PTCP should be considered in the assessment of low platelet count. While decreasing the transfer time of blood specimens may decrease PTCP incidence, microscopic inspection of the blood smear may avoid erroneous diagnosis of thrombocytopenia.

In the Cohen diabetic rat (genetically-selected sucrose-fed) ovariectomy resulted in a significantly decreased incidence of nephropathy, while estradiol treatment to the ovariectomized animal increased the rate of nephropathy to the levels occurring in the uncastrated untreated diabetic female. In the male diabetic animal orchidectomy caused a slight decrease in the rate of nephropathy whereas estradiol treatment to the orchidectomized animal resulted in a slight increase in the rate. No difference was found between the ovariectomized and the uncastrated diabetic female as to the spontaneous blood glucose, plasma insulin, serum cholesterol or TG levels, but a significant difference was found in their plasma estradiol levels.

It has been shown that the metabolic responses to the ingestion of carbohydrates depend upon a) the type of the ingested carbohydrate and b) the genetic build-up of the recipient. In the non-susceptible animal, the ingestion of high sucrose, fructose or glucose diets will ensue in "normal" metabolic responses. In the susceptible animal the ingestion of these same carbohydrates will result in impairment of the carbohydrate and lipid metabolism, which will ultimately lead to the development of diabetes and diabetic angiopathy while their siblings with the same genetic build-up consuming starch, will not.

No abstract

Blood loss is a significant problem encountered in patients undergoing total joint arthroplasty, and is considered to be one of the factors affecting the outcome of the operation. Traditionally these patients have been treated with blood transfusions. The introduction of recombinant human erythropoietin (rHuEpo) into clinical practice enabled assessment of its effectiveness to decrease the allogeneic blood transfusion requirement (BTR), thus avoiding or minimizing transfusion-related complications. Fifteen patients undergoing total hip replacement (THR, 10 patients) and total knee replacement (TKR, 5 patients) in our institute (from January-April 1997), were studied. After signing an informed consent they received daily s.c. rHuEpo (100 IU/kg for those with hemoglobin (Hb) > 13 g/dl, 300 IU/kg for Hb < 13) during the 10 days prior to surgery and the 4 days following the operation. Allogeneic red blood cell (RBC) transfusions were given as needed. Hb levels were measured on days -10, 0, +1.3 and 7 of the procedure and the BTR was recorded. The results were compared with those of previous patients operated on from January-December 1996. Patients who were eligible for the study but refused to participate served as controls. The mean Hb level in the study group prior to rHuEpo administration (day -10) was 13.41 g/dl, similar to those of the control group (13.47 g/dl on day 0). However, the mean Hb levels in the rHuEpo treated patients on days 0, 1, 3 and 7 were 14.37, 11.09, 10.99, and 11.2 g/dl, respectively. This way compared with the levels of 13.47 (p = 0.016), 9.88 (p = 0.024), 9.60 (p = 0.004) and 9.97 g/dl (p = 0.007) in the control patients. The difference between the rHuEpo treated patients and the control patients was more significant among the THR patients than among the TKR patients. Of the 10 rHuEpo-treated THR patients, only a single patient required one allogeneic blood unit, as compared with 23 units transfused to the 30 control patients. None of the rHuEpo-treated TKR patients required blood transfusion as opposed to 4 units needed by the 11 control patients. In total, only one allogeneic blood unit was required by the study group which way calculated to an average consumption of 0.066 blood unit per person, compared with 27 blood units used by the 41 controls, i.e. 0.66 blood units per person (p < 0.001). In the patients treated, rHuEpo was very well tolerated with no adverse effects.