The American journal of medicine
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Granular lymphocyte proliferation and neutropenia with or without splenomegaly occurs with unknown frequency in rheumatoid arthritis. We decided to evaluate the prevalence of Felty's syndrome and granular lymphocyte proliferation among patients with rheumatoid arthritis and to determine the fraction of patients with granular lymphocyte proliferation who also had rheumatoid arthritis. ⋯ Granular lymphocyte proliferation and neutropenia with or without splenomegaly in rheumatoid arthritis commonly resembles typical Felty's syndrome. Further, the six patients with granular lymphocyte proliferation represent 20 percent of our institution's patients with granular lymphocyte proliferation, supporting the previously described common association of this disorder with rheumatoid arthritis. The relatively large fraction of deaths (due to malignancy and infection) among the patients with typical Felty's syndrome suggests that their mean survival may be comparatively less than in those with granular lymphocyte proliferation.
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Review Case Reports
Pulmonary embolism as a result of Hickman catheter-related thrombosis.
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Elderly and younger patients who were successfully resuscitated and hospitalized following out-of-hospital cardiac arrest were studied to determine if there was a significant difference in hospital course and long-term survival between the two groups. ⋯ Resuscitation of elderly patients in whom out-of-hospital cardiac arrest occurs is reasonable and appropriate, according to the findings of this study. Even though elderly patients are more likely than younger patients to die during hospitalization, the hospital stay of the elderly is not longer, the elderly do not have more residual neurologic impairments, and survival after hospital discharge is similar to that in younger patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prazosin versus hydrochlorothiazide as initial antihypertensive therapy in black versus white patients.
A randomized, drug-controlled trial was conducted to evaluate the comparative efficacy of hydrochlorothiazide versus prazosin in controlling mild diastolic hypertension in black and white patients. Serum lipid and lipoprotein levels were also studied. Overall, 22 men and 14 women, of whom 50 percent were black, aged 21 to 69 years, were randomly assigned to treatment with either of these two agents. ⋯ Prazosin therapy reduced total cholesterol levels by 20.5 mg/dl and low-density lipoprotein cholesterol levels by 19.0 mg/dl, and hydrochlorothiazide increased total cholesterol levels by 11.4 mg/dl and increased low-density lipoprotein levels by 9.3 mg/dl; but no differences in triglyceride, high-density lipoprotein, plasma high-density lipoprotein2, or high-density lipoprotein3 levels were noted. Both agents were well tolerated in black and white patients. The combination of effective blood pressure control with no adverse effects on the serum lipid profile may make prazosin preferable to hydrochlorothiazide for treating mild diastolic hypertension in black as well as white patients.