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PubMed2002

Clinical trials update: highlights of the scientific sessions of The American College of Cardiology 2002: LIFE, DANAMI 2, MADIT-2, MIRACLE-ICD, OVERTURE, OCTAVE, ENABLE 1 & 2, CHRISTMAS, AFFIRM, RACE, WIZARD, AZACS, REMATCH, BNP trial and HARDBALL.

This article continues a series of reports updating recent research developments of particular interest to personnel involved in the treatment and management of patients with heart failure. This is a summary of selected presentations made at the American College of Cardiology 51st Annual Scientific Session held in Atlanta on 17-20 March 2002. Reports of the following clinical studies are included: LIFE, DANAMI 2, MADIT-2, MIRACLE-ICD, OVERTURE, OCTAVE, ENABLE 1 & 2, CHRISTMAS, AFFIRM, RACE, WIZARD, AZACS, REMATCH, BNP trial and HARDBALL.

Cardiology↗
PubMed1991

Dental care for the homeless over Christmas 1990.

Each year since 1970, the charity CRISIS has provided a place of warmth and shelter for the homeless of London (guests) over the Christmas period. In 1990 they converted a large factory warehouse off the Old Kent Road and set it up to cook meals, provide beds, games, televisions, hairdressing, chiropody, medical and dental care--and information on housing, as well as general advice. Washing and cleaning facilities were provided in Portakabins parked in the yard outside the warehouse. Guests were provided with a complete change of clothing, which were altered to fit if necessary.

Adolescent↗
PubMed1992

[Christmas tree ornament cataract--an indication for disordered lipid metabolism?].

Cataract combined with Christmas tree decoration crystals in the lens is a relatively rare but very impressing cataract formation. The aim of this controlled study was to give an answer to the question, whether cholesterol level in blood is as important for local cholesterol accumulation in the lens as it is for the mechanism of arteriosclerosis. The blood levels of cholesterol, triglyceride, HDL and LDL were examined in 35 patients (average age 83.5 years; 26 women, 9 men). There was no significant difference between these parameters and those of a control group, which is similar in age and sex proportion. Therefore it is presumed, that these crystals of cholesterol are a result of lens metabolism and not of hypercholesterolemia.

Aged↗
PubMed1983

["Christmas tree decoration" crystals in the lens].

In lens crystal cataracts resembling Christmas tree decorations there are, most commonly in the nucleus, crystals in tubular cavities whose double refraction corresponds to that of cholesterol. There are considerable differences in the sizes of the crystals and they are not restricted to the borders of the lens fibers. In the cortex the cholesterol crystals minute if they are found here at all are situated in areas disposed to water-cleft formation.

Cataract↗
PubMed1974

A comparison of bovine prothrombin, factor IX (Christmas factor), and factor X (Stuart factor).

A comparison has been made of the electrophoretic behavior, chemical composition, amino-terminal sequence, and immunological properties of bovine prothrombin, factor IX (Christmas factor), and factor X (Stuart factor). Some immunological crossreactivity was found between the antibody to prothrombin and factor X although prothrombin and factor X differ substantially in amino-acid and carbohydrate composition. Considerable amino-acid sequence homology was found in the amino-terminal portion of prothrombin, factor IX, and the light chain of factor X. These data provide further evidence to support the hypothesis that at least three of the vitamin K-dependent clotting factors have evolved from a common ancestral gene.

Amino Acid Sequence↗
PubMed1979

Comparison of amino acid sequence of bovine coagulation Factor IX (Christmas Factor) with that of other vitamin K-dependent plasma proteins.

The amino acid sequence of bovine blood coagulation Factor IX (Christmas Factor) is presented and compared with the sequences of other vitamin K-dependent plasma proteins and pancreatic trypsinogen. The 416-residue sequence of Factor IX was determined largely by automated Edman degradation of two large segments, containing 181 and 235 residues, isolated after activating Factor IX with a protease from Russell's viper venom. Subfragments of the two segments were produced by enzymatic digestion and by chemical cleavage of methionyl, tryptophyl, and asparaginyl-glycyl bonds. Comparison of the amino acid sequences of Factor IX, Factor X, and Protein C demonstrates that they are homologous throughout. Their homology with prothrombin, however, is restricted to the amino-terminal region, which is rich in gamma-carboxyglutamic acid, and the carboxyl-terminal region, which represents the catalytic domain of these proteins and corresponds to that of pancreatic serine proteases.

