bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hepatic pathology in AIDS: a pathological study from Mumbai, India
Authors: Lanjewar DN , Rao RJ , Kulkarni SB , Hira SK 
Published: July 2004

ObjectivesTo assess the spectrum of hepatic disorders in AIDS, liver specimens from 171 patients (155 autopsies and 16 biopsies) were reviewed.MethodsA retrospective and prospective study of 171 autopsy and biopsy specimens was carried out at a tertiary level hospital in Mumbai, India.ResultsOf the patients included in the study, 127 (74%) were male and 44 (26%) were female. The heterosexual route was the predominant mode of HIV transmission, identified in 163 (95%) patients. A total of 99 of 171 patients (58%) showed significant pathological lesions, and the most common pathological processes involving the liver appeared to be secondary to infections. None of our patients showed isolated infectious diseases of the liver. The spectrum of liver diseases identified was as follows: tuberculosis in 70 patients (41%), cryptococcosis in eight (5%), cytomegalovirus infection in six (3%), hepatitis B infection in five (3%), candidiasis in one (0.5%), malaria in one (0.5%), cirrhosis in six (3%), amyloidosis in one (0.5%) and primary hepatic lymphoma in one (0.5%).ConclusionsAIDS patients were found to have a high prevalence of underlying hepatic abnormalities. The spectrum of disease among patients with AIDS in India differs from that in developed countries. Our results suggest that hepatic tuberculosis is more common in AIDS than previously recognized, and that liver specimens should be examined routinely for the presence of acid‐fast bacilli.
Efficacy, safety and predictive factors of virological success of a boosted amprenavir‐based salvage regimen in heavily antiretroviral‐experienced HIV‐1‐infected patients
Authors: Clevenbergh P , Boulmé R , Kirstetter M , Dellamonica P 
Published: July 2004

BackgroundAmprenavir (APV) has been shown to be effective in naive or treatment‐experienced HIV‐1 infected patients. However, the safety and efficacy of the APV 600 mg/ritonavir (RTV) 100 mg twice a day (bid) combination, the usually recommended dosage for boosted APV, have been less well studied. We assessed the predictive factors associated with virological success of APV/RTV‐based regimens.MethodsPatients in the PharmAdapt study receiving an APV/RTV‐containing regimen were included in the study. The predictivity of covariates on virological response at 4 months was analysed according to the data analysis plan. We processed logistic regression using bootstrapping to allow several covariates in the models.ResultsForty patients received an APV/RTV‐containing regimen, 38 of whom were male (95%). Risk factors were heterosexual contacts (four patients; 10%), homosexual contacts (31 patients; 78%), and intravenous drug use (four patients; 10%). Twenty‐seven per cent of patients were Centers for Disease Control and Prevention Classification System (CDC) stage A, 38% were stage B and 35% were stage C. The median baseline CD4 count was 313 cells/μL [interquartile range (IQR) 211, 414], and the median baseline viral load was 4.4 log10 HIV‐1 RNA copies/mL (IQR 3.7, 4.9). Patients were exposed to a median number of 7.5 (IQR 6, 9) drugs for a median number of 3.8 (IQR 3.3, 4.3) years. The baseline number of resistance mutations was 4 [IQR 3, 5 for nucleoside reverse transcriptase inhibitors (NRTIs), 1 (IQR 0, 2)] for non‐nucleoside reverse transcriptase inhibitors (NNRTIs) and 6 [IQR 5, 8 for protease inhibitors (PIs)]. At month 4, median viral load decreased to 1.2 log10 copies/mL (IQR 0.3, 1.6); 50% of patients had a viral load<200 copies/mL by intention‐to‐treat analysis. The number of APV resistance mutations was associated with viral load changes. Median APV concentration was 1750 ng/mL (IQR 1130, 2520). At month 4, using several cut‐offs, neither APV concentration nor the genotypic inhibitory quotient was predictive of viral load changes. Baseline viral load and the number of protease mutations were associated with outcome.ConclusionsEfficacious APV concentrations need to be determined for antiretroviral‐experienced patients. Baseline viral load and the number of mutations on the protease coding region (PRO) were associated with the virological outcome of APV/RTV‐based regimens.
Causes of death among patients with HIV in Singapore from 1985 to 2001: results from the Singapore HIV Observational Cohort Study (SHOCS)
Authors: Bellamy R , Sangeetha S , Paton NI 
Published: July 2004

