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Biomedical subjects

P Jacobs

Publications and source records attributed to P Jacobs.

At least 487 records · Page 27Linked to original sources
PubMed1981

The role of continuous-flow blood fraction separators in clinical practice.

Continuous-flow blood fraction separators facilitate the efficient exchange of large volumes of plasma or red cells and therefore have clinical application in the rapid correction of abnormalities located predominantly in either of these compartments. Plasmapheresis has been successfully used in managing 2 patients with previously refractory myasthenia gravis, in reducing the antibody titre in a rhesus-sensitized woman, and in diminishing anti-A titre in a patient requiring bone marrow transplantation from an ABO-incompatible but HLA- and MLC-identical sibling. Continuous-flow red cell exchange effectively reduced the haemoglobin S concentration in an individual with sickle cell disease prior to general anaesthesia and abdominal surgery. Complications were not encountered although the procedures were carried out repetitively over prolonged periods of time. All 5 patients tolerated their exchanges without discomfort. As with any new and expensive technique, caution should attend the introduction of continuous-flow plasma or red cell exchange into clinical medicine. Careful evaluation of the safety and the benefits is needed to establish perspective and to distinguish between established and developmental indications.

Acetylcholine↗
PubMed1981

Bone marrow transplantation followed by normal pregnancy.

A full-term normal male child was delivered using forceps fifteen months after successful allogeneic bone marrow transplantation in a woman who presented with severe acute aplastic anemia. The uneventful course of this pregnancy demonstrates that the high-dose cylcophosphamide administration used to prepare the patient for the procedure need not irreversibly suppress ovarian or endocrine function. This observation has relevance for the increasing numbers of young patients with aplastic anemia or acute leukemia undergoing bone marrow transplantation.

Adult↗
PubMed1981

Sulfonylureas and platelet function.

The platelets of many patients with diabetes mellitus are abnormally sensitive to the effects of aggregatory agents in vitro. It has been proposed that this abnormal platelet function may play a role in the pathogenesis of vascular disease in diabetic subjects. We have investigated the effects of six weeks of treatment with the sulfonylurea agents gliclazide and glyburide on platelet aggregation in 10 noninsulin-dependent diabetic subjects. During treatment with diet alone, the platelets of these patients were abnormally sensitive to aggregation in response to 1 microM of adenosine diphosphate, as compared with those in normal controls. Treatment with both drugs normalized ADP-induced aggregation in these patients. Treatment with glyburide significantly reduced aggregation in response to 10 microM of epinephrine and collagen at 750 microgram/ml. The alteration in platelet function did not correlate with the improvement in plasma glucose concentration, thus suggesting that this may be an effect of the drug. Although one must be cautious in extrapolating these in vitro findings to the clinical situation, this alteration in platelet aggregatory function may be of importance in the prevention of vascular disease in diabetic subjects.

Adenosine Diphosphate↗
PubMed1981

Cost of capital, target rate of return, and investment decision making.

Recent attempts to develop an investment decision criterion for nonprofit hospitals that follows that for-profit criteria have resulted in little agreement. Terminological considerations are much to blame for this lack of consensus among researchers in the field. Attempts have been made to identify a "cost of capital" for nonprofit institutions, and to employ this concept in a manner similar to the way it is employed in a for-profit setting. In fact, the application of this concept to nonprofit institutions has resulted in confusion. The use of "target rate of return" in its place would orient the debate more properly toward institutional ends and the means required to achieve them.

Capital Financing↗
PubMed1980

The classification, investigation and treatment of the anaemic patient.

Anaemia is one of the commonest symptoms reported to medical practitioners by their patients. A combined morphological and functional approach to classification is preferred, but the crucial point is the need to establish the cause of the symptom before selecting any form of therapy. Treatment before making an accurate diagnosis, especially the use of haematinics other than those specifically needed, may be dangerous and cannot be too strongly deprecated.

Anemia↗
PubMed1980

The University of Cape Town leukaemia centre: the first 5 years.

In the last 5 years there has been an increasing commitment to cell support regimens and bone marrow transplantation in leukaemia and the clinical service has developed in parallel with laboratory-based research programmes. In the acute leukaemias there has been a major attempt to improve diagnostic accuracy and to classify the tumours functionally, while the clinical approach is currently comparing bone marrow transplantation during the first complete remission with early or late cytotoxic intensification programmes. As regards cell support, allogeneic granulocytes and platelets are being provided for patients in both the leukaemia and the transplantation programmes. In addition, new techniques are being developed for increasing the efficiency of cell collection and characterizing their in vitro function. Bone marrow transplantation is the preferred form of treatment for patients with severe acute aplastic anaemia. Laboratory research is directed at defining graft-versus-host disease and attempting to eliminate this phenomenon with immunological adjuvants.

Academic Medical Centers↗