tbuckley/cabot-search huggingface dataset:
Heparin-Associated Thrombocytopenia
Authors: THOMAS G. BURNAKIS
Journal: Annals of Internal Medicine (1984)

Letters and Corrections1 August 1984Heparin-Associated ThrombocytopeniaTHOMAS G. BURNAKIS, PHARM.D.THOMAS G. BURNAKIS, PHARM.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-101-2-279_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: King and Kelton (1) point out an important side effect of heparin. Given the incidence of thrombocytopenia and the number of persons treated, most clinicians can expect to see a few thrombocytopenic patients. However, I am concerned by the authors' recommendation against monitoring platelet counts.Their basis for this recommendation, as supported by their Figure 1, appears to be that thrombocytopenia and thrombosis occur simultaneously; therefore, monitoring would not aid intervention. Yet, the legend for this figure states that the relationship shown is one of first documentation of thrombosis or thrombocytopenia. Could this not represent some bias...References1. King D and Kelton J. Heparin-associated thrombocytopenia. Ann Intern Med. 1984;100:535-40. LinkGoogle Scholar2. CIMO P, MOAKE J, WEINGER R, BEN-MENACHEM Y, and KHALIL K. Heparin-induced thrombocytopenia: association with a platelet aggregating factor and arterial thromboses. Am J Hematol. 1979;6:125-33. CrossrefMedlineGoogle Scholar3. KAPSCH D and SILVER D. Heparin-induced thrombocytopenia with thrombosis and hemorrhage. Arch Surg. 1981;116:1423-7. CrossrefMedlineGoogle Scholar4. NELSON J, LERNER R, GOLDSTEIN R, and CAGIN N. Heparin-induced thrombocytopenia. Arch Intern Med. 1978;138:548-52. CrossrefMedlineGoogle Scholar5. CIPOLLE R, RODVOLD K, SEIFERT R, CLARENS R, and RAMIREZ-LASSEPAS M. Heparin-associated thrombocytopenia: a prospective evaluation of 211 patients. Ther Drug Monk. 1983;5:205-11. CrossrefMedlineGoogle Scholar1. KING D and KELTON J. Heparin-associated thrombocytopenia. Ann Intern Med. 1984;100:535-40. LinkGoogle Scholar2. WEITBERG A, SPREMULLI E, and CUMMINGS F. Effect of low-dose heparin on the platelet count. South Med J. 1982;75:190-2. CrossrefMedlineGoogle Scholar1. KING D and KELTON J. Heparin-associated thrombocytopenia. Ann Intern Med. 1984;100:535-40. LinkGoogle Scholar2. MALCOLM I, WIGMORE T, and STEINBRECHER U. Heparin-associated thrombocytopenia: low frequency in 104 patients treated with heparin of intestinal mucosal origin. Can Med Assoc J. 1979;120:1086-8. MedlineGoogle Scholar3. POWERS P, CUTHBERT D, and HIRSH J. Thrombocytopenia found uncommonly during heparin therapy. JAMA. 1979;241:2396-7. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: THOMAS G. BURNAKIS, PHARM.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1984Volume 101, Issue 2Page: 279-280KeywordsHeparinPlateletsThrombosis ePublished: 1 December 2008 Issue Published: 1 August 1984 PDF downloadLoading ...
Dutch regulate sponsorship of hospitals
Authors: T. Sheldon
Journal: BMJ (1999)

Dutch hospitals and health institutions are being urged to sign a new code of conduct regulating sponsorship and fundraising, which researchers estimate now raise more than £200m ($320m) a year.

The code, backed by the Ministry of Health, follows MPs' questions over the implications of industry offering hospitals “technical support” and pharmaceutical companies sponsoring patients' groups.

