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61.
During a 4-year multicenter cooperative study of acquired factor VIII inhibitors in persons with hemophilia A, new inhibitors were detected in 31 of 1,306 patients who entered the study without an inhibitor or the history of an inhibitor. The incidence of new inhibitors was eight per 1,000 patient-years of observation. The factor VIII:C level before inhibitor development was less than or equal to 0.03 U/mL in 29 individuals and 0.06 U/mL and 0.07 U/mL in the remaining two. Factor VIII:Ag levels were measured in 27 individuals and were less than 0.03 U/mL in 23 and 0.05 to 0.11 U/mL in the remaining four. Maximum inhibitor levels ranged from 1.0 to 9,044 Bethesda U/mL. In seven patients under the age of 20, relatively weak inhibitors (none higher than 4.3 Bethesda U/mL) were detected on only a single occasion despite continued factor VIII challenge. In the other 24 patients with inhibitors detected on multiple occasions, 50% had appeared by age 20 and 71% by age 30. Seventeen of the 31 inhibitors, including 12 of 15 with maximum values greater than 10 Bethesda U/mL, developed within 75 exposure days to factor VIII. 相似文献
62.
Cytotoxic T lymphocytes (CTL) have been implicated in immunity to
Plasmodium falciparum infection and disease. We have previously described
the use of peptides to define malaria-specific CTL epitopes. To determine
whether these peptide epitopes are processed intracellularly from the whole
antigen we have developed recombinant vaccinia viruses (rVV) expressing
three malaria antigens: thrombospondin-related adhesive protein (TRAP),
Pfs16 and the C- terminal half of liver-stage antigen (LSA)-1. Target cells
infected with recombinant viruses were lysed by malaria-specific CTL from
semi- immune African donors. We also tested the ability of cells infected
with these recombinant vaccinia viruses to re-stimulate malaria- specific
CTL in peripheral blood lymphocytes from malaria immune adults. Two other
pox virus recombinants, NYVAC, an attenuated vaccinia virus, and ALVAC, a
canarypox virus, both expressing malaria antigens were also evaluated for
their ability to stimulate malaria-specific CTL in contrast to peptide,
none of these viruses successfully re- stimulated CTL from the peripheral
blood lymphocytes of semi-immune donors. The ability of human CTL from
naturally exposed individuals to recognize processed antigen supports the
relevance of these cells in protective immunity to malaria.
相似文献
63.
Percutaneous dilation of benign biliary strictures 总被引:1,自引:0,他引:1
Moore AV Jr; Illescas FF; Mills SR; Wertman DE; Heaston DK; Newman GE; Zuger JH; Salmon RB; Dunnick NR 《Radiology》1987,163(3):625-628
Percutaneous balloon dilation of benign biliary strictures was successful in 15 of 18 patients in whom the procedure was attempted. Successful dilation was achieved in nine of 11 patients who had biliary enteric strictures, with follow-up of 22-55 months (mean, 35.4 months) after catheter removal in seven patients. Five of six strictures in the biliary tree that developed after surgery were successfully dilated, with long-term follow-up available in two patients (58 and 42 months). A patient with an inflammatory common bile duct stricture that was successfully dilated was followed up for 18 months. Percutaneous dilation of biliary tract strictures is a promising technique with good long-term results and may be the initial treatment of choice in biliary stricture management. 相似文献
64.
Margarida MC Resende Cleber A Rocha Nely FM Corrêa Renato RG Veiga Sandro JF Passos Neil F Novo Yara Juliano Carlos AV Damasceno 《International wound journal》2016,13(4):526-530
Irrigating wounds with tap water does not increase colonisation, but controlled studies are required for further evidence. Microbial colonisation was assessed in skin wounds, before and after irrigation with tap water, and was compared with irrigation using 0·9% sodium chloride sterile solution. The study included 120 subjects with chronic, traumatic, vascular, pressure or neuropathic wounds. A total of 60 wounds were randomly assigned to be irrigated with tap water (tap water group) and another 60 to be irrigated with 0·9% sodium chloride sterile solution (saline group), at a pressure of 0·46–0·54 PSI. Samples were collected from the centre of each wound using Levine's technique, before and after irrigation, and cultivated in thioglycollate, hypertonic mannitol agar, eosin methylene blue (EMB) agar, blood agar and Sabouraud agar at 37°C for 72 hours. There was concordance (kappa test) and discordance (McNemar test) regarding the count of positive and/or negative samples before and after irrigation in each group. The proportion of reduction of positive samples was similar for both groups in all cultures. Colony‐forming unit count before and after irrigation was similar in both groups and in all cultures, except for the culture in hypertonic mannitol agar from the tap water group, for which the count was lower after irrigation (Wilcoxon z = 2·05, P = 0·041). It is concluded that skin wound irrigation with tap water leads to further reduction of Gram‐positive bacteria compared with 0·9% sodium chloride sterile solution, with no difference in colonisation of haemolytic bacteria, Gram‐negative bacteria and fungi. 相似文献
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Abstract: Until recently, little attention has been directed towards the role the toothbrush may play in human health, even though a report of toothbrush as a significant factor in the infection appeared in 1920. It is common knowledge that the human mouth harbours a wide variety of microorganisms, some of which, at any given time, can be assumed to be potential pathogens. This was not known when toothbrushes were originally designed, yet the common toothbrush has been used in basically the same form for about 200 years. In today's world of organ transplantation and alteration of the immune system, it is important to consider the toothbrush as a source of potential pathogens. Given the fact that very often people will traumatize themselves with their toothbrush, this trauma may become a potential portal of entry for organisms. In this article, we have attempted to demonstrate the importance of toothbrush disinfection, given tips on home toothbrush care and hope to motivate the dentists to educate the patients on the importance of toothbrush disinfection. 相似文献
69.
Background:
Cancer fear and fatalism are believed to be higher in ethnic minorities and may contribute to lower engagement with cancer prevention and early detection. We explored the levels of cancer fear and fatalism in six ethnic groups in the United Kingdom and examined the contribution of acculturation and general fatalism.Methods:
A cross-sectional survey of 720 White British, Caribbean, African, Indian, Pakistani, and Bangladeshi women (120 of each) was conducted. Three items assessed cancer fear and two cancer fatalism. Acculturation was assessed using (self-reported) migration status, ability to speak English, and understanding of health leaflets; general fatalism with a standard measure.Results:
Relative to White British women, African and Indian women were more fearful of cancer, Bangladeshi women less fearful, and Pakistani and Caribbean women were similar to White British women. Cancer fatalism was higher in all the ethnic minority groups compared with White British women. Less acculturated women were less likely to worry (ORs 0.21–0.45, all P<0.05) or feel particularly afraid (ORs 0.11–0.31, all P<0.05) but more likely to feel uncomfortable about cancer (ORs 1.97–3.03, all P<0.05). Lower acculturation (ORs 4.30–17.27, P<0.05) and general fatalism (OR 2.29, P<0.05) were associated with the belief that cancer is predetermined.Conclusions:
In general, cancer fear and fatalism are more prevalent among ethnic minority than White British women and even more so in less acculturated ethnic minorities. This may affect their participation in cancer prevention and early detection. 相似文献70.