bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasma exchange for preeclampsia: III. Immediate peripartal utilization for selected patients with hellp syndrome
Authors: Martin James N. , Perry Kenneth G. , Roberts William E. , Files Joe C. , Norman Patricia F. , Morrison John C. , Blake Pamela G. 
Published: February 2007

AbstractOBJECTIVE: To explore the potential efficacy of plasma exchange as an ancillary interventive therapeutic tool immediately before or after delivery in the patient with severe preeclampsia/eclampsia and hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. STUDY DESIGN: Two gravidas with complicated severe preeclampsia/eclampsia/HELLP syndrome were treated emergently in the immediate peripartal period with single‐volume plasma exchange and fresh frozen plasma fluid replacement using the IBM 2997 Cell Separator. RESULTS: Despite multiple platelet unit infusions, one primigravida in active labor at 5 cm cervical dilatation and 39 weeks' gestation remained at a platelet count of 14,000/μL and began to ooze from her gums. A second primigravida remained obtunded, oliguric, and thrombocytopenic with epistaxis and hematuria following cesarean delivery and platelet transfusions. A single expedited 3‐liter plasma exchange procedure reversed the rapidly deteriorating clinical situation for each patient and accelerated recovery from HELLP syndrome. Both patients and progeny suffered no permanent sequelae. CONCLUSION: Based on our experience, we believe that the therapeutic modality of plasma exchange with fresh frozen plasma can be employed effectively for the pregnant patient with severe atypical HELLP syndrome that progressively worsens during labor or the early puerperium despite the use of conventional transfusion therapy.
Preoperative autologous donation: Surgery clinic staff knowledge/attitudes
Authors: Randels M. J. , Ferguson K. , Strauss R. G. , Daniels M. , Stehling L. , Toy P. 
Published: February 2007

AbstractPreoperative autologous blood donation (PABD) is both under‐ and overused. Although the decision to order PABD lies with the surgeon, it is quite likely that other surgery clinic personnel influence patient acceptance and enrollment into PABD programs. Accordingly, we measured knowledge, attitudes, and the referral practice of clinic personnel pertaining to PABD. We administered a questionnaire to 102 nurses and 33 clerks working in surgery clinics at three university medical centers‐one center in an area with a high incidence of AIDS and two centers in areas of low incidence of AIDS. Knowledge of PABD was poor when assessed by six questions. Only 6% each of nurses and clerks answered all questions correctly; 55% of nurses and 54% clerks missed three or more of the six questions. Surprisingly, no differences (P > .05) in knowledge deficits were noted when personnel from high and low AIDS areas were compared‐indicating an overall need for education about PABD. In general, attitudes about PABD were positive, as most respondents (63%) gave favorable answers. Clinic personnel from the high AIDS area had even more favorable attitudes (P = .02). Because of these favorable attitudes, it seems likely that educational programs dealing with PABD would be readily accepted by clinic personnel. Greater knowledge should enhance the effectiveness of clinic staff in identifying, counseling, and referring eligible patients for this service.
Sequential transplants using mobilized peripheral blood progenitor cells
Authors: Ghalie Richard , Richman Carol M. , Bender James G. , McLeod Bruce C. , Lee Wanda , Czyzewski Ann , Manson Sharon , Cobleigh Melody A. , Reed Susan , Pierre Ron , George Selma , Kaizer Herbert 
Published: February 2007

