bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dapsone-Induced Acute Pancreatitis
Authors: Jha Shivkumar H , Reddy Jyothi A , Dave Jatin K 
Published: July 2003

Objective To report a case of acute pancreatitis associated with dapsone use. Case Summary An 87-year-old white man was prescribed dapsone for dermatitis herpetiformis. Four weeks later, he developed acute abdominal pain requiring hospitalization. The patient had elevated serum amylase and lipase levels. Laboratory test results for other possible etiologies were negative. His symptoms resolved when dapsone was discontinued. Dapsone was reintroduced for exacerbation of dermatitis herpetiformis 4 months later. The patient again had severe abdominal pain with high amylase and lipase levels. Again, symptoms resolved following dapsone discontinuation. Discussion Only 1 other case of pancreatitis associated with dapsone was found in a MEDLINE search of the literature (1966–June 2003) using the key terms dapsone and pancreatitis. An objective causality assessment revealed dapsone to be a probable cause of acute pancreatitis, based on the Naranjo probability scale. Drugs should always be considered as causative factors for pancreatitis in patients without known risk factors. Dapsone is increasingly used as a second line of treatment of Pneumocystis carinii pneumonia (PCP). The recognition of dapsone-induced pancreatitis is of particular importance in these patients. Conclusions While dapsone is traditionally used for the treatment of leprosy and dermatitis herpetiformis, its use for PCP prophylaxis, malaria, brown recluse spider bites, and acne is not uncommon. Pancreatitis is an uncommon adverse effect of dapsone, and greater awareness of this association will prompt a high index of suspicion in an appropriate clinical setting. Further reporting of cases and clinical research of drug-induced pancreatitis is indicated.
Venous Thromboembolism Prophylaxis in a South Australian Teaching Hospital
Authors: Learhinan Elizabeth R , Alderman Christopher P 
Published: July 2003

Background Venous thromboembolism (VTE) is relatively common among hospitalized patients, is often clinically silent, and is associated with substantial morbidity and mortality. Risk stratification and routine use of thromboprophylaxis for patients at moderate to high risk for VTE are key strategies that can be used to prevent VTE. Objective To assess the appropriateness of the selection and implementation of thromboprophylactic measures for prevention of VTE within a South Australian teaching hospital. Methods Guidelines for risk stratification and prophylaxis were compiled from a range of studies, consensus statements, and tertiary references. Using prospective, observational methodology, data collection was performed through case note audit for 130 inpatient admissions over a 4-week period. Results The decisions regarding the usage of thromboprophylaxis were considered inappropriate in 32% of cases in the study cohort. Suboptimal practices were also observed with respect to factors including the choice between mechanical and pharmacologic methods and the timing of initiation and cessation of thromboprophylaxis. Conclusions These findings provide evidence suggesting that the selection and implementation of thromboprophylaxis require improvement and that appropriate means to facilitate this improvement need to be developed and evaluated through future research.
White Coat Ceremonies in US Schools of Pharmacy
Authors: Brown Daniel L , Ferrill Mary J , Pankaskie Marvin C 
Published: July 2003

Background Pharmacy and medical schools share similar concerns regarding the need to place greater emphasis on professional socialization. Many academic institutions of both professions have elected to establish a white coat ceremony to initiate the process of inculcating professional values. However, a recent literature search revealed little published information on pharmacy white coat ceremonies. Objective To determine the prevalence of white coat ceremonies in US schools of pharmacy and identify commonalities between ceremonies conducted at different schools. Methods In April 2002, a 25-question survey was sent via E-mail to the deans of the 83 accredited schools of pharmacy in the US. The survey solicited details about the nature of each school's white coat ceremony or reasons why the school does not conduct a ceremony. Results The first ceremony in pharmacy was held at the University of Kentucky in 1995. As of May 2002, 51 of the 83 schools had already conducted a white coat ceremony and another 10 indicated plans to initiate a ceremony by the end of the year. Telephone follow-up confirmed that, as of May 2003, the number had risen to 61 schools. Most schools conduct the ceremony during the first professional year. Common features include presentation of the coat, recitation of an oath, a speech by an honored guest, a class photograph, and a reception. Conclusions The white coat ceremony is a growing phenomenon in pharmacy education that could play a pivotal role in the quest to better achieve professional socialization among students.
Triclonal gammopathy in an extranodal non‐Hodgkin lymphoma patient
Authors: Tirelli Angelo , Guastafierro Salvatore , Cava Benedetto , Lucivero Giacomo 
Published: July 2003

