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Iatrogenic anemia

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https://www.readbyqxmd.com/read/29169341/prevalence-genetic-variants-and-clinical-implications-of-g-6-pd-deficiency-in-burkina-faso-a-systematic-review
#1
Abdoul Karim Ouattara, Pouiré Yameogo, Lassina Traore, Birama Diarra, Maléki Assih, Tegwindé Rébéca Compaore, Dorcas Obiri-Yeboah, Serge Théophile Soubeiga, Florencia Wendkuuni Djigma, Jacques Simpore
BACKGROUND: It is now well-known that some antimalarials such as primaquine may induce severe hemolytic anemia in people with G-6-PD deficiency. Antimalarial drug prescriptions must, therefore take into account the patient's G-6-PD status in malaria endemic areas such as Burkina Faso, where the prevalence of this genetic abnormality is relatively high. Although great clinical heterogeneity is observed depending on the molecular nature of the deficiency and the residual enzyme activity in the red blood cell, there is very poor data on the prevalence of G-6-PD deficiency and the distribution of involved genetic variants in Burkina Faso...
November 23, 2017: BMC Medical Genetics
https://www.readbyqxmd.com/read/29163728/results-of-a-quality-improvement-project-aimed-at-eliminating-healthcare-waste-by-changing-medical-resident-test-ordering-behavior
#2
Sushilkumar Satish Gupta, Radhika Voleti, Vimbai Nyemba, Selma Demir, Olaoluwatomi Lamikanra, Nomsa Musemwa, Angela Saverimuthu, Kamaldeen Agoro, Robert D Kalter, Peter Homel, Melvyn Hecht, Lawrence B Wolf, Edward K Chapnick, Michael G Kantrowitz, Stephan L Kamholz
Background: In light of rising healthcare costs and evidence of inefficient use of medical resources, there is growing interest in reducing healthcare waste by clinicians. Unwarranted lab tests may lead to further tests, prolonged hospital stays, unnecessary referrals and procedures, patient discomfort, and iatrogenic anemia, resulting in significant economic and clinical effects. Blood tests are essential in guiding medical decisions, but they are also associated with significant financial and clinical costs...
December 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29153377/iatrogenic-iron-overload-and-its-potential-consequences-in-patients-on-hemodialysis
#3
Guy Rostoker, Nosratola D Vaziri
Iron overload was considered rare in hemodialysis patients until recently, but its clinical frequency is now increasingly recognized. The liver is the main site of iron storage and the liver iron concentration (LIC) is closely correlated with total iron stores in patients with secondary hemosiderosis and genetic hemochromatosis. Magnetic resonance imaging (MRI) is now the gold standard method for estimating and monitoring LIC. Studies of LIC in hemodialysis patients by magnetic susceptometry thirteen years ago and recently by quantitative MRI have demonstrated a relation between the risk of iron overload and the use of intravenous (IV) iron products prescribed at doses determined by the iron biomarker cutoffs contained in current anemia management guidelines...
November 16, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29038877/the-assessment-of-the-risk-of-acute-kidney-injury-in-patients-undergoing-an-urgent-endovascular-treatment-due-to-severe-renal-bleeding
#4
P Piasecki, T Ząbkowski, K Brzozowski, J Narloch, P Zięcina, M Dziuk, K Tkaczewski, H Zieliński
INTRODUCTION: This study was designed to assess the clinical factors associated with the development of acute kidney injury (AKI) in patients undergoing endovascular treatment during the course of severe renal bleeding. METHODS: A retrospective analysis was performed of 36 consecutive patients who were treated endovascularly between January 2006 and December 2016 for anemia caused by iatrogenic (26 pts) or posttraumatic (10 pts) renal bleeding. Typical patient data, baseline, and postprocedural blood parameters were evaluated...
