The Western journal of medicine
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Platelets play an important role in hemostasis, and alterations in platelet function may be the cause of abnormal bleeding in a wide variety of congenital and acquired clinical disorders. Platelet dysfunction may be classified as disorders of (1) substrate connective tissue, (2) adhesion, (3) aggregation and (4) platelet-release reaction. The congenital defects of platelet function, although uncommon, have provided important insights into platelet physiology and pathophysiology and, as a group, are less common, better characterized and more readily classified than the acquired defects. ⋯ A specific diagnosis often requires measurements of the factor VIII and von Willebrand factor complex and other tests of platelet function. Some of these tests may be available only in specialized laboratories. Therapy for bleeding episodes resulting from platelet dysfunction is directed at (1) removing or treating the underlying cause of the platelet disorder; (2) replacing the missing plasma cofactors needed to support normal platelet function (such as by the transfusion of cryoprecipitate in patients with von Willebrand disease, and (3) transfusing functional platelets in the form of platelet concentrates in patients with disorders of intrinsic platelet dysfunction.
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Significant amounts of cyanide are released when amygdalin (Laetrile), a cyanogenic glycoside, is given orally or intravenously to rats. The amount of cyanide liberated following oral administration is dependent in part on the bacterial flora of the gut and can be suppressed by antibiotic pretreatment of the animals. Bacteria from human feces likewise hydrolyze amygdalin with release of cyanide. Humans taking amygdalin orally in the hope of preventing cancer are likely to be exposed to levels of cyanide in excess of that associated with the development of tropical ataxic neuropathy in people of underdeveloped countries where food containing cyanogenic glycosides is a staple part of the diet.