Though the code is voluntary, its authors believe that it …
Routine postnatal examination. Pelvimetry is unnecessary ...
Authors: P J Danielian, R C Henshaw, H K Hinshaw
Journal: BMJ (1993)

Rituals in antenatal careConsider women's psychosocial needs EDITOR,-We welcome Philip Steer's call to dis- card outdated rituals in antenatal care and to explore more promising interventions.'A con- siderable body of evidence casts doubt on many of the procedures carried out in antenatal consultations; the work of Hall et al in Aberdeen2 and comparative evidence from Europe3 suggest that fewer antenatal visits may be acceptable.However, we would urge caution on two counts before the schedule of visits is changed.Firstly, although the experience in Aberdeen is reassuring, as is that of a trial in Zimbabwe (S P Munjanja, conference on the Royal College of Obstetricians and Gynaecologists and safe motherhood, 13-14 July 1992), there are no results from randomised controlled trials of different schedules ofvisits in Britain.Perhaps more importantly, any proposed changes in the schedule of antenatal visits should be shown to meet women's psychosocial needs as well as to be clinically safe.Although trials of social support have not shown any great effects on traditional clinical outcomes, the evidence shows that "supported mothers are more likely . . . to feel 'in control' during pregnancy and postpartum, to be satisfied with their medical care, not to feel unhappy after the birth, to have partners who feel involved with the baby, to be breastfeeding, to report physical well-being and to have babies with fewer worrying health problems."4If the number of antenatal visits is reduced without these important measures being taken into account, benefits may be lost.We are currently conducting a randomised controlled trial of a reduction in the number of antenatal visits for low risk women.We hope that this will provide helpful information about the clinical and psychosocial effectiveness of different schedules ofvisits.
Outcome and Impact of Surgery in Paradoxical Low-Flow, Low-Gradient Severe Aortic Stenosis and Preserved Left Ventricular Ejection Fraction
Authors: Dania Mohty, Julien Magne, Mathieu Deltreuil, Victor Aboyans, Najmeddine Echahidi, Claude Cassat, Philippe Pibarot, Marc Laskar, Patrice Virot
Journal: Circulation (2013)

The clinical relevance and management of paradoxical low-flow, low-gradient aortic stenosis (LFLG-AS) with preserved left ventricular ejection fraction remain debated. The aim of this study is to determine the features and outcome of LFLG-AS assessed using cardiac catheterization.Between 2000 and 2010, 768 patients with preserved left ventricular ejection fraction (>50%) and severe AS (valve area ≤ 1 cm(2)) without other valvular disease underwent cardiac catheterization. Mean age was 74 ± 8 years, 42% were women, and 46% had associated coronary artery disease. The prevalence of LFLG (indexed left ventricular stroke volume <35 mL/m(2) and mean gradient <40 mm Hg), normal flow high gradient, normal flow low gradient, and low flow high gradient were 13%, 50%, 22%, and 15%, respectively. Compared with patients with normal flow high gradient, those with LFLG were significantly older, with significantly reduced systemic arterial compliance and vascular resistances and increased valvulo-arterial impedance (all P<0.05). Ten-year survival was reduced in LFLG-AS (32 ± 9%) compared with normal flow high gradient (66 ± 4%; P=0.0002). After adjustment for other risk factors, LFLG-AS was independently associated with reduced long-term survival (hazard ratio, 1.85; 95% confidence interval, 1.08-3.07; P=0.02). However, despite higher operative mortality, patients with LFLG-AS undergoing aortic valve replacement seemed to have better long-term survival than those managed conservatively (5-year survival rate: 63 ± 6% versus 38 ± 15%; P=0.007; hazard ratio, 0.23; 95% confidence interval, 0.09-0.59; P=0.002).This large cardiac catheterization-based study reports that the LFLG-AS entity is not rare and is associated with worse outcome whether treated medically or surgically. However, these patients may have better long-term survival if treated surgically. Further prospective studies are needed to confirm this finding.
A dynamic prognostic model to predict survival in post–polycythemia vera myelofibrosis
Authors: Francesco Passamonti, Elisa Rumi, Marianna Caramella, Chiara Elena, Luca Arcaini, Emanuela Boveri, Cecilia Del Curto, Daniela Pietra, Laura Vanelli, Paolo Bernasconi, Cristiana Pascutto, Mario Cazzola, Enrica Morra, Mario Lazzarino
Journal: Blood (2008)
The surface temperature of electromagnetic velocity probes
Authors: M. A. S. Jones, D. G. Wyatt
Journal: Cardiovascular Research (1970)

