摘要:

Prophylactic platelet administration is indicated at counts below 20×109/1. The bleeding tendency and severity were compared between thrombocytopenic patients with acute-lymphocytic leukemia (ALL) and acute non-lymphocytic leukemia (ANLL) in the ranges of 10–20×109/1 platelets, while prophylactic platelet administration was given only below 10×109/1. The bleeding tendency for ALL was quite similar at platelet counts above or below 10×109/1. The bleeding tendency was significantly lower (p<0.001) when the platelets were above this level in ANLL patients. When the thrombocytopenia was caused by chemotherapy, the bleeding was significantly lower in both types of leukemia above 10×109/1 (p<0.05 for ALL, p<0.001 for ANLL) as compared with lower counts. When the thrombocytopenia was caused by leukemia, the bleeding tendency was similar in both types of leukemia and at all platelet counts (below 20×109/1). Fever, not associated with sepsis, augmented the bleeding severity of patients with ANLL. Stable or rising counts of platelets were associated with significantly lower bleeding tendency above 10×109/1 only in ANLL patients. The decision for prophylactic platelet administration at counts below 20×109/1 should be guided by the type of the leukemia (ALL vs. ANLL), the cause of throm-bocytopenia (chemotherapy vs. leukemia per se), the trend of the platelet counts, presence of fever and patient's age (below or above 18 years). Prophylactic platelet administration can be safely postponed until the count is below 10 × 109/1 in paitents with ANLL, without fever, with chemotherapy-induced thrombocytopenia and older than 18 years, regardless of the platelet trend.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The acute hemodynamic effect of an intravenous (IV) bolus of vanadate (10 μmol/kg bwt) followed by an IV infusion at 0.5 μmol/kg min was studied in Wistar rats at three different levels of Na intake: low Na+(0.5mEq/24 h), normal Na+(1.5 mEq/24 h), and high Na+(15 mEq/24 h). Hemodynamic changes were measured using the radioactive microsphere method. Vanadate decreased cardiac output by 52.0 ± 6.4% in low Na+rats, by 41.2 ± 3.3% in normal Na+, and by 29.2 ± 3.1% in high Na+group. Total peripheral resistances increased by 47.1 ± 26% in high Na+, group. Total peripheral resistances increased by 47.1 ± 26% in high Na+rats, by 80.1 ± 6.6% in normal Na+, and by 96.3 ± 4.5% in low Na+group. Renal blood flow decreased by 70 ± 4% in low Na+, 58 ± 3% in normal Na+, and 39 ± 3% in high Na+, Cerebral, testicular, and splanchnic blood flow showed smaller changes. These results demonstrate that intravenous vanadate induces marked hemodynamic changes that depend on Na+intake being more striking when the intake of sodium is reduced.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Cerebral arterial pulsatile flow changes and the effect of partial plasma excahnge transfusion on these pulsatile flow patterns were studied in neonatal polycythemia/hyperviscosity syndrome by transcutaneous Doppler technique. Twenty-two infants with cord blood hematocrit >58% (>2 SD above the mean) were studied from a total of 2,400 infants who were screened for cord hematocrit over a 6-month period. Each of 22 infants had the following initial studies: radial artery hematocrit, viscosity, intracranial pressure measurement, and anterior cerebral arterial Doppler study to determine pulsatility index, mean systolic, mean and diastolic, and mean flow velocities, and area underneath the curve of the velocity tracings/min. Twelve of 22 infants had radial artery hematocrit <63%, were normoviscous (<13.5 cps, 11.25 sec-1) and were designated as control infants. Ten (study infants) were poly-cythemic (hematocrit ≥63%) and hyperviscous (≥13.5 cps, 11.25 sec-1). All study patients were treated by partial plasma exchange transfusion. Initial studies were repeated after exchange transfusion. Control infants were not treated. Prior to exchange procedure, the polycythemic hyperviscous infants had significantly higher hematocrit, viscosity, and pulsatility index; the other Doppler measurements and heart rate were lower than those of control babies. The exchange procedure resulted in signigicantly decreased hematocrit, viscosity, and pulsatility index and increase in the other Doppler measurements, heart rate, and intracranial pressure. All postexchange measurements of study infants were not statistically different from the control infants. These data suggest that neonatal polycythemia/hyperviscosity syndrome may be associated with abnormal cerebral hemodynamics that could improve with partial plasma exchange transfusion.