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21.
Amidolytic assay of human factor XI in plasma: comparison with a coagulant assay and a new rapid radioimmunoassay 总被引:6,自引:0,他引:6
The traditional coagulant assay for plasma factor XI suffers from a relatively high coefficient of variation, the need for rare congenitally deficient plasma, and a poor correlation between precision and sensitivity. We have developed a simple functional amidolytic assay for factor XI in plasma using the chromogenic substrate PyrGlu-Pro-Arg- p-nitroanilide (S-2366). After inactivation of alpha 1-antitrypsin, CI inhibitor, and other plasma protease inhibitors with CHCI3, plasma was incubated with kaolin, in the absence of added calcium, which limited the enzymes formed to those dependent on contact activation. Soybean trypsin inhibitor was used to minimize the action of kallikrein on the substrate. Once the reaction was complete, corn trypsin inhibitor was used to inactive factor XIIa, the enzyme generated by exposure of plasma to negatively charged surfaces, which had activated the factor XI. The assay is highly specific for factor XI, since plasma totally deficient in that zymogen yielded only 1%-3% of the enzymatic activity in normal plasma under identical conditions. The requirements for complete conversion of factor XI to XIa in plasma within 60 min were, respectively, factor XII, 0.6 U/ml, and high molecular weight kininogen, 0.2 U/ml. Prekallikrein was not an absolute requirement for complete activation but did accelerate the reaction. The intraassay coefficient of variation was 3.4%, and the mean of 35 normal plasmas was 1.00 U +/- 0.24 SD. In addition, a new rapid radioimmunoassay was devised using staphylococcal protein A as the precipitating agent for a complex of factor XI antigen with monospecific rabbit antibody. The mean was 1.01 U +/- 0.30 SD. The correlation coefficients for amidolytic versus coagulant and amidolytic versus radioimmunoassay were r = 0.95 for the former and 0.96 for the latter. Thus, a simple, accurate amidolytic assay and a radioimmunoassay have been devised for measuring factor XI in plasma that correlate well with the coagulant activity of factor XI, as determined in our laboratory. 相似文献
22.
Bipadabhanjan Mallick Narendra Dhaka Vishal Sharma Sarthak Malik Saroj K. Sinha Usha Dutta Pankaj Gupta Ajay Gulati Thakur D. Yadav Vikas Gupta Rakesh Kochhar 《Pancreatology》2019,19(1):143-148
Background and objectives
Despite improvement in outcomes of acute pancreatitis (AP), some subgroups remain at increased risk. We studied the impact of onset-to-admission interval to a tertiary care centre on outcomes in AP.Methods
Retrospective analysis of consecutive patients with first episode of AP admitted between 2009 and 2017 on the basis of onset-to-admission interval: ≤7 days, 8–21 days and >21 days was done. Patients were assessed for severity and managed using a step-up approach. Primary outcome measures were surgical necrosectomy and mortality.Results
Of 745 patients (age 39.26?±?13.18?yrs, 69% male), 380 (51%) had presented ≤7 days, 229 (30.7%) between 8 and 21 days and 136 (18.3%) >21 days after pain onset. Severe pancreatitis was highest in 8–21 days group (129; 56.3%) followed by?≤?7 days (166; 43.7%) and >21 days of illness (52; 38.2%).Surgical intervention rates were highest in the 8–21 days group(14%) followed by?>?21 days (12.5%) and ≤7 days (6.6%) respectively (p?=?0.007). Also, mortality was highest in patients with onset to admission interval of 8–21 days (24%) followed by?>?21 days (15.4%) and ≤7 days (14.2%) (P?=?0.007). On the multivariate analysis, age, late presentation, and the presence of organ failure were found to predict the mortality.Conclusion
Patients presenting between 8 and 21 days after onset perform poorly than those presenting earlier or later than them in terms of severity, organ failure, need for surgery and mortality although organ failure remains the most important determinant of outcome. This data can help in devising guidelines for referral of such patients. 相似文献23.
Understanding the current sexual health service provision for mental health consumers by nurses in mental health settings: Findings from a Survey in Australia and England 下载免费PDF全文
Chris Quinn RN DAS Cert PN Grad Dip PhD Chris Platania‐Phung BA PhD Christopher Bale BSc MSc PhD Elizabeth Hughes BSc DipHE RN PhD 《International journal of mental health nursing》2018,27(5):1522-1534
Nurses in mental health settings avoid talking to consumers about sexual health concerns. It is unclear whether this avoidance prevents the provision of sexual healthcare. The present study gathered information about how mental health nurses respond to sexual health issues within their routine practice, what issues they address, and their view on their role in promoting sexual health for consumers. A cross‐sectional study using an electronic survey questionnaire, originally generated from a previous study in the united kingdom, was employed. The study occurred in four National Health Service Trusts in England and a national call for participants in Australia. Participants were nurse clinicians (n = 303) who self‐selected by completing surveys available via email and newsletters containing links to the survey. The results demonstrated that mental health nurses do not routinely include sexual health in their practice and are poorly prepared in knowing what to do with a sexual health issue, and what services to assist consumers to use. In conclusion, it has been well established in the literature that mental health consumers experience high sexual health needs that potentially impact on health and recovery. Mental health nurses are ideally placed to promote sexual health and refer consumers to sexual health and family planning services. Training to improve the confidence and responsiveness of mental health nurses to sexual health is an urgent need. 相似文献
24.
