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- Kulkarni, Roshni, et al.
(author)
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Therapeutic choices for patients with hemophilia and high-titer inhibitors
- 2001
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In: American Journal of Hematology. - : Wiley. - 0361-8609 .- 1096-8652. ; 67:4, s. 240-246
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Journal article (peer-reviewed)abstract
- Effective treatment of bleeding episodes in hemophilia with high titer inhibitors (HTI) remains a challenge, despite the fact that the therapeutic armamentarium has expanded considerably over the past few years. Treatment safety has improved with the availability of porcine factor VIII (FVIII) and bypassing products such as recombinant factor VIIa (rFVIIa), and plasma-derived activated Prothrombin Complex Concentrates (aPCCs) that are virally inactivated. The major drawbacks of rFVIIa and aPCCs are their unpredictable hemostatic effect, lack of laboratory assays to monitor efficacy and dosing frequency, and the risk of thrombosis. The proceedings of a one-day workshop of physicians who specialized in treating patients with hemophilia held in Vienna on May 13, 2000 have been summarized. In making a decision regarding the choice of product, physicians often consider the type of bleeding episode (life or limb threatening), age of the patient, volume of the reconstituted product, previous exposure to plasma derived products, cost, efficacy, and safety. For plasma naive patients, to achieve rapid hemostasis a majority of the panelists used porcine FVIII (for patients who lack porcine inhibitory antibodies) or rFVIIa. For patients previously treated with plasma derived factors, in addition to the above concentrates, aPCCs were recommended. Although no data exists regarding safety and efficacy, switching products was routinely practiced either because of availability or cost. Furthermore, the panelists were uncertain about the efficacy of bypassing agents in the prevention of joint disease in inhibitor patients. The workshop participants felt that future research offers the best solution to resolve some of the dilemmas faced by clinicians and may help individualise treatment in a hemophilia patient with a high titer inhibitor.
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- Persson, L., et al.
(author)
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Separation of mass-overlapped time of flight-energy elastic recoil detection analysis data using Ryan and Jamieson's dynamic analysis method
- 2001
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In: Nuclear Instruments and Methods in Physics Research Section B. - 0168-583X .- 1872-9584. ; 179:3, s. 403-411
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Journal article (peer-reviewed)abstract
- Time of flight-energy (ToF-E) elastic recoil detection analysis (ERDA) data often contains mass signals with considerable overlap from adjacent isotopes in the mass-energy plane. An evaluation has been carried out of the suitability of the dynamic analysis method proposed by Ryan and Jamieson to decompose elemental signals with overlapping mass. This method is shown to work very well on generated test data and the result when it was applied to experimental data appears quite promising. Very accurate mass calibration and lineshape determination was found to be a prerequisite for the application of the method.
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