ObjectivesTo investigate the major primary and contributory causes of death among HIV patients in Singapore.DesignA retrospective observational cohort study of all adult patients seen at the national referral centre for HIV in Singapore between 1985 and 2001.MethodsData were extracted from the patients' records by 10 trained health care workers. AIDS‐defining conditions were established using predefined criteria. For each case, a single principal cause of death and up to three contributory causes were identified.ResultsA total of 1504 patients aged 17 years or over were seen before the end of 2001, of whom 504 have died. The most frequent principal causes of death were Mycobacterium avium (17.5%), Mycobacterium tuberculosis (9.7%), pneumonia (cause unknown) (6.5%) and Cryptococcus neoformans (6.7%). Three hundred and eighteen patients (63.1%) died from an AIDS‐defining condition.ConclusionsThe causes of death were similar to those found in Western cohorts, except that disseminated M. avium was a more frequent cause of death.
Small Intestinal Volvulus in 115 Horses: 1988–2000
Authors: Stephen Jennifer O. , Corley Kevin T.T. , Johnston Janet K. , Pfeiffer Dirk 
Published: July 2004

Objective—To evaluate the historical data, signalment, clinical signs, results of laboratory analyses, treatment, and outcome of horses with small intestinal (SI) volvulus.Study Design—Retrospective study.Sample Population—One hundred and fifteen client‐owned horses, aged 1 month to 21 years.Methods—Clinical signs, laboratory data, surgical or necropsy findings, and outcome for horses with SI volvulus were obtained from medical records, identified by computer search and manual review.Results—There was no statistical difference in signalment between cases and the hospital population. Seventy‐four percent of horses were ≥3 years. There were considerable variations in clinical signs on admission; high heart rate and signs of severe pain were not consistent features. Examination per rectum identified distended small intestine in only 69% of horses. One hundred horses had surgery, and small intestine resection was performed in 25. Eighty‐four horses were recovered from surgery, and 67 horses survived to hospital discharge (80% of horses recovered from surgery, 58% of 115 horses). Forty‐eight percent that were ultimately discharged had a post‐operative complication and these horses had a longer average stay than horses with no complication (11 days versus 8.9 days).Conclusions—We identified 115 horses with primary SI volvulus over a 12‐year period. We found that the population of horses with this lesion was older than has previously been reported and that the prognosis for post‐operative survival to hospital discharge is good (80%). Post‐operative complications were common, and affected approximately half the horses that were ultimately discharged from the hospital.Clinical Relevance—This information may aid diagnosis and prognosis and guide decision making for horses with this condition.
Suboccipital Craniectomy, Dorsal Laminectomy of C1, Durotomy and Dural Graft Placement as a Treatment for Syringohydromyelia with Cerebellar Tonsil Herniation in Cavalier King Charles Spaniels
Authors: Vermeersch Katie , Van Ham Luc , Caemaert Jacques , Tshamala Mulenda , Taeymans Olivier , Bhatti Sofie , Polis Ingeborgh 
Published: July 2004

Objective— To evaluate retrospectively the efficacy of the suboccipital craniectomy and dorsal laminectomy of C1 with durotomy and placement of a dural graft for treatment of syringohydromyelia (SHM) because of cerebellar tonsil herniation in Cavalier King Charles spaniels (CKCS). This technique is used with great success in human medicine.Study Design— Four CKCS diagnosed by Magnetic resonance imaging (MRI) of SHM because of cerebellar tonsil herniation and not responsive to medical therapy underwent a suboccipital craniectomy and dorsal laminectomy of C1 (2 dogs) and of C1 and partial C2 (2 dogs) with durotomy and placement of a dural graft. Three dogs were evaluated neurologically 24 hours, 1 month, and 3 months postoperatively and evaluations were compared with preoperative neurological examination. Repeat MRI took place 3 months postoperatively.Results—Neurological examinations showed neither improvement nor progression of clinical signs 3 months postoperatively. MRI showed no regression of syrinx size 3 months postoperatively.Conclusion— Improvement was not seen. Given the progressive nature of the disorder, evaluation over a longer period of time is necessary to detect if progression has stopped. Some modification to the surgical technique is needed to accomplish the same results as in human medicine. A study of a larger population is needed to attain more reliable information.Clinical Relevance— Suboccipital craniectomy and dorsal laminectomy of C1 with durotomy and placement of a dural graft is a feasible technique in CKCS, but needs some modification to accomplish the same results as in human medicine.
Influence of Limb Positioning and Measurement Method on the Magnitude of the Tibial Plateau Angle
Authors: Reif Ullrich , Dejardin Loic M. , Probst Curtis W. , DeCamp Charlie E. , Flo Gretchen L. , Johnson Allen L. 
Published: July 2004

