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Immune thrombocytopenia has been reported with increased incidence in high-risk persons such as intravenous drug addicts and homosexual men who have serologic evidence of infection with human immunodeficiency virus (HIV). Thrombotic thrombocytopenic purpura, generally regarded as a rare disorder, has also been seen in association with exposure to HIV. Two patients had classical symptoms and laboratory findings of thrombotic thrombocytopenic purpura and the acquired immunodeficiency syndrome (AIDS)-related complex. Both patients belong to high-risk groups. They were treated with conventional therapy for thrombotic thrombocytopenic purpura and followed for 3 months. Their response to treatment was no different from that of other groups of patients with this syndrome. This article alerts physicians to the possible association of thrombotic thrombocytopenic purpura, AIDS, and AIDS-related complex. [ABSTRACT FROM AUTHOR]

Seventy normal male East Indians were selected to study the length of the fluorescent (f), non-fluorescent (nf), and total length of the Y chromosome by the QFQ technique. The length of the Y chromosome was classified into five groups using subjectively defined criteria, namely, very small, small, average, large, and very large. The frequencies of Y/F indices for these groups were 0.0%, 1.42%, 15.71%, 58.57%, and 24.28%, respectively. The variation in the total length of the Y chromosome was accounted for by variations in the length of the nf as well as the f segments. The mean Y/F, f/F, and nf/F indices for East Indians were 1.20, 0.47, and 0.73, respectively. A longer Y was noted in East Indians primarily owing to an increase in size of the nf segment in comparison to normal black and Caucasian populations. Furthermore, it is emphasised that the definition of 'average' or 'large' Y varies from race to race. [ABSTRACT FROM PUBLISHER]

Sixty normal male American blacks were selected to study the length of fluorescent (f), non-fluorescent (nf), and total length of the Y chromosome by the QFQ technique. The length of the Y chromosome was classified into five groups: very small, small, average, large, and very large. The frequencies of Y/F indices for these groups were 0.0, 3.33, 56.67, 30.00, and 10.00%, respectively. The variation in the total length of the Y chromosome was accounted for by variations in the length of the nf as well as the f segment. A longer Y was noted in blacks owing to an increase in size of the nf segment in comparison with a normal Caucasian population. Forty percent of American blacks had large or very large Y chromosomes, while this class comprised only 18.3% of Caucasians, which is significantly different (p less than 0.05). Furthermore, the length of the Y chromosome was normally distributed among Caucasians, while among blacks the distribution was skewed to the left. The mean Y/F, f/F, and nf/F indices were 1.09 +/- 0.10, 0.42 +/- 0.09, and 0.67 +/- 0.04, respectively. [ABSTRACT FROM PUBLISHER]

Sixty normal male Caucasians were selected to study the length of the Y chromosome. QFQ banding was performed. Chromosomes 19 and 20 (F) and Y were measured directly from the film. Y/F, f/F, and nf/F indices (f = fluorescent; nf = non-fluorescent segment) were determined. The length of the Y chromosome was classified into 5 groups; very small, small, average, large, and very large with Y/F indices of less than 0.8, 0.81--0.94, 0.95--1.09, 1.1--1.23, and greater than 1.23, respectively. The frequencies of Y/F indices for these groups were 0 (0%), 9 (15.0%), 40 (66.7%), 8 (13.3%), and 3 (5.0%), respectively. The most frequent class was 0.95--1.09 and was defined as the 'average' Y/F index for the human Y chromosome. The variation in the total length of the Y chromosome was accounted for by variations in the length of the non-fluorescent as well as the fluorescent segments. No relation between f and nf segments was observed. The mean Y/F, f/F, and nf/F indices were 1.022, 0.441, and 0.574, respectively. [ABSTRACT FROM PUBLISHER]

Segmentation of the secondary constriction region ( h) of human chromosomes 1, 9 and 16 is demonstrated by a high resolution banding technique. Based on these staining properties, it is suggested that the composition of the h region in human chromosomes is heterochromatic as well as euchromatic. [ABSTRACT FROM AUTHOR]

The article focuses on the purulent pericarditis in acute leukemia. Purulent pericarditis is an unknown complication of leukemia. It has received only limited attention in the pediatric literature. Staphylococcus, is the most frequently isolated organism. The most innocent infection such as otitis media or pneumonia in a leukemic child may lead to major complications and should therefore be treated promptly and vigorously. The characteristic findings of fever, cardiomegaly, positive echocardiogram and ST changes on ECG associated with purulent pericarditis were not obscured by the leukemic process or the chemotherapeulic agents.

