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  • 1
    Language: English
    In: Thrombosis Research, September 2018, Vol.169, pp.93-95
    Description: Keywords Blood platelet disorder; Thrombocytopenia; Heparin; Cardiac surgery; Thrombosis Highlights * HIT can be a challenging diagnosis in cardiac surgery patients. * Case of early and persistent post-operative thrombocytopenia * Initial immunologic and serologic HIT assays negative but ultimately had HIT * Important to weigh clinical suspicion with laboratory results when diagnosing HIT Abbreviations HIT, heparin-induced thrombocytopenia; CABG, coronary artery bypass grafting; Ig, immunoglobulin; PF4, platelet factor 4; POD, post-operative day; ELISA, enzyme-linked immunosorbent assay; SRA, serotonin release assay Author Affiliation: (a) Department of Medicine, Tufts Medical Center, 800 Washington St, Boston, MA 02111, USA (b) Division of Hematology, Department of Medicine, Tufts Medical Center, 800 Washington St, Boston, MA 02111, USA * Corresponding author at: 800 Washington St, Boston, MA 02111, USA. Article History: Received 16 March 2018; Revised 28 June 2018; Accepted 3 July 2018 Byline: Rima Patel [rpatel8@tuftsmedicalcenter.org] (a), Cindy Varga [cvarga1@tuftsmedicalcenter.org] (b,*)
    Keywords: Blood Platelet Disorder ; Thrombocytopenia ; Heparin ; Cardiac Surgery ; Thrombosis ; Medicine
    ISSN: 0049-3848
    E-ISSN: 1879-2472
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  • 2
    Language: English
    In: The American Journal of Cardiology, 01 January 2016, Vol.117(1), pp.135-140
    Description: Echocardiography is the preferred initial imaging method for assessment of cardiac masses. Cardiac magnetic resonance (CMR) imaging, with its excellent tissue characterization and wide field of view, may provide additional unique information. We evaluated the predictive value of echocardiography and CMR imaging parameters to identify tumors and malignancy and to provide histopathologic diagnosis of cardiac masses. Fifty patients who underwent CMR evaluation of a cardiac mass with subsequent histopathologic diagnosis were identified. Echocardiography was available in 44 of 50 cases (88%). Echocardiographic and CMR characteristics were evaluated for predictive value in distinguishing tumor versus nontumor and malignant versus nonmalignant lesions using histopathology as the gold standard. The Wilcoxon rank-sum test was used to compare the 2 imaging methods' ability to provide the correct histopathologic diagnosis. Parameters associated with tumor included location outside the right atrium, T2 hyperintensity, and contrast enhancement. Parameters associated with malignancy included location outside the cardiac chambers, nonmobility, pericardial effusion, myocardial invasion, and contrast enhancement. CMR identified 6 masses missed on transthoracic echocardiography (4 of which were outside the heart) and provided significantly more correct histopathologic diagnoses compared to echocardiography (77% vs 43%, p 〈0.0001). In conclusion, CMR offers the advantage of identifying paracardiac masses and providing crucial information on histopathology of cardiac masses.
    Keywords: Medicine
    ISSN: 0002-9149
    E-ISSN: 1879-1913
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  • 3
    In: Journal of Physiology, 15 March 2017, Vol.595(6), pp.2065-2084
    Description: Older pregnant women have a greater risk of operative delivery, still birth and post‐term induction. This suggests that maternal age can influence the timing of birth and processes of parturition. We have found that increasing maternal age in C57BL/6J mice is associated with prolongation of gestation and length of labour. Older pregnant mice also had delayed progesterone withdrawal and impaired myometrial function. Uterine ageing and labour dysfunction should be investigated further in older primigravid women.
    Keywords: Cervix ; Maternal Age ; Mitochondria ; Myometrium ; Parturition ; Smooth Muscle ; Uterus
    ISSN: 0022-3751
    E-ISSN: 1469-7793
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  • 4
    Language: English
    In: Journal of the American College of Cardiology, 05 April 2011, Vol.57(14), pp.E1202-E1202
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S0735-1097(11)61202-3 Byline: Mohsen Sharifi, Rima Patel, Tariq Niazi, Elnaz Emrani, Mahshid Mehdipour
    Keywords: Medicine
    ISSN: 0735-1097
    E-ISSN: 1558-3597
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  • 5
    Language: English
    In: Journal of Cardiovascular Magnetic Resonance, 01 February 2012, Vol.14(Suppl 1), p.P298
    Description: Meeting abstractsEMPTY Summary To determine the diagnostic value of cardiac magnetic resonance imaging (CMR) in the characterization of cardiac masses in a tertiary care medical center.
