Platelet turnover and kinetics in immune thrombocytopenic purpura: results with autologous 111In-labeled platelets and homologous 51Cr- labeled platelets differ

Mean platelet survival and turnover were simultaneously determined with autologous 111In-labeled platelets (111In-AP) and homologous 51Cr- labeled platelets (51Cr-HP) in ten patients with chronic immune thrombocytopenic purpura (ITP). In vivo redistribution of the 111In-AP was quantitated with a scintillation camera and computer-assisted image analysis. The patients were divided into two groups: those with splenic platelet sequestration (spleen-liver 111In activity ratio greater than 1.4), and those with diffuse sequestration in the reticuloendothelial system. The latter patients had more severe ITP reflected by pronounced thrombocytopenia, decreased platelet turnover, and prominent early hepatic platelet sequestration. Mean platelet life span estimated with 51Cr-HP was consistently shorter than that of 111In-AP. Platelet turnover determined with 51Cr-HP was thus over-estimated. The difference in results with the two isotope labels was apparently due to greater in vivo elution of 51Cr. Although the limitations of the techniques should be taken into account, these findings indicate that platelet turnover is not always normal or increased in ITP, but is low in severe disease. We suggest that this may be ascribed to damage to megakaryocytes by antiplatelet antibody. The physical characteristics in 111In clearly make this radionuclide superior to 51Cr for the study of platelet kinetics in ITP.     

Direct medical costs of adverse events in Dutch hospitals

Background  

Up to now, costs attributable to adverse events (AEs) and preventable AEs in the Netherlands were unknown. We assessed the total direct medical costs associated with AEs and preventable AEs in Dutch hospitals to gain insight in opportunities for cost savings.     

一种用于筛选降血糖及降血脂药物的动物模型

一种用于筛选降血糖及降血脂药物的动物模型刘京，申竹芳，刘海帆，叶菲，谢明智（中国医学科学院药物研究所，中国协和医科大学北京１０００５０）糖尿病为常见病和多发病，同时伴有多方面的并发症，脂质代谢紊乱即其中之一。这就要求治疗糖尿病时，除控制病人的血糖外，...     

Air pollution from traffic and risk for brain tumors: a nationwide study in Denmark

Purpose

Air pollution is an established lung carcinogen, and there is increasing evidence that air pollution also negatively affects the brain. We have previously reported an association between air pollution and risk of brain tumors in a cohort study based on only 95 cases. We set out to replicate that finding in a large nationwide case–control study.

Methods

We identified all 4,183 adult brain tumor cases in Denmark in the years 2000–2009 and 8,018 risk set sampled population controls matched on gender and year of birth. We extracted residential address histories and estimated mean residential nitrogen oxides (NO _x ) concentrations since 1971 with a validated dispersion model. Categorical and linear odds ratios (OR) and confidence intervals (CI) were calculated with conditional logistic regression models.

Results

The highest risk estimates for any brain cancer were observed among subjects with the highest average exposure levels (80–99 µg/m³: OR 1.27, 95 % CI 0.82–1.96; ≥100 µg/m³: 1.40, 95 % CI 0.87–2.26 as compared to <20 µg/m³ NO _x ), but there was no increased OR at NO _x levels below 80 µg/m³ and when modeled linearly there was no significant association with risk of brain cancer (OR 1.11, 95 % CI 0.84–1.46 per 100 µg/m³ NO _x ). In sub-analysis the OR associated with exposures ≥100 µg/m³ was 2.30 (95 % CI 1.15–4.59) for non-glioma and 0.89 (95 % CI 0.44–1.77) for glioma.

Conclusions

This study did not support the relatively strong linear association between air pollution and risk of brain tumors which was found in our previous study. The suggestion of an increased brain tumor risk at high exposures merits further attention as does the differing results according to tumor morphology.

     

Neuromuscular electrical stimulation in early rehabilitation of Guillain-Barré syndrome: A pilot study

Introduction: In Guillain-Barré syndrome (GBS), patients often develop muscle atrophy from denervation and immobilization. We, therefore, conducted a pilot study of neuromuscular electrical stimulation (NMES) to evaluate feasibility, safety, and effect on muscle wasting in the early phase of GBS. Methods: Seventeen patients were randomized to receive 20 min of muscle fiber stimulation followed by 40 min of NMES of the right or left quadriceps muscle with the untreated side as control. Cross-sectional area (CSA) of the muscle measured by ultrasound and isometric knee extensor strength were the primary and secondary outcome measures. Results: No treatment related adverse effects were recorded. Change in CSA was -0.25 cm² (confidence interval [CI], -0.93–0.42) on the stimulated side versus -0.60 cm² (CI, -1.32–0.11) on the nonstimulated side (P = 0.08). No effect was observed on muscle strength. Conclusions: NMES seems safe and feasible in the early phase of GBS. Further studies are needed to explore effect on muscle function. Muscle Nerve 59:481–484, 2019