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Sample records for anaemia undergoing radiotherapy

  1. Anaemia and radiation therapy; Anemie et radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Denis, F. [Clinique d' Oncologie et de Radiotherapie, INSERM U619, 37 - Tours (France); Lartigau, E. [Centre de Lutte Contre le Cancer Oscar-Lambret, Dept. de Radiotherapie, 59 - Lille (France)

    2004-11-01

    Anaemia is frequent in cancer and may increase tumour hypoxia that stimulates angiogenesis. However, erythropoietin is a hypoxia-inducible stimulator of erythropoiesis which seems to improve quality of life in cancer patients. Two recent phase III randomized studies showed negative results using erythropoietin in head and neck cancer patients and in metastatic breast cancer patients with impaired specific survival. In vitro and in vivo experiments have provided erythropoietin-receptor expression in endothelial cancer cells including malignant tumours of the breast, prostate, cervix, lung, head and neck, ovary, melanoma, stomach, gut, kidney etc. Biologic effect of erythropoietin and its receptor linkage induces proliferation of human breast cancer and angiogenesis and may limit anti-tumour effect of cancer treatment, in part, by tumour vascularization improvement. In addition, the use of exogenous erythropoietin could be able to favour tumour progression by improving tumour oxygenation and nutriment supply. If erythropoietin receptor were functional in human cancer. the assessment of erythropoietin receptor expression on tumour cell may help to select patients benefiting from exogenous erythropoietin. However. the relationship between erythropoietin receptor expression, tumour growth and exogenous erythropoietin. requires more studies. The results of recent clinical trials suggest that using erythropoietin should be avoided in non-anemic patients and discussed in patients receiving curative therapy. (authors)

  2. The prevalence of iron deficiency anaemia in patients undergoing bariatric surgery.

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    Khanbhai, M; Dubb, S; Patel, K; Ahmed, A; Richards, T

    2015-01-01

    As bariatric surgery rates continue to climb, anaemia will become an increasing concern. We assessed the prevalence of anaemia and length of hospital stay in patients undergoing bariatric surgery. Prospective data (anaemia [haemoglobin bariatric surgery. Results from a prospective database of 1530 patients undergoing elective general surgery were used as a baseline. Fifty-seven patients (14%) were anaemic pre-operatively, of which 98% were females. Median MCV (fL) and overall median ferritin (μg/L) was lower in anaemic patients (83 vs. 86, p=0.001) and (28 vs. 61, psurgery patients, prevalence of anaemia was similar (14% vs. 16%) but absolute iron deficiency was more common in those undergoing bariatric surgery; microcytosis pbariatric surgery. In bariatric patients with anaemia there was an overall increased length of hospital stay.

  3. Care of patients undergoing external radiotherapy

    International Nuclear Information System (INIS)

    The anxiety and associated depression suffered by most patients undergoing radiotherapy is discussed and the possibilities open to the nurse to encourage and reassure patients thus facilitating physical care are considered. The general symptoms of anorexia, nausea, tiredness, skin problems, alopecia, bonemarrow depresssion and rapid tumour destruction are described and nursing care prescribed. The side-effects which may occur following radiation of the brain, head and neck region, eyes, oesophagus, lung, abdomen, pelvis, bones, skin, spine, and spinal cord are considered from the nursing standpoint. The specialised subject of radiotherapy in children is discussed briefly. (U.K.)

  4. Spur cell anaemia and hepatic iron stores in patients with alcoholic liver disease undergoing orthotopic liver transplantation

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    Pascoe, A; Kerlin, P; Steadman, C; Clouston, A; Jones, D.; Powell, L; Jazwinska, E; Lynch, S; Strong, R

    1999-01-01

    BACKGROUND—Following orthotopic liver transplantation (OLT) histological examination of explant livers from patients with alcoholic liver disease (ALD) sometimes shows extensive iron deposits in a distribution suggestive of homozygous haemochromatosis.
AIMS—To use haemochromatosis gene (HFE) assays to distinguish between ALD with notable siderosis and hereditary haemochromatosis. To evaluate the possible influence of spur cell haemolytic anaemia on hepatic iron loading.
PATIENTS—Thirty seven ...

  5. Examining Mediators and Moderators of Yoga for Women With Breast Cancer Undergoing Radiotherapy.

    Science.gov (United States)

    Ratcliff, Chelsea G; Milbury, Kathrin; Chandwani, Kavita D; Chaoul, Alejandro; Perkins, George; Nagarathna, Raghuram; Haddad, Robin; Nagendra, Hongasandra Ramarao; Raghuram, N V; Spelman, Amy; Arun, Banu; Wei, Qi; Cohen, Lorenzo

    2016-09-01

    Hypothesis This study examines moderators and mediators of a yoga intervention targeting quality-of-life (QOL) outcomes in women with breast cancer receiving radiotherapy.Methods Women undergoing 6 weeks of radiotherapy were randomized to a yoga (YG; n = 53) or stretching (ST; n = 56) intervention or a waitlist control group (WL; n = 54). Depressive symptoms and sleep disturbances were measured at baseline. Mediator (posttraumatic stress symptoms, benefit finding, and cortisol slope) and outcome (36-item Short Form [SF]-36 mental and physical component scales [MCS and PCS]) variables were assessed at baseline, end-of-treatment, and 1-, 3-, and 6-months posttreatment. Results Baseline depressive symptoms (P = .03) and sleep disturbances (P Yoga may provide the greatest mental-health-related QOL benefits for those experiencing pre-radiotherapy sleep disturbance and depressive symptoms. Yoga may improve physical-health-related QOL by increasing ability to find benefit in the cancer experience. PMID:26867802

  6. A national survey of supportive practices for patients undergoing radiotherapy for oral cancers

    International Nuclear Information System (INIS)

    Purpose: Xerostomia and mucositis are two of the main radiation induced toxicities experienced by patients undergoing radiotherapy to the oral cavity. These toxicities can lead to significant weight loss with the potential to cause complications with radiotherapy treatment. Literature has shown that nutritional intervention can help to minimise these side effects. The aim of the survey was to explore current practice across the UK in nutritional intervention for these patients. Method: Postal questionnaires were sent to all 63 radiotherapy departments in the UK in November 2009. Results: 29 responses (43%) were received. 90% (n = 26) of the departments used 3D-Conformal radiotherapy (3D-CRT) as the main technique for treatment of these patients, with 48% (n = 14) of departments having implemented Intensity modulated radiotherapy (IMRT). All departments referred their patients to a dietician. 93% (n = 27) of departments placed percutaneous endoscopic gastrostomy or radiologically-inserted gastrostomy tubes. 55% (n = 16) departments administered nasogastric tubes. Conclusion: This survey verified many common practices regarding dietary care and advice, some variation was evident in the use of feeding tubes. All responding centres referred patients to a dietician with the aim to maintain nutritional status and prevent weight loss that could contribute to uncertainty in treatment setup. This survey also demonstrated that since Macknelly and Day's (2009) study, a greater number of centres have implemented IMRT for patients undergoing radiotherapy to the head and neck. Although IMRT has been shown to reduce xerostomia, this audit found no changes in the dietary care and advice given to these patients

  7. A prospective analysis of factors that influence weight loss in patients undergoing radiotherapy

    Institute of Scientific and Technical Information of China (English)

    Jon Cacicedo; Francisco Casquero; Lorea Martinez-Indart; Olga del Hoyo; Alfonso Gomez de Iturriaga; Arturo Navarro; Pedro Bilbao

    2014-01-01

    Malnutrition occurs frequently in patients with cancer. Indeed, a variety of nutritional and tumor-related factors must be taken into account in these patients. Recognizing this relationship, we aimed to prospectively evaluate the risk factors that influence weight loss in patients undergoing radiotherapy with oral nutritional supplementation and dietetic counseling. Weight loss of 74 patients during radiotherapy and 1 month after treatment was analyzed. Parameters such as age, gender, tumor location, tumor stage, Eastern Cooperative Oncology Group performance status (ECOG PS) score, and the use of chemotherapy were analyzed to evaluate their influence on weight loss. All patients underwent oral nutritional supplementation and dietetic counseling. Forty-six (65.7%) patients lost weight, with a mean weight loss of (4.73 ± 3.91) kg, during radiotherapy. At 1 month after treatment, 45 (66.2%) patients lost weight, presenting a mean weight loss of (4.96 ± 4.04) kg, corresponding to a (6.84 ± 5.24)% net reduction from their baseline weight. Head and neck cancer patients had a mean weight loss of (3.25 ± 5.30) kg, whereas the remaining patients had a mean weight loss of (0.64 ± 2.39) kg (P=0.028) during radiotherapy. In the multivariate analysis, the head and neck tumor location (P = 0.005), use of chemotherapy (P = 0.011), and ECOG PS score of 2-3 (P = 0.026) were considered independent risk factors. Nutritional status and parameters, such as tumor location (especially the head and neck), the use of chemotherapy, and the ECOG PS score, should be evaluated before radiotherapy because these factors can influence weight loss during radiotherapy and 1 month after treatment.

  8. A prospective analysis of factors that influence weight loss in patients undergoing radiotherapy.

    Science.gov (United States)

    Cacicedo, Jon; Casquero, Francisco; Martinez-Indart, Lorea; del Hoyo, Olga; Gomez de Iturriaga, Alfonso; Navarro, Arturo; Bilbao, Pedro

    2014-04-01

    Malnutrition occurs frequently in patients with cancer. Indeed, a variety of nutritional and tumor-related factors must be taken into account in these patients. Recognizing this relationship, we aimed to prospectively evaluate the risk factors that influence weight loss in patients undergoing radiotherapy with oral nutritional supplementation and dietetic counseling. Weight loss of 74 patients during radiotherapy and 1 month after treatment was analyzed. Parameters such as age, gender, tumor location, tumor stage, Eastern Cooperative Oncology Group performance status (ECOG PS) score, and the use of chemotherapy were analyzed to evaluate their influence on weight loss. All patients underwent oral nutritional supplementation and dietetic counseling. Forty-six (65.7%) patients lost weight, with a mean weight loss of (4.73 ± 3.91) kg, during radiotherapy. At 1 month after treatment, 45 (66.2%) patients lost weight, presenting a mean weight loss of (4.96 ± 4.04) kg, corresponding to a (6.84 ± 5.24)% net reduction from their baseline weight. Head and neck cancer patients had a mean weight loss of (3.25 ± 5.30) kg, whereas the remaining patients had a mean weight loss of (0.64 ± 2.39) kg (P = 0.028) during radiotherapy. In the multivariate analysis, the head and neck tumor location (P = 0.005), use of chemotherapy (P = 0.011), and ECOG PS score of 2-3 (P = 0.026) were considered independent risk factors. Nutritional status and parameters, such as tumor location (especially the head and neck), the use of chemotherapy, and the ECOG PS score, should be evaluated before radiotherapy because these factors can influence weight loss during radiotherapy and 1 month after treatment.

  9. New perspectives in the nursing role in cancer patients undergoing radiotherapy

    Directory of Open Access Journals (Sweden)

    Lavdaniti M.

    2012-01-01

    Full Text Available Introduction: Cancer is the second leading cause of death worldwide and the radiotherapy is one of the types of cancer treatment. It is calculated that more than half of all people with cancer will undergoing radiotherapy as at least part of their cancer treatment. Purpose: The purpose of the present study was the description of role of nurse in radiation oncology. Method: Literature review of the relevant articles in the databases pubmed and scopus was conducted, but also were used articles of international professional nursing organizations Results: The radiation oncology nursing role is multidimensional and is focused in patient assessment, patient and family education, support and counselling, physical care of patient and in the research. The patient’s care is mainly focused in the conducting of suitable nursing interventions that will alleviate the patient from the side effects of radiotherapy. Conclusions: The nurses should be known the technologies that are used in the radiotherapy so that they are enable to educate their patients and provide qualitative nursing care. Changes in the health care environment and changes in treatment and technology continue to drive cancer care. So nurses should collaborate and communicate with other members of interdisciplinary team and incorporate evidence into practice

  10. Management of anemia in patients undergoing curative radiotherapy. Erythropoietin, transfusions, or better nothing?

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    Dunst, J. [Dept. of Radiotherapy, Martin Luther Univ. Halle-Wittenberg, Halle (Germany)

    2004-11-01

    Background and results: anemia is a well-known risk factor for decreased local control and survival in patients undergoing curative radiotherapy. There is clear evidence from recent clinical investigations that anemia is an independent risk factor and hemoglobin (Hb) levels during radiotherapy are important (and not pretreatment Hb levels). The most likely explanation for the prognostic impact is the association with tumor hypoxia. An ''optimal'' Hb range with regard to tumor oxygenation seems to exist, and Hb levels < 11 g/dl and > {proportional_to}15 g/dl impair tumor oxygenation but have (over a broader range) no significant impact on normal tissue oxygenation. There is some evidence from retrospective and prospective studies that the response to radiotherapy and the prognosis, especially in cervical cancers, might be improved if the Hb levels during radiotherapy can be maintained in the optimal range, either by transfusions or by erythropoietin. The effect of any antianemic therapy should be analyzed according to whether or not treatment was successful with regard to achieving optimal Hb levels during irradiation. Erythropoietin is probably more effective in steadily increasing and stabilizing Hb levels, but bears the risk of overcorrection of Hb levels. The clinical relevance of erythropoietin receptors on tumor cells remains questionable. Conclusions: treatment of anemia with the objective of improving local control and survival in radiotherapy patients is probably more difficult and sophisticated than coping with symptoms of anemia or improving quality of life. Nevertheless, the potential of antianemic treatment is high on the basis of experimental and clinical data, and further clinical trials are warranted. (orig.)