The surface temperature rise of Mills's velometer and of a dummy velometer thermally similar to that described by Warbasse, Hellman, Gillilan, Hawley, and Babitt (1969) have been calculated and experimentally determined under various conditions. The results are in satisfactory agreement. Typical rises for Mills's velometer (excited at its nominal dissipation of 0·45 watt) are 10°C under the conditions for assessing zero flow response, and 1·5°C in flowing water. Corresponding values for the dummy velometer excited at 14 W are in excess of 63°C (the surface was then above the boiling point of water initially at 37°C) and 33°C respectively. The effect of the heated probes upon the precipitation of plasma proteins has also been investigated. It is concluded that, with one reservation, Mills's velometer is thermally safe, but that the instrument described by Warbasse et al. (1969) and by Bond and Barefoot (1967) is not thermally safe and is not suitable for use in man.
Applications of numerical methods to simulate the movement of contaminants in groundwater.
Authors: N Z Sun
Journal: Environmental Health Perspectives (1989)

This paper reviews mathematical models and numerical methods that have been extensively used to simulate the movement of contaminants through the subsurface. The major emphasis is placed on the numerical methods of advection-dominated transport problems and inverse problems. Several mathematical models that are commonly used in field problems are listed. A variety of numerical solutions for three-dimensional models are introduced, including the multiple cell balance method that can be considered a variation of the finite element method. The multiple cell balance method is easy to understand and convenient for solving field problems. When the advection transport dominates the dispersion transport, two kinds of numerical difficulties, overshoot and numerical dispersion, are always involved in solving standard, finite difference methods and finite element methods. To overcome these numerical difficulties, various numerical techniques are developed, such as upstream weighting methods and moving point methods. A complete review of these methods is given and we also mention the problems of parameter identification, reliability analysis, and optimal-experiment design that are absolutely necessary for constructing a practical model.
Respecting the Autonomy of Competent Patients
Authors: Marcia Angell
Journal: New England Journal of Medicine (1984)

The weight of recent opinion, as well as a new body of law, supports the rights of competent adults to have information about their medical condition and to participate in decisions concerning their health.1 2 3 4 5 This is not to say that patients are invited to make technical decisions that they may not be qualified to make; rather, they have the right to make the value judgments that are a part of most important medical decisions and that they are uniquely qualified to make.The article by Bedell and Delbanco in this issue of the Journal tells us something about how the . . .
CHLORIC AeTHER: ITS PROPERTIES AND USES, ESPECIALLY IN CHOLERAIC AND OTHER FORMS OF DIARRHOEA, AND IN CHOLERA
Authors: G. B. Mead
Journal: BMJ (1854)

DIARBBEA and cholera have undoubtedly of late very much increased in prevalence in this country.The latter, once only an occasional visitor to our shores, now appears to have become domesticated among us; and in future we may look forward to the deaths from this disorder forming a not inconsiderable item in the returns of the Registrar- General.Undoubtedly epidemic diarrhceas are much more frequent now than formerly; and they often assume a form which sets at defiance all the established modes of treatment.Whenever diarrhoea prevails as an epidemic, though the flux in the majority of cases is readily checked by the or4inarymodes of treatment,and though where spasmodic pain is combined, it generally is relieved by opium and other ano- dynes, yet a certain number of cases occur, which, though not marked by any other peculiarity save persistence of the Pain and flux, obstinately resist all ordinary treatment; and if the patients, previousily to the attack, have been m a debilitated condition, they are placed in imminent danger.During the years 1846, 7, and 8, the typhus fever pre- railed to a considerable extent in several of the most popu- lous districts of the Bradford (Yorkshire) Union.
Time Dependent Improvement in Survival for Women with Multiple Brain Metastases from HER2 Positive Breast Cancer: The Influence of Systemic Therapy.
Authors: T. Tillett, R. Huckett, D. Church, J. Braybrooke, E. Whipp, A. Bahl, C. Price
Journal: Cancer Research (2009)

