bluuebunny/crossref_metadata_2025_split huggingface dataset:
Headaches Associated with Rathke's Cleft Cyst
Authors: Nishioka Hiroshi , Haraoka Jo , Izawa Hitoshi , Ikeda Yukio 
Published: July 2006

Objective.—Headaches are common presentations in patients with Rathke's cleft cyst (RCC). This study was conducted to elucidate the characteristics and underlying mechanisms of the headache.Methods.—We retrospectively studied 46 patients with RCC, 33 of whom underwent surgical intervention.Results.—Headache, particularly frontal headache, was the most common symptom, occurring in 27 patients (58.7%). Eleven patients with sudden episodic headache mimicking that of pituitary apoplexy. Although the presence of headache did not correlate with cyst size, it was significantly more common in RCCs with: high‐ and iso intensity content on T1‐weighted MR image (P= .0363), mucous content within the cyst (P= .0023), and intense chronic inflammation at the cyst wall (P= .0276). Among 6 patients with histologically recognized intense inflammation, every patient had frontal headache (P= .0407), 5 patients had episodic headache (P= .0002), and 4 patients had associated hypopituitarism (P= .0073), none of which improved after surgical intervention. Headaches improved after surgery in 17 of 21 patients (81.0%).Conclusions.—Headache, particularly frontal episodic headache, is a common and characteristic manifestation in patients with RCC and may indicate intermittent inflammatory reactions caused by mucous content. Patients with episodic headache should undergo surgical treatment to prevent exacerbation of the inflammation that can result in irreversible endocrine dysfunction.
Utilization of platelet transfusions in the intensive care unit: indications, transfusion triggers, and platelet count responses
Authors: Arnold Donald M. , Crowther Mark A. , Cook Richard J. , Sigouin Christopher , Heddle Nancy M. , Molnar Laura , Cook Deborah J. 
Published: July 2006

BACKGROUND: A description of current platelet (PLT) transfusion practice in the intensive care unit (ICU) is needed.STUDY DESIGN AND METHODS: All thrombocytopenic patients (PLT count, <150 × 109/L) who received PLT transfusions were identified from a previous prospective study of consecutive medical‐surgical ICU patients; trauma, orthopedic, and cardiac surgery were exclusions. Risk factors for ineffective transfusions were examined.RESULTS: Of 261 ICU patients, 118 (45.2%) had thrombocytopenia and a PLT count nadir of less than 50 × 109 per L (n = 22), 50 to 99 × 109 per L (n = 37), and 100 to 149 × 109 per L (n = 59). Twenty‐seven (22.9%) patients received PLT transfusions (n = 76 transfusions) and 37 (31.4%) had major bleeding. PLT dose was approximately 3 to 4 × 1011 per L transfusion. Therapeutic (n = 24) and prophylactic (n = 52) PLT transfusion triggers were 51 × 109 per L (interquartile range [IQR], 26 to 68) and 41 × 109 per L (IQR, 20 to 57), respectively, as measured at a median of 4.5 hours (IQR, <1.6 to 6.9) before transfusion. A single PLT transfusion resulted in a median PLT increase of 14 × 109 per L (IQR, −2 to 30) measured at 5.2 hours (IQR, 1.8 to 8.8) after the transfusion; however, no PLT count increase was observed after 17 transfusions given to 13 (48.1%) patients. No risk factors for ineffective transfusions were identified.CONCLUSIONS: Among critically ill patients, most PLT transfusions were administered to prevent, rather than to treat, bleeding, with a transfusion trigger of 40 to 50 × 109 per L. Nearly half of ICU patients who received transfusions failed to mount a PLT count increase after a single transfusion. Prospective studies are needed to determine the effects of PLT transfusions on bleeding and predictors of ineffective transfusions in the ICU.
Mailing of a sickle cell disease educational packet increases blood donors within an African American community
Authors: Price Cynthia L. , Boyd Jessica H. , Watkins André R. , Fleming Fay , DeBaun Michael R. 
Published: July 2006

