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21.
Mary Ellen Turner Kanwal Kher Tamara Rakusan Lawrence D’Angelo Sudesh Kapur Dena Selby Patricio E. Ray 《Pediatric nephrology (Berlin, Germany)》1997,11(2):161-163
We describe the clinical and pathological findings of the hemolytic uremic syndrome (HUS) in two children with human immunodeficiency
virus (HIV) infection. Both patients presented with microangiopathic hemolytic anemia, thrombocytopenia, and subsequently
developed renal failure. The diagnosis of HUS was confirmed by renal histopathology in both patients. None of these children
presented with bloody diarrhea, evidence of circulating antibody response to Escherichia coli O157 lipopolysaccharide, or other known risk factors for HUS, except for the presence of HIV infection. Each patient was
treated with intravenous plasma infusion and renal replacement therapy. Their clinical course was characterized by non-oliguria
and lack of significant hypertension throughout the acute phase of the disease. Despite these favorable clinical parameters,
both patients developed end-stage renal failure. The etiology of this atypical HUS characterized by poor renal survival remains
unknown and the role of HIV infection in its pathogenesis, although possible, is unclear.
Received March 5, 1996; received in revised form and accepted October 15, 1996 相似文献
22.
Significant increase (p less than 0.05) in circulating platelet counts was observed in a wide spectrum of experimental tumors in mice. The mechanism of this abnormality was investigated in strain A mice bearing a transplantable ascites tumor, Sarcoma 180 (S 180). Thrombocytosis observed in the tumor hosts was not due to prolonged platelet surviva], as 51Cr platelet half-life was normal. On the other hand, stimulation of thrombopoiesis, expressed in terms of platelet 75Selenomethionine (75SeM) incorporation, appeared to be the primary reason for elevated platelet counts in the tumor-bearers. Evaluation of thrombopoietic activity in the femoral marrow and spleen by measuring organ uptake of 75SeM and megakaryocyte counts indicated that tumor-induced stimulation in thrombopoiesis may be attributed to enhancement in splenic activity. Pretreatment of normal mice with tumor ascites or tumor cell-conditioned medium resulted in enhancement in thrombopoiesis. The findings suggest the production of some factor(s) by the tumor cells which probably mediate the stimulation of platelet production in tumor hosts. 相似文献
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25.
M. J. Ray P. A. Carroll S. J. E. Just G. A. T. Hawson J. H. N. Belt 《Journal of clinical monitoring and computing》1994,10(2):97-100
Objective. The Ciba Corning 512 coagulation monitor (CC512) can be used to monitor heparin therapy by performing an activated
partial thromboplastin time (APTT) at the patient’s bedside. This study was designed to compare the CC512 results to results
using the laboratory system. The relative sensitivities of both systems to the effect of oral anticoagulant therapy also was
investigated.Methods. Activated partial thromboplastin times were performed with both the CC512 and laboratory system on 74 specimens from patients
receiving IV heparin therapy, and on 14 specimens from patients on warfarin only. Heparin assays were performed on 43 of the
specimens from the heparinized patients.Results. When a patient was receiving heparin only, the APTT results of the CC512 proved to be similar to existing laboratory methods.
The CC512 APTT results of patients on warfarin only were markedly prolonged, whereas the laboratory APTTs were only slightly
affected.Conclusion. The CC512 results were comparable to the laboratory system. However, the CC512 APTT was more sensitive to the effect of
warfarin than the laboratory APTT system used in this study. CC512 APTT results on a patient receiving both oral and intravenous
anticoagulation could be misleading.
The authors wish to thank D.M. O’Brien and the nursing staff of the Coronary Care Unit for providing CC512 data and laboratory
specimens, and I. Smith for the preparation of graphics. We also wish to thank Australian Diagnostics Corporation, which provided
consumables. 相似文献
26.
