Universal WBC reduction

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75583/1/j.1537-2995.2000.40060751.x.pd

Clinical Utility of Definitive Drug–Drug Interaction Testing in Primary Care

Drug⁻drug interactions (DDIs) are a leading cause of morbidity and mortality. New tools are needed to improve identification and treatment of DDIs. We conducted a randomized controlled trial to assess the clinical utility of a new test to identify DDIs and improve their management. Primary care physicians (PCPs) cared for simulated patients presenting with DDI symptoms from commonly prescribed medications and other ingestants. All physicians, in either control or one of two intervention groups, cared for six patients over two rounds of assessment. Intervention physicians were educated on the DDI test and given access to these test reports when caring for their patients in the second round. At baseline, we saw no significant differences in making the DDI diagnosis (p = 0.071) or DDI-related treatment (p = 0.640) between control and intervention arms. By round two, providers who accessed the DDI test performed significantly better in making the DDI diagnosis (+41.6%) and performing DDI-specific treatment (+12.2%) than in the previous round, and were 9.8 and 20.4 times more likely to diagnose and identify the DDI (p < 0.001 for all). The introduction of a definitive DDI test significantly increased identification, appropriate management, and counseling of DDIs among PCPs, which has the potential to improve clinical care

The Course of D-dimers as Fibrinolytic Products Generated During Cardiopulmonary Bypass

D-dimers are the expressed degradation products of the lysis of fibrin. Fibrin monomers may normally occur during routine cardiopulmonary bypass (CPB); therefore, fibrinolysis could play a protective role. Serum D-dimer levels were observed at six events associated with routine CPB. An expected patient D-dimer level while heparinized would be <0.5 ug/ml showing that fibrin is not being formed. The majority of elevated D-dimer levels came at the termination of CPB when only one of twenty patients investigated showed a minimal DD level of 8.0 ug/ml at termination of CPB. Even

The Course of D-Dimers as Fibrinolytic Products Generated During Cardiopulmonary Bypass

D-Dimers are the expressed degradation products of the lysis of fibrin. Fibrin monomers may normally occur during routine cardiopulmonary bypass (CPB); therefore, fibrinolysis could play a protective role. Serum D-dimer levels were observed at six events associated with routine CPB. An expected patient D-dimer level while heparinized would be <0.5 mcg/ml showing that fibrin is not being formed. The majority of elevated D-dimer levels came at the termination of CPB when only one of twenty patients investigated showed a minimal D-dimer level of 8.0 ug/ml at termination of CPB. Table