BACKGROUND: Low blood donor rates among African American persons are recognized; however, few strategies exist to increase these numbers.STUDY DESIGN AND METHODS: A 1‐year, prospective, ecologic study performed before and after an educational intervention designed to test the hypothesis that increased education about the importance of blood donation for children with sickle cell disease (SCD) would result in an increase in total blood donors among African American persons.RESULTS: Approximately 5000 videos were mailed to 50 percent of the households in a zip code where 98 percent of the residents are African American. In the first 6‐month interval after mailing the video packet, there was a 75 percent (217 vs. 124; p = 0.05) increase in the total number of presenting donors and a 64 percent (126 vs. 77; p = 0.02) increase in the total number of first‐time donors from the same 6‐month period in the previous year. During the second 6‐month interval, the total number of first‐time donors declined. No significant increase in donor activity was noted during the two 6‐month periods after the intervention in the surrounding zip codes.CONCLUSION: A mass mailing directed toward educating African American persons about the importance of blood donation for children with SCD may increase the number of total African American donors.
Phlebotomist interpersonal skill predicts a reduction in reactions among volunteer blood donors
Authors: Stewart Kendra Ray , France Christopher R. , Rader Aaron W. , Stewart Jesse C. 
Published: July 2006

BACKGROUND: Adverse reactions in response to blood donation negatively affect the likelihood of donor return. In this study, the interpersonal skill of phlebotomists was examined as a potential predictor of both donor reactions and returns for future donation.STUDY DESIGN AND METHODS: Participants were 82 phlebotomists who completed the Social Skills Inventory, a global measure of interpersonal skill. Scores on this measure were used to predict the likelihood of donor reaction (rated by phlebotomists) and return for future donation in two samples of volunteer blood donors associated with these phlebotomists. Use of two samples permitted examination of phlebotomist interpersonal skill as a predictor of donor reactions and returns both before and after the phlebotomists were aware of the interpersonal skills assessment.RESULTS: Results of multilevel logistic regression analyses demonstrated that a one‐standard‐deviation increase in Social Skills Inventory score was associated with a significant reduction in the likelihood of donor reaction in the first sample (odds ratio [OR], 0.86; 95% confidence interval [CI], 0.76‐0.96) and with a marginally significant reduction in the likelihood of donor reaction in the second sample (OR, 0.90; 95% CI, 0.79‐1.02). Social Skills Inventory scores were not related to returns for future donation in either sample.CONCLUSIONS: This study provides the first empirical evidence that phlebotomist interpersonal skill predicts the experience of reactions among volunteer blood donors. A focus on the interpersonal skill of phlebotomists may therefore provide an additional avenue for improving donors’ physical well‐being and satisfaction, thereby enhancing donor retention.
Platelet binding and phagocytosis by macrophages
Authors: Badlou Bahram A. , Wu Ya Ping , Smid W. Martin , Akkerman Jan‐Willem N. 
Published: July 2006

BACKGROUND: Earlier it was reported that metabolic arrest followed by incubation at 4°C reduces the platelet (PLT) storage defect. Here it is reported that this treatment also reduces binding and phagocytosis by macrophages.STUDY DESIGN AND METHODS: Phagocytosis of mepacrine‐labeled PLTs by macrophages changes the latter into bright fluorescent particles easily detected by fluorescence‐activated cell sorting.RESULTS: In combination with conventional binding analysis it was found that binding to phorbol 12‐myristate 13‐acetate–matured THP‐1 cells is primarily regulated by PLT P‐selectin expression and phagocytosis by combined phosphatidylserine (PS) exposure and glycoprotein (GP) Ibα clustering. It was found that trapping of PLT Ca2+ and raising cAMP reduces phagocytosis by lowering PS exposure. Chilling of PLTs leads to an increase in binding and PS‐ and GPIbα‐mediated phagocytosis. Prior depletion of PLT energy stores prevents this increase by preserving low Ca2+ concentration, PS exposure, and PS‐mediated phagocytosis.CONCLUSION: These data characterize the individual factors that control PLT binding and phagocytosis and might help to define conditions that improve the survival of stored PLTs after transfusion.
Novel monoclonal antibody‐based enzyme immunoassay for determining plasma levels of ADAMTS13 activity
Authors: Kato Seiji , Matsumoto Masanori , Matsuyama Tomomi , Isonishi Ayami , Hiura Hisahide , Fujimura Yoshihiro 
Published: July 2006

