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itp review

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https://www.readbyqxmd.com/read/28208757/pathogenesis%C3%A2-and%C3%A2-therapeutic%C3%A2-mechanisms%C3%A2-in%C3%A2-immune%C3%A2-thrombocytopenia%C3%A2-itp
#1
REVIEW
Anne Zufferey, Rick Kapur, John W Semple
Immune thrombocytopenia (ITP) is a complex autoimmune disease characterized by low  platelet counts. The pathogenesis of ITP remains unclear although both antibody-mediated and/or  T cell-mediated platelet destruction are key processes. In addition, impairment of T cells, cytokine  imbalances, and the contribution of the bone marrow niche have now been recognized to be  important. Treatment strategies are aimed at the restoration of platelet counts compatible with  adequate hemostasis rather than achieving physiological platelet counts...
February 9, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28195872/rethinking-our-definition-of-postoperative-success-a-comparative-analysis-of-three-upper-eyelid-retraction-repair-techniques-using-novel-metrics-to-capture-functional-and-aesthetic-outcomes
#2
Jacob A Evans, Thomas J E Clark, M Bridget Zimmerman, Richard C Allen, Jeffrey A Nerad, Keith D Carter, Erin M Shriver
PURPOSE: To compare 3 upper eyelid retraction repair techniques and introduce novel metrics, which enhance the analysis of postoperative aesthetic outcomes. METHODS: Retrospective review with Image J 1.48 digital analysis of patients who underwent repair of thyroid-related upper eyelid retraction at the University of Iowa from 1996 to 2014 via 1 of 3 surgical techniques, septum-opening levator recession with Muellerectomy, modified septum-preserving levator recession with Muellerectomy, and modified septum-preserving full-thickness blepharotomy, was conducted...
February 10, 2017: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28180979/the-influence-of-isolated-thoracoplasty-on-the-evolution-of-pulmonary-function-after-treatment-of-severe-thoracic-scoliosis
#3
Heiko Koller, Tobias L Schulte, Oliver Meier, Juliane Koller, Viola Bullmann, Wolfgang Hitzl, Michael Mayer, Tobias Lange, Jens Schmücker
INTRODUCTION AND PURPOSE: Isolated thoracoplasty (iTP) on the convex side is performed long time after scoliosis surgery has been performed. ITP is thought to cause a further decline in pulmonary function (PF); however, the amount of decline is ill defined. The objectives of this study were to examine the influence of iTP on the postoperative evolution of PF and rib hump reduction in patients that previously undergone scoliosis surgery. METHODS: Over an 11-year period, 75 patients underwent iTP...
February 8, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28156637/complications-of-intrathecal-pump-therapy-in-malignancy-related-pain
#4
Egidio Del Fabbro
: 102 Background: Intrathecal pumps (ITP) are used to manage severe malignancy related pain by delivering analgesics directly into the cerebrospinal fluid, in theory allowing for a reduced opioid dose and fewer complications. Although there is literature to support efficacy in patients with cancer, including improved survival, this mode of drug delivery also carries a risk of serious complications. Reports of complications in non-malignant pain suggest the risks and mortality related to ITP may be under-appreciated and that injury and liability occur with both ITP placement and ITP maintenance...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28034281/is-there-any-role-for-splenectomy-in-adulthood-onset-chronic-immune-thrombocytopenia-in-the-era-of-tpo-receptors-agonists-a-critical-overview
#5
Vibor Milunovic, Inga Mandac Rogulj, Slobodanka Kolonic Ostojic
Immune thrombocytopenia (ITP) in adulthood is characterized by chronic relapsing course. Despite the efficacious first line treatment (corticosteroid, intravenous immunoglobulin), majority of patients will enter the chronic phase warranting another treatment approach. Until recently, splenectomy performed in ITP chronic phase represented the standard of care with long-term remissions in more than 70% of patients, but however has never been tested in clinical trials. However, with the advances of our understanding of ITP pathophysiology and the shifting focus on megakaryocyte impairment, novel drugs were introduced in treatment paradigm, mainly trombopoietin receptor agonists (TPO-RAs); romiplostim and eltrombopag...
December 29, 2016: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/28006767/a-2-year-longitudinal-prospective-study-of-the-effects-of-eltrombopag-on-bone-marrow-in-patients-with-chronic-immune-thrombocytopenia
#6
Russell K Brynes, Raymond S M Wong, Maung M Thein, Kalpana K Bakshi, Paul Burgess, Dickens Theodore, Attilio Orazi
BACKGROUND: The long-term effects of eltrombopag on bone marrow (BM) reticulin and/or collagen deposition in previously treated adults with chronic immune thrombocytopenia (ITP) were assessed. METHODS: Three BM biopsies were collected at baseline and after 1 and 2 years of eltrombopag treatment. Specimens were centrally processed, stained for reticulin and collagen, independently reviewed by 2 hematopathologists, and rated according to the European Consensus 0-3 scale of marrow fibrosis (MF)...
December 23, 2016: Acta Haematologica
https://www.readbyqxmd.com/read/27991534/efficacy-and-safety-of-thrombopoietin-receptor-agonists-in-patients-with-primary-immune-thrombocytopenia-a-systematic-review-and-meta-analysis
#7
Li Wang, Zhe Gao, Xiao-Ping Chen, Hai-Yan Zhang, Nan Yang, Fei-Yan Wang, Li-Xun Guan, Zhen-Yang Gu, Sha-Sha Zhao, Lan Luo, Hua-Ping Wei, Chun-Ji Gao
Immune thrombocytopenia (ITP) is an autoimmune disease characterized by increased platelet destruction and impaired platelet production. In this study, we conducted a systematic review and meta-analysis to determine the efficacy and safety of thrombopoietin receptor agonists (TPO-RAs) in primary ITP patients. Thirteen randomized controlled trials were included in this study, the pooled results of which demonstrated that TPO-RAs significantly increased platelet response (R) and durable response (DR) rates [risk ratio (RR): 2...
December 19, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27977588/clinical-characteristics-of-immune-thrombocytopenia-associated-with-autoimmune-disease-a-retrospective-study
#8
COMPARATIVE STUDY
Yuan Liu, Shiju Chen, Yuechi Sun, Qingyan Lin, Xining Liao, Junhui Zhang, Jiao Luo, Hongyan Qian, Lihua Duan, Guixiu Shi
To clarify clinical characteristics of immune thrombocytopenia (ITP) subsets associated with autoimmune diseases (AIDs).Five thousand five hundred twenty patients were reviewed retrospectively. One hundred four ITP patients were included for analysis. Clinical manifestations at first thrombocytopenic episode were recorded.Systemic lupus erythematosus (SLE) and primary Sjogren syndrome (pSS) accounted for a large part in AIDs associated with secondary ITP. SLE-ITP, pSS-ITP, and primary ITP (pITP) patients were different in several aspects in clinical and immunological characteristics...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27958258/case-of-twin-pregnancy-complicated-by-idiopathic-thrombocytopenic-purpura-treated-with-intravenous-immunoglobulin-review-of-the-literature
#9
W X Zhao, X F Yang, J H Lin
Idiopathic thrombocytopenic purpura (ITP) is an acquired thrombocytopenia without other clear cause of thrombocytopenia. It is not common in a singleton pregnancy and less common in twin pregnancy. We report a 33-year-old ITP pluripara whose first pregnancy was uneventful. She carried twin pregnancy, complicated by recurrent very low platelets, and gave birth to preterm twins. This patient received multiple courses of intravenous immunoglobulin (IVIG) and showed a significant platelet count improvement with IVIG therapy...
January 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/27935215/donors-with-immune-thrombocytopenia-do-they-pose-a-risk-to-transplant-recipients
#10
P B Trotter, M Robb, D Summers, C J E Watson, M Clatworthy, J A Bradley, Q A Hill, J Neuberger
Transplant-mediated alloimmune thrombocytopenia (TMAT) from donors with immune thrombocytopenia (ITP) can result in significant bleeding complications in the recipient. The risk to a recipient of TMAT if they receive an organ from a donor with ITP is unknown. The outcomes of recipients of organs from deceased donors with ITP recorded in the UK Transplant Registry between 2000 and 2015 were reviewed. Twenty-one deceased organ donors had a predonation diagnosis of ITP. These donors were significantly more likely to have died from intracranial hemorrhage than were all other deceased organ donors (85% vs...
November 7, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27895357/better-outcome-of-splenectomy-in-younger-patients-suffering-from-chronic-immune-thrombocytopenia-itp
#11
Sabah Saqib, Rizwan Sultan, Hasnain Zafar
Immune thrombocytopenia purpura (ITP) may need splenectomy after failure of medical treatment. The aim of this study was to explore the outcome of splenectomy in chronic ITP and to point out factors which can predict better response to splenectomy. This retrospective chart review was conducted at the Aga Khan University Hospital, Karachi, and comprised adult patients who underwent splenectomy for ITP from October 2005 to December 2015. Of the 51 patients, 37(72.5%) were females and 14(27.5%) were males. The overall median age was 32 years (interquartile range: 18-65 years)...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27885349/chronic-lymphocytic-leukemia-with-translocation-2-14-p16-q32-a-case-report-and-review-of-the-literature
#12
Francisco Socola, Giovanni Insuasti-Beltran, Rodolfo Henrich Lobo, Shebli Atrash, Appalanaidu Sasapu
We report the case of a young African American male with no significant past medical history presenting with low back and bilateral leg pain; presenting CBC and chemistries revealed elevated white blood cell count of 250,000, with anemia (Hb 6.8 g/dL) and thrombocytopenia (platelets 9 K/μL), and elevated LDH, 1008. Physical examination findings were notable for diffuse lymphadenopathy and lower extremity skin nodules. Interestingly the bone marrow biopsy revealed involvement by CLL/SLL with translocation (2;14)(p16;q32) and trisomy 12...
2016: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/27812394/balancing-therapy-with-thrombopoietin-receptor-agonists-and-splenectomy-in-refractory-immune-thrombocytopenic-purpura-a-case-of-postsplenectomy-thrombocytosis-requiring-plateletpheresis
#13
Jacquelyn Zimmerman, Kelly J Norsworthy, Robert Brodsky
Immune thrombocytopenic purpura (ITP) causes thrombocytopenia through the autoimmune destruction of platelets. Corticosteroids remain the first line of therapy, and traditionally splenectomy has been the second. While the availability of thrombopoietin receptor agonists (TPO-RAs) has expanded treatment options, there is little data for the ideal management of these agents in preparation for splenectomy. Thrombocytosis has been reported after splenectomy in patients treated with TPO-RA preoperatively, with one prior case requiring plateletpheresis for symptomatic thrombocytosis...
2016: Case Reports in Hematology
https://www.readbyqxmd.com/read/27807534/the-centenary-of-immune-thrombocytopenia-part-1-revising-nomenclature-and-pathogenesis
#14
REVIEW
Rita Consolini, Annalisa Legitimo, Maria Costanza Caparello
The natural history of the immune thrombocytopenia (ITP) is interesting and intriguing because it traces different steps underlying autoimmune diseases. The review points out the main steps that have accompanied the stages of its history and the consequential changes related to its terminology. ITP is an autoimmune disease resulting from platelet antibody-mediated destruction and impaired megakaryocyte and platelet production. However, research advances highlight that a complex dysregulation of the immune system is involved in the pathogenesis of this condition...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27787747/platelet-count-evolution-as-a-predictor-of-outcome-after-splenectomy-for-immune-thrombocytopenic-purpura
#15
Moonhwan Kim, Keun Myoung Park, Woo Young Shin, Yun-Mee Choe, Keon-Young Lee, Seung-Ik Ahn
Splenectomy is the definitive second-line therapy for refractory immune thrombocytopenic purpura (ITP), and has a reported response rate of 50-80%. Medical attention should be reconsidered when there is no evidence of accessory spleen in refractory ITP patients after splenectomy. The purpose of this study was to determine whether platelet count evolution differs between patients with a successful or unsuccessful result after splenectomy for ITP. Archived records of 104 consecutive patients that underwent splenectomy for ITP were reviewed...
October 27, 2016: International Journal of Hematology
https://www.readbyqxmd.com/read/27784400/-pulsed-high-dose-dexamethasone-therapy-and-its-application-in-children-with-immune-thrombocytopenia-review
#16
Ling-Ling Fu, Run-Hui Wu
Immune thrombocytopenia (ITP) is the most common immune-mediated acquired bleeding disorders in children. The prognosis of majority of these patient are well, with recent complete remission. However, a few patients are facing the risk of bleeding since they do not respond to the first-line therapy, and need second-line therapy. The present second-line treatments are difficult to be popularized due to their efficacy, side-effects, costs and some other factors. The pulsed high-dose dexamethasone (HDD) therapy with its good effect, small adverse effects and low cost in adults has been used as the first-line therapy in newly diagnosed ITP, which now has attracted the attention of pediatricians...
October 2016: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/27764999/a-fatal-case-of-transplantation-mediated-alloimmune-thrombocytopenia-following-liver-transplantation
#17
Q A Hill, L C Harrison, A D Padmakumar, R G Owen, K R Prasad, G F Lucas, P Tachtatzis
OBJECTIVE AND IMPORTANCE: Transplantation-mediated alloimmune thrombocytopenia (TMAT) occurs when leukocytes transferred in a donor organ from a patient with immune thrombocytopenia (ITP), mount a response against recipient platelets. We present the first fatal case of TMAT following liver transplantation and review its aetiology and treatment. CLINICAL PRESENTATION: The liver donor had ITP and died from an intracranial haemorrhage. The recipient platelet count fell to 2 × 10(9)/l on post-operative day 2...
October 21, 2016: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/27695216/the-role-of-laparoscopy-in-the-identification-and-management-of-missing-accessory-spleens-after-primary-splenectomy-a-case-report-and-literature-review
#18
George Vaos, Elpis Mantadakis, Stefanos Gardikis, Michael Pitiakoudis
We present a 7-year-old boy with recurrent thrombocytopenia after primary laparoscopic splenectomy for immune thrombocytopenia (ITP). Imaging modalities (ultrasound, computed tomography scan, and scintigraphy) revealed two accessory spleens while the subsequent second laparoscopy revealed 11, which were successfully removed. The relevant medical literature is reviewed, and the value of laparoscopy for chronic ITP is highlighted.
October 2016: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/27670221/advances-in-the-pathophysiology-of-primary-immune-thrombocytopenia
#19
María Perera, Teresa Garrido
OBJECTIVES: Classically, immune thrombocytopenia (ITP) was thought to be caused by the destruction and insufficient production of platelets, as mediated by autoantibodies. More recently other immune mechanisms that contribute to the disease have been discovered. This review attempts to address the main unresolved questions in ITP. METHODS: We review the most current knowledge of the pathophysiology of ITP. Immunological effects of available therapies are also described...
January 2017: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/27651973/primary-splenic-angiosarcoma-presenting-as-idiopathic-thrombocytopenic-purpura-a-case-report-and-review-of-the-literature
#20
S Christopher N Frontario, Anna Goldenberg-Sandau, Darshan Roy, Roy Sandau
Angiosarcoma of the spleen is a rare malignancy that arises from vascular endothelial origin. This neoplasm is highly malignant and diagnosis is often delayed due to the vague presentation of clinical symptoms. A case report and concise review of the current diagnostic criteria and surgical treatment are provided to aid in the detection and treatment of this malignancy. We present a case of a 56-year-old female who presented with massive splenomegaly secondary to angiosarcoma of the spleen. The patient suffered from longstanding symptomatic anemia and thrombocytopenia...
2016: Case Reports in Surgery
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