AbstractModest success has been achieved with the use of high‐dose cytotoxic therapy and bone marrow transplantation in solid tumors. Patient outcome can potentially be improved with further intensification of the therapy. The rapid hematologic recovery achieved with mobilized peripheral blood progenitor cells (PBPC) may reduce the toxicity of transplantation enabling the use of sequential courses of myeloablative therapy. We report on 42 patients with solid tumors enrolled in a tandem transplant protocol involving the use of PBPC mobilized with cyclophosphamide (4 g/m2), etoposide (1 g/m2), and granulocyte‐colony‐stimulating factor (G‐CSF: 10 μg/kg/day). This regimen significantly increased the number of circulating progenitor cells; only 1‐2 aphereses were sufficient to collect 2.5 × 108/kg mononuclear cells, our goal for each transplant course. The median number of circulating colony‐forming units (CFU) and CD34+ cells obtained for each transplant course were 70.3 × 104/kg and 11.7 × 106/kg, respectively. There was a significant correlation between the numbers of CD34+ cells and CFU measured in the apheresis product (r = 0.49, P = .003). The first transplant regimen given to 38 patients consisted of thiotepa, carboplatin, and cyclophosphamide. The second transplant regimen given to 29 patients consisted of busulfan and etoposide. Hematologic recovery was comparable after each of the two transplant courses. The median time to neutrophil recovery over 0.5 × 109/L and to platelet transfusion independence was 9 and 8 days, respectively. There was no difference in engraftment rates after transplant with PBPC only (n = 28 courses) compared to transplant with PBPC plus bone marrow (n = 39 courses). There was a significant correlation between hematologic recovery after transplant and the number of CD34+ cells present in the PBPC. In conclusion, 1) PBPC are significantly mobilized with this combination chemotherapy and G‐CSF, 2) mobilized PBPC result in rapid engraftment after myeloablative therapy, 3) hematologic recovery rates are comparable after sequential PBPC transplants, 4) PBPC alone are sufficient for long‐term engraftment, and 5) rapid engraftment after PBPC transplant enables the use of a second course of myeloablative therapy within a short interval of time.
Plasmapheresis combined with interferon: An effective therapy for multiple sclerosis
Authors: Medenica Rajko D. , Mukerjee Sonjoy , Alonso Kenneth , Lazovic Gavrilo , Huschart Teresa 
Published: February 2007

AbstractThe rationale for the use of interferon (IFN) in the treatment of multiple sclerosis (MS) is based on its recognized antiviral and immunomodulating actions. The pathogenesis of MS is believed to be due to an immunologic response in a genetically predisposed individual, localized within the central nervous system white matter, and triggered by exposure to an environmental agent such as a virus. Based on our personal experience we find that the efficacy of IFN therapy is hampered in MS patients by the presence of an interferon inhibitor factor (IIF) in the patients' sera which we have isolated and characterized. When plasmapheresis (PP) was done on 24 MS patients with intermittent 3‐day administration of IFN‐a and human leukocyte IFN, marked increase of IFN in 18 patients and modest increase in three patients correlated with clinical improvement. Three clinical nonresponders showed no increase in IFN levels following therapy. The ability to remove IIF and lymphokine inhibitor factor (LIF) by PP may explain the successful treatment of our patients. We describe the evaluation of helper T cells, suppressor T cells, HLADR antigen, natural killer cells, and monocyte/macrophage cell populations by flow cytometry before and after PP. A significant increase in these immune‐competent cells correlated with marked improvement in Kurtzke disability status scale in 13 patients, while eight stabilized. Patients showing progression of the disease either showed decrease or no change in these parameters after therapy. Encouraging results from this pilot study suggest that PP combined with immunomodulatory regimens of IFN may be an effective therapy for MS.
Plasma separation for artificial liver support
Authors: Lepage Elaine B. , Lane Robert , McKay Dan , Rozga Jacek , Demetriou Achilles A. 
Published: February 2007

AbstractA bioartificial liver (BAL) support system, using plasma separation, has been developed to support acute liver failure patients. This study examined 14 consecutive BAL treatments in nine patients with severe acute liver failure. We report methods to achieve and manage plasma separation for an extended period of time. The mean duration of a BAL treatment was 435 minutes, with 26–59 liters of blood processed. Ionized hypocalcemia resulting in muscle twitching was a side effect of the therapy. Ionized calcium levels decreased significantly (P lt; .02) after BAL treatment; however, total calcium levels increased (P lt; .05). No significant changes were noted in heart rate, electrocardiogram [Q—T (Q—Tc) interval], blood pressure, prothrombin time, partial thromboplastin time, hematocrit, platelet count and serum phosphorous, magnesium, glucose, and pH. Plasma fibrinogen levels decreased significantly (P lt; .002). Ionized hypocalcemia due to the chelating effect of sodium citrate was controlled by calcium chloride administration, adjustment of blood separation rates, and reduction of the blood‐to‐citrate ratio. This report demonstrates that intensive, large‐volume plasma separation for long periods of time can be achieved safely in critically ill patients without serious adverse effects.
Clinical perspectives of platelet transfusions: Defining the optimal dose
Authors: Strauss Ronald G. 
Published: February 2007

