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Bethesda units

Nicholas J Olson, Donna Robert, Amin A Hedayat, Xiaoying Liu, Deborah L Ornstein
Factor V inhibitors are rare and have varied clinical presentations. We report on a 76-year-old female admitted to the hospital for pneumonia and treated with multiple antibiotics. Her baseline prothrombin time was 15.6 s and the activated partial thromboplastin time was 35 s. On admission day 10, she developed arm weakness and brain imaging showed a subdural hematoma. The prothrombin time was now 59.1 s with an activated partial thromboplastin time of more than 160 s and a normal thrombin time. A mixing study did not correct the clotting times and coagulation factor assays showed a nonspecific inhibition pattern...
September 24, 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Michael Losos, Scott Scrape, Sarita Joshi, Aaron Shmookler, Jian Chen
Acquired hemophilia A (AHA) is a rare autoimmune disorder that leads to factor VIII (FVIII) deficiency via autoantibody formation. Standard treatment options include FVIII bypassing factors and immunosuppression. However, the role of therapeutic plasma exchange (TPE) is not clear in the treatment of AHA. We present a case of idiopathic AHA in a 66 year old female with severe bleeding and a FVIII inhibitor of 17.6 Bethesda units (BU). She failed to respond to standard treatment including maximum dose of recombinant FVIIa (rFVIIa), rituximab, and other immunosuppressive agents...
September 20, 2016: Journal of Clinical Apheresis
Amber M Vasquez, Noelisa Montero, Mark Laughlin, Ehren Dancy, Russell Melmed, Lynn Sosa, Louise Francois Watkins, Jason P Folster, Nancy Strockbine, Heather Moulton-Meissner, Uzma Ansari, Matthew L Cartter, Maroya Spalding Walters
The mcr-1 gene confers resistance to the polymyxins, including the antibiotic colistin, a medication of last resort for multidrug-resistant infections. The mcr-1 gene was first reported in 2015 in food, animal, and patient isolates from China (1) and is notable for being the first plasmid-mediated colistin resistance mechanism to be identified. Plasmids can be transferred between bacteria, potentially spreading the resistance gene to other bacterial species. Since its discovery, the mcr-1 gene has been reported from Africa, Asia, Europe, South America, and North America (2,3), including the United States, where it has been identified in Escherichia coli isolated from three patients and from two intestinal samples from pigs (2,4-6)...
2016: MMWR. Morbidity and Mortality Weekly Report
Jennifer Mai Falk, Inge Scharrer
BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is a rare, episodic clinical syndrome involving the production of thrombi in the microvasculature accompanied by thrombocytopenia and symptoms of organ ischemia. Idiopathic TTP develops when a patient produces antibodies that react with the protease ADAMTS13. The course after an episode is unpredictable; patients may relapse frequently or never. There is no laboratory value that can reliably predict potential relapse. STUDY DESIGN AND METHODS: To assess diagnostic and predictive values for risk of relapse, plasma samples from 27 patients with idiopathic TTP in remission were analyzed for anti-ADAMTS13 immunoglobulin (Ig)G, ADAMTS13 activity, and ADAMTS13 inhibitor titer...
August 11, 2016: Transfusion
Melissa L Givens, Patricia A Deuster, Brian R Kupchak
The Consortium of Health and Military Performance hosted a symposium in April 2015 entitled "Androgens, Anabolic Steroids, and Related Substances: What We Know and What We Need to Know" in response to concerns from the field regarding Anabolic Androgenic Steroids use by U.S. service members. The symposium was attended by military and civilian subject-matter experts in sports medicine and anabolic steroids and was held at the United Service Organizations (Naval Support Activity Bethesda) in Bethesda, Maryland...
