Thrombotic microangiopathy associated with synthetic cannabinoid receptor agonists.

Marijuana is one of the most commonly used recreational drugs in the United States. As marijuana is illegal in the majority of countries, the use of readily available and unregulated synthetic cannabinoids (SCBs) has increased. Little is known about the potential adverse effects of SCBs especially in regards to their nephrotoxicity.

Autoimmune hemolytic anemia associated with babesiosis.

Background: Babesiosis is endemic in selected areas in North America. Babesia infection is commonly associated with anemia, thrombocytopenia, hyponatremia and elevated liver enzymes. Autoimmune hemolytic anemia (AIHA) is known to be caused by parasitic and viral infections but has not been well characterized.

Babesiosis-associated immune thrombocytopenia.

Thrombocytopenia is a common feature of babesiosis. The mechanism for thrombocytopenia in babesiosis remains elusive. We report a case of babesiosis with severe new onset immune thrombocytopenia (ITP).

Measuring spatial variation in secondary production and food quality using a common consumer approach in Lake Erie.

Lake Erie is a large lake straddling the border of the USA and Canada that has become increasingly eutrophic in recent years. Eutrophication is particularly focused in the shallow western basin. The western basin of Lake Erie is hydrodynamically similar to a large estuary, with riverine inputs from the Detroit and Maumee Rivers mixing together and creating gradients in chemical and physical conditions.

The Conundrum of "Warfarin Hypersensitivity": Prolonged Partial Thromboplastin Time From Factor IX Propeptide Mutation.

Carboxylation of glutamic acid residues of vitamin K dependent clotting factors (II, VII, IX, and X) is essential to their biological functioning. Binding of these factors to γ-glutamyl carboxylase enzyme for carboxylation reaction is mediated by wild-type propeptide, a small sequence of amino acids that precede the actual polypeptide. Missense mutations at certain residue severely decrease the affinity of mutated propeptide for the enzyme.

Fatty acid composition at the base of aquatic food webs is influenced by habitat type and watershed land use.

Spatial variation in food resources strongly influences many aspects of aquatic consumer ecology. Although large-scale controls over spatial variation in many aspects of food resources are well known, others have received little study. Here we investigated variation in the fatty acid (FA) composition of seston and primary consumers within (i.

Rivermouth alteration of agricultural impacts on consumer tissue δ(15)N.

Terrestrial agricultural activities strongly influence riverine nitrogen (N) dynamics, which is reflected in the δ(15)N of riverine consumer tissues. However, processes within aquatic ecosystems also influence consumer tissue δ(15)N. As aquatic processes become more important terrestrial inputs may become a weaker predictor of consumer tissue δ(15)N.

Hypersensitivity to plasma exchange in a patient with thrombotic thrombocytopenic purpura.

To a limited extent, thrombotic thrombocytopenic purpura (TTP) in addition to its clinical features is being defined nowadays with laboratory tests such as the assay for the Von Willebrand factor-cleaving protease (ADAMTS 13) and its antibody. We present a case report of a patient with TTP and idiopathic thrombocytopenic purpura (ITP) who had an elevated inhibitor level after plasma exchange. After instituting plasma exchange, patient improved clinically with a platelet count in the normal range.

A prospective study of a hand-held ultrasound device in abdominal aortic aneurysm evaluation.

Purpose: Effective treatment of abdominal aortic aneurysm (AAA) requires both early detection and timely repair to reduce aneurysm-related mortality. The purpose of this prospective study was to evaluate the utility of a hand-held ultrasonography (US) device in AAA screening in a Veterans Affairs vascular surgical service.

Methods: During a 16-month period, patients with risk factors for AAA were evaluated in a blinded fashion with a hand-held US device performed by physicians.

Two patients with heparin-induced thrombocytopenia followed by idiopathic (immune) thrombocytopenic purpura: case report.

Heparin-induced thrombocytopenia (HIT) and idiopathic thrombocytopenic purpura (ITP) are separate and well-recognized clinical syndromes, 10both having potential for disastrous outcomes. Sequential occurrence of these two diseases has not been reported in the literature. We report herein two patients who were initially diagnosed as having HIT but whose later clinical course was similar to ITP.