bluuebunny/crossref_metadata_2025_split huggingface dataset:
C3 and C4 hypocomplementemia and associated diseases in Arabians
Authors: KOSHAK Emad A. 
Published: November 2005

AbstractBackground:  Hypocomplementemia, which is a state of decrease in the complement (C) proteins in the serum, is frequently encountered in a wide range of diseases.Objective:  To explore the diversity of C3 and C4 hypocomplementemia and associated diseases in patients seen at King Abdulaziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia.Methods:  Serum samples send to the clinical immunology laboratory with requests for the measurements of C3 and C4 tests by nephelometry were studied. Files of patients with C3 and/or C4 hypocomplementemia were reviewed for demographic and diagnostic data.Results:  Out of 270 complement tests, C3 and/or C4 hypocomplementemia was found in 196 different tests (72.6%), and only 175 tests were studied. Their ages ranged between 1 week and 81 years (mean 26 ± 17 SD), and female sex was predominant in 143 tests (81.3%). Hypocomplementemia was detected as follows: C3 in 64 tests (23.7%) with sole C3 in 3 tests only (1.5%); C4 in 193 samples (71.5%) with sole C4 in 132 tests (67.3%); and combined C3 with C4 hypocomplementemia in 61 tests (22.6%). Cross‐tabulation revealed that 95% of C3 hypocomplementemia were significantly associated with C4 hypocomplementemia (P < 0.001). Conversely, only 31% of C4 hypocomplementemia were significantly associated with C3 hypocomplementemia (P < 0.001). SLE was the predominant disease associated with hypocomplementemia in 104 tests (53.1%), followed by kidney diseases in 20 tests (10.2%) and chronic liver disease in eight tests (4.1%).Conclusion:  C4 hypocomplementemia was a common laboratory verdict in patients at KAUH. Of interest, most of C3 hypocomplementemia tests were associated with C4 hypocomplementemia and lone C3 hypocomplementemia is rare. The diagnosis of systemic lupus erythematosus was the predominant disease associated with hypocomplementemia. Supplementary awareness of immunopathological mechanisms leading to involvement of complement proteins in many diseases is essential to enhance its clinical utility.
Etiopathogenic role of HLA‐B27 alleles in ankylosing spondylitis
Authors: AKKOC Nurullah , KHAN Muhammad Asim 
Published: November 2005

AbstractHLA‐B27 is the major genetic susceptibility factor for ankylosing spondylitis (AS). However, its precise role in the pathogenesis of AS still remains unclear, even though its gene has been cloned and sequenced, and its crystallographic structure has been defined. Arthritogenic peptide and molecular mimicry hypotheses propose mechanisms related to an antigen‐presenting function of HLA‐B27 to be responsible for disease development. However, peculiar aspects of its immunobiology, such as its misfolding and heavy chain dimerization raise the possibility of involvement of pathogenic mechanisms unrelated to its physiological function. Moreover, HLA‐B27 is not a single allele, but a family of 31 different alleles, named HLA‐B*2701 to HLA‐B*2727. Studies worldwide indicate that the relatively common alleles (subtypes) HLA‐B*2705, B*2704, and B*2702 are strongly associated with AS, whereas HLA‐B*2706 which is prevalent in South‐east Asia and HLA‐B*2709 which is prevalent on the Italian island of Sardinia, seem to lack such an association. The distinction between the disease‐associated subtypes and those that are not associated, may provide clues to the actual role of HLA‐B27 in disease pathogenesis. B*2706 differs from B*2704 by only two residues, and B*2709 differs from B*2705 by only one residue. Moreover, both B*2706 and B*2709 bind an endogenous peptide (derived from vasoactive intestinal peptide type 1 receptor) and also an exogenous peptide (latent membrane protein 2 of Epstein‐Barr virus) but in two drastically diverse conformations. These recent X‐ray diffraction studies of individual peptides in the context of different HLA‐B27 alleles broaden our perception of the possible pathogenetic role of this molecule in the development of AS and related spondyloarthopathies. In summary, the pathogenetic role of HLA‐B27 in AS seem to be quite heterogenous, and cannot be explained by a single mechanism, and new ideas have been raised based on the aberrant immunobiologic features of HLA‐B27.
Can survival of systemic lupus erythematosus be further improved?
Authors: MOK C. C. 
Published: November 2005