AbstractThe case of a patient with an extranodal non‐Hodgkin lymphoma and three M‐components (IgGκ + IgGλ + IgMλ) in the serum is described. Three separate populations of M‐component producing cells have been identified. Since a κ→λ chain switch is not demonstrated, the synthesis of IgGκ and IgGλ by two distinct clones is obvious. IgMλ and IgGλ M‐components are synthesized by two different plasma cell populations that could represent two unrelated cell clones or, alternatively, two subclones originated by a common precursor. After chemotherapy the IgGλ M‐component is replaced by heavy γ chains without evidence of λ light chains. Am. J. Hematol. 73:273–275, 2003. © 2003 Wiley‐Liss, Inc.
Thrombopoietin concentrations in peripheral blood correlated with platelet numbers in two patients with thrombocytopenia by chronic graft‐versus‐host disease
Authors: Hirayama Yasuo , Sakamaki Sumio , Tsuji Yasushi , Sagawa Tamotsu , Chiba Hiroki , Matsunaga Takuya , Kuroda Hiroyuki , Kusakabe Toshiro , Akiyama Takehide , Kato Junji , Niitsu Yoshiro 
Published: July 2003

AbstractThrombocytopenia is well known to be one of the clinical manifestations of chronic graft‐versus‐host disease (cGVHD). However, there exist cases in which the cause of thrombocytopenia has been unexplained. Recently, thrombopoietin (TPO) from bone marrow (BM) stromal cells and transforming growth factor (TGF)‐β from platelets and megakaryocytes have been identified as strong positive and negative regulators of megakaryopoiesis in vivo. We hypothesized that the decreased TPO production from BM could be one of the causes of thrombocytopenia in the patients with cGVHD. In the present study, therefore, TPO and TGF‐β concentrations in peripheral blood (PB) and BM were measured serially in two patients with acute leukemia who had received fully matched stem cell transplantation from relatives and subsequently developed extensive cGVHD with thrombocytopenia. The results showed that platelet numbers correlated well with the TPO concentrations, which were consistently higher in BM than in PB. The difference in TPO concentrations between BM and PB was decreased when the platelet levels were low, indicating that the amount of TPO production from BM decreased throughout the duration of thrombocytopenia. TGF‐β concentrations were normal during all periods in which measurements were carried out. Thus, our results suggest that one mechanism of thrombocytopenia in patients with cGVHD is low TPO production by BM cells. Am. J. Hematol. 73:285–289, 2003. © 2003 Wiley‐Liss, Inc.
Acquired and reversible Pelger‐Huët anomaly of polymorphonuclear neutrophils in three transplant patients receiving mycophenolate mofetil therapy
Authors: Asmis Lars M. , Hadaya Karine , Majno Pietro , Toso Christian , Triponez Frédéric , Starobinski Michel 
Published: July 2003

