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Biomedical subjects

M A Heisel

Publications and source records attributed to M A Heisel.

14 recordsLinked to original sources
PubMed2000

Human coagulation factor FVIIa (recombinant) in the management of limb-threatening bleeds unresponsive to alternative therapies: results from the NovoSeven emergency-use programme in patients with severe haemophilia or with acquired inhibitors.

This open-label, emergency-use study evaluated the efficacy and safety of activated human coagulation factor VIIa (recombinant) (rFVIIa) (NovoSeven; Novo Nordisk Pharmaceuticals, Inc., New Jersey, USA) in treating limb-threatening joint or muscle bleeds in 17 patients with haemophilia A or B and six patients with acquired inhibitors to factor VIII or factor IX. All patients had previously failed on one or more alternative therapies. rFVIIa administration was effective or partially effective in controlling joint or muscle bleeds in 34 out of 35 (97%) bleeding episodes; in 23 patients, 14 of 17 (82%) muscle bleeds and 16 of 18 (89%) joint bleeds were effectively controlled. These findings suggest that rFVIIa is an effective and well-tolerated therapeutic option in the management of joint or muscle haemorrhage in patients with haemophilia and in patients with acquired inhibitors.

Adolescent↗
PubMed1989

Feasibility study for neonatal neuroblastoma screening in the United States.

Urine was obtained from infants born at two large metropolitan Minneapolis/St. Paul, Minnesota hospitals to determine whether normal levels of urinary catecholamine metabolites in neonates can be used for subsequent neuroblastoma screening as well as to determine compliance with collecting such urine in a voluntary program. The results suggest that there are wide variations in raw values of urinary creatinine, homovanillic acid, and vanillylmandelic acid through the first 4 days of age, apparently because of maternal creatinine and catecholamine metabolite influences. Such maternal influences appear negligible by 3 weeks of age. Furthermore, the study suggests that voluntary compliance in the United States with collecting urine at home without rigorous public education and/or methods for reminding parents may be very poor.

Biomarkers, Tumor↗
PubMed1988

Older women in developing countries.

Women's issues are markedly underrepresented in international policy and research discussions. This paper addresses these deficits by delineating the particular conditions of aging women in developing countries. While these women experience many of the age-related problems as their counterparts in developed countries, cultural and economic influences place them at a greater disadvantage.

Aged↗
PubMed1984

Congenital pernicious anemia: report of seven patients, with studies of the extended family.

Seven children ages 1 1/2 to 12 years with congenital pernicious anemia were detected in an extended Mexican family. All affected children had megaloblastic anemia accompanied by low serum B12 and normal serum folate levels. Gastric fluid analysis in six patients revealed normal gastric acidity and absent intrinsic factor. Serum antibodies to intrinsic factor or parietal cells were also absent. Schilling tests performed in six of the seven patients yielded abnormal results. Of the three patients in whom gastric biopsy was done, two had normal histologic findings (including examination by electron microscopy) and one had mild atrophy. All patients responded rapidly to parenterally administered vitamin B12 therapy. In addition, 170 family members were screened for the defect with complete blood counts and serum B12 levels. Such screening detected pernicious anemia in two of the children, but no other abnormalities that could be attributed to pernicious anemia were found in other family members. Based on the family pedigree, autosomal recessive inheritance is likely. The variability of age of presentation in this family is noteworthy and suggests that expression may be modified by still undefined factors.

Anemia, Pernicious↗
PubMed1984

Effects of X-irradiation on artificial blood vessel wall degradation by invasive tumor cells.

Artificial vessel wall cultures, constructed by growing arterial endothelial cells on preformed layers of rat smooth muscle cells, were used to evaluate the effects of X-irradiation on tumor cell-induced tissue degradation. Bovine endothelial cells had radiation sensitivities similar to those of rat smooth muscle cells. Preirradiation of smooth muscle cells, before the addition of human fibrosarcoma (HT 1080) cells, did not increase the rate of degradation and destruction by the invasive cells. However, the degradation rate was decreased if the cultures were irradiated after the addition of HT 1080 cells. The presence of bovine endothelial cells markedly inhibited the destructive abilities of fibrosarcoma cells, but preirradiation of artificial vessel walls substantially decreased their capabilities to resist HT 1080-induced lysis. These findings suggest that the abilities of blood vessels to limit extravasation may be compromised by ionizing radiation.

