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D J Blomberg

Publications and source records attributed to D J Blomberg.

13 recordsLinked to original sources
PubMed1993

The pathologist as a clinical consultant for hemostasis in the community hospital.

Most of the clinically recognized disorders of hemostasis were described before the availability of today's sensitive and specific molecular assays. Even though many of these newer assays are not yet technically practical for the average community hospital, in certain situations they are indispensable to accurate diagnosis and treatment. The most significant advances, however, have come not from the tests themselves but from the new insights they have provided into the basic mechanisms of hemostasis, thereby extending the usefulness of the widely available older global clotting assays. Pathologists who are able to integrate this increased understanding of the pathophysiology of various disorders with the history and physical findings will be better able to assist their clinical counterparts in the most cost-effective approach to the care of their patients.

Blood Coagulation Disorders↗
PubMed1987

The use of an expert system in the clinical laboratory as an aid in the diagnosis of anemia.

Experience with an expert system developed for the purpose of classification of anemias is presented. Input for this system consists of limited demographic information on each patient and the results of the complete blood count, with the incorporation of the results of further chemical testing (serum iron/total iron binding capacity/ferritin and serum B12/serum folate/red blood cell folate), if indicated. Performance of this system is demonstrated using data from 84 patients seen in the authors' laboratory selected either because of a request for evaluation by the attending physician or because of significant anemias. Using this limited input, the system was able to accurately classify 74 of 84 (88%) of cases according to previously established criteria. The output from the system is overread by a pathologist. Future directions are also discussed.

Anemia↗
PubMed1986

Evaluation of a new classification system for anemias using Consult Learning System.

Since the advent of electronic particle counting, anemias have customarily been classified by evaluating cell size (MCV) and hemoglobin content (MCH). Recently a new parameter estimating red cell size heterogeneity (the 'red cell distribution width' or 'RDW') has been introduced. We have evaluated a proposed classification of anemias based upon this new parameter in a large group of hospitalized patients utilizing an expert system based upon statistical pattern recognition and compared our results to other studies. The potential advantages of using such a system over currently existing uni-dimensional classification systems to evaluate clinical problems are discussed.

Anemia↗
PubMed1980

Infiltration of a cerebral artery aneurysm by malignant lymphoma cells with acute rupture: Report of a case.

A 55 year old woman died suddenly of a ruptured cerebral artery aneurysm. The aneurysm. was infiltrated by cells from a silent, nodular, poorly differentiated lymphocytic lymphoma, which also involved the spleen and abdominal lymph nodes. Compared to leukemias, the incidence of cerebral hemorrhage in non-Hodgkin's lymphomas is exceedingly rare, this being the first case reported in detail. A brief discussion of the etiology of cerebral hemorrhage in lymphomas is provided.

Brain Neoplasms↗
PubMed1980

Post-transfusion purpura as a gynecologic complication.

Post-transfusion purpura (PTP) is a recently separated category of thrombocytopenic purpura occurring mainly in women. It is an acute, severe thrombocytopenic state with clinical manifestations of hemorrhage that may be fatal. It usually occurs 5 to 8 days after transfusion, usually after administration of whole blood. The typical patient is a middle-aged, multiparous white woman who has received a transfusion and has undergone an operation, often a gynecologic procedure. Diagnosis may be suspected by normal clotting studies, bone marrow biopsy showing increased megakaryocytes, and demonstration of a potent antibody reactive against platelets by clot-retraction inhibition, complement fixation, or 51Cr-release studies. The treatment of choice is exchange transfusion or plasmapheresis, unless these procedures are medically contraindicated. Because of the lack of reports in the gynecology literature on PTP, a case report and discussion are presented.

Biopsy↗
PubMed1977

Rupture of a tuberculous pseudoaneurysm of the innominate artery into the trachea and esophagus: report of a case and review of the literature.

Spontaneous rupture of a tuberculous pseudoaneurysm of the innominate artery, undiagnosed until necropsy, occurred simultaneously into the trachea and the esophagus in a patient receiving anti-tuberculosis chemotherapy. This is the first reported instance of a tuberculous innominate artery aneurysm, the third tuberculous aneurysm with rupture into the trachea, the sixth into the esophagus, and the first with rupture into both structures. A review of the literature relating to tuberculous aneurysms of the major arteries is provided.

Aged↗
PubMed1976

CPK-MB isoenzyme: use in diagnosis of acute myocardial infarction in the early postoperative period.

The diagnosis of acute myocardial infarction (AMI) in the early postoperative period may be quite difficult in certain patients. Electrocardiograms fail to be diagnostic of AMI in as many as one third of patients with myocardial injury found at autopsy. Enzyme patterns commonly used to diagnose AMI in patients admitted to coronary care units are obscured by muscle injury, medications, cardioversion, surgical manipulation, and blood transfusion. The MB isoenzyme of creatinine phosphokinase (CPK) has been described as a specific indicator of myocardial injury. Therefore the CPK-MB isoenzyme level was evaluated as a potential aid in the diagnosis of AMI in the early postoperative period. Thirty patients undergoing cardiac surgery and 7 patients undergoing thoracic surgery not involving the heart were studied. CPK-MB isoenzyme was present in the serum in 10 of 30 patients after cardiac surgery but in none of 7 patients after thoracic surgery. The presence of CPK-MB isoenzyme was found to be a valuable adjunctive indicator in the diagnosis of AMI in the early postoperative period.

Adolescent↗
PubMed1975

Creatine kinase isoenzymes. Predictive value in the early diagnosis of acute myocardial infarction.

This is a prospective study of the value of the creatine kinase (CK) isoenzyme determination in the early diagnosis of acute myocardial infarction. The presence or absence of the MB isoenzyme was correlated with electrocardiogram and standard enzymes. The frequency of falsely positive and falsely negative results for CK-MB, electrocardiogram and each standard enzyme was calculated and, using the elements of conditional probability theory, their predictive values for the diagnosis of acute myocardial infarction were determined. Results indicate that CK-MB combines the best attributes of the electrocardiogram and standard enzyme tests: detectable MB isoenzyme activity by acrylamide slab electrophoresis has a predictive value for the diagnosis if acute myocardial infarction comparable to that of a positive electrocardiogram; absence of MB isoenzyme activity, in the 24 hour period following the onset of symptoms, excludes the diagnosis of acute myocardial infarction with a probability equivalent to that provided by normal standard enzyme results.

Clinical Enzyme Tests↗