BACKGROUND: ADAMTS13 specifically cleaves unusually large von Willebrand factor (VWF) multimers, which induce platelet thrombi formation under high shear stress. ADAMTS13 activity is deficient in patients with thrombotic thrombocytopenic purpura (TTP). The determination of plasma levels of ADAMTS13 activity is a prerequisite for a differential diagnosis of thrombotic microangiopathies. Here, a unique and highly sensitive enzyme immunoassay (EIA) of ADAMTS13 activity is described.STUDY DESIGN AND METHODS: ADAMTS13 hydrolyzes the peptide bond between Y1605 and M1606 of VWF. In this assay, a recombinant fusion protein (GST‐VWF73‐His) is used as a substrate. A panel of mouse monoclonal antibodies (MoAbs) that specifically recognizes Y1605, which is the C‐terminal edge residue of the VWF‐A2 domain and is generated by the enzymatic cleavage, has been produced. These antibodies were prepared with a synthetic decapeptide, termed N‐10 (1596‐DREQAPNLVY‐1605), as the immunogen. Twenty‐six clones specific to N10 were obtained, and one anti‐N10 MoAb was used in this study.RESULTS: With horseradish peroxidase–conjugated anti‐N10 MoAb, a standard enzyme assay was established. This assay was highly sensitive, and the detection limit was 0.5 percent of the normal. Further, an inhibitor of ADAMTS13 was measured to a level of 0.1 Bethesda units per mL. ADAMTS13 activity was measured in 20 patients with Upshaw‐Schulman syndrome, a congenital TTP, and 61 acquired TTP patients. The activity measured by this assay and by the classic VWF multimer assay showed high correlation.CONCLUSION: A convenient and highly sensitive EIA for ADAMTS13 activity has been established. This assay can be introduced for routine laboratory work in transfusion medicine.
Breaking boundaries? Sexual consent in the jury room
Authors: Finch Emily , Munro Vanessa E 
Published: July 2006

By introducing legal tests centring upon concepts of freedom, capacity and reasonableness, the Sexual Offences Act 2003 reflects a deliberate legislative attempt both to provide a clearer structure for jury deliberation on sexual consent and to hold defendants to a higher level of accountability in relation to their belief in its existence. While these developments are well intentioned, it is argued that they may ultimately prove to be of limited effect. More specifically, it is suggested that there is an inherent complexity in the concepts of freedom, capacity and reasonableness, at least in the largely undefined form in which they have been introduced, such that the Act may, in practice, simply result in the proliferation of a new set of malleable legal tests and unpredictable legal outcomes.Drawing on a series of mock jury deliberations undertaken by the authors in which participants were asked, having observed a short rape trial reconstruction, to apply the tests set out in the Sexual Offences Act 2003 in order to reach a verdict, this paper examines the ways in which the concepts of freedom, capacity and reasonableness were interpreted. Bearing in mind the inevitable constraints of the mock jury methodology (in particular its verisimilitude to real juries), this paper suggests that there may, nonetheless, be some valuable lessons to be gleaned from these deliberations about the future application of the law in actual rape cases.
Rituximab maintenance improves clinical outcome of relapsed/resistant follicular non-Hodgkin lymphoma in patients both with and without rituximab during induction: results of a prospective randomized phase 3 intergroup trial
Authors: van Oers Marinus H. J. , Klasa Richard , Marcus Robert E. , Wolf Max , Kimby Eva , Gascoyne Randy D. , Jack Andrew , van't Veer Mars , Vranovsky Andrej , Holte Harald , van Glabbeke Martine , Teodorovic Ivana , Rozewicz Cynthia , Hagenbeek Anton 
Published: July 2006

AbstractWe evaluated the role of rituximab (R) both in remission induction and maintenance treatment of relapsed/resistant follicular lymphoma (FL). A total of 465 patients were randomized to induction with 6 cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) (every 3 weeks) or R-CHOP (R: 375 mg/m2 intravenously, day 1). Those in complete remission (CR) or partial remission (PR) were randomized to maintenance with R (375 mg/m2 intravenously once every 3 months for a maximum of 2 years) or observation. R-CHOP induction yielded an increased overall response rate (CHOP, 72.3%; R-CHOP, 85.1%; P < .001) and CR rate (CHOP, 15.6%; R-CHOP, 29.5%; P < .001). Median progression-free survival (PFS) from first randomization was 20.2 months after CHOP versus 33.1 months after R-CHOP (hazard ratio [HR], 0.65; P < .001). Rituximab maintenance yielded a median PFS from second randomization of 51.5 months versus 14.9 months with observation (HR, 0.40; P < .001). Improved PFS was found both after induction with CHOP (HR, 0.30; P < .001) and R-CHOP (HR, 0.54; P = .004). R maintenance also improved overall survival from second randomization: 85% at 3 years versus 77% with observation (HR, 0.52; P = .011). This is the first trial showing that in relapsed/resistant FL rituximab maintenance considerably improves PFS not only after CHOP but also after R-CHOP induction.
Randomized Phase II Trial of Letrozole and Letrozole Plus Low-Dose Metronomic Oral Cyclophosphamide As Primary Systemic Treatment in Elderly Breast Cancer Patients
Authors: Bottini Alberto , Generali Daniele , Brizzi Maria Pia , Fox Stephen B. , Bersiga Alessandra , Bonardi Simone , Allevi Giovanni , Aguggini Sergio , Bodini Giuliana , Milani Manuela , Dionisio Rossana , Bernardi Claudio , Montruccoli Arianna , Bruzzi Paolo , Harris Adrian L. , Dogliotti Luigi , Berruti Alfredo 
Published: July 2006

