Pre-transplant lung function is predictive of survival following pediatric bone marrow transplantation.

Background: Pulmonary toxicity is well described in recipients of bone marrow transplants (BMT), and accounts for a sizeable proportion of post-transplant mortality. The majority of the data on post-transplant pulmonary function is from adults, although several small pediatric case series have been described. In adults, pre-transplant lung function has been predictive of post-transplant respiratory failure and mortality.

An experimental protocol for fertility preservation in prepubertal boys recently diagnosed with cancer: a report of acceptability and safety.

Background: Gonadal damage is a consequence of therapy for pediatric malignancies. Prepubertal males have no semen or mature spermatozoa, posing a challenge for fertility preservation. Testicular tissue cryopreservation is a potential option but is still experimental.

Coupling of axial and transverse displacement fields in a straight beam due to boundary conditions.

A classical simply-supported beam is modified by tilting the pad constraining the roller. The consequence is that the axial and transverse displacements of the beam are coupled by the boundary conditions. The eigenanalysis methodology is extended to this unusual situation where displacement components are coupled, even though each displacement has a different associated wavenumber.

Predicting deep venous thrombosis in pregnancy: out in "LEFt" field?

Background: Clinicians' assessment of pretest probability, based on subjective criteria or prediction rules, is central to the diagnosis of deep venous thrombosis (DVT). Pretest probability assessment for DVT diagnosis has never been evaluated in pregnant women.

Objective: To evaluate the accuracy of clinicians' subjective assessment of pretest probability for DVT diagnosis and identify prediction variables that could be used for pretest probability assessment in pregnant women with suspected DVT.

Factors that predict risk of thrombosis in relatives of patients with unprovoked venous thromboembolism.

Background: Factors that predict the risk of venous thromboembolism in the first-degree relatives of patients with unprovoked venous thromboembolism are uncertain but important for counseling. We aimed to identify risk factors for, and quantify the risk of, venous thromboembolism in first-degree relatives of patients (index case patients) with a first episode of unprovoked venous thromboembolism.

Methods: In a cross-sectional study, using a standardized method and without knowledge of whether patients or their relatives had thrombophilia, we assessed the prevalence of previous venous thromboembolism in 1,916 first-degree relatives of 378 unselected patients with a first episode of unprovoked venous thromboembolism.

Physical performance limitations in the Childhood Cancer Survivor Study cohort.

Physical performance limitations are one of the potential long-term consequences following diagnosis and treatment for childhood cancer. The purpose of this review is to describe the risk factors for and the participation restrictions that result from physical performance limitations among childhood cancer survivors who participated in the Childhood Cancer Survivor Study (CCSS). Articles previously published from the CCSS cohort related to physical performance limitations were reviewed and the results summarized.

Oral vitamin K versus placebo to correct excessive anticoagulation in patients receiving warfarin: a randomized trial.

Background: Low-dose oral vitamin K decreases the international normalized ratio (INR) in overanticoagulated patients who receive warfarin therapy. Its effects on bleeding events are uncertain.

Objective: To see whether low-dose oral vitamin K reduces bleeding events over 90 days in patients with warfarin-associated coagulopathy.

Low molecular weight heparin and aspirin for recurrent pregnancy loss: results from the randomized, controlled HepASA Trial.

Objective: To compare live birth rates in women with recurrent pregnancy loss (RPL) and either autoantibodies or a coagulation abnormality, treated with low molecular weight heparin plus aspirin (LMWH/ASA) or ASA alone, and to place our results in context with other randomized clinical trials (RCT) with similar cohorts.

Methods: The HepASA Trial was an RCT including patients with a history of RPL and at least 1 of the following: antiphospholipid antibody (aPL), an inherited thrombophilia, or antinuclear antibody. Treatment groups were stratified by aPL status and history of early versus late pregnancy losses.

Cerebral glucose metabolic response to combined total sleep deprivation and antidepressant treatment in geriatric depression: a randomized, placebo-controlled study.

A randomized, placebo-controlled study was performed to evaluate whether the onset of the glucose metabolic effects of a selective serotonin reuptake inhibitor (paroxetine) would be accelerated by total sleep deprivation (TSD). Patients were randomly assigned to one of three groups: TSD and paroxetine treatment, TSD and 2 weeks of placebo followed by paroxetine treatment, or 2 weeks of paroxetine treatment. Sixteen elderly depressed patients who met DSM-IV criteria for major depressive disorder and nine age-matched comparison subjects underwent positron emission tomography (PET) studies of cerebral glucose metabolism at baseline, post-TSD (or a normal night's sleep for the paroxetine- only group), post-recovery sleep and 2 weeks post-paroxetine or placebo treatment (patients only).

Detecting influenza epidemics using search engine query data.

Seasonal influenza epidemics are a major public health concern, causing tens of millions of respiratory illnesses and 250,000 to 500,000 deaths worldwide each year. In addition to seasonal influenza, a new strain of influenza virus against which no previous immunity exists and that demonstrates human-to-human transmission could result in a pandemic with millions of fatalities. Early detection of disease activity, when followed by a rapid response, can reduce the impact of both seasonal and pandemic influenza.

Determinants and time course of the postthrombotic syndrome after acute deep venous thrombosis.

Background: The reason some patients with deep venous thrombosis (DVT) develop the postthrombotic syndrome is not well understood.

Objective: To determine the frequency, time course, and predictors of the postthrombotic syndrome after acute DVT.

