Fecal occult blood testing (FOBT) is performed routinely before starting therapeutic anticoagulation in patients despite it never being validated to predict gastrointestinal bleeding (GIB) risk. Our objective was to determine the utility in checking the guaiac FOBT test (gFOBT) before initiating therapeutic anticoagulation in patients with a new diagnosis of venous thromboembolism (VTE).This was a retrospective chart review that examined patients with a diagnosis of VTE admitted during a 2-year period in one mid-sized tertiary care center. The gFOBT was performed before initiating anticoagulation, excluding patients with overt GIB, and analysis was performed to determine GIB outcomes. In addition, demographics, laboratory data, and comorbidities were recorded at the time of admission, and an admission hypertension, abnormal renal/liver function, stroke history, GIB history or predisposition, labile international normalization ratio, elderly, drugs/alcohol concomitantly (HAS-BLED) score was recorded to determine other factors that were predictive of new-onset GIB when starting anticoagulation.Initially, 718 patients with a new diagnosis of VTE were screened for 2 years. Ultimately, 375 patients were prescribed anticoagulation therapy and 244 had documented gFOBT. Of these 375, 14 (3.73%) had a GIB episode. A positive gFOBT was present on admission in 85.7% of those who bled (P < 0.001). The negative predictive value of gFOBT was 99.02%; however, the positive predictive value was only 30.77%. A HAS-BLED score >2 at admission significantly predicted GIB during admission as well (median 2.4 for those with GIB and 1.6 for those without GIB, P = 0.02).Despite its beneficial negative predictive value, gFOBT before initiating therapeutic anticoagulation is unlikely to change the management of patients without evidence of overt GIB.
Studies were undertaken to determine the effect of Bacillus Calmette-Guerin (BCG) on the cellular and humoral response in mice receiving cyclophosphamide, methotrexate, and 5-fluorouracil (CMF). C57BL/6 mice were given i.p. injections of sheep red blood cells and were grafted with BALB/c skin on Day 0. Treatment consisted of CMF, BCG, or both CMF and BCG. The number of plaque-forming spleen cells producing antibody against sheep red blood cells was measured on Days 5, 10, and 14. Skin grafts were evaluated frequently until complete rejection had occurred.
The primary humoral response as measured by number of plaque-forming cells per 106 nucleated spleen cells in mice treated with CMF or CMF and BCG was significantly reduced ( p < 0.05) as compared to controls on Days 5, 10, and 14. The primary humoral response in mice treated with CMF and BCG was significantly reduced ( p < 0.05) as compared to mice treated with CMF alone on Day 10. The secondary humoral response in mice treated with CMF or CMF and BCG was significantly reduced ( p < 0.05) as compared to controls on Day 10. Cellular response as measured by skin graft survival was not altered by CMF or by CMF and BCG, but it was increased significantly ( p < 0.01) by BCG.
ADVERTISEMENT RETURN TO ISSUEPREVArticleNEXT1,2-Benzothiazines. II. The Preparation and Sodium Borohydride Reduction of 3-Acyl-2H-1,2-benzothiazin-4(3H)-one 1,1-Dioxides1Harold Zinnes, Roger A. Comes, Francis R. Zuleski, Albert N. Caro, and John Shavel Jr.Cite this: J. Org. Chem. 1965, 30, 7, 2241–2246Publication Date (Print):July 1, 1965Publication History Published online1 May 2002Published inissue 1 July 1965https://pubs.acs.org/doi/10.1021/jo01018a029https://doi.org/10.1021/jo01018a029research-articleACS PublicationsRequest reuse permissionsArticle Views295Altmetric-Citations35LEARN ABOUT THESE METRICSArticle Views are the COUNTER-compliant sum of full text article downloads since November 2008 (both PDF and HTML) across all institutions and individuals. These metrics are regularly updated to reflect usage leading up to the last few days.Citations are the number of other articles citing this article, calculated by Crossref and updated daily. Find more information about Crossref citation counts.The Altmetric Attention Score is a quantitative measure of the attention that a research article has received online. Clicking on the donut icon will load a page at altmetric.com with additional details about the score and the social media presence for the given article. Find more information on the Altmetric Attention Score and how the score is calculated. Share Add toView InAdd Full Text with ReferenceAdd Description ExportRISCitationCitation and abstractCitation and referencesMore Options Share onFacebookTwitterWechatLinked InRedditEmail Other access optionsGet e-Alertsclose Get e-Alerts
Small cell carcinoma (SCC) is most commonly found in the lung but is occasionally found in the gastrointestinal tract and other extrapulmonary sites. Incidences of SCC in the esophagus and stomach are rare and have been reported almost exclusively in older individuals. The following case presents the discovery of small cell carcinoma of the stomach and esophagus in a 35 year old woman, which is the youngest reported incidence of this to date. Additionally, her course reflects the importance of early diagnostic endoscopy with biopsy and adequate sampling with appropriate immunohistochemical staining when malignancy is in the differential diagnosis, regardless of age or risk factors.
