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https://www.readbyqxmd.com/read/28638625/early-eculizumab-use-in-atypical-haemolytic-uraemic-syndrome-in-a-jehovah-s-witness-refusing-blood-products
#1
May Al-Shaghana, Andrew Bentall, Mark D Jesky, William Lester, Graham Lipkin
Thrombotic microangiopathy (TMA) is characterized by microscopic angiopathic haemolytic anaemia, thrombocytopenia and organ injury. Supportive therapies include the use of blood products. Recently the terminal complement inhibitor eculizumab has been approved in atypical haemolytic uraemic syndrome (aHUS) in some countries. We report the case of a 23-year-old female Jehovah's Witness presenting with vaginal haemorrhage from thrombocytopaenia, severe anaemia (nadir Hb 28 g/L) and anuric acute kidney injury with TMA secondary to aHUS...
June 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28620089/development-and-validation-of-risk-prediction-equations-to-estimate-survival-in-patients-with-colorectal-cancer-cohort-study
#2
Julia Hippisley-Cox, Carol Coupland
Objective To develop and externally validate risk prediction equations to estimate absolute and conditional survival in patients with colorectal cancer. Design Cohort study.Setting General practices in England providing data for the QResearch database linked to the national cancer registry.Participants 44 145 patients aged 15-99 with colorectal cancer from 947 practices to derive the equations. The equations were validated in 15 214 patients with colorectal cancer from 305 different QResearch practices and 437 821 patients with colorectal cancer from the national cancer registry...
June 15, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28602181/health-outcomes-and-costs-for-injured-young-people-hospitalised-with-and-without-chronic-health-conditions
#3
Rebecca J Mitchell, Kate Curtis, Jeffrey Braithwaite
BACKGROUND: The prevalence of chronic health conditions such as diabetes among young people is increasing. Limited information is known about the impact of these conditions on young people who have been traumatically injured. Injury is the global leading cause of death and disability in young people. The aim of this study is to compare health outcomes for injured young people with and without chronic health conditions. METHOD: A retrospective examination of injury in young people aged≤25years with and without a chronic health condition using linked hospitalisation and mortality records during 1 January 2010 to 30 June 2014 in New South Wales, Australia...
June 8, 2017: Injury
https://www.readbyqxmd.com/read/28596204/malignant-hypertension-as-a-rare-cause-of-thrombotic-microangiopathy
#4
Guramrinder Thind, Karthik Kailasam
Malignant hypertension can occasionally be associated with microangiopathic haemolytic anaemia. A 38-year-old male presented with nausea, vomiting, loss of appetite and oliguria for 2 weeks. He was diagnosed with hypertensive emergency with cardiac and renal dysfunction. Interestingly, further workup was diagnostic for the presence of thrombotic microangiopathy (TMA): haemoglobin =12.7 g/dL, indirect bilirubin =2.0 mg/dL, haptoglobin ≤6 mg/dL, platelet count =121 000/μL and schistocytes on peripheral smear...
June 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28592199/diffuse-alveolar-haemorrage-as-initial-presentation-of-systemic-lupus-erythematosus-a-case-report
#5
M E Cucuzza, S D Marino, L Schiavone, P Smilari, F Filosco, P Barone
Diffuse alveolar haemorrhage (DAH) is a rare life-threatening complication of systemic lupus erythematosus (SLE), associated with high mortality rates. It usually occurs in patients with an established diagnosis of SLE. It has been reported as the initial presentation of SLE in 11-20% of cases. It occurs most frequently in females. We describe the case of a child, aged 14 years, with fever, asthenia, haemoptysis, dyspnea, anaemia, increased inflammatory markers, positivity to ANA, nDNA, direct Coombs tests, anticardiolipin antibodies and complement factors consumption...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28582636/living-with-the-burden-of-relapse-in-multiple-myeloma-from-the-patient-and-physician-perspective
#6
Cyrille Hulin, Timon Hansen, Louise Heron, Rachel Pughe, Matthew Streetly, Ananda Plate, Sue Perkins, Kate Morgan, Antoine Tinel, Filipe Rodrigues, Karthik Ramasamy
Multiple myeloma (MM) is a progressive plasma cell malignancy, with a range of clinical features including bone lesions, renal insufficiency, anaemia, and hypercalcaemia. Novel agents have significantly improved patient survival, however most patients will suffer multiple relapses. Although clinical challenges and economic costs of relapse are recognised, the psychological impact of relapse is not fully appreciated. Additionally, there is little information on how physicians perceive the impact of relapse on their patients' emotional state and how this might affect patient management...
May 31, 2017: Leukemia Research
https://www.readbyqxmd.com/read/28466968/clinical-and-genetic-predictors-of-renal-dysfunctions-in-sickle-cell-anaemia-in-cameroon
#7
Amy Geard, Gift D Pule, Bernard Chetcha Chemegni, Valentina J Ngo Bitoungui, Andre P Kengne, Emile R Chimusa, Ambroise Wonkam
Micro-albuminuria and glomerular hyperfiltration are primary indicators of renal dysfunctions in Sickle Cell Disease (SCD), with more severe manifestations previously associated with variants in APOL1 and HMOX1 among African Americans. We have investigated 413 SCD patients from Cameroon. Anthropometric variables, haematological indices, crude albuminuria, albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) were measured. Patients were genotyped for 3·7 kb alpha-globin gene (HBA1/HBA2) deletion, and for variants in APOL1 (G1/G2; rs60910145, rs73885319, rs71785313) and HMOX1 (rs3074372, rs743811)...
May 3, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28462544/efficacy-of-c-e-r-a-in-routine-clinical-practice-for-correction-of-anaemia-and-maintenance-of-the-haemoglobin-levels-in-ckd-patients-not-on-dialysis
#8
P J Promod, R Deshpande, N K Mohanty, S Kulkarni, H A Shah, A Ganju, A Kukreja, S Joshi
INTRODUCTION: C.E.R.A. reported effective correction of anaemia and was well tolerated in International studies on CKD patients not on dialysis. OBJECTIVE: The study aimed to describe the management of renal anaemia in CKD patients not on dialysis with C.E.R.A. in routine clinical practice in India. METHODS: This was a prospective, single-arm, open-label, multi-centre, non-interventional, Phase IV study which followed 108 CKD Stage III-IV patients, not on dialysis with Hb < 10 g/dL for correction of anaemia with C...
March 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28438219/adverse-drug-reactions-and-kinetics-of-cisplatin-excretion-in-urine-of-patients-undergoing-cisplatin-chemotherapy-and-radiotherapy-for-head-and-neck-cancer-a-prospective-study
#9
Marília Berlofa Visacri, Eder de Carvalho Pincinato, Graziele Baldan Ferrari, Júlia Coelho França Quintanilha, Priscila Gava Mazzola, Carmen Silvia Passos Lima, Patricia Moriel
BACKGROUND: Cisplatin is a high-potency anticancer agent; however, it causes significant adverse drug reactions (ADRs). Potential pharmacokinetic markers must be studied to predict or prevent cisplatin-induced ADRs and achieve better prognosis. This study was designed to investigate the relationship between ADRs and kinetics of cisplatin excretion in the urine of patients undergoing high-dose cisplatin chemotherapy and radiotherapy for head and neck cancer. METHODS: Outpatients with head and neck cancer received a first cycle of high-dose cisplatin chemotherapy (80-100 mg/m(2)) concurrent to radiotherapy...
April 24, 2017: Daru: Journal of Faculty of Pharmacy, Tehran University of Medical Sciences
https://www.readbyqxmd.com/read/28421565/iron-homeostasis-in-inflammation-a-single-centre-prospective-observational-study-in-medical-inpatients
#10
Carl Chrobak, Jan Adam Sidler, Alix O'Meara, Sabine Schaedelin, Balthasar L Hug
AIMS OF THE STUDY: We aimed to assess a potential association of iron status with mortality and morbidity of inpatients with systemic inflammation. METHODS: This was a single centre prospective observational study. From April 2014 to October 2014, all consecutive medical inpatients aged >=18 years with a C-reactive protein value >5 mg/l on hospital admission were eligible for the study. We excluded pregnant women and patients with terminal renal insufficiency or past allogeneic stem cell transplantation...
April 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28395880/treatment-of-metastatic-uveal-melanoma-with-adoptive-transfer-of-tumour-infiltrating-lymphocytes-a-single-centre-two-stage-single-arm-phase-2-study
#11
Smita S Chandran, Robert P T Somerville, James C Yang, Richard M Sherry, Christopher A Klebanoff, Stephanie L Goff, John R Wunderlich, David N Danforth, Daniel Zlott, Biman C Paria, Arvind C Sabesan, Abhishek K Srivastava, Liqiang Xi, Trinh H Pham, Mark Raffeld, Donald E White, Mary Ann Toomey, Steven A Rosenberg, Udai S Kammula
BACKGROUND: Uveal melanoma is a rare tumour with no established treatments once metastases develop. Although a variety of immune-based therapies have shown efficacy in metastatic cutaneous melanoma, their use in ocular variants has been disappointing. Recently, adoptive T-cell therapy has shown salvage responses in multiple refractory solid tumours. Thus, we sought to determine if adoptive transfer of autologous tumour-infiltrating lymphocytes (TILs) could mediate regression of metastatic uveal melanoma...
April 7, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28374163/carboplatin-instead-of-cisplatin-in-combination-with-dexamethasone-high-dose-cytarabine-with-or-without-rituximab-dhac-r-is-an-effective-treatment-with-low-toxicity-in-hodgkin-s-and-non-hodgkin-s-lymphomas
#12
B Tessoulin, P Thomare, E Delande, J Moynard, T Gastinne, A Moreau, C Bossard, B Mahé, N Blin, V Dubruille, C Touzeau, J S Boudreault, F Perrin, A Lok, T Guillaume, A Garnier, P Peterlin, P Gallas, P Chevallier, P Moreau, Steven Le Gouill
The DHAP regimen (high-dose cytarabine in combination with dexamethasone and cisplatin) with or without rituximab (DHAP+/-R) is one of the most common regimens in daily practice. It is considered the standard treatment for relapse or refractory Hodgkin's and non-Hodgkin's lymphoma (NHL). Cisplatin nephrotoxicity is a major concern, and other platinum compounds are being tried. We performed a monocentric retrospective analysis to evaluate the use of carboplatin, so-called DHAC+/-R regimen. The purpose was to assess the toxicity of the DHAC+/-R regimen in real-life...
April 3, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28361568/heterogeneous-impact-of-body-mass-index-on-in-hospital-mortality-in-acute-heart-failure-syndromes-an-analysis-from-the-attend-registry
#13
Akiomi Yoshihisa, Takamasa Sato, Katsuya Kajimoto, Naoki Sato, Yasuchika Takeishi
BACKGROUND: Although the obesity paradox may vary depending upon clinical background factors such as age, gender, aetiology of heart failure and comorbidities, the reasons underlying the heterogeneous impact of body mass index (BMI) on in-hospital cardiac mortality under various conditions in patients with acute heart failure syndromes (AHFSs) remain unclear. METHODS: Among 4617 hospitalised patients with AHFSs enrolled in the Acute Decompensated Heart Failure Syndromes (ATTEND) registry, the patient characteristics and in-hospital cardiac mortality rates in those with low BMI (BMI <25 kg/m(2), n = 3263) were compared to those with high BMI (BMI ⩾25 kg/m(2), n = 1354)...
March 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28357112/immunoglobulin-g4-related-disease-a-rare-steroid-responsive-disease
#14
Vorawut Thanthitaweewat, Poonchavist Chantranuwatana, Naricha Chirakalwasan
A 70-year-old man presented with progressive dyspnoea and weight loss. Physical examination revealed only mild pale conjunctiva. The workup showed mild anaemia, mild impaired renal function, and high globulin level. Multiple myeloma was excluded by normal serum protein electrophoresis. The chest radiography and computed tomography (CT) revealed bilateral multifocal patchy infiltration with mediastinal adenopathy. Bronchoscopy was performed. Bronchoalveolar lavage (BAL) fluid examination was negative for infection and malignancy...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28347544/ocular-involvement-in-atypical-haemolytic-uraemic-syndrome
#15
A Sampedro López, B Domínguez Moro, J M Baltar Martin, C Garcia Monteavaro, J J Barbón García
CASE REPORT: The case is presented of a young man with an atypical haemolytic-uraemic syndrome (aHUS), complicated with bilateral serous retinal detachment, cotton wool spots, and a branch artery occlusion. Treatment with plasmapheresis, haemodialysis and systemic eculizumab led to the blood and urine parameters returning to normal, as well as resolution of the retinal anomalies. Genetic analysis show both mutations in complement factor H and C3. DISCUSSION: Haemolytic-uraemic syndrome (HUS) is a thrombotic microangiopathy characterised by microangiopathic haemolytic anaemia, thrombocytopenia, and acute renal failure...
March 24, 2017: Archivos de la Sociedad Española de Oftalmología
https://www.readbyqxmd.com/read/28339660/eculizumab-in-secondary-atypical-haemolytic-uraemic-syndrome
#16
Teresa Cavero, Cristina Rabasco, Antía López, Elena Román, Ana Ávila, Ángel Sevillano, Ana Huerta, Jorge Rojas-Rivera, Carolina Fuentes, Miquel Blasco, Ana Jarque, Alba García, Santiago Mendizabal, Eva Gavela, Manuel Macía, Luis F Quintana, Ana María Romera, Josefa Borrego, Emi Arjona, Mario Espinosa, José Portolés, Carolina Gracia-Iguacel, Emilio González-Parra, Pedro Aljama, Enrique Morales, Mercedes Cao, Santiago Rodríguez de Córdoba, Manuel Praga
Background: Complement dysregulation occurs in thrombotic microangiopathies (TMAs) other than primary atypical haemolytic uraemic syndrome (aHUS). A few of these patients have been reported previously to be successfully treated with eculizumab. Methods: We identified 29 patients with so-called secondary aHUS who had received eculizumab at 11 Spanish nephrology centres. Primary outcome was TMA resolution, defined by a normalization of platelet count (>150 × 10 9 /L) and haemoglobin, disappearance of all the markers of microangiopathic haemolytic anaemia (MAHA), and improvement of renal function, with a ≥25% reduction of serum creatinine from the onset of eculizumab administration...
March 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28291603/proliferative-kidney-disease-in-rainbow-trout-oncorhynchus-mykiss-under-intensive-breeding-conditions-pathogenesis-and-haematological-and-immune-parameters
#17
Miroslava Palikova, Ivana Papezikova, Zdenka Markova, Stanislav Navratil, Jan Mares, Lukas Mares, Libor Vojtek, Pavel Hyrsl, Eva Jelinkova, Heike Schmidt-Posthaus
Proliferative kidney disease (PKD) is an endoparasitic disease of salmonid fish caused by Tetracapsuloides bryosalmonae (Myxozoa: Malacosporea). This study presents a comprehensive view on PKD development in rainbow trout (Oncorhynchus mykiss) reared at an intensive fish breeding facility, with focus on mortality, pathology/histopathology, haematological findings and immune functions. Diseased and reference fish were sampled monthly and time course of natural infection was followed up from the onset of clinical signs (September 2014) to full recovery (January 2015)...
March 6, 2017: Veterinary Parasitology
https://www.readbyqxmd.com/read/28272834/urate-oxidase-for-the-prevention-and-treatment-of-tumour-lysis-syndrome-in-children-with-cancer
#18
REVIEW
Daniel Kl Cheuk, Alan Ks Chiang, Godfrey Cf Chan, Shau Yin Ha
BACKGROUND: Tumour lysis syndrome (TLS) is a serious complication of malignancies and can result in renal failure or death. Previous reviews did not find clear evidence of benefit of urate oxidase in children with cancer. This review is the second update of a previously published Cochrane review. OBJECTIVES: To assess the effects and safety of urate oxidase for the prevention and treatment of TLS in children with malignancies. SEARCH METHODS: In March 2016 we searched CENTRAL, MEDLINE, Embase, and CINAHL...
March 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28237973/modulatory-effects-of-melatonin-and-vitamin%C3%A2-%C3%A2-c-on-oxidative-stress-mediated-haemolytic-anaemia-and-associated-cardiovascular-dysfunctions-in-rats
#19
Temitayo Olabisi Ajibade, Ademola Adetokunbo Oyagbemi, Ladoke A Durotoye, Temidayo Olutayo Omóbòwálé, Ebunoluwa Racheal Asenuga, Funsho Olakitike Olayemi
Background Phenylhydrazine (PHE) in experimental animal models has been widely reported to cause haemolytic anaemia, via the induction of oxidative stress and thus causing deleterious cardiovascular complications. Hence, this study was designed to evaluate the possible modulatory role of melatonin (MLT) or vitamin C when co-administered with PHE. Methods Anaemia was established with PHE administration. MLT or vitamin C was co-administered with PHE. Haematological parameters, markers of oxidative stress, enzymic and non-enzymic antioxidants, blood pressure and electrocardiograms were assessed...
March 1, 2017: Journal of Complementary & Integrative Medicine
https://www.readbyqxmd.com/read/28237970/clinical-predictors-of-length-of-stay-in-adults-with-congenital-heart-disease
#20
Ari Cedars, Lawrence Benjamin, Sara V Burns, Eric Novak, Amit Amin
OBJECTIVE: Length of stay (LOS) is a major driver of inpatient care costs. To date, few studies have investigated risk factors associated with increased LOS in patients with adult congenital heart disease (ACHD). In the present work, we sought to address this knowledge gap. METHODS: We conducted an analysis of the State Inpatient Databases from Arkansas, California, Florida, Hawaii, Nebraska and New York. We analysed data on admissions in patients with ACHD and constructed a series of hierarchical regression models to identify the clinical factors having the greatest effects on LOS...
February 25, 2017: Heart: Official Journal of the British Cardiac Society
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