Search PubMed⌕ Search

Biomedical subjects

J P Isbister

Publications and source records attributed to J P Isbister.

At least 73 records · Page 4Linked to original sources
PubMed1980

Massive blood transfusion.

Massive blood transfusion is associated with a wide range of adverse effects, some of which are understood, but controversy surrounds the effects of massive blood loss and transfusion on haemostasis and oxygen transport. Until we have a better understanding of the underlying pathophysiology and while storage of blood remains imperfect, there is a good case for the empirical use of super-fresh blood in this clinical setting. A practical approach to the exsanguinated patient is presented.

Acid-Base Imbalance↗
PubMed1980

Should autologous blood transfusion be rediscovered?

With a greater appreciation and understanding of reactions to homologous blood transfusion there has been a renewed interest in autologous blood transfusion. The techniques and indications for preoperative banked autologous blood, perioperative haemodilution and recycled salvaged autologous blood transfusion are described. When circumstances permit, autologous blood transfusion is a safe, economical and efficient alternative to homologous blood.

Blood Preservation↗
PubMed1979

Plasma exchange: a selective form of blood-letting.

The technique of, and indications for, plasma exchange are presented. This selective form of plasma removal has re-established "blood-letting" in medical therapeutics on a scientific basis. It is the most appropriate therapy when hyperviscosity or haemostatic failure complicate immunoproliferative disease. Plasma exchange is also a significant advance in the management of fulminant forms of autoimmune disease, but in many other conditions it must be regarded as experimental.

Anemia, Hemolytic, Autoimmune↗
PubMed1979

Allogeneic bone marrow transplantation across the ABO barrier.

Allogeneic bone marrow transplantation in severe aplastic anaemia has been shown to be a worth-while procedure. A case in which a group O patient received a successful marrow transplant from a group B donor is reported. Major ABO incompatibility is not a contraindication to bone marrow transplantation.

ABO Blood-Group System↗
PubMed1979

In-vitro synthesis of an anti-BI cold agglutinin complicating a case of lymphoma.

A woman of 47 with lymphocytic lymphoma was found to have a high-titer cold autoagglutinin of anit-BI specificity. Her group B erythrocytes autoagglutinated of anti-BI specificity. Her group B erythrocytes autoagglutinated in vitro and the direct antiglobulin reaction was positive, but she had no symptom of cold intolerance, no evidence of hemolysis, and she could receive transfusions of compatible group O erythrocytes. In addition, evidence for synthesis of the autoantibody by the lymphoma cells was obtained by short-term bone-marrow culture.

ABO Blood-Group System↗
PubMed1978

Lymphoproliferative disease with IgM lambda monoclonal protein and autoimmune hemolytic anemia. A report of four cases and a review of the literature.

Four patients with lymphoproliferative disease with immunoglobulin M lambda (IgMlambda) monoclonal proteins and severe autoimmune hemolytic anemia are described. These patients had many features in common that may warrant their recognition as a specific entity within the lymphoproliferative spectrum. In each case, a wide thermal range low titer cold agglutinin was present. The association of cold autoimmune hemolytic anemia with IgMlambda monoclonal protein and lymphoproliferative disease is unusual. The literature on IgM monoclonal proteins associated with lymphoproliferative disease is reviewed with emphasis on the presence of direct antiglobulin test positive autoimmune hemolytic anemia.

Adult↗
PubMed1978

The effects of plasma exchange on cholesterol metabolism.

Four patients heterozygous for familial hypercholesterolaemia were treated by repeated plasma exchange with or without lipid-lowering drugs. Repeated plasma exchange without drug therapy in 3 patients was associated with a significant 18--28% decrement in plasma cholesterol level, comparing control with plateau values observed 3 weeks after exchange. Further decrements in plateau values followed the addition of lipid-lowering drugs used in combination, clofibrate--nicotinic acid or clofibrate--nicotinic acid--cholestyramine (range of total decrement 39--50%). Plasma exchange was associated with an increased excretion of endogenous faecal steroids, but this increase was completely abolished by the subsequent administration of clofibrate--nicotinic acid. This therapy prevented any increase in bile acid excretion with concomitant use of cholestyramine resin. Plasma exchange with drug therapy was associated with a sustained rise in plasma cholesterol specific radioactivity. In a fourth patient, clofibrate--nicotinic acid was administered prior to plasma exchange and led to a 24% fall in plasma cholesterol. Subsequent plasma exchange in this patient produced no sustained change in plasma cholesterol plateau level. In two patients, withdrawal of drugs allowed plasma cholesterol to return to pre-exchange control levels. These observations suggest that plasma exchange probably produced an increase in endogenous cholesterol synthesis and a mobilisation of tissue cholesterol. In relation to plateau cholesterol values 3 weeks after an exchange, the data suggested that the reduction in plasma cholesterol level with plasma exchange and drug therapy could have been achieved by intensive drug therapy alone.

Adult↗
PubMed1978

Experience with large volume plasmapheresis in malignant paraproteinaemia and immune disorders.

Clinical experience with large volume plasmapheresis in a wide range of malignant and immune disorders is described. An average of 4 litres of plasma was exchanged for various colloid and electrolyte solutions. Patient tolerance was good but close medical and nursing supervision in monitoring fluid balance and adverse reactions to replacement fluids is necessary. Plasmapheresis has been established to be of benefit in immunoproliferative diseases when complicated by hyperviscosity, and may also have a place in other cases with haemostatic or renal impairment. Autoantibodies, alloantibodies and immune complexes can be removed by plasmapheresis, but the effect is usually transient and the procedure should be combined with immunosuppressive therapy in most cases. The removal of blocking factors in disseminated malignant melanoma is an experimental procedure at present, but initial results have been encouraging.

Adult↗
PubMed1977

Development of Rh-specific maternal autoantibodies following intensive plasmapheresis for Rh immunisation during pregnancy.

Two cases of autoantibody formation following large volume plasmapheresis for rhesus immunisation during pregnancy are described. In each case the autoantibody was directed against the Rh complex but showed a preference for G-positive cells. It is postulated that repeated plasmapheresis in the presence of persistent antigenic stimulation has removed a feedback inhibition of the immune response. The specificity of the alloantibody has broadened resulting in cross-reactivity against self-antigens. The possible implications of these cases in relation to autoimmunity are discussed.

Adult↗
PubMed1976

Granulocyte transfusion therapy.

This paper summarizes the present state of knowledge in the field of granulocyte transfusion therapy and reviews the past literature. The various centrifugation and filtration methods for separation and collection of granulocytes are described and comparisons of their effectiveness are made. Clinical applications of granulocyte transfusions and the possible complications which may result are discussed. It is indicated that the role of granulocyte transfusion therapy will assume increasing importance in the future.

Animals↗
PubMed1976

Reactions to rapid infusion of stable plasma protein solution during large volume plasma exchange.

Five per cent heat treated stable plasma protein solution (SPPS) has been rapidly infused into 25 patients, as fluid replacement during large volume plasmapheresis. Reactions were produced in 20 patients. Subjective symptoms of flushing, nasal stuffiness, fullness and throbbing in the head, colicky abdominal pain, metallic taste or apprehension were observed in 16 patients, and 11 patients became hypotensive with an average systolic pressure of 70 mm Hg. These observations support earlier reports of hypotension due to rapid SPPS infusion, and document the occurrence of subjective symptoms which may be the harbingers of a hypotensive reaction. In view of the known presence of a bradykinin-like substance in some heat treated plasma protein solutions, hypotension during SPPS infusion should be interpreted with caution in the light of these findings.

Blood Proteins↗