2,808 research outputs found

    Delayed-onset heparin-induced thrombocytopenia presenting with multiple arteriovenous thromboses: case report

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    <p>Abstract</p> <p>Background</p> <p>Delayed-onset heparin-induced thrombocytopenia with thrombosis, albeit rare, is a severe side effect of heparin exposure. It can occur within one month after coronary artery bypass grafting (CABG) with manifestation of different thrombotic events.</p> <p>Case presentation</p> <p>A 59-year-old man presented with weakness, malaise, bilateral lower limb pitting edema and a suspected diagnosis of deep vein thrombosis 18 days after CABG. Heparin infusion was administered as an anticoagulant. Clinical and paraclinical work-up revealed multiple thrombotic events (stroke, renal failure, deep vein thrombosis, large clots in heart chambers) and 48 ×10<sup>3</sup>/μl platelet count, whereupon heparin-induced thrombocytopenia was suspected. Heparin was discontinued immediately and an alternative anticoagulant agent was administered, as a result of which platelet count recovered. Heparin-induced thrombocytopenia, which causes thrombosis, is a serious side effect of heparin therapy. It is worthy of note that no case of delayed-onset heparin-induced thrombocytopenia with thrombosis associated with cardiopulmonary bypass surgery has thus far been reported in Iran.</p> <p>Conclusion</p> <p>Delayed-onset heparin-induced thrombocytopenia should be suspected in any patient presenting with arterial or venous thromboembolic disorders after recent heparin therapy, even though the heparin exposure dates back to more than a week prior to presentation; and it should be ruled-out before the initiation of heparin therapy.</p

    Does landscape-scale conservation management enhance the provision of ecosystem services?

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    Biodiversity conservation approaches are increasingly being implemented at the landscape-scale to support the maintenance of metapopulations and metacommunities. However, the impact of such interventions on the provision of ecosystem services is less well defined. Here we examine the potential impacts of landscape-scale conservation initiatives on ecosystem services, through analysis of five case study areas in England and Wales. The provision of multiple ecosystem services was projected according to current management plans and compared with a baseline scenario. Multicriteria analysis indicated that in most cases landscape-scale approaches lead to an overall increase in service provision. Consistent increases were projected in carbon storage, recreation and aesthetic value, as well as biodiversity value. However, most study areas provided evidence of trade-offs, particularly between provisioning services and other types of service. Results differed markedly between study areas, highlighting the importance of local context. These results suggest that landscape-scale conservation approaches are likely to be effective in increasing ecosystem service provision, but also indicate that associated costs can be significant, particularly in lowland areas

    Neural correlates of enhanced visual short-term memory for angry faces: An fMRI study

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    Copyright: © 2008 Jackson et al.Background: Fluid and effective social communication requires that both face identity and emotional expression information are encoded and maintained in visual short-term memory (VSTM) to enable a coherent, ongoing picture of the world and its players. This appears to be of particular evolutionary importance when confronted with potentially threatening displays of emotion - previous research has shown better VSTM for angry versus happy or neutral face identities.Methodology/Principal Findings: Using functional magnetic resonance imaging, here we investigated the neural correlates of this angry face benefit in VSTM. Participants were shown between one and four to-be-remembered angry, happy, or neutral faces, and after a short retention delay they stated whether a single probe face had been present or not in the previous display. All faces in any one display expressed the same emotion, and the task required memory for face identity. We find enhanced VSTM for angry face identities and describe the right hemisphere brain network underpinning this effect, which involves the globus pallidus, superior temporal sulcus, and frontal lobe. Increased activity in the globus pallidus was significantly correlated with the angry benefit in VSTM. Areas modulated by emotion were distinct from those modulated by memory load.Conclusions/Significance: Our results provide evidence for a key role of the basal ganglia as an interface between emotion and cognition, supported by a frontal, temporal, and occipital network.The authors were supported by a Wellcome Trust grant (grant number 077185/Z/05/Z) and by BBSRC (UK) grant BBS/B/16178