Background: The increased morbidity and mortality associated with liberal blood product usage have been convincingly demonstrated. The clinical problems they pose have prompted development of more restrictive evidence-based transfusion criteria. Education alone has a limited impact on the adoption of these criteria into practice. New York Methodist Hospital undertook a proactive approach to reduce unnecessary transfusions., Method: In November 2008, an interventional monitoring program to ensure adherence to transfusion criteria for packed red blood cells (PRBC), platelets, fresh frozen plasma (FFP), and cryoprecipitate transfusions was started. Blood bank technologists routinely monitored transfusion requests against a list of established criteria and experienced clinicians reviewed and adjudicated transfusion requests when the blood bank technologist's action was appealed., Results: Transfusion usage decreased sharply in Year 1 (November 2008-October 2009) and continued to decrease in Year 2 (November 2009-October 2010). PRBC use decreased by 30.1% and 37.7%, with a 47.6% decrease in multi-unit transfusions; platelet use decreased by 24.3% and 41.2%; fresh frozen plasma use decreased by 41.8% and 31.1%; and cryoprecipitate use decreased by 38.7% and 56.1% during monitoring Years 1 and 2, respectively. Decreases occurred despite a 4.0% increase in hospital admissions during the monitoring years. The decreased blood product usage was accompanied by 28.6% reduction in complications. A 26.1% decrease in blood product requests from Year 1 to Year 2 suggested a practice change by the ordering physicians themselves. The total cost of blood products decreased by $2,235,676., Conclusion: We established a successful method to reduce transfusions of all blood products using strict adherence to evidence-based criteria and continuous monitoring. Our model translates into improved patient safety by decreasing the number of unnecessary transfusions. This also led to a significant reduction in hospital expenses., (Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.)

The primate T-cell lymphoma viruses (PTLV) are divided into six distinct species. The biology and epidemiology of PTLV-1 and PTLV-2 are very well understood. However, that of PTLV-3, 4, 5, and 6 are not. Recently, in Cameroon, three and one humans were shown to be infected with HTLV-3 and HTLV-4, respectively. We undertook a study to ascertain whether any of these two retroviruses were present in the peripheral blood mononuclear cell DNA of New York State subjects deemed at risk for PTLV infection. Samples were analyzed by PTLV-3 and PTLV-4 specific PCR assays from the following human and simian subject types: African-American medical clinic patients; HTLV EIA+, WB indeterminate blood donors; intravenous drug users; patients with leukemia, lymphoma, myelopathy, polymyositis, or AIDS; and African chimpanzees. None of the 1200 subjects was positive for HTLV-3 or 4. The data indicate that, at the time of sample collection, no evidence exists for the dissemination of HTLV-3 or 4 to New York State. Continued epidemiological studies are warranted to explore the worldwide prevalence rates and dissemination patterns of HTLV-3 and 4 infections, and their possible disease associations.

In order to assess the prevalence rate of HTLV-1-associated T-cell lymphomas and human retrovirus infection in general, approximately 21,000 individuals representing various patient populations, retroviral risk groups, and blood donors were examined for HTLV-I, HTLV-II, HIV-1, or HIV-2 infection using serologic and PCR assays. The prevalence rates among volunteer blood donors were 0.02% and 0% for HTLV and HIV, respectively. Significantly increased HTLV prevalence rates were observed among paid blood donors, African American health care clinic patients, Amerindians, recipients of HTLV-positive cellular blood products, intravenous drug users, sexual contacts and family members of HTLV-positive people, and patients with primary thrombocytosis and other-than-low-grade non-Hodgkin's lymphoma (NHL). Among some of these groups there were significant differences in the prevalence of HTLV-I versus HTLV-II. The eight HTLV-positive NHL patients all had mature, high-grade, CD4+ T-cell lymphomas with clonally integrated HTLV-I, for a prevalence of 4% among other-than-low-grade NHL patients. Seven of the eight died from their disease within 2 years despite treatment. Interestingly, two groups at risk for HTLV infection, namely needle stick victims and recipients of HTLV-infected and/or pooled plasma products, showed no evidence for infection. Significantly increased HIV-1 prevalence was observed among paid blood donors, African Americans, homosexuals, female prostitutes, hemophiliacs, and other-than-low-grade NHL patients. Only one patient was infected with HIV-2. Of the nine HIV-positive, other-than-low-grade NHL patients, seven HIV-1 positives had B-cell lymphomas, one HIV-1 positive had an HTLV-I-positive CD4+ T-cell lymphoma, and one infected with HIV-2 had a CD4+ T-cell lymphoma that was HTLV negative. The data indicate that HTLV-I lymphoma, while uncommon, is not necessarily rare among other-than-low-grade NHL cases in the United States and, given its poor prognosis, should probably be studied separately in clinical trials.