AbstractThe survival rate with systemic lupus erythematosus (SLE) has improved tremendously in the past few decades, especially in developed countries. However, late mortality is still a great concern. Roughly, one out of six to seven patients is still at risk of death 10 years after SLE diagnosis. Early diagnosis and treatment of SLE and its related complications, and the judicious use of immunosuppression is the key to improving early mortality rates in this disease. To reduce late mortality, minimizing organ damage and prevention of SLE‐ or therapy‐related complications such as thromboembolism, osteoporotic fractures and premature menopause, is essential. This article discusses the various means that may help to further improve the outcome of SLE.
The differences between manifestations of rheumatoid arthritis in men and women
Authors: SOROOSH Soosan G. , SOROOSH Mohsen G. , DASTJERDI Farhad M. , FARAHVASH Mohammad H. , NADERI Alireza , VAHEDI Homayoon 
Published: November 2005

AbstractBackground:  Rheumatoid arthritis (RA) is a chronic, multisystemic disease of unknown aetiology. The main feature of RA is a symmetric, additive inflammatory arthritis of small peripheral joints. The disease is more common in women. There is some evidence about the role of sex in pathogenesis and clinical features of RA.Aim:  The aim of this study is the recognition of the aspects of RA in female and male patients.Method:  This study includes the RA patients referred to the RA Research Clinic of Imam Hospital, Tehran, Iran, between 1998 and 1999 of which 160 were selected. One hundred and twenty‐two were female and 38 male, showing a female to male ratio of 3 : 1.Results:  The mean age at the time of diagnosis of RA was 37 and 43 years in women and men respectively. The mean duration of disease before diagnosis was 8.8 years in women and 5.8 years in men. The indices of pain, limitation of movement and swelling of joints were higher in women, but only for the pain indices was the difference between the two sexes stastistically significant. No statistically significant difference in joint deformity was found between the two sexes but erosive joint lesions were more common in women. Involvement of the small joints of the upper limbs was more prevalent in women but hip and cervical spine involvement was more frequent in men. Considering extra‐articular involvement, rheumatoid nodules, pulmonary and cardiac involvement and vasculitis was more prevalent in men but only for cardiac involvement was a statistically significant difference between the two sexes found. Rheumatoid factor was positive in 60% of both sexes. There was no statistically significant differences in lab tests and treatment strategy between the two sexes.Conclusion:  RA has a more severe course and worse prognosis in women; however, extra‐articular involvement is more frequent in men.
Mortality in rheumatoid arthritis: time to take it seriously
Authors: ARSHAD Anwar , SHAHID Mohammed Shahdan 
Published: November 2005

AbstractRheumatoid arthritis (RA) is often regarded as benign and not a serious disease. Yet patients with RA have a substantially reduced life expectancy. Patients with RA are particularly at risk of death from cardiovascular disease, infection and renal disease. A few variables are now recognized as important predictive markers, such as disease duration, severity, sex, educational level and treatment.
Cognitive, Extrapyramidal, and Magnetic Resonance Imaging Predictors of Functional Impairment in Nondemented Older Community Dwellers: The Sydney Older Person Study
Authors: Bennett Hayley P. , Piguet Olivier , Grayson David A. , Creasey Helen , Waite Louise M. , Lye Tanya , Corbett Alastair J. , Hayes Michael , Broe G. Anthony , Halliday Glenda M. 
Published: November 2005

Objectives: To identify the clinical correlates of functional incapacity in the community living “old‐old.”Design: Cross‐sectional.Setting: Community‐based.Participants: One hundred six nondemented people aged 80 to 94.Measurements: Participants were medically and cognitively assessed, underwent magnetic resonance imaging scanning (MRI), and were interviewed regarding their functional status: activities of daily living (ADLs), instrumental ADLs (IADLs), and the complex IADL functions of reading, hobbies, and socializing.Results: Dependency in IADLs, but not ADLs, was present. After controlling for age, sex, and education, extrapyramidal (EP) signs were significantly associated with two of the three IADLs, with EP signs comprising a composite score of 10 EP signs (e.g., resting tremor) and a 5‐meter timed walk. Cognitive test performance on a range of tests was also associated with functional status. A hierarchical model confirmed the association between the EP signs and cognitive test performance and functional scores, but no “pattern” of cognitive association emerged. Hippocampal volume was associated with socializing.Conclusion: This study has shown that many nondemented very old people living in the community are losing capacity to perform IADL functions and that areas of incapacity are associated with the presence of EP signs and impaired cognition. These results highlight the need for health workers to include an assessment of EP and cognitive status in their evaluation of older persons living in the community, even in the context of a lack of dementia diagnosis. Furthermore, it signifies the need to directly evaluate IADL function to identify need for intervention and support if required. This group of old‐old individuals may now be considered the “survivors” of their cohort, and early detection of the difficulties they are experiencing will enable clinicians to respond appropriately, thus providing them a higher quality of life for their years to come.
Glycated Hemoglobin Levels and Intellectual Activity in an Aged Population
Authors: Amano Hidenori , Watanabe Shuichiro , Kumagai Shu , Yukawa Harumi , Suzuki Takao , Shibata Hiroshi 
Published: November 2005

