Sickle cell anemia and hyperuricemia.
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Anemia, Sickle Cell↗
Biomedical subjects
M Spivack
Publications and source records attributed to M Spivack.
Sensory distortions in tunnels and corridors.
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Hospital Design and Construction↗
Hemolytic anti-hr" (e) detectable solely by an automated polybrene technique.
An example of a hemolytic anti-hr" (e) detectable solely by an AutoAnalyzer-Polybrene (AAP) system is reported. The antibody was undetectable by routine indirect antiglobulin and enzyme tests, and produced a delayed intravascular hemolytic transfusion reaction. The anti-hr" (e) was no longer AAP detectable five months after the transfusion reaction. This paper points out the potential usefulness of the AAP technique in detecting alloantibodies in cases of transfusion reactions where no antibody specificity can be demonstrated by standard manual techniques.
Antibody Specificity↗
Clinical and serologic management of patients with methyldopa-induced positive antiglobulin tests.
Methyldopa can produce both a positive direct antiglobulin test and less commonly a positive indirect antiglobulin test. When the drug-induced antibody is present in the serum, it acts as a panagglutinin and reacts with all normal red blood cells; consequently crossmatch-compatible blood cannot be prepared. Although the methyldopa-induced antibody itself rarely produces hemolysis, difficulties can arise in previously unscreened patients in whom the panagglutinin may mask an unknown, pre-existing, and potentially hemolytic alloantibody. We report on our clinical and serologic management of 14 such patients for whom transfusions were requested.
Antibody Formation↗
Administration of microaggregate filtered blood using a manual infusion pump.
Administration sets containing in-line plastic blood pumps are commonly used to transfuse blood. Flow rates were measured while six units of whole blood and red blood cells were infused through a blood pump administration set coupled to either a large pore 260-micron filter or a 20-micron microaggregate blood filter. Using the same type of blood pump administration system and three units of whole blood, the flow rates achieved by the currently available microaggregate blood filters were compared. Results showed that despite a smaller pore size the 20-micron microaggregate blood filter achieved flow rates that were faster than or equal to those recorded for the larger pore (260-micron) filter. This was attributed to the larger filtration surface area possessed by the smaller pore filter, 140 cm2 versus only 30 cm2 for the 260-micron filter. All of the microaggregate filters studied were able to filter three units of whole blood at flow rates in excess of 80 ml/minute. There was no evidence of blood pump induced hemolysis. We concluded that a manual infusion pump can be used to transfuse microaggregate filtered blood rapidly enough to be acceptable for routine clinical or intraoperative use.
Blood Flow Velocity↗
Management of patients with anti-Cartwright (Yta).
Five patients with anti-Cartwright (Yta) in their serum were observed during a 14-month period. One of the patients in whom a 51Cr-labeled donor red cell survival study was done showed increased destruction of infused Yta-positive red cells while three other patients tested showed a survival of greater than 85 percent at 1 hour. None of the antibodies potentiated interaction between sensitized red cells and heterologous activated mononuclear cells. The fifth patient received many transfusions of Yta-positive red cells without any adverse reaction. Performance of a 1-hour red cell survival with 51Cr-labeled Yta-positive cells is recommended when time permits to determine whether patients with anti-Yta can receive Yta-positive red cells or, alternatively, whether they must receive Yta-negative red cells. This approach not only is the safest for the patient, but allows conservation of Yta-negative blood. Such an approach also should be used in patients with antibodies against other high-incidence antigens.
Aged↗
Experience with autologous bone marrow harvesting and transfusion of marrow-derived red cells.
Marrow red cells (MRBCs) from 56 autologous bone marrow harvests were rescued after processing and transfused as the sole transfusion support after surgery. There was no correlation between volume of harvest and total mononuclear cell (MNC) count. The marrow collection induced a significant decrease in hematocrit values (mean, 6.1; range, -0.3-12.3; p less than 0.001) unrelated to the patient's diagnosis, age, or gender. Processing of the marrows resulted in a mean transfused MRBC mass of 258 mL (range, 101-494 mL), representing 78 percent (range, 43-100%) of the MRBC mass collected. The amount of MRBCs transfused correlated with total MNC count (p less than 0.01). All autologous MRBC transfusions were well tolerated. It can be concluded that autologous MRBC transfusions are safe and may eliminate the need for homologous blood transfusions after marrow harvest.
Adult↗
Subacute consumption coagulopathy--an unusual complication of angiography.
A 20-year-old female with congenital venous malformations in her left lower extremity had a self-limited, moderate consumption coagulopathy following angiographic studies. This episode was documented by both conventional coagulation studies and by 125l fibrinogen survival studies. It seems likely that venography triggered a local inflammation in the vascular malformations, which resulted in a localized consumption coagulopathy which abated as did the phlebitis in three weeks. We are aware of no prior reports of this complication of venography. Patients with venous malformations who undergo venography should have appropriate coagulation screening performed before and after the procedure so that any similar episode can be promptly diagnosed and treated, if treatment is deemed necessary.
Adult↗
Presumed immune thrombocytopenia and carcinoma: report of three cases and review of the literature.
Three patients presenting in a one-year period with coexisting carcinoma and presumed immune thrombocytopenia are the subject of this report. Review of the literature disclosed a paucity of previous reports of this association. Possible pathogenic mechanisms resulting in this association are discussed. All three patients responded to corticosteroids in usual doses used in treatment of chronic idiopathic thrombocytopenic purpura. The association of carcinoma with immune thrombocytopenia may be more common than has been previously appreciated.
Adrenal Cortex Hormones↗