July 2016: Military Medicine
L Duplat-Bermúdez, R Ruiz-Medrano, D Landsman, L Mariño-Ramírez, B Xoconostle-Cázares
In this dataset we integrated figures comparing leaf number and rosette diameter in three Arabidopsis FT overexpressor lines (AtFTOE) driven by KNAT1 promoter, "A member of the KNOTTED class of homeodomain proteins encoded by the STM gene of Arabidopsis" [5], vs Wild Type (WT) Arabidopsis plats. Also, presented in the tables are some transcriptomic data obtained by RNA-seq Illumina HiSeq from rosette leaves of Arabidopsis plants of AtFTOE 2.1 line vs WT with accession numbers SRR2094583 and SRR2094587 for AtFTOE replicates 1-3 and AtWT for control replicates 1-2 respectively...
September 2016: Data in Brief
Flora Peyvandi, Pier M Mannucci, Isabella Garagiola, Amal El-Beshlawy, Mohsen Elalfy, Vijay Ramanan, Peyman Eshghi, Suresh Hanagavadi, Ramabadran Varadarajan, Mehran Karimi, Mamta V Manglani, Cecil Ross, Guy Young, Tulika Seth, Shashikant Apte, Dinesh M Nayak, Elena Santagostino, Maria Elisa Mancuso, Adriana C Sandoval Gonzalez, Johnny N Mahlangu, Santiago Bonanad Boix, Monica Cerqueira, Nadia P Ewing, Christoph Male, Tarek Owaidah, Veronica Soto Arellano, Nathan L Kobrinsky, Suvankar Majumdar, Rosario Perez Garrido, Anupam Sachdeva, Mindy Simpson, Mathew Thomas, Ezio Zanon, Bulent Antmen, Kaan Kavakli, Marilyn J Manco-Johnson, Monica Martinez, Esperanza Marzouka, Maria G Mazzucconi, Daniela Neme, Angeles Palomo Bravo, Rogelio Paredes Aguilera, Alessandra Prezotti, Klaus Schmitt, Brian M Wicklund, Bulent Zulfikar, Frits R Rosendaal
BACKGROUND: The development of neutralizing anti-factor VIII alloantibodies (inhibitors) in patients with severe hemophilia A may depend on the concentrate used for replacement therapy. METHODS: We conducted a randomized trial to assess the incidence of factor VIII inhibitors among patients treated with plasma-derived factor VIII containing von Willebrand factor or recombinant factor VIII. Patients who met the eligibility criteria (male sex, age <6 years, severe hemophilia A, and no previous treatment with any factor VIII concentrate or only minimal treatment with blood components) were included from 42 sites...
May 26, 2016: New England Journal of Medicine
K Pénzes, K Rázsó, É Katona, A Kerényi, M Kun, L Muszbek
UNLABELLED: Essentials Autoantibody against factor XIII (FXIII) is a rare but severe acquired hemorrhagic diathesis. In an elderly patient, anti-FXIII-A antibody led to severe bleedings with fatal outcome. The neutralizing autoantibody bound to FXIII with high affinity (Ka≈10(9) m(-1) ). The dominant effect of the autoantibody was the inhibition of activated FXIII. SUMMARY: Autoantibodies may develop against the catalytic A subunit of factor XIII (FXIII-A) or the carrier B subunit (FXIII-B)...
August 2016: Journal of Thrombosis and Haemostasis: JTH
Amy Callahan, Nancy J Ames, Mary Lou Manning, Kate Touchton-Leonard, Li Yang
PURPOSE/OBJECTIVES: To identify factors associated with oncology nurses' use of hazardous drug (HD) safe-handling precautions in inpatient clinical research units.
. DESIGN: Descriptive, cross-sectional.
. SETTING: The National Institutes of Health Clinical Center in Bethesda, Maryland.
. SAMPLE: 115 RNs working on high-volume HD administration units. 
. METHODS: Survey data were collected online using the Hazardous Drug Handling Questionnaire...