October 16, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28921037/-the-patient-blood-management-concept-joint-recommendation-of-the-german-society-of-anaesthesiology-and-intensive-care-medicine-and-the-german-society-of-surgery
#5
REVIEW
P Meybohm, T Schmitz-Rixen, A Steinbicker, W Schwenk, K Zacharowski
Patient blood management is a multimodal concept that aims to detect, prevent and treat anemia, optimize hemostasis, minimize iatrogenic blood loss, and support a patient-centered decision to provide optimal use of allogeneic blood products. Although the World Health Organization (WHO) has already recommended patient blood management as a new standard in 2010, many hospitals have not implemented it at all or only in part in clinical practice. The German Society of Anaesthesiology and Intensive Care Medicine and the German Society of Surgery therefore demand that i) all professionals involved in the treatment should implement important aspects of patient blood management considering local conditions, and ii) the structural, administrative and budgetary conditions should be created in the health care system to implement more intensively many of the measures in Germany...
October 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28774729/-thrombotic-microangiopathy-and-cancer
#6
Rania Kheder El-Fekih, Clément Deltombe, Hassan Izzedine
Thrombotic microangiopathy (TMA) is a group of disorders characterized by mechanical hemolytic anemia with thrombocytopenia and an ischemic organic lesion of variable and potentially fatal importance affecting mostly the kidneys and the brain with histologically a disseminated and occlusive microvasculopathy. The incidence of TMA represents 15% of acute kidney failure in oncological setting, largely due to the introduction of anti-angiogenic agents over the past decade. It may be more rarely related to cancer itself...
July 31, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28574188/hospital-acquired-anemia-due-to-diagnostic-and-therapy-related-blood-loss-in-inpatients-with-myasthenia-gravis-receiving-therapeutic-plasma-exchange
#7
Steven A Mann, Lance A Williams, Marisa B Marques, Huy P Pham
INTRODUCTION: Daily laboratory testing (DLT) is an important cause of iatrogenic anemia. Therapeutic plasma exchanges (TPE) represent another source of blood loss. This study investigated the contributions of DLT and TPE to changes in hemoglobin of inpatients with myasthenia gravis (MG) exacerbation. STUDY DESIGN AND METHODS: All admissions for MG that included TPE between 2008 and 2012 were identified. The DLT- and TPE-related blood losses per patient were estimated based on the number of laboratory tests and TPE procedures...
June 2, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28561148/-preoperative-preparation-patient-blood-management-what-is-optimal
#8
Patrick Meybohm, Markus M Müller, Kai Zacharowski
Patient Blood Management (PBM) focusses on anemia management, the minimization of (unnecessary) iatrogenic blood loss and the exhaustion of natural tolerance to anemia with rational use of red blood cell transfusion. The focus of the current review article is now the preoperative phase with the following PBM components: management of anemia, pre-transfusion analytics and management of anticoagulants. Preoperative anemia is an independent risk factor for increased perioperative morbidity and mortality. In elective surgery, the causes of anemia should be diagnosed prior to surgery as early as possible, and if indicated, a specific treatment for treatable causes should be initiated...
May 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28516093/iatrogenic-supravalvular-aortic-stenosis
#9
Paolo Bosco, Antonella Ferrara, Samer A M Nashef
We describe a case of hemolytic anemia and proximal anastomotic site stenosis following emergency repair of a Type A aortic dissection. This rare complication led to a reoperation to correct the iatrogenic aortic stenosis and cure the consequent hemolysis. A "sandwich" technique (with two Teflon strips on the outside and inside of the aortic wall) was used in the initial repair to reinforce the suture line and prevent bleeding from the aortic anastomoses. At the time of reoperation, the inner Teflon strip at the proximal aortic anastomosis was found to have inverted into the aortic lumen, as suggested by the preoperative magnetic resonance imaging...
