bluuebunny/crossref_metadata_2025_split huggingface dataset:
A randomized controlled trial comparing standard- and low-dose strategies for transfusion of platelets (SToP) to patients with thrombocytopenia
Authors: Heddle Nancy M. , Cook Richard J. , Tinmouth Alan , Kouroukis C. Tom , Hervig Tor , Klapper Ellen , Brandwein Joseph M. , Szczepiorkowski Zbigniew M. , AuBuchon James P. , Barty Rebecca L. , Lee Ker-Ai ,   for the SToP Study investigators of the BEST Collaborative
Published: December 2008

AbstractA noninferiority study was performed comparing low-dose and standard-dose prophylactic platelet transfusions. A double-blind randomized controlled trial (RCT) was performed in 6 sites in 3 countries. Thrombocytopenic adults requiring prophylactic platelet transfusion were randomly allocated to standard-dose (300-600 × 109 platelets/product) or low-dose (150- < 300 × 109 platelets/product) platelets. The primary outcome (World Health Organization [WHO] bleeding ≥ grade 2) was assessed daily through clinical examination, patient interview, and chart review. A WHO grade was assigned through adjudication. The Data Safety Monitoring Board stopped the study because the difference in the grade 4 bleeding reached the prespecified threshold of 5%. At this time, 129 patients had been randomized and 119 patients were included in the analysis (58 low dose; 61 standard dose). Three patients in the low-dose arm (5.2%) had grade 4 bleeds compared with none in the standard-dose arm. WHO bleeding grade 2 or higher was 49.2% (30/61) in the standard-dose arm and 51.7% (30/58) in the low-dose group (relative risk [RR], 1.052; 95% confidence interval [CI], 0.737-1.502). A higher rate of grade 4 bleeding in patients receiving low-dose prophylactic platelet transfusions resulted in this RCT being stopped. Whether this finding was due to chance or represents a real difference requires further investigation. These clinical studies are registered on http://www.clinicaltrials.gov as NCT00420914.
The impact of Fc engineering on an anti-CD19 antibody: increased Fcγ receptor affinity enhances B-cell clearing in nonhuman primates
Authors: Zalevsky Jonathan , Leung Irene W. L. , Karki Sher , Chu Seung Y. , Zhukovsky Eugene A. , Desjarlais John R. , Carmichael David F. , Lawrence Chris E. 
Published: December 2008

AbstractCD19, a B cell–restricted receptor critical for B-cell development, is expressed in most B-cell malignancies. The Fc-engineered anti-CD19 antibody, XmAb5574, has enhanced Fcγ receptor (FcγR) binding affinity, leading to improved FcγR-dependent effector cell functions and antitumor activity in murine xenografts compared with the non–Fc-engineered anti-CD19 IgG1 analog. Here, we use XmAb5574 and anti-CD19 IgG1 to further dissect effector cell functions in an immune system closely homologous to that of humans, the cynomolgus monkey. XmAb5574 infusion caused an immediate and dose-related B-cell depletion in the blood (to <10% of baseline levels) concomitant with a sustained reduction of natural killer (NK) cells. NK cells had fully recovered by day 15, whereas B-cell recovery was underway by day 57. B cells in secondary lymphoid tissues were depleted (to 34%-61% of vehicle), with involuted germinal centers apparent in the spleen. Anti-CD19 IgG1 had comparable serum exposure to XmAb5574 but demonstrated no B-cell depletion and no sustained NK-cell reduction. Thus, increasing FcγR binding affinity dramatically increased B-cell clearing. We propose that effector cell functions, possibly those involving NK cells, mediate XmAb5574 potency in cynomolgus monkeys, and that enhancing these mechanisms should advance the treatment of B-cell malignancies in humans.
Cardiac tamponade, an unusual and fatal complication of esophagus dilatation for benign stenosis: a case report
Authors: Greven Wendela L , Kooij Nicole , Peters Herman M , Kardux Joost , Spronk Peter E 
Published: December 2008

Abstract

Introduction
We present a patient with a fatal late esophago-pericardial fistula three months after dilatation for benign oesophagus stenosis

Case presentation
A 71-year-old caucasian male with a known benign esophagus stenosis was referred to the ICU. On arrival an asystole developed which proved to be due to a large pericardial effusion. Pericardial fluids were drained, but the patients' condition worsened and he died due to multiple organ failure. Postmortum investigation revealed an esophago-pericardial fistula.

