bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Stockholm experience with ABO‐incompatible kidney transplantations without splenectomy
Authors: Tydén Gunnar , Kumlien Gunilla , Genberg Helena , Sandberg John , Sedigh Amir , Lundgren Torbjörn , Gjertsen Henrik , Fehrman Ingela 
Published: March 2006

Abstract: Background: ABO‐incompatible kidney transplantations have previously only been performed after several pre‐operative sessions of plasmapheresis followed by splenectomy, and with the conventional triple‐drug immunosuppressive protocol being reinforced with anti‐lymphocyte globulin and B‐cell‐specific drugs. We have designed a protocol without splenectomy, based on antigen‐specific immunoadsorption, rituximab and a conventional triple‐drug immunosuppressive protocol.Methods: The protocol called for a 1‐month pre‐transplantation conditioning period, starting with one dosage of rituximab and followed by full‐dose tacrolimus, mycophenolate mofetil and prednisolone. Antigen‐specific immunoadsorption was performed on pre‐transplantation days −6, −5, −2 and −1. After the last session, 0.5 g/kg of intravenous immunoglobulin (IVIG) was administered. Postoperatively, three more apheresis sessions were given every third day.Results: Twenty‐one patients have received transplants with this protocol. The ABO‐antibodies (Abs) were readily removed by the antigen‐specific immunoadsorption and were kept at a low level post‐transplantation by further adsorptions. There were no side effects, and all but one patient have normal renal transplant function.Conclusions: We conclude that after one infusion each of rituximab and IVIG, and antigen‐specific immunoadsorption, blood‐group incompatible renal transplantations can be performed with standard immunosuppression and without splenectomy, and with excellent short‐ and long‐term results.
First two ABO‐incompatible living renal transplantations using splenectomy, rituximab, plasmapheresis and IVIG as a preconditioning regimen: a single center experience in the Balkans
Authors: Ivanovski Ninoslav , Popov Zivko , Masin‐Spasovska Jelka , Dimcevska Anita Hristova , Kolevski Perko 
Published: March 2006

Abstract: Background: Due to the growing organ shortage in the Balkans and still underdeveloped cadaver transplantation, we started accepting living expanded criteria renal donors including elderly, marginal and unrelated donors (spouses, etc). The ABO‐incompatible renal transplantation was initiated last year. The first two successful cases are presented.Methods: A 40‐yr‐old mother (blood group A1B) and a 57‐yr‐old husband (blood group B) were considered as suitable donors for an 18‐yr‐old daughter (blood group B) and a 52‐yr‐old wife (blood group O). Both the recipients had a relatively long dialysis treatment before the surgery. The anti‐A1 and anti‐B titer of isoaglutinins was 1 : 64 in both the recipients before the procedure. A routine laparoscopic splenectomy was performed 40 and 45 days before the transplantation, without any complications. In the 10 days pre‐conditioning period, rituximab was administered in a single dose of 375 mg/m2. At the same time four to five plasmaphereses were performed to reduce the isoaglutinins to below 1 : 4. On the last night before the surgery intravenous immunoglobulin (IVIG) in a dose of 0.5 g/kg/bw was administered. Standard induction and maintenance therapy was introduced (Dacllizumab, CyA‐Neoral, MMF and steroids) according to the accepted policy in our transplant center. The routine plasmaphereses were performed in the first 2 weeks after transplantation to keep the isoaglutinins titer below 1 : 8.Results: Ten and 6 months after the surgery both recipients are doing well. Their graft function remains stable (actual serum creatinin 140 and 230 μm/L, respectively). In the 1 month protocol biopsy a subclinical cellular and mild vascular rejection occurred, and both recipients were treated by steroid pulse therapy. One to two additional plasmaphereses were performed. The regularly monitored anti‐A1 and anti‐B isoaglutinins titer was kept below 1 : 8 during a period of follow‐up.Conclusion: The first short‐term results fully justify the ABO‐incompatible living renal transplantation. The authors consider ABO‐incompatible transplantation as a safe and promising procedure which may, together with expanded criteria living donors, ameliorate the actual donor shortage in the region.
Application of the mixed venous blood concentration equation in desflurane anesthesia
Authors: Wu C. C. , Ho W. M. , Hung W. T. , Yang N. C. , Hwang K. L. , Wong K. C. 
Published: March 2006