AbstractTo halt bleeding in patients with severe thrombocytopenia due to bone marrow failure, it is desirable to achieve a post‐transfusion blood platelet count of 40 × 109/L by platelet transfusions. Based on calculations of corrected count increments, each 1 × 1011 platelets transfused will increase the blood platelet count approximately 10 × 109/L per each square meter of patient body surface area. Thus, the post‐transfusion blood platelet count will be approximately 20 × 109/L following transfusion of 3 × 1011 platelets to a 5 foot, 8 inch patient weighing 170 pounds (2.0 m2), who is bleeding because of a pre‐transfusion platelet count of 5 × 109/L. The post‐transfusion platelet count likely will be even lower in sick patients (sepsis, amphotericin B plus antibiotic therapy, splenomegaly, graft‐vs.‐host disease, etc.) or if platelets are lost from the unit by leukofiltration before transfusion. Although a dose of 3 × 1011 platelets is acceptable, in a regulatory sense for product quality, it is inadequate to control bleeding in most thrombocytopenic adult patients. Adjusting dose for body size, bleeding patients with pre‐transfusion blood platelet of <10 × 109/L and weighing >120 pounds should receive approximately 6 × 1011 platelets, those weighing 30 to 120 pounds should receive 3 × 1011 platelets, and infants weighing <30 pounds (15 kg) should receive 5–10 ml/kg of platelet concentrate.
Blood center perspective: Defining the ideal platelet concentrate
Authors: Axelrod Frederick B. , Ooley Patrick W. 
Published: February 2007

AbstractDuring the past two decades, an increased demand for platelets has challenged blood collection centers to produce a safe and readily available supply. Defining the ideal platelet for transfusion is a process that cannot be decided by a single entity. Collection centers are only one member of a partnership which involves the donor, transfusion service, hospital administration, clinicians, and patients. Regulatory definitions exist to help guide collection centers to the minimum acceptable criteria for the production of platelets, but in reality, the standard by which clinicians judge the efficacy of the product is most important.
T‐cell responses in photoimmune therapy
Authors: Heald Peter W. , Kim Hong Yong , Perez Maritza , Edelson Richard L. , Berger Carole L. 
Published: February 2007

AbstractThe extracorporeal inactivation of a lymphocyte rich buffy coat suspension with ultraviolet A light and 8 methoxypsoralen can lead to dramatic clinical improvements following reinfusion of the damaged cells. This therapy is reviewed in the context of the disease it is most commonly used for: cutaneous lymphoma. Studies with cutaneous lymphoma patients have shown an active immune response against purified tumor cells. In addition a mouse model for an impact of therapy on a T‐cell lymphoma has demonstrated results that parallel those from clinical studies in humans. The impact of photoimmune therapy on in vivo and in vitro T‐cell responses to cutaneous lymphoma is discussed.
Influence of type of exchange fluid on survival in therapeutic apheresis for thrombotic thrombocytopenic purpura
Authors: Owens Michael R. , Sweeney Joseph D. , Tahhan Raymond H. , Fortkolt Peter 
Published: February 2007

AbstractThrombotic thrombocytopenic purpura (TTP) is a potentially lethal disease that may respond favorably to plasma infusion or therapeutic plasma exchange (TPE) with frozen plasma (FP) as the exchange fluid. Frozen plasma from which the cryo‐precipitated fraction has been removed (cryopoor plasma, CP) has reportedly been useful in refractory cases in which a response to FP is not being observed. We report a retrospective analysis of all cases of TTP treated by TPE with either FP (1985–1989) or CP (1989–1993) as exchange fluid at a large tertiary care hospital between the years 1985 and 1993. A severity score index was compiled for each patient using the platelet count, mental status, hematocrit, and renal function at the time of diagnosis. Nineteen patients were treated with FP (group I) and 18 patients with CP (group 2). Groups did not differ in age, gender, race, hematologic parameters, or severity scores. Patients treated with CP, however, had more plasma exchanges (14 ± 10 vs. 12 ± 8, respectively) and more fluid exchanged than these treated with FP (50 L ± 36 vs. 37 L ± 40, respectively). Survival was 72% in the CP group and 47% in the FP group.Although a survival advantage for the use of CP as exchange fluid in the treatment of TTP is suggested by our observations, the retrospective nature of the study, lack of randomization, and sequential rather than concurrent use of FP and CP indicates caution in interpretation. The data do indicate, however, that use of CP is acceptable as the initial exchange fluid in TTP.
Physician coverage of therapeutic apheresis
Authors: Woll Judith E. 
Published: February 2007