Conclusion
Causes of an acute tamponade should also be sought in semirecent events, such as manipulation to the oesophagus months before the acute critical illness.
The role of attributions in the process of overcoming shame: A qualitative analysis
Authors: Van Vliet K. Jessica 
Published: December 2008

ObjectivesWhile attributions have been found to play an important role in the experience of shame, little is currently known about attributions that occur as part of shame reparation. This exploratory study investigated the attributions associated with recovery from shame, based on the perspectives of participants.DesignGrounded theory was used in data collection and analysis. This approach has been used extensively for developing understandings of how people construct meaning, interpret events, and act on the basis of their beliefs and interpretations.MethodsThe participants were nine women and four men between the ages of 24 and 70. Data came from interviews in which the participants recalled a distressing shame experience and described how they recovered. Emphasis was on the participants' subjective perspectives, meanings, and interpretations.ResultsShame involved global and stable dispositional attributions where the entire self was regarded as flawed and unattractive, and participants perceived themselves as powerless to change an unwanted identity. Internal causal attributions and self‐blame were present in most but not all shame experiences. Recovery involved a movement towards specific and unstable attributions that enhanced self‐concept and maximized a sense of power and control over the future. Shared and external factors that contributed to the event were also identified.ConclusionsWhen applied to psychotherapy for shame‐related distress, these findings point to the importance of exploring clients' attributions related to specific shame events and using interventions that promote attributional change. Directions for further research are discussed.
Comparison of density gradient and single layer centrifugation of stallion spermatozoa: Yield, motility and survival
Authors: Morrell J. M. , Dalin A‐M. , Rodriguez‐Martinez H. 
Published: December 2008

SummaryReasons for performing study: A new, simpler, technique of colloidal centrifugation has recently been developed, designated single layer centrifugation (SLC). This technique requires evaluation by comparison with a density gradient for its ability to select the best quality spermatozoa and its practicality of use on studfarms.Objective: To compare the effect of 2 methods of colloidal centrifugation, density gradient centrifugation and single layer centrifugation, on stallion sperm motility, yield and survival, using freshly collected extended stallion semen.Methods: Aliquots of extended stallion semen from 10 stallions (38 ejaculates) were processed by the 2 methods of colloidal centrifugation. For both uncentrifuged and centrifuged samples, sperm yield was calculated and subjective sperm motility assessed over several days to provide an estimate of sperm survival. Some stored semen samples, held at 4°C overnight, were also available for testing.Results: For fresh, extended semen, a similar recovery yield of motile spermatozoa was seen for the 2 methods of preparation for single layers and density gradients, respectively. Sperm motility and survival rate were significantly improved by colloidal centrifugation compared to unprocessed ejaculate, without any significant difference between methods (SLC vs. gradient). However, the yield was reduced by 18–20% when cold‐stored semen was used for centrifugation compared to fresh semen; and more variation between ejaculates was observed than for fresh ejaculates. Again, sperm motility and sperm survival were improved in the centrifuged sperm preparations compared to stored, unprocessed ejaculates.Potential relevance: The 2 colloid centrifugation techniques produce equivalent sperm preparations in terms of sperm quality. However, the SLC method would be more practical and convenient for use in the field.
Storage‐associated artefact in equine muscle biopsy samples
Authors: Stanley R. L. , Maile C. , Piercy R. J. 
Published: December 2008