Design: Prospective, multicenter cohort study.

Disruption of bradycardia associated with discriminative conditioning in combat veterans with PTSD.

The effects of combat-related posttraumatic stress disorder (PTSD) on heart rate (HR) responding associated with a discriminative delay eyeblink (EB) conditioning paradigm are reported. Combat PTSD+, Combat PTSD-, and Noncombat PTSD- veterans were assessed with psychometric self-report measures, and baseline heart rate variability (HRV) was measured before receiving a 72-trial session of discriminative EB classical conditioning. Two types (red or green light) of conditioned stimuli (CS) were used: one (CS+) predicted a tone, followed immediately by an aversive stimulus (corneal airpuff); the other (CS-) predicted a tone alone, not followed by the airpuff.

Influence of thrombophilia on risk of recurrent venous thromboembolism while on warfarin: results from a randomized trial.

We sought to determine whether thrombophilic defects increase recurrent venous thromboembolism (VTE) during warfarin therapy. Six hundred sixty-one patients with unprovoked VTE who were randomized to extended low-intensity (international normalized ratio [INR], 1.5-1.

Recurrent venous thromboembolism after pregnancy-associated versus unprovoked thromboembolism.

It is not known whether women who develop venous thromboembolism (VTE) during pregnancy have a higher or lower incidence of recurrent VTE than women with unprovoked VTE. The aim of the study was to compare the risk of recurrent VTE among women with pregnancy-associated VTE to women with unprovoked VTE. Hospital discharge data identified women age 18-46 years old with pregnancy-associated or unprovoked index VTE between 1994 and 2005.

Differences in clinical presentation of deep vein thrombosis in men and women.

Background: As assessment of clinical pretest probability is the first step in the diagnostic evaluation of deep vein thrombosis (DVT), it is important to know if the clinical features of DVT are the same in men and women.

Objectives: To compare the prevalence and clinical characteristics of DVT, and the accuracy of clinical pretest probability assessment, between men and women with suspected DVT.

Methods: A retrospective analysis of individual patient data from three prospective studies by our group that evaluated diagnostic tests for a suspected first episode of DVT.

The relationship between unprovoked venous thromboembolism, age, and acute myocardial infarction.

Background: Patients with unprovoked venous thromboembolism (VTE) may be at increased risk of acute myocardial infarction (AMI). However, the nature and clinical significance of this association remain unclear, particularly as it relates to age of presentation.

Methods: We performed a longitudinal matched cohort study utilizing multiple administrative databases.

Late effects in survivors of tandem peripheral blood stem cell transplant for high-risk neuroblastoma.

Background: Increasing numbers of children with advanced neuroblastoma are achieving cure. We describe the clinical late effects specific to survivors of stage IV neuroblastoma all similarly treated using tandem autologous peripheral blood stem cell rescue with TBI.

Method: The medical records of 35 neuroblastoma patients treated at CHOP between 1997 and 2001 were examined.

Is long-term pharmacist-managed anticoagulation service efficient? A pragmatic randomized controlled trial.

Background: Some pharmacist-managed anticoagulation services (PMAS) provide initial follow-up to patients on oral anticoagulant, who are transferred to their physician once they are stabilized. This may be as effective as and less expensive than long-term PMAS follow-up.

Methods: Once PMAS patients were stabilized and ready for discharge, they were randomized to be transferred to their physician or stay with the PMAS.

Oral thrombin inhibitor dabigatran etexilate vs North American enoxaparin regimen for prevention of venous thromboembolism after knee arthroplasty surgery.

Dabigatran, an oral once-daily unmonitored thrombin inhibitor, has been tested elsewhere using enoxaparin 40 mg once daily. We used the North American enoxaparin 30 mg BID regimen as the comparator. This was a double-blind, centrally randomized trial.

Determinants of health-related quality of life during the 2 years following deep vein thrombosis.

Background/objectives: We prospectively measured change in quality of life (QOL) during the 2 years after a diagnosis of deep vein thrombosis (DVT) and evaluated determinants of QOL, including development of the post-thrombotic syndrome (PTS).

Patients/methods: Consecutive patients with acute DVT were recruited from 2001 to 2004 at eight hospitals in Canada. At study visits at baseline, and 1, 4, 8, 12 and 24 months, clinical data were collected, standardized PTS assessments were performed, and QOL questionnaires were self-completed.

Anticoagulant treatment of deep vein thrombosis and pulmonary embolism.

Venous thrombosis is a common disease. As the mean age of the population increases, so does the incidence of venous thromboembolism. Anticoagulant therapy is equally effective in young and older patients, and can reduce substantially the associated morbidity and mortality.

Sperm banking for adolescents with cancer.

Recent advances in diagnostic and therapeutic methods in pediatric oncology have led to greater survival rates in children with malignancies. However, major long-term complications can occur that limit the quality of survival, infertility being one of them. Chemotherapy, radiation treatment, surgery, and combinations of these treatments have been implicated in causing infertility, with males being especially sensitive to therapy.

Evaluation of a venous-return assist device to treat severe post-thrombotic syndrome (VENOPTS). A randomized controlled trial.

Severe post-thrombotic syndrome (PTS) is responsible for considerable disability, reduced quality of life and increased health care costs. Current therapies are limited and often ineffective. We performed a two-centre, randomized, cross-over controlled trial to evaluate Venowave, a novel lower-limb venous-return assist device, for the treatment of severe PTS.