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Peripheral blood eosinophilia and vascular occlusions are rare occurrences in patients with pleural mesothelioma whereas eosinophilia may associate with thrombosis. We describe a patient with mesothelioma who developed peripheral blood eosinophilia followed by deep vein thrombosis despite being on low molecular weight heparin prophylaxis. We discuss the genesis of peripheral blood eosinophilia and thrombosis in pleural mesothelioma.

Effects of rosiglitazone on contralateral iliac artery after vascular injury in hypercholesterolemic rabbits
Background: The objective was to evaluate the effects of rosiglitazone on iliac arteries of hypercholesterolemic rabbits undergoing balloon catheter injury in the contralateral iliac arteries. Methods: White male rabbits were fed a hypercholesterolemic diet for 6 weeks and divided into two groups as follows: rosiglitazone group, 14 rabbits treated with rosiglitazone (3 mg/Kg body weight/day) during 6 weeks; and control group, 18 rabbits without rosiglitazone treatment. All animals underwent balloon catheter injury of the right iliac artery on the fourteenth day of the experiment. Results: There was no significant difference in intima/media layer area ratio between the control group and the rosiglitazone group. Rosiglitazone did not reduce the probability of lesions types I, II, or III (72.73% vs. 92.31%; p = 0.30) and types IV or V (27.27% vs. 7.69%; p = 0.30). There were no differences in the extent of collagen type I and III deposition or in the percentage of animals with macrophages in the intima layer. The percentage of rabbits with smooth muscle cells in the intima layer was higher in rosiglitazone group (p = 0.011). Conclusion: These findings demonstrate that rosiglitazone given for 6 weeks did not prevent atherogenesis at a vessel distant from the injury site.

Successful management of acute thromboembolic disease complicated with Heparin induced Thrombocytopenia type II (HIT II): a case series
Heparin-induced thrombocytopenia type II (HIT II) is a rare immune-mediated complication of heparin. The diagnosis of HIT is considered in patients exposed to heparin, presenting with thrombocytopenia and thrombosis. We present two cases with massive pulmonary embolism and HIT, successfully treated with the administration of fondaparinux, an alternative anticoagulant, combined with the insertion of an inferior vena cava filter for the prevention of new thromboembolic events. The two cases supplement the available data of the use of fondaparinux in patients with HIT and pulmonary embolism, before further large studies establish its efficacy and safety in this group of patients. Moreover, the management of these patients reveals the need for future evaluation of the combined therapy of alternative anticoagulant agents with the placement of vena cava filters.

The value of D-dimer in the detection of early deep-vein thrombosis after total knee arthroplasty in Asian patients: a cohort study
Background and purposeThe relationship of D-dimer and deep-vein thrombosis (DVT) after total knee arthroplasty (TKA) remains controversial. The purpose of this study was to assess the value of D-dimer in the detection of early DVT after TKA. Methods: The measurements of plasma D-dimer level were obtained preoperatively and at day 7 postoperatively in 78 patients undergoing TKA. Ascending venography was performed in 7 to 10 days after surgery. The plasma D-dimer levels were correlated statistically with the venographic DVT. Results: Venographic DVT was identified in 40% of patients. High plasma D-dimer level >2.0 g/ml was found in 68% of patients with DVT and 45% without DVT (P < 0.05). Therefore, high D-dimer level greater than 2.0 g/ml showed 68% sensitivity, 55% specificity, 60% accuracy, 50% positive predictive rate and 72% negative predictive rate in the detection of early DVT after TKA. Conclusion: High plasma D-dimer level is a moderately sensitive, but less specific marker in the detection of early of DVT after TKA. Measurement of serum D-dimer alone is not accurate enough to detect DVT after TKA. Venography is recommended in patients with elevated D-dimer and clinically suspected but asymptomatic DVT after TKA.

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Big Pharma “Doomed” if it Doesn’t Change, Says Eli Lilly Chairman
(NaturalNews) With patents set to expire on major products and no new blockbusters on the horizon, the pharmaceutical industry must adapt or die, the chairman of Eli Lilly and Co. has said.”I think the industry is doomed if we don’t change,” said Sidney Taurel.The expiration of patents on top moneymaking drugs is expected to reduce the top drug companies’ profits by a total of $67 billion between 2007 and 2012, or 50 percent of those companies’ combined 2007 sales in the United States. This decline in income is expected to be the industry’s first in 40 years.Once a drug’s patent expires after 20 years, the market is opened up to generic versions, which are typically sold at a cost close to that of production, in contrast to the 90 or 95 percent profit margins enjoyed by patent-protected drugs. Once the patent expired on Merck’s cholesterol drug Zocor, for example, the company’s revenues from the drug dropped an estimated 82 percent.Drugs set to go generic by 2012 include Lipitor, the best-selling drug in history, which grossed Pfizer $13 billion in 2006. Also due to lose their patent protection are asthma medication Singulair, blood-pressure drug Cozaar, and osteoporosis drug Fosamax, which currently bring in 44 percent of Merck’s income.Meanwhile, no new drugs have emerged on the horizon to take the place of these money-makers. Compared with 1995-1999, 43 percent fewer new drugs came to market between 2002 and 2006.”There haven’t been any new therapies that are proven to reduce death and disability for atherosclerosis since the introduction of the statins in the late 1980s,” said Richard C. Pasternak, Merck’s vice president of Cardiovascular Clinical Research.As a result, Moody’s Investors Service has lowered the pharmaceutical industry’s outlook from “stable” to “negative,” and investment has dropped drastically.Many in the pharmaceutical industry are hoping to shift their focus to biotechnology, where the laws currently do not allow the development of generic drugs. High-grossing biotech drugs include cancer drug Avastin, which costs $4,400 per month, and Gaucher disease treatment Cerezyme, which costs $200,000 per year.

Venous thromboembolism prevention post neck of femur fractures - does it make a difference?
Neck of femur fractures predispose patients to venous thromboembolism (VTE). NICE has issued guideline 46 to reduce this risk through the use of antithrombic agents. We audited our department’s VTE practise by reviewing the clinical notes of 123 consecutive patients with no exclusions. We found our compliance to be a low 6%. We also found that patients were likely to be given low molecular heparin (LMWH) only during their hospital stay. Reasons for the low adherence were probably secondary to confusion caused by the multiple thromboprophylaxis protocols used in our department. The correlation between duration of heparin administration and length of hospital stay was due to logistical difficulty in administering VTE prophylaxis out of hospital setting.

One-third of infant deaths are because of premature births a larger percentage than previously thought.
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