Background:  We have previously proposed an equation derived from Fick's law and Lin's concept of effective blood concentration (EBC) to calculate the mixed venous blood concentration (MVBC) of isoflurane. Desflurane has a lower blood/air partition coefficient than isoflurane and, as such, promotes a faster induction and recovery from anesthesia. In this study, we investigated the application of the MVBC equation to predict the MVBC of desflurane.Methods:  We maintained anesthesia with a fixed inspired concentration (CI) of desflurane (10%) during cardiac anesthesia in 11 patients. In order to measure the real concentrations of desflurane in mixed venous blood, pulmonary arterial blood samples were collected at different time points via a Swan–Ganz catheter for gas chromatographic‐mass spectrometric determination. The relationship between the calculated concentrations and the actual blood sample concentrations of desflurane in mixed venous blood was investigated. Lin's EBC method was also used and the results were compared with those of MVBC.Results:  The calculations from our derived MVBC equation and the actual blood concentrations showed a similar kinetic pattern; the concentration levels were approximately the same and correlated well (r = 0.89) during anesthesia. However, the EBC method failed to accurately estimate the actual blood concentrations.Conclusions:  The results demonstrate that our equation, but not the EBC method, may be useful for estimating pulmonary blood concentrations of desflurane. The clinical significance and the importance of the method merit further investigation.
Chronic Eosinophilic Dermatitis in the Scrotal Area Associated with Stephanofilariasis Infestation of Charolais Bull in France
Authors: Watrelot‐Virieux D. , Pin D. 
Published: March 2006

SummaryA species of stephanofilaria is recorded as the cause of chronic eosinophilic dermatitis in the scrotal area of one charolais bull in France. Macroscopical and histopathological description of the lesion are given with a brief description of the parasite.
In vitro and in vivo Effects of Lufenuron on Dermatophytes Isolated from Cases of Canine and Feline Dermatophytoses*
Authors: Zur Gila , Elad Daniel 
Published: March 2006

SummaryLufenuron is a benzyl‐urea phenol compound that inhibits chitin synthesis and is used as an insecticide. Its efficacy in the therapy of dermatophytosis in dogs and cats was evaluated in several clinical studies, with contradictory results. We assessed the in vitro susceptibility of dermatophytes isolated from dogs and cats to lufenuron, and the clinical response of skin lesions to the drug. Dermatophyte cultures isolated from clinical cases were exposed to lufenuron by three different methods: direct application and application of whole blood or subcutaneous tissue samples obtained from a lufenuron‐treated healthy dog. No inhibition of dermatophyte growth was observed in any of the samples after 1 week of incubation. Eight dogs and six cats with skin lesions were included in the in vivo survey. Results indicated that six of seven skin lesions that were diagnosed as being caused by dermatophytes did not respond to lufenuron whereas six of seven skin lesions that were not caused by dermatophytes improved. We concluded that lufenuron, in the way it was administered in this study, had no inhibitory activity on dermatophytes in vitro or in vivo and its clinical use as an anti‐fungal agent is questionable. An immunomodulatory effect of the drug is, however, possible.
Clinical Evaluation of a Peptide‐ELISA based upon N‐terminal B‐cell Epitope of the VapA Protein for Diagnosis ofRhodococcus equiPneumonia in Foals
Authors: Phumoonna T. , Muscatello G. , Chicken C. , Gilkerson J. R. , Browning G. F. , Barton M. D. , Heuzenroeder M. W. 
Published: March 2006

