The diagnosis of idiopathic immune thrombocytopenia remains a clinical diagnosis based on the exclusion of other causes of immune and nonimmune thrombocytopenia. Measurement of platelet-associated Ig (PAIg), while sensitive, is nonspecific for the diagnosis of immune thrombocytopenia. Published experience of antigen capture assays (including monoclonal antibody immobilization of platelet antigens or MAIPA) suggest a high sensitivity and specificity (70% to 80%) in selected groups of patients. In a prospective evaluation of 158 patients with thrombocytopenia from all causes, we report a sensitivity of 51% and specificity of 80% for direct MAIPA assays. MAIPA was considerably better in discriminating immune from nonimmune thrombocytopenia than two assays of PAIgG. Antiplatelet antibodies detected by MAIPA were more frequently directed against the glycoprotein (GP) IIb/IIIa than the GP Ib/IX complex. Our experience suggests that MAIPA assays are useful in the laboratory assessment of thrombocytopenia, should be performed before therapy, and that some patients with ‘nonimmune’ thrombocytopenia may have genuine antiplatelet antibodies.
Saxophonists Bernie McGann, Kim Sanders and Tony Gorman are instantly recognisable by their distinctive sounds. Their lives and music exemplify three different ways that individual identity shaped the structure and sound of jazz in an Australian context. What musical materials and processes do they use to express their identity? How does their music reflects their cultural, social, and personal histories, and aesthetic preferences? What insights does their creative work offer into understandings about musical thought and practice, and identity in Australian jazz culture? These questions are investigated through analysis and discussion of a composition and improvisation from a seminal recording by each saxophonist: McGann’s ‘Playground’, Sanders’ ‘Gnome Chomsky’s Deep Focus Boogie-Woogie’ and Gorman’s ‘Spice Island’. The differences between these three saxophonists, and the wide variety of global musical source cultures they draw from indicate the impossibility of representing a singular Australian jazz identity. I argue that it is imperative to consider Australian jazz identity as multiply-constituted, and to undertake critical enquiry to understand and document the musical practices of the individuals and groups who create and inhabit Australia’s richly nuanced musical spaces.
In the medieval French epics Raoul de Cambrai, Garin le Loherenc, and Gerbert de Mez, the poets sketch noble women and queens who belittle, berate, and render impotent the ruler and his men. These chansons de geste exploit and invert the topos of woman's legendary rebellious nature, voicing through subversive epic ladies an idealized feudal order predicated on loyal service and just reward. If, in the metafiction of an ideal epic world, land and lady are two sides of the gift the ideal king bestows on the ideal knight, in these works the king's brutal attempts to dominate his men waste both lady and land. Portraying the practices of scorched earth and systematic rape as political tools of royal expansion, these epics deliver powerful images of women exercising a righteous resistance through subversive acts, words, and desires. Like Eve, these epic ladies resist patriarchal dominance corporally through their desires and their mouths, and so, women's resistant tongues and desires work to restore order in political landscapes wasted by their kings' empty words and impotence.
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