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management of anemia

Yael Einbinder, Timna Agur, Kirill Davidov, Tali Zitman-Gal, Eliezer Golan, Sydney Benchetrit
BACKGROUND: Anemia management strategies among chronic hemodialysis patients with high ferritin levels remains challenging for nephrologists. OBJECTIVES: To compare anemia management in stable hemodialysis patients with high (≥ 500 ng/ml) vs. low (< 500 ng/ml) ferritin levels. METHODS: In a single center, record review, cohort study of stable hemodialysis patients who were followed for 24 months, an anemia management policy was amended to discontinue intravenous (IV) iron therapy for stable hemodialysis patients with hemoglobin > 10 g/dl and ferritin ≥ 500 ng/ml...
July 2018: Israel Medical Association Journal: IMAJ
Eshetu Molla, Hassen Mamo
OBJECTIVE: Current data on soil-transmitted helminth infections, anemia and malnutrition that are largely neglected is vital to the control and management of them in a specific setting. This study was, therefore, aimed at determining the status of the three health concerns in one of the high-risk groups, schoolchildren, in South Ethiopia. RESULTS: Among the 443 sampled schoolchildren, 54% were infected with soil-transmitted helminths (STHs) and 15.4% of them had anaemia, while the prevalence rate of undernutrition was 28...
August 13, 2018: BMC Research Notes
Yuki Matsumoto, Haeru Hayashi, Koichiro Tahara, Takuya Yasuda, Shoko Tsubouchi, Yusuke Yamamoto, Takahiro Mizuuchi, Hiroaki Mori, Tetsuji Sawada
Gastric antral vascular ectasia (GAVE) is a rare cause of chronic gastric hemorrhaging and iron deficiency anemia and is characterized by a distinctive endoscopic appearance. The main treatment of GAVE is endoscopic; however, medication is necessary in refractory cases. We herein report a 69-year-old woman with systemic sclerosis (SSc) who developed recurrent severe anemia after endoscopic treatment of GAVE that was successfully managed using intravenous cyclophosphamide (IVCY). The recurrence of GAVE after discontinuation of IVCY was successfully managed using a combination of IVCY and endoscopic treatment, without blood transfusion...
August 10, 2018: Internal Medicine
Cristina O Mărginean, Lorena E Meliț, Liliana Gozar, Cristian Dan Mărginean, Maria O Mărginean
Kawasaki disease (KD) is a febrile vasculitis, which is commonly defined by fever and at least four specific clinical symptoms. Incomplete KD is defined by suggestive echocardiographic findings with an incomplete clinical picture. Refractory KD is diagnosed in patients resistant to intravenous immunoglobulin (IVIG). We report the case of a 6-month-old male infant admitted to our clinic for persistent fever and onset of a generalized polymorphous rash, accompanied by high fever, rhinorrhea, and cough for the past 7 days...
2018: Frontiers in Pediatrics
Yoichiro Okubo, Emi Yoshioka, Masaki Suzuki, Kota Washimi, Kae Kawachi, Yoichi Kameda, Tomoyuki Yokose
Background: Although gangliocytic paraganglioma (GP) is considered a rare benign neuroendocrine tumor, cases of mortality have been reported. Occasionally, GP is misdiagnosed as neuroendocrine tumor G1, which is associated with a poorer prognosis than GP. To avoid such misdiagnoses, it is important to understand the clinicopathological characteristics of GP. Thus, herein, we discuss the current literature on the clinicopathological characteristics of GP. Methods: We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement...
2018: Frontiers in Oncology
Phillip Staibano, Iris Perelman, Julia Lombardi, Alexandra Davis, Alan Tinmouth, Marc Carrier, Ciara Stevenson, Elianna Saidenberg
Anemia is a frequently diagnosed condition that may be a symptom of or complication of many illnesses affecting patients of all demographics. Anemia can lead to both worsened clinical outcomes and reduced quality of life. Patient-reported outcome measures (PROMs) are methodological tools used to capture the impact of disease on patient well-being. Use of PROMs in medical research is becoming more common as it is increasingly recognized that disease outcomes of interest to researchers and clinicians are not always consistent with patients' greatest concerns related to their diseases...