SummaryA total of 227 field samples from naturally exposed foals aged between 3 weeks and 6 months were used in an evaluation of a peptide‐based enzyme‐linked immunosorbent assay (ELISA) for diagnosis ofRhodococcus equiinfection. A biotinylated peptide derived from the virulence‐associated protein A (VapA) ofR. equi, a horse pathogen, was synthesized and designated as PN11‐14. The peptide corresponds to the N‐terminal B‐cell epitope TSLNLQKDEPNGRASDTAGQ of the VapA protein. Based upon a serum immunoglobulin (Ig)G titre of 512 as a positive cut‐off value for theR. equiinfection, the ELISA provided the overall sensitivity of 47.62%, specificity of 69.67% and an accuracy of 59.47% with a positive predictive value of 57.47% for trueR. equipneumonia. The assay was improved by detecting VapA‐specific IgGb antibodies against N‐terminal B‐cell epitope of the VapA protein rather than IgG antibodies. The VapA‐IgGb ELISA showed the overall sensitivity of 70.47%, specificity of 72.13% and accuracy of 71.36% with a positive predictive value of 68.52%. Diagnosis ofR. equidisease in 6‐week‐old foals showed that the VapA‐IgGb ELISA provided an increasing trend (P = 0.0572) in sensitivity of 82.4% in comparison with the VapA‐IgG ELISA which showed the sensitivity of 58.8%. However, differences in specificity of both tests were statistically insignificant (P = 0.357) as analysed by the McNemar test. These results indicated that detection of VapA‐specific IgGb antibodies may be a better predictor ofR. equidisease in foals.
Echinococcus multilocularis in Austrian Foxes from 1991 until 2004
Authors: Duscher G. , Pleydell D. , Prosl H. , Joachim A. 
Published: March 2006

SummaryThe prevalence rates of Echinococcus multilocularis in foxes (n = 5600) evaluated in several Austrian surveys conducted between 1991 and 2004 were analysed for spatial and temporal differences. Data from early studies (1993–1997) in which the intestinal scraping technique (IST) was utilized were compared with data from recent (1999–2004) investigations, which made use of the shaking in a vessel technique (SVT), and it was assessed whether or not the infection rates of Austrian foxes had increased between the investigated intervals. In total, data from 85 districts are presented and both the retrospective and recent data are available from 39 of these districts. A Bayesian hierarchical model of parasite prevalences is presented which (i) accounts for differences in the sensitivity of IST and SVT, (ii) incorporates spatial auto‐correlation between neighbouring districts, (iii) investigates the possibility of a temporal shift in the infection status of foxes, and (iv) quantifies uncertainty at each level of the model. The national average prevalence rates in the mid‐1990s and at the turn of the millennium were 2.4% (95% confidence intervals 1.1–4.8) and 3.9% (95% confidence intervals 1.5–8.4) respectively. Above average prevalence rates were observed in the western and the northern parts of the country. Evidence is also presented for a temporal augmentation of the prevalence rates in some districts in the northern and eastern parts of the country. These findings are in concordance with several investigations in other European states where both newly emerged areas and elevated levels of transmission in existing endemic areas have been found. None of the districts investigated here showed significant evidence of a drop in prevalence.
Transgenic analysis of the medaka mesp‐b enhancer in somitogenesis
Authors: Terasaki Harumi , Murakami Ryohei , Yasuhiko Yukuto , Shin‐i Tadasu , Kohara Yuji , Saga Yumiko , Takeda Hiroyuki 
Published: March 2006

Somitogenesis is a critical step during the formation of metameric structures in vertebrates. Recent studies in mouse, chick, zebrafish and Xenopus have revealed that several factors, such as T‐box genes, Notch/Delta, Wnt, retinoic acid and FGF signaling, are involved in the specification of nascent somites. By interacting with these pathways, the Mesp2‐like bHLH transcription factors are transiently expressed in the anterior presomitic mesoderm and play a crucial role in somite formation. The regulatory mechanisms of Mesp2 and its related genes during somitogenesis have been studied in mouse and Xenopus. However, the precise mechanism that regulates the transcriptional activity of Mesp2 has yet to be determined. In our current report, we identify the essential enhancer element of medaka mesp‐b, an orthologue of mouse Mesp2, using transgenic techniques and embryo manipulation. Our results demonstrate that a region of approximately 2.8 kb, upstream of the mesp‐b gene, is responsible for both the initiation and anterior localization of mesp‐b transcription within a somite primordium. Furthermore, putative motifs for both T‐box transcription factors and Notch/Delta signaling are present in this enhancer region and are essential for activity.
Sweat testing for cystic fibrosis: A review of New Zealand laboratories
Authors: Mackay Richard , George Peter , Kirk Jean 
Published: March 2006