Amino Acid Sequence↗
PubMed2002

Long-lasting "christmas tree rash" in an adolescent: isotopic response of indeterminate cell histiocytosis in pityriasis rosea?

A 13-year-old girl developed a non-pruritic pityriasis rosea-like rash, which did not respond to topical corticosteroids or UV therapy but persisted for 2 years. The lymphohistiocytic infiltrate in the upper dermis showed mononuclear cells immunoreactive with S100, CD68, factor XIIIa and CD1a. Electron microscopic evaluation of these cells demonstrated lamellated dense bodies but no Birbeck granules, lipid vacuoles or cholesterol crystals. Two diagnoses were made: a primarily clinical diagnosis of generalized eruptive histiocytosis and a more cell-biology-based diagnosis of an indeterminate cell histiocytosis. Three years later, the lesions are showing spontaneous resolution, with loss of erythema and flattening. Our patient's indeterminate cells fulfil Rowden's classical definition (dendritically shaped epidermal non-keratinocytes without identifying cytoplasmic features), as well as Zelger's newer definition (cells with features of both macrophages and dendritic cells). A Christmas tree pattern has not been previously described in indeterminate cell histiocytosis. Development of indeterminate cell histiocytosis in the lesions of a healing pityriasis rosea might explain the unusual distribution pattern. The development of a skin disorder at the site of an unrelated, already healed skin disease is known as an isotopic response. Key

Adolescent↗
PubMed1996

Comparison of the spending function method and the Christmas tree correction for group sequential trials.

Sequential designs for continuous monitoring can be derived from the theory of a Brownian motion process. In practice, infrequent analyses lead to a discrete monitoring process. In this paper, two methods proposed to correct for discrete monitoring are compared. The methods are used to create procedures similar to both the O'Brien and Fleming test and the triangular test and are compared in terms of the error rates. For the O'Brien and Fleming test, the spending function method is found to achieve the required error rates more accurately than the Christmas tree correction, while for the triangular test, both methods perform as planned.

Clinical Trials as Topic↗
PubMedDate not supplied

Respiratory, acid-base, and metabolic responses of the Christmas Island blue crab, Cardisoma hirtipes (Dana), during simulated environmental conditions.

The dependency of the Christmas Island blue crab, Cardisoma hirtipes, on fresh water for respiratory gas exchange and transport was investigated in laboratory simulations. The gas exchange rates of air-breathing C. hirtipes were similar to those of other land crabs but decreased to 20% in submerged crabs. Crabs with access to air maintained arterial and pulmonary O2 content (CO2) and partial pressure (PO2), while in submerged crabs the PO2 and CO2 rapidly decreased (by 50%). There was no anaerobiosis, but haemolymph glucose concentration and cardiac output decreased when crabs were submersed, which suggests a hypometabolic state. Submersion induced a metabolic rather than a respiratory alkalosis, and since respiratory gas exchange was low, CO2 excretion to water was unimportant. Cardisoma hirtipes haemocyanin (Hc) has high O2 affinity but low pH sensitivity, which facilitates O2 uptake from hypoxic environments. The high Hc-O2 affinity supports O2 loading but may prevent access to a venous O2 reserve. Calcium, magnesium, and urate, but not L-lactate, were effectors of Hc-O2 affinity. In submerged crabs increased circulating urate maintained haemolymph O2 content. The CO2 capacitance and nonbicarbonate buffering of the haemolymph were relatively low. A significant Haldane effect seemed important for CO2 excretion but would require CO2 and O2 exchange to occur at the same organ (gills or lungs). Submersion interferes with respiration and is not needed for haemolymph acid-base balance; thus; C. hirtipes is an air-breathing crab.

Acid-Base Equilibrium↗
PubMed1977

Factor IX levels in patients with hemophilia B (Christmas disease) following transfusion with concentrates of factor IX or fresh frozen plasma (FFP).