October 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28332306/impact-of-iatrogenic-iron-overload-on-the-course-of-hepatitis-c-in-the-dialysis-population-a-plea-for-caution
#10
REVIEW
Guy Rostoker, Nosratola D Vaziri
About 2.5% of the world population, corresponding to about 177 million individuals, are infected by hepatitis C virus (HCV), a small, single-stranded RNA virus. The prevalence of HCV infection among dialysis patients in Japan, Europe, and North America during the 2012 to 2015 period was found to be 8.7% in the DOPPS study. Nosocomial HCV spread in hemodialysis facilities still occurs. Increased hepatic tissue iron has been shown to play a deleterious role in the course of hepatitis C, favor development of fibrosis and cirrhosis and possibly increase the risk of liver cancer in the general population...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28331607/-simplified-international-recommendations-for-the-implementation-of-patient-blood-management-sir4pbm
#11
Patrick Meybohm, Bernd Froessler, Lawrence T Goodnough, Andrew A Klein, Manuel Muñoz, Michael F Murphy, Toby Richards, Aryeh Shander, Donat R Spahn, Kai Zacharowski
BACKGROUND: More than 30% of the world's population are anemic with serious medical and economic consequences. Red blood cell transfusion is the mainstay to correct anemia, but it is also one of the top five overused procedures and carries its own risk and cost burden. Patient blood management (PBM) is a patient-centered and multidisciplinary approach to manage anemia, minimize iatrogenic blood loss, and harness tolerance to anemia in an effort to improve patient outcome. Despite resolution 63...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/27816130/anesthesia-for-patients-with-anemia
#12
REVIEW
Aryeh Shander, Gregg P Lobel, Mazyar Javidroozi
Anemia is a common and often ignored condition in surgical patients. Anemia is usually multifactorial and iron deficiency and inflammation are commonly involved. An exacerbating factor in surgical patients is iatrogenic blood loss. Anemia has been repeatedly shown to be an independent predictor of worse outcomes. Patient blood management (PBM) provides a multimodality framework for prevention and management of anemia and related risk factors. The key strategies in PBM include support of hematopoiesis and improving hemoglobin level, optimizing coagulation and hemostasis, use of interdisciplinary blood conservation modalities, and patient-centered decision making throughout the course of care...
December 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27689245/vessel-preserving-stent-assisted-coil-embolization-of-an-extracranial-internal-carotid-artery-pseudoaneurysm-that-developed-after-tonsillectomy-in-a-pediatric-patient-initial-case-report
#13
Jeffrey Steinberg, Vincent Cheung, Gunjan Goel, J Scott Pannell, Javan Nation, Alexander Khalessi
Although there have been reports of carotid artery pseudoaneurysm formation after adenoidectomy and/or tonsillectomy secondary to iatrogenic injury, there are no case reports of successful endovascular reconstruction of the injured artery in the pediatric population. In most pediatric cases, the internal carotid artery (ICA) is sacrificed. The authors report on a 6-year-old girl who presented with odynophagia, left-sided Horner's syndrome, hematemesis, and severe anemia 6 months after a tonsillectomy. On examination she was found to have a pulsatile mass along the left posterior lateral oropharynx, and imaging demonstrated a dissection of the extracranial left ICA and an associated pseudoaneurysm...
January 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27650099/invasive-fungal-sinusitis-by-lasiodiplodia-theobromae-in-an-patient-with-aplastic-anemia-an-extremely-rare-case-report-and-literature-review
#14
REVIEW
Hyun Jung Gu, Young Jin Kim, Hee Joo Lee, Sung Hwa Dong, Sung Wan Kim, Hee Jae Huh, Chang-Seok Ki
Human Lasiodiplodia theobromae infection has not been reported frequently. We report the first case of invasive L. theobromae nasal and neck infection. A 66-year-old male visited our hospital with anemia and general weakness. He showed pancytopenia, and his bone marrow examination revealed markedly decreased hematopoietic cells. The patient was presumed to have iatrogenic aplastic anemia due to mushroom toxicity. He began treatment for multiple organ infections with broad-spectrum antibiotics and antifungal agents...
December 2016: Mycopathologia
https://www.readbyqxmd.com/read/27564784/patient-and-operative-factors-associated-with-complications-following-adolescent-idiopathic-scoliosis-surgery-an-analysis-of-36-335-patients-from-the-nationwide-inpatient-sample
#15
Rafael De la Garza Ramos, C Rory Goodwin, Nancy Abu-Bonsrah, Amit Jain, Emily K Miller, Nicole Huang, Khaled M Kebaish, Paul D Sponseller, Daniel M Sciubba
OBJECTIVE The aim of this study was to investigate the incidence of and factors associated with complications following idiopathic scoliosis surgery in adolescents. METHODS The Nationwide Inpatient Sample database was used to identify patients 10-18 years of age who had undergone spinal fusion for adolescent idiopathic scoliosis (AIS) from 2002 to 2011. Twenty-three unique in-hospital postoperative complications, including death, were examined. A series of logistic regressions was used to determine if any demographic, comorbid, or surgical parameter was associated with complication development...
December 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27562519/-hospital-acquired-anemia-facts-consequences-and-prevention
#16
REVIEW
Y Ozier, C Aubron, B-V Nguyen
Hospital-acquired anemia is common, especially in the most critically ill patients. It may be associated with poor patient outcomes. It may result from increased blood loss, impaired red cell production or reduced red cell life span. Multiple associated factors may contribute simultaneously or sequentially to the decrease in hemoglobin level. Some of them are related to the underlying disease and others are iatrogenic. Clinicians should be aware of the importance and consequences of iatrogenic anemia caused by diagnostic blood sampling...
November 2016: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/27538924/safe-reduction-of-blood-volume-in-the-blood-gas-laboratory
#17
Phillip R Jensen, Boaz A Markewitz
BACKGROUND: Phlebotomy is a significant cause of iatrogenic anemia in the critical care environment. It is estimated that one-third of all transfusions of packed red blood cells in intensive care units (ICU) result from phlebotomy. The aims of this study were to determine if utilizing the 1mL blood gas syringe for an adult population would impact the rate at which specimens were acceptable for testing and result reporting based on lab specimen rejection criteria; and to compare blood utilization between the 2 different syringes...
November 2016: Laboratory Medicine
https://www.readbyqxmd.com/read/27366305/atypical-presentation-of-a-hepatic-artery-pseudoaneurysm-a-case-report-and-review-of-the-literature
#18
Casey M Luckhurst, Chelsey Perez, Amy L Collinsworth, Jose G Trevino
Classically, hepatic artery pseudoaneurysms (HAPs) arise secondary to trauma or iatrogenic causes. With an increasing prevalence of laparoscopic procedures of the hepatobiliary system the risk of inadvertent injury to arterial vessels is increased. Pseudoaneurysm formation post injury can lead to serious consequences of rupture and subsequent hemorrhage, therefore intervention in all identified visceral pseudoaneurysms has been advocated. A variety of interventional methods have been proposed, with surgical management becoming the last step intervention when minimally invasive therapies have failed...
June 28, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27317382/patient-blood-management-bundles-to-facilitate-implementation
#19
REVIEW
Patrick Meybohm, Toby Richards, James Isbister, Axel Hofmann, Aryeh Shander, Lawrence Tim Goodnough, Manuel Muñoz, Hans Gombotz, Christian Friedrich Weber, Suma Choorapoikayil, Donat R Spahn, Kai Zacharowski
More than 30% of the world's population are anemic with serious economic consequences including reduced work capacity and other obstacles to national welfare and development. Red blood cell transfusion is the mainstay to correct anemia, but it is also 1 of the top 5 overused procedures. Patient blood management (PBM) is a proactive, patient-centered, and multidisciplinary approach to manage anemia, optimize hemostasis, minimize iatrogenic blood loss, and harness tolerance to anemia. Although the World Health Organization has endorsed PBM in 2010, many hospitals still seek guidance with the implementation of PBM in clinical routine...
January 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/27091216/iatrogenic-iron-overload-in-dialysis-patients-at-the-beginning-of-the-21st-century
#20
REVIEW
Guy Rostoker, Nosratola D Vaziri, Steven Fishbane
Iron overload used to be considered rare in hemodialysis patients but its clinical frequency is now increasingly realized. The liver is the main site of iron storage and the liver iron concentration (LIC) is closely correlated with total iron stores in patients with secondary hemosideroses and genetic hemochromatosis. Magnetic resonance imaging is now the gold standard method for LIC estimation and monitoring in non-renal patients. Studies of LIC in hemodialysis patients by quantitative magnetic resonance imaging and magnetic susceptometry have demonstrated a strong relation between the risk of iron overload and the use of intravenous (IV) iron products prescribed at doses determined by the iron biomarker cutoffs contained in current anemia management guidelines...
May 2016: Drugs
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