  11. Daily electronic portal imaging of implanted gold seed fiducials in patients undergoing radiotherapy after radical prostatectomy

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to measure interfraction prostate bed motion, setup error, and total positioning error in 10 consecutive patients undergoing postprostatectomy radiotherapy. Methods and Materials: Daily image-guided target localization and alignment using electronic portal imaging of gold seed fiducials implanted into the prostate bed under transrectal ultrasound guidance was used in 10 patients undergoing adjuvant or salvage radiotherapy after prostatectomy. Prostate bed motion, setup error, and total positioning error were measured by analysis of gold seed fiducial location on the daily electronic portal images compared with the digitally reconstructed radiographs from the treatment-planning CT. Results: Mean (± standard deviation) prostate bed motion was 0.3 ± 0.9 mm, 0.4 ± 2.4 mm, and -1.1 ± 2.1 mm in the left-right (LR), superior-inferior (SI), and anterior-posterior (AP) axes, respectively. Mean set-up error was 0.1 ± 4.5 mm, 1.1 ± 3.9 mm, and -0.2 ± 5.1 mm in the LR, SI, and AP axes, respectively. Mean total positioning error was 0.2 ± 4.5 mm, 1.2 ± 5.1 mm, and -0.3 ± 4.5 mm in the LR, SI, and AP axes, respectively. Total positioning errors >5 mm occurred in 14.1%, 38.7%, and 28.2% of all fractions in the LR, SI, and AP axes, respectively. There was no significant migration of the gold marker seeds. Conclusions: This study validates the use of daily image-guided target localization and alignment using electronic portal imaging of implanted gold seed fiducials as a valuable method to correct for interfraction target motion and to improve precision in the delivery of postprostatectomy radiotherapy

  12. Examining Mediators and Moderators of Yoga for Women With Breast Cancer Undergoing Radiotherapy.

    Science.gov (United States)

    Ratcliff, Chelsea G; Milbury, Kathrin; Chandwani, Kavita D; Chaoul, Alejandro; Perkins, George; Nagarathna, Raghuram; Haddad, Robin; Nagendra, Hongasandra Ramarao; Raghuram, N V; Spelman, Amy; Arun, Banu; Wei, Qi; Cohen, Lorenzo

    2016-09-01

    Hypothesis This study examines moderators and mediators of a yoga intervention targeting quality-of-life (QOL) outcomes in women with breast cancer receiving radiotherapy.Methods Women undergoing 6 weeks of radiotherapy were randomized to a yoga (YG; n = 53) or stretching (ST; n = 56) intervention or a waitlist control group (WL; n = 54). Depressive symptoms and sleep disturbances were measured at baseline. Mediator (posttraumatic stress symptoms, benefit finding, and cortisol slope) and outcome (36-item Short Form [SF]-36 mental and physical component scales [MCS and PCS]) variables were assessed at baseline, end-of-treatment, and 1-, 3-, and 6-months posttreatment. Results Baseline depressive symptoms (P = .03) and sleep disturbances (P < .01) moderated the Group × Time effect on MCS, but not PCS. Women with high baseline depressive symptoms in YG reported marginally higher 3-month MCS than their counterparts in WL (P = .11). Women with high baseline sleep disturbances in YG reported higher 3-months MCS than their counterparts in WL (P < .01) and higher 6-month MCS than their counterparts in ST (P = .01). YG led to greater benefit finding than ST and WL across the follow-up (P = .01). Three-month benefit finding partially mediated the effect of YG on 6-month PCS. Posttraumatic stress symptoms and cortisol slope did not mediate treatment effect on QOL. Conclusion Yoga may provide the greatest mental-health-related QOL benefits for those experiencing pre-radiotherapy sleep disturbance and depressive symptoms. Yoga may improve physical-health-related QOL by increasing ability to find benefit in the cancer experience.

  13. Anti-emetic effect of granisetron in patients undergoing cranial and craniospinal radiotherapy

    International Nuclear Information System (INIS)

    Approximately 30-59% of patients undergoing cranial or craniospinal radiotherapy experience nausea and/or vomiting. Here, we evaluated the effectiveness of granisetron for controlling emesis in patients treated with cranial or craniospinal radiotherapy. Between December 2011 and January 2013, 34 patients (19 males, 15 females; age range, 3-80 years) received cranial or craniospinal radiotherapy at our department. All but one male patient, who developed meningitis during the irradiation period were enrolled in this retrospective study. Patients who experienced irradiation-induced vomiting (grade 1) or nausea (grade 2) were treated with granisetron as a rescue anti-emetic. Episodes were graded as no vomiting, no nausea, no anti-emetic; no vomiting, nausea, no anti-emetic; no vomiting, nausea with anti-emetic; and vomiting. Of the 9 patients who underwent whole-brain or whole neural-axis irradiation, 5 (55.6%) experienced grade 2 nausea or vomiting. Two of 6 patients (33.3%) treated with whole ventricle irradiation experienced grade 2 nausea or vomiting. Three of 18 patients (16.7%) who underwent local-field irradiation experienced grade 2 nausea or vomiting. Patients who underwent wide-field irradiation experienced nausea, vomiting, and anorexia (p<0.05). Complete response (no vomiting, no additional rescue anti-emetic, and no nausea) was observed in 5 of 9 patients treated with granisetron. Four of 9 patients (44.4%) treated with granisetron experienced constipation (grade 1 or 2); its administration had no major adverse effects in our study population. Rescue therapy with granisetron is safe and effective to treat nausea and vomiting in patients subjected to cranial or craniospinal irradiation. (author)

  14. Fatigue and Quality of Life of Women Undergoing Chemotherapy or Radiotherapy for Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    Winnie K.W.So; Gene Marsh; W.M.Ling; F.E Leung; Joe C.K.Lo; Maggie Yeung; George K.H.Li

    2009-01-01

    OBJECTIVE To examine fatigue and quality of life (QOL) in breast cancer patients undergoing chemotherapy or radiotherapy.METHODS A self-report survey derived from the Chinese version of Brief Fatigue Inventory, the Functional Assessment of Chronic Illness Therapy for Breast Cancer, and the Medical Outcomes Study Social Support Survey. Descriptive statistics was used to examine the intensity of fatigue and the prevalence of severe fatigue. Multivariate analysis of variance was used to determine factors that affect the five domains of QOL among the participants.RESULTS The majority of the participants (n = 261) perceived a mild level of fatigue, but 35.6% of them suffered severe fatigue. Fatigue had a significantly negative association with all domains of QOL except social/family wellbeing. The participants who were receiving chemotherapy, undergoing curative treatment and having inadequate social support were more likely to have poorer QOL in all five domains (after adjustment for age).CONCLUSION Although the majority of the participants experienced a mild level of fatigue, there was a substantial group of breast cancer patients who perceived their fatigue as severe. The findings of this study showed that fatigue had a detrimental effect on the various aspects of the participants'QOL. Demographic and clinical characteristics of breast cancer patients who were at risk of getting poorer QOL were identified. The results of the study demonstrate that we should enhance healthcare professionals' awareness of the importance of symptom assessment, and provide them with information for planning effective symptom-management strategies among this study population.

  15. Application of alanine dosimetry in dose assessment for ocular melanoma patients undergoing proton radiotherapy – preliminary results

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    Mierzwińska Gabriela

    2015-09-01

    Full Text Available Basing on alanine solid state/electron paramagnetic resonance (EPR dosimetry, a supplementary method of cumulatively recording the therapeutic dose received by ocular cancer patients undergoing fractionated proton radiotherapy is proposed. By applying alanine dosimetry during the delivery of consecutive fractions, the dose received within each fraction can be read out by EPR spectrometry and a final permanent cumulative record of the total dose delivered obtained. The dose response of the alanine detector was found to be practically independent on its position within the extended proton Bragg peak region. Dose measurements based on entrance dose recorded in proton beams individually formed for each patient are presented. The described method will be applied as a complementary Quality Assurance procedure for patients undergoing proton radiotherapy at the Institute of Nuclear Physics, Polish Academy of Sciences, Krakow, Poland (IFJ PAN.

  16. Prognostic factors, patterns of recurrence and toxicity for patients with esophageal cancer undergoing definitive radiotherapy or chemo-radiotherapy

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the effectiveness and tolerability of definitive chemo-radiation or radiotherapy alone in patients with esophageal cancer. We retrospectively analyzed the medical records of n = 238 patients with squamous cell carcinoma or adenocarcinoma of the esophagus treated with definitive radiotherapy with or without concomitant chemotherapy at our institution between 2000 and 2012. Patients of all stages were included to represent actual clinical routine. We performed univariate and multivariate analysis to identify prognostic factors for overall survival (OS) and progression-free survival (PFS). Moreover, treatment-related toxicity and patterns of recurrence were assessed. Patients received either chemo-radiation (64%), radiotherapy plus cetuximab (10%) or radiotherapy alone (26%). In 69%, a boost was applied, resulting in a median cumulative dose of 55.8 Gy; the remaining 31% received a median total dose of 50 Gy. For the entire cohort, the median OS and PFS were 15.0 and 11.0 months, respectively. In multivariate analysis, important prognostic factors for OS and PFS were T stage (OS: P = 0.005; PFS: P = 0.006), M stage (OS: P = 0.015; PFS: P = 0.003), concomitant chemotherapy (P < 0.001) and radiation doses of >55 Gy (OS: P = 0.019; PFS: P = 0.022). Recurrences occurred predominantly as local in-field relapse or distant metastases. Toxicity was dominated by nutritional impairment (12.6% with G3/4 dysphagia) and chemo-associated side effects. Definitive chemo-radiation in patients with esophageal cancer results in survival rates comparable with surgical treatment approaches. However, local and distant recurrence considerably restrict prognosis. Further advances in radio-oncological treatment strategies are necessary for improving outcome. (author)

  17. Prospective evaluation of quality of life effects in patients undergoing palliative radiotherapy for brain metastases

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    Steinmann Diana

    2012-07-01

    Full Text Available Abstract Background Recently published results of quality of life (QoL studies indicated different outcomes of palliative radiotherapy for brain metastases. This prospective multi-center QoL study of patients with brain metastases was designed to investigate which QoL domains improve or worsen after palliative radiotherapy and which might provide prognostic information. Methods From 01/2007-01/2009, n=151 patients with previously untreated brain metastases were recruited at 14 centers in Germany and Austria. Most patients (82 % received whole-brain radiotherapy. QoL was measured with the EORTC-QLQ-C15-PAL and brain module BN20 before the start of radiotherapy and after 3 months. Results At 3 months, 88/142 (62 % survived. Nine patients were not able to be followed up. 62 patients (70.5 % of 3-month survivors completed the second set of questionnaires. Three months after the start of radiotherapy QoL deteriorated significantly in the areas of global QoL, physical function, fatigue, nausea, pain, appetite loss, hair loss, drowsiness, motor dysfunction, communication deficit and weakness of legs. Although the use of corticosteroid at 3 months could be reduced compared to pre-treatment (63 % vs. 37 %, the score for headaches remained stable. Initial QoL at the start of treatment was better in those alive than in those deceased at 3 months, significantly for physical function, motor dysfunction and the symptom scales fatigue, pain, appetite loss and weakness of legs. In a multivariate model, lower Karnofsky performance score, higher age and higher pain ratings before radiotherapy were prognostic of 3-month survival. Conclusions Moderate deterioration in several QoL domains was predominantly observed three months after start of palliative radiotherapy for brain metastases. Future studies will need to address the individual subjective benefit or burden from such treatment. Baseline QoL scores before palliative radiotherapy for brain metastases may

  18. Influence of preventive dental treatment on mutans streptococci counts in patients undergoing head and neck radiotherapy

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    Lívia Buzati Meca

    2009-01-01

    Full Text Available The aim of this study was to evaluate the influence of chlorhexidine gluconate, sodium fluoride and sodium iodine on mutans streptococci counts in saliva of irradiated patients. MATERIAL AND METHODS: Forty-five patients were separated into three experimental groups and received chlorhexidine (0.12%, sodium fluoride (0.5% or sodium iodine (2%, which were used daily during radiotherapy and for 6 months after the conclusion of the treatment. In addition, a fourth group, composed by 15 additional oncologic patients, who did not receive the mouthwash or initial dental treatment, constituted the control group. Clinical evaluations were performed in the first visit to dental clinic, after initial dental treatment, immediately before radiotherapy, after radiotherapy and 30, 60, 90 days and 6 months after the conclusion of radiotherapy. After clinical examinations, samples of saliva were inoculated on SB20 selective agar and incubated under anaerobiosis, at 37ºC for 48 h. Total mutans streptococci counts were also evaluated by using real-time PCR, through TaqMan system, with specific primers and probes for S. mutans and S. sobrinus. RESULTS: All preventive protocols were able to reduce significantly mutans streptococci counts, but chlorhexidine gluconate was the most effective, and induced a significant amelioration of radiotherapy side effects, such as mucositis and candidosis. CONCLUSION: These results highlights the importance of the initial dental treatment for patients who will be subjected to radiotherapy for head and neck cancer treatment.

  19. Management of predictable pain using fentanyl pectin nasal spray in patients undergoing radiotherapy

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    Bell BC

    2013-12-01

    Full Text Available Brent C Bell, E Brian Butler Department of Radiation Oncology, Houston Methodist Hospital, The Texas Medical Center, Houston, TX, USA Background: Studies report the need for improved pain management in the radiation oncology setting. Many patients with well controlled background pain experience breakthrough pain in cancer (BTPc that can interrupt their treatment schedule with a potentially negative impact on outcomes. BTPc can be unpredictable and predictable; both types of pain can be managed with fast-acting analgesics, but predictable pain lends itself to anticipatory management. Methods: Five consecutive cases are described in which fentanyl pectin nasal spray (FPNS was used to manage BTPc, with an emphasis on the anticipatory management of predictable pain in cancer patients receiving radiotherapy. Results: Patients (four men, one woman, age range 32–84 years, were diagnosed with various cancers. All patients were receiving opioid treatment for chronic pain, and experienced predictable pain with radiotherapy which included pain associated with lying on a treatment table for a sustained time during an average of 29 radiotherapy treatments; pain associated with radiation simulation and radiotherapy; pain associated with odynophagia related to increasing mucositis during treatment, resulting in decreased nutritional intake; pain associated with the customized immobilization mask for head and neck cancer patients; and pain associated with defecation. Some patients also reported pain awakening them randomly at night (eg, sleep interruption. All patients attained lower pain intensity scores (2/10 to 3/10, reduced from approximately 7/10, when they were treated with FPNS 20 minutes before a predictable pain event. No patient experienced any pain-related interruptions to their course of radiotherapy. The average number of radiotherapy sessions was 29 per patient, excluding one short-course treatment for one patient. Conclusion: FPNS offers a good

  20. Assessment of Olfactory Threshold in Patients Undergoing Radiotherapy for Head and Neck Malignancies

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    Mir Mohammad Jalali

    2014-10-01

    Conclusion:  Deterioration in olfactory threshold scores was found at 6 months after initiation of radiation therapy. Provided that these results are reproducible, an evaluation of olfactory functioning in patients with head and neck malignancies using in vivo dosimetry may be useful for determining the optimal dose for patients treated with conformal radiotherapy techniques while avoiding the side effects of radiation.