AbstractA “snapshot” survey of physician coverage for evaluation and supervision of therapeutic apheresis procedures shows significant variation in current clinical practice between 39 blood center‐ and 41 non‐blood center‐based programs. Whereas 56% of blood center‐based programs usually require physician's “in person” evaluation of the patient, 86% of non‐blood center programs do (P< .005). Similarly, non‐blood center‐based programs were more likely to have physicians on the premises to supervise first and subsequent procedures and to bill separately for medical coverage. These differences were unrelated to location of the procedure (in hospital, blood bank, outpatient department, or other), the size of the program, or any information provided on adverse reactions.
Efficacy and safety of plateletpheresis by donors with low‐normal platelet counts
Authors: Rogers R. L. , Johnson H. , Ludwig G. , Winegarden D. , Randels M. J. , Strauss R. G. 
Published: February 2007

AbstractOur practice is to defer donors with blood platelet (PLT) counts of <180 × 109/L because PLT yields are low, when compared to PLT units collected from donors with higher counts. In an attempt to minimize deferral, we determined whether 33 donors, who repeatedly demonstrated low‐normal PLT counts (150–180 × 109/L) on multiple occasions during the prestudy period, might safely donate satisfactory apheresis PLT units simply by extending the apheresis collection time by 20 min (men) and 40 min (women). Repeat plateletpheresis procedures were scheduled at ≥28‐day intervals. The mean PLT yield (N = 92) was 5.8 × 1011 with 97% of units containing ≥4.0 × 109 PLTs. Although donors entered the study only after they had repeatedly exhibited predonation PLT counts of <180 × 109/L, PLT counts were not always below this level at the time of study collections. However, analyzing only donations with true predonation PLT counts of <180 × 109/L (N = 35), the mean PLT yield was excellent—5.4 × 1011 with 97% of units containing ≥4.0 × 1011 PLTs. The average fall in donor blood PLT counts (pre‐ vs. postdonation) was 36%, with only ten of 99 postdonation counts being <100 × 109/L; the lowest was 69 × 109/L. Thus, extending the apheresis collection time permitted donors who in the past were routinely deferred because of low PLT counts to safely donate satisfactory PLT units.
Timescales and Phenomenology of Mechanically Stimulated Glasses: a Review
Authors: D'Amore Alberto , Grassia Luigi , Acierno Domenico 
Published: February 2007

AbstractThe principal features of the volumetric as well as the viscoelastic response of mechanically stimulated glasses can be summarized as follows: i) the time‐aging time shift factors contract upon increasing the probe stress (i.e. the stress apparently modifies the volume recovery kinetics), ii) the volume recovery baseline remains unaltered (i.e. the underlying structure of the stimulated glass remains unchanged) iii) yielding scales linearly with the logarithmic of the strain rate. Here we present a review of the above features with aid of a series of numerically simulated results concerning the responses of glassy polycarbonate. Simulations are obtained coupling a modified KAHR equation with the constitutive law for linear viscoelasticity within the domain of the reduced time. It will be shown that by using a minimum of experimental (PVT and linear viscoelastic) data inputs even the subtle intricacies can be predicted. Furthermore a new class of results concerning the stress‐strain behaviour of glassy polymers is presented that never appeared before.
Preparation and Properties of Nanostructured Rubber Composites with Montmorillonite
Authors: Cataldo Franco 
Published: February 2007

AbstractMontmorillonite exfoliated nanoclay was prepared by treating montmorillonite with an alkyalmmonium salt. It has been characterized by FT‐IR spectroscopy and thermal analysis (TGA‐DTA). The nanoclay composites, in which the rubber matrix was introduced by mixing solutions of the elastomer with the organically modified clay was then compounded with carbon black filler at 2.5, 5, 10, 15 phr loading level of nanoclay. The sulfur cured rubber samples were tested against a reference compound not filled with the nanoclay. Rheometrical and scorch measurements have shown that the nanoclay increases the curing speed and reduces the scorch safety. A very high reinforcement and stiffening effect due to the nanoclay was observed especially at 5 and 10 phr nanoclay filling level and especially at low extension modulus which can be increased up to 40% its original level than in the reference compound. An anisotropic behavior has been recorded in the stress‐strain curve: for instance the 50% modulus was found >20% higher when measured parallel to the alignment of the exfoliated nanoclay lamellae in comparison to the modulus perpendicular to the lamellae orientation. The compounds with nanoclay show no adverse effects in tensile strength and in tear resistance, in De Mattia crack initiation and in abrasion resistance. Nanoclay reduces also the hysteresis and heat build up of the rubber compounds.
Effect of Morphology on the Relaxation Processes and Mechanical Properties in Polyimide/Silica Hybrids
Authors: Ragosta Giuseppe , Musto Pellegrino , Abbate Mario , Russo Pietro , Scarinzi Gennaro 
Published: February 2007

