Detection of Platelet Antibody Using Rosette Technique with Anti-IgG Antibody-Coated Polyacrylamide Gel

Abstract. Paraformaldehyde-fixed platelets from normal donors were used for detection of antibody to platelet by in vitro sensitization (indirect method) utilizing rabbit anti-human IgG heavy chain specific antibody-coated polyacrylamide gels (Immunobeads). The sensitized platelets formed rosettes with Immunobeads and the positive rosette count was over 30%, while control showed less than 8% when normal sera were used. This method was also applicable for detecting antibody-sensitized platelets in vivo (direct method) in patients with autoimmune thrombocytopenia. This method is simple, rapid and reproducible for clinical use. Direct and indirect immunofluorescent antibody tests and a blocking test with anti-human serum also supported the results of Immunobead rosetting technique.     

SEVERE DIARRHEA DUE TO COKEROMYCES RECVRVATUS IN A BONE MARROW TRANSPLANT RECIPIENT

Cokeromyces recurvatus , a sporangiola-forming dimorphic is a rare cause of urogenital infection in humans. We report here a case of severe watery diarrhea due lo C. recurvains , which was treated successfully with high-dose oral nystatin therapy. We speculate that our patient was probably predisposed to infections due to opportunistic organisms, such as C. recurvatus , because of post-transplantation immunosuppression. To our knowledge, our patient represents the first documented case of diarrhea due to C. recurvatus in man und this ease highlights the potential pathogenic capability of this opportunistic organism in immunosuppressed patients.     

Visual factors that significantly impact academic performance.

BACKGROUND: Both race and socio-economic status are correlated to performance in the classroom. These two factors are inter-related, since minorities, proportion-wise, are more highly represented in the lower socio-economic strata. Inefficient visual skills have been shown to be more prevalent among minority groups and in low socio-economic groups. These inefficient visual skills impact the students' learning. This study was undertaken to discover the visual skills that were significantly correlated with academic performance problems. METHOD: A total of 2,659 examinations were performed on 540 children over the course of six examination periods, which were administered over three consecutive school years. Socio-economic, racial, and standardized academic performance data (Iowa Test of Basic Skills--ITBS) were furnished by the families and the school system. The visual and demographic data from the examinations were then compared to performance on the 21 subtests of the ITBS. RESULTS: Some visual factors were found to be a much better predictor of scores on the ITBS than either race or socio-economic status. Even though the significance of these two demographic variables was small, race and socio-economic variables were each significant in about a third of the 21 ITBS scores. CONCLUSION: Visual factors are significantly better predictors of academic success as measured by the ITBS than is race or socio-economics. Visual motor activities are better predictors of ITBS scores than are binocularity or accommodation. These latter skills were significant predictors also, but to a lesser degree.     

Perspectives of Patients and Providers in Using Shared Decision Making in Psychiatry

Community Mental Health Journal - There is increased interest over the last decade in the use of Shared Decision Making with individuals with serious mental illness to improve engagement in...     

The effectiveness of quetiapine versus conventional antipsychotics in improving cognitive and functional outcomes in standard treatment settings

OBJECTIVE: To examine the effectiveness of quetiapine versus conventional antipsychotics in improving cognitive and functional outcomes. METHOD: Forty stable outpatients with DSM-IV schizophrenia treated in public outpatient clinics were randomly assigned to continue taking conventional antipsychotic medications or switch to quetiapine for 6 months, beginning September 1998 and ending July 2000. Neurocognitive and functional measures were obtained at study entry, 3 months, and 6 months by raters blinded to treatment. Group differences were examined using repeated-measures analyses of covariance for mixed models. RESULTS: The mean (SD) dose of conventional antipsychotics in chlorpromazine equivalents was 348.00 (348.28) mg/day; the mean (SD) dose of quetiapine was 319.25 (142.55) mg/day. A cognitive function summary score improved in the quetiapine group relative to the group treated with conventional antipsychotics over the 6-month period (F = 5.80, df = 1,28.9; p <.023). Patients taking quetiapine did better with respect to both verbal fluency (initiation) and verbal memory. There were also statistically significant group differences with respect to quality of life favoring the quetiapine group (F = 4.87, df = 1,29; p <.04). Differences were not found with respect to adaptive functioning. CONCLUSION: Quetiapine improved cognition relative to conventional agents. After 6 months, groups differed by more than 1 standard deviation when baseline cognitive functioning was taken into account. No group differences were found with respect to improvements in community functioning. Improvements in adaptive functioning may lag behind improvements in cognition. Psychosocial programming may be necessary to translate gains in cognition into improvements in adaptive functioning.     