Bipadabhanjan Mallick Narendra Dhaka Pankaj Gupta Ajay Gulati Sarthak Malik Saroj K. Sinha Thakur D. Yadav Vikas Gupta Rakesh Kochhar 《Pancreatology》2018,18(7):727-733
Background and objectives
Percutaneous catheter drainage (PCD) is used as a first step in the management of symptomatic fluid collections in patients with acute pancreatitis (AP). We aimed to compare the outcome of patients with acute necrotic collection (ANC) and those with walled-off necrosis (WON), who had undergone PCD as a part of management of AP.Methods
Consecutive patients of AP with symptomatic ANC or WON undergoing PCD were evaluated. Primary outcome measures were need for additional surgical necrosectomy and mortality. Secondary outcome measures were need for up-gradation of first PCD, need for additional drain, in-hospital as well as total duration of PCD and length of hospital stay.Results
Indications of PCD in 375 patients (258 with ANC and 117 with WON) were suspected infected pancreatic necrosis (n?=?214), persistent organ failure (n?=?117) and pressure symptoms (n?=?44). Need for additional surgical necrosectomy was seen in 14% patients with ANC and in 12% of patients with WON (p?=?0.364) and mortality was 19% in patients with ANC as compared to 13.7% in those with WON (p?=?0.132). There was no significant difference in the secondary outcome parameters between patients who underwent PCD for ANC or WON. Complications of PCD were comparable between patients with ANC and WON except development of external pancreatic fistula which occurred more often in patients with WON than in those with ANC (24.4% versus 34.2% respectively, p?=?0.034).Conclusion
Persistent organ failure in more often an indication of PCD in patients with ANC than in WON and suspected infection is more commonly an indication in WON than in ANC. Early PCD is as efficacious and safe as delayed PCD. 相似文献25.
26.
Piyush Narayan Mallick Surjya Prasad Upadhyay Raj Kumar A Singh Shiv Kumar Singh 《Indian Journal of Critical Care Medicine》2013,17(2):113-115
Poor neurological outcome is a common sequel of prolonged cardiac arrest. Although Therapeutic Hypothermia (TH) for neuroprotection has been a subject for research for over Half a century, its use has been limited because of many controversies and lack of clear guidelines. However for over two decades there has been a revival of interest in mild therapeutic hypothermia (32-34°C) for neuroprotection. However its use after primary asystolic cardiac arrest has been questioned.Herein presenting two cases of prolonged asystolic arrest (39 minutes and 25 minutes); where therapeutic hypothermia was successfully used in following prolonged cardio pulmonary resuscitation. On patients who were in deep coma after resuscitation, TH was applied for 24 hours as per institutional protocol with full neurological recovery in both the cases. Therapeutic hypothermia might have a potential role in even in non-shockable arrests and should be considered in every successful cardiopulmonary resuscitation with poor neurological status. 相似文献
27.
Hemalatha Parangusan Jolly Bhadra Zubair Ahmad Shoaib Mallick Farid Touati Noora Al-Thani 《RSC advances》2020,10(45):26604
Polyaniline (PANI)/Cu–ZnS composites with porous microspheres are prepared by a hydrothermal and in situ polymerization method. The structural, optical, and morphological properties are characterized by X-ray powder diffraction, FTIR, UV-vis, scanning electron microscope, transmission electron microscope. The XRD results confirmed that the PANI/Cu–ZnS composite is formed. The morphological analyses exhibited that the PANI/Cu–ZnS composite comprises the porous microspherical structures. The emission peaks obtained in photoluminescence spectra confirm the presence of surface defects in the prepared composite. The UV-DRS study shows that the bandgap of the samples is found to decrease for the PANI/Cu–ZnS composite compared to the pure Cu–ZnS sample. The calculated band gap (Eg) value of PANI/Cu–ZnS composite is 2.47 eV. Furthermore, the fabricated gas sensor based on PANI/Cu–ZnS can perform at room temperature and exhibits good gas sensing performance toward CO2 gas. In particular, PANI/Cu–ZnS sensor shows good response (31 s) and recovery time (23 s) upon exposure to CO2 gas. The p/n heterojunction, surface defects, and porous nature of the PANI/Cu–ZnS composite microsphere enhanced sensor performance.Polyaniline (PANI)/Cu–ZnS composites with porous microspheres are prepared by a hydrothermal and in situ polymerization method. 相似文献
28.
29.
Internal medicine resident knowledge of transfusion medicine: results from the BEST‐TEST international education needs assessment 下载免费PDF全文
30.
Sushma Bhatnagar Saraswathi Devi NK Vinod PN Jain G Durgaprasad Sanjaykumar H Maroo Ketan R Patel 《Indian Journal of Palliative Care》2014,20(3):182-187