SummaryReasons for performing study: Muscle biopsy is increasingly used in equine veterinary practice for investigating exertional, inflammatory or immune mediated myopathies and unexplained muscle atrophy. Although formalin‐fixed samples are often used, for complete evaluation, fresh‐frozen tissue is required. Freezing muscle in veterinary practice is impractical: samples sent to specialist laboratories for processing are therefore susceptible to delays, potentially leading to artefact and compromising histological interpretation.Hypothesis: Altered temperature, duration and hydration status influence the severity of storage‐induced artefact in equine muscle.Methods: Skeletal muscle obtained immediately post euthanasia was divided into 6 independent samples from each of 8 horses. One sample per horse was frozen immediately in isopentane precooled in liquid nitrogen. Additional samples were stored in conditions designed to mimic possible situations encountered in practice, including increased storage times, temperature and hydration status. Following storage, stored samples were frozen as before. Cryosections were stained using haematoxylin and eosin and ranked for artefact on 2 occasions by 2 blinded observers. The best samples were processed subsequently with a panel of routine stains and immunolabelled for collagen V to enable the measurement of minimum fibre diameters.Results: Both prolonged storage and increased hydration resulted in more storage‐associated artefact. Samples stored for 24 h chilled on dry gauze were ranked higher than those stored on damp gauze; however, a panel of routinely‐used histochemical staining techniques was unaffected by chilled 24 h storage. There was no significant effect of storage on mean fibre diameter; however, both chilled dry and damp storage for 24 h caused a significant increase in fibre‐size variability.Conclusion and potential relevance: Caution should be exercised when interpreting fibre size profiles in shipped samples. Equine muscle biopsy samples are optimally shipped in dry gauze, sealed in plastic containers and shipped on ice packs to be processed within 24 h and can thus be interpreted by the receiving laboratory with minimal artefact.
Efficacy of thermal cautery for intermittent dorsal displacement of the soft palate as compared to conservatively treated horses: Results from 78 treadmill diagnosed horses
Authors: Barakzai S. Z. , Boden L. A. , Hillyer M. H. , Marlin D. J. , Dixon P. M. 
Published: December 2008

SummaryReasons for performing study: Previously, objective comparisons of surgical procedures to relieve dorsal displacement of the soft palate (DDSP) have been limited by the presumptive basis of the diagnostic measures applied.Objectives: To assess and compare the efficacy of thermal cautery surgery to conservatively treated controls in racehorses definitively diagnosed with idiopathic intermittent DDSP.Hypothesis: Both conservative and surgical treatments have a beneficial result on racing performance in racehorses affected with DDSP.Methods: Race records were obtained for Thoroughbred racehorses definitively diagnosed with DDSP using highspeed treadmill endoscopy. Racing performance was assessed based on prize money won.Results: Forty‐eight horses that underwent thermal cautery and 30 conservatively treated controls were included. Pretreatment earnings significantly decreased in the race immediately prior to diagnosis. A high proportion of previously raced horses returned to racing after both treatments (90–96%). Intrahorse comparison of earnings in 3 races pre‐ vs. post treatment showed that 53% of conservatively treated horses and 36% of the thermal cautery group had improved performance. Although the difference between these 2 groups may be interpreted as being clinically significant, it was not statistically significant.Conclusions and potential relevance: A higher percentage of conservatively treated controls had improved individual performance compared to horses treated with thermal cautery. Thermal cautery appears less effective than other previously published surgical treatments for DDSP. Comparison of the 2 treatment methods should be interpreted cautiously because treatments were not randomised, resulting in baseline variability between groups.
Effect of poll flexion and dynamic laryngeal collapse on tracheal pressure in Norwegian Coldblooded Trotter racehorses
Authors: Strand E. , Fjordbakk C.T. , Holcombe S. J. , Risberg A. , Chalmers H. J. 
Published: December 2008

SummaryReason for performing study: Dynamic laryngeal collapse (DLC) associated with poll flexion is a newly diagnosed upper respiratory tract obstructive disorder that causes poor racing performance.Objectives: To determine if Norwegian Coldblooded Trotters (NCTs) affected with DLC associated with poll flexion differ from normal, elite NCTs based on simple airway mechanics measurements.Methods: Five normal elite NCTs and 6 NCTs diagnosed previously with DLC underwent treadmill videoendoscopy while tracheal pressures were measured continuously. Alternating head positions were used such that horses were exercised with free head carriage and induced poll flexion at heart rates >200 beats/min.Results: Peak inspiratory tracheal pressures were significantly more negative for horses with DLC compared to the elite horses. This difference was only significant during the exercise phases when the poll region was flexed, P = 0.0015. Head position significantly affected peak inspiratory pressure for both elite and affected horses, P<0.0001.Conclusions and clinical relevance: Induced poll flexion significantly affected peak inspiratory pressure (PIP) in all horses; however, PIPs were significantly more negative in those affected with DLC. Based upon the tracheal pressure measurements recorded in this study, DLC in NCTs is a severe obstructive upper respiratory tract disorder that is induced by poll flexion.
Long‐term assessment of horses and ponies post exposure to monensin sodium in commercial feed
Authors: Hughes K. J. , Hoffmann K. L. , Hodgson D. R. 
Published: December 2008