  1. Proteome data of whole saliva which are associated with development of oral mucositis in head and neck cancer patients undergoing radiotherapy.

    Science.gov (United States)

    Jehmlich, Nico; Stegmaier, Petra; Golatowski, Claas; Salazar, Manuela Gesell; Rischke, Christian; Henke, Michael; Völker, Uwe

    2016-09-01

    Saliva as major human body fluid may act as an indicator of oral disease status. Oral mucositis is a common and often treatment-limiting side effect of radiotherapy for head and neck cancer patients. In this dataset, we provide the complete proteome dataset (raw and search files) of the patients at baseline of radiotherapy treatment in patients undergoing radiotherapy analyzed by nano liquid chromatography coupled to mass spectrometry (LC-MS/MS). In the data set, 5323 tryptic peptides were identified which can be assigned to 487 distinct proteins (≥2 peptides). The MS data have been deposited to the ProteomeXchange ("ProteomeXchange provides globally coordinated proteomics data submission and dissemination" [1]) via the PRIDE partner repository with the dataset identifier PRIDE: PXD003230. The data are associated with the previously published work, "Differences in the whole saliva baseline proteome profile associated with development of oral mucositis in head and neck cancer patients undergoing radiotherapy" [2]. PMID:27358911

  2. Incidence of pneumonia and risk factors among patients with head and neck cancer undergoing radiotherapy

    International Nuclear Information System (INIS)

    This study investigated the incidence and patient- and treatment-related risk factors related to pneumonia acquired during radiotherapy (PNRT) in head and neck cancer (HNC) patients. Using the universal insurance claims data, 15,894 total HNC patients between 1998 and 2007 were included in this analysis. PNRT was defined as the occurrence of pneumonia within 90 days of the commencement of radiotherapy. Information also included some demographic characteristics, treatment-related factors, and comorbidities. Appropriate statistical tests were performed to assess the difference between patients with and those without PNRT. A logistic regression was used to estimate the odds ratio (OR) of PNRT among the variables examined. In total, 772 patients (4.86%) were identified with PNRT as the case group, whereas 15,122 subjects of the same cancer without PNRT formed the control group. Of patients with PNRT, 632 (81.9%) were hospitalized with a mean length of stay of 25.9 days. Results from the multiple logistic regression showed that an older age and certain comorbidities were associated with an increased risk of PNRT. Patients with cancer of the tongue, buccal mucosa, oropharynx, and hypopharynx/larynx were at particularly higher risk (OR = 1.28, 1.28, 1.67, and 1.74, respectively). Compared to radiotherapy alone, concurrent chemoradiotherapy had no effect on the PNRT. Patients in the PNRT group had higher overall medical costs and length of stay. The incidence of PNRT in HNC patients receiving radiotherapy was approximately 5%. Notably, an older age, certain comorbidities, and certain specific tumor sites were associated with an increased risk

  3. Predicted risks of radiogenic cardiac toxicity in two pediatric patients undergoing photon or proton radiotherapy

    International Nuclear Information System (INIS)

    Hodgkin disease (HD) and medulloblastoma (MB) are common malignancies found in children and young adults, and radiotherapy is part of the standard treatment. It was reported that these patients who received radiation therapy have an increased risk of cardiovascular late effects. We compared the predicted risk of developing radiogenic cardiac toxicity after photon versus proton radiotherapies for a pediatric patient with HD and a pediatric patient with MB. In the treatment plans, each patient’s heart was contoured in fine detail, including substructures of the pericardium and myocardium. Risk calculations took into account both therapeutic and stray radiation doses. We calculated the relative risk (RR) of cardiac toxicity using a linear risk model and the normal tissue complication probability (NTCP) values using relative seriality and Lyman models. Uncertainty analyses were also performed. The RR values of cardiac toxicity for the HD patient were 7.27 (proton) and 8.37 (photon), respectively; the RR values for the MB patient were 1.28 (proton) and 8.39 (photon), respectively. The predicted NTCP values for the HD patient were 2.17% (proton) and 2.67% (photon) for the myocardium, and were 2.11% (proton) and 1.92% (photon) for the whole heart. The predicted ratios of NTCP values (proton/photon) for the MB patient were much less than unity. Uncertainty analyses revealed that the predicted ratio of risk between proton and photon therapies was sensitive to uncertainties in the NTCP model parameters and the mean radiation weighting factor for neutrons, but was not sensitive to heart structure contours. The qualitative findings of the study were not sensitive to uncertainties in these factors. We conclude that proton and photon radiotherapies confer similar predicted risks of cardiac toxicity for the HD patient in this study, and that proton therapy reduced the predicted risk for the MB patient in this study

  4. Tetrahydrocannabinol vs. Prochlorperazine: the effects of two antiemetics on patients undergoing radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ungerleider, J.T.; Andrysiak, T.A.; Fiarbanks, L.A.; Tesler, A.S.; Parker, R.G.

    1984-02-01

    The authors tested the effectiveness of orally administred delta-9-tetrahydrocannabinol (THC) as compared to prochlorperazine for the alleviation of symptoms, such as vomiting and nausea, experienced by patients receiving radiotherapy. The test subjects rated the severity of their illness, as well as the extent of their subsequent moods, their level of concentration, their amount of physical activity, and their desire for social interaction. They chose the drug they preferred and recorded its side effects. The use of THC was slightly more beneficial than the use of prochlorperazine.

  5. Prophylaxis of mucosal toxicity by oral propantheline and cryotherapy in children with malignancies undergoing myeloablative chemo-radiotherapy

    International Nuclear Information System (INIS)

    Mucosal toxicity is an incapacitating complication of intensive chemo-radiotherapy for children with malignant disorders, and is physically and psychologically distressful. It is therefore important to minimize mucosal toxicity in those patients. In this report, the effects of the combined prophylaxis of oral cooling (cryotherapy) and administration of propantheline, an anticholinergic drug, were studied in patients (aged 2-16 year) with acute leukemias or solid tumors, who underwent myeloablative chemo-radiotherapy and autologous peripheral blood stem cell rescue from 1993 to 1997. Patients were pretreated with the combined prophylaxis (n=12) or single prophylaxis (n=5), or left untreated (n=7). The combined prophylaxis significantly reduced the severe mucositis (combined, 8.3%; single, 20.0%; and untreated, 42.9%) and severe diarrhea (combined, 16.7%; single, 60.0%; and untreated, 57.1%). Moreover, the combined prophylaxis tended to shorten the periods of febrile episodes defined as temperature >38 deg C (combined, 3.8 days; single, 4.6 days; and untreated, 5.6 days). Therefore, the combination of propantheline and oral cryotherapy may be feasible and effective for reduction of mucosal toxicity in patients with malignancy who undergo high-dose chemotherapy. (author)

  6. ANAEMIA DURING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Jindal Sanam

    2013-01-01

    Full Text Available Nutritional anaemia due to iron and folate deficiency is a major global Public Health problem. South Asia ranks among the regions, which have the highest prevalence of anaemia in the world and India perhaps has the highest prevalence of anaemia among the South Asian countries. Prevalence of anaemia is higher among pregnant women and preschool children. Even among higher income educated segments of population about 50% of children, adolescent girls and pregnant women are anaemic. Inadequate dietary iron, folate intake and poor bioavailability of dietary iron from the fibre, phytate rich Indian diets are the major factors responsible for high prevalence of anaemia. Increased requirement of iron during growth and pregnancy and chronic blood loss contribute to higher prevalence in specific groups. Many times anaemia is directly or indirectly responsible for maternal deaths. Early detection and effective management of anaemia in pregnancy can contribute substantially to reduction in maternal mortality. Maternal anaemia is associated with poor intrauterine growth and increased risk of preterm births and low birth weight rates. This in turn results in higher perinatal morbidity and mortality, and higher infant mortality rate. Maternal anaemia contributes to intergenerational cycle of poor growth in the offspring. Early detection and effective management of anaemia in preganancy can lead to substantial reduction in under nutrition in childhood, adolescence and improvement in adult height.

  7. [Anaemia in the elderly].

    Science.gov (United States)

    Leischker, Andreas Herbert; Fetscher, Sebastian; Kolb, Gerald Franz

    2016-07-01

    In the elderly, even mild anaemia leads to significantly decreased quality of life and reduced survival rate. Therefore even mild anaemias should be worked up especially in the elderly. More than 75 % of all anaemias have a specific and treatable cause.Differential diagnosis of anaemia in the elderly is much more challenging compared to the differential diagnosis in younger patients: in older patients often more than one dysfunction is responsible for the anaemia simultaneously. Many routine laboratory parameters are changed by ageing and are therefore only of limited value for diagnosis of anaemia. Soluble transferinreceptor and hepcidin are two parameters feasible for differential diagnosis of the causes of anaemia in the elderly.The most common cause of iron deficiency anaemia in the elderly is gastrointestinal bleeding. Many causes for gastrointestinal bleeding -like angiodysplasia of the colon - can readily be treated with endoscopic therapy. For this reason, colonoscopy is part of the standard workup for elderly patients with iron-deficient anaemia (IDA) if no contraindications exist.Therapy of anaemia is based on the specific cause or the causes. In IDA, the first step other than causal treatment is to replace iron orally. If this is not tolerated because of side effects or does not lead to a sufficient rise in the haemoglobin level, intravenous iron replacement therapy is indicated. Folic acid deficiency is generally treated orally, whereas vitamin B12 deficiency is generally treated by the parenteral - preferably subcutaneous - route. In anaemia due to chronic renal failure and anaemia due to myelodysplastic syndromes, the underlying cause must be treated, furthermore erythropoiesis-stimulating agents can be indicated. PMID:27359315

  8. Comparison of two indwelling central venous access catheters in dogs undergoing fractionated radiotherapy

    International Nuclear Information System (INIS)

    Twenty dogs with neoplasms requiring multiple radiation treatments received either percutaneous vascular access catheters (PVACs; Cook, Bloomington, IN) or subcutaneous vascular access ports (SVAPs; Vascular-Access-Ports, Norfolk Medical Products, Inc., Skokie, IL); 10 dogs were entered in each group. All catheters were implanted and removed aseptically and the catheter tips were cultured during implant removal. Complications with PVACs included mild incisional swelling and redness and accidental severance or rupture of the catheter. Complications with SVAPs included incisional or port swelling, bruising or redness, hematoma formation, and pain. Ports in 4 of these dogs could not be used for 1 to 3 days after surgery because of swelling and pain. Surgical wound complications, when pooled for comparison, occurred significantly more frequently with the SVAPs (P = .023). Wound complications associated with both catheters were self-limiting and resolved within 7 days. Bacterial cultures were positive in two PVACs and four SVAP tips, however, none of these dogs had clinical signs of infection or sepsis. Although both types of indwelling catheters were functional in a clinical setting, PVACs were preferred to SVAPs for dogs undergoing radiation therapy because of decreased time for implantation and fewer overall complications

  9. Automated delineation of brain structures in patients undergoing radiotherapy for primary brain tumors: From atlas to dose–volume histograms

    International Nuclear Information System (INIS)

    Purpose: To implement and evaluate a magnetic resonance imaging atlas-based automated segmentation (MRI-ABAS) procedure for cortical and sub-cortical grey matter areas definition, suitable for dose-distribution analyses in brain tumor patients undergoing radiotherapy (RT). Patients and methods: 3T-MRI scans performed before RT in ten brain tumor patients were used. The MRI-ABAS procedure consists of grey matter classification and atlas-based regions of interest definition. The Simultaneous Truth and Performance Level Estimation (STAPLE) algorithm was applied to structures manually delineated by four experts to generate the standard reference. Performance was assessed comparing multiple geometrical metrics (including Dice Similarity Coefficient – DSC). Dosimetric parameters from dose–volume-histograms were also generated and compared. Results: Compared with manual delineation, MRI-ABAS showed excellent reproducibility [median DSCABAS = 1 (95% CI, 0.97–1.0) vs. DSCMANUAL = 0.90 (0.73–0.98)], acceptable accuracy [DSCABAS = 0.81 (0.68–0.94) vs. DSCMANUAL = 0.90 (0.76–0.98)], and an overall 90% reduction in delineation time. Dosimetric parameters obtained using MRI-ABAS were comparable with those obtained by manual contouring. Conclusions: The speed, reproducibility, and robustness of the process make MRI-ABAS a valuable tool for investigating radiation dose–volume effects in non-target brain structures providing additional standardized data without additional time-consuming procedures

  10. Occurrence of yeasts, pseudomonads and enteric bacteria in the oral cavity of patients undergoing head and neck radiotherapy

    Directory of Open Access Journals (Sweden)

    Elerson Gaetti-Jardim Júnior

    2011-09-01

    Full Text Available The aim of this study was to evaluate the occurrence of yeasts, pseudomonads and enteric bacteria in the oral cavity of patients undergoing radiotherapy (RT for treatment of head and neck cancer. Fifty patients receiving RT were examined before, during and 30 days after RT. Saliva, mucosa, and biofilm samples were collected and microorganisms were detected by culture and polymerase chain reaction (PCR. The most prevalent yeasts in patients submitted to RT were Candida albicans, C. tropicalis, C. krusei, C. glabrata and C. parapsilosis. Citrobacter, Enterobacter, Enterococcus, Klebsiella, Proteus, and Pseudomonas were the most frequently cultivated bacteria. Before RT, targeted bacteria were cultivated from 22.2% of edentulous patients and 16.6% of dentate patients; 30 days after RT, these microorganisms were recovered from 77.8% edentulous and 46.8% dentate patients. By PCR, these microorganisms were detected from all edentulous patients, 78.1% of dentate patients. The presence of Gram-negative enteric roads and fungi was particularly frequent in patients presenting mucositis level III or IV. Modifications in the oral environment due to RT treatment seem to facilitate the colonization of oral cavity by members of family Enterobacteriaceae, genera Enterococcus and Candida.

