bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased Withdrawal Volume per Deposit for Pre‐Operative Autologous Blood Donation in Adolescents
Authors: Erb T. , Möller R. , Christen P. , Signer E. , Frei F.J. 
Published: December 2004

Abstract
Objectives:
This study was undertaken to assess the feasibility, tolerance, haemodynamic and haematologic effects of an aggressive phlebotomy schedule for autologous blood donation (ABD) in adolescents undergoing major orthopaedic surgery. Methods: Twenty adolescents were studied prospectively; 10 patients in group A donated 20% of the circulating blood volume on 2 occasions, whereas 10 patients in group B donated 10% on 4 occasions. Results: The amount of blood donated, subjective tolerance, cardiovascular changes during the procedure and pre‐operative haemoglobin level did not differ between the study groups (group A 111±16 vs. group B 106±10 g/l). The increase in erythropoietin was greater and occurred sooner in group A than in group B. Conclusion: In adolescents ABD is feasible with a reduced number of appointments as they demonstrate tolerance to phlebotomies with a volume which is double the standard per deposit.
Evaluation of virus and prion reduction in a new intravenous immunoglobulin manufacturing process
Authors: Trejo S. R. , Hotta J. A. , Lebing W. , Stenland C. , Storms R. E. , Lee D. C. , Li H. , Petteway S. , Remington K. M. 
Published: December 2004

Background and Objectives Minimizing the transmission risk of infectious diseases is of primary importance in the manufacture of products derived from human plasma. A novel chromatography‐based intravenous immunoglobulin (IGIV) manufacturing process was developed and the reduction of virus and transmissible spongiform encephalopathies (TSE) during the manufacturing process was assessed. Mechanistically distinct steps that could affect virus reduction were identified, and the robustness of virus reduction over the range of process conditions was determined.Materials and Methods Virus and TSE reduction by processing steps were assessed using a scaled‐down version of the IGIV manufacturing process.Results Virus and TSE reduction at manufacturing process set points were well within safety standards. Robustness studies verified that the reproducibility of virus reduction was maintained at or beyond operating parameter extremes. Virus reduction across two combined manufacturing steps was lower than the sum of virus‐reduction values across the individual steps, indicating mechanistic similarity of the two steps with respect to virus reduction. Only reduction from mechanistically distinct steps was claimed.Conclusions This comprehensive approach to pathogen safety provides the new immunoglobulin manufacturing process with a detailed, yet realistic, assessment of the risk of transmission of infectious pathogens.
Human immunodeficiency virus‐1 and hepatitis C virus RNA among South African blood donors: estimation of residual transfusion risk and yield of nucleic acid testing
Authors: Fang C. T. , Field S. P. , Busch M. P. , Heyns A. du P. 
Published: December 2004

Background and Objectives South Africa is an endemic area for human immunodeficiency virus 1 (HIV‐1) infection, which has an impact on the safety of the blood supply. We studied the presence of HIV‐1 and hepatitis C virus (HCV) RNA, and recent HIV seroconversion, in blood donors in order to estimate transfusion risk and to determine whether nucleic acid testing (NAT) could effectively improve blood safety.Materials and Methods Unlinked samples collected in 1999 from 9077 HIV‐low prevalence (LP) and 10 632 HIV‐high prevalence (HP) donors were studied. Donor demographic information and serology results were collected prior to breaking the linkage. All samples were individually tested using a multiplex NAT assay for HIV‐1 and HCV RNA. HIV antibody‐positive samples were further tested using a ‘detuned’ (less sensitive) enzyme immunoassay (EIA) procedure to determine whether a donor had recently acquired infection. Data were used to estimate the residual transfusion risk and to project NAT yield.Results HIV was 45 times more prevalent in the HP‐ than in the LP donor group; and among the HP group, female donors had a significantly higher prevalence of HIV than male donors. All seven HIV‐1 p24 antigen‐positive samples in the study were also HIV NAT positive. Two HIV NAT‐positive samples were anti‐HIV negative; both of these samples were from HP donors. Assuming that 10% of the 900 000 annual donations in South Africa are from the HP group, we projected an annual NAT yield of 8·5 cases over the current screening of antibody and p24 antigen. However, if p24 antigen testing were to be eliminated, this number would be increased to 17 cases per year. Based on ‘detuned’ EIA results, the incidence rate for HIV infection was estimated at 1·29 and 51·12 per 10 000 per year for the LP and HP donor groups, respectively. Assuming a 15‐day earlier detection by HIV NAT compared with antibody tests, these incidence rates project that NAT may intercept an additional 23 (95% confidence interval: 15–33) HIV‐positive donations per year. For HCV, two viral RNA and antibody‐positive samples (one from the LP group and one from the HP group) and no NAT yield cases were found in the study.Conclusions Implementation of routine NAT blood screening would allow elimination of HIV‐1 p24 antigen testing and improve the safety of the blood supply in South Africa. However, the cost–benefit ratio of introducing such an expensive technology in a country with a limited health budget will have to be carefully considered.
Additive effects of dipyridamole and Trolox in protecting human red cells during photodynamic treatment
Authors: Besselink G. A. J. , Van Engelenburg F. A. C. , Ebbing I. G. , Hilarius P. M. , De Korte D. , Verhoeven A. J. 
Published: December 2004

