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management of anemia

M Safer, I Zemni, F Ben Abderrazak, M Khelil, C Zoghlami, A Ben Abdelaziz
BACKGROUND: Determining the performance level of hemodialysis facilities, including an evaluation of biological tests, is a prerequisite for quality assessment of these healthcare structures. OBJECTIVE: The purpose of this work was to evaluate the compliance and adequacy of biological tests performed in 2014 in Center-East Tunisia hemodialysis units. METHODS: Data were collected using an analysis grid for 15 biological indicators including 11 process items and four results items used to determine the compliance and adequacy rates respectively...
December 12, 2018: Revue D'épidémiologie et de Santé Publique
Urshila Durani, Ronald S Go, Neil E Kay
Autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia purpura (ITP) have been associated with B-cell lymphoproliferative disorders. Here, we review the epidemiology, pathogenesis, diagnosis, and treatment of these autoimmune disorders, specifically in the setting of B-cell malignancies. AIHA and ITP are classically associated with chronic lymphocytic leukemia (CLL) but have also been reported in plasmacytic and lymphoproliferative disorders. AIHA includes both warm AIHA and cold agglutinin disease, the latter of which is strongly associated with Waldenström macroglobulinemia...
October 2018: Clinical Advances in Hematology & Oncology: H&O
Andrea U Steinbicker
PURPOSE OF REVIEW: Anemia can contribute negatively to a patient's morbidity and mortality. Which treatment options do exist and what role do anesthesiologists play in management of perioperative anemia treatment? This review gives an overview about recent findings. RECENT FINDINGS: Patient Blood Management and standards for the management and treatment of anemia have been established worldwide. Various logistic settings and approaches are possible. With a special focus on cardiovascular anesthesia, intravenous iron is a therapeutic option in the preoperative setting...
December 6, 2018: Current Opinion in Anaesthesiology
Haruna Katayama, Azusa Nagao, Ryosuke Hosokai, Takashi Suzuki
A female patient in her forties exhibited no evidence of abnormal bleeding at birth. At the age of 6 years, she experienced pain in bilateral thighs and knee joints without any occasion. Accordingly, the bleeding tendency was suspected, and the coagulation profile assessment revealed prolongation of the APTT (122 s). Further tests revealed a marked reduction in the factor X activity (FX:C) to 4.5%, and the patient was diagnosed with congenital factor X deficiency; at that time, the case was reported by Mori et al...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Kenji Okamoto, Shinya Osone, Taeko Saito, Toshihiko Imamura, Hajime Hosoi
A 19-year-old male with therapy-related myelodysplastic syndrome underwent allogeneic bone marrow transplantation with reduced-intensity conditioning from his HLA-identical sibling whose ABO blood type exhibited major incompatibility with the patient. After post-transplantation 1 month, chimerism analysis of the bone marrow revealed mixed chimerism with 30% of recipient cells, and after post-transplantation 3 months, complete remission was maintained; however, recipient granulocytes were elevated up to 50% per the chimerism analysis...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Rini Savitri Daulay, Allisa Majeda, Heda Melinda Nataprawira
Adolescent is a high-risk population for developing tuberculosis (TB) disease, unfortunately adolescence TB remains to be neglected. Clinical manifestations of TB are usually chronic and nonspecific that could be mimicking other disease. Unrecognized TB disease will lead to misdiagnosis, delayed, and inappropriate management. A 15-year-old female adolescent, admitted to the hospital due to severe anemia, loss of body weight accompanied with recurrent fever and tend to be easily tired. She was through investigation for hematology disorder with normal results...
October 2018: International Journal of Mycobacteriology
Luca Elli, Francesca Ferretti, Stefania Orlando, Maurizio Vecchi, Erika Monguzzi, Leda Roncoroni, Detlef Schuppan
Celiac disease (CD) is the most common autoimmune enteropathy worldwide. In CD, dietary gluten triggers a T cell driven small intestinal inflammation in a subset of genetically predisposed subjects, expressing the HLA DQ2 and/or DQ8 genes on their antigen presenting cells. HLA DQ2/DQ8 can bind gluten peptides after their prior modification by the CD autoantigen, tissue transglutaminase (TG2). This process leads to the activation of gluten reactive T cells, small bowel villous atrophy, crypt hyperplasia and intraepithelial lymphocytosis, the histological hallmarks of CD...