AbstractPolyimide/silica hybrids were produced by a sol‐gel process and were examined in terms of their morphology, dynamic‐mechanical properties and mechanical performances. Two types of morphology were obtained by tailoring the composition of the precursor solution mixture, i.e. phase‐ separated or co‐continuous systems. These morphologies were found to exhibit considerably different properties. In particular, co‐continuous nanocomposite systems were found much more effective in suppressing molecular relaxation processes than micron sized particulate hybrids. The latter systems, on the other hand, exhibited enhanced ductility and fracture toughness
Innovative Poly(Butylene Terephthalate) Based Nanocomposites: a Preliminary Investigation
Authors: Acierno D. , Amendola E. , Callegaro G. , Napolitano G. 
Published: February 2007

AbstractA polymer‐clay nanocomposite based on Poly(butyleneterephthalate) (PBT) and an innovative organoclay has been synthesized via intercalation of Bis(hydroxyethyl terephthalate) (BHET) in Na‐Montmorillonite layers. Chemical and physical properties of this nanocomposite have been studied in comparison to other PBT/nanocomposites based on two commercial organoclay: Cloisite 25A and Somasif MEE. Nanocomposites have been prepared via melt compounding using a twin‐screw extruder, with extrusion rate of 150 rpm. Samples were characterized by using wide‐angle X‐ray diffraction, TEM, thermal and mechanical analysis.
Characterization of hdpe/ha Composites Treated with Titanate and Zirconate Coupling Agents
Authors: Carmen Albano , Rosestela Perera , Arquímedes Karam , Gema González , Nohemy Domínguez , Yanixia Sánchez , Luís Brito Juaquín 
Published: February 2007

AbstractThe development of new materials for bone substitution has been of great interest for the scientific community in the last years. High‐density polyethylene (HDPE) and hydroxyapatite (HA) composites have been used in biomedical applications without any inflammatory response. However, the differences in nature of both materials have motivated the use of coupling agents to improve their interfacial interactions. In this work, the effects of adding three different commercial coupling agents (NZ12, Lica01, Lica12) to high‐density polyethylene (HDPE)/hydroxyapatite (HA) composites were studied. Composites containing 20 parts per hundred (phr) of HA previously treated with the already mentioned coupling agents were characterized by mechanical tests and their morphologies were analyzed afterwards. Composites with 0.3 and 0.5 wt% of NZ12 unfolded an increase in their Young's modulus and tensile strength, as a consequence of an improved dispersion of the filler into the polymeric matrix. Analysis of the samples by XPS showed that the zirconate coupling agent interacted more with the HA, as reflected in the lower binding energies of the corresponding oxygen atoms, which agrees with their better performance from the mechanical point of view.
Influence of Electrical, Chemical and Morphological Properties of Inorganic/Organic Interface on Light Emitting Devices Performance
Authors: Vacca Paolo , Petrosino Mario , Chierchia Rosa , Guerra Alfredo , Minarini Carla , Rubino Alfredo 
Published: February 2007

Abstractstudies on the influence of chemical and physical treatments on the properties of indium–tin oxide (ITO) thin films are reported. The ITO films are utilized as transparent anodes of organic light‐emitting diodes (OLEDs) incorporating poly(9,9‐dihexyl‐9H‐fluorene‐2,7‐diyl) (PF6) as the hole transporter material and 8‐hydroxyquinoline aluminum salt (Alq3) as emitter material. Chemical (HCl, piranha solutions), thermal (vacuum annealing), physical treatments (oxygen plasma, UV ozone) and combined treatments are studied. First, ITO layers with different treatments are characterized by using four point probe method, contact angle measurement, X‐Ray diffraction (XRD), surface profilometer, scanning electron microscopy (SEM), UV‐Vis‐IR transmittance. Later, electrical and optical properties of OLEDs with treated ITO as anode are extensively investigated.