Background and Objectives Photodynamic treatment (PDT) of red blood cell (RBC) suspensions has been reported to result in virus inactivation, but also in deterioration of cell quality. Recently, we have demonstrated the potential usefulness of the reactive oxygen species scavenger dipyridamole in selectively protecting RBCs against the harmful side‐effects of PDT. Unfortunately, dipyridamole‐conferred protection against long‐term photohaemolysis was incomplete. In the present study, dipyridamole was applied in combination with Trolox (a hydrophilic vitamin E analogue) in order to augment RBC protection.Materials and Methods Leucodepleted RBC suspensions (30% haematocrit) were treated with 1,9‐dimethylmethylene blue (DMMB) and red light, and the effect of inclusion of dipyridamole and Trolox was assessed on potassium leakage as well as on short‐term and long‐term photohaemolysis. Possible interference of the scavenger cocktail with virus inactivation was examined using extracellular pseudorabies virus (PRV).Results Treatment of RBC with DMMB and red light resulted in enhanced potassium leakage and both short‐ and long‐term haemolysis. Dipyridamole and Trolox showed additive protective effects against induction of potassium leakage and photohaemolysis, suggesting different protection mechanisms for the two scavengers. Combined inclusion of dipyridamole and Trolox did not interfere with efficacy of PRV inactivation.Conclusions Combined inclusion of dipyridamole and Trolox results in substantially improved selectivity of photodynamic treatment of RBC suspensions.
A Dc‐ phenotype encoded by an RHCE–D(5–7/8)–CE hybrid allele
Authors: Cotorruelo C. M. , Biondi C. S. , Borrás S. E. García , Di Mónaco R. A. , Racca A. 
Published: December 2004

Background and Objectives The Rh system is genetically controlled by the homologous RHD and RHCE genes that encode the RhD and RhCcEe polypeptides, respectively. Deletions, point mutations and rearrangements between both genes are responsible for the great polymorphism of this system. The aim of this work was to analyse the genetic basis of a Dc‐ phenotype.Materials and Methods DNA samples from the Dc‐ propositus and family members were obtained from peripheral blood. RHCE intron 4‐exon 5 and RH exons 4, 5, 6 and 7 were analysed by polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP). Exon 9 was studied by PCR–sequence‐specific primers (SSP). The RH locus was further analysed by using a PCR designed for a hybrid allele.Results No RHCE‐specific fragments were found when analysing exons 5, 6 and 7 of the RH locus from the propositus’ DNA, while exons 4 and 9 of both RH genes were present.Conclusions The results obtained indicated that the Dc‐ phenotype is encoded by a novel RHCE–D(5–7/8)–CE hybrid allele.
Combining Genotype Groups and Recursive Partitioning: An Application to Human Immunodeficiency Virus Type 1 Genetics Data
Authors: Foulkes A. S. , De Gruttola V. , Hertogs K. 
Published: December 2004