Objective— To evaluate the effect of limb positioning and measurement technique on the magnitude of the radiographically determined tibial plateau angle (R‐TPA).Study Design— In vitro study, R‐TPA was determined by 6 blinded observers and image measurement software.Animals— Five canine cadaver hind limbs.Methods— The legs were positioned on a custom‐made positioning device simulating a radiographic tabletop technique in lateral recumbency. True lateral positioning was defined by superimposition of femoral and tibial condyles on the radiographic projection. Radiographs were taken while the specimens were relocated in a proximal, distal, caudal, and cranial direction with respect to the radiographic beam. For each specimen, 25 different radiographic views were obtained and 6 blinded observers determined the radiographic TPA using 2 different methods. The conventional method used precise anatomic landmarks to determine the tibial plateau. To simulate osteoarthritic changes complicating identification of these landmarks, the tangential method estimated the tibial plateau as the tangent to the central portion of the tibial plateau. After periarticular soft tissue dissection the anatomic tibial plateau angle (A‐TPA) was determined. The A‐TPA and the R‐TPA were compared.Results— The R‐TPA significantly decreased as limb position with respect to the X‐ray beam changed from cranial proximal to caudal distal. The maximal mean radiographic R‐TPA difference was 3.6° with the first and 5.7° with the second method. Regardless of the method used there was no significant difference between A‐TPA and R‐TPA in the true lateral position. In the peripheral positions, however, significant differences between anatomic and radiographic TPA were seen.Conclusions— Limb positioning influenced the radiographic appearance of the tibial plateau and the magnitude of the measured TPA. Cranial and proximal positioning of the limb relative to the X‐ray beam leads to overestimation whereas caudal and distal positioning leads to underestimation of the TPA.Clinical Relevance— True lateral positioning of the tibia defined by superimposition of the femoral and tibial condyles should be used for accurate TPA determination before tibial plateau leveling osteotomy.
Quantification of Staphylococcus aureus Adhesion to Equine Bone Surfaces Passivated with Plasmalyte™ and Hyperimmune Plasma
Authors: Bauer Sandra M. , Santschi Elizabeth M. , Fialkowski James , Clayton Murray K. , Proctor Richard A. 
Published: July 2004

Objective— To quantify the adhesion of Staphylococcus aureus to 4 equine bone surfaces passivated in a balanced polyionic solution (Plasmalyte™) or hyperimmune equine plasma (Polymune plasma™).Study Design— In vitro comparative study.Sample Population— Third metacarpal bone (MC3) surface explants from 9 equine cadavers.Methods— Approximately 1 cm2 sections of periosteum were removed from MC3 and stapled to sterile stainless steel screens. Three bone surface explants were cut using a surgical saw to present 1 cm2 surfaces of subperiosteal bone, cut cortical bone, or endosteum. Duplicate explants of each surface were immersed for 1 hour in Plasmalyte™ or hyperimmune equine plasma. Each explant was then placed in a well of a 6‐well sterile tissue culture plate with the surface of interest exposed. Each surface was inoculated with approximately 100 colony‐forming units of S. aureus in 10 μL of Mueller Hinton broth and incubated for 6 hours at 37°C. After gentle rinsing to remove non‐adherent bacteria, samples were sonicated for 5 minutes at 60 kHz to loosen adhered bacteria. The number of adherent bacteria was determined by serial dilutions and incubation of the sonicate. Scanning electron microscopy (SEM) was performed on samples identically treated from an additional horse to confirm bacterial removal by sonication from all surfaces and support quantitative culture results.Results— Less S. aureus adhered to periosteum than to cortical bone, cut cortical bone, and endosteal surfaces, which were all similar. Exposure of all surfaces to hyperimmune plasma reduced S. aureus adherence compared with Plasmalyte™ exposure; SEM supported these conclusions.Conclusion— Less bacteria adhere to periosteum than other bone surfaces. Hyperimmune plasma reduces bacterial adhesion to all bone tissue surfaces.Clinical Relevance— Understanding the factors that affect bacterial adhesion to bone will facilitate development of improved intraoperative lavage solutions to reduce the morbidity and mortality associated with postoperative infection.
Parainguinal Laparocystotomy for Urolith Removal in Geldings
Authors: Beard Warren 
Published: July 2004

