SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Of the three ethylenediaminetetraacetic acid (EDTA) salts used for anticoagulation of blood specimens for hematologic testing, potassium salts are the most readily soluble. Tripotassium EDTA is dispensed as a liquid and thus causes a slight dilution of the specimen. This salt also has been shown to affect the red blood cell size more at increased concentrations and on storage than the dipotassium salt. Therefore, dipotassium EDTA is recommended as the anticoagulant of choice in specimen collection for blood cell counting and sizing. The amount of dipotassium EDTA used is 1.5-2.2 mg (3.7-5.4 mumol) per milliliter of blood.
Antibiotic prophylaxis for infective endocarditis is recommended for cardiac patients at risk who undergo an at-risk procedure. Efforts should focus on patients with the highest risk, i.e., those with a prosthetic valve undergoing a dental procedure. Amoxicillin is the main recommendation in patients who are not allergic to penicillin. In patients allergic to penicillin clindamycin orally or vancomycin intravenously are proposed. Aminoglycosides are added for gastrointestinal or urological procedures.
Resting and stress echocardiography is a 'one-stop shop', which enables a wide range of information to be collected on resting function, myocardial viability, and induced ischaemia, all of which are useful for prognostic stratification. Large scale, multicentre, prospectively collected data show the prognostic failure of resting function and inducible ischaemia, both independently and combined, which are especially effective in predicting cardiac death. The GISSI data show that the increment of risk as a result of reduction in ventricular function has a hyperbolic trend, with a relatively moderate increase in mortality for ejection fraction values between 50 and 30%, but with marked increases below 30%. The EPIC data show that the 1-year risk of cardiac death is as low as 2% in patients with negative dipyridamole stress echocardiography: it doubles if the test is positive at a high dose, and is almost four times higher if it is positive at a low dose. In the field of prognostic stratification, in the absence of carefully controlled studies, the choice between coronary angiography as the only essential study, or use of a non-invasive test to discriminate access to catheterization currently reflect alternate philosophical approaches rather than scientifically based decisions. In the invasive approach, stress echocardiography offers relief from the vicious circle of chest pain-coronary angiography revascularization. In the non-invasive and physiological approach, stress echo is capable of offering, in one sitting, an insight into the main determinants of survival: function, viability, and ischaemia.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Limited primary data are available to indicate in which areas physicians' interview performances are deficient. Videotaped recordings of 48 house officers performing a complete medical history were evaluated using a checklist to assess content, questioning technique, and interview style. Frequent deficiencies included inadequate social, psychiatric, and drug reaction histories. Several house officers demonstrated a marked tendency toward an overly directed interview style. The use of a detailed checklist during the observation of a complete medical history facilitates both accurate evaluation and specific detailed feedback to house officers.
Explore the source record for details and available documents.
OBJECTIVE: To determine rates of disseminated Mycobacterium avium complex (MAC) infection among AIDS patients in developed and developing countries, and to determine whether different rates reflect differences in exposure or immunity, or both. DESIGN: Prospective cohort study. SETTING: University hospitals and outpatient AIDS programs. METHODS: HIV-infected subjects with CD4 counts < 200 x 10(6)/l were interviewed and had CD4 lymphocyte counts, blood cultures for mycobacteria (baseline and at 6 months), and skin tests with purified protein derivative (PPD) and M. avium sensitin. RESULTS: Among 566 study patients rates of disseminated MAC were 10.5-21.6% in New Hampshire, Boston and Finland compared to 2.4-2.6% in Trinidad and Kenya (P < 0.001). PPD skin test reactions > or = 5 mm were present in 20% of patients from Kenya compared to 1% at other sites (P < 0.001). Among patients from the United States and Finland, multiple logistic regression indicated that occupational exposure to soil and water was associated with a decreased risk of disseminated MAC, whereas the following were associated with an increased risk of disseminated MAC: low CD4 count, swimming in an indoor pool, history of bronchoscopy, regular consumption of raw or partially cooked fish/shellfish and treatment with granulocyte colony-stimulating factor. CONCLUSIONS: Rates of disseminated MAC in AIDS are higher in developed than developing countries and are due to both differences in exposure and differences in immunity. These data provide a rationale for prevention of MAC through both active immunization and reduction in exposure to the organism.