Summary
Understanding the relationship between human immunodeficiency virus type 1 genotypic markers of resistance and response to therapy presents an analytic challenge because of the high dimensionality of the viral genome and the complex interactions across sites on the genome. Recursive partitioning is a natural approach to classifying patients on the basis of covariates that capture information on the variability of a response variable and is therefore well suited to handling both of these features of the problem. In the human immunodeficiency virus genetics setting, we aim to classify patients on the basis of the genotypic characteristics of their infecting viral population so that the resulting groups explain the most variability in drug susceptibility phenotype. Recursive partitioning is also informative in identifying meaningful genotypic patterns that define the resulting classes. By combining dimension reduction techniques with recursive partitioning we can arrive at different classification schemes which are potentially more informative. Furthermore, the use of weighted distance metrics in the clustering algorithm allows us to update and potentially to improve on this classification scheme. An illustration of the relative benefits of the various approaches is provided by using 2559 protease sequences and the corresponding 50% inhibitory concentrations for Indinavir.
P33Fetal diaphragmatic hernia: our experience of 43 cases
Authors: Galindo A. , Carrera  , Arbues J. , Puente J. M. , Benedicto  , Cano I. , De La Fuente P. 
Published: December 2004

AimTo review our experience with diaphragmatic hernia (DH).MethodsWe review retrospectively 43 cases prenatally diagnosed and 7 postnatally between January 1990 and November 1999.ResultsThe incidence was 1/1496 deliveries. Sensitivity was 86%. Mean gestational age at diagnosis was 29 weeks. In 15 cases (38%), diagnosis was ≤ 22 weeks; perinatal mortality rate (PMR) in these did not differ significantly from that in cases of later diagnosis (80% vs. 50%). In 36 cases (83.7%) there was left‐sided DH and in 7 cases (16.3%) was right‐sided without differences in PMR (58.3% vs. 71.4%). In 17 cases (39.5%) associated anomalies were observed; PMR was significantly higher than in isolated cases (94.1% vs. 38.5%). In 14 cases (32.5%) liver herniation was noted; PMR was also significantly higher than in cases without herniation (78.6% vs. 51.7%). The incidence of polyhydramnios was 30% (13/43); differences in PMR between subgroups were statistically significant (76.9% vs. 16.7%). A pseudohypoplasia of the left heart was observed in 9 cases (20.1%); PMR was significantly higher than the observed in cases without it (77.8% vs. 55.9%). Mean weight of the newborns was 2435 g. The PMR in cases < 2500 g was significantly higher than in newborns > 2500 g (75% vs. 26.3%). Overall PMR in cases prenatally diagnosed was 60.5% and in those postnatally diagnosed was 43% (not statistically significant). Considering only prenatally diagnosed isolated cases, the survival rate rose to 65.3% and excluding terminations of pregnancy to 85%.ConclusionThe prognosis of DH largely depends on the existence of associated defects but there are several prognostic factors associated with a worse outcome. However isolated cases may have a favourable outcome with ‘classical’ management.
WS07: Fetal endoscopy and invasive procedures WS07‐01Fetal hydrolaparoscopy and endoscopic cystotomy in complicated cases of lower urinary tract obstruction
Authors: Quintero R. A. , Bornick P. W. , Morales W. J. , Allen M. H. , Johnson P. K. 
Published: December 2004

BackgroundVesicoamniotic shunting may be difficult or impossible in selected cases of fetal lower obstructive uropathy (LOU). The purpose of this paper is to describe the performance of fetal hydrolaparoscopy (FHL) and endoscopic fetal cystotomy (EFC) in fetuses with complicated LOU.MethodFHL‐EFC was performed in one patient with a markedly thickened bladder that could not be entered percutaneously. A peritoneoamniotic shunt was also placed. FHL‐EFC was performed in a second patient with a collapsed bladder from a previous vesicocentesis, as vesicoinfusion resulted in further ascites. Fetal cystoscopy was performed after EFC, and posterior urethral valves were ablated with YAG‐laser. A vesicoamniotic shunt was inserted.ResultsAdequate bladder drainage was obtained in both cases. The first baby required bilateral nephrostomies and a permanent cystotomy at birth, and is scheduled for a bladder expansion procedure at one year of age. The second patient had premature rupture of membranes and fetal demise from treatment of this complication 5 days after the original procedure.ConclusionFHL‐EFC can be performed in complicated LOU cases. The procedure involves the creation of a defect in the bladder dome under direct endoscopic visualization within a hydroperitoneum. Peritoneo or vesicoamniotic shunting, or ablation of posterior urethral valves may then be performed. FHL‐EFC should be reserved only for complicated cases of LOU where conventional vesicoamniotic shunting is not possible.
F02Sonographic preoperative assessment of myometrial invasion in endometrial cancer
Authors: Exacoustòs C. , Romanini M. E. , Rinaldo D. , Carusotti C. , Arduini D. , Benedetti‐Panici P. , Romanini C. 
Published: December 2004