Multimodality treatment of upper extremity bone and soft tissue sarcomas

Management of soft tissue sarcomas requires a multidisciplinary approach with the help of a surgical-orthopedic oncologist, medical oncologist, radiation oncologist, pathologist, hand surgeon, and physiatrist/physical therapist. The indication and benefits of chemotherapy and radiation therapy for soft tissue sarcomas remain somewhat controversial.However, the encouraging results of studies using the most active chemotherapeutic agents gives credence to considering neoadjuvant chemoradiation therapy or postoperative adjuvant chemotherapy in this group of patients.     

Risk of Meningococcal Infection in College Students

Context  The number of meningococcal outbreaks on college campuses have been increasing in the past few years. However, no published studies have documented the incidence of invasive meningococcal infection in college students or whether the incidence is higher than in the general population of the same age. Objective  To compare the incidence of invasive meningococcal infection in Maryland college students with that of the general population of the same age. Design  Retrospective cohort study. Setting and Patients  Maryland residents with meningococcal infection from 1992-1997 identified from active, laboratory-based, statewide surveillance for invasive meningococcal disease. Main Outcome Measures  Incidence of invasive meningococcal infection. Results  Of 228 patients with invasive meningococcal infection, 67 were aged 16 to 30 years; 11 and 3 of these attended Maryland 4- and 2-year colleges, respectively. Of these, 12 (86%) had infection caused by Neisseria meningitidis serogroups included in the current meningococcal vaccine. The average annual incidence was 1.74 per 100,000 among students in 4-year schools vs 1.44 per 100,000 for the general population of the same age (P=.60). Among students in 4-year schools, the incidence was 3.24 per 100,000 in on-campus residents vs 0.96 per 100,000 in off-campus residents (relative risk, 3.4; 95% confidence interval, 1.0-11.6; P=.05). Conclusions  The incidence of meningococcal infection in college students is similar to the incidence in the general population of the same age, but college students residing on campus appear to be at higher risk than those residing off campus.      

A phase I trial of intravenous infusion of ONYX-015 and enbrel in solid tumor patients

ONYX-015 is an attenuated chimeric human group C adenovirus, which preferentially replicates in and lyses tumor cells that are p53 negative. The purpose of this phase I, dose-escalation study was to determine the safety and feasibility of intravenous infusion with ONYX-015 in combination with enbrel in patients with advanced carcinoma. Enbrel is a recombinant dimer of human tumor-necrosis factor (TNF)-alpha receptor, previously shown to reduce the level of functional TNF. Nine patients, three in each cohort received multiple cycles of ONYX-015 infusion (1 x 10(10), 1 x 10(11) and 1 x 10(12) vp weekly for 4 weeks/cycle) in addition to subcutaneous enbrel (only during cycle 1) injections per FDA-indicated dosing. Of the nine patients, four had stable disease. No significant adverse events were attributed to the experimental regimen, confirming that enbrel can be safely administered along with oncolytic virotherapy. Two of the three patients in cohort 3 had detectable viral DNA at days 3 and 8 post-ONYX-015 infusion. Their detectable circulating viral DNA was markedly higher during cycle 1 (with enbrel coadministration) as compared with cycle 2 (without enbrel) at the same time points. Area under the curve determinations indicate a marked higher level of TNF-alpha induction and accelerated clearance at cycle 2 in the absence of enbrel. Further assessment is recommended.