SummaryReasons for performing study: Acute monensin intoxication in equids is well described; however, the long‐term effects of sublethal intoxication and ability to return to previous use are less well understood. Long‐term observations may allow improved estimation of prognosis in cases of sublethal intoxication.Objectives: To assess horses and ponies exposed to sublethal amounts of monensin for evidence of chronic sequelae and ability to return to prior/intended use.Methods: Twenty‐nine horses and 8 ponies were assessed utilising serum biochemistry, treadmill exercise stress testing, electrocardiography, and pre‐ and post exercise echocardiography ≥6 weeks after ingestion of monensin‐contaminated feed. Animals with evidence of monensin‐induced cardiomyopathy were re‐examined after a period of rest of ≥11 months. Follow‐up information was obtained by owner telephone interview ≥52 months after exposure.Results: During resting echocardiography, 11 animals had reduced/low‐normal left ventricular fractional shortening (FS); an increase in FS in 8 of these animals was measured ≥11 months later. Six animals had reduced or low‐normal FS during post exercise echocardiography. Two horses had ventricular premature depolarisations during exercise. Follow‐up information was available for 35 animals: 21 returned to athletic/reproductive use, 13 were retired immediately and one died. Mean FS increased significantly (P<0.001) between initial and second examination in 15 animals that underwent resting echocardiography on 2 occasions.Conclusions: Some equids exposed to sublethal doses of monensin may not develop permanent myocardial disease and a return to athletic/reproductive use is possible.Potential relevance: Exercise stress testing, echocardiography and electrocardiography may be useful for detection and monitoring of cardiac dysfunction in equids exposed to monensin and determining whether a return to athletic/reproductive use is possible.
Comparison of radiography and ultrasonography to detect osteochondrosis lesions in the tarsocrural joint: A prospective study
Authors: Relave F. , Meulyzer M. , Alexander K. , Beauchamp G. , Marcoux M. 
Published: December 2008

SummaryReasons for performing study: Lesions located on the medial malleolus of the tarsocrural joint can be difficult to image radiographically. Ultrasonography allows evaluation of articular cartilage and subchondral bone.Objectives: To compare dorso30° lateral‐plantaromedial‐oblique (DL‐PlMO) and dorso45° views to detect lesions on the medial malleolus, to validate the use of ultrasonography to show lesions in the tarsocrural joint and to compare its sensitivity to radiography.Methods: Tarsocrural joints (n = 111) with osteochondrosis were evaluated ultrasonographically and radiographically prior to arthroscopic lesion debridement. A complete radiographic examination was made and the best view to detect each lesion recorded. Longitudinal and transverse ultrasonography of the dorsal aspect of the joint was performed and the best scan plane to image each lesion recorded.Results: There were 94 joints with lesions on the distal intermediate ridge of tibia, 24 with lesions on the medial malleolus, and 4 with lesions on the lateral trochlear ridge. The sensitivity of radiography to detect lesions on the medial malleolus and distal intermediate ridge of tibia was 71 and 96%, respectively. Eighty‐two percent of lesions on the medial malleolus were better imaged on dorso30° view. The sensitivity of ultrasonography to detect lesions on the medial malleolus and distal intermediate ridge of tibia was 83 and 98%, respectively. Ultrasonography was significantly more sensitive than radiography to detect lesions on the medial malleolus and distal intermediate ridge of tibia.Conclusion: Dorso30° lateral‐plantaromedial‐oblique view was the best to image lesions on the medial malleolus. Ultrasonography was a valuable diagnostic tool to diagnose lesions in the tarsocrural joint and was more sensitive than radiography for lesions located on the medial malleolus and distal intermediate ridge of tibia.Clinical relevance: Radiographic examination should include a dorso30° view for detection of lesions on the medial malleolus and ultrasonography should be considered to diagnose osteochondrosis in the tarsocrural joints.
Lesions of the deep digital flexor tendon in the digit: A correlative MRI and post mortem study in control and lame horses
Authors: Blunden A. , Murray R. , Dyson S. 
Published: December 2008