Abstract Background: Women with multiple breast cancer brain metastases (BM) ineligible for neurosurgery or radiosurgery have a poor prognosis and the role of systemic therapy is ill defined.Method: The outcomes for 120 women treated for multiple (≥2) BM between 2002-2008 at this regional cancer centre have been analysed according to time of BM diagnosis (Cohorts (A) 2002-5 &amp; (B) 2006-8) and HER2 status of the primary tumour (+ or -). We have previously shown that A+ patients experienced longer survival than A-, the advantage apparently restricted to a subgroup of A+ who continued trastuzumab after BM diagnosis (Church et al, Am J Clin Oncol 2008, 31(3) 250-4).Results: There was no difference in survival between B- and A- cohorts (B- patients (n=25) survival median 119 days; A- patients (n=53) median survival 118 days; p=0.57). In contrast there was a time dependent improvement in survival favouring B+ patients (n=19, median 520 days,) over A+ patients (n=23, median 148 days, p &amp;lt;0.02). B+ and A+ cohorts differed significantly in the consistency of their exposure to both trastuzumab (T) and chemotherapy (CT) post BM (p&amp;lt;0.02). Subsequently, patients in the B+ cohort was more frequently treated with additional lines of CT and 5 patients in the B+ cohort (versus none in A+) went on to receive second line anti-HER2 therapy (lapatinib).CohortT + CTLines of CT≥ 2LapatinibMedian survival12 month survivalA+ (n=23)39% (9pts)22% (5)0% (o)148 days30%B+ (n=19)79% (15pts)58% (11)26% (5)520 days80% p&amp;lt;0.02p&amp;lt;0.03p&amp;lt;0.02p&amp;lt;0.02 A+ and B+ were not significantly different with regard to presence of systemic metastases (SM) or time from SM to BM (median A+ 304 days; B+ 334, p=0.3)Conclusion: Following our earlier observation on the A+ cohort, the improvement in survival for B+ may reflect increased optimism of patients and physicians regarding the role of systemic therapy. Although no randomised trial has been performed, it is increasingly apparent from these and other data that HER2+ patients with multiple BM benefit from continued incorporation of systemic therapy into clinical management strategies and, at variance with historic experience, survival &amp;gt; 1 year can now be expected. Randomised trials, specifically to identify the best agents to accompany anti-HER2 therapy, will be required to further extend this benefit. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5092.
The Step 2 Clinical Skills Examination
Authors: James A. Hallock, Donald E. Melnick, James N. Thompson
Journal: JAMA (2006)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Abstract 4000: Cellular MRI of human breast cancer cells labeled with gadofluorine M
Authors: Michael M. Lizardo, John A. Ronald, Yuanxin Chen, Bernd Misselwitz, Brian K. Rutt, Ann F. Chambers
Journal: Cancer Research (2010)

Abstract The ability to non-invasively locate and quantify tumor cell number at a metastatic site would be of considerable interest in pre-clinical and clinical metastasis research. To this end, our objective is to develop positive-contrast cellular magnetic resonance imaging (MRI) for use in quantifying tumor cell number at a metastatic site in vivo. The goals of the current study were to characterize the in vitro labeling of MDA-MB-231-luc-D3H2LN human breast cancer cells with a novel positive contrast MR agent Gadofluorine M (GdF), and to demonstrate the detectability of GdF-labeled cells in vitro at clinical strength MRI (1.5 and 3Tesla) scanners. Briefly, cells (1.5 × 107cells) were loaded by simple incubation for 24h with GdF at concentrations ranging from 25μM to 10mM. GdF-loading from 25μM to 1000μM did not result in significant changes in metabolic activity. Higher GdF-loading concentrations, 2500μM and 10mM, resulted in a 16% and 21% reduction in metabolic activity, respectively. The lowest GdF-loading concentration used (25μM) resulted in a significant (9-fold) increase in MR signal enhancement which then plateaued from 100μM to 1000μM. T1-relaxometry of cell pellets demonstrated a similar statistical trend in relaxation rates of cell pellets for all loading conditions, and at both field strengths. Inductively-coupled plasma atomic emission spectroscopy was performed on the cell pellet extracts to assess the average amount of GdF that had accumulated per cell at each incubating concentration. Since the relaxivity of an MR contrast agent can be affected by its intracellular location, we assessed whether internalized GdF-cc (GdF analog where the mannose moiety was replaced with carbocyanine) was cytosolic or compartmentalized into endosomes, via immunostaining for mannose-6-phosphate receptor. Using confocal fluorescence microscopy, we found that GdF is largely cytosolic and did not co-localize to late endosomes, an optimal situation for achieving maximum positive-contrast by T1-shortening since endosomal compartmentalization can lessen the enhancement seen in MR images. From these results, we have determined that the GdF loading concentration of 1000μM permits the highest payload for detection by cellular MRI in clinical field strength scanners. Information from this proof-of-principle study will support future work to develop positive-contrast cellular MRI as a new approach to quantitative imaging of metastatic cells in vivo. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4000.
A Cyproheptadine-Reversible Defect in ACTH Control Persisting after Removal of the Pituitary Tumor in Cushing's Disease
Authors: Harvey V. Lankford, H. St. George Tucker, William G. Blackard
Journal: New England Journal of Medicine (1981)