AbstractDeficient nuclear segmentation and abnormal chromatin condensation define Pelger‐Huët anomaly of polymorphonuclear neutrophils. Next to the hereditary irreversible form, acquired forms both reversible and irreversible have been described. We describe three transplant patients who were all investigated for a left shift in the absence of symptoms or signs of infection and in whom acquired reversible Pelger‐Huët anomaly was discovered. The abnormal PMN phenotype was induced by mycophenolate mofetil (MMF). MMF is a necessary but not sufficient condition for the development of the anomaly. In our three patients a dose–response effect was observed regarding plasma MMF concentration and severity of neutrophil dysplasia. Except for one slightly elevated value, the patients' plasma MMF levels were within the therapeutic range. None of the patients, one who was neutropenic at presentation and two who were non‐neutropenic, developed infectious complications. From our three cases as well as those of other authors, we identify previous graft rejection episodes as a potential predisposing factor for the development of PHA. In the first patient, drug withdrawal led to normalization of PMN morphology. In the other two patients, the left shift disappeared after dose reduction. In these latter two patients, a form of desensitization to the effect of MMF on neutro‐ phils was observed following re‐augmentation of MMF dose. Am. J. Hematol. 73:244–248, 2003. © 2003 Wiley‐Liss, Inc.
Inflammatory mediators promote strong sickle cell adherence to endothelium under venular flow conditions
Authors: Walmet Paula S. , Eckman James R. , Wick Timothy M. 
Published: July 2003

AbstractAdherence of sickle erythrocytes to endothelium in venules is thought to initiate or propagate vaso‐occlusive episodes. Because of blood shear forces with normal microvascular flow, adherence in post‐capillary venules requires binding via high‐affinity receptor‐mediated pathways. Microvascular flow in sickle patients is episodic, even in asymptomatic patients, so adherence may also occur at low shear not requiring high‐affinity binding. Sickle cell binding to endothelium was quantified under flow or static incubation with unusually large vWF, thrombospondin, α4β1/VCAM‐1 or α4β1/fibronectin (FN). Adherence under flow at 0.5 dyne/cm2 shear stress leads to the greatest number of adherent sickle cells. Adherence under flow at 1.0 dyne/cm2 leads to the strongest adherence. Static incubation conditions promote weak adherence of low numbers of sickle cells to endothelium. Following attachment at 1.0 dyne/cm2, adherence strength was 2.5 ± 0.1 or 2.6 ± 0.2 dynes/cm2 for α4β1/VCAM‐1 or α4β1/FN pathways, a level 50% greater than adherence strength mediated by thrombospondin or ULvWF (1.7 ± 0.08 or 1.6 ± 0.07 dynes/cm2, respectively). Sickle cell adhesion promoted by simultaneous activation of α4β1/VCAM‐1 and α4β1/FN pathways is the strongest at 6.2 ± 0.2 dynes/cm2 and adherent red cells resist detachment shear stresses up to 10 dynes/cm2. These data demonstrate that sickle cell adhesion to endothelium is regulated both by receptor/ligand affinity and flow conditions. Thus, both microvascular flow conditions and receptor–ligand interactions may regulate sickle cell adherence in vivo. Am. J. Hematol. 73:215–224, 2003. © 2003 Wiley‐Liss, Inc.
D‐dimer assay in Gaucher disease: Correlation with severity of bone and lung involvement
Authors: Shitrit David , Rudensky Bernard , Zimran Ari , Elstein Deborah 
Published: July 2003