Objective—To describe parainguinal laparocystotomy for urolith removal and to report outcome.Study Design—Prospective clinical study.Animals—Ten geldings with uroliths.Methods—Signalment, number, size, type of uroliths, surgical technique, and complications were recorded. Long‐term follow‐up was obtained by telephone interviews with the client and/or examination by the referring veterinarian.Results—Cystic calculi, 3–9 cm in diameter, were removed by parainguinal laparocystotomy. Mean surgical time was 59 minutes (range, 40–100 minutes). With this approach, ligation of the pudendal or superficial epigastric vessels was not needed. Serous incisional drainage resolved without treatment in 3 horses and 2 horses developed moderate‐to‐severe incisional swelling. On long‐term follow‐up (mean, 52 months; range, 11–82 months) for 9 horses, owners reported no recurrence of clinical signs associated with cystic calculi.Conclusions—Parainguinal laparotomy represents a satisfactory alternative approach to the apex of the bladder for urolith removal.Clinical Relevance—Parainguinal laparocystotomy avoids the pudendal and superficial epigastric blood vessels that are encountered when performing median or paramedian laparocystotomy in geldings. This approach minimizes dead space by avoiding the reflection of the prepuce in paramedian or median approaches.
Arthroscopic Removal of Axial Osteochondral Fragments of the Proximoplantar Aspect of the Proximal Phalanx Using Electrocautery Probes in 23 Standardbred Racehorses
Authors: Simon Olivier , Laverty Sheila , Bouré Ludovic , Marcoux Marcel , O. Szöke Mihaly 
Published: July 2004

Objectives—To describe the outcome after arthroscopic electrosurgical excision of axial osteochondral (OC) fragments of the proximal plantar aspect of the 1st phalanx (P1) in horses.Study Design—Retrospective study.Population—Twenty‐three Standardbred racehorses.Methods—Medical records of Standardbred racehorses that had arthroscopic dissection of axial OC fragments of the proximal plantar aspect of P1 with electrocautery probes were reviewed. Horses were positioned in dorsal recumbency; a 1.5% glycine solution was used to maintain joint distension. The arthroscope portal was in the proximal plantar joint pouch and OC fragments were approached using either an ipsilateral or a contralateral triangulation technique. Dissection of the fibrous attachments was performed using loop and hook electrocautery probes. Follow‐up was obtained by telephone questionnaire of owners or trainers and examination of race summary records.Results—Thirty‐three axial OC fragments were removed from 28 metatarsophalangeal joints (left, 14; right, 14). No major operative or postoperative complications occurred. Seven of 8 (79%) of horses that raced before surgery raced after surgery. Thirty‐six percent (n=4) of horses that had not raced before surgery raced after surgery.Conclusion—Intra‐articular electrosurgery is a safe, easy alternative to conventional excision of axial OC fragments of the proximal plantar aspect of P1.Clinical Relevance—Arthroscopic excision using electrocautery probes is a valid alternate method for removal of axial OC fragments of the proximal plantar aspect of P1. In addition, the dorsal recumbency position facilitates removal of several fragments and multiple joint surgery.
Partial Esophagectomy with Single Layer Closure for Treatment of Esophageal Sarcomas in 6 Dogs
Authors: Ranen Eyal , Shamir Merav H. , Shahar Ron , Johnston Dudley E. 
Published: July 2004

Objective— To report partial esophagectomy (PE) as a treatment for esophageal sarcoma in dogs.Study Design— Retrospective study (2000–2002).Animals— Six dogs with caudal thoracic esophageal tumors.Methods— Medical records of 6 dogs that had surgical removal of esophageal tumors were reviewed. Signalment, medical history, physical examination results, complete blood count, surgical procedure, tumor classification, postoperative treatment, and complications were retrieved.Results— Esophageal masses were approached by thoracotomy and esophagotomy on the side opposite the mass, removed with 1 cm margins by full thickness excision, and the defects closed with a single layer of interrupted sutures. All dogs recovered rapidly without major complications. Tumors were fibrosarcoma (3 dogs), undifferentiated sarcoma (1), and osteosarcoma (2). Five dogs were administered doxorubicin chemotherapy after surgery. Good quality of life was observed postoperatively in 5 dogs until deterioration necessitated euthanasia; survival ranged from 2–16 months. The remaining dog was alive, 20 months after surgery.Conclusions— Partial esophagectomy and closure using 1 suture layer, was an effective, simple, and safe technique for removal of sarcomas of the distal thoracic esophagus.Clinical Relevance— Removal of esophageal masses by partial esophagectomy can be used reliably as a method of esophageal surgery.
Microvolt T‐Wave Alternans as Predictor of Electrophysiological Testing Results in Professional Competitive Athletes
Authors: Furlanello Francesco , Galanti Giorgio , Manetti Paolo , Capalbo Andrea , Pucci Nicola , Michelucci Antonio , Marangoni Daniele , Terrasi Francesco , Pettinati Giacinto , Cappato Riccardo 
Published: July 2004