May 1, 2016: Oncology Nursing Forum
S Werwitzke, U Geisen, U Nowak-Göttl, H Eichler, B Stephan, U Scholz, K Holstein, R Klamroth, P Knöbl, A Huth-Kühne, B Bomke, A Tiede
UNLABELLED: Essentials Factor VIII (FVIII) binding IgG detected by ELISA could be an alternative to the Bethesda assay. We studied the performance of anti-FVIII IgG ELISA in patients with acquired hemophilia and controls. Anti-FVIII IgG > 99th percentile of controls was highly sensitive and specific. Patients with high anti-FVIII IgG have a lower chance of achieving remission. SUMMARY: Background Acquired hemophilia A is a severe bleeding disorder that requires fast and accurate diagnosis as it occurs often unexpectedly in previously healthy men and women of every age...
May 2016: Journal of Thrombosis and Haemostasis: JTH
Jeel Moya-Salazar, Victor Rojas-Zumaran
OBJECTIVES: To validate the modification of the prolonged Papanicolaou stain based on the quality control of time, units and staining stages (micro- and macroscopic), and on the stain reactivation based on the control. STUDY DESIGN: A prospective study was performed on 125,358 cervical smears in Lima (Peru). The microscopic quality control included evaluating the cytological characteristics through the staining quality index (SQI) and the quality criteria for samples described by the Bethesda System (TBS)...
2016: Acta Cytologica
Ashley Wilder Smith, Nita L Seibel, Denise R Lewis, Karen H Albritton, Donald F Blair, Charles D Blanke, W Archie Bleyer, David R Freyer, Ann M Geiger, Brandon Hayes-Lattin, James V Tricoli, Lynne I Wagner, Bradley J Zebrack
Each year, 70,000 adolescents and young adults (AYAs) between ages 15 and 39 years in the United States are diagnosed with cancer. In 2006, a National Cancer Institute (NCI) Progress Review Group (PRG) examined the state of science associated with cancer among AYAs. To assess the impact of the PRG and examine the current state of AYA oncology research, the NCI, with support from the LIVESTRONG Foundation, sponsored a workshop entitled "Next Steps in Adolescent and Young Adult Oncology" on September 16 and 17, 2013, in Bethesda, Maryland...
April 1, 2016: Cancer
Marsha Samson, Nancy Porter, Olubunmi Orekoya, James R Hebert, Swann Arp Adams, Charles L Bennett, Susan E Steck
This systematic review summarizes research on the use of progestin and breast cancer risk. Although mainly used for contraception, progestin can help treat menstrual disorders, and benign breast, uterine, and ovarian diseases. Breast cancer is the leading site of new, non-skin, cancers in females in the United States, and possible factors that may modulate breast cancer risk need to be identified. ProQuest (Ann Arbor, MI) and PubMed-Medline (US National Library of Medicine, Bethesda MD, USA) databases were used to search for epidemiologic studies from 2000 to 2015 that examined the association between progestin and breast cancer...
January 2016: Breast Cancer Research and Treatment
Hee Young Ju, Hye Lim Jang, Young Shil Park
BACKGROUND: Inhibitory antibodies to factor VIII (FVIII) or IX (FIX) are important issues when managing patients with hemophilia A or B. Advances in bypassing agents such as recombinant activated FVII (rFVIIa) and activated prothrombin complex concentrates (APCC) have enabled the aggressive management of hemophilia with inhibitors during emergency or elective surgery. This study provides an updated evaluation of the safety and effectiveness of bypassing agents in treating perioperative bleeding...
September 2015: Blood Research
Clement Karsenty, Philippe Maury, Nathalie Blot-Souletie, Magalie Ladouceur, Bertrand Leobon, Valérie Senac, Pierre Mondoly, Meyer Elbaz, Michel Galinier, Yves Dulac, Didier Carrié, Philippe Acar, Sebastien Hascoet
BACKGROUND: In recent decades, advances in surgery and therapeutic catheterization have steadily increased the life expectancy and prevalence of adults with congenital heart disease (CHD). AIMS: We assessed medical and psychosocial variables of adults with CHD, according to the disease complexity. METHODS: We included, from a single-centre observational cohort study, 135 consecutive adults with CHD (median age of 40 years, interquartile range: 28...