We studied two phases of cortisol feedback suppression of ACTH in nine patients who had had adrenalectomy for Cushing's disease. Four had been treated by adrenalectomy alone and presumably had ACTH-secreting pituitary tumors. Five others were studied two or more years after transsphenoidal removal of an ACTH-secreting microadenoma. In both groups, cortisol-ACTH feedback during the first 30 minutes of cortisol infusion was abnormal; plasma ACTH fell only 2.7±2.6 per cent (mean ±S.E.), as compared with 28.0±10.1 per cent in five hypoadrenal controls (P<0.01). The fall in ACTH during the second phase of cortisol infusion was similar in the patients and the controls. Cyproheptadine corrected the feedback abnormality occurring during the first phase in both groups of patients with Cushing's disease; ACTH fell by 24.4±4.8 per cent (P<0.005). Persistence of a cortisol-ACTH feedback abnormality after removal of the pituitary tumor in Cushing's disease, as well as the correction by cyproheptadine, suggests that higher centers have a role in the pathophysiology of Cushing's disease. (N Engl J Med. 1981; 305:1244–8.)
WHO declares polio a public health emergency
Authors: A. Gulland
Journal: BMJ (2014)

The World Health Organization has declared the spread of polio a global public health emergency, which, if left unchecked, could derail efforts to eradicate the disease.1

The 14 members of WHO’s international health regulations emergency committee met at the end of April alongside representatives from the nine states where wild poliovirus has been found in the past 12 months: Afghanistan, Cameroon, Equatorial Guinea, Ethiopia, Israel, Nigeria, Pakistan, Somalia, and Syria.

The committee presented its findings to Margaret Chan, WHO’s director general, informing her that the cross border spread of wild poliovirus in 2014 was an “extraordinary event.” On 5 May Chan declared the situation a global public health emergency under international health regulations. The last such declaration was made in 2009 over the H1N1 influenza pandemic.

Bruce Aylward, WHO’s assistant director general for polio eradication and emergencies, …
Impairment of neutrophil Fc gamma receptor mediated transmembrane signalling in active rheumatoid arthritis.
Authors: N.J Goulding, P.M Guyre
Journal: Annals of the Rheumatic Diseases (1992)

Neutrophil Fc gamma receptor (Fc gamma R) signalling responses were compared in healthy subjects, patients with definite rheumatoid arthritis (RA), ankylosing spondylitis, and osteoarthritis. The patients with A were subdivided into those with active synovitis and those with quiescent disease. Basal intracellular calcium ion concentrations in patients with inactive RA were significantly higher than in control subjects, which in turn were greater than in patients with active RA. Transient cytosolic calcium ion fluxes were observed after binding Fc gamma RII or Fc gamma RIII with specific monoclonal antibodies and cross linking with the F(ab')2 fragment of antimouse IgG. Response times were significantly faster for Fc gamma RII than for Fc gamma RIII. Peak concentrations of intracellular calcium ions after neutrophil stimulation were comparable for Fc gamma RII and RIII in healthy subjects. Neutrophils in patients with ankylosing spondylitis and osteoarthritis responded to Fc gamma R triggering, but in the group with active RA fluxes of calcium ions were severely depressed. Neutrophils isolated from patients with RA with quiescent disease showed exaggerated responses when compared with controls. Expression of all three Fc gamma R types on neutrophils from patients with active RA, as measured by monoclonal antibody binding, was comparable with control cells. Impairment of neutrophil Fc gamma R cytosolic signalling in active RA could reflect a receptor signalling defect with potential effects on Fc mediated functions, or a fundamental defect in calcium ion homeostasis within these cells.