An interview technique to complement traditional criteria used in selecting internal medicine housestaff.
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Biomedical subjects
Publications and source records attributed to E S Kurtides.
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The case of a patient with agnogenic myeloid metaplasia and myelofibrosis engrafted upon a longstanding treated case of polycythemia rubra vera and presenting with ascites due to peritoneal implants of myeloid tissue is presented. Comments on the differential diagnosis of ascites in general, and especially in myelofibrosis, are entered. The specific simple methodology for the confirmation of this diagnosis through microscopic examination of the sediment of the ascitic fluid for the detection of megakaryocytes and erythroblasts is presented. Radiotherapy in moderate amounts offers a very effective and long-lasting form of this entity.
We present a case in which an activated partial thromboplastin time (aPTT) inhibitor may have significantly contributed to prolonged bleeding in a patient and review five similar cases. The possibility of an aPTT inhibitor should be considered in the evaluation of patients with unexplained prolongation of PTT and PT. Such patients may develop significant bleeding even in the absence of other hematologic abnormalities.
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Paraplegia developed in a 70-year-old man with a 15-year history of polycythemia rubra vera and a two-year history of myelofibrosis, due to extensive epidural involvement by extramedullary hematopoiesis. Early diagnosis and aggressive therapy is essential if permanent paralysis is to be avoided.
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Two patients with ovarian carcinoma developed acute erythroleukemia following prolonged chemotherapy with an alkylating agent. An analysis of our patients, together with literature review of similar cases, suggests that the duration of chemotherapy may have been the most important factor in the leukemogenesis. We suggest that the duration of chemotherapy required to achieve a cure in patients with ovarian carcinoma in complete remission can be determined only by prospective controlled trials.
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