Objectives: To examine the association between glycated hemoglobin (GHb) and aspects of daily activities in an elderly population.Design: Cross‐sectional population‐based survey.Setting: Nangai village, an agricultural community with a population of about 5,000 located in Akita prefecture in the north of Japan.Participants: Nine hundred thirty‐five people aged 65 and older.Measurements: GHb percentages, self‐reported measures of activities of daily living (ADLs) and instrumental activities of daily living (IADLs), intellectual activity (IA), and social role (SR).Results: An exploratory analysis indicated that nondiabetic subjects in the lowest tertile of GHb tend to have lower IA than those in the middle tertile, if they were aged 70 and older. No consistent association appeared between GHb and ADLs, IADLs, or SR. Linear and logistic regression analyses, controlling for other risk factors, indicated significantly lower IA scores in the low and high GHb tertiles (P<.001 and P=.04, respectively) than in the middle in nondiabetic subjects aged 70 and older and without stroke history or IADL impairments. The value of GHb related to the maximal IA score was 5.0% to 5.2% as the middle tertile; or 5.2%, assuming a logistic regression model including a squared term with GHb as a continuous variable. A similar relationship was observed in the whole nondiabetic sample aged 70 and older but not in the younger counterpart.Conclusion: There is an inverted U‐shaped relationship between GHb and intellectual activity in older people without diabetes mellitus. One possible interpretation is that suboptimal blood glucose could contribute to intellectual inactivity in older people.
Five percent albumin for adult burn shock resuscitation: lack of effect on daily multiple organ dysfunction score
Authors: Cooper Andrew B. , Cohn Stephen M. , Zhang Haibo S. , Hanna Kim , Stewart Thomas E. , Slutsky Arthur S. ,   the ALBUR Investigators
Published: November 2005

BACKGROUND:  The effect of 5 percent human albumin on multiple organ dysfunction was investigated during the first 14 days of treatment to determine whether albumin resuscitation might benefit adult burn patients.STUDY DESIGN AND METHODS:  Multicenter unblinded controlled trial with stratified block (two patients per block) randomization by center and mortality prediction at enrollment (high‐risk stratum [predicted mortality, 50%‐90%] and low‐risk stratum [predicted mortality, <50%]). The primary outcome was the worst multiple organ dysfunction score (MODS), excluding the cardiovascular component, to Day 14. Eligible adults (>15 years) suffering from thermal injury not more than 12 hours before enrollment received fluid resuscitation with Ringer's lactate (n = 23) or 5 percent human albumin plus Ringer's lactate (n = 19) by protocol to achieve recommended (American Burn Association) resuscitation endpoints.RESULTS:  Forty‐two patients were randomly assigned. There were no significant differences (median [95% confidence intervals]) in age (36 [24‐45] vs. 31 [25‐39] years), burn size (39 [32‐53] vs. 32 [26‐34] total body surface area percentage), inhalation injury (n = 12/19 vs. n = 11/23), or baseline MODS (3 [1‐5] vs. 1.5 [0‐2]) between the treatment and control groups. In an intention‐to‐treat analysis, there was no significant difference between the treatment and control group in the lowest MODS from Day 0 to Day 14 (analysis of covariance, p = 0.73).CONCLUSION:  Treatment with 5 percent albumin from Day 0 to Day 14 does not decrease the burden of MODS in adult burn patients.
Platelet dose consistency and its effect on the number of platelet transfusions for support of thrombocytopenia: an analysis of the SPRINT trial of platelets photochemically treated with amotosalen HCl and ultraviolet A light
Authors: Murphy Scott , Snyder Edward , Cable Ritchard , Slichter Sherrill J. , Strauss Ronald G. , McCullough Jeffrey , Lin Jin‐Sying , Corash Laurence , Conlan Maureen G. ,   the SPRINT Study Group
Published: November 2005

