A group of patients has been identified with cutaneous necrotizing venulitis (vasculitis). These patients, some with concomitant connective tissue disorders, have skin lesions that separate them from the arteritis commonly described as rheumatoid vasculitis. HLA typing has been performed on 31 of these unrelated patients with cutaneous necrotizing venulitis, including 19 with associated chronic disorders. The antigen pair A11, BW35 was found in 5 of these 19 patients and in 11 of 346 controls. This difference in frequency is statistically significant. Because HLA genes appear to be linked to immune response genes, these data suggest that such genes may exist in patients with this form of cutaneous necrotizing venulitis with associated connective tissue disease.

Antibody Formation↗

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Three decades of health care use by the elderly, 1965-1998.

Over the past three decades health spending and hospital use increased more for the elderly than for persons under age sixty-five. Medicare spending for the oldest old (age eighty-five and older) increased faster than for persons ages sixty-five to seventy-four, but that increase was due entirely to greater postacute care use. Health care trends are consistent with the idea that Medicare has improved the health of the elderly. Greater spending increases for the elderly may reflect legislative developments such as the passage of Medicare and its continued fee-for-service nature and the failure to pass universal coverage, as well as changes in the health care delivery system such as the rapid growth in managed care enrollment among persons under age sixty-five.

Aged↗

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Flow cytometric immunophenotype of canine lymph node aspirates.

Increasing availability of reagents able to distinguish subtypes of lymphocytes and other leukocytes has enabled greater understanding of lymphocyte biology and pathology in the dog. Lymphocytes in circulation most commonly are subjected to immunophenotypic assessment by flow cytometry, but needle aspirates of lymph nodes can be similarly suitable for immunophenotypic examination. In this investigation, the feasibility of immunophenotyping samples obtained by needle aspiration of lymph nodes from 32 dogs with no physical abnormalities and 6 dogs with lymphoma was determined. In addition, samples from 6 dogs were stored overnight at 4 degrees C and reanalyzed 24 hours later. For each sample, stained smear preparations were examined microscopically for lymphocyte morphology, neoplasia, and the presence of inflammatory cells. Expression of antigens on a corresponding sample of aspirated cells was determined by flow cytometric detection of antibody binding on a minimum of 10,000 events. The distribution of data was determined with Anderson-Darling tests, and reference intervals incorporating the central 95% of values were established. Adequate samples were obtained from 30 of 32 clinically normal dogs. Immunophenotypic results after 24 hours of storage were consistent with those obtained immediately after sampling. Reference intervals for lymphocyte subsets from normal dog lymph nodes were similar to the proportions of CD3+, CD4+, CD8+, and CD21+ lymphocytes found in blood. Aspirates of enlarged lymph nodes from dogs with lymphoma were readily classified by this technique. Aspiration of lymph nodes from dogs for comprehensive analysis by flow cytometry is feasible and applicable to immunophenotyping of lymphoma.

Animals↗

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Age stereotyping: are we oversimplifying the phenomenon?

This study investigates the use of age stereotypes in evaluating individuals' behavior in context-specific situations. One hundred university students assessed young male, young female, old male, and old female characters in four vignettes using the Rosencranz and McNevin Semantic Differential. The data revealed limited but conflicting evidence of the use of stereotypes when the stimuli portrayed target characters in lifelike situations rather than in an experimental vacuum. It is argued that while stereotyping can occur in specific contexts, its form is greatly influenced by other aspects of the situation. The need to reconceptualize the notion of stereotypes of the elderly is discussed, and a shift in emphasis toward the analysis of subgroup stereotypes as opposed to one consistent global stereotype of old age is urged.

Adult↗

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Neuroblastoma of the anterior mediastinum in an 80-year-old woman.

A 7-cm anterior mediastinal tumor in an 80-year-old woman was found by light and electron microscopy to be a neuroblastoma. Immunoreactivity for neuron-specific enolase, synaptophysin, and chromogranin supported the diagnosis. Neuroblastoma is an uncommon tumor in adults and we are not aware of a previous report of such a tumor in a patient of this age.

Aged↗

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An outside job.

Would you turn the management of clinical assets over to an outside company? More and more hospitals are doing it. Here, two executives from a Bellevue WA hospital explain how "outsourcing" is working for them.

Capitation Fee↗

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Proceedings: Distribution of HL-A antigens in patients with juvenile rheumatoid arthritis (JRA).

Explore the source record for details and available documents.

Arthritis, Juvenile↗

PubMedDate not supplied

Creative permanency planning: residential services for families.

A children's institution offers a creative program for single mothers and their families--a 24-hour child care facility on the campus that provides residential service for the entire family. Over several months, the staff helps with family problems such as income, housing, abuse and other family dysfunctions and prevention of separation. Though small, the program has experienced success and has operated on a small budget for the last 10 years.

Adult↗

PubMedDate not supplied

An analysis of isolated aortic valve surgery and combined procedures in patients over 70 years of age.

Ninety-four patients over the age of 70 years were submitted to 95 operations for aortic valve disease. Seventy-seven patients had isolated aortic valve operations and a further 17 underwent additional procedures. The hospital mortality for the whole group was 15.7%. The actuarial five year survival was 66%. Concomitant coronary revascularization increased the perioperative risk. Myocardial protection by cold crystalloid cardioplegia improved results reducing the perioperative mortality for AVR alone from 21.7 to 11.1%. We believe that these patients should not be denied operative intervention since worthwhile improvement generally ensues. Coronary artery grafting can be hazardous. Bioprostheses inserted with myocardial protection favours surgery over continued medical management which offers little for these elderly symptomatic patients.

Actuarial Analysis↗