  11. Radiotherapy

    International Nuclear Information System (INIS)

    The need for radiotherapy research is exemplified by the 100,000 cancer patients who will fail treatment locally and/or regionally annually for the next several years but who would benefit from better local treatment modalities. Theoretically, all of the areas of investigation discussed in this projection paper have the potential to significantly improve local-regional treatment of cancer by radiotherapy alone or in combination with other modalities. In many of the areas of investigation discussed in this paper encouraging results have been obtained in cellular and animal tumor studies and in limited studies in humans as well. In the not too distant future the number of patients who would benefit from better local control may increase by tens of thousands if developments in chemotherapy and/or immunotherapy provide a means to eradicate disseminated microscopic foci of cancer. Thus the efforts to improve local-regional control take on even greater significance

  12. Proteome data of whole saliva which are associated with development of oral mucositis in head and neck cancer patients undergoing radiotherapy

    Directory of Open Access Journals (Sweden)

    Nico Jehmlich

    2016-09-01

    Full Text Available Saliva as major human body fluid may act as an indicator of oral disease status. Oral mucositis is a common and often treatment-limiting side effect of radiotherapy for head and neck cancer patients. In this dataset, we provide the complete proteome dataset (raw and search files of the patients at baseline of radiotherapy treatment in patients undergoing radiotherapy analyzed by nano liquid chromatography coupled to mass spectrometry (LC–MS/MS. In the data set, 5323 tryptic peptides were identified which can be assigned to 487 distinct proteins (≥2 peptides. The MS data have been deposited to the ProteomeXchange (“ProteomeXchange provides globally coordinated proteomics data submission and dissemination” [1] via the PRIDE partner repository with the dataset identifier PRIDE: PXD003230. The data are associated with the previously published work, “Differences in the whole saliva baseline proteome profile associated with development of oral mucositis in head and neck cancer patients undergoing radiotherapy” [2].

  13. The Therapeutic Effects of Rehmannia Oral Liquid for the Syndrome of Heat Accumulation with Yin Consumption in Esophagus Cancer Patients Undergoing Radiotherapy - A Report of 60 Cases

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To observe the clinical therapeutic effects of Rehmannia Oral Liquid on the syndrome of heat accumulation with Yin consumption in intermediate or late esophagus cancer patients undergoing radiotherapy. Methods: The IFN-α, TNF-α, IL-1β and TGF-β1 levels in sera were determined by the method of ABC-WLISA before and after the treatment with Rehmannia Oral Liquid. At the same time, the observation was carried out on the patient's general condition, symptoms and signs, barium meal or CT examinations, and biopsy. Another 30 cases of esophagus cancer were treated singly with radiotherapy as the control group. Results: Rehmannia Oral Liquid could obviously improve the patient's general condition, and the symptoms and signs after radiotherapy. Based on the X-ray examination and biopsy, the short-term local control rate of the treatment group and the control group was 70.0% and 40.0% respectively, showing a significant difference (P0.05) after treatment. The difference between groups was significant (P<0.05). Conclusion: Rehmannia Oral Liquid can obviously reduce the radiotherapy reaction, improve the quality of life, and raise the therapeutic effects. The action mechanism of the Liquid may lie in balancing the cytokine network and regulating the disordered signal transmission.

  14. Assessment of pulmonary toxicities in breast cancer patients undergoing treatment with anthracycline and taxane based chemotherapy and radiotherapy- a prospective study

    Directory of Open Access Journals (Sweden)

    Aramita Saha

    2013-12-01

    showed a similar declining pattern.-------------------------Cite this article as:Saha A, Chattopadhyay S. Assessment of pulmonary toxicities in breast cancer patients undergoing treatment with anthracycline and taxane based chemotherapy and radiotherapy- a prospective study. Int J Cancer Ther Oncol 2013; 1(2:01021.DOI: http://dx.doi.org/10.14319/ijcto.0102.1

  15. Infectious Salmon Anaemia

    OpenAIRE

    Institute, Marine

    2011-01-01

    This leaflet gives information on infectious salmon anaemia (ISA). ISA is caused by a single stranded RNA virus of the family Orthomyxoviridae. ISA is listed as a non-exotic disease under EU Directive 2006/88/EC, and is notifiable in Ireland, according to S.I. No. 261 of 2008.

  16. Iron deficiency anaemia.

    Science.gov (United States)

    Lopez, Anthony; Cacoub, Patrice; Macdougall, Iain C; Peyrin-Biroulet, Laurent

    2016-02-27

    Anaemia affects roughly a third of the world's population; half the cases are due to iron deficiency. It is a major and global public health problem that affects maternal and child mortality, physical performance, and referral to health-care professionals. Children aged 0-5 years, women of childbearing age, and pregnant women are particularly at risk. Several chronic diseases are frequently associated with iron deficiency anaemia--notably chronic kidney disease, chronic heart failure, cancer, and inflammatory bowel disease. Measurement of serum ferritin, transferrin saturation, serum soluble transferrin receptors, and the serum soluble transferrin receptors-ferritin index are more accurate than classic red cell indices in the diagnosis of iron deficiency anaemia. In addition to the search for and treatment of the cause of iron deficiency, treatment strategies encompass prevention, including food fortification and iron supplementation. Oral iron is usually recommended as first-line therapy, but the most recent intravenous iron formulations, which have been available for nearly a decade, seem to replenish iron stores safely and effectively. Hepcidin has a key role in iron homoeostasis and could be a future diagnostic and therapeutic target. In this Seminar, we discuss the clinical presentation, epidemiology, pathophysiology, diagnosis, and acute management of iron deficiency anaemia, and outstanding research questions for treatment.

  17. Analysis of the testicular dose in patients undergoing radiotherapy for carcinoma of the prostate; Analisis de las dosis testiculares en pacientes sometidos a tratamiento radioterapico de carcinoma de prostata

    Energy Technology Data Exchange (ETDEWEB)

    Bejar Navarro, M. J.; Ordonez Marquez, J.; Hervas Moron, A.; Alvarez Rodriguez, S.; Garcia-Galloway, E.; Sanchez Casanueva, R.; Polo Rubio, A.; Rodriguez-Patron, R.; Yanowsky, K.; Gomez Dos Santos, V.

    2013-07-01

    The objectives of this work are: -Studying comparatively the doses received in testes in patients undergoing radiotherapy of prostate carcinoma with external beam radiation and brachytherapy of low rate using I-125 seeds. -Compare doses due to images of verification using Cone Beam CT (CBCT), with doses of radiotherapy treatment itself. -Determine the seminal alterations and cytogenetic after treatment with ionizing radiation (RTE or BQT) in patients diagnosed with prostate cancer and its relation with testicular dose. (Author)

  18. The effect of nutrition intervention in lung cancer patients undergoing chemotherapy and/or radiotherapy: a systematic review.

    Science.gov (United States)

    Kiss, Nicole K; Krishnasamy, Meinir; Isenring, Elisabeth A

    2014-01-01

    The prevalence of malnutrition in lung cancer patients across a variety of treatment modalities and disease stages ranges from 45% to 69%. Malnutrition is associated with poorer clinical outcomes in cancer patients. This systematic review examined whether dietary counseling or oral supplements during chemotherapy and/or radiotherapy in patients with lung cancer affect patient or clinical outcomes. Relevant nutrition intervention studies from 1980 to March 2012 were identified. Articles meeting predetermined inclusion/exclusion criteria were critically appraised and included in the review. The outcomes of interest included dietary intake, weight, nutritional status, quality of life, functional status, treatment response, and survival. Five eligible studies were identified including 3 randomized controlled trials, 1 historical cohort, and 1 case series. These studies suggest dietary counseling improves energy and protein intake during chemotherapy in patients with lung cancer but has no benefit to other outcomes during chemotherapy. There is insufficient evidence regarding the effect on patient or clinical outcomes during radiotherapy. Randomized trials examining dietary counseling in patients with lung cancer during radiotherapy are required.

  19. Randomized controlled trial to evaluate the effects of progressive resistance training compared to progressive muscle relaxation in breast cancer patients undergoing adjuvant radiotherapy: the BEST study

    International Nuclear Information System (INIS)

    Cancer-related fatigue (CRF) is one of the most common and distressing side effects of cancer and its treatment. During and after radiotherapy breast cancer patients often suffer from CRF which frequently impairs quality of life (QoL). Despite the high prevalence of CRF in breast cancer patients and the severe impact on the physical and emotional well-being, effective treatment methods are scarce. Physical activity for breast cancer patients has been reported to decrease fatigue, to improve emotional well-being and to increase physical strength. The pathophysiological and molecular mechanisms of CRF and the molecular-biologic changes induced by exercise, however, are poorly understood. In the BEST trial we aim to assess the effects of resistance training on fatigue, QoL and physical fitness as well as on molecular, immunological and inflammatory changes in breast cancer patients during adjuvant radiotherapy. The BEST study is a prospective randomized, controlled intervention trial investigating the effects of a 12-week supervised progressive resistance training compared to a 12-week supervised muscle relaxation training in 160 patients with breast cancer undergoing adjuvant radiotherapy. To determine the effect of exercise itself beyond potential psychosocial group effects, patients in the control group perform a group-based progressive muscle relaxation training. Main inclusion criterion is histologically confirmed breast cancer stage I-III after lumpectomy or mastectomy with indication for adjuvant radiotherapy. Main exclusion criteria are acute infectious diseases, severe neurological, musculosceletal or cardiorespiratory disorders. The primary endpoint is cancer-related fatigue; secondary endpoints include immunological and inflammatory parameters analyzed in peripheral blood, saliva and urine. In addition, QoL, depression, physical performance and cognitive capacity will be assessed. The BEST study is the first randomized controlled trial comparing progressive

  20. A New Model for Predicting Acute Mucosal Toxicity in Head-and-Neck Cancer Patients Undergoing Radiotherapy With Altered Schedules

    Energy Technology Data Exchange (ETDEWEB)

    Strigari, Lidia, E-mail: strigari@ifo.it [Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Rome (Italy); Pedicini, Piernicola [Department of Medical Physics, Regional Cancer Hospital C.R.O.B, Rionero in Vulture (Italy); D' Andrea, Marco [Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Rome (Italy); Pinnaro, Paola; Marucci, Laura; Giordano, Carolina [Department of Radiotherapy, Regina Elena National Cancer Institute, Rome (Italy); Benassi, Marcello [Department of Medical Physics, Istituto Scientifico Romagnolo per lo Studio e la Cura dei tumori, Meldola (Italy)

    2012-08-01

    Purpose: One of the worst radiation-induced acute effects in treating head-and-neck (HN) cancer is grade 3 or higher acute (oral and pharyngeal) mucosal toxicity (AMT), caused by the killing/depletion of mucosa cells. Here we aim to testing a predictive model of the AMT in HN cancer patients receiving different radiotherapy schedules. Methods and Materials: Various radiotherapeutic schedules have been reviewed and classified as tolerable or intolerable based on AMT severity. A modified normal tissue complication probability (NTCP) model has been investigated to describe AMT data in radiotherapy regimens, both conventional and altered in dose and overall treatment time (OTT). We tested the hypothesis that such a model could also be applied to identify intolerable treatment and to predict AMT. This AMT NTCP model has been compared with other published predictive models to identify schedules that are either tolerable or intolerable. The area under the curve (AUC) was calculated for all models, assuming treatment tolerance as the gold standard. The correlation between AMT and the predicted toxicity rate was assessed by a Pearson correlation test. Results: The AMT NTCP model was able to distinguish between acceptable and intolerable schedules among the data available for the study (AUC = 0.84, 95% confidence interval = 0.75-0.92). In the equivalent dose at 2 Gy/fraction (EQD2) vs OTT space, the proposed model shows a trend similar to that of models proposed by other authors, but was superior in detecting some intolerable schedules. Moreover, it was able to predict the incidence of {>=}G3 AMT. Conclusion: The proposed model is able to predict {>=}G3 AMT after HN cancer radiotherapy, and could be useful for designing altered/hypofractionated schedules to reduce the incidence of AMT.

  1. Estimation of neutron-equivalent dose in organs of patients undergoing radiotherapy by the use of a novel online digital detector

    International Nuclear Information System (INIS)

    Neutron peripheral contamination in patients undergoing high-energy photon radiotherapy is considered as a risk factor for secondary cancer induction. Organ-specific neutron-equivalent dose estimation is therefore essential for a reasonable assessment of these associated risks. This work aimed to develop a method to estimate neutron-equivalent doses in multiple organs of radiotherapy patients. The method involved the convolution, at 16 reference points in an anthropomorphic phantom, of the normalized Monte Carlo neutron fluence energy spectra with the kerma and energy-dependent radiation weighting factor. This was then scaled with the total neutron fluence measured with passive detectors, at the same reference points, in order to obtain the equivalent doses in organs. The latter were correlated with the readings of a neutron digital detector located inside the treatment room during phantom irradiation. This digital detector, designed and developed by our group, integrates the thermal neutron fluence. The correlation model, applied to the digital detector readings during patient irradiation, enables the online estimation of neutron-equivalent doses in organs. The model takes into account the specific irradiation site, the field parameters (energy, field size, angle incidence, etc) and the installation (linac and bunker geometry). This method, which is suitable for routine clinical use, will help to systematically generate the dosimetric data essential for the improvement of current risk-estimation models. (paper)

  2. Dose verification in carcinoma of uterine cervix patients undergoing 3D conformal radiotherapy with Farmer type ion chamber

    Directory of Open Access Journals (Sweden)

    Challapalli Srinivas

    2014-01-01

    Full Text Available External beam radiotherapy (EBRT for carcinoma of uterine cervix is a basic line of treatment with three dimensional conformal radiotherapy (3DCRT in large number of patients. There is need for an established method for verification dosimetry. We tried to document absorbed doses in a group of carcinoma cervix patients by inserting a 0.6 cc Farmer type ion chamber in the vaginal cavity. A special long perspex sleeve cap is designed to cover the chamber for using in the patient′s body. Response of ionization chamber is checked earlier in water phantom with and without cap. Treatment planning was carried out with X-ray computed tomography (CT scan and with the chamber along with cap in inserted position, and with the images Xio treatment planning system. Three measurements on 3 days at 5-6 fraction intervals were recorded in 12 patients. Electrometer measured charges are converted to absorbed dose at the chamber center, in vivo. Our results show good agreement with planned dose within 3% against prescribed dose. This study, is a refinement over our previous studies with transmission dosimetry and chemicals in ampules. This preliminary work shows promise that this can be followed as a routine dose check with special relevance to new protocols in the treatment of carcinoma cervix with EBRT.

