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Biomedical subjects

C Kaplan

Publications and source records attributed to C Kaplan.

At least 163 records · Page 9Linked to original sources
PubMed1988

Sources of resistance to an intern support group.

When senior house officers were observed to be resistant to an intern support group, they were surveyed in order to identify the sources of their resistance. Sixty-nine percent of house officers in postgraduate year two (PGY-2) and PGY-3 responded to an anonymous seven-item survey. Although their attitudes toward supportive programs were generally favorable, a minority of the house officers felt that residents expressing the need for support were less competent than other residents or needed to change to a less rigorous specialty. A majority felt that it was unfair to require senior house officers to provide coverage for interns attending a support group. They felt that support should be made available to all house officers rather than interns only and that stress would be reduced by eliminating the sources of stress as well as by providing supportive programs. Training program directors need to be aware of and anticipate these attitudes before designing supportive programs.

Attitude of Health Personnel↗
PubMed1988

Follow-up of subjects with isolated and persistent anti-core (anti-p24 or anti-p17) antibodies to HIV.

Systematic screening of blood donations by enzyme-linked immunosorbent assay (ELISA) for HIV antibodies carries a false-positive rate: the sera involved react in Western blot to core antigens (p24 or p17) but reactivity to envelope is absent. We studied 22 subjects with persistent and isolated anti-core reactivities; 75 HIV seropositive patients were controls. The epidemiological data and the follow-up and biological tests performed in these two populations argue that donors with persistent and isolated anti-core antibodies are not seroconverting for HIV. We conclude: (1) that verification of all anti-HIV ELISA-positive sera by Western blot is essential and that the presence of at least once anti-envelope (gp120 or gp41) antibody is indispensable for the diagnosis of HIV infection; (2) that the solitary anti-p24 or anti-p17 bands observed on Western blot are false-positive. There is no evidence that donors with such reactivities are HIV-infected.

Adult↗
PubMed1988

Management of alloimmune thrombocytopenia: antenatal diagnosis and in utero transfusion of maternal platelets.

Neonatal alloimmune thrombocytopenia (NAIT) can cause severe bleeding in the central nervous system (CNS) and death or severe neurologic sequelae. The expression of the PLA1 antigen is detectable as early as 19 weeks of gestation. Alloimmunization can therefore lead to fetal thrombocytopenia very early in pregnancy. Until recently, we have had no means of detecting and assessing the severity of fetal thrombocytopenia during pregnancy. The level of the maternal antibody is not of a predictable value since 20% of the mothers had no circulating antibodies in our series. An alternative approach is to carry out investigations on fetal blood samplings. This management leads to an exact knowledge of the fetal status and antenatal diagnosis is feasible as early as the 21st week of gestation. Early diagnosis facilitates appropriate management and makes possible such therapeutic options as in utero maternal platelet transfusions. We report our experience in the antenatal diagnosis and management of nine cases with in utero transfusion in the six cases with severe thrombocytopenia. All neonates did well, with no signs of bleeding at birth. No side effects of therapy were noted after a period ranging from 6 months to 3 years.

Antigens, Human Platelet↗
PubMed1987

Progestin-dependent effect of forskolin on human endometrial aromatase activity.

We have previously demonstrated that the aromatase activity in human endometrial stromal cells is stimulated by progestin and enhanced by oestrogen. In this study, we have investigated the effect of forskolin (Fk), an agent that stimulates the hormone-sensitive adenylate cyclase in mammalian cells, on the intracellular cAMP content and aromatase activity in endometrial stromal cells in primary culture. Stromal cells were isolated from proliferative and secretory endometria and were individually cultured in nutrient medium or medium supplemented with medroxyprogesterone acetate (MPA), oestradiol (E2) and Fk, separately or in combination. The intracellular cAMP content of stromal cells was increased after incubation with Fk. Stromal cells treated with Fk alone or FK and MPA for 1-3 days sustained the elevated intracellular cAMP content but 90% of this nucleotide was released to the medium. Aromatase activity was either not affected or was increased up to 5-fold over the control by Fk alone. Forskolin exerted a synergistic effect upon aromatase activity in the presence of progestin or progestin and oestradiol. Sequential incubation of the stromal cells with MPA and then Fk indicated that the additional increase in aromatase activity caused by Fk occurred after 24 h of incubation. These results demonstrate that intracellular cAMP exerts a stimulatory effect on aromatase activity in progestin-conditioned stromal cells. We also investigated whether the endometrial aromatase activity changes in vivo during the reproductive cycle by measuring the activities in endometrial specimens obtained from women during their reproductive age.(ABSTRACT TRUNCATED AT 250 WORDS)

4-(3-Butoxy-4-methoxybenzyl)-2-imidazolidinone↗
PubMed1987

Platelet antibodies in systemic lupus erythematosus.

In systemic lupus erythematosus (SLE), the precise cause of the thrombocytopenia is unknown. Since platelet associated IgG is increased in many patients, it has been suggested that the destruction of platelets might be dependent on specific antibodies. In nine patients with SLE, platelet associated immunoglobulins were found together with free serum antibody which bound to platelets from all normal subjects. Using an immunoblotting technique with membrane proteins from normal platelets incubated with patient sera, target antigens were localized on a band of mol wt 108,000 in two cases (B. and N.) and on a band of mol wt 66,000 in a third (M.). When the same technique was applied to autologous platelets of patient N., autoantibody binding to the protein of mol wt 108,000 was demonstrated. The antigenic determinants were not removed from the platelets by enzyme treatment or by disulphide bond reduction, and were localized in the cytoplasmic fraction of the platelets.

Autoantibodies↗
PubMed1987

[Idiopathic autoimmune thrombopenic purpura and pregnancy].

Immune thrombocytopenic purpura can no longer be considered as incompatible with pregnancy provided that close surveillance is undertaken. However, the main risk (a possible intracranial hemorrhage) persists in the newborn when severe thrombocytopenia due to the placental transfer of maternal IgG has occurred. None of the maternal parameters is predictive of the fetal thrombocytopenia or of its magnitude. A platelet count on fetal blood obtained by in utero or scalp sampling allows the choice between vaginal delivery or cesarean section, to limit the risk of intracranial bleeding. In most cases i.v. IgG infusion allows rapid correction of severe thrombocytopenia in the newborn.

Autoimmune Diseases↗