    Clinical relevance of heparin-PF4 complex antibody in DVT after total joint replacement

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    <p>Abstract</p> <p>Background</p> <p>Antibodies to the heparin-platelet factor-4 (HPF-4) complex (HIT antibodies) have been observed in patients with heparin-induced thrombocytopenia (HIT). These antibodies are thought to be involved in thrombosis through activation of platelet/endothelial cells. This prospective study was conducted to determine the incidence of post-operative HIT antibodies to assess the associated risk of deep vein thrombosis (DVT) in patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA).</p> <p>Methods</p> <p>We studied 104 patients who underwent unilateral primary TKA (n = 44) and primary THA (n = 60) with short-duration prophylaxis (1–2 days of a fixed dose of unfractionated heparin). HIT antibodies were assayed using a sandwich-type ELISA before the operation and after heparin treatment (post-operative day 7).</p> <p>Results</p> <p>In the clinical outcome, the incidence of symptomatic DVT was 15.4% (16/104, TKA; 10, THA 6) and pulmonary embolism (PE) was not observed. The total seroconversion rate of HIT antibodies at post-operative day 7 was 34.6% (36/104). Among 36 seroconverted patients, 11 (30.6%) developed symptomatic DVT and 5 out of 68 of the non-seroconverted patients (7.4%) developed symptomatic DVT. The incidence for DVT was significantly higher in the seroconverted patients compared with that of the non-seroconverted patients (odds ratio 5.5, 95%CI: 1.7–17.6 <it>p </it>= 0.0028). Furthermore, in the patients with symptomatic DVT, the titer of HIT antibodies at post-operative day 7 was significantly higher compared with those without symptomatic DVT.</p> <p>Conclusion</p> <p>Our data therefore suggest that seroconversion for HIT antibodies generated by heparin is associated with a risk of DVT in patients undergoing total joint replacement.</p

    Investigating the highest melting temperature materials : a laser melting study of the TaC-HfC system

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    TaC, HfC and their solid solutions are promising candidate materials for thermal protection structures in hypersonic vehicles because of their very high melting temperatures (\u3e4000 K) among other properties.  The melting temperatures of slightly hypostoichiometric TaC, HfC and three solid solution compositions (Ta1−xHfxC, with x = 0.8, 0.5 and 0.2) have long been identified as the highest known. In the current  research, they were reassessed, for the first time in the last fifty years, using a laser heating technique.  They were found to melt in the range of 4041–4232 K, with HfC having the highest and TaC the lowest.  Spectral radiance of the hot samples was measured in situ, showing that the optical emissivity of these compounds plays a fundamental role in their heat balance. Independently, the results show that the melting point for HfC0.98, (4232 ± 84) K, is the highest recorded for any compound studied until now

    Chemotherapy-induced senescent cancer cells engulf other cells to enhance their survival.

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    In chemotherapy-treated breast cancer, wild-type p53 preferentially induces senescence over apoptosis, resulting in a persisting cell population constituting residual disease that drives relapse and poor patient survival via the senescence-associated secretory phenotype. Understanding the properties of tumor cells that allow survival after chemotherapy treatment is paramount. Using time-lapse and confocal microscopy to observe interactions of cells in treated tumors, we show here that chemotherapy-induced senescent cells frequently engulf both neighboring senescent or nonsenescent tumor cells at a remarkable frequency. Engulfed cells are processed through the lysosome and broken down, and cells that have engulfed others obtain a survival advantage. Gene expression analysis showed a marked up-regulation of conserved macrophage-like program of engulfment in chemotherapy-induced senescent cell lines and tumors. Our data suggest compelling explanations for how senescent cells persist in dormancy, how they manage the metabolically expensive process of cytokine production that drives relapse in those tumors that respond the worst, and a function for their expanded lysosomal compartment
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