Lancet
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Letter Case Reports
Cerebral air emboli with use of central venous catheter in mobile patient.
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Comparative Study Clinical Trial Controlled Clinical Trial
Safety and immunogenicity of Pseudomonas aeruginosa conjugate A vaccine in cystic fibrosis.
To assess the safety and immunogenicity of a Pseudomonas aeruginosa octavalent O-polysaccharide-toxin A conjugate vaccine, 22 patients (mean age 7 years) with cystic fibrosis who had no history of colonisation with P aeruginosa were immunised with the vaccine. Adverse reactions were mild and self-limiting. IgG antibody concentrations to all vaccine antigens were significantly raised after vaccination and remained so for 12 months. ⋯ A booster dose given at 12 months led to an anamnestic response. There was no significant change in clinical status after vaccination. Further work to assess efficacy in patients with cystic fibrosis can now be considered since our findings support the safety and immunogenicity of the vaccine.
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Case Reports
Safety of stringent prophylactic platelet transfusion policy for patients with acute leukaemia.
Early studies suggested that the risk of haemorrhagic complications become unacceptable when platelet counts drop below 20 x 10(9)/l. Because there are insufficient data to define 20 x 10(9)/l as the threshold for prophylactic platelet transfusions, the practicability of a more restrictive transfusion policy has been assessed prospectively in 102 consecutive patients being treated for acute leukaemia. ⋯ For patients with coagulation disorders or anatomical lesions, or for those on heparin, the threshold should be at least 20 x 10(9)/l. Such a restrictive platelet transfusion policy, which is applicable not only to thrombocytopenia associated with acute leukaemia but also to other forms of hypoproliferative thrombocytopenia, reduces exposure of such patients to blood donors and results in substantial health-care savings.