  3. Audiotaped social comparison information for cancer patients undergoing radiotherapy : Differential effects of procedural, emotional and coping information

    NARCIS (Netherlands)

    Bennenbroek, FTC; Buunk, BP; Stiegelis, HE; Hagedoorn, M; Sanderman, R; Van den Bergh, ACM; Botke, G; Buunk, Abraham (Bram)

    2003-01-01

    The present study focused on the effects of social comparison information on subjective understanding of radiation therapy, validation of emotions, and self-efficacy of cancer patients undergoing radiation therapy. The effects of three different audiotapes, containing different kinds of social compa

  4. Individualizing anaemia therapy.

    Science.gov (United States)

    de Francisco, Angel L M

    2010-12-01

    Individualized strategies for managing renal anaemia with erythropoiesis-stimulating agents (ESAs) need to be advanced. Recent outcomes from clinical studies prompted a narrowing of the guideline-recommended haemoglobin target (11-12 g/dL) due to increased mortality and morbidity when targeting higher haemoglobin concentrations. Maintaining a narrow target is a clinical challenge, as haemoglobin concentration tends to fluctuate. The goal of individualized treatment is to achieve the haemoglobin target at the lowest ESA dose while avoiding significant fluctuations in haemoglobin concentrations and persistently low or high concentrations. This may require changes to the ESA dose and dosing frequency over the course of treatment.

  5. A prospective randomized comparative clinical trial comparing the efficacy between ondansetron and metoclopramide for prevention of nausea and vomiting in patients undergoing fractionated radiotherapy to the abdominal region

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hee Chul; Suh, Chang Ok; Seong, Jin Sil; Cho, Jae Ho; Lim, John Jihoon; Park, Won; Song, Jae Seok; Kim, Gwi Eon [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of)

    2001-06-01

    This study is a prospective randomized clinical trial comparing the efficacy and complication of anti-emetic drugs for prevention of nausea and vomiting after radiotherapy which has moderate emetogenic potential. The aim of this study was to investigate whether the anti-emetic efficacy at ondansetron(Zofran) 8 mg bid dose (Group O) is better than the efficacy of metoclopramide 5 mg tid dose (Group M) in patients undergoing fractionated radiotherapy to the abdominal region. Study entry was restricted to those patients who met the following eligibility criteria: histologically confirmed malignant disease; no distant metastasis; performance status of not more than ECOG grade 2; no previous chemotherapy and radiotherapy. Between March 1997 and February 1998, 60 patients enrolled in this study. All patients signed a written statement of informed consent prior to enrollment. Blinding was maintained by dosing identical number of tables including one dose of matching placebo for Group O. The extent of nausea, appetite loss, and the number of emetic episodes were recorded everyday using diary card. The mean score of nausea, appetite loss and the mean number of emetic episodes were obtained in a weekly interval. Prescription error occurred in one patient. And diary cards have not returned in 3 patients due to premature refusal of treatment. Card from one patient was excluded from the analysis because she had a history of treatment for neurosis. As a result, the analysis consisted of 55 patients. Patient characteristics and radiotherapy characteristics were similar except mean age was 52.9{+-} 11.2 in group M, 46.5{+-}9.6 in group O. The difference of age was statistically significant. The mean score of nausea, appetite loss and emetic episodes in a weekly interval was higher in group M than O. In group M, the symptoms were most significant at 5th week. In a panel data analysis using mixed procedure, treatment group was only significant factor detecting the difference of

  6. Pulse oximetry in severe anaemia

    DEFF Research Database (Denmark)

    Ramsing, T; Rosenberg, J

    1992-01-01

    Measurement of arterial oxygen saturation by pulse oximetry was performed in two patients with acute and chronic anaemia (haemoglobin concentrations: 2.9 mmol/l (4.7 g/dl) and 1.9 mmol/l (3.0 g/dl), respectively) using a Radiometer OXI and a Nellcor N-200 pulse oximeter. The two oximeters read...... alternating different values in the two patients. In conclusion, pulse oximeters are able to give a value for oxygen saturation even at extreme anaemia, and when a high value is given, it possibly reflects arterial oxygen saturation. The value of pulse oximetry in severe anaemia is discussed....

  7. Genetic variant in CD44 confer susceptibility to acute skin reaction in breast cancer patients undergoing radiotherapy

    International Nuclear Information System (INIS)

    Heterogeneity in toxicity to normal tissue is observed in 10% of cancer patients after radiotherapy (RT) which limits the therapeutic outcome. Response to RT is manifested from alterations in gene of vivid pathways involving DNA damage-repair, inflammatory cytokine, cell cycle regulation, antioxidant response etc. Therefore, the common sequence variants in these radioresponsive genes may modify the severity of normal tissue toxicity and identification of the same may have clinical relevance as a predictive biomarker. The present study was aimed to evaluate the potential modifying role of genetic variants in NFE2L2, OGG1, NEIL3, RAD17, PTTG1, REV3L, ALAD, CD44, RAD9A, LIG3, SH3GL1, BAXS, XRCC1, MAD2L2 and TGFBR3 on the individual susceptibility to RT induced acute skin reactions. All the 132 breast cancer patients were treated with a total dose of 50 Gy in case of mastectomy and 60 Gy in breast conservation surgery. The severity of skin damage was scored according to the Radiation Therapy Oncology Group (RTOG) criteria and the toxicity scores were dichotomized as non-over-responders (NOR; RTOG<2) and over-responders (NOR;RTOG>2) for analysis. Out of the 132 subjects, 44 were ORs. Among the 20 studied SNPs of indicated genes, the rs8193 (CD44) polymorphism lying in the miRNA binding site was significantly (p<0.05) associated with the RT induced adverse skin reactions. The non-coding CD44 3'-UTR serves as a competitor for miRNA binding and subsequently inactivates miRNA functions, by freeing the target mRNAs from being repressed. Therefore, though the role of CD44 in radiosensitivity is unknown, the change in the miRNA binding to CD44mRNA transcripts may regulate expression of several genes involved in pathophysiology of normal tissue radiosensitivity leading to the observed outcome. (author)

  8. A Phase III placebo-controlled trial of oral pilocarpine in patients undergoing radiotherapy for head-and-neck cancer

    International Nuclear Information System (INIS)

    Purpose: To test the hypothesis that the use of oral pilocarpine during and after radiotherapy (RT) for head-and-neck cancer would reduce the symptoms of post-RT xerostomia. Methods and Materials: One hundred thirty patients were randomized in a double-blind method to receive either pilocarpine (5-mg tablets) or placebo three times daily starting on Day 1 of RT and continuing for 1 month after treatment. The eligibility criteria included a planned dose of >50 Gy as radical or postoperative RT for head-and-neck cancer, with at least 50% of both parotid glands included in the treatment fields. The primary outcome measure was the severity of xerostomia as assessed by a patient-completed linear analog scale 3 months after RT. Secondary outcome measures included quality of life during therapy (as assessed by the McMaster University Head-and-Neck Questionnaire) and severity of mucositis during RT (as assessed using Radiation Therapy Oncology Group scales). Results: No difference was observed between the pilocarpine-treated patients and the placebo group in the severity of xerostomia score as assessed by linear analog scale at baseline and 1, 3, and 6 months after treatment (repeated measures analysis, p=0.92). No difference was apparent in the severity of mucositis during RT; 56.3% of patients receiving pilocarpine had Grade III/IV mucositis compared with 50.8% treated with placebo. No difference in quality of life was noted between the treatment groups during or after RT. The questionnaire score at 3 months after RT was 5.0 (SD 1.0). in the pilocarpine group and 4.9 (SD 0.9) in the placebo group. Conclusion: We were unable to detect a beneficial effect of pilocarpine on RT-induced xerostomia when administered during RT for head-and-neck cancer

  9. High-dose-rate Intracavitary Radiotherapy in the Management of Cervical Intraepithelial Neoplasia 3 and Carcinoma In Situ Presenting With Poor Histologic Factors After Undergoing Excisional Procedures

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Bae, E-mail: ybkim3@yuhs.ac [Department of Radiation Oncology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Kim, Young Tae [Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Cho, Nam Hoon [Department of Pathology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Koom, Woong Sub [Department of Radiation Oncology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Kim, Sunghoon; Kim, Sang Wun; Nam, Eun Ji [Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Kim, Gwi Eon [Department of Radiation Oncology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of)

    2012-09-01

    Purpose: To assess the effectiveness of high-dose-rate intracavitary radiotherapy (HDR-ICR) in patients with cervical intraepithelial neoplasia 3 (CIN 3) and carcinoma in situ (CIS) presenting with poor histologic factors for predicting residual disease after undergoing diagnostic excisional procedures. Methods and Materials: This study was a retrospective analysis of 166 patients with CIN 3 (n=15) and CIS (n=151) between October 1986 and December 2005. They were diagnosed by conization (n=158) and punch biopsy (n=8). Pathologic analysis showed 135 cases of endocervical gland involvement (81.4%), 74 cases of positive resection margins (44.5%), and 52 cases of malignant cells on endocervical curettage (31.3%). All patients were treated with HDR-ICR using Co{sup 60} or Ir{sup 192} at a cancer center. The dose was prescribed at point A located 2 cm superior to the external os and 2 cm lateral to the axis of the tandem for intact uterus. Results: Median age was 61 years (range, 29-77). The median total dose of HDR-ICR was 30 Gy/6 fractions (range, 30-52). At follow-up (median, 152 months), 2 patients developed recurrent diseases: 1 CIN 2 and 1 invasive carcinoma. One hundred and forty patients survived and 26 patients died, owing to nonmalignant intercurrent disease. Rectal bleeding occurred in one patient; however, this symptom subsided with conservative management. Conclusions: Our data showed HDR-ICR is an effective modality for CIN 3 and CIS patients presenting with poor histologic factors after excisional procedures. HDR-ICR should be considered as a definitive treatment in CIN 3 and CIS patients with possible residual disease after undergoing excisional procedures.

  10. Is hidradenitis suppurativa associated with anaemia?

    DEFF Research Database (Denmark)

    Miller, I M; Johansen, M E; Mogensen, U B;

    2016-01-01

    BACKGROUND: Chronic inflammatory diseases may be associated with anaemia of inflammation. Hidradenitis suppurativa is a chronic inflammatory dermatological disease associated with metabolic comorbidities, low quality of life and fatigue. Anaemia may cause fatigue, and it has been hypothesized...... that HS-related fatigue may be partly due to anaemia. OBJECTIVE: Our objective was to investigate a possible association between HS and anaemia. METHODS: We performed a hospital-based and population-based cross-sectional study investigating the red blood cell profile, i.e. haemoglobin. RESULTS: We...... revealed that 60% had normocytic anaemia and 40% microcytic anaemia, in concordance with anaemia of inflammation. CONCLUSION: In contrast to our hypothesis, this study showed that HS is not associated with anaemia. Thus, anaemia may not be the cause of the described fatigue in HS patients. Furthermore...

  11. A prospective randomized double-blind trial comparing ondansetron versus prochlorperazine for the prevention of nausea and vomiting in patients undergoing fractionated radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Priestman, T.J. (Royal Hospital, Wolverhampton (United Kingdom)); Roberts, J.T. (Newcastle General Hospital (United Kingdom)); Upadhyaya, B.K. (Glaxo Group Research Ltd., Greenford (United Kingdom))

    1993-01-01

    In a multicentre, international double-blind trial, patients undergoing courses of five or more daily radiotherapy treatments to the upper abdomen were randomized to receive either oral ondansetron 8 mg t.d.s. or oral prochlorperazine 10 mg t.d.s. throughout their radiation course in order to try to prevent nausea and vomiting. A total of 192 patients were recruited, 135 of whom were included in the efficacy analysis; of these, 70 received ondansetron and 65 prochlorperazine. Forty-three (61%) of the patients prescribed ondansetron and 23 (35%) of those given prochlorperazine had a complete response, with no emetic episodes throughout their treatment course. There was, however, no significant difference between the two groups with respect to the incidence and severity of nausea. Seventeen (24%) of the patients on ondansetron and 19 (29%) of those given prochlorperazine were treatment failures, experiencing more than five emetic episodes on their worst day during the study. Both drugs were well tolerated, although constipation was seen more commonly with ondansetron. (author).

  12. Haematological Profile in Haemolytic Anaemia

    Directory of Open Access Journals (Sweden)

    R.H. Deshpande

    2012-04-01

    Full Text Available Objectives: The present study was carried to find out the frequency of haemolytic anaemia, to know the different etiological factors and their percentage in the region of marathwada, Maharashtra. Background: Knowledge of frequency and different etiological factors is essential for the information of magnitude and treatment of the patients. The present study was done in the department of pathology, Gov. Medical College, Aurangabad, district of Maharashtra. The patients from marathwada region of the Maharashtra were included in this study. The concerned study of “Haemoglobinopathies in Childhood” was conducted by Anil J in 1984 in the same institute. Methodology: Total 76 clinically suspected cases were investigated. For the study routine investigations like Hb estimation, peripheral blood smear examination, reticulocyte count and special investigations like sickling test, Hb solubility test, estimation of faetal haemoglobin and Hb electrophoresis were carried out. Results: Total 76 cases were studied. Out of it 51 cases were male (67.10% and 25 (32.89% cases were female. The patients are in the age group, 5 months to 45 years. Out of 76 cases 51 cases were diagnosed as haemolytic anaemia. In these 51 cases of haemolytic anaemia, 42 cases (82.35% of haemoglobinopathies, it cases (15.68% of malaria and one case (1.96% of auto immune haemolytic anaemia were found to have as causative factor. Conclusion: It showed that the frequency of haemolytic anaemia in studied 76 cases was 67.10%. In diagnosed 51 cases of haemolytic anaemia, the causative factor as haemoglobinopathy was 82.35% and other than haemoglobinopathy was 17.65%. It also showed that majority of the cases in this region were belonging to beta thalassaemia major, which is more common in western zone of India followed by sickle cell anaemia.

