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711.
Koshy M; Entsuah R; Koranda A; Kraus AP; Johnson R; Bellvue R; Flournoy-Gill Z; Levy P 《Blood》1989,74(4):1403-1408
During the entry examination, leg ulcers were present in 2.5% of 2,075 patients 10 years of age and older with sickle cell disease who entered into the Cooperative Study of Sickle Cell Disease (CSSCD) between 1979 and 1986. Prevalence rates were highest among patients with sickle cell anemia and sickle cell anemia with thalassemia genotypes. Among sickle cell anemia patients free of ulcers at entry, the overall incidence was 5.73 per 100 person years in those having associated alpha-thalassemia and 9.97 for those without. Among sickle cell anemia patients with two alpha genes, the estimated incidence of leg ulcers is 2.38 per 100 person years and 6.12 per 100 person years among sickle cell anemia patients with three alpha genes (P less than .05). In both groups, the incidence was highest among those patients over 20 years of age and considerably higher among males than females (P less than .001). Leg ulcers were nonexistent in patients with sickle beta plus thalassemia and sickle hemoglobin C disease. Low steady-state hemoglobin is associated with a higher incidence of ulcer formation (P less than .0001) in sickle cell anemia patients. The protective effect of hemoglobin F is apparent at all levels of total hemoglobin among sickle cell anemia patients and those with associated alpha-thalassemia. 相似文献
712.
713.
Physically restraining elderly people who are residents in long term aged care facilities is common. However, the extent to which carers are aware of the effects of restraint on the restrained person, and of legal consequences for themselves, is low. In this paper, mechanisms of physical restraint are discussed and justifications and myths debunked. The dilemma that carers face, and the loss of autonomy and self control of the aged person who is restrained, are also considered. Legal consequences for carers of the aged are analysed in the light of the need to reduce physical restraint of aged people in institutional care to a minimum. 相似文献
714.
BACKGROUND: During storage of platelet concentrates at 22 degrees C, changes occur in surface glycoproteins, and membranous vesicles appear in the supernatant plasma. The extent of these changes during refrigerated storage is not known. STUDY DESIGN AND METHODS: Membranous microparticles and changes in surface or total glycoprotein Ib (GPIb) were studied in platelet concentrates divided into aliquots stored at either 4 degrees C or 22 degrees C for 5 days. RESULTS: The refrigerated platelets showed greater loss of total GPIb, slightly less binding of monoclonal antibodies to surface GPIb, and reduced aggregation response to ristocetin relative to the paired platelet controls at 22 degrees C. Moreover, the platelets stored at 4 degrees C produced 45-percent more microparticles and 64-percent more platelet factor 3 activity in the supernatant plasma than were produced by the controls. These differences were augmented by warming both 4 degrees C- and 22 degrees C-stored platelets at 37 degrees C for 1 to 4 hours. CONCLUSION: Storage of platelets at 4 degrees C causes increased membrane vesiculation and accelerated loss of GPIb. The magnitude of these differences was small, but it may contribute to marked reductions in platelet survival in circulation. 相似文献
715.
Analysis of antibodies against components of the autonomic nervous system in diabetes mellitus 总被引:1,自引:0,他引:1
Stroud CR; Heller SR; Ward JD; Hardisty CA; Weetman AP 《QJM : monthly journal of the Association of Physicians》1997,90(9):577-585
Antibodies to autonomic nervous system structures have previously been
detected using a complement fixation immunofluorescence test in the sera of
patients with insulin-dependent diabetes mellitus (IDDM) and non-insulin
dependent diabetes mellitus (NIDDM). These antibodies might play a role in
the aetiology of autonomic neuropathy. Sera from 45 IDDM, 40 NIDDM and 52
control subjects were tested by immunofluorescence for antibodies to human
sympathetic ganglia, human adrenal medulla and rabbit vagus nerve. The use
of human sympathetic ganglia was compared with rabbit tissue for the
detection of sympathetic ganglia antibodies; the results for these
autonomic nervous system antibodies were also compared with results using
an ELISA. There was no relationship between the presence of antibodies
detected by ELISA and those detected by immunofluorescence, but of 14 IDDM
patients with thyroid antibodies, 12 had autonomic nervous system
antibodies detected by either immunofluorescence or ELISA (p < 0.005
compared to patients without thyroid antibodies). To further characterize
the autoantigen(s), immunoblotting was performed. An adrenal antigen
corresponding to 74 kDa was detected in sera from three patients, only one
of whom had antibodies detectable by ELISA and immunofluorescence. One IDDM
serum showed specific binding to a vagus nerve antigen corresponding to 33
kDa. No specific binding to sympathetic ganglia antigen was demonstrated.