Animals↗
PubMed1983

Factors influencing prognosis in childhood autoimmune hemolytic anemia.

Prognostic factors were evaluated in 25 children with autoimmune hemolytic anemia (AIHA). Patients with acute disease were generally 2-12 years of age at diagnosis, had a sudden onset of symptoms, showed low reticulocyte counts, had decreased numbers of nucleated red blood cells or early white blood cells precursors on peripheral blood smear, and had normal platelet counts. They responded well to steroids and the disease resolved within 6 months without mortality. Children with chronic AIHA were generally less than 2 or greater than 12 years of age, had a more prolonged onset of symptoms, had increased reticulocyte counts, had increased numbers of nucleated red blood cells and early white blood cell precursors on peripheral blood smear, and had decreased platelet counts. They had a variable response to steroids frequently requiring other modalities of treatments and had a mortality of 25%. Females in this group had a significant incidence of associated diseases. Autoantibodies were characterized as to temperature sensitivity and reaction with class specific antiglobulin reagents and were related to the type of AIHA.

Acute Disease↗
PubMed1983

Radionuclide bone scan in neuroblastoma.

A comparison of radionuclide bone scans with other methods of monitoring disease status was undertaken in a series of 51 children with neuroblastoma. The radionuclide bone scan was more accurate than either conventional radiographic studies or physical examination in localizing the primary tumor. When the extent of bony metastatic disease was evaluated, the bone scan and radiographic skeletal surveys were generally both positive, but the bone scan tended to show evidence of greater metastatic disease than radiographs.

Adolescent↗
PubMed1983

Hypertension in children with neurogenic tumors.

Fifty-nine children with neurogenic tumors were examined for the presence of hypertension. Eleven of the 59 (19%) were found to have elevated blood pressure levels at the time of diagnosis or with progression of their disease. Several antihypertensive agents produced poor or only partial pressure control. All blood pressure levels returned to normal values after tumor excision or administration of effective antitumor therapy. There was no correlation of hypertension with urinary catecholamine levels. The etiologies of hypertension in children with neurogenic tumors are discussed.

Abdominal Neoplasms↗
PubMed1982

Frequency of early death in children with acute leukemia presenting with hyperleukocytosis.

The relationship of hyperleukocytosis, early death, and intracerebral hemmorahage was determined in 547 pediatric patients with acute leukemia. Hyperleukocytosis occurred in 7.3% of patients with acute leukemia. The early mortality rate was significantly increased in hyperleukocytic patients when compared to the nonhyperleukocytic group. Hyperleukocytic patients with ANLL had a significantly greater risk of early death than nonhyperleukocytic patients with ANLL. The difference in the incidence of early death between hyperleukocytic and nonhyperleukocytic patients with ALL/AUL was not statistically significant. In the hyperleukocytic patients intracerebral hemorrhage was the universal cause of early death but this entity did not occur in any of the nonhyperleukocytic patients. There was no correlation of intracerebral hemorrhage to thrombocytopenia or coagulation abnormalities. Autopsies confirmed intracerebral hemorrhage and leukostasis with leukemic infiltration of the brain tissue.

Acute Disease↗
PubMedDate not supplied

The use of implantable venous access devices (IVADs) in children with hemophilia.

PURPOSE: Implantable venous access devices (IVADs), either centrally or peripherally implanted, have become increasingly popular in children with hemophilia to assist in the early treatment of bleeding episodes and in the prevention of arthropathy. Their use has been associated with complications including thrombosis, thrombophlebitis, and infection. We attempted to better define whether the benefits associated with IVADs in this population outweight the associated risks. PATIENTS AND METHODS: We studied the medical records of 35 children from the University of Minnesota's Comprehensive Hemophilia Center who received IVADs between 1992 and 1996. RESULTS: There was no bleeding or thrombophlebitis associated with IVADs in our population. One patient required removal of a central IVAD due to thrombosis. The central IVADs were associated with local infection and bacteremia rates of 3% and 33%, respectively. The rates of local infection and bacteremia associated with peripheral IVADs were both 25%. The majority of infections were cleared with antibiotics, and ports remained intact. Both types of IVADs were associated with a high patient/parent satisfaction. CONCLUSION: Despite being associated with a significant incidence of infection, we believe the benefits of IVADs for children with hemophilia and their families outweigh the risks. Possible explanations for the observed infection rates are discussed.

Adolescent↗