There has been no systematic re-examination of variables that may affect the level and duration of response of patients with hemophilia B (Christmas disease) to transfusion. Therefore, 49 of our transfusion episodes and 171 previously reported transfusions were evaluated. Mean calculated initial increase of Factor IX levels (delta %/unit (U) of procoagulant activity infused/kg) was 0.82 +/- 0.09% (mean +/-S.E.) in previously reported cases and 1.01 +/- 0.13% in our patients, after transfusion of concentrate; but only 0.05 +/- 0.11% after fresh frozen plasma (FFP). Response was not altered by acute hemorrhage, baseline Factor IX levels, or body weight. Proplex (Hyland) and Konyne (Cutter) produced similar responses. Following transfusion, the disappearance curve was biphasic. The mean T1/2 for the second component was 27.5 hrs, but the direct T1/2 was only 6.4 +/- 1.0 hr. Regardless of common clinical variables, increase of Factor IX following transfusion of American concentrates is 1.0% (or 0.01 U)/1 administered/kg. Appropriate frequency of transfusion depends upon an understanding of the biphasic disappearance of Factor IX. Importantly, the initial frequency of transfusion therapy should be based on a direct T1/2 of only 6 to 8 hrs.

Blood Transfusion↗
PubMed1979

Christmas bow tragedies.

Two cases of fatal accidents involving plastic buttons from Christmas bows are described. Although accidents are the commonest cause of death in children less than 3 years old, governmental mechanisms, properly enforced, can be instrumental in preventing such catastrophies.

Child, Preschool↗
PubMed2006

No poinsettia this Christmas.

Poinsettia is one of the most delightful decorations during the Christmas season. Natural rubber latex and poinsettia share some common allergen proteins. Hence, people with latex allergy may develop cross-reactivity with poinsettia. We report the case of a 50-year-old white female with a history of latex allergy, who developed a skin rash due to exposure to the poinsettia plant. The patient was admitted to the hospital for evaluation of near syncope. Her diagnostic workup was normal. She received a poinsettia plant from a friend during hospitalization. Because of her latex allergy, we carried out an extensive research of literature which revealed a cross-reactivity between latex allergy and poinsettia. The rash responded well to systemic antihistaminic treatment and removal of the plant from the room.

Allergens↗
PubMed1975

A five year experience of the use of factor IX type DE(I) concentrate for the treatment of Christmas disease of Oxford.

A survey is presented of the use of the Oxford type DE(I) II-IX-X concentrate in the treatment of Christmas disease in Oxford from January 1970 to September 1974. 72 different patients were treated with a total of 2436 bottles of this concentrate from 143 different batches (each bottle containing 800-1000 units of factor IX). Although most doses were given for the treatment of minor haemorrhages into joints and muscles, 717 bottles of concentrate were used to treat 11 patients who underwent 14 major surgical operations. No episode of intravascular clotting or pulmonary embolism was seen in any patient receiving the concentrate. A detailed study of the plasma levels of factor V, VIII, total progressive antithrombin, platelets and fibrinogen degradation products was carried out before and after transfusion of type DE(I) concentrate in 14 patients. No significant alteration in those factors was found after the transfusion.

Antithrombins↗
PubMed1976

Christmas disease (haemophilia B) in a girl with deletion of the short arm of one X-chromosome (functional Turner syndrome).

A I-year-old girl with severe Christmas disease and a factor IX content less than I% of normal is described. The family history was negative and coagulation studies on her relatives were normal. Genetic investigation showed an XXp-karyotype with deletion of the short arm of one X-chromosome, a cytogenetic variant of Turner syndrome. The transmission pathway of the haemophilia gene is discussed.

Chromosome Aberrations↗
PubMed1972

Tranexamic acid in control of haemorrhage after dental extraction in haemophilia and Christmas disease.

In a double-blind trial tranexamic acid (AMCA, Cyclokapron), 1 g three times a day for five days, significantly reduced blood loss and transfusion requirements after dental extraction in patients with haemophilia and Christmas disease. No side effects were seen in either group of patients. Screening tests showed no toxic action of tranexamic acid on the liver, kidney, or heart.

Adolescent↗
PubMed2004

Best evidence topic report. Suicide at christmas.

A short cut review was carried out to establish whether the risk of suicide and parasuicide increases at Christmas. Fifteen papers were found using the reported search, of which six presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Emergency Medical Services↗