A procedure for the detection of brodifacoum (BDF) in serum was developed. Extraction of BDF was achieved by acidification of 2 ml of serum with 1 ml of 1.5% acetic acid followed by dual extractions with 10 ml diethyl ether and ether: acetonitrile [1:1]. In spiking experiments, 68 +/- 3, 61 +/- 4 and 65 +/- 5% of added BDF was recovered from serum containing 1000, 100 and 25 ng BDF/ml, respectively. Two high performance liquid chromatography solvent systems were used for chromatographic separation (A: 1.5% acetic acid, pH 4.5: acetonitrile [1:2] with 1% dibutylamine; and B:O.2 M tris(hydroxymethyl)aminomethane, pH 7.5:acetonitrile [1:3]). Detection limits were 75 and 3 ng BDF/ml of serum using ultraviolet absorption (254 nm) and fluorescence measurement (313 nm excitation, 375 nm emission), respectively. This method has been used successfully to monitor serum concentrations of BDF in experimental and field cases of exposure. 相似文献
27.
Louis E. Samuels M.D. Sameer Sharma B.A. Rohinton J. Morris M.D. M.L. Ray Kuretu M.D. Karl E. Grunewald M.D. Michael D. Strong III M.D. Stanley K. Brockman M.D. 《Journal of cardiac surgery》1996,11(2):121-127
A bstract Objectives and Background : The purpose of this study was to document our initial experience with patients 90 years of age and older and to determine whether cardiac surgery is justified in this age group. Cardiac surgery in octogenarians has proven to be a successful and worthwhile procedure. A small group of nonagenarians with severe coronary artery disease (CAD) and aortic valve disease refractory to medical therapy have been considered for surgery. Methods : Fourteen patients aged 90 or more underwent cardiac surgery for symptomatic CAD or aortic valvular disease refractory to medical therapy. Eight patients underwent isolated coronary artery bypass grafting (CABG) and six patients underwent aortic valve replacement (AVR). All patients were in NYHA Class IV preoperatively. Results : Hospital mortality occurred in one patient (7%). Hospital morbidity occurred in 10 patients (71%) and included 7 cardiac, 5 neurological, 1 gastrointestinal, 1 infectious, and 1 pulmonary event. All survivors left the hospital symptomatically improved. The mean length of stay was 26 days. Four CABG patients went on to die at a mean of 2 years and 2 months, and 3 remain alive at a mean of 2 years and 4 months. Three AVR patients expired at a mean of 3 years and 4 months, and 3 remain alive at 4 years and 1 month. Conclusions : Cardiac surgery in carefully selected nonagenarians is justified and can be performed with acceptable results. 相似文献
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Kallol Ray Chaudhuri Pablo Martinez-Martin Anthony H V Schapira Fabrizio Stocchi Kapil Sethi Per Odin Richard G Brown William Koller Paolo Barone Graeme MacPhee Linda Kelly Martin Rabey Doug MacMahon Sue Thomas William Ondo David Rye Alison Forbes Susanne Tluk Vandana Dhawan Annette Bowron Adrian J Williams Charles W Olanow 《Movement disorders》2006,21(7):916-923
Nonmotor symptoms (NMS) of Parkinson's disease (PD) are not well recognized in clinical practice, either in primary or in secondary care, and are frequently missed during routine consultations. There is no single instrument (questionnaire or scale) that enables a comprehensive assessment of the range of NMS in PD both for the identification of problems and for the measurement of outcome. Against this background, a multidisciplinary group of experts, including patient group representatives, has developed an NMS screening questionnaire comprising 30 items. This instrument does not provide an overall score of disability and is not a graded or rating instrument. Instead, it is a screening tool designed to draw attention to the presence of NMS and initiate further investigation. In this article, we present the results from an international pilot study assessing feasibility, validity, and acceptability of a nonmotor questionnaire (NMSQuest). Data from 123 PD patients and 96 controls were analyzed. NMS were highly significantly more prevalent in PD compared to controls (PD NMS, median = 9.0, mean = 9.5 vs. control NMS, median = 5.5, mean = 4.0; Mann-Whitney, Kruskal-Wallis, and t test, P < 0.0001), with PD patients reporting at least 10 different NMS on average per patient. In PD, NMS were highly significantly more prevalent across all disease stages and the number of symptoms correlated significantly with advancing disease and duration of disease. Furthermore, frequently, problems such as diplopia, dribbling, apathy, blues, taste and smell problems were never previously disclosed to the health professionals. 相似文献