BACKGROUND:  The SPRINT trial examined efficacy and safety of photochemically treated (PCT) platelets (PLTs). PCT PLTs were equivalent to untreated (control) PLTs for prevention of bleeding. Transfused PLT dose and corrected count increments (CIs), however, were lower and transfusion intervals were shorter for PCT PLTs, resulting in more PCT than control transfusions. PLT dose was analyzed to determine the impact of the number of PLTs transfused on transfusion requirements.STUDY DESIGN AND METHODS:  Transfusion response was compared for patients with all doses of ≥3.0 × 1011 and the complementary subset of patients with any dose of fewer than 3.0 × 1011. Analyses included comparison of bleeding, number of PLT and red blood cell (RBC) transfusions, transfusion intervals, and CIs between PCT and control groups within each PLT dose subset.RESULTS:  Mean PLT dose per transfusion in the PCT group was lower than in the control group (3.7 × 1011 vs. 4.0 × 1011; p < 0.001). More PCT patients received PLT doses of fewer than 3.0 × 1011 (n = 190) than control patients (n = 118; p < 0.01). Comparisons of patients receiving comparable PLT doses showed no significant differences between PCT and control groups for bleeding or number of PLT or RBC transfusions; however, transfusion intervals and CIs were significantly better for the control group.CONCLUSIONS:  When patients were supported with comparable doses of PCT or conventional PLTs, the mean number of PLT transfusions was similar. Lower CIs and shorter transfusion intervals for PCT PLTs suggest that some PLT injury may occur during PCT. This injury does not result in a detectable increase in bleeding, however.
Buffering and dilution in red blood cell storage
Authors: Hess J.R. , Rugg N. , Joines A.D. , Gormas J.F. , Pratt P.G. , Silberstein E.B. , Greenwalt T.J. 
Published: November 2005

BACKGROUND:  Red blood cell (RBC) storage solutions work in a narrow pH range between 7.2 and 6.4. While keeping RBC within that pH range, ATP production can be increased by buffering or dilution.STUDY DESIGN AND METHODS:  In the first study, 12 units of packed CP2D RBCs were pooled in groups of four, realiquoted, and added to one of four additive solutions (ASs): AS‐3, 110 mL; EAS‐61, 170 mL; EAS‐78, 170 mL; or EAS‐81, 110 mL. EAS‐78 and ‐81 contain bicarbonate. Units were sampled approximately weekly for 10 weeks for biochemical measures. In the second study, 12 volunteers donated RBCs for measures of 51Cr in vivo recovery after 6 or 8 weeks of storage in EAS‐81.RESULTS:  RBCs stored in the higher‐volume or buffered ASs had higher RBC ATP concentrations. The combination had an additive effect. Hemolysis was reduced in dilute ASs and less so with buffering. RBCs stored for 8 weeks (n = 6) in EAS‐81 exhibited 87 ± 2 percent 24‐hour 51Cr in vivo recovery and 0.4 ± 0.2 percent hemolysis.CONCLUSIONS:  It is possible to store RBCs for 8 weeks in buffered conventional volume ASs. Combining buffering and increased AS volume improves stored RBC characteristics further.
The median whole‐blood donation time in the best‐case scenario: findings at one blood center
Authors: Newman B.H. , Patel B.R. 
Published: November 2005

