Heparin-induced thrombocytopenia (HIT) is a potentially serious syndrome. Since there are some alternatives to treatment with heparin in patients who develop HIT, the decision as to which to use should be based on renal and hepatic function, drug availability and the available monitoring resources. We report a patient who received heparin for mechanical aortic valve replacement. Her clinical course was complicated by HIT, which was treated initially by danaparoid. The syndrome progressed with new thrombotic complications, and eventually was treated successfully by bivalirudin (Angiomax; Medison Pharma Ltd, Petach Tikva, Israel) for 9 days. We propose that treatment with bivalirudin for several days is a safe and effective alternative to heparin therapy in patients who develop HIT.
We show that the index defined via a trace for Fredholm elements in a Banach algebra has the property that an index zero Fredholm element can be decomposed as the sum of an invertible element and an element in the socle. We identify the set of index zero Fredholm elements as an upper semiregularity with the Jacobson property. The Weyl spectrum is then characterized in terms of the index.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.