December 5, 2018: European Journal of Internal Medicine
M Vélez, U Palacios-Barahona, M M Arango-Posada, J Ramos-Castañeda
INTRODUCTION: Cephalomedullary nails are used for the treatment of hip fractures; however, there are few studies that allow identifying data on the complications of the use of these devices and the results in terms of restoration of the functionality of the patient. METHODS: A cross-sectional study of patients with femur fracture was conducted during the period from January 2008 to December 2012. Data on demographic and clinical variables were collected. Telephone follow-up was performed up to six postoperative months...
May 2018: Acta Ortopédica Mexicana
Getachew Ferede, Moges Tiruneh, Ebba Abate, Yitayih Wondimeneh, Endalamaw Gadisa, Rawleigh Howe, Abraham Aseffa, Belay Tessema
BACKGROUND: Dengue is one of the most common arboviral diseases with increased outbreaks annually in tropical and subtropical areas. In Ethiopia, there are no data regarding clinical, hematological and biochemical parameters which are very important in the clinical management of dengue patients. Hence this study was carried out to provide the first baseline data of clinical, hematological and biochemical profiles of patients infected with dengue virus. METHODS: A cross-sectional study was carried out among febrile patients in northwest Ethiopia from March 2016 to May 2017...
December 4, 2018: BMC Infectious Diseases
Bon-Nyeo Koo, Min A Kwon, Sang-Hyun Kim, Jong Yeop Kim, Young-Jin Moon, Sun Young Park, Eun-Ho Lee, Min Suk Chae, Sung Uk Choi, Jeong-Hyun Choi, Jin-Young Hwang
Considering the functional role of red blood cells (RBC) in maintaining a proper supply of oxygen to the tissues, RBC transfusion can be a life-saving intervention in situations of severe bleeding or anemia. RBC transfusion is often inevitable to address intraoperative massive bleeding; it is a key component of safe perioperative patient management. Unlike general medical resources, packed RBCs (pRBCs) have limited availability because their supply relies entirely on voluntary donations. Besides, excessive utilization of pRBCs may aggravate prognosis or increase the risk of developing infectious diseases...
December 5, 2018: Korean Journal of Anesthesiology
Chun-Hou Huang, Tso-Fu Wang, Yi-Feng Wu, Yi-Tso Cheng, Shu-Fen Lo, Tsung-Cheng Hsieh, Tai-Chu Peng
BACKGROUND: Enteral feeding tubes used to manage the nutritional status of esophageal cancer were evaluated regarding their effectiveness in patients receiving neoadjuvant therapy. PATIENTS AND METHODS: A retrospective study evaluating patients with esophageal squamous cell carcinoma undergoing neoadjuvant therapy between 2001 and 2014 was conducted at a medical center. Hospital patients' records for enteral access (EA) insertion and treatment outcomes were statistically analyzed...
December 2018: Anticancer Research
Keyvan Karkouti, Loretta T S Ho
The use of extracorporeal circulation for cardiac surgery and extracorporeal life support poses tremendous challenges to the hemostatic equilibrium given its diametric tendency to trigger hyper- and hypocoagulopathy. The necessity of anticoagulant therapy to counteract the hemostatic activation by the extracorporeal circuitry compounded by unfavorable patient and surgical factors significantly increase the risk of catastrophic bleeding in patients who require extracorporeal circulation. Preoperative measures, such as stratification of high-risk bleeding patients, and optimization of the modifiable variables, including anemia and thrombocytopenia, provide a crude estimation of the likelihood and may modify the risk of catastrophic bleeding...
November 30, 2018: Hematology—the Education Program of the American Society of Hematology
Sarah H O'Brien
Heavy menstrual bleeding (HMB) is frequently reported by adolescents. The role of the hematologist is threefold in evaluating such patients: (1) perform a clinical and laboratory evaluation for an underlying bleeding disorder on the basis of the degree of clinical suspicion, (2) identify and manage any concomitant iron deficiency, and (3) provide input to the referring provider regarding the management of HMB, particularly for patients with identified hemostatic defects. Several clues in the menstrual history should raise suspicion for an underlying bleeding disorder, such as menses lasting >7 days, menstrual flow which soaks >5 sanitary products per day or requires product change during the night, passage of large blood clots, or failure to respond to conventional therapies...