BACKGROUND:  Whole‐blood donation times in a donor population when there are no impediments to blood donation at any point can be used to determine the shortest median whole‐blood donation time. This statistic is relevant to blood donors and collection staff.STUDY DESIGN AND METHODS:  Small, overstaffed blood drives in August 2004 were evaluated via operation records and supervisor interviews to determine if there were any impediments to whole‐blood donation at any point in the process. Four‐hundred ninety‐two whole‐blood donations from 33 blood drives were not impeded and were evaluated for whole‐blood donation times. Registration records (entry time) and blood donor records (phlebotomy start and end time) provided three objective time points for the process, the median postphlebotomy interval at the phlebotomy station was estimated, and 10 minutes was assigned for the refreshment period.RESULTS:  The median donation time for the whole‐blood donation process was 50 minutes. The 25 to 75 percent range was 46 to 56 minutes, and the 10 to 90 percent range was 42 to 64 minutes. First‐time blood donors had blood donation times that were 5 to 6 minutes longer than in repeat blood donors (55.5 min vs. 50 min), and women had slightly longer donation times than men (51 min vs. 49 min). Five percent of the donors had donation times that exceeded 69 minutes.CONCLUSION:  The median whole‐blood donation time and range under the best circumstances was defined based on the process in place in our blood center in August 2004.
The Impact of Catecholamines on Defibrillation Threshold in Patients with Implanted Cardioverter Defibrillators
Authors: KALUS JAMES S. , WHITE C. MICHAEL , CARON MICHAEL F. , GUERTIN DANETTE , MCBRIDE BRIAN F. , KLUGER JEFFREY 
Published: November 2005

Objectives: To determine the effect of physiologic catecholamine concentrations on the defibrillation threshold (DFT) in patients with implanted cardioverter defibrillators.
Background: DFT is the minimum energy delivered by an implanted cardioverter defibrillator that successfully converts ventricular fibrillation. DFT testing is performed under conscious sedation. Since activities of daily living enhance sympathetic tone substantially over these nadir levels, it is important to explore the impact of catecholamines on DFT.
Methods: In this double‐blind study, we determined DFT by the step‐down method. Patients (n = 50) were stratified by beta‐blocker use and then randomized to a 7‐minute infusion of epinephrine, norepinephrine, or placebo. After study infusion, DFT testing was repeated. Changes in DFT with different study medications were compared. Subgroup analyses of the effects of catecholamines on DFT, based on beta‐blocker use, were also performed.
Results: Norepinephrine reduced DFT from baseline measurements by 22.6% (P = 0.008). Neither epinephrine nor placebo impacted DFT (P = 0.999, P = 0.317, respectively). In the subgroup analyses, DFT was reduced with norepinephrine regardless of beta‐blocker use, while epinephrine reduced DFT among those receiving beta‐blockers. No change in DFT was observed in either of the placebo subgroups.
Conclusions: Elevation of plasma norepinephrine concentrations reduces the DFT, while elevations in epinephrine had no effect. Norepinephrine seems to reduce DFT regardless of beta‐blocker therapy but epinephrine's effects are beta‐blocker dependent.
Biochemical Evidence of Cardiac Damage Following Transvenous Implantation of a Permanent Antibradycardia Pacemaker Lead
Authors: NIKOLAOU NIKOLAOS I. , SPANODIMOS STAVROS G. , TSAGLIS ELIAS P. , ANTONATOS DIONYSIOS G. , PATSILINAKOS SOTIRIS P. , FOURNARAKIS GEORGIOS M. , TSIGAS DIMITRIOS L. 
Published: November 2005

Objectives: We tested the hypothesis that transvenous permanent pacemaker lead implantation causes clinically detectable myocardial damage.
Background: Histological evidence of myocardial damage has been reported after antibradycardia pacemaker lead implantation.
Methods: We studied 30 patients undergoing implantation of a full antibradycardia pacemaker system (pulse generator plus leads) and 10 patients in whom only a generator was implanted. Blood samples for cardiac troponin‐I (CTNI), CK‐MB mass, and myoglobin measurement were drawn at baseline, at the end of the procedure, and at 2, 6, 12, 24, 48, and 72 hours thereafter.
Results: Abnormal CTNI levels were noted only in 24 of the 30 patients undergoing a full system implantation. CTNI levels were already abnormal at the end of the procedure in 16 and became so in all 24 during the next 6 hours. Peak levels were reached within 6 hours in 21 patients and were compatible with “minimal” necrosis (CTNI < 1.5 pg/mL) in 20. Maximum ventricular lead diameter and number of implanted leads were independent predictors of peak CTNI levels. CK‐MB mass also increased after the procedure, but exceeded the normal range in only 10 patients. Myoglobin levels increased significantly both in patients undergoing a complete system implantation and in those where only a pulse generator was implanted.
Conclusions: Transvenous insertion of endocardial leads for permanent pacing is accompanied in most patients by “minimal” myocardial damage. In this setting CTNI level kinetics are fast, characterized by early elevation and peak.