Antibodies against autonomic nervous system antigens are an inconsistent
feature of diabetes, and appear more associated with coincidental
autoimmunity against other organs such as the thyroid.
相似文献
716.
Davie AP; Francis CM; Caruana L; Sutherland GR; McMurray JJ 《QJM : monthly journal of the Association of Physicians》1997,90(5):335-339
We assessed the value of symptoms, past history, medications and signs in
the evaluation of patients who might have heart failure secondary to left
ventricular systolic dysfunction. An open-access echocardiography service
was set up to help identify patients with left ventricular systolic
dysfunction who might benefit from treatment with an
angiotensin-converting-enzyme inhibitor. History and examination were
recorded for each of these patients. The patients were divided into groups
according to whether left ventricular systolic function was preserved or
not and whether various clinical features were present or not. Of 259
consecutive patients studied, 41 had impairment of left ventricular
systolic function as assessed by echocardiography. Past history of
myocardial infarction and displaced apex beat were the best single
predictors of left ventricular systolic dysfunction as assessed by
echocardiography. The combination of past history of myocardial infarction
and displaced apex had the best positive predictive value of all. Patients
with such clinical features or combinations of clinical features may not
need echocardiography, and where access to this resource is limited, it
could be reserved for patients without such diagnostic features.
相似文献
717.
The neutrophil-specific NB antigen system has been serologically characterized with human alloantisera. Two alleles, NB1 and NB2, have been described; however, there may be important quantitative or qualitative variation in the expression of NB1 and NB2. Human alloantibodies have been used to identify the 58- to 64-kDa glycoprotein (GP) on which NB1 antigen is located, but an NB2 antigen- bearing molecule has not yet been identified. To identify the NB2 molecule, human alloantibody to NB1 was used to isolate the 58- to 64- kDa NB1 GP, and rabbits were immunized with this GP. Two rabbit antisera were produced. Both antisera immunoblotted and immunoprecipitated the 58- to 64-kDa GP on which NB1 is located, but neither identified the molecule on which NB2 is located. The inability of two rabbit polyclonal antibodies specific for the NB1 molecule to react with the NB2-bearing molecule suggests that considerable differences may exist between these two molecules or that NB2 as currently defined is not related to NB1. 相似文献
718.
Autoimmunity as an aetiological factor in vitiligo 总被引:2,自引:0,他引:2
N Rezaei†‡ NG Gavalas‡ AP Weetman‡ EH Kemp‡ 《Journal of the European Academy of Dermatology and Venereology》2007,21(7):865-876
Vitiligo is a common dermatological disorder characterized by the presence on the skin of depigmented macules resulting from the destruction of cutaneous melanocytes. Autoimmunity is an important hypothesis with regard to vitiligo aetiology and the evidence for autoimmune responses being involved in the pathogenesis of this disorder will be discussed in the present review. All immune system compartments, including innate and adaptive immunity have been implicated in vitiligo development. Particularly relevant are autoantibodies and autoreactive T cells in vitiligo patients that have cytotoxic effects upon pigment cells. Furthermore, predisposition to vitiligo appears to be associated with certain alleles of the major histocompatibility complex class II antigens as well as with other autoimmune-susceptibility genes. Moreover, the association of vitiligo with autoimmune disorders, the animal models of the disease, and the positive response to immunosuppressive therapeutic agents emphasize the role of autoimmunity in the development of this disorder. 相似文献
719.
Rosa Ruchlemer Ronen Ben‐Ami Maskit Bar‐Meir Jennifer R. Brown Marion Malphettes Rogier Mous Sanne H. Tonino Carole Soussain Noelie Barzic Julia A. Messina Preetesh Jain Regev Cohen Brian Hill Stephen P. Mulligan Marcel Nijland Yair Herishanu Ohad Benjamini Tamar Tadmor Koh Okamoto Benjamin Arthurs Batsheva Gottesman Arnon P. Kater Munir Talha Barbara Eichhorst Maya Korem Naama Bogot Fransien De Boer Jacob M. Rowe Tamar Lachish 《Mycoses》2019,62(12):1140-1147
720.