AbstractThe D‐dimer assay as a marker of cross‐linked fibrin may also be an indicator of active microvascular thrombosis, even in patients without overt hypercoagulation. In type I Gaucher disease, there is tremendous phenotypic variability that cannot be ascribed solely to different genotypes. Thus, there are no predictive tests to ascertain patients at risk for bone involvement, such as avascular necrosis, or lung disease, particularly pulmonary hypertension, which are two of the major causes of morbidity in Gaucher disease and which are slow to respond to enzyme replacement therapy. Previous studies to correlate these parameters with thrombophilic profiles have not been conclusive. Levels of D‐dimers were assayed and compared to the presence of avascular necrosis and abnormally elevated TI gradient among other variables, in 118 unselected adult patients (52 males) with Gaucher disease. Of these, 19 patients had very mild Gaucher disease (Severity Score Index, SSI < 5) and 23 had severe disease (SSI > 15); 29 had avascular necrosis; 37 were splenectomized (due to massive splenomegaly and hypersplenism). As an indirect measure of pulmonary hypertension, TI gradient was used: 90 patients had normal TI gradients (<25 mmHg), and 12 patients had abnormal TI gradients (>30 mmHg). There were significant correlations between D‐dimers and avascular necrosis, splenectomy, and elevated TI gradient. Thus, the D‐dimer assay may be potentially predictive of bone and lung involvement in Gaucher disease. Am. J. Hematol. 73:236–239, 2003. © 2003 Wiley‐Liss, Inc.
Early lymphopenia as a risk factor for chemotherapy‐induced febrile neutropenia
Authors: Choi Chul Won , Sung Hwa Jung , Park Kyong Hwa , Yoon So Young , Kim Seok Jin , Oh Sang Cheul , Seo Jae Hong , Kim Byung Soo , Shin Sang Won , Kim Yeul Hong , Kim Jun Suk 
Published: July 2003

AbstractFebrile neutropenia (FN) is a frequent complication of cancer chemotherapy, which causes death in 4–21% of patients and worsens the quality of life of patients. As a simple and accurate way of identifying patients who are at risk of FN, a lymphocyte count on post‐chemotherapy day 5 was suggested. To confirm the feasibility of this method and to define the incidence of FN among our own patient group, we conducted this prospective study. From September 2001 to February 2002, patients who received cytotoxic chemotherapy at Guro Hospital, Korea University, were enrolled. Blood sampling for a complete blood count was done on the starting day of chemotherapy and on day 3 and day 5 post‐chemotherapy. The prospective results of the CBC were compared between the FN group and non‐FN group. During the study period, 82 patients were enrolled. The male to female ratio was 52:30, and the median age was 56 years old (range: 14–78). Underlying malignancies were non‐Hodgkin's lymphoma (14 patients), stomach cancer (17), breast cancer (11), NSCLC (7), hepatobiliary cancer (10), sarcoma (3), colorectal cancer (3), and others (17). The incidence of FN was 18% (15/82 patients), and ANC at the time of FN was 275 ± 327/μl. Duration of fever was 3.9 ± 3.5 days. The incidence of FN was significantly higher in patients with lymphocyte counts at day 3 ≤ 500/μl (P = 0.06), day 5 ≤ 500/μl (P = 0.023), day 3 ≤ 700/μl (P = 0.01), and day 5 ≤ 700/μl (P = 0.0001). As a result of a logistic regression test, a day‐5 lymphocyte count ≤ 700/μl was identified as an independent risk factor for FN.In conclusion, a day‐5 lymphocyte count <700/μl was a risk factor for FN. To strengthen our result, we are planning to validate in a larger patient group. Am. J. Hematol. 73:263–266, 2003. © 2003 Wiley‐Liss, Inc.
Imatinib in Philadelphia chromosome‐positive chronic phase CML patients: Molecular and cytogenetic response rates and prediction of clinical outcome
Authors: le Coutre Philipp , Kreuzer Karl‐Anton , Na Il‐Kang , Schwarz Michaela , Lupberger Joachim , Holdhoff Matthias , Baskaynak Gökben , Gschaidmeier Harald , Platzbecker Uwe , Ehninger Gerhard , Prejzner Witold , Huhn Dieter , Schmidt Christian A. 
Published: July 2003

