFTHERIOTIS DIONYSSIOS , LIVANIS EFTHIMIOS , THEODORAKIS GEORGE , TH KREMASTINOS DIMITRIOS 
Published: June 2007

Background:

Heart rate turbulence (HRT) following isolated premature complexes is a baroreceptor‐mediated prognostic marker. Short runs of spontaneous, nonsustained ventricular tachycardia (nsVT) exert a greater hemodynamic effect than extrasystoles and may trigger a more potent turbulence‐like response (HRTVT), possibly related to other risk‐related markers, such as heart rate variability (HRV), left ventricular ejection fraction (EF), and original HRT parameters (turbulence slope [TS] and turbulence onset [TO]).
Methods:

We studied 27 patients with heart failure (HF) and nsVT (4–7 beats) on 24‐hour Holter electrocardiographic recordings (mean age 58 ± 3.6 years, EF 36%± 5.0%). Following nsVT, TSVT and TOVT were measured according to the original definitions. HRV, TS, and TO were also assessed.
Results:

HRTVT parameters were related to HRV. A significant relation existed between TSVT and EF (r= 0.66, P < 0.05). HRTVT parameters were related to the originally described (TS and TO), whereas TOVT was higher than TO (1.63 ± 1.6 vs −1.7 ± 0.65, P < 0.05).
Conclusions:

In mild‐to‐moderate HF, turbulence is observed following short nsVT runs and is related to prognostically important HRV indexes and EF. HRTVT is similar to HRT but TOVT is shifted toward more positive values than TO. HRTVT might be prognostically significant.
Hypotony maculopathy
Authors: Costa Vital Paulino , Arcieri Enyr Saran 
Published: June 2007

Abstract.Hypotony maculopathy, first described in 1954 by Dellaporta, usually occurs after antiglaucomatous surgery or after perforating eye injuries; it is characterized by hypotony associated with fundus abnormalities, including papilloedema, vascular tortuosity and chorioretinal folds. In hypotony maculopathy, the scleral wall collapses inward, resulting in redundancy of the choroid and retina, leading to chorioretinal wrinkling. As the antero‐posterior diameter of the vitreous cavity decreases, the very thick perivofeal retina surrounding the very thin foveal retina is thrown into radial folds around the fovea. It has been reported that hypotony maculopathy occurs in up to 20% of cases of glaucoma filtering surgery and has become more common after the introduction of antimetabolites. Young age, myopia, primary filtering surgery, systemic illnesses and elevated preoperative intraocular pressure (IOP) have been found to be associated with hypotony maculopathy. Hypotony maculopathy is treated with procedures designed to elevate IOP, which may reverse the inward scleral bowing and improve visual acuity. The successful treatment of hypotony maculopathy depends on the correct identification of its cause. Once the cause is detected, treatment should be employed as soon as possible because delayed normalization of the IOP may result in permanent macular chorioretinal changes and poor vision. This review will explore the definition, mechanisms, clinical findings and treatment of hypotony maculopathy.
Comparison of methods for determining platelet numbers and volume in cavalier King Charles spaniels
Authors: Bertazzolo W. , Comazzi S. , Sesso L. , Scarpa P. , Ru G. , Paltrinieri S. 
Published: June 2007

Objective:The purpose of this study was to compare platelet concentration in cavalier King Charles spaniels (CKCS) measured by different methods commonly used in veterinary hospitals and commercial laboratories.Methods:Blood samples obtained from 41 (CKCS) were analysed by impedance cell counter, laser cell counter and microscopic estimation. Quantitative buffy coat analysis was performed only on 17 samples, selected from (CKCS) that had low platelet counts detected by cell counters. Platelet counts, platelet estimations and platelet parameters using these different methods were compared.Results:The median platelet number was lower when estimated using impedance cell counter (1363×109/l) with respect to laser cell counter (1723×109/l), microscopic estimation (2383×109/l) or quantitative buffy coat analyser (2923×109/l) (P<0·01). Although impedance cell counter, laser cell counter and microscopic estimation were positively correlated, there was no acceptable agreement among methods. (CKCS) with macrothrombocytes in blood smears had significantly lower counts on impedance cell counter, laser cell counter and microscopic estimation. The percentages of (CKCS) with platelet count < 1003×109/l were 34·1 per cent (impedance cell counter), 26·8 per cent (laser cell counter), 22·0 per cent (microscopic estimation) (not statistically different) and 5·8 per cent (quantitative buffy coat analyser) (P<0·05).ClinicalSignificance:(CKCS) with macrothrombocytosis have low platelet counts on impedance cell counters, laser cell counters and microscopic estimation. (CKCS) with low platelet counts may have a normal platelet crit detected by a quantitative buffy coat analyser and thus a normal circulating platelet mass.
Screening of anti‐HPA‐1a antibodies in HPA‐1a‐negative mothers
Authors: Husebekk A. , Kjær Killie M. , Kjeldsen‐Kragh J. , Skogen B. 
Published: June 2007