  13. Coeliac disease with autoimmune haemolytic anaemia.

    OpenAIRE

    Miller, D. G.

    1984-01-01

    Two patients are described who have developed autoimmune haemolytic anaemia in association with their coeliac disease. Autoimmune haemolytic anaemia may represent an extension of immunological disorders linked with coeliac disease, centred on the histocompatibility antigen B8.

  14. Haemoglobin and anaemia in the SMART study

    DEFF Research Database (Denmark)

    Mocroft, Amanda; Lifson, Alan R; Touloumi, Giota;

    2011-01-01

    Data from randomized trials on the development of anaemia after interruption of therapy are not well-described.......Data from randomized trials on the development of anaemia after interruption of therapy are not well-described....

  15. Effects of Psychological Interventions in Cancer Patients Undergoing Radiotherapy%癌症放疗患者不同心理干预方式效果研究

    Institute of Scientific and Technical Information of China (English)

    汪达山; 李桂兰; 陈建华; 刘新民

    2011-01-01

    group were significantly lower than those in the control group(P<0.01); Compared with anxiety and depression at week 4 and week 8, anxiety and depression were significantly lower than those at week 0 (P<0.01); but both were rebound significantly at week 8 than those at week 4(P<0.01). Conclusion: Both the clinical training in relaxation with music and antidepressant medications are necessary for that they can help the cancer patients undergoing radiotherapy to relieve soon and can increase the patients' compliance with the cancer treatment.

  16. The UK HeartSpare Study: Randomised evaluation of voluntary deep-inspiratory breath-hold in women undergoing breast radiotherapy

    International Nuclear Information System (INIS)

    Purpose: To determine whether voluntary deep-inspiratory breath-hold (vDIBH) and deep-inspiratory breath-hold with the active breathing coordinator™ (ABCDIBH) in patients undergoing left breast radiotherapy are comparable in terms of normal-tissue sparing, positional reproducibility and feasibility of delivery. Methods: Following surgery for early breast cancer, patients underwent planning-CT scans in vDIBH and ABCDIBH. Patients were randomised to receive one technique for fractions 1–7 and the second technique for fractions 8–15 (40 Gy/15 fractions total). Daily electronic portal imaging (EPI) was performed and matched to digitally-reconstructed radiographs. Cone-beam CT (CBCT) images were acquired for 6/15 fractions and matched to planning-CT data. Population systematic (Σ) and random errors (σ) were estimated. Heart, left-anterior-descending coronary artery, and lung doses were calculated. Patient comfort, radiographer satisfaction and scanning/treatment times were recorded. Within-patient comparisons between the two techniques used the paired t-test or Wilcoxon signed-rank test. Results: Twenty-three patients were recruited. All completed treatment with both techniques. EPI-derived Σ were ⩽1.8 mm (vDIBH) and ⩽2.0 mm (ABCDIBH) and σ ⩽2.5 mm (vDIBH) and ⩽2.2 mm (ABCDIBH) (all p non-significant). CBCT-derived Σ were ⩽3.9 mm (vDIBH) and ⩽4.9 mm (ABCDIBH) and σ ⩽ 4.1 mm (vDIBH) and ⩽ 3.8 mm (ABCDIBH). There was no significant difference between techniques in terms of normal-tissue doses (all p non-significant). Patients and radiographers preferred vDIBH (p = 0.007, p = 0.03, respectively). Scanning/treatment setup times were shorter for vDIBH (p = 0.02, p = 0.04, respectively). Conclusions: vDIBH and ABCDIBH are comparable in terms of positional reproducibility and normal tissue sparing. vDIBH is preferred by patients and radiographers, takes less time to deliver, and is cheaper than ABCDIBH

  17. Eating As Treatment (EAT) study protocol: a stepped-wedge, randomised controlled trial of a health behaviour change intervention provided by dietitians to improve nutrition in patients with head and neck cancer undergoing radiotherapy

    Science.gov (United States)

    Britton, Ben; McCarter, Kristen; Baker, Amanda; Wolfenden, Luke; Wratten, Chris; Bauer, Judith; Beck, Alison; McElduff, Patrick; Halpin, Sean; Carter, Gregory

    2015-01-01

    Introduction Maintaining adequate nutrition for Head and Neck Cancer (HNC) patients is challenging due to both the malignancy and the rigours of radiation treatment. As yet, health behaviour interventions designed to maintain or improve nutrition in patients with HNC have not been evaluated. The proposed trial builds on promising pilot data, and evaluates the effectiveness of a dietitian-delivered health behaviour intervention to reduce malnutrition in patients with HNC undergoing radiotherapy: Eating As Treatment (EAT). Methods and analysis A stepped-wedge cluster randomised design will be used. All recruitment hospitals begin in the control condition providing treatment as usual. In a randomly generated order, oncology staff at each hospital will receive 2 days of training in EAT before switching to the intervention condition. Training will be supplemented by ongoing supervision, coaching and a 2-month booster training provided by the research team. EAT is based on established behaviour change counselling methods, including motivational interviewing, cognitive–behavioural therapy, and incorporates clinical practice change theory. It is designed to improve motivation to eat despite a range of barriers (pain, mucositis, nausea, reduced or no saliva, taste changes and appetite loss), and to provide patients with practical behaviour change strategies. EAT will be delivered by dietitians during their usual consultations. 400 patients with HNC (nasopharynx, hypopharynx, oropharynx, oral cavity or larynx), aged 18+, undergoing radiotherapy (>60 Gy) with curative intent, will be recruited from radiotherapy departments at 5 Australian sites. Assessments will be conducted at 4 time points (first and final week of radiotherapy, 4 and 12 weeks postradiotherapy). The primary outcome will be a nutritional status assessment. Ethics and dissemination Ethics approval from all relevant bodies has been granted. Study findings will be disseminated widely through peer

  18. Recommendations for the clinical practice: Standards, options and recommendations 2003 for the use of recombinant erythropoietin (alpha and beta epoetine, alpha darbepoetine, EPO) in the taking charge of anemia in oncology for the patients treated by radiotherapy, update; Recommandations pour la pratique clinique: Standards, Options et Recommandations 2003 pour l'utilisation de l'erythropoietine recombinante (epoetine alfa et beta, darbepoetine alfa, EPO) dans la prise en charge de l'anemie en cancerologie pour les patients traites par radiotherapie, mise a jour

    Energy Technology Data Exchange (ETDEWEB)

    Marchal, Ch. [Centre Alexis-Vautrin, oncologue-radiotherapeute, 54 - Nancy (France); Spaeth, C. [Centre Alexis-Vautrin, oncologue medical, 54 - Nancy (France); Casadevall, N. [Hopital Hotel-Dieu, hematologue, 75 - Paris (France); Daouphars, M. [Hopital Notre-Dame-de-Bon-Secours, pharmacien, 57 - Metz (France); Marec-Berard, P. [Centre Leon-Berard, oncologue-pediatre, 69 - Lyon (France); Fabre, N. [FNCLCC, methodologiste, 75 - Paris (France); Haugh, M. [FNCLCC, methodologiste, 75 - Paris (France)

    2004-06-01

    Standards, Options and Recommendations for the use of recombinant erythropoietin (epoietin alpha and beta darbepoietin alpha, EPO) in the management of anaemia in oncology for patient undergoing radiotherapy - UPDATE 2003. Context. - 'The Standards, Options and Recommendations' (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centres (FNCLCC), the twenty French cancer centres, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. Objectives. - To update the Standards, Options and Recommendations clinical practice guidelines for the use of recombinant erythropoietin (epoietin alpha and beta darbepoietin-alpha, EPO) in the management of anaemia in oncology for patient undergoing radiotherapy. Methods. - The working group identified the questions requiring up-dating from the previous guideline. Medline and Embase were searched using specific search strategies from January 1999 to October 2002. Literature monitoring was performed to identify randomized clinical trials published between October 2002 to November 2003. In addition several Internet sites were searched in October 2002. Results. - There is no standard attitude for use of rHuEPO in patients undergoing radiotherapy. There is no evidence to support use of rHuEPO in patients with ENT cancer receiving radiotherapy alone. In patients undergoing curative radiotherapy, it is recommended to correct anaemia under 10 g/dL using transfusion rather than rHuEPO. When the haemoglobin concentration is between 12 g/dL and 14 g/dL initial use of rHuEPO can be an option under certain conditions for radio-chemotherapy if the risk of

  19. Severe Anaemia during Late Pregnancy

    Directory of Open Access Journals (Sweden)

    Mahenaz Akhtar

    2012-01-01

    Full Text Available Vitamin B12 deficiency is uncommon in pregnancy, it occurs in 10–28% of uncomplicated pregnancies, and is associated with a few complications. We present a case report of a 21-year-old patient with severe anaemia during late pregnancy caused by vitamin B12 deficiency. At 38 weeks gestation and with a BMI of 48.9, a history of rupture of membranes was given but not confirmed. On examination, she appeared pale and therefore full blood counts were done. Interestingly her haemoglobin (Hb levels were 3.7 g/dL. Folate and vitamin B12 levels were also found to be low, and the diagnosis of anaemia caused by vitamin B12 deficiency was made. After treatment with vitamin B12 injections, folic acid and blood transfusions, the patient’s haemoglobin levels improved from 3.7 g/dL to 10.7 g/dL. The conclusion is that effective history taking, diagnosis, and management can prevent many complications that are usually associated with vitamin B12 deficiency anaemia.

  20. Comments on M. Henke's article: 'erythropoietin to treat head and neck cancer patients with anaemia undergoing radiotherapy: randomized, double blind, placebo controlled trial' or how a cytokine stay a cytokine; Commentaires sur l'article de M. Henke: ''erythropoietin to treat head and neck cancer patients with anaemia undergoing radiotherapy: randomised, double blind, placebo controlled trial'' ou comment une cytokine reste une cytokine

    Energy Technology Data Exchange (ETDEWEB)

    Lartigau, E. [Centre Oscar-Lambret, Dept. de Radiotherapie, 59 - Lille (France); Denis, F. [Centre Hospitalier Universitaire, Clinique d' oncologie et de radiotherapie, Inserm U316, 37 - Tours (France)

    2004-06-01

    For fifty years, the radio therapists have been working on the concept of oxygen effect, that corresponds to the reduction of the biological effect observed with the low linear energy transfer radiation (Let) used in routine when irradiated cells are exposed to a low concentration in oxygen. The appearance of erythropoietin at the beginning of 1990 has reopened the debate: clean molecules without any risk in transfusion, allowing to increase the hemoglobin concentration for the cancerous patients. The benefit of anemia correction could be important and the article of Henke and al. constitutes a first step in the research of new therapies. (N.C.)

  1. Severe acquired anaemia in Africa: new concepts

    NARCIS (Netherlands)

    M. Boele van Hensbroek; F. Jonker; I. Bates

    2011-01-01

    Severe anaemia is common in Africa. It has a high mortality and particularly affects young children and pregnant women. Recent research provides new insights into the mechanisms and causes of severe acquired anaemia and overturns accepted dogma. Deficiencies of vitamin B12 and vitamin A, but not of

  2. Current And Future Diagnostics Of Anaemia

    NARCIS (Netherlands)

    K. Stouten (Karlijn)

    2016-01-01

    markdownabstractAnaemia is often encountered in general practice but the prevalence of the different aetiology remains elusive. We analysed a large database of general practice patients newly diagnosed with anaemia, allowing for the detailed study of the prevalence of a wide range of causes and a th

  3. Factors for oral infections in patients with oral cancer undergoing radiotherapy%口腔癌患者放疗期间口腔感染的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    曾定芬; 李晓霞; 孙荣昊; 江华; 范玉霞; 阳静

    2015-01-01

    目的 探讨接受放疗的口腔癌患者发生口腔感染的相关因素.方法 选择2012年3月至2014年5月四川省肿瘤医院头颈外科因口腔癌接受放疗患者241例为研究对象.采用SPSS17.0软件中的单因素分析方法,分析口腔癌放疗患者发生口腔感染的相关因素,再将有统计学意义的变量进行多因素Logistic回归分析.结果 241例患者中93例(38.59%)发生口腔感染.93例发生口腔感染的患者中49例(52.69%)为真菌感染,44例(47.31%)为细菌感染,38例(40.86%)为混合感染.93例口腔感染患者中55例(59.14%)是在放疗4周以后发生的感染.多因素Logistic回归分析显示,口腔癌放疗后发生口腔感染的影响因素包括:临床分期、口腔健康习惯、居住地、是否同步放化疗及手术(P值均<0.05).结论 口腔癌放疗患者口腔感染多发生在放疗中后期.其中疾病临床分期晚、口腔健康习惯不良、城镇人口、放化疗同步及有手术史是导致口腔癌患者放疗后口腔感染发生的重要危险因素.%Objective To investigate the factors associated with oral infections in patients with oral cancer undergoing radiotherapy.Methods Clinical data of 241 patients with oral cancer undergoing radiotherapy between March 2012 and May 2014 in sichuan cancer hospital were reviewed.Univariate and multivariate analyses were performed to determine the factors related to oral infection occurring in the patients.SPSS 17.0 software was used to analyze the data.Results Ninety-three (38.59%) of 241 cases had oral infection.Among the 93 cases,49 (52.69%) cases presented with fungal infections,44 (47.31%) cases with bacterial infection,and 38 (40.86%) cases with mixed infection.Oral infection occurred since the fifth week after radiotherapy in 55 (59.14%) patients.Multivariate Logistic regression analysis showed that the risk factors for oral infection after radiotherapy were the late stage of cancer,poor oral health

  4. The anaemia of Plasmodium vivax malaria

    Directory of Open Access Journals (Sweden)

    Douglas Nicholas M

    2012-04-01

    Full Text Available Abstract Plasmodium vivax threatens nearly half the world’s population and is a significant impediment to achievement of the millennium development goals. It is an important, but incompletely understood, cause of anaemia. This review synthesizes current evidence on the epidemiology, pathogenesis, treatment and consequences of vivax-associated anaemia. Young children are at high risk of clinically significant and potentially severe vivax-associated anaemia, particularly in countries where transmission is intense and relapses are frequent. Despite reaching lower densities than Plasmodium falciparum, Plasmodium vivax causes similar absolute reduction in red blood cell mass because it results in proportionately greater removal of uninfected red blood cells. Severe vivax anaemia is associated with substantial indirect mortality and morbidity through impaired resilience to co-morbidities, obstetric complications and requirement for blood transfusion. Anaemia can be averted by early and effective anti-malarial treatment.

  5. Anaemia and IBD - an overlooked problem?

    DEFF Research Database (Denmark)

    Jakobsen, Dorrit; Bager, Palle

      Aim: To evaluate the process of introducing screening tools and treatment algorithms' for anaemia: detection, management and monitoring for IBD patients in an outpatient setting.   Background: Prevalence of anaemia among IBD patients have wide estimates (8,8 % - 73,7%). A reduced production...... of erythrocytes due to inflammatory inhibition of the bone marrow (chronic inflammatory anaemia) and/or lack of "building material" such as iron, folate or Vitamin-B12 are often found in IBD patients - especially Crohn´s disease patients. Furthermore blood loss due to gastrointestinal bleeding is seen. Anaemia...... due to iron deficiency can be treated with oral- or intravenous iron replacement. To systematize management of anaemia in IBD patients' different tools has been developed at Aarhus University Hospital since 2006.   Patients and Methods: Data related to 111 IBD-patients treated with intravenous iron...

  6. Efficacy of benzydamine hydrochloride, chlorhexidine, and povidone iodine in the treatment of oral mucositis among patients undergoing radiotherapy in head and neck malignancies: A drug trail

    Directory of Open Access Journals (Sweden)

    G Roopashri

    2011-01-01

    Full Text Available Background and Objectives: Oral mucositis is a common and debilitating complication of radiotherapy, which is associated with significant morbidity. It is therefore extremely important that mucositis be prevented, or at least treated to reduce its severity and sequelae. The objective of the study was to manage oral mucositis induced by radiotherapy and to reduce pain by using Benzydamine hydrochloride (0.15%, Chlorhexidine (0.2%, and Povidone iodine (5%. Results: Benzydamine hydrochloride was observed to be effective and delayed the development of severe form of mucositis and appears more efficient in the management of radiation-induced mucositis. Conclusion: Benzydamine hydrochloride (0.15% is safe, well tolerated, helps not just in delaying the progression of mucositis but also reduces the intensity of pain.

  7. Intraindividual comparison of two different skin care conceptions in patients undergoing radiotherapy of the head-and-neck region. Creme or powder?

    Energy Technology Data Exchange (ETDEWEB)

    Schreck, U.; Paulsen, F.; Bamberg, M.; Budach, W. [Dept. of Radiooncology, Univ. of Tuebingen (Germany)

    2002-06-01

    Objectives: This study evaluated for the first time in intraindividual comparison the conception of care with creme or powder. Acute skin reactions on the left and right side of the neck during symmetrically performed radiotherapy and subjective impairment were assessed. Patients and Methods: Twelve patients receiving radiotherapy of the head-and-neck region up to 50, 60, 66 and 72 Gy, respectively, were asked to treat one side of the neck with creme, the contralateral side with powder after random assignment. Objective and subjective assessment and photodocumentation were performed at therapy onset and weekly during therapy. The photodocumentation provides an impressive course of acute skin reactions under these care concepts. Results: Altogether we saw no relevant difference in favor of care with creme or powder according to objective as well as subjective assessment criteria (Figures 2 and 3). In this intraindividual comparison the results are independent from interindividual different sensitivity to radiotherapy, total dose or fractionation. Therefore the small patient number is a minor limitation for evidence. Our results are in accordance to trials comparing other care concepts. Conclusions: A relevant effect concerning onset and degree of acute skin reactions or differences in symptom relief could not be demonstrated. Both conceptions are to be regarded equal in terms of subjective symptom relief and in extent of acute skin reactions. The lack of differences may be explained by the fact that the underlying pathophysiological processes cannot be influenced by topical agents. (orig.)

  8. 乳腺癌术后放疗患者患侧上肢穴位按揉的效果观察%Effects of Acupoint Massage on Mobility of Shoulders in Patients with Breast Caner Undergoing Radiotherapy

    Institute of Scientific and Technical Information of China (English)

    吴慧英

    2011-01-01

    目的 探讨穴位按揉对乳腺癌术后行放射治疗患者患肢功能恢复的效果.方法 将乳腺癌术后行放射治疗的60例患者分为观察组和对照组各30例.对照组实施常规的手功能锻炼,观察组在对照组的基础上立即指导患者在肩髎、中府、曲泽、列缺、内关、少商进行穴位按揉,少商穴指掐1 min,余穴取揉法、一指禅推法,每穴按揉2~5 min,比较治疗3周后两组患侧上肢肩关节活动度.结果 观察组患者患肢肩关节活动度提高,有效率为83%;对照组有效率为60%,两组疗效比较差异有统计学意义(P<0.05).结论 在常规肩关节功能锻炼基础上加以穴位按揉,能促进乳腺癌术后放疗患者患肢血液循环,提高患侧上肢肩关节活动度.%Objective To explore the effects of acupoint massage on the mobility of shoulders in patients with breast caner undergoing radiotherapy. Methods A total of 60 patients with breast cancer undergoing radiotherapy were randomized into control group with routine rehabilitation exercise and experiment group in which patients received acupoint massage 2~5 min per time for 3 weeks in addition to routine exercise. The ROM of the shoulder was measured 3 weeks later. Results 83% of the patients in experiment group showed improvement in the shoulder mobility, while only 60% did in control group (P<0.05). Conclusion Acupoint massage combined with rehabilitation exercise could improve shoulder mobility more effectively in patients with breast caner undergoing radiotherapy than rehabilitation exercise only.

  9. Função pulmonar em mulheres com câncer de mama submetidas à radioterapia: um estudo piloto Pulmonary function in women with breast cancer undergoing radiotherapy: a pilot study

    Directory of Open Access Journals (Sweden)

    Renata de Carvalho Schettino

    2010-09-01

    Full Text Available O câncer de mama é a forma de câncer que mais causa mortes entre mulheres no Brasil. O tratamento consiste em intervenção cirúrgica, quimioterapia, hormonioterapia e radioterapia, esta última responsável por uma significativa diminuição na taxa de recorrência local do câncer, mas que pode afetar a função pulmonar. O objetivo deste estudo foi detectar alterações pulmonares funcionais decorrentes da radioterapia no tratamento do câncer de mama. Participaram do estudo 10 mulheres submetidas a tratamento do câncer de mama, avaliadas quanto à função pulmonar antes e após a radioterapia. Foram mensuradas capacidade inspiratória e capacidade vital forçada, por espirômetro de incentivo, e pressões inspiratória e expiratória máximas, por manovacuômetro. Embora tenha havido redução, em vários casos, dos valores medidos antes e depois da radioterapia, não foi encontrada diferença estatisticamente significativa. Nas pacientes avaliadas, pois, a radioterapia não parece ter prejudicado a função pulmonar.Breast cancer is the cancer that most causes death among women in Brazil. The treatment consists in surgery, chemotherapy, hormontherapy, and radiotherapy, the latter being responsible for important decrease in recurrence rates, though it may affect pulmonary function. The aim of this study was to detect lung function changes due to radiotherapy in breast cancer treatment. Ten women who were undergoing breast cancer treatment were assessed as to pulmonary function before and after radiotherapy. Measurements taken were inspiratory capacity and forced vital capacity, by means of incentive spirometer, and maximum inspiratory and expiratory pressures, using a pressure meter. Though in many cases measures found after radiotherapy were lower, no significant difference could be found. Thus radiotherapy did not seem to affect lung function in the assessed sample of women with breast cancer.

  10. Prevalence of anaemia among school adolescent girls.

    Directory of Open Access Journals (Sweden)

    Neha Goyal

    2015-09-01

    Full Text Available Background: Anaemia is a major public health problem especially among adolescent females and can result in diminished physical growth and cognitive development, performance in school and at work, and affects reproduction. Findings from NFHS-3 (2005-06 indicate that 56% of the adolescent girls in India are anaemic and, of these 17% suffer from moderate to severe anaemia. Aim & Objective: To find the prevalence of anaemia among adolescent girls in rural and urban schools of Haldwani. Materials and Methods: A cross-sectional study was carried out in rural as well as urban schools of Haldwani from October 2012 to March 2014 among 770 (443 rural and 327 urban adolescent girls selected by multistage random sampling, using predesigned and pretested questionnaire to collect relevant data, and estimating haemoglobin concentration using Haemoglobin Colour Scale. Data was analysed by using SPSS v 20. Results: 48.18% of adolescent girls were found to have anaemia. Prevalence of anaemia was 43.11% and 55.04% among rural and urban school girls respectively. Mean haemoglobin concentration of study subjects was 11.35g/dl. Prevalence of mild, moderate and severe anaemia among study population was 34.53%, 10.13% and 3.52% respectively. Conclusion: The present study revealed that half of the school going adolescent girls were suffering from anaemia in rural and urban areas of Haldwani

  11. Quality of life assessment in advanced non-small-cell lung cancer patients undergoing an accelerated radiotherapy regimen: report of ECOG study 4593

    International Nuclear Information System (INIS)

    Purpose: To prospectively evaluate the quality of life (QOL) before, at completion, and after therapy for patients receiving an accelerated fractionation schedule of radiotherapy for advanced, unresectable non-small-cell lung cancer in a Phase II multi-institutional trial. Methods and Materials: The Functional Assessment of Cancer Therapy-Lung (FACT-L) patient questionnaire was used to score the QOL in patients enrolled in the Eastern Cooperative Oncology Group Phase II trial (ECOG 4593) of hyperfractionated accelerated radiotherapy in non-small-cell lung cancer. Radiotherapy (total dose 57.6 Gy in 36 fractions) was delivered during 15 days, with three radiation fractions given each treatment day. The protocol was activated in 1993, and 30 patients had accrued by November 1995. The FACT-L questionnaire was administered at study entry (baseline), on the last day of radiotherapy (assessment 2), and 4 weeks after therapy (assessment 3). The FACT-L includes scores for physical, functional, emotional, and social well-being (33 items), and a subscale of lung cancer symptoms (10 additional items). The summation of the physical, functional, and lung cancer symptom subscales (21 items) constitutes the Trial Outcome Index (TOI), considered the most clinically relevant outcome measure in lung cancer treatment trials. Results: The FACT-L completion rates at the designated study time points were as follows: baseline, 30 of 30 (100%); assessment 2, 29 (97%) of 30; and assessment 3, 24 (80%) of 30. At treatment completion, statistically significant declines in QOL scores were noted, compared with baseline for physical and functional well-being. Emotional well-being scores improved at both assessment 2 and assessment 3. The physical and functional scores returned approximately to baseline values at assessment 3. The change in TOI score was evaluated as a function of the clinical response to treatment, toxicity grade, and survival; no clear association was noted. A trend for the

  12. Characteristics of users and implications for the use of complementary and alternative medicine in Ghanaian cancer patients undergoing radiotherapy and chemotherapy: a cross- sectional study

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    Yarney Joel

    2013-01-01

    Full Text Available Abstract Background There is widespread use of Complementary and Alternative Medicine (CAM in Ghana, driven by cultural consideration and paradigm to disease causation. Whether there is concurrent use of conventional medicine and CAM in cancer patients is unknown. This study investigates the prevalence, pattern and predictors of CAM use in cancer patients. Overlapping toxicity, sources of information, and whether users inform their doctor about CAM use is examined. Method Cross-sectional study using a questionnaire administered to cancer patients, who were receiving radiotherapy and or chemotherapy or had recently completed treatment at a single institution was used. Results Ninety eight patients participated in the study with a mean age of 55.5 (18–89, made up of 51% females. Married individuals formed 56% of the respondents, whilst 49% had either secondary or tertiary education. Head and neck cancer patients were 15.3%, breast (21.4%, abdomen/pelvic cancers constituted (52%.Seventy seven (78.6% patients received radiotherapy only, 16.3% received radiation and chemotherapy and 5.3% had chemotherapy only. Ninety five patients were diagnosed of cancer within the past 24 months,73.5% were CAM users as follows; massage(66.3%, herbal(59.2%, mega vitamins(55.1%, Chinese medicine(53.1%,and prayer(42.9%. Sixty eight percent were treated with curative intent. Overlapping toxicity was reported. Majority (83.3% of users had not informed their doctor about CAM use. On univariate analysis, female (p=0.004 and palliative patients, p=0.032 were more likely to be CAM users. Multivariate analysis identified female (p Friends and Media are the main sources of information on CAM. There was increase in CAM use after the diagnosis of cancer mainly for Chinese Medicine and vitamins. Conclusion There is high CAM usage among Cancer patients, comparable to use in the general population, there is concurrent use of CAM and conventional medicine with reported

  13. Therapeutic efficacy of traditional Chinese medicine, Shen-Mai San, in cancer patients undergoing chemotherapy or radiotherapy: study protocol for a randomized, double-blind, placebo-controlled trial

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    Lo Lun-Chien

    2012-12-01

    Full Text Available Abstract Background Cancer is one of the major health issues worldwide. An increasing number of cancer patients are offered treatment with surgery, chemotherapy and radiotherapy. Traditional Chinese medicine (TCM is one of the most common complementary therapies offered to cancer patients in Taiwan. We designed a randomized, double-blind, placebo-controlled clinical trial to evaluate the efficacy of TCM in patients with cancer. Methods/design In this study, inclusion criteria are postoperative patients with histologically confirmed cancer within 3 years who are undergoing chemotherapy or radiotherapy, more than 18 years old, have given signed informed consent, have the ability to read Chinese, and the ability for oral intake. Exclusion criteria include being pregnant, breast feeding, having completed chemotherapy or radiotherapy, brain metastasis with Eastern Cooperative Oncology Group (ECOG performance status of two to four, delusion or hallucinations, acute infection, and have received medications under other clinical trials. The patients were separated into an intervention group (Shen-Mai-San, SMS and a placebo group for four weeks using a randomized, double-blind procedure. The European Organization for Research and Treatment of Cancer (EORTC Quality of Life questionnaire (QOL-C30 was used to evaluate the quality of life. General data, hemoglobin (Hb, hematocrit (Hct, glutamic-oxalacetic transaminase (GOT, glutamic-pyruvic transaminase (GPT, blood urea nitrogen (BUN, creatinine, carcinoembryonic antigen (CEA, TCM diagnosis data and heart rate variability (HRV were also recorded. These data were collected at baseline, two weeks and four weeks after receiving medication. The patients were prescribed granules which contained therapeutic medicines or placebo. Paired-T test was used for statistical analysis. Discussion Shen-Mai-San is composed of processed Ginseng radis, Liriope spicata, and Schizandrae fructus. It was found to be effective for

  14. [Revised practice guideline 'Anaemia in midwifery practice'

    NARCIS (Netherlands)

    Beentjes, M.; Jans, S.M.P.J.