November 2015: Archives of Cardiovascular Diseases
Kim Brøsen
No abstract text is available yet for this article.
September 2015: Basic & Clinical Pharmacology & Toxicology
Ayami Isonishi, Charles L Bennett, Barbara Plaimauer, Friedrich Scheiflinger, Masanori Matsumoto, Yoshihiro Fujimura
BACKGROUND: Plasma exchange (PE) is the first-line treatment for primary acquired thrombotic thrombocytopenic purpura (aTTP) with severe deficiency of ADAMTS13 activity (ADAMTS13:AC). Some patients are poor responders to PE, raising concern over multiple pathogenetic pathways. STUDY DESIGN AND METHODS: Based on 52 aTTP patients in our national cohort study, we monitored plasma levels of ADAMTS13, clinical and laboratory findings, and outcomes. In a representative poor responder to PE, we examined an ADAMTS13 inhibitor (ADAMTS13:INH) complex in plasma milieu, by means of a large-pore isoelectric focusing (IEF) analysis...
October 2015: Transfusion
A D Shapiro, C Schoenig-Diesing, L Silvati-Fidell, W Y Wong, V Romanov
INTRODUCTION: Antihaemophilic factor (recombinant), plasma/albumin-free method (rAHF-PFM) is a human recombinant full-length factor VIII (FVIII) approved worldwide for the control and prevention of bleeding episodes, routine prophylaxis and perioperative management in adults and children with haemophilia A. AIM: To evaluate rAHF-PFM safety [including adverse events (AEs) and inhibitor incidence] from 12 interventional studies spanning >10 years. METHODS: The study population comprised 418 treated patients (median age = 18...
November 2015: Haemophilia: the Official Journal of the World Federation of Hemophilia
William B White, Zorina S Galis, Jeffrey Henegar, David E Kandzari, Ronald Victor, Domenic Sica, Raymond R Townsend, J Rick Turner, Renu Virmani, Laura Mauri
This scientific statement provides a summary of presentations and discussions at a cardiovascular Think Tank co-sponsored by the American Society of Hypertension (ASH), the United States Food and Drug Administration (FDA), and the National Heart, Lung, and Blood Institute (NHLBI) held in North Bethesda, Maryland, on June 26, 2014. Studies of device therapies for the treatment of hypertension are requested by regulators to evaluate their safety and efficacy during their development programs. Think Tank participants thought that important considerations in undertaking such studies were: (1) Preclinical assessment: how likely it is that both efficacy and safety data indicating benefit in humans will be obtained, and/or whether a plausible mechanism of action for efficacy can be identified; (2) Early human trial(s): the ability to determine that the device has an acceptable benefit-to-risk balance for its use in the intended patient population and without the influence of drug therapy during a short-term follow-up period; and (3) Pivotal Phase III trial(s): the ability to prove the effectiveness of the device in a broad population in which the trial can be made as non-confounded as possible while still allowing for the determination for benefits when added to antihypertensive therapies...
May 2015: Journal of the American Society of Hypertension: JASH
Caileen M Brison, Steven M Mullen, Michelle E Wuerth, Kira Podolsky, Matthew Cook, Jacob A Herman, Justin D Walter, Shannon L Meeks, P Clint Spiegel
The factor VIII C2 domain is essential for binding to activated platelet surfaces as well as the cofactor activity of factor VIII in blood coagulation. Inhibitory antibodies against the C2 domain commonly develop following factor VIII replacement therapy for hemophilia A patients, or they may spontaneously arise in cases of acquired hemophilia. Porcine factor VIII is an effective therapeutic for hemophilia patients with inhibitor due to its low cross-reactivity; however, the molecular basis for this behavior is poorly understood...
2015: PloS One
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