November 30, 2018: Hematology—the Education Program of the American Society of Hematology
Narla Mohandas
Significant advances have been made in diagnosis and clinical management of inherited red cell membrane disorders that result in hemolytic anemia. Membrane structural defects lead to hereditary spherocytosis (HS) and hereditary elliptocytosis (HE), whereas altered membrane transport function accounts for hereditary xerocytosis (HX) and hereditary overhydrated stomatocytosis (OHS). The degrees of membrane loss and resultant increases in cell sphericity determine the severity of anemia in HS and HE, and splenectomy leads to amelioration of anemia by increasing the circulatory red cell life span...
November 30, 2018: Hematology—the Education Program of the American Society of Hematology
Helen J Madsen, Aparna Annam, Roger Harned, Taizo A Nakano, Lauren O Larroque, Ann M Kulungowski
BACKGROUND: Lymphatic malformations (LMs) are congenital and arise from errors in vascular embryogenesis. LMs are categorized by cyst size as microcystic, macrocystic, or combined. Abdominal LMs are rare. Surgical resection of abdominal LMs has been the mainstay of therapy, but recurrence and morbidity are high. We sought to determine the effectiveness of sclerotherapy treatment for abdominal LM. METHODS: A single-center, retrospective review from 2014 to 2018 was conducted evaluating pediatric patients with abdominal LM...
January 2019: Journal of Surgical Research
Jeffrey J Siracuse, Alik Farber, Thea James, Thomas W Cheng, Yi Zuo, Jeffrey A Kalish, Douglas W Jones, Bindu Kalesan
INTRODUCTION: Firearm injuries can be morbid and potentially have high resource utilization. Historically, trauma and vascular surgery patients are at higher risk for readmissions. Our goal was to assess the risk for readmission among patients undergoing vascular repair after a firearm injury. METHODS: The National Readmission Database was queried from 2011-2014. All firearm injuries with or without vascular repair were analyzed. Multivariable analysis was conducted to assess the effect of concurrent vascular repair on readmissions at 30, 90, and 180 days...
November 27, 2018: Annals of Vascular Surgery
Claire Stanley, Amanda Baillargeon, Amanda Selk
OBJECTIVE: To evaluate the knowledge, attitudes, and beliefs of women during pregnancy and the postpartum period related to placentophagy. DESIGN: Mixed methods study (cross-sectional survey and online discussions). SETTING: We used social media to advertise the study to mother/parenting groups. Online discussion groups were conducted through Google Groups. PARTICIPANTS: Women during pregnancy and in the postpartum period and placenta encapsulation specialists with Internet access...
November 26, 2018: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
Andrew Iskandar, Andrew Hwang, Constantin A Dasanu
Castleman disease is a rare B-cell lymphoproliferative disorder characterized by lymph node enlargement with or without constitutional signs. Herein, we describe a unique patient with multicentric Castleman disease and retroviral infection who presented with a sudden onset of constitutional signs and was found to have severe warm-antibody autoimmune hemolytic anemia. Rituximab monotherapy yielded an excellent clinical response. We aim to inform the medical community of this rare paraneoplastic phenomenon in patients with Castleman disease and its effective management...
November 28, 2018: Journal of Oncology Pharmacy Practice
Brian Veauthier, Jaime R Hornecker
Crohn's disease is a chronic inflammatory condition that affects the gastrointestinal tract. It can cause lesions from mouth to anus and may result in extraintestinal complications. The prevalence of Crohn's disease is increasing in adults and children. Genetic predispositions to Crohn's disease have been identified, and specific environmental factors have been associated with its development. Common presenting symptoms include diarrhea, abdominal pain, rectal bleeding, fever, weight loss, and fatigue. Physical examination should identify unstable patients requiring immediate care, include an anorectal examination, and look for extraintestinal complications...
December 1, 2018: American Family Physician
Sung-Soo Park, Hyeon-Seok Eom, Jin Seok Kim, Youngil Koh, Chul Won Choi, Je-Jung Lee, Kihyun Kim, Cheolwon Suh, Jae Hoon Lee, Chang-Ki Min
Despite the recently reported efficacy of daratumumab monotherapy for patients with relapsed or refractory multiple myeloma, outcomes in real practice following daratumumab monotherapy have yet to be investigated. A multi-center retrospective study of 16 Korean patients receiving daratumumab monotherapy for relapsed or refractory multiple myeloma was conducted. The overall response rate was 56.3%. Three patients with creatinine clearance <30 ml/min even achieved an overall response. The median progression-free survival was 2...
November 23, 2018: Japanese Journal of Clinical Oncology
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