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Biomedical subjects

S V Kevy

Publications and source records attributed to S V Kevy.

At least 37 records · Page 2Linked to original sources
PubMed1984

Lymphocytapheresis in chronic progressive multiple sclerosis: immunologic and clinical effects.

We studied the effects of lymphocytapheresis in five patients with chronic progressive MS. Ten lymphocytapheresis treatments were given in 2 weeks, followed by 1 treatment every 2 weeks for 2 to 6 months. Four of five patients had a fall in the circulating lymphocyte count during the initial treatment, and in three patients a modest lymphopenia was sustained with maintenance therapy. In patients with abnormal T4:T8 ratios, no improvement in the T4:T8 ratio occurred. There was no apparent clinical effect in this pilot study.

Adult↗
PubMed1983

Intensive immunosuppression in progressive multiple sclerosis. A randomized, three-arm study of high-dose intravenous cyclophosphamide, plasma exchange, and ACTH.

Fifty-eight patients with severe, progressive multiple sclerosis were prospectively randomized to one of three treatments: 20 received intravenous ACTH, 20 received high-dose intravenous cyclophosphamide plus ACTH, and 18 were placed on a regimen consisting of plasma exchange, low-dose oral cyclophosphamide, and ACTH. The three groups were similar in age, sex, duration and type of disease, and degree of disability. Before treatment and six months and one year after treatment, a disability-status score, ambulation index, and functional-status score were determined, and a quantitative neurologic examination was performed. In the ACTH group, the number of patients stabilized or improved was 8 of 20 at six months and 4 of 20 at one year; in the cyclophosphamide-ACTH group, 18 of 20 at six months and 16 of 20 at one year; and in the plasma exchange group, 11 of 18 at six months and 9 of 18 at one year. High-dose cyclophosphamide plus ACTH was most effective in halting progression of the disease at both 6 and 12 months (at 12 months, cyclophosphamide-ACTH vs. ACTH, P = 0.0004; cyclophosphamide-ACTH vs. plasma exchange, P = 0.087). Thus, progressive multiple sclerosis may be stabilized by short-term, intensive immunosuppression with cyclophosphamide plus ACTH.

Administration, Oral↗
PubMed1982

Hepatic effects of a phthalate ester plasticizer leached from poly(vinyl chloride) blood bags following transfusion.

The effects of di(2-ethylhexyl) phthalate (DEHP) on hepatic function and histology were evaluated in the rhesus monkey undergoing platelet and plasma transfusion. The average cumulative amount infused in one year is comparable to that received by patients who undergo chronic transfusion. Abnormalities in hepatic scan and BSP kinetics persisted for up to 26 months after transfusion, as did histologic abnormalities. Patients undergoing maintenance hemodialysis receive a yearly dose of DEHP which is 10-20 times that which produced hepatotoxicity in the transfused rhesus.

Animals↗
PubMed1978

Use of prothrombin complex concentrates in hemophiliacs with inhibitors: clinical and laboratory studies.

Nine patients with severe classic hemophilia and inhibitors against factor VIII were treated for 156 bleeding episodes with 503 infusions of Proplex, Konyne, or Auto-Factor IX, three preparations of prothrombin complex concentrates (PCCs). Approximately two thirds of the bleeding episodes were managed successfully. Although the prothrombin time (PT) and partial thromboplastin time (PTT) were shortened after most PCC infusions, there was no evidence of disseminated intravascular coagulation. The degree of shortening of PT or PTT was not related to the particular PCC preparation used, dose, or cessation of hemorrhage. All PCC preparations contained activated clotting factors, as manifested by their ability to shorten the PTT of normal plasma, factor-VIII-deficient plasma, and factor-IX-deficient plasma. Shortening, which was greater with Auto-Factor IX than with the other products, was inhibited partially by a factor IX antibody and blocked completely by prolonged incubation with plasma. Although the nature of the procoagulant material in PCCs is uncertain, these products are of proven benefit to hemophilic patients with high-titer inhibitors. Side effects have been minimal and inhibitor titers have not risen.

Adolescent↗
PubMed1977

Effects of a plasticizer leached from polyvinyl chloride on the subhuman primate: a consequence of chronic transfusion therapy.

The effects of di-2-ethylhexyl phthalate (DEHP) on hepatic function and histology were evaluated in the rhesus monkey undergoing chronic transfusion. DEHP was solubilized as a result of leaching by platelets or plasma stored in polyvinyl chloride (PVC) blood bags. The average cumulative amount of DEHP infused in 1 year was 69.3 mg., or 21.3 mg./kg. Comparable amounts of DEHP are received by patients who undergo chronic transfusions with whole blood, packed cells, platelets, and plasma in the same time period. Four of the seven PVC-transfused monkeys had abnormal 99mTc liver-spleen scan ratios, four of the seven demonstrated abnormal BSP clearance, and six of the seven had abnormal liver histopathology upon completion of transfusion therapy. These findings persisted in a majority of the monkeys throughout the follow-up period. DEHP persisted in the tissues for up to 14 months after transfusion. The nontransfused monkeys and those transfused with platelets processed in polyethylene containers were normal.

Animals↗
PubMed1976

The use of epsilon-aminocaproic acid for the management of hemophilia in dental and oral surgery patients.

The use of epsilon-aminocaproic acid has proved to be an efficient and practical method for treating hemophiliacs who require dental work. In the past, patients requiring extractions were admitted to a hospital for approximately ten days and received replacement infusions every 12 hours during their stay. This resulted in a large expense because of the cost of the material and the hospitalization itself, not to mention the trauma sustained by the patient both physically and psychologically. Also, by decreasing the number of factor infusions, the risk of complications such as the transmission of hepatitis, allergic reaction, or inhibitor formation decreased. The same protocol using a single infusion of the appropriate factor replacement with supplementary epsilon-aminocaproic acid can be used for the management of patients with other coagulation disorders such as factor IX deficiency (Christman disease), factor XI deficiency, and von Willebrand's disease. Since this paper was submitted, seven more patients have been treated using this protocol. An additional seven odontectomies, 33 extractions, operative dentistry in 18 quadrants, and alveoloplasties in two full arches have been performed. This brings the total to 23 treatment sesions with 18 patients undergoing 124 procedures. One additional minor bleeding episode occurred, resulting in a total rate of four bleeding episodes in 23 treatment sessions and 124 procedures. Our incidence of complications secondary to epsilon-aminocaproic acid specifically remains zero.

Adolescent↗
PubMed1976

Clinical uses of frozen-thawed erythrocytes in pediatrics.

Frozen red cells have a definite place in the mangement of a transfusion service even if one does not include its originally intended use -- inventory control. Undoubtedly, the benefits achieved from frozen red cells can be accomplished in less expensive ways. However the growth in transsplantion and intensive chemotherapy with its concommiatant uses of granulocyte and platelet support predict a greater upsurge in the use of frozen red cells in the very near future.

Anemia, Aplastic↗