    Keywords: Medicine
    ISSN: 1097-6647
    E-ISSN: 1532-429X
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  • 6
    Language: English
    In: Journal of Pharmaceutical Sciences, March 2018, Vol.107(3), pp.856-862
    Description: The reported proof of principle study demonstrated the feasibility of local delivery of a c-Met inhibitor (VXc-140) in a subcutaneous xenograft tumor model. VXc-140 was formulated in a wafer delivery system for direct implantation into the tumor. Systemic and local tumor exposure of VXc-140 was analyzed. High tumor exposures coupled with fast release of compound were associated with significant tumor regression and reduction in tumor levels of phosphorylated c-Met. High VXc-140 tumor-to-plasma ratios (∼42 at the tumor periphery) were achieved. The tumor response achieved (7/11 partial response) with VXc-140 with the local delivery in the wafer (4 mg over 15 days) was comparable to the regression observed (11/15 partial response) for VXc-140 in the oral delivery (∼8 mg total administered once a day for 2 weeks). Notably, the plasma levels in animals implanted with VXc-140 wafers ranged from 2 to 4 μM, which, although higher than trough levels achieved with oral administration, were well below oral Cmax levels (∼42 μM) suggesting that toxicities associated with Cmax exposure may be reduced or eliminated by local delivery. The high tumor to plasma exposure of VXc-140 and the efficacy observed with local wafer delivery warrants further exploration into the utility of local delivery.
    Keywords: Cancer ; Biodegradable Polymers ; Controlled Release ; Drug Effects ; Plga ; Pharmacy, Therapeutics, & Pharmacology
    ISSN: 0022-3549
    E-ISSN: 1520-6017
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  • 7
    Language: English
    In: International Journal of Engineering Research and, 04/01/2016, Vol.V5(04)
    ISSN: International Journal of Engineering Research and
    E-ISSN: 2278-0181
    Source: CrossRef
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  • 8
    Language: English
    In: American Heart Journal, May 2014, Vol.167(5), pp.715-722
    Description: In a prospective study, we previously identified plaque disruption (PD: plaque rupture or ulceration) in 38% of women with myocardial infarction (MI) without angiographically obstructive coronary artery disease (CAD), using intravascular ultrasound (IVUS). Underlying plaque morphology has not been described in these patients and may provide insight into the mechanisms of MI without obstructive CAD. Forty-two women with MI and 〈50% angiographic stenosis underwent IVUS (n = 114 vessels). Analyses were performed by a blinded core laboratory. Sixteen patients had PD (14 ruptures and 5 ulcerations in 18 vessels). Plaque area, % plaque burden, lumen area stenosis, eccentricity, and remodeling index were calculated for disrupted plaques and largest plaque by area in each vessel. Disrupted plaques had lower % plaque burden than the largest plaque in the same vessel (31.9% vs 49.8%, = .005) and were rarely located at the site of largest plaque (1/19). Disrupted plaques were typically fibrous and were not more eccentric or remodeled than the largest plaque in the same vessel. Plaque disruption was often identifiable on IVUS in women with MI without obstructive CAD. Plaque disruption in this patient population occurred in fibrous or fibrofatty plaques and, contrary to expectations based on prior studies of plaque vulnerability, did not typically occur in eccentric, outwardly remodeled, or soft plaque in these patients. Plaque disruption rarely occurred at the site of the largest plaque in the vessel. These findings suggest that the pathophysiology of PD in women with MI without angiographically obstructive CAD may be different from MI with obstructive disease and requires further investigation.
    Keywords: Medicine
    ISSN: 0002-8703
    E-ISSN: 1097-6744
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  • 9
    In: Case Reports in Infectious Diseases, 2016, Vol.2016, 4 pages
    Description: Extrapulmonary tuberculosis (TB) is uncommon but not rare. Bone and joint involvement constitute about 10% of extrapulmonary TB cases, with the spine being the most frequently affected site. Spinal TB patients typically present with back pain but other constitutional or pulmonary symptoms may be absent, rendering the diagnosis difficult. This case explores challenges in the diagnosis of spinal TB. We report a case of a 39-year-old woman presenting with vague back swelling for many years. Imaging revealed osteomyelitis of the spine but initial studies and cultures were negative for. The diagnosis was confirmed weeks later when cultures demonstrated. Considering the severe complications of untreated spinal TB including paraplegia and need for surgical intervention, high suspicion is critical in early diagnosis.
    Keywords: Case Report;
    ISSN: 2090-6625
    E-ISSN: 2090-6633
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  • 10
    In: Advances in Hematology, 2018, Vol.2018, 10 pages
    Description: Myelodysplastic syndromes (MDS) are a heterogeneous group of diseases characterized by ineffective hematopoiesis and a wide spectrum of manifestations ranging from indolent and asymptomatic cytopenias to acute myeloid leukemia (AML). MDS result from genetic and epigenetic derangements in clonal cells and their surrounding microenvironments. Studies have shown associations between MDS and other autoimmune diseases. Several immune mechanisms have been identified in MDS, suggesting that immune dysregulation might be at least partially implicated in its pathogenesis. This has led to rigorous investigations on the role of immunomodulatory drugs as potential treatment options. Epigenetic modification via immune check point inhibition, while well established as a treatment method for advanced solid tumors, is a new approach being considered in hematologic malignancies including high risk MDS. Several trials are looking at the efficacy of these agents in MDS, as frontline therapy and in relapse, both as monotherapy and in combination with other drugs. In this review, we explore the utility of immune checkpoint inhibitors in MDS and current research evaluating their efficacy.
    Keywords: Review Article;
    ISSN: 1687-9104
    E-ISSN: 1687-9112
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