BackgroundThe purpose of this study was to assess the accuracy of transvaginal sonography (TVS) and Color/Power Doppler (CFD/PD) in evaluating the depth of myometrial invasion and preoperative staging of endometrial cancer.MethodAll patients (pts) with histological confirmed endometrial cancer were evaluated sonographically before surgery. In all patients the endometrium was scanned by TVS to evaluate thickness, echogenicity, border, intraluminal fluid and intracavitary masses. CFD/PD were used to evaluate vessels distribution and resistance indices: Myometrial infiltration was evaluated more or less than 50%. Sonographic results were compared to histological staging obtained after surgery.Results53 patients were enrolled. All had endometrial thickness > 5 mm, mean thickness 19.5 ± 10.5 mm. Myometrial invasion was < 50% in 35 pts, TVS evaluation was exact in 33 cases, with a sensitivity of 94% and a positive predictive value (PPV) of 94%. An infiltration > 50% was seen with TVS in 12 pts and was histologically confirmed in 11, with a sensitivity of 82% and PPV of 75%. Other 3 pts had a cervical infiltration, 3 had stage 3, one had stage 4. TVS evaluated correctly 48 patients with a sensitivity of 91%.ConclusionsTVS seems to be a valuable, noninvasive and unexpensive diagnostic method for the assessment of myometrial invasion.
THE CLINICAL EPIDEMIOLOGY OF CARDIOVASCULAR DISEASES IN CHRONIC KIDNEY DISEASE: Hemodynamic Cardiovascular Risk Factors in Chronic Kidney Disease: What are the Effects of Intervention?
Authors: McMahon Lawrence P. 
Published: December 2004

ABSTRACTLeft ventricular (LV) volume and pressure overload occur frequently in chronic kidney disease (CKD). Anemia is a risk factor for left ventricular hypertrophy (LVH) and dilatation, heart failure, and death. Normalization of hemoglobin with erythropoietin may prevent LVH and dilatation in CKD, but in patients in later phases of their cardiac disease, this intervention is not of benefit. Increased vascular volume causes hypertension, which in turn causes LVH, cardiac failure, and ischemic heart disease (IHD). Manifestations of arteriosclerosis are associated with adverse cardiac outcomes, and angiotensin converting enzyme (ACE) inhibitors may improve LVH and markers of arteriosclerosis. Aortic stenosis in dialysis patients occurs infrequently, but may deteriorate rapidly. The hemodialysis milieu is the quintessential model of LV overload cardiomyopathy.
Studies of the Recovery and the Cost of Low‐Glycerol Cryopreserved Human Red Blood Cells
Authors: Bowman H. S. , Oski F. A. , Reihart J. , Simmonds M. A. , Cunningham R. K. 
Published: December 2004

Red blood cells were equilibrated with 28 per cent (v/v) glycerol and 3 per cent mannitol in 0.65 g/100 ml sodium chloride. The units were frozen by immersion into liquid nitrogen and stored at ‐160 C. After thawing, they were reconstituted and washed using the IBM 2991 Blood Cell Processor. Freeze‐thaw rate curves, the effect of thawing techniques, the effect of varying postthaw washing and processing techniques, estimates of red blood cell losses because of hemolysis, and in vitro recovery were determined. In vivo recovery was determined by 51Cr techniques 24 hours after infusion and Ashby survivals and subsequent life span were measured. Metabolic, scanning electronmicroscopy, cost estimates and quality control studies were done on the reconstituted red blood cells. Recipients were evaluated before and after transfusion for metabolic erythrocyte characteristics and for evidence of hemolysis.The modified method requires less wash solution and less technician time than does the standard low‐glycerol method. Two units for the same recipient could be passed through the IBM software with no alteration of cell survival or loss. Revision of the IBM 2991 processing procedure provided excellent recovery of viable previously frozen red blood cells at probably a lower cost.
Exchange Transfusion in Reye's Syndrome with Saline‐Washed Red Blood Cells
Authors: Casper J. T. , Varma R. R. , Lewis J. D. , Harrington G. J. , Aster R. H. 
Published: December 2004