Background: Several studies have confirmed the equivalence of the microvolt T‐wave alternans (mTWA) and the electrophysiology (EPS) tests in cardiac disease. No data are available in populations of competitive athletes with arrhythmias that might jeopardize the pursuit of their professional career. Methods: We prospectively studied 100 trained competitive athletes, including elite types (72/100), (mean age ± standard deviation: 26.1 ± 4.5 years). Forty‐eight of them were wholly normal (Group A, mean age: 24.5 ± 8.5 years) and 52 of them had severe arrhythmias (Group B, mean age: 28.2 ± 11.5 years) and were symptomatic in 85% of cases for prolonged palpitations and syncope, but lacked any overt structural heart disease at standardized cardiological screening.All athletes were evaluated with the microvolt T‐wave alternans exercise–stress test, using the Heart Wave System with Microvolt Sensors. Group B underwent EPS to evaluate inducibility to sustained ventricular tachycardia (VT) during programmed electrical stimulation. Results: In Group A, the mTWA outcome was determinate in 45 subjects (94%) and indeterminate in 3 (6%). No symptomatic event was reported in a follow‐up of 36.1 months. In Group B, the mTWA test was positive in 7 symptomatic subjects (15%), indeterminate in 3 (7%), and negative for the remaining 42 subjects (76%). Forty‐one of 42 negative mTWA subjects were also negative in the EPS test, without any syncope or sustained VT during 25.3 months of follow‐up. In the positive mTWA test subjects, 5 (72%) were positive for inducibility of rapid sustained monomorphic VT in EPS, 1 was positive for severe sustained atrial tachyarrhythmias, and 1 refused EPS. We were able to pronounce a correct diagnosis of lymphocytic myocarditis for only 1 mTWA and EPS‐positive subject. For the other 4 positive patients with arrhythmogenic micropathology, severe arrhythmic events were revealed in the follow‐up and aggressive hybrid treatment was necessary. Conclusion: Microvolt‐TWA study seems to be a useful, noninvasive, and feasible tool for evaluating arrhythmic risk in the athletic population. The mTWA test showed a high negative predictive value, using both EPS and the follow‐up observation for severe arrhythmic cardiac events as an endpoint. The positive predictive value was present in a limited number of cases that were, however, subjects with a high risk of sudden arrhythmic death.
Sildenafil Citrate Does Not Alter Ventricular Repolarization Properties: Novel Evidence from Dynamic QT Analysis
Authors: Kaya Dayimi , Guler Cem , Esen Ali Metin , Barutcu Irfan , Dincel Cetin 
Published: July 2004

Background: Sildenafil citrate may have direct cardiac electrophysiological effects, and is possibly responsible for some cardiac events. The aim of our study was to investigate the effects of sildenafil citrate on QT dynamicity properties with a new QT analysis program showing even small changes in ventricular repolarization. Methods: Twenty‐four‐hour Holter electrocardiographic recordings were used to obtain the data in the predrug phase (1‐hour rest position before drug administration), and in the postdrug phase (1‐hour rest position, which began 60 minutes after 50 mg oral sildenafil citrate administration). With the special QT analysis program (Verda, Reynolds Medical Ltd., UK); mean values of RR, QT, QTo (corrected QT), J (the exponent of correction formula) and S (QT/RR plots slope) parameters together with QT variability indexes (QTVI) were calculated for study phases. Results: Mean ± SEM values for RR and QT were higher in postdrug phase than in predrug phase (RR: 845 ± 42 ms vs 816 ± 46 ms, P < 0.05; QT: 371 ± 8 ms vs 361 ± 9 ms, P < 0.05). However, sildenafil did not induce any significant change in mean ± SEM values for QTo, J, and S in postdrug phase compared with predrug phase (408 ± 10 ms vs 406 ± 8 ms, 0.474 ± 0.030 vs 0.433 ± 0.025, 0221 ± 0.020 vs 0.198 ± 0.017, respectively; P > 0.05). QTVIs were also not different in each phase (predrug: −0.874 ± 0.071 vs postdrug: −0.997 ± 0.067, P = 0.109). Conclusions: Fifty milligrams sildenafil does not affect QT dynamicity properties. The cardiac events associated with sildenafil could not be explained with ventricular arrhythmias.