July 12, 2018: Transfusion Medicine Reviews
Chetasi Talati, David Sallman, Alan F List
Myelodysplastic syndrome (MDS) with deletion 5q [del(5q)] is a distinct clinical and pathologic disease subset that is exquisitely sensitive to lenalidomide for the treatment of red blood cell transfusion-dependent anemia. Lenalidomide resistance, including primary resistance, occurs by clonal evolution, which is frequently attributable to the presence of somatic mutations in the DNA-binding domain of the TP53 gene. The treatment options after development of resistance to lenalidomide are limited and consist of hypomethylating agents, clinical trials, and allogeneic hematopoietic stem cell transplantation...
July 30, 2018: Clinical Lymphoma, Myeloma & Leukemia
Helena Moreira Silva, Gisela Silva, Emília Costa, Rosa Lima, Fernando Pereira
We describe the case of a previously healthy 8-year-old girl presenting with a 1-year history of iron deficiency anemia. There was no report of hematemesis, abdominal pain or melena. Laboratory work-up excluded iron malabsorption as the underlying cause. Therefore, endoscopic evaluation was performed to exclude gastrointestinal blood loss, which revealed the presence of a 7 mm reddish lesion located within the ampulla of Vater. Capsule endoscopy excluded alternative diagnoses and concomitant lesions. Histopathological examination confirmed the diagnosis of pyogenic granuloma...
August 9, 2018: Clinical Journal of Gastroenterology
Issam N Albaroudi, Majed Khodder, Tareq Al Saadi, Tarek Turk, Lama A Youssef
Background: Given the public health significance of anemia, the long-term sequelae of iron deficiency anemia (IDA) on children, the expected effect of war on the trends of anemia in Syrian society, and the lack of assessment on the national burden of anemia and/or iron deficiency (ID) data, there is a vital need to investigate all-cause anemia, ID, and IDA in Syria during the crisis. Objective: To investigate the prevalence of ID and IDA in Syrian children, the effectiveness of oral iron supplements in the management of ID, and the diagnostic effectiveness of conventional iron markers...
July 2018: Avicenna Journal of Medicine
Christina Wittkamp, Lisa Traeger, Ines Ellermann, Maria Eveslage, Andrea U Steinbicker
Preoperative anemia occurs in about one third of patients who undergo elective surgery and is associated with an impaired outcome. Therefore, screening of preoperative anemia was established in the context of a multidisciplinary Patient Blood Management (PBM) program at the University Hospital of Muenster, Germany. Anemic patients without contraindications were treated with intravenous (IV) iron (ferric carboxymaltose) to increase their hemoglobin (Hgb) levels and hence to treat anemia prior to surgery. Interestingly, we detected a large variability in the response of Hgb levels after IV iron administration...
2018: PloS One
Vivienne Keding, Kai Zacharowski, Wolf O Bechstein, Patrick Meybohm, Andreas A Schnitzbauer
BACKGROUND: Patient Blood Management (PBM) is a systematic quality improving clinical model to reduce anemia and avoid transfusions in all kinds of clinical settings. Here, we investigated the potential of PBM in oncologic surgery and hypothesized that PBM improves 2-year overall survival (OS). METHODS: Retrospective analysis of patients 2 years before and after PBM implementation. The primary endpoint was OS at 2 years after surgery. We identified a sample size of 824 to detect a 10% improvement in survival in the PBM group...
August 7, 2018: World Journal of Surgical Oncology
Michael E Brier, Adam E Gaweda, George R Aronoff
Substantial progress has been made in the application of computer-driven methods to provide erythropoietic dosing information for patients with anemia resulting from chronic kidney disease. Initial solutions were simply computerized versions of traditional paper-based anemia management protocols. True personalization was achieved through the use of advanced modeling techniques such as artificial neural networks, physiologic models, and feedback control systems. The superiority of any one technique over another has not been determined, but all methods have shown an advantage in at least one area over the traditional paper expert system used by most dialysis facilities...
July 2018: Seminars in Nephrology
Jin-Shan Zhang, Long Li, Wei Cheng, Wen-Ying Hou
PURPOSE: Ligation of abnormal portosystemic shunt has been used to treat type II Abernethy malformation, but it may not be suitable for all of patients. In this study, Rex shunt were carried out to manage type II Abernethy malformation with portal venous dysplasia. The outcomes are evaluated retrospectively. METHODS: Between Jun 2014 and Jan 2015, two boys (age: 4.8 and 12.8 years respectively) with type II Abernethy malformation underwent Rex shunt with ligation of inferior mesenteric vein (IMV)...