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Thyrotropin releasing hormone (TRH) in the human cerebrospinal fluid (CSF) of 102 patients with non-neurologic and neurologic diseases was measured by a specific TRH radioimmunoassay. TRH levels in CSF were 17.6 ± 3.4 pg/ml (mean ± SE) in non-neurologic diseases. TRH levels in CSF were significantly elevated in cases of spinal cord tumor and multiple sclerosis (acute phase). Elevated TRH levels in CSF were decreased in these diseases by operation or prednisolone treatment, respectively. From these data, it is suggested that TRH is present in the human CSF and that measurement of TRH levels in CSF may be a useful indicator of the activity of certain neurologic diseases.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Twenty subjects with clinically stable asthma were treated in double-blind crossover manner with inhaled and oral metaproterenol, alone and in combination. The combination of inhaled and oral metaproterenol resulted in a greater degree of bronchodilation than either inhaled or oral alone. Inhaled metaproterenol was not associated with any significant side effects. Oral metaproterenol was associated with a small but significant increase in pulse rate and systolic blood pressure, and a small incidence of unpleasant sensations such as tremor and palpitation. Older subjects were more likely to experience the unpleasant sensations, whereas younger subjects were more likely to experience the increase in pulse rate.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The intracavitary administration of chemotherapeutic agents for their cytotoxic properties as therapy for tumors confined to body cavities has significant theoretical appeal. Pharmacokinetic evaluation of several clinically useful antineoplastic drugs has confirmed modeling predictions that suggested a major advantage for cavity exposure to the agents compared with that of the plasma when the drugs are delivered directly into the body cavity. As the direct penetration of the agents into tissue is quite limited, the greatest potential utility of this therapeutic approach would be in patients with microscopic residual disease following debulking surgery or as therapy for patients with a high risk of intraperitoneal recurrence. Major toxicities of this innovative technique include abdominal pain (chemical serositis) and infection. Additional clinical evaluation will be required to define a role for cytotoxic intracavitary chemotherapy in the management of malignant disease.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Antinuclear antibody (ANA) was demonstrated in two children with otherwise typical Henoch-Schönlein purpura (HSP). The presence of ANA may reflect underlying immunoregulatory abnormalities in HSP.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

A 58-year-old man presented with hyperthyroidism. By palpation, the left lobe of the thyroid was diffusely enlarged, and the right lobe was normal. Radioactive iodide scintiscan demonstrated homogeneous uptake that was localized to the enlarged left lobe, with near total suppression of uptake on the right. TSH stimulation led to clear visualization of a normal appearing right lobe, findings most consistent with an autonomously functioning solitary nodule on the left. Left hemithyroidectomy cured the hyperthyroidism. However, no single dominant nodule was found in the left lobe. Rather, there was diffuse thyroidal hyperplasia of the micronodular variety, consistent with multinodular toxic goiter. Thus, in this patient with a usually diffuse form of thyroid disease, the autonomously functioning hyperactive follicles were localized predominantly to one thyroid lobe. This variant expands the clinical spectrum of multinodular toxic goiter, and further emphasizes the extent of asymmetry in the distribution of hyperactive follicles than can occur in this disorder.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Kingella species are rarely reported as a cause of endocarditis. We report two cases ofK. denitrificans endocarditis occurring in patients with prosthetic valves.K. denitrificans has not been previously reported to cause prosthetic valve endocarditis. Both patients may have developed bacteremia from altered upper respiratory or oral mucosa with subsequent prosthetic valve infection. Treatment with penicillin G and streptomycin was successful in the first patient, whereas ampicillin alone resulted in clinical cure in the second case. Neither patient required further surgery. In vitro antibiotic susceptibility testing indicated that both organisms were highly sensitive to cefotaxime and ampicillin.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Reported is the unique occurence of sarcoidosis, Hodgkin's disease, and autoimmune hemolytic anemia in the same patient. Although the diagnosis of sarcoidosis preceded that of Hodgkin's disease by 29 years, massive splenomegaly had been present for 13 years before Hodgkin's disease was diagnosed following splenectomy. The known associations of sarocoidosis and Hodgkin's disease as well as each disease with autoimmne hemolytic anemia are reviewed.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID