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Moniek W M van de Luijtgaarden, Fergus J Caskey, Christoph Wanner, Nicholas C Chesnaye, Maurizio Postorino, Cynthia J Janmaat, Anirudh Rao, Claudia Torino, Marian Klinger, Christiane Drechsler, Olof Heimburger, Maciej Szymczak, Marie Evans, Friedo W Dekker, Kitty J Jager
Background: The epidemiology and prognosis of chronic kidney disease (CKD) differ by sex. We aimed to compare symptom prevalence and the clinical state in women and men of ≥65 years of age with advanced CKD receiving routine nephrology care. Methods: The European QUALity study on treatment in advanced chronic kidney disease (EQUAL) study follows patients from six European countries of ≥65 years of age  years whose estimated glomerular filtration rate (eGFR) dropped to ≤20 mL/min/1...
June 13, 2018: Nephrology, Dialysis, Transplantation
Iain C Macdougall
PURPOSE OF REVIEW: Iron deficiency is a major contributory cause to the development of anaemia in chronic kidney disease (CKD), and thus, iron replacement therapy plays a critical role in the management of this condition. The two main routes for administering iron are oral and intravenous, and there have been a number of new publications relevant to both routes of administration. RECENT FINDINGS: Recent developments on the topic of iron management in CKD include the introduction of new oral iron preparations, as well as two recent meta-analyses on iron therapy in CKD (one on oral versus intravenous iron, and one on high- versus low-dose intravenous iron in haemodialysis patients)...
June 13, 2018: Current Opinion in Nephrology and Hypertension
Virginie Moulin, Francesco Grandoni, Julien Castioni, Henri Lu
Thiamine-responsive megaloblastic anaemia (TRMA) is a syndrome associated with megaloblastic anaemia, diabetes mellitus and sensorineural deafness, due to mutations in the SLC19A2 gene, which codes for a thiamine carrier protein. Oral thiamine supplementation is the main treatment. We report the case of a 25-year-old woman known for TRMA, who presented with pancytopenia (haemoglobin 7.6 g/dL, leucocytes 2.9×109 /L, thrombocytes 6×109 /L) revealed by dyspnoea. Investigations excluded coagulopathy, a recent viral infection, vitamin and iron deficiencies, and a malignant process...
June 14, 2018: BMJ Case Reports
Ahmad Amer, Maital Kaidar, Diana Tasher, Amir Lotan, Ilan Dalal
Epstein Barr virus (EBV) infections include a wide spectrum of clinical manifestations, ranging from asymptomatic to multiple organ involvement (1). Several complications have been described and renal involvement is usually nephritic and not nephrotic. Nephritic includes haematuria, proteinuria, renal impairment and salt retention causing hypertension and oedema, while nephrotic is defined as heavy proteinuria, with a protein/creatinine ratio of >200 mg/mmol, hypoalbuminemia of <25 g/L and oedema (2-4)...
June 14, 2018: Acta Paediatrica
Yoshitaka Furuto, Hirotsugu Hashimoto, Hajime Horiuti, Yuko Shibuya
RATIONALE: TAFRO syndrome is a systemic inflammatory disease proposed recently from Japan. The cause of TAFRO syndrome is unclear. Moreover, the disease characteristics and kidney pathology are yet unknown well and there are few cases. Herein, we report a patient with TAFRO syndrome and present the features of the renal histopathology. PATIENT CONCERNS: A 55-year-old woman presented to our hospital with the main complaint of subacute dyspnoea. DIAGNOSIS: Physical findings included a low-grade fever and generalised oedema...
June 2018: Medicine (Baltimore)
Ketil Størdal, Harry J McArdle, Helen Hayes, German Tapia, Marte K Viken, Nicolai A Lund-Blix, Margaretha Haugen, Geir Joner, Torild Skrivarhaug, Karl Mårild, Pål R Njølstad, Merete Eggesbø, Siddhartha Mandal, Christian M Page, Stephanie J London, Benedicte A Lie, Lars C Stene
Iron overload due to environmental or genetic causes have been associated diabetes. We hypothesized that prenatal iron exposure is associated with higher risk of childhood type 1 diabetes. In the Norwegian Mother and Child cohort study (n = 94,209 pregnancies, n = 373 developed type 1 diabetes) the incidence of type 1 diabetes was higher in children exposed to maternal iron supplementation than unexposed (36.8/100,000/year compared to 28.6/100,000/year, adjusted hazard ratio 1.33, 95%CI: 1.06-1.67)...
June 13, 2018: Scientific Reports
Tingyan Shi, Rong Jiang, Jinjin Yu, Huijuan Yang, Dongsheng Tu, Zhiyuan Dai, Yang Shen, Yuqin Zhang, Xi Cheng, Huixun Jia, Ruiqin Tu, Huaying Wang, Jie Tang, Yuting Luan, Shumo Cai, Rongyu Zang
BACKGROUND: We assessed the efficacy of adding intraperitoneal (IP) chemotherapy to standard first-line intravenous (IV) chemotherapy in epithelial ovarian cancer (EOC) patients. METHODS: Patients with stage IIIC-IV EOC who underwent optimal debulking surgery were randomly assigned to four cycles of weekly IP chemotherapy with cisplatin (50 mg/m2 ) and etoposide (100 mg/m2 ) followed by six cycles of IV chemotherapy every 3 weeks (IP/IV arm), or were administered IV chemotherapy alone (IV arm)...
June 14, 2018: British Journal of Cancer
Priya Rajan, Srinivas Murki, Suseela Vavilala, Nirupama Surubhotla
Objectives: To study the recent trends in maternal and perinatal outcomes of triplet pregnancy from a perinatal centre in South India. Methods: All triplet pregnancies booked at Fernandez hospital, Hyderabad (a tertiary care perinatal centre in South India), or those referred between 2000 and 2014 were included in the study. The maternal, fetal and neonatal outcome and any interventions like cerclage, steroid administration were studied. Results: There were 82 triplet deliveries over the study period of 15 years (82 per 69,584 live births)...
June 2018: Journal of Obstetrics and Gynaecology of India
Megan E Costa, Benjamin Trumble, Hillard Kaplan, Michael D Gurven
Ideal family size (IFS) is measured in social surveys to indicate unmet need for contraception and impending shifts in fertility behaviour. Whether exceeding IFS affects parental behaviour in ways that result in lower investments in child nutrition, well-being, and educational attainment is not known. This study examines parental IFS and the association between exceeding stated ideals and child nutritional status in a high-fertility, high-mortality population in the Bolivian Amazon. Height-for-age z-scores, weight-for-age z-scores, weight-for-height z-scores, stunting, haemoglobin, and anaemia status in 638 children aged 0-5 years are predicted as a function of birth order in relation to parental IFS, adjusting for household characteristics and mother and child random effects...
June 11, 2018: Maternal & Child Nutrition
Nidhi Prabhakar, Chirag K Ahuja, Niranjan Khandelwal
Bilateral basal ganglia lesions are a common non-specific finding seen in many diseases. One of the differential diagnoses for it, in a child, is kernicterus occurring due to hyperbilirubinemia. Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common cause of severe hyperbilirubinemia. A 1-year old child presented to the hospital with history of generalized dystonia in the previous 3 days. MRI showed evidence of symmetrical lesions in bilateral globus pallidus, which were hyperintense on T2/FLAIR and isointense on T1...
April 2018: Annals of Neurosciences
Edith Lahner, Marina Capasso, Marilia Carabotti, Bruno Annibale
BACKGROUND: Pernicious anaemia (PA) is associated with increased gastric cancer risk, but the evidence is conflicting regarding the associated risk of other cancers. AIM: To systematically determine the incidence rates of gastro-intestinal cancers other than gastric cancers (GI-other-than-GC) and non-gastrointestinal cancers (non-GIC) in PA adults, globally and per tumour site, and the risk associated with PA for GI-other than GC and non-GIC. METHODS: Studies of PA patients reporting the incidence of GI-other-than-GCs and non-GICs were identified with MEDLINE (PubMed)-EMBASE (from first date available to April 2017)...
May 24, 2018: Digestive and Liver Disease
Ricardo Brandt Oliveira, Ana Lourdes Candolo Martinelli, Luiz Ernesto Almeida Troncon, Jorge Elias
A 17-year-old woman, with a history of three operations on the upper gut in early life and intermittent diarrhoea, presented with a history of epistaxis and leg ecchymosis for the previous 3 months. Initial investigation revealed mild anaemia, low serum albumin, moderately elevated aminotransferases and an exceedingly prolonged prothrombin time (PT) which was promptly shortened to normal by intravenous vitamin K. Additional investigations revealed a grossly abnormal glucose hydrogen breath test, a dilated duodenum and deficiencies of vitamins A, D and E...
June 6, 2018: BMJ Case Reports
Noel Clarke, Pawel Wiechno, Boris Alekseev, Nuria Sala, Robert Jones, Ivo Kocak, Vincenzo Emanuele Chiuri, Jacek Jassem, Aude Fléchon, Charles Redfern, Carsten Goessl, Joseph Burgents, Robert Kozarski, Darren Hodgson, Maria Learoyd, Fred Saad
BACKGROUND: Patients with metastatic castration-resistant prostate cancer and homologous recombination repair (HRR) mutations have a better response to treatment with the poly(ADP-ribose) polymerase inhibitor olaparib than patients without HRR mutations. Preclinical data suggest synergy between olaparib and androgen pathway inhibitors. We aimed to assess the efficacy of olaparib plus the androgen pathway inhibitor abiraterone in patients with metastatic castration-resistant prostate cancer regardless of HRR mutation status...
June 4, 2018: Lancet Oncology
Titilope A Adeyemo, Oyesola O Ojewunmi, Idat A Oyetunji, Helen Rooks, David C Rees, Adebola O Akinsulie, Alani S Akanmu, Swee Lay Thein, Stephan Menzel
Genetic variants at three quantitative trait loci (QTL) for fetal haemoglobin (HbF), BCL11A, HBS1L-MYB and the β-globin gene cluster, have attracted interest as potential targets of therapeutic strategies for HbF reactivation in sickle cell anaemia (SCA). We carried out the first systematic evaluation of critical single nucleotide polymorphisms at these disease modifier loci in Nigerian patients with SCA. Common variants for BCL11A and HBS1L-MYB were strongly associated with HbF levels. At both loci, secondary association signals were detected, illustrating the mapping resolution attainable in this population...
2018: PloS One
Kyoungjin Lee, Hyangkyu Lee, Jeongok Park, Sun Ha Jee
Objectives: The purpose of this study was to examine sex differences in factors associated with metabolic syndrome in Korean adults without diabetes mellitus. Study design: Cross-sectional design. Methods: The dataset of Korea National Health and Nutrition Examination Survey from 2010 to 2013 was used. Among a total of 33552 adults aged ≥30, subjects who (i) were diagnosed or had been treated for diabetes mellitus, (ii) had a fasting blood glucose level of 126 mg/dL or higher or (iii) had a glycosylated haemoglobin level of 6...
June 5, 2018: Family Practice
Ubong Bassey Akpan, Udeme Asibong, Henry Chima Okpara, Emmanuel Monjok, Saturday Etuk
BACKGROUND: Studies have shown that administration of anthelmintic drugs in pregnancy can reduce the incidence of maternal anaemia; however, data on other maternal and perinatal outcomes are limited. AIM: This study was therefore conducted to evaluate the direct impact of mass deworming on delivery and perinatal outcome. MATERIAL AND METHODS: A total of 560 healthy pregnant women in their second trimester were randomised to receive a single dose of oral mebendazole (500 mg) and placebo...
May 20, 2018: Open Access Macedonian Journal of Medical Sciences
Hongxuan Tong, Zhu Fan, Biyuan Liu, Tao Lu
FOLFIRINOX has been one of the first-line options for advanced pancreatic cancer, even though it induces significant adverse effects. Several institutions have begun using modified FOLFIRINOX to decrease its side effects and increase its tolerability. We systematically investigated the outcome from patients who initially received modified FOLFIRINOX as a chemotherapy regimen for advanced pancreatic cancer. We used the random-model generic inverse variance method to analyse the binary data with 95% confidence intervals (CIs)...
June 6, 2018: Scientific Reports
María Laura Bucalo, Carlo Barbieri, Susana Roca, Jasmine Ion Titapiccolo, Maria Soledad Ros Romero, Rosa Ramos, Mercedes Albaladejo, Diana Manzano, Flavio Mari, Manuel Molina
INTRODUCTION: Anaemia is common in haemodialysis patients and treating it with erythropoiesis-stimulating agents (ESAs) is complex due to many factors. OBJECTIVES: To assess the usefulness of the Anaemia Control Model (ACM) in the treatment of anaemia in haemodialysis. METHODS: ACM is a software that predicts the optimal dose of darbepoetin and iron sucrose to achieve target haemoglobin (Hb) and ferritin levels, and makes prescription suggestions...
June 3, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Janelisa Musaya, Enock Matovu, Edward Senga, Moffat Nyirenda, John Chisi
Background: Anaemia commonly results from destruction of erythrocytes in the peripheral blood and failure of the bone marrow haematopoietic cells to replenish the erythrocytes. The mechanisms involved in trypanosoma-induced anaemia, including the role of the bone marrow haematopoietic cells are incompletely understood. We studied the responses of a tetrapeptide, AcSDKP, and IL-10, and their association with bone marrow nucleated cells in a Trypanosoma brucei brucei GVR35 experimental infection model...
September 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
Ibukun-Oluwa Omolade Abejirinde, Renate Douwes, Azucena Bardají, Rudolf Abugnaba-Abanga, Marjolein Zweekhorst, Jos van Roosmalen, Vincent De Brouwere
BACKGROUND: Quality antenatal care (ANC) is recognised as an opportunity for screening and early identification of pregnancy-related complications. In rural Ghana, challenges with access to diagnostic services demotivate women from ANC attendance and referral compliance, leading to absent or late identification and management of high-risk women. In 2016, an integrated diagnostic and clinical decision support system tagged 'Bliss4Midwives' (B4M), was piloted in Northern Ghana. The device facilitated non-invasive screening of pre-eclampsia, gestational diabetes and anaemia at the point-of-care...
June 5, 2018: BMC Pregnancy and Childbirth
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