Purpose To investigate the activity of letrozole plus/minus oral metronomic cyclophophamide as primary systemic treatment (PST) in elderly breast cancer patients. Methods One hundred fourteen consecutive elderly women with T2-4 N0-1 and estrogen receptor–positive breast cancer were randomly assigned to primary letrozole therapy (2.5 mg daily for 6 months) or a combination of letrozole plus oral cyclophosphamide (50 mg/daily for 6 months) in an open-labeled, randomized phase II trial. Tumor response was assessed clinically, and tumor Ki67 index and vascular endothelial growth factor (VEGF) -A levels were measured before and after treatment. Results Overall response rate was 71.9% (95% CI, 60.0 to 83.8) in the 57 patients randomly assigned to receive primary letrozole and 87.7% (95% CI, 78.6 to 96.2) in the 57 patients randomly assigned to receive letrozole plus cyclophosphamide. The difference in activity between treatment arms was predominantly confined to patients with ductal histology. There was a significantly greater suppression of Ki67 and VEGF-A expression in the letrozole/cyclophosphamide-treated group than in the letrozole-treated group, leading to lower Ki67 and VEGF expression at post-treatment residual histology (P = .03 and P = .002, respectively). Conclusion Both letrozole and letrozole plus cyclophosphamide treatments appeared active as PST in elderly breast cancer patients. Metronomic scheduling of cyclophosphamide may have an antiangiogenetic effect and the combination of letrozole plus cyclophosphamide warrants testing in a randomized phase III trial.
Prospective Study of FGFR3 Mutations As a Prognostic Factor in Nonmuscle Invasive Urothelial Bladder Carcinomas
Authors: Hernández Silvia , López-Knowles Elena , Lloreta Josep , Kogevinas Manolis , Amorós Alex , Tardón Adonina , Carrato Alfredo , Serra Consol , Malats Núria , Real Francisco X. 
Published: July 2006

Purpose To determine the frequency and the prognostic value of fibroblast growth factor receptor 3 (FGFR3) mutations in patients with nonmuscle invasive bladder tumors according to tumor stage and grade. Patients and Methods Seven hundred seventy-two patients with newly diagnosed bladder tumors were recruited. Tumors were reviewed by expert pathologists. Patients were prospectively followed-up (median, 62.6 months for disease-free patients) through review of hospital records and telephone interviews. The sequence of exons 7 and 10 of FGFR3 was analyzed by polymerase chain reaction and direct sequencing. We assessed the association of mutations with stage and grade. The predictive value of mutations for recurrence, progression, and mortality were assessed using Kaplan-Meier and Cox multivariable models. Results Mutations were more common among low malignant potential neoplasms (LMPN; 77%) and TaG1/TaG2 tumors (61%/58%) than among TaG3 tumors (34%) and T1G3 tumors (17%). The S249C, Y375C, S248C, and G372C mutations accounted for 91.5% of all sequence changes. The A393E substitution was associated with LMPN (P < .001). The F386L polymorphism was more frequent among patients with low-grade tumors (odds ratio, 6.97; 95%CI, 1.40 to 47.06; P = .009). In the multivariable analysis of all superficial tumors, mutations were associated with increased risk of recurrence. However, in the stratified analyses only patients with TaG1 tumors had a significantly higher risk of recurrence (hazard ratio, 2.12; 95%CI, 1.28 to 3.53; P = .004). Conclusion The findings of this large study strongly support the notion that FGFR3 mutations characterize a subgroup of bladder cancers with good prognosis; patients with mutant TaG1 tumors have a higher risk of recurrence; and the F386L variant is selectively associated with low-grade tumors.
Health Status Measurements at Diagnosis As Predictors of Survival Among Adults With Brain Tumors
Authors: McCarter Helen , Furlong William , Whitton Anthony C. , Feeny David , DePauw Sonja , Willan Andrew R. , Barr Ronald D. 
Published: July 2006

