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151.
Karissa Y. Kim PharmD CACP ; Kelly Epplen PharmD CACP ; Farzin Foruhari MD ; Hattie Alexandropoulos PharmD 《Progress in cardiovascular nursing》2006,21(2):1-4
A 79-year-old man with a history of deep vein thrombosis and pulmonary embolism received anticoagulation therapy with warfarin 5 mg daily for 8 months. He was diagnosed with osteomyelitis and underwent partial metatarsal resection of his right foot. After surgery, antibiotics were initiated including ertapenem sodium 1 g intravenously every 24 hours, vancomycin 1400 mg intravenously every 24 hours, and rifampin 300 mg by mouth twice daily. Achieving a therapeutic level of anticoagulation was difficult despite escalating doses of warfarin, because of the interaction with rifampin. A 5- to 6-fold increase in warfarin dose was prescribed to reach therapeutic international normalized ratios (INRs), but even these increases were insufficient to maintain his INR in the therapeutic range. After rifampin was discontinued, warfarin doses were gradually reduced over the next 2 months. When concurrent warfarin-rifampin therapy is necessary, vigilant monitoring is imperative and significant increases in warfarin doses are likely. 相似文献
152.
Selecting antibodies to detect HER2 overexpression by immunohistochemistry in invasive mammary carcinomas. 总被引:1,自引:0,他引:1
Agostinho Pinto Gouvêa Fernanda Milanezi Sandra Jean Olson Dina Leitao Fernando Carlos Schmitt Helenice Gobbi 《Applied immunohistochemistry & molecular morphology》2006,14(1):103-108
There is an increasing clinical demand for HER2 analysis in breast cancer, especially since the release of trastuzumab. The authors assessed the ability of immunohistochemistry to detect HER2 overexpression in invasive mammary carcinomas (IMC) using five antibodies. Paraffin-embedded samples of 86 IMCs (T2N0) were used to compare the immunohistochemical overexpression of HER2 using two polyclonal antibodies (HercepTest [DAKO] and A0485 [DAKO]) and three monoclonal antibodies (CB11 from two different laboratories, Biogenex and Novocastra, and 4D5 [Genentech]). All immunostainings were scored according to the FDA-approved HercepTest recommendations. The HercepTest-positive cases were compared with gene amplification by FISH (Oncor Inform, Ventana). The HercepTest was positive in 31 of the 86 cases (36.1%). The DAKO antibody A0485 was positive in 25 of the 66 (37.8%). Monoclonal antibody 4D5 was positive in only 15 of the 86 cases (17.4%). There was almost total agreement in results between the two CB11 antibodies: 25 of the 86 positive cases (29.1%). All cases positive for CB11 or 4D5 were HercepTest positive. Most of the HercepTest 2+ cases were negative when using either monoclonal antibody. FISH was positive in 19 of the 20 HercepTest 3+ cases and negative in 5 HercepTest 2+ cases. Three CB11-2+ cases showed no amplification by FISH. In three FISH-positive cases the immunohistochemistry showed no overexpression by all antibodies used. These findings suggest that immunohistochemistry may be used reliably as a primary methodology for evaluating HER2; however, the use of polyclonal antibodies may not be adequate to assess HER2 overexpression. CB11, regardless of the manufacturer (Biogenex or Novocastra), showed better concordance with FISH (kappa=0.83) than did the polyclonal antibodies. 相似文献
153.
154.
Changing economic, political, environmental, and social conditions continue to have a cumulative impact on Australian regional communities, and in many instances, rural communities are being forced to initiate their own strategies in order to remain economically and socially viable. However, while communities respond in differing ways to similar change events, as do individuals, research examining the change process has largely been undertaken at the individual level. This article reports on an investigation of the characteristics that moderate a community's ability to manage change and the types of collective coping strategies communities employ to deal with change events. A model of community change process was used as the framework to examine the links between community characteristics, appraisal of change events (forest restructuring and tourism), and the use of collective strategies in three communities in Western Australia. Findings suggest that a community's mobilization of strategies is dependent on the collective assessment of the change event, the nature of the event, and the characteristics of the community. The implications for intervention through policy and community development are discussed briefly. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 201–216, 2004. 相似文献
155.
156.
John Fung Dympna Kelly Zakiyah Kadry Kusum Patel-Tom Bijan Eghtesad 《Liver transplantation》2005,11(3):267-280
Although calcineurin inhibitors (CNIs) remain the mainstay of immunosuppression in liver transplantation (LTX), their long-term toxicity significantly contributes to morbidity and mortality. The elucidation of mechanisms of alloimmunity and leukocyte migration have provided novel targets for immunosuppression development. The toxicities of these agents differ from that of the CNI and act additively or synergistically. CNI avoidance protocols in LTX have not been achieved routinely; however, pilot trials have begun to delineate the limitations and promises of such approaches. CNI-sparing protocols appear to be much more promising in balancing the early need for minimizing rejection while tapering doses and minimizing long-term toxicity. 相似文献
157.
Jean-Pierre Lindenmayer M.D. Ruth Bernstein-Hyman Ph.D. Sandra Grochowski B.A. 《The Psychiatric quarterly》1994,65(4):299-322
Schizophrenic psychopathology is heterogeneous and multidimensional. Various strategies have been developed over the past
several years to assess and measure more accurately discrete domains of psychopathology. One of the more fruitful strategies
to investigate more homogenous domains of psychopathology has been the positive-negative syndrome approach. However, this
approach is unable to address a number of important issues. Most schizophrenics present a mixed syndrome; the criteria for
what constitutes a positive and negative syndrome are variable; distinguishing primary from secondary negative symptoms can
be difficult. In order to address some of these problems, we propose the introduction of a five syndrome model based on a
reanalysis of factor analytic procedures used on 240 schizophrenics assessed with the Positive and Negative Syndrome Scale
(PANSS). We present data on a 5-factor solution which appears to best fit the psychopathological data and which is supported
by three independent and comparable factor analyses; negative, positive, excitement, cognitive and depression/anxiety domains
of psychopathology give patients their individual mark. Data on internal consistency of the five factors and on initial validation
using demographic and clinical variables are presented. 相似文献
158.
159.
Sandra Lobo Jaroslav Cervenka Arnold London Mary Ella M. Pierpont 《American journal of medical genetics. Part A》1992,43(4):701-703
We report on a patient with interstitial deletion of 10q and compare her to 8 previously described patients, 2 of whom have chromosomal breakpoints similar to our patient. Minor anomalies including broad forehead, hypertelorism, strabismus, prominent philtrum, and “dysplastic” pinnae are present in our patient. Psychomotor retardation and hypotonia are universal findings in 10q interstitial deletion. Growth retardation, not present in our patient, is seen in some. These clinical findings are sufficiently distinct to suggest early chromosome studies. © 1992 Wiley-Liss, Inc. 相似文献
160.