AbstractPrevious clinical trials with the tyrosine kinase inhibitor imatinib in chronic‐phase Philadelphia chromosome‐positive chronic myelogenous leukemia (CML) resulted in 95% of hematologic and 60% major cytogenetic remissions in patients who failed a previous interferon‐α‐containing regimen. In an identical clinical trial setting with 39 chronic‐phase CML patients we achieved comparable cytogenetic response rates after a median follow up of 30.1 weeks, with an almost identical toxicity profile. In order to identify predictive markers for the therapeutical use of imatinib, we monitored apart from standard hematology parameters bcr/abl fusion transcripts by quantitative real‐time fluorescence RT‐PCR. As previous investigations demonstrated that the plasma protein α‐1 acid glycoprotein might inactivate circulating levels of free imatinib by protein binding with high affinity, we assessed plasma α‐1 acid glycoprotein concentrations in our study cohort as well. Median bcr/abl fusion transcripts declined gradually over the entire treatment period and became significantly lowered at month 3 after initiation of imatinib therapy. Further, we observed elevated pretreatment levels of α‐1 acid glycoprotein in patients who relapsed with leukemia, whereas initial bcr/abl mRNA copy numbers were not of predictive value. In addition, we provide data showing molecular response to this therapy in the vast majority of patients. Finally, our results support the hypothesis, that initially elevated plasma levels of α‐1 acid glycoprotein might serve as a predictive marker for the clinical outcome of treatment with imatinib. Am. J. Hematol. 73:249–255, 2003. © 2003 Wiley‐Liss, Inc.
HLA system affects the age‐at‐onset in chronic myeloid leukemia
Authors: Oguz Fatma Savran , Kalayoglu Sevgi , Diler A. Sarper , Tozkir Hilmi , Sargin Deniz , Carin Mahmut , Dorak M. Tevfik 
Published: July 2003

AbstractChronic myeloid leukemia (CML) occurs from childhood to old age. The adult form is characterized by the presence of Philadelphia chromosome resulting from bcr/abl translocation. The BCR–ABL fusion proteins are immunogenic, and the junctional sequences show unique HLA class I and class II restriction patterns in vitro. A previous study in the west of Scotland showed an influence of several HLA genotypes on the age‐at‐onset of CML. In the present study, we examined the HLA‐A, ‐B, and ‐DRB1/3/4/5 allele and haplotype distributions in Turkish CML patients diagnosed in a single center where they are routinely HLA‐typed by PCR‐SSP analysis as a preparation for stem cell transplantation. The patients were 169 subjects of age 17–60 years. The older patients were not HLA typed and missing from the study group. The age‐matched control group (n = 213) was healthy blood donors from the same geographical area. HLA‐B*37 showed a risk association with CML [P = 0.02; odds ratio (OR) = 5.35]. The DRB1*10 association at similar magnitude was due to its linkage disequilibrium (LD) with B*37. HLA‐B*35 and DRB1*11 showed independent protective effects (P = 0.007 and 0.017; OR = 0.54 and 0.60, respectively). The protective association of DRB1*11 may be due to its involvement in the presentation of the common (b3a2) fusion gene. HLA‐B*14 and DRB1*01 showed strong LD, and all 5 patients who were positive for the presumed haplotype B*14‐DRB1*01 were of age 43 years old or older (P = 0.003), suggesting a delay effect. We also examined the influence of homozygosity for DRB3 (DR52) and DRB4 (DR53) haplotypes on susceptibility. As previously shown in CML and CLL, DRB4 homozygosity was a risk marker (P = 0.01; OR = 3.36), and DRB3 homozygosity was protective (P = 0.007; OR = 0.51). Despite the lack of elderly patients in the study group, the opposite accelerating (DRB4) and delaying (DRB3) effects of homozygous genotypes on the age‐at‐onset were evident. Besides replicating previously found associations in a different population, this study also suggested new, and probably population‐specific associations in CML. The mechanisms by which the HLA system modifies susceptibility to CML are unknown, likely to include immune and nonimmune ones, and worthy of further studies. Am. J. Hematol. 73:256–262, 2003. © 2003 Wiley‐Liss, Inc.
Deep vein thrombosis followed by internal jugular vein thrombosis as a complication of in vitro fertilization in a woman heterozygous for the prothrombin 3′ UTR and factor V Leiden mutations
Authors: McGowan B.M.C. , Kay L.A. , Perry D.J. 
Published: July 2003

