Heparin-induced thrombocytopenia and heart operation: management with tedelparin.

Anticoagulation for cardiopulmonary bypass in the infrequent clinical setting of thrombocytopenia associated with the use of unfractionated heparin is a very serious problem. We describe a case in which a low-molecular-weight heparin (tedelparin) was selected for this purpose based on a platelet aggregation test, permitting adequate anticoagulation during cardiopulmonary bypass for valve replacement. This case report might help establish an adequate anticoagulation protocol when faced with a patient suffering from this condition.

The morale-productivity relationship: how close?

Is there a direct relationship between morale and productivity? According to Robert H. Garin, professor of secondary and higher education at East Texas State University and John F. Cooper, dean of instruction at Patrick Henry Community College, the traditional view that the individual whose morale is high will be highly productive, or vice versa, is not a necessarily valid one. The authors analyzed the historical development of the major representative research studies and concepts concerning the morale-productivity relationship and found that the relationship evolved from one of simple direct correlation to the present viewpoint that a variety of factors--such as the environment, motivation, job levels, and so on--must be taken into consideration before any positive conclusion can be drawn. Because of the national concern over the decline in American productivity standards, Garin and Cooper believe that the morale-productivity relationship is an area ripe for further experimental research.