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61.
Clinical bleeding tendency and tests of immune function were studied prospectively in 11 human immunodeficiency virus (HIV)-infected hemophiliacs with immune thrombocytopenic purpura (ITP) and a platelet count less than 50,000/microL. These 11 patients represented 13% of a well-characterized cohort of 87 HIV + hemophiliacs. ITP developed a mean 3.5 years after seroconversion, mean platelet count at presentation was 36,000/microL (range 15,000 to 49,000/microL), and the mean age at seroconversion was 37.1 years. Nine patients (82%) suffered bleeding complications, including four with intracranial hemorrhage, which was fatal in three. At the onset of ITP, five had AIDS and six were asymptomatic. Mean T4 lymphocyte count at onset of ITP was 126 +/- 32/microL (range 5 to 267/microL). Sustained treatment responses occurred with intravenous gammaglobulin (2 of 2), one of whom spontaneously remitted, and with zidovudine (1 of 2), but not with steroids (0 of 6) or danazol (0 of 3). In conclusion, 13% of a cohort of HIV + hemophiliacs has developed ITP with platelets less than 50,000/microL, a significant proportion of whom (82%) have experienced bleeding complications. It is recommended that treatment for ITP in HIV + hemophiliacs be instituted once the platelet count falls below 50,000/microL in order to avoid serious hemorrhagic sequelae. 相似文献
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MG Hayes M Urbanek M-F Hivert LL Armstrong J Morrison C Guo LP Lowe DA Scheftner A Pluzhnikov DM Levine CP McHugh CM Ackerman L Bouchard D Brisson BT Layden D Mirel KF Doheny MV Leya RN Lown-Hecht AR Dyer BE Metzger TE Reddy NJ Cox WL Lowe Jr. for the HAPO Study Cooperative Research Group. 《Diabetes》2013,62(10):3641
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Mycotic aneurysms of the aorta: radiologic features 总被引:2,自引:0,他引:2
Four patients with a total of six mycotic aneurysms of the aorta were examined with computed tomography (CT) after intravenous contrast material enhancement, and with abdominal or thoracic aortography. In the three patients with mycotic aneurysms involving the abdominal aorta, CT scans showed a vascular paraaortic structure without calcified walls adjacent to a nondilated aorta, and a large non-contrast-enhanced retroperitoneal mass representing inflammatory tissue and blood from a contained aortic rupture. A CT scan of one aneurysm of the thoracic aorta demonstrated an enhanced saccular mass originating from the aorta without paraspinal component. In three of four patients, the CT findings were corroborated by aortographic evidence of an eccentric aneurysmal sac in an atypical location for atheromatous disease. In four patients with clinical manifestations suggesting mycotic aneurysm of the aorta, a combination of CT and angiographic imaging provided accurate diagnostic information for planning adequate and early surgical treatment. 相似文献
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Paula G. Blanco MV Daniel O. Arias MV Cristina Gobello DMV DECAR 《Journal of ultrasound in medicine》2008,27(12):1745-1750
Objective. The aim of this article is to review the current knowledge of Doppler ultrasound in canine pregnancy. A brief introduction of Doppler principles and their applications in human obstetrics is also included. Methods. A review of the peer‐reviewed published literature was conducted of the articles pertaining to the use of Doppler ultrasound in canine pregnancy, general Doppler principles, and Doppler applications in human obstetrics. Results. In bitches, Doppler ultrasound has been used to assess ovarian, uterine, umbilical, fetal aorta, common carotid artery, and fetal caudal vena cava blood flow during normal gestation. Most of these vessels increase their blood flow during normal pregnancy. The resistive index and systolic/diastolic ratio of the uterine arteries have been recently described in an experimental pharmacologically induced model of abnormal canine gestation. Both indices progressively increase up to abortion, probably because of progesterone deprivation. Moreover, resistive index abnormalities have been found in canine cases of spontaneous abnormal gestations as described in human medicine. Conclusions. Doppler ultrasound is a useful method for assessing development of the placental and fetal circulation during normal and abnormal canine pregnancy. Further studies are still necessary to widely use this technique in clinical practice. 相似文献