August 3, 2018: Annals of Vascular Surgery
Mary A M Rogers, M Todd Greene, Jennifer A Davis, David Ratz, Latoya E Kuhn, Sanjay Saint, Vineet Chopra
Objective: Although transfusion guidelines have changed considerably over the past two decades, the adoption of patient blood management programs has not been fully realized across hospitals in the United States. Patients and Methods: We evaluated trends in red blood cell (RBC), platelet and plasma transfusion at three Veterans Health Administration (VHA) hospitals from 2000 through 2010. Results: There were 176,521 hospitalizations in 69,621 patients; of these, 13...
September 2017: Journal of Clinical Outcomes Management: JCOM
Nobuyoshi Matsuoka, Mie Akaike, Takashi Murayama, Hideya Hashimoto, Yoshifumi Hirokawa, Tatsu Inoki
A 73-year-old female was hospitalized with thrombotic microangiopathy (TMA) diagnosis because of consciousness disturbance, anemia, thrombocytopenia, renal dysfunction, and electrocardiogram abnormality. The patient died on day 12 of the symptom onset. The immunohistochemical analysis of microclot found in the autopsy of coronary artery confirmed TMA. It was suggested that the relationship to collagen disease by antinuclear antibody positive and the necessity of initiating circulation management and plasma exchange immediately before approximately 1×104 of platelets for the prognosis...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
David P Steensma
Clonal hematopoiesis (CH)-an expansion of blood cells derived from a single hematopoietic stem cell-is a defining feature of hematologic cancers, but recently CH was also found to be a frequent consequence of aging. When aging-associated CH results from acquisition of a somatic mutation in a driver gene associated with leukemia, and this mutation is present at a variant allele frequency of at least 0.02 (2%) yet the patient does not meet World Health Organization diagnostic criteria for a hematologic neoplasm, this state is termed clonal hematopoiesis of indeterminate potential (CHIP)...
August 2018: Mayo Clinic Proceedings
Vanesa Gregorc, Raffaele Cavina, Sivia Novello, Francesco Grossi, Chiara Lazzari, Enrica Capelletto, Carlo Genova, Giulia Salini, Antonio Lambiase, Armando Santoro
BACKGROUND: Relapsed small cell lung cancer (SCLC) patients have limited treatment options and poor outcomes. NGR-hTNF is a vascular-targeting agent, which increases intratumoral chemotherapy penetration and T-lymphocyte infiltration. METHODS: Twenty-eight patients relapsing after at least one platinum-based regimen with a treatment-free interval shorter ( n  = 16; platinum-resistant) or longer ( n  = 12; platinum-sensitive) than 3 months received NGR-hTNF 0...
August 3, 2018: Oncologist
Catherine Amlie-Lefond, Jonathan Flanagan, Julie Kanter, William B Dobyns
Sickle cell disease (SCD) is one of the most common autosomal recessive diseases in humans, occurring at a frequency of 1 in 365 African-American and 1 in 50 sub-Saharan African births. Despite progress in managing complications of SCD, these remain a major health burden worldwide. Stroke is a common and serious complication of SCD, most often associated with steno-occlusive cerebral arteriopathy, but little is known about its pathogenesis. Transcranial Doppler ultrasonography is currently the only predictive test for future development of stroke in patients with sickle cell anemia and is used to guide preventative treatment...
July 31, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Catherine Copley-Merriman, Kendall Stevinson, Frank Xiaoqing Liu, Jingshu Wang, Josephine Mauskopf, Evelina A Zimovetz, Bartosz Chmielowski
BACKGROUND: Treatments for advanced melanoma are associated with different adverse events (AEs), which may be costly to manage. This study aimed to evaluate direct costs associated with managing treatment-related AEs for advanced melanoma through a systematic literature review. METHODS: Systematic searches were conducted of the PubMed, Embase, Cochrane, BIOSIS, and EconLit medical literature databases to identify studies providing estimates of direct costs and health care resource utilization for the management of AEs of melanoma treatments, published between January 1, 2007, and February 23, 2017...
August 2018: Medicine (Baltimore)
Sen Li, Shu-Jie Wang, Yong-Qiang Zhao
Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant disorder characterized by vascular dysplasia, including typically systemic telangiectases and arteriovenous malformations (AVMs). Due to its variable clinical manifestations, HHT patients often seek medical care from different medical subspecialties and thus experience delays in diagnosis and treatment.This study is designed to analyze the clinical features and treatment options for patients with HHT.Hospitalized patients with a definitive diagnosis of HHT from November 1973 to July 2016 in Peking Union Medical College Hospital were identified after reviewing medical records and electronic databases...
August 2018: Medicine (Baltimore)
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