Results from a study of more than 100 000 pregnant women show that the pathophysiology of neonatal alloimmune thrombocytopenia (NAIT) and haemolytic disease of the newborn (HDN) has many equalities [1]. It has been reported that NAIT is more than three times more frequent compared with HDN. This makes it tempting to consider a design for screening for HPA 1a negativity and follow up in/after the pregnancy based on the same principles as for RhD‐negative pregnant women. Even without available vaccination, it is strongly indicated that screening and Caesarean section 2–4 weeks prior to term in mothers with the HPA‐1a‐negative platelet type, reduce neonatal morbidity and mortality due to NAIT.
Blood transfusion services in countries that joined the EU in the last years: Czech Republic
Authors: Turek P. , Zimová R. 
Published: June 2007

The Czech Republic is a country in the middle of Europe with 10·3 million inhabitants and 80 000 km2. It became a European Union (EU) member in 2004. Blood transfusion service is disperse, hospital based. Blood is collected mostly from voluntary non‐remunerated blood donors and the country is self‐sufficient in blood components and plasma for fractionation. Predeposit autologeous programme is popular and covers around 4·5% of red cells needs. Donor population is stable and relatively safe. Total of 21 HIV positive donors have been detected during last 20 years, the incidence of hepatitis in blood donors is decreasing being below 0·10 pro mille for hepatitis B virus and below 0·20 pro mille for hepatitis C virus in 2005. European standards have been accepted and implemented during last 15 years; safety (quality) and general availability being the priorities. Donor selection, blood collection, processing and testing comply with EU directives. Producers of blood components (blood establishments) are under control of the state authority (State Institute for Drug Control). Recommendations based on expert opinion are available for clinical use of blood. Adverse effects of treatment are followed and investigated. Costs of blood components and plasma products are covered by general health insurance.
Errare humanum est ... but it is also human to prevent errors
Authors: Cummins D. 
Published: June 2007

Identification errors remain the most serious and the most common type of error in blood transfusion practice. Adverse events may occur when a patient has similar or identical identifiers to another patient (a ‘doppelgänger’), is doubly registered (a ‘duplicate registration’), or when registration details are derived from two or more separate sources (a ‘hybrid registration’). Such categorization provides a valuable conceptual framework for the development of appropriate risk management strategies. Distinguishing doppelgängers from duplicate registrations is not always easy. A search of the Harefield Hospital Patient Administration System (PAS) database revealed 39 registrations that shared a forename, surname and date of birth with at least one other registration. Thirty‐seven of these cases involved a duplicate registration, one involved a hybrid registration, and one involved a doppelgänger. A national strategic tracing service is available in the UK to help resolve difficult cases. Little attention has been directed at the extent to which risk reduction strategies in this area are in conflict with political and regulatory agendas. Most notable are initiatives that aim to preserve patient confidentiality. The less that is known about an individual, the greater is the risk he will be mistaken for someone who possesses similar identifiers to himself. An important, but largely unexplored, contributor to patient identification errors is innate cognitive bias. The fundamental concept underlying all blood transfusion – unique patient identity – is inherently ambiguous and vulnerable to a range of misperceptions, particularly with regard to the twin themes of coincidence and uniqueness. A major challenge will be to develop approaches in practice and education that are suitably informed by insights gleaned from cognitive and evolutionary psychology.
Potential applications of dendritic cells
Authors: De Vries I. Jolanda M. , Punt C. J. A. , Adema G. J. , Figdor C. G. 
Published: June 2007

Dendritic cells (DCs) are the professional antigen‐presenting cells of the immune system. Following infection or inflammation they undergo a complex process of maturation, and migrate to lymph nodes where they present antigens to T cells. Their decisive role in inducing immunity formed the rationale for DC immunotherapy: DCs loaded with tumor antigens are injected into cancer patients to stimulate T cells to eradicate tumors. Effective immune responses and favourable clinical outcomes have indeed been observed, but only in a minority of patients.For effective immunotherapy DCs need to traffic throughout the vascular and lymphatic system to reach the T‐cells located within lymph nodes. Though most immunotherapeutic agents are administered intravenously, DCs are predominantly administered intradermally. We observed that < 5% of intradermally administered mature DCs reach the draining lymph nodes amounting to inefficient homing. Despite this low number we could measure effective immune responses in some patients, but generally this may be too low.We demonstrated that DC maturation is a prerequisite to exert their immunostimulatory capacity in vivo. Immuno‐monitoring revealed a remarkable difference in immune responses. In patients vaccinated with immature DC the KLH responses as well as DTH reactivity against KLH and tumor‐peptides were weak and absent, respectively. In contrast, in patients vaccinated with mature DC a pronounced T cell as well a B cell response (IgG) against KLH were observed. Analysis of the response against the tumor peptides demonstrated little or no reactivity in blood. However, following intradermal administration of a delayed type hypersensitivity (DTH) challenge with gp100‐ and tyrosinase‐peptide loaded DC essentially all patients vaccinated with mature DC showed a positive induration. Moreover, we showed the predictive value of the presence or absence of antigen‐specific T cells in biopsies from DTH sites. In clinically responding patients, T cells specific for the antigen preferentially accumulated in the DTH site in accordance with the applied antigen in the DTH challenge.