RESUMEN
Cefotetan disodium-induced hemolytic anemia has been reported previously, and some of these cases have been severe or fatal. We describe a case of severe hemolytic anemia that occurred in an 80-year-old woman who received cefotetan prophylactically after surgery for a small bowel obstruction. Eight days after the first dose of cefotetan, the patient developed a severe Coomb test-positive hemolytic anemia. Using flow cytometry, we demonstrated cefotetan-specific antibodies in her posttreatment serum, which were detectable at a serum dilution up to 1:10 000. The patient received corticosteroid therapy and blood transfusions, with improvement of her hematologic parameters, but died 54 days after admission for respiratory failure. To our knowledge, this is the first use of flow cytometry for the detection of cefotetan-induced red blood cell antibodies. This technique offers a sensitive, rapid, objective method for detecting drug-induced antibodies.
Asunto(s)
Anemia Hemolítica/inducido químicamente , Cefotetán/efectos adversos , Cefamicinas/efectos adversos , Corticoesteroides/uso terapéutico , Anciano , Anciano de 80 o más Años , Anemia Hemolítica/terapia , Anticuerpos/inmunología , Transfusión Sanguínea , Cefotetán/inmunología , Cefamicinas/inmunología , Eritrocitos/inmunología , Resultado Fatal , Femenino , HumanosRESUMEN
This study evaluated the personality characteristics of senior enlisted and occupationally successful Navy submarine personnel. One hundred subjects completed the Schedule for Nonadaptive and Adaptive Personality (SNAP). Results indicated that the traits of detachment, propriety, and workaholism were most descriptive of the sample. Thirty-seven percent met SNAP criteria for a personality disorder, typically antisocial, obsessive-compulsive, or avoidant. The results are discussed in terms of adaptation to environmental demands aboard submarines. Suggestions for further research are offered.