RESUMO
World-wide use of large amounts of highly purified Factor VIII and Factor IX concentrates has increased steadily over the last decade. The increase has resulted in more effective treatment of patients with haemophilia, especially those patients on home care and 'demand' therapy, those on prophylactic therapy for chronic bleeding or those on maintenance therapy for the suppression of inhibitors. Changing socioeconomic conditions have also contributed to greater use of the concentrates. The trend is putting an increasing strain on conventional methods for collecting and fractionating plasma. These include the donor, the nature of the anticoagulant, methods for purification of the clotting factors, procedures for denaturation and/or separation of viral contaminants and patterns of clinical usage. As a result, it is essential that we upgrade the quantity and quality of plasma collected and utilize the most effective new methods for increasing the yield and purity of the plasma fractions. Of special significance are recently described procedures for heat inactivation and/or separation of viral contaminants from the fractions and the long-term promise of genetically engineered proteins.
Assuntos
Fatores de Coagulação Sanguínea/isolamento & purificação , Transfusão de Sangue/métodos , Hemofilia A/terapia , Plasma/análise , Formação de Anticorpos , Fatores de Coagulação Sanguínea/uso terapêutico , Coleta de Amostras Sanguíneas/métodos , Fracionamento Químico/métodos , DNA Recombinante/uso terapêutico , Fator IX/uso terapêutico , Fator IXa , Fator VIII/imunologia , Fator VIII/isolamento & purificação , Fator VIII/uso terapêutico , Fibrinogênio/isolamento & purificação , Hepatite Viral Humana/etiologia , Humanos , Reação TransfusionalAssuntos
Equinococose Hepática/diagnóstico , Ultrassonografia , Adulto , Feminino , Humanos , MasculinoAssuntos
Síndrome de Budd-Chiari/diagnóstico , Ultrassonografia , Feminino , Humanos , Fígado , Pessoa de Meia-IdadeRESUMO
The most successful method of preoperative parathyroid adenoma localization is achieved by assay of venous samples for parathyroid hormone content. Selective sampling of the small veins draining the parathyroid glands increases the accuracy of prediction. Our review of 95 recent cases confirms an efficacy of prediction in 87.5%. The anatomy of the veins draining the parathyroid glands is outlined and we note variations that may occur in the inferior thyroid venous drainage. We consider contralateral venous flow to be of greater significance than has been recognized hitherto. This cross flow occurs through the thyroid plexus, and also via the vertebral venous plexus posteriorly and the anterior jugular veins in the front of the neck. Recent improvements in hormone assay combined with greater knowledge of the parathyroid venous drainage pattern of the individual patient may further improve the prediction rate.
Assuntos
Hiperparatireoidismo/diagnóstico , Glândulas Paratireoides/irrigação sanguínea , Hormônio Paratireóideo/sangue , Cateterismo , Humanos , Hiperparatireoidismo/sangue , Hiperparatireoidismo/diagnóstico por imagem , Flebografia , Cuidados Pré-Operatórios , Veias/anatomia & histologiaRESUMO
Nine patients with extensive peripheral arterial disease were treated with subcutaneous injections of ancrod (Arvin) for 10 to 21 days. Reduction in plasma fibrinogen was associated with a sustained reduction in plasma and blood viscosity, and a sustained increase in nutritional skin blood flow, measured by a Xenon-133 clearance technique (P less than 0.001). These findings may be relevant to the therapeutic effect of ancrod in ischemic rest pain.