AbstractThrombosis of the internal jugular vein is a rare event but one that can have serious consequences. Most cases reported in the literature have occurred in patients with indwelling central venous catheters, in association with head and neck sepsis, or in hypercoagulable states. However, a small number of cases have been associated with in vitro fertilization and more often with the ovarian hyperstimulation syndrome (OHSS). We report the case of a 30‐year‐old woman heterozygous for both the prothrombin 3′ UTR mutation and for the factor V Leiden mutation who presented with a proximal deep vein thrombosis following in vitro fertilization. She subsequently developed an internal jugular vein thrombosis extending into the subclavian and axillary vein despite therapeutic anticoagulation with a low molecular weight heparin. Thromboembolic events can occur in the absence of other clinical features of OHSS, especially in patients with underlying prothrombotic abnormalities. Neck pain and swelling in a pregnant woman, especially one that has undergone in vitro fertilization, should be taken seriously and investigated with duplex scanning and/or MRI. Women with a personal or family history of thrombosis undergoing in vitro fertilization should be made fully aware of the potential thrombotic risks and should be considered for a thrombophilia screen. Am. J. Hematol. 73:276–278, 2003. © 2003 Wiley‐Liss, Inc.
Two patients with heparin‐induced thrombocytopenia followed by idiopathic (immune) thrombocytopenic purpura: Case Report
Authors: Waheed Faisal , Naseer Nauman , Ahmed Tauseef , Nelson John C. 
Published: July 2003

AbstractHeparin‐induced thrombocytopenia (HIT) and idiopathic thrombocytopenic purpura (ITP) are separate and well‐recognized clinical syndromes, 10both having potential for disastrous outcomes. Sequential occurrence of these two diseases has not been reported in the literature. We report herein two patients who were initially diagnosed as having HIT but whose later clinical course was similar to ITP. Although dysfunction of immune system seems to play a role, the precise mechanisms for the development of these diseases are unclear. As both conditions have different natural histories and require different treatment modalities, it is important to recognize that these two diseases may be seen sequentially. Am. J. Hematol. 73:290–293, 2003. © 2003 Wiley‐Liss, Inc.
Delayed introduction of G‐CSF after chemotherapy does not affect peripheral blood stem cell yield and engraftment kinetics in children with high‐risk malignancies: Retrospective study of 45 cases
Authors: Dolgopolov Igor , Andreeva Ludmila , Yankelevich Maxim , Mscheidze Demur , Siegel Stuart , Mentkevich George 
Published: July 2003

AbstractWe retrospectively compared the effects of two time points of G‐CSF (Filgrastim) introduction for PBSC mobilization in 45 children with different malignancies. Seventeen patients received the first G‐CSF dose on day 2 or 3 following chemotherapy (group 1). Twenty‐eight patients received a “flexible” G‐CSF injection schedule when the G‐GSF was started at the time of the first platelet count rise during post‐chemotherapy recovery phase (group 2). Leukapheresis was performed when WBC recovery reached >2.0 × 109/l or if the peripheral blood CD34+ cell level was >0.01 × 109/l. A median of 2 (1–4) leukapheresis procedures was performed in both groups to yield a median of 4.2 and 6.1 × 106 CD34+ cells/kg in groups 1 and 2, respectively, which was generally sufficient for auto‐transplantation. The proportion of patients with a failure of PBSC collection was similar and G‐CSF consumption estimated through the total cycle dose was 2.3 times less in group 2 without increasing infectious risks. The short‐term hematological recovery and the early post‐transplant course were similar in the two groups. Delayed introduction of G‐CSF after chemotherapy allowed PBSC harvest equivalent to that obtained after early G‐CSF introduction. This approach could be an interesting alternative in PBSC mobilization but should be assessed by a prospective controlled study. Am. J. Hematol. 73:225–229, 2003. © 2003 Wiley‐Liss, Inc.