Background:  Evolving diagnostic criteria for cystic fibrosis, broadening of the populations being tested and the need to interpret intermediate sweat test results have imposed a much greater need to standardize the collection and analysis of sweat.Aim:  To identify variations in sweat testing in New Zealand laboratories and compare these with guidelines from the UK and the USA.Methods:  All laboratories in New Zealand offering sweat testing were identified and data collected from these laboratories by structured questionnaire.Results:  There were no New Zealand laboratories that conformed to either set of guidelines. Inconsistencies were observed in minimum sweat quantities, the nature of the iontophoresis solution, the sweat electrolytes analysed, quoted reference ranges and recommendations made as a consequence of the result.Conclusions:  Conformity to the guidelines would help to minimize variation in sweat testing in New Zealand. Performance of a sufficient number of tests to maintain expertise is critical, but geographical constraints make patient travel to distant centres difficult in a small, scattered population. A possible solution, where numbers permit, may be the collection of sweat locally, with referral to a major laboratory for analysis. This is only possible with adequate training in collection and follow‐up audit of the sweat testing procedure both in the collection and in the analytical phase.
Measles immunity and immunisation status in Australian children 1 to 4 years of age
Authors: Hogg Geoffry G , Darlington, Raelene J , Hogg Katharine G , Lester Rosemary 
Published: March 2006

Aim:  Determine measles seropositivity and vaccine coverage in children aged 1 to 4 years inclusive. Compare data in those who produced immunisation records and those who relied on parental recall. Establish variables associated with seropositivity.Methods:  Design: Population‐ and area‐based, cluster sample of 1‐ to 4‐year‐olds; households surveyed by trained interviewer. Setting: Australia‐wide, excluding New South Wales. Questionnaires completed between February and April 1995. Subjects: 2117 completed questionnaires were returned for children aged 1 to 4 years, 923 of whom provided a sufficient blood sample for analysis.Results:  Overall seropositivity was 86% for the 923 children tested and was strongly associated with previous immunisation (P < 0.001) and age (P < 0.001), but not with parental report of a previous measles diagnosis (P = 0.581). Eight hundred and forty‐three (91%) reported previous measles immunisation, with 760 (90%) of these testing seropositive. Four hundred and ninety‐one (55%) parents/guardians produced immunisation records, while 400 (45%) relied on recall. Immunised children whose parents relied on recall were equally likely to be seropositive as children whose parents produced records. The 923 children tested were representative of the 2117 who completed questionnaires in all factors except age, where children below 2 years old were under represented (P < 0.001).Conclusions:  These data support the current second routine measles immunisation prior to school entry, and reinforce the need to promote the first routine dose to achieve measles elimination.
Clinical course of hospitalised children infected with human metapneumovirus and respiratory syncytial virus
Authors: Morrow Brenda M , Hatherill Mark , Smuts Heidi EM , Yeats Jane , Pitcher Richard , Argent Andrew C 
Published: March 2006

Aim:  To describe the clinical presentation and outcomes of hospitalised patients infected with human metapneumovirus (hMPV) and human respiratory syncytial virus (hRSV) in a tertiary hospital in Cape Town, South Africa.Methods:  hMPV was identified in 17 respiratory specimens submitted for viral studies during the period 2001–2003. These patients’ medical folders were retrospectively reviewed for clinical, radiological and laboratory data, together with a convenience sample of 20 hRSV‐infected patients.Results:  hMPV‐infected patients were older than those infected with hRSV (P = 0.04) and required a longer hospital stay (P = 0.02). Presenting clinical signs and symptoms were similar between groups. Fourteen (87.5%) hMPV‐ and 16 (80%) hRSV‐infected patients presented with co‐morbid and/or immunosuppressive conditions (P ≥ 0.5). The most common abnormalities on chest radiographs in both groups were bronchial wall thickening, focal consolidation and atelectasis. Six (37.5%) hMPV‐ and 11 (55%) hRSV‐infected patients required admission to the paediatric intensive care unit (P > 0.1) with five (31.3%) hMPV‐ and eight (40%) hRSV‐infected patients requiring intubation and ventilation (P > 0.5). Three (18.7%) hMPV‐patients and three (15%) hRSV‐infected patients died during this admission (P > 0.5). All hMPV‐infected patients who died had significant co‐morbid conditions.Conclusions:  These data confirm that hMPV is a significant respiratory pathogen in this setting, with similar presentation and outcome to hRSV infection. This is the largest report of hMPV infection causing significant morbidity, prolonged hospital stay and death, associated with underlying risk factors.
Doses of systemic corticosteroids in hospitalised children with acute asthma: A systematic review
Authors: Zhang Linjie , Mendoza Raúl A 
Published: March 2006