Reye's syndrome (RS) consists of encephalopathy, fatty degeneration of viscera, and elevation of ammonia, certain amino acids, and liver enzymes in the blood. It is most characteristically a disease of children and has been considered to have a poor prognosis despite the use of various treatment regimens. Exchange transfusion (ET) with fresh blood (less than 24 hours old) for the removal of toxic metabolic byproducts in RS is a relatively recent development which appears to have improved the survival rates. However, because RS may occur in epidemic proportions at any time the demand for fresh blood can place an excessive stress on blood resources. We have, therefore, utilized saline‐washed (to remove potentially toxic metabolites) red blood cells (RBC's) less than six days old, and fresh frozen citrate‐phosphate‐dextrose (CPD) plasma in treating this disorder. Nine patients in the Milwaukee community with severe encephalopathy secondary to RS were treated with ET.These patients collectively required 151 units of washed RBC's for 21 ET. Eight of nine patients survived without sequelae. Age of blood used did not correlate with the number of exchanges required or the eventual outcome. A continual computerized EEC in five patients provided objective evidence of the effectiveness of ET. We conclude that ET with saline‐washed RBC's reconstituted with fresh frozen plasma (FFP) is a fast, safe, and effective means of treating patients with RS.
Development and Use of Pediatric Frozen Red Cell Packs
Authors: Staples J. W. , Fritz G. E. 
Published: December 2004

Repeated transfusion of small increments of blood are frequently required for the sick and premature newborn infant to correct endogenous hypovolemia and/or to replace blood obtained for laboratory monitoring purposes. Previously fresh group and type specific whole blood was used. To eliminate waste of fresh whole blood, maintain fresh red blood cell properties, eliminate the hazards of transfusing plasma and to provide a more efficient system, a pediatric frozen red cell pack (PFRCP) has been developed.Units of group O rr red blood cells are glycerolized using a high glycerol method. The glycerolized red blood cells are separated into three equal aliquots and frozen. When needed, the PFRCP are deglycerolized by a modified procedure using the IBM Cell Processor.During a six month period, 71 infants were given 153 separate transfusions of deglycerolized red blood cells using 102 PFRCP prepared from 34 units of red blood cells. Red blood cell recovery, hematocrit, white blood cell removal, residual glycerol, total protein, and supernatant hemoglobin levels were measured. Clinical response was followed and found to be excellent.
Enhanced Solubility of 2,8 Dihydroxyadenine (DOA) in Human Urine
Authors: Peck C. C. , Bailey F. J. , Moore G. L. 
Published: December 2004

Water solubility of the adenine catabolite 2,8 dihydroxyadenine (DOA) frequently forms the basis for predicting potential DOA crystal formation in human urine following infusion of adenine‐fortified blood. Measurements relevant to solubility, ionic dissociation, and supersaturability of DOA in aqueous buffers and human urine at 37 C establish striking quantitative differences in the physico‐chemical behavior of DOA in the two media. The basal solubility of DOA is 1.53 + 0.04 mg/1 (≅9 times 10‐6 M) in water (pH 6.5). DOA is an ampholyte characterized by aqueous thermodynamic macrodissociation constants of pKa1= 2.6, pKa2= 8.1, and pKa3= 11.52. This compound displays pH‐dependent solubility, although significant solubility increases beyond basal values do not occur within the physiologic pH range for human urine. Supersaturated aqueous solutions (three to sixteen times basal solubility) can be achieved but are unstable.In contrast, human urine at 37 C exhibits enhanced capacity for solubilizing DOA. In vitro basal solubility is 2.68 + 0.84 mg/l at pH 5.0 and 4.97 + 1.49 mg/l at pH 7.8. The apparent pK2 for DOA in urine of 7.9 to 8.1 is dependent upon urine osmolality. Urine can be supersaturated with DOA in vitro to approximately ten times its basal solubility by adding DOA solubilized in weak base, or by evaporation of a urine‐DOA mixture. DOA remains supersaturated in urine for at least 16 hours despite gentle agitation. Little variation in in vitro DOA apparent supersaturation was found among urine samples from four normal individuals (40.38 + 3.33 mg/l). A patient receiving oral adenine exhibited urinary DOA solubility in considerable excess (96.0 mg/l) of that predicted from water and from in vitro urine solubility studies. Thus, water solubility of DOA is poorly predictive of in vitro and in vivo DOA solubility in human urine. On the basis of these data, estimates of the load of adenine‐fortified blood expected to result in urinary DOA crystal formation may be revised upward.