SummaryReasons for performing study: Lameness associated with lesions of the deep digital flexor tendon (DDFT) in the digit is now recognised as an important cause of lameness, but there is currently limited information about the pathological nature of the lesions.Objectives: To compare: signal intensity changes on magnetic resonance images with histopathology; and histopathological changes in the DDFT from horses with no history of foot‐related lameness (Group C) and horses with lesions of the DDFT confirmed using magnetic resonance imaging (MRI) (Group D).Methods: Transverse sections of the DDFT were harvested from 3 sites in all horses: 1) immediately proximal to the navicular bursa (E1); 2) at the level of the navicular bone (E2); and 3) close to the tendon's insertion (E3). If lesions were identified at E1 or had been identified further proximally using MRI, additional sections were obtained until, in most cases, the proximal limit of the lesion was identified. All DDFTs were graded histopathologically using predefined criteria. The MR images were reviewed to determine the location and sequences in which increased signal intensity was seen.Results: No haemorrhage or inflammatory cell infiltration was seen in any horse. At level E1, septal thickening, ghosting of blood vessels and blood vessel occlusion were common in Group D, but were not seen in Group C. Less commonly, there was core necrosis, only seen in Group D. At level E2, septal and vascular changes were most obvious in Group D. Core necrosis, dorsal splitting, crevicing and fibrillation were seen only in Group D. Septal and vascular changes were present in both Groups C and D at level E3, but fibrocartilaginous metaplasia, splitting, crevicing and fibrillation, or core necrosis or fibroplasia were seen only in Group D. Core lesions in Group D often extended proximal to E1, and ranged in length from 0.5–13 cm. Core necrosis was generally associated with increased signal intensity in fat suppressed images.Conclusions: Lesions of the DDFT in the digit appear to be primarily degenerative, and may be a sequel to vascular compromise. Increased signal intensity on fat suppressed MR images is not necessarily associated with frank fluid or evidence of inflammation, but may reflect major matrix changes in the tendon.Potential relevance: Further information about the causes of these lesions is required to develop preventative strategies.
Distal limb cast sores in horses: Risk factors and early detection using thermography
Authors: Levet T. , Martens A. , Devisscher L. , Duchateau L. , Bogaert L. , Vlaminck L. 
Published: December 2008

SummaryReasons for performing study: There is a lack of evidence‐based data on the prevalence, outcome and risk factors of distal limb cast sores, and no objective tool has been described for the early detection of cast sores.Objectives: To investigate the prevalence, location, outcome and risk factors of cast sores after application of a distal limb cast and to determine whether static thermography of the cast is a valuable tool for the assessment of sores.Methods: A prospective study was conducted on horses treated with a distal limb cast. At each cast removal, cast sores were graded as superficial sores (SS), deep dermal sores (DS) or full thickness skin ulcerations (FS). In several cases, a thermographic evaluation of the cast was performed immediately prior to removal and differences in temperature (ΔT) between the coolest point of the cast and 2 cast regions predisposed for sore development (dorsoproximal mc/mtIII and palmar/plantar fetlock) were calculated.Results: Mean ± s.d. total casting time of 70 horses was 31 ± 18 days. Overall, 57 legs (81%) developed at least SS. Twenty‐four legs (34%) ultimately developed DS and one horse had an FS. Multivariable analysis showed that the severity of sores was positively associated with increasing age (OR: 1.111, P = 0.028), a normal (vs. swollen) limb (OR: 3.387, P = 0.023) and an increase in total casting time (OR per week: 1.363, P = 0.002). The thermographic evaluation (35 casts) revealed that the severity of sores was positively associated with increasing ΔT (OR: 2.100, P = 0.0005). The optimal cut‐off values for the presence of SS and DS were set at, respectively, ΔT = 2.3 and 4.3°C.Conclusion and potential relevance: Distal limb cast is a safe coaptation technique with increasing risk of developing sores with time. Thermography is a valuable and rapid clinical tool to monitor the development of cast sores.