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Biomedical subjects

R Suri

Publications and source records attributed to R Suri.

44 records · Page 3Linked to original sources
PubMed1983

The clinical relevance of platelet aggregation study in myeloproliferative disorders.

30 unselected patients with various entities of the myeloproliferative syndrome were entered into a prospective study to evaluate the relationship between platelet aggregation abnormalities and hemostatic complications and the role of aggregation study in myeloproliferative disorders. 21 patients showed impaired collagen-induced aggregation and absent second phase epinephrine-induced response. 6 of these patients had bleeding manifestations. 4 patients hyperaggregated with ADP, collagen, epinephrine and arachidonic acid. Of these, 3 had thrombotic complications as their initial presentation. In the 6-40 months follow-up no new cases of bleeding or thromboembolic phenomena were encountered among the remaining patients. In 3 patients aggregation abnormalities heralded the specific myeloproliferative disorder by months or years. We conclude from this study that routine platelet aggregation study in classical myeloproliferative disorders is unwarranted as it is costly and does not improve the diagnostic accuracy nor yield any predictive information concerning the tendency to bleed. It is useful as an accessory investigative tool in the atypical or early myeloproliferative patient whose clinical features, blood and marrow findings although suggestive are not diagnostic of a specific myeloproliferative entity.

Adolescent↗
PubMed1981

Repair of major intracardiac anomalies associated with atrioventricular discordance.

Thirty-five patients with atrioventricular (AV) discordance underwent repair of major intracardiac defects. Ventricular septal defect (VSD) was the most frequently encountered lesion, present alone or in combination with other lesions in 86% of these patients. Pulmonary stenosis (51%) and tricuspid insufficiency (37%) were the other lesions encountered. The initial operative mortality of 8.6% is approaching that for these same defects when repaired in the patient with normal atrioventricular connections. However, the late mortality of 19% with an average follow-up of 4.4 years is higher than expected in the absence of AV discordance. Reoperation for residual or recurrent defects was required in 9 of the 32 survivors and was associated with a mortality of 33%. Seven of the 9 reoperations were required for tricuspid valve dysfunction. Elective repair of major anomalies in association with AV discordance can be accomplished safely, but these patients require careful long-term follow-up in anticipation of late problems.

Adolescent↗
PubMed1981

New concepts on the acute leukaemias: morphology, classification, cell biology, chemotherapy, supportive care, immunotherapy and bone marrow transplantation.

The advances in chemotherapy, understanding of leukaemia cell biology and supportive care for acute leukaemia patients offer substantial prospect for cure in the future. Intensive treatment of acute leukaemia requires the resources of specialised unites for support of bone marrow failure. Where possible, patients should be referred to such units for diagnostic classification and intensive remission induction therapy. The understanding of leukaemia cell biology and the detection of colony stimulating activity in normal granulocytes and marrow has helped in predicting early relapses in leukaemia patients. Allogeneic sibling bone marrow transplantation for patients in remission offers a 70% chance of 3 years survival and disease-free state compared to 10% survival for the non-grafted patients treated on maintenance chemotherapy alone. Current evidence suggests that such transplanted patients do not require long term chemotherapy or anti-G.V.H. treated now that the problem of graft-versus-host disease in transplant recipients appears to be overcome by the use of Cyclosporin A.

Acute Disease↗
PubMed1981

One year review of the blood cell separator programme.

Using the Haemonetic Model 30 intermittent continuous flow centrifuge, 142 procedures, including 64 granulocytes and platelets, 68 platelet collection, 8 therapeutic leukapheresis and 2 plasmapheresis were performed. Granulocyte transfusions (mean collection 1.39 x 10(10) granulocytes) were given to 27 neutropenic patients for febrile episodes which were unresponsive to systemic antibiotics. Thirty-eight thrombocytopenic patients received a mean of 4.2 x 10(11) platelets per collection. Bleeding was controlled in most of the patients who received transfusion with a mean rise in platelet count of 30.6 x 10(9)/L. Therapeutic leukapheresis were performed on 3 patients with chronic leukaemias. A mean of 2.53 x 10(11) cells were collected per run with a mean fall of 58.2 x 10(9)/L in the patients' white blood cell count. Plasmapheresis was used to treat 1 patient with multiple myeloma. The authors' experience demonstrates that cell separator support is essential for patients with bone marrow depression and that the therapeutic leukapheresis is effective therapy for selected patients with chronic leukaemias. Plasmapheresis is effective in patients with hyperviscosity syndrome.

Adult↗
PubMed1980

Priapism complicating chronic granulocytic leukemia.

Since 1952 we have seen nine patients with priapism leading to a diagnosis of chronic granulocytic leukemia (CGL) and a tenth patient who gave a history of priapism when CGL was diagnosed as a result of other symptoms. Seven patients had had one or more transient episodes of prolonged erection before the diagnosis of CGL was established. All ten had high blood leukocyte counts (mean 380 X 10(9)/liter, range 186-782) in comparison with other newly diagnosed patients. We estimate the incidence of this complication at 1%-2% of all male patients presenting with CGL. Treatment of patients in this series varied greatly. Five patients were treated mainly by local measures with r without cytotoxic drugs at conventional dosage, three were treated by sapheno-cavernous bypass operations and leukapheresis followed by cytotoxic drugs at high dosage, and two were treated initially by leukapheresis alone. In general, the prompt initiation of measures designed to reduce the leukocyte count seemed more valuable than the surgical procedures employed in these patients.

Adolescent↗
PubMedDate not supplied

Hormonal changes in the postpartum and implications for postpartum depression.

The months following childbirth are a time of heightened vulnerability to depressive mood changes. Because of the abrupt and dramatic changes occurring in hormone levels after delivery, many studies have examined the role of hormonal factors in postpartum depression. The authors review the literature on potential hormonal etiologies in postpartum depression, in particular for progesterone, estrogen, prolactin, cortisol, oxytocin, thyroid, and vasopressin. While evidence for an etiologic role is lacking for most hormones, changes in certain hormonal axes may contribute to depressive mood changes in some women following childbirth.

Depression, Postpartum↗