PurposeThe intent of this study was to determine whether baseline measures of functional capacity and performance could be used to predict survival in adults following the diagnosis of brain tumors.Patients and MethodsComprehensive health status and health-related quality of life (HRQL) were measured using the Health Utilities Index (HUI; McMaster University, Hamilton, Canada) system by a self-assessment questionnaire in a survey of 100 consecutive patients. The Karnofsky Performance Score (KPS) and Folstein's Mini-Mental State Examination (MMSE) scores were measured by a physician blinded to the HUI results. The patients were observed for up to 5 years to recorded dates of death.ResultsAn HUI questionnaire was completed for 93% of the patients and 69% died within 5 years of assessment. The HUI revealed a burden of morbidity and complexity of disability that far exceeded that reported for the general population. KPS and MMSE correlated strongly with each other (r = 0.52; P < .001). A decrease of 0.1 units in HUI Mark 2 (HUI2) self-care single-attribute utility score was associated with an increased hazard of death of 30% (P = .023) for patients with low-grade tumors (n=25). For patients with high-grade tumors (n=56), a 10 unit decrease in the KPS, a 5 unit decrease in MMSE, and a 0.1 decrease in HUI Mark 3 (HUI3) speech and dexterity single-attribute scores were associated with an increased hazard of death of 20% (P = .022), 26% (P = .015), 36% (P = .021), and 18% (P = .035), respectively.ConclusionScores derived from the measurement of HRQL following diagnosis can predict survival in adults with brain tumors.
Phase III Trial Comparing 4-Day Chronomodulated Therapy Versus 2-Day Conventional Delivery of Fluorouracil, Leucovorin, and Oxaliplatin As First-Line Chemotherapy of Metastatic Colorectal Cancer: The European Organisation for Research and Treatment of Cancer Chronotherapy Group
Authors: Giacchetti Sylvie , Bjarnason Georg , Garufi Carlo , Genet Dominique , Iacobelli Stefano , Tampellini Marco , Smaaland Rune , Focan Christian , Coudert Bruno , Humblet Yves , Canon Jean Luc , Adenis Antoine , Re Giovanni Lo , Carvalho Carlos , Schueller Johannes , Anciaux Nicole , Lentz Marie-Ange , Baron Benoît , Gorlia Thierry , Lévi Francis 
Published: July 2006

Purpose In two previous randomized trials, the adjustment of chemotherapy delivery to circadian rhythms improved tolerability and anticancer activity compared with constant-rate infusion during 5 days in patients with metastatic colorectal cancer. Patients and Methods For this multicenter randomized trial, it was hypothesized that a chronomodulated infusion of fluorouracil, leucovorin, and oxaliplatin for 4 days (chronoFLO4) would improve survival by 10% compared with conventional 2-day delivery of the same drugs (FOLFOX2). Patients were treated every 2 weeks with intrapatient dose escalation. Results Baseline characteristics were similar in both arms for the 564 patients (36 institutions, 10 countries). Median survival was 19.6 months (95% confidence limit [CL] = 18.2, 21.2) with chronoFLO4 and 18.7 months with FOLFOX2 (95% CL = 17.7, 21.0; P = .55). The main dose-limiting toxicities were diarrhea for chronoFLO4 and neutropenia for FOLFOX2. The analysis of survival predictors showed that sex was the single most important factor (P = .001). In women, the risk of an earlier death with chronoFLO4 was increased by 38% compared with FOLFOX2, with median survival times of 16.3 and 19.1 months (P = .03), respectively. In men, the risk of death was decreased by 25% with chronoFLO4 compared with FOLFOX2, with median survival times of 21.4 and 18.3 months (P = .02), respectively. Conclusion Both regimens achieved similar median survival times more than 18 months with an acceptable toxicity. The chronomodulated schedule produced a survival advantage over FOLFOX in men. The strong sex dependency of optimal scheduling of fluorouracil, leucovorin, and oxaliplatin calls for translational investigations of determinants related to the patient's molecular clock.
Preparation and Thermal Evolution of Sol–Gel Derived Zirconia and Ceria–Zirconia Precursors
Authors: Settu T , Gobinathan R 
Published: July 2006

Abstract
Precursor powders of pure and 10 mol% ceria doped zirconia have been prepared by physical gelation of zirconium(IV) dichloride oxide, cerium nitrate, and oxalic acid using triple distilled water as solvent at room temperature (ca. 27 °C). Both the zirconium(IV) and doped zirconium(IV) oxalate oxide gels are transparent and are dried at 40 °C. The thermal evolution and crystallization behaviors of the amorphous gels have been investigated by TGA, DTA, and X-ray diffraction analysis. On calcination at 850 °C, zirconia precursor transformed to a monoclinic phase whereas only tetragonal phase has been observed for doped zirconia precursor. Estimation of the surface area and IR characterization have also been carried out for the prepared dried powders.