Aim:  To present the doses of systemic corticosteroids reported by clinical trials in hospitalised children with acute asthma and to assess the possible relationship between doses of corticosteroids and clinical responses.Methods:  An electronic search of MEDLINE databases (January 1949–February 2005) and Cochrane Controlled Clinical Trials Register (February 2005) was undertaken using a combination of indexing terms related to systemic corticosteroids and acute asthma. Studies were selected if they met the following criteria: (i) randomized controlled trial; (ii) children aged 1–18 years and admitted to hospital for acute asthma; and (iii) treatment group consisting of systemic corticosteroids.Results:  Nine trials were included for this review. There was considerable variation between the reported doses of systemic corticosteroids. Only two trials assessed clinical responses to different doses of systemic corticosteroids. Both trials failed to show any therapeutic advantage of higher doses over lower doses. The results of the two trials were not suitable for pooling.Conclusions:  Current data are not sufficient for establishing dose–response relationship of systemic corticosteroids in hospitalised children with acute asthma. Larger randomized trials are needed.
Kawasaki disease in New Zealand
Authors: Heaton Paul , Wilson Nigel , Nicholson Ross , Doran John , Parsons Alan , Aiken Geoff 
Published: March 2006

Aim:  To determine the epidemiology, management and outcome of Kawasaki disease (KD) in New Zealand.Design:  Prospective audit using New Zealand Paediatric Surveillance Unit (NZPSU) Reports.Setting:  Single country 2‐year epidemiological study.Patients:  All patients diagnosed with KD in New Zealand reported to the NZPSU from January 2001 to December 2002.Main outcome measures:  Incidence of KD; time to diagnosis; use of intravenous immunoglobulin; cardiac features and outcome.Results:  Forty‐nine new cases were identified. The annual incidence was 8.0 cases/100 000 children aged less than 5 years. Age at onset was less than 5 years in 86% of cases. Incidence was 4.6/100 000 for children of European origin, 9.6 for Maori, 12.2 for Pacific Islanders and 32.2 for children of East Asian origin. KD was diagnosed at a median of 6 days from onset of illness. 89% had fever and four or more diagnostic features. All patients had at least one echocardiogram: There was one small (2%) coronary artery aneurysm only; 13 (26%) had mild coronary artery dilatation. Thirty‐five per cent did not have an echocardiogram performed four or more weeks from illness onset. 45 (92%) cases received intravenous immunoglobulin at median day six. There was one death due to occlusive coronary artery disease in a 3‐month‐old boy with atypical symptoms in whom KD was diagnosed at post‐mortem.Conclusions:  The incidence of KD in New Zealand is defined with significantly variable risk according to ethnicity. Most patients received appropriate rapid diagnosis and treatment but there was considerable variation in practice in regard to number and timing of echocardiograms. There was a low coronary artery aneurysm rate (2%). Accelerated vaso‐occlusive disease was responsible for the single fatality in an atypical case.
Antibiotic prescribing rates for acute otitis media in a paediatric emergency department
Authors: Steinmann Kai , Babl Franz E 
Published: March 2006

Objective:  To audit antibiotic prescribing rates for acute otitis media (AOM) at a tertiary paediatric emergency department (ED).Methods:  All children who presented to the ED in 2002 (during defined 4‐week periods in spring, summer, autumn and winter) and were given a diagnosis of AOM were eligible for analysis. Data were extracted retrospectively, providing information on demographics and antibiotic therapy.Results:  A total of 306 patients with AOM were available for analysis. Forty‐three children (14%) were <1 year, 69 (23%) 1–2 years, and 194 (63%) > 2 years of age. Sixty‐eight patients (22%) were receiving antibiotics prior to presentation to the ED, and antibiotics were prescribed for 206 (67%). Antibiotic prescribing was independent of patient age.Conclusions:  Despite ready access to clinical guidelines that recommend an expectant approach for children with AOM who are older than 1 or 2 years of age, antibiotic prescribing rates were high in the ED.