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Biomedical subjects

M L Lewis

Publications and source records attributed to M L Lewis.

At least 109 records · Page 6Linked to original sources
PubMed1975

Intrarenal platelet consumption in the diffuse proliferative nephritis of systemic lupus erythematosus.

1. Platelet survival and an index of the localization of platelets in the kidney were studied in patients with the proliferative nephritis of systemic lupus erythematosus, either focal or diffuse, and in control subjects. Platelet survival was reduced in patients with proliferative lupus nephritis, more in those with diffuse rather than focal renal involvement. 2. The index of renal platelet localization in patients with diffuse proliferative nephritis suggested an intrarenal platelet consumption not found in other groups. 3. A patient with the classical platelet autoantibody disease, idiopathic thrombocytopenic purpura, also showed reduced platelet survival but localization of platelets was in the spleen rather than the kidney. 4. Intrarenal platelet consumption in diffuse proliferative lupus nephritis may be an epiphenomenon of pre-existing scarring or platelet aggregation secondary to immune complex-formation, which contributes to the progressive sclerosing lesions of this form of nephritis.

Adult↗
PubMed1975

Fibrinogen metabolism in acute hepatitis and active chronic hepatitis.

Coagulation studies, including those of radioactive fibrinogen metabolism, were performed in seven patients with acute viral hepatitis and 12 patients with active chronic hepatitis. An increased fractional catabolic rate for fibrinogen was observed in four patients from the first group, and seven from the second. The catabolic rate was increased in those patients with the greatest degree of hepatic necrosis as demonstrated by the raised serum aminotransferase levels. There was no correlation between the rate of fibrinogen catabolism and the standard clotting tests, but the SDPS test (indicating the presence of fibrin monomers in the circulation) was consistently positive in those cases where the catabolic rate was increased.

Acute Disease↗
PubMed1974

Coagulation factor concentrate in the treatment of the haemorrhagic diathesis of fulminant hepatic failure.

To assess the value of clotting factor concentrate infusions in fulminant hepatic failure, a controlled trial was performed in which nine patients were randomly allocated to treatment with either concentrate alone or concentrate plus heparin. The five patients receiving concentrate alone all died, with major bleeding as the direct cause of death in three, whereas in the four receiving heparin as well there was only one instance of bleeding and one patient survived. Clinical evidence of intravascular coagulation appeared in two patients treated with concentrate alone and the laboratory evidence of this progressed during the period of infusions in all patients in both treatment groups, although to a lesser extent in those receiving heparin. Additional evidence for intravascular coagulation came from the changes observed in factor VIII levels which, although initially high in all patients, fell subsequently, particularly in those given concentrate alone. There was some improvement in the prothrombin ratio in both groups of patients but not complete correction, and serial assays of clotting factors showed that although factor II rose to high levels during treatment, factors IX and X showed little response. Thus, the use of concentrate of factor IX in this trial, as well as potentiating intravascular coagulation, was inadequate as replacement for the clotting factor deficiencies.

Acute Disease↗
PubMed1974

Cyclic thrombocytopenia: a thrombopoietin deficiency?

Severe cyclic thrombocytopenia is reported in a young woman. This rare phenomenon is of considerable theoretical interest in relation to platelet kinetics. In this patient platelet and fibrinogen survival times exclude the possibility of excessive peripheral platelet destruction. Serial plasma thrombopoietin levels suggest that a deficiency of this protein may be the underlying factor. As a result platelet production may fall to a very low level. The megakaryocyte, however, remains responsive and the hypothesis advanced is that under these circumstances the intermenstrual platelet increase, normally caused by the interplay of the sex hormones, becomes grossly exaggerated.

Adult↗
PubMed1971

Early and intensive therapy of intravascular coagulation in acute liver failure.

Four consecutive patients, three with fulminant hepatic failure and one with a severe relapse of serum hepatitis, who showed evidence of intravascular coagulation, were treated intensively with heparin and fresh frozen plasma. Rapid correction of the coagulation disturbance was achieved, and all four patients recovered completely. The necessity for starting such treatment early in the course of the disease and before the onset of major gastrointestinal bleeding is stressed, and it is suggested that intravascular coagulation may act as an intermediary in the pathogenesis of the hepatic necrosis.

Acute Disease↗
PubMed1970

Determinants of pulmonary blood volume.

Pulmonary blood volume was determined by the radiocardiographic technique in 49 patients coming to cardiac catheterization. Since this method has not been directly compared with the more commonly used double injection of dye. 25 comparisons were carried out in 13 patients of the series. Agreement was good over a range of 4.5-21.1 heart cycles since there was no statistically significant difference between transit time values measured by the two methods. The relation of pulmonary blood volume to other hemodynamic factors in these 49 patients, with and without cardiac or pulmonary disease, was evaluated by means of multiple regression analysis. The analysis carried out for mean transit time indicates that this parameter varies predominately with flow. Pulmonary blood volume, in this series of resting recumbent individuals, varies to a significant degree only with total blood volume and with pulmonary venous pressure. No parameters of vascular distensibility, such as pulmonary vascular resistance, were found to affect the volume of blood in the lungs. The fact that variations in pulmonary blood volume among the subjects could be described by a multiple regression equation linear with respect to total blood volume and pulmonary venous pressure indicates that these variations are the result of passive distention of components of the vascular bed.

Adult↗
PubMed1946

External Otitis.

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Journal Article↗
PubMedDate not supplied

Competency-based nursing in a rehabilitation setting.

The success of achieving a competency-based rehabilitation nursing practice is shared in this article. An education day provided a comprehensive approach to ensure that practicing staff nurses stay abreast of the knowledge and skills necessary to provide quality patient care. This article details the decision-making process, competency development, strategies, and evaluation of the competency program. Formal documentation of competency testing is an asset for follow-up and accreditation review.

Clinical Competence↗