    2012-01-01

    The practice guideline of the Royal Dutch Organization of Midwives 'Anaemia in primary care midwifery practice' published in 2000, has recently been revised. The revised guideline takes physiological haemodilution during pregnancy into consideration and provides gestation specific reference values f

  15. A randomized phase III prospective trial of bethanechol to prevent mucositis, candidiasis, and taste loss in patients with head and neck cancer undergoing radiotherapy. A secondary analysis

    International Nuclear Information System (INIS)

    The aim of this study was to determine the impact of bethanechol administration concomitant to radiotherapy (RT) on oral mucositis, candidiasis and taste loss. We performed a secondary analysis of a previously conducted prospective randomized trial which evaluated the effect of bethanechol on salivary gland dysfunction before, during, and after RT for head and neck cancer (HNC), in comparison to artificial saliva. Mucositis, candidiasis and taste loss were analyzed in 36 patients. Mucositis was scored using the World Health Organization (WHO) method; candidiasis was diagnosed by means of clinical examination, whereas taste loss was assessed by the patients' subjective report of absence of taste. No significant differences were observed between groups in relation to frequency and severity of mucositis or frequency of candidiasis and taste loss. In conclusion, bethanechol does not appear to reduce the incidence of mucositis, candidiasis, and taste loss when administered during RT. (author)

  16. Cerebral microcirculation during experimental normovolaemic anaemia

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    Judith eBellapart

    2016-02-01

    Full Text Available Anaemia is accepted amongst critically ill patients as an alternative to elective blood transfusion. This practice has been extrapolated to head injury patients with only one study comparing the effects of mild anaemia on neurological outcome. There are no studies quantifying microcirculation during anaemia. Experimental studies suggest that anaemia leads to cerebral hypoxia and increased rates of infarction, but the lack of clinical equipoise when testing the cerebral effects of transfusion amongst critically injured patients, supports the need of experimental studies. The aim of this study was to quantify cerebral microcirculation and the potential presence of axonal damage in an experimental model exposed to normovolaemic anaemia, with the intention of describing possible limitations within management practices in critically ill patients. Under non-recovered anaesthesia, six Merino sheep were instrumented using an intracardiac transeptal catheter to inject coded microspheres into the left atrium to ensure systemic and non-chaotic distribution. Cytometric analyses quantified cerebral microcirculation at specific regions of the brain. Amyloid precursor protein staining was used as an indicator of axonal damage. Animals were exposed to normovolaemic anaemia by blood extractions from the indwelling arterial catheter with simultaneous fluid replacement through a venous central catheter. Simultaneous data recording from cerebral tissue oxygenation, intracranial pressure and cardiac output was monitored. A regression model was used to examine the effects of anaemia on microcirculation with a mixed model to control for repeated measures. Homogeneous and normal cerebral microcirculation with no evidence of axonal damage was present in all cerebral regions, with no temporal variability, concluding that acute normovolaemic anaemia does not result in short term effects on cerebral microcirculation in the ovine brain.

  17. Anaemia impedes functional mobility after hip fracture surgery

    DEFF Research Database (Denmark)

    Foss, N.B.; Kristensen, M.T.; Kehlet, H.

    2008-01-01

    BACKGROUND: the impact of anaemia on the outcome after a hip fracture surgery is controversial, but anaemia can potentially decrease the physical performance and thereby impede post-operative rehabilitation. We therefore conducted a prospective study to establish whether anaemia affected functional...... was measured on each of the first three post-operative days, and anaemia defined as Hb ..., respectively. A significant association between anaemia and the ability to walk independently before the correction of anaemia was present on each of the 3 days separately (P

  18. Survey of patient dosimetry for head and neck cancer patients undergoing external radiotherapy treatment: A study from northeastern hospitals of India

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    Sharma Arunkumar

    2009-01-01

    Full Text Available Aim : To study dosimetry of patients during the external radiotherapy of head and neck cancers from different hospitals of the northeastern region (NER of India. Materials and Methods : 35 confirmed cases of head and neck cancers reporting to three different hospitals in the NER of India who underwent radiation treatment were the materials for the study. Dosimetry was carried out at 8(eight anatomical points to these patients, namely, target (entrance and exit points, forehead, chest, abdomen, gonad, arm, and leg respectively by thermoluminescence (TL as well as optically stimulated luminescence (OSL dosimeters. Unlike conventional appliances, we used common iodized salt as TL/OSL phosphor. Results : Patient dosimetry was found to vary with an average of 1.17 ± 0.39 Sv at forehead, 1.24 ± 0.39 Sv at chest, 0.52 ± 0.13 Sv at gonad to a minimum of 0.26 ± 0.07 Sv at leg areas when exposed to a cumulative dose of 65 Sv at the target. Conclusion : Maximum dose received from a stray radiation is about 1.5 Sv at forehead/chest and dosimetry of patient among the three centers is not significantly different at the 5% level of probability.

  19. Differentiation of irradiation and cetuximab induced skin reactions in patients with locally advanced head and neck cancer undergoing radioimmunotherapy: the HICARE protocol (Head and neck cancer: ImmunoChemo and Radiotherapy with Erbitux) – a multicenter phase IV trial

    International Nuclear Information System (INIS)

    In order to improve the clinical outcome of patients with locally advanced squamous cell carcinoma of the head and neck (LASCCHN) not being capable to receive platinum-based chemoradiation, radiotherapy can be intensified by addition of cetuximab, a monoclonal antibody that blocks the epidermal growth factor receptor (EGFR). The radioimmunotherapy with cetuximab is a feasible treatment option showing a favourable toxicity profile. The most frequent side effect of radiotherapy is radiation dermatitis, the most common side effect of treatment with cetuximab is acneiform rash. Incidence and severity of these frequent, often overlapping and sometimes limiting skin reactions, however, are not well explored. A clinical and molecular differentiation between radiogenic skin reactions and skin reactions caused by cetuximab which may correlate with outcome, have never been described before. The HICARE study is a national, multicenter, prospective phase IV study exploring the different types of skin reactions that occur in patients with LASCCHN undergoing radioimmun(chemo)therapy with the EGFR inhibitor cetuximab. 500 patients with LASCCHN will be enrolled in 40 participating sites in Germany. Primary endpoint is the rate of radiation dermatitis NCI CTCAE grade 3 and 4 (v. 4.02). Radioimmunotherapy will be applied according to SmPC, i.e. cetuximab will be administered as loading dose and then weekly during the radiotherapy. Irradiation will be applied as intensity-modulated radiation therapy (IMRT) or 3D-dimensional radiation therapy. The HICARE trial is expected to be one of the largest trials ever conducted in head and neck cancer patients. The goal of the HICARE trial is to differentiate skin reactions caused by radiation from those caused by the monoclonal antibody cetuximab, to evaluate the incidence and severity of these skin reactions and to correlate them with outcome parameters. Besides, the translational research program will help to identify and confirm novel

  20. 以鼻咽癌放疗患者为实例培训年轻护士临床实践能力的探讨%Study on extended nursing needs of nasopharyngeal carcinoma patients undergoing radiotherapy

    Institute of Scientific and Technical Information of China (English)

    倪杰; 陆勤美; 周晓梅; 陆美芹

    2016-01-01

    Objective To explore the effective method of developing young nurses ' clinical practicing ability with specialized characteristics. Methods The training and examination group was composed of department head nur-ses, head nurses and specialized nurses. Nasopharyngeal carcinoma patients undergoing radiotherapy were taken as the target cases. A total of 33 nurses with 2 to 5 years' working experience were trained and examined in terms of the follow-ing 6 core abilities, namely, their clinical thinking and judgement ability, illness evaluation and observation ability, health education and rehabilitation, communication and humanity care, specialized theory knowledge and operating skills by means of theory and operating training, nursing teaching and ward rounds, demonstrating on site and exami-ning while teaching. Results The 6 core competences of the young nurses after training were significantly better than that before the training, 70%of them achieved excellent and good level. Conclusion It's an effective training method to develop the young nurses' clinical practical abilities by means of taking nasopharyngeal carcinoma patients undergoing radiotherapy as practical examples.%目的:探讨培养具有专科特色的年轻护士临床实践能力的有效方法。方法科护士长、护士长、专科护士组成的培训考核组以鼻咽癌放疗患者为实例,通过理论及操作培训、护理教学查房、实境示范及带教考核等方法对33名工作2~5年内的护士围绕临床思维与判断能力、病情评估与观察能力、健教康复、沟通表达及人文关怀、专科理论知识、操作技能6项核心能力进行培训和考核。结果经过培训后年轻护士6项核心能力明显优于培训前,70%的护士达到了优秀和良好的等级。结论以鼻咽癌放疗患者为实例培训年轻护士临床实践能力是一种有效的培训方法。

  1. Prolactinoma presenting as chronic anaemia with osteoporosis: a case report

    OpenAIRE

    Hanley John P; MacLean Fergus R

    2010-01-01

    Abstract Introduction Unexplained anaemia is a rare mode of presentation for prolactinoma. We describe a case of a man, with chronic anaemia ascribed to old age. Six years later, he was evaluated and diagnosed with a prolactinoma and resultant osteoporosis. Prolactinoma in old people may present insidiously with chronic anaemia and osteoporosis with or without sexual dysfunction. Case presentation We describe the case of a 70-year-old Caucasian man who presented with mild anaemia and tirednes...

  2. Intermittent Preventive Antimalarial Treatment for Children with Anaemia.

    OpenAIRE

    Athuman, Mwaka; Kabanywanyi, Abdunoor M; Rohwer, Anke C

    2015-01-01

    Background Anaemia is a global public health problem. Children under five years of age living in developing countries (mostly Africa and South-East Asia) are highly affected. Although the causes for anaemia are multifactorial, malaria has been linked to anaemia in children living in malaria-endemic areas. Administering intermittent preventive antimalarial treatment (IPT) to children might reduce anaemia, since it could protect children from new Plasmodium parasite infection (the parasites tha...

  3. Erythropoietin and radiotherapy; Erythropoietine et radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Le Fur, E.; Albarghach, M.N.; Pradier, O. [CHU de Morvan, Dept. de radiotherapie, 29 - Brest (France)

    2010-01-15

    Erythropoietin (E.P.O.) is a glycoprotein hormone. This hormone is a growth factor for red blood cells precursors in the bone marrow. The decrease of oxygen partial pressure, a reduced number of erythrocytes caused by bleeding or excessive destruction, or increased tissues oxygen requirements lead to increased secretion of E.P.O.. Its action takes place on bone marrow erythroblastic cells through specific receptors. E.P.O. stimulates the proliferation of red cell precursors stem cells in the bone marrow, thus increasing their production in one to two weeks. The effectiveness of E.P.O. at increasing haemoglobin and improving patients quality of life has been demonstrated by several studies. However, its use in radiotherapy remains controversial. While tumour hypoxia caused by anaemia is a factor of radio resistance and thus a source of local failure, tumour expression of E.P.O. receptors presents a significant risk for tumour progression and neo-angiogenesis, which would be increased during the administration of E.P.O.. The purpose of this article is to answer the question: is there a place for E.P.O. in combination with radiotherapy in the management of cancer?

  4. Chronic anaemia, hyperbaric oxygen and tumour radiosensitivity

    Energy Technology Data Exchange (ETDEWEB)

    McCormack, M.; Nias, A.H.W.; Smith, Eileen (Saint Thomas' Hospital, London (UK). Richard Dimbleby Research Lab.)

    1990-10-01

    The present study examined the relationship between anaemia and tumour response to radiation given in air or HPO in C{sub 3}H mice transplanted with a mammary adenocarcinoma using a growth delay assay to assess radiation response. Radiation studies with these anaemic mice demonstrated that the tumour radiosensitivity was decreased when treatment was given in air. HPO was successful in overcoming the increased radioresistance associated with anaemia. This result suggested that tumours grown in anaemic mice have a higher hypoxic fraction than those grown in control mice. Changes in host physiology with chronic anaemia may contribute to the benefit seen with HPO but such alterations per se may be inadequate to maintain tumour oxygenation when treatment is given in air. (author).

  5. PERINATAL OUTCOME IN SEVERE ANAEMIA COMPLICATING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Nirmala Devi

    2015-06-01

    Full Text Available BACKGROUND: Anaemia is the commonest global public health problem and especially harmful when the pregnancy is complicated by anaemia. Women in reproductive age group are more vulnerable for iron deficiency anaemia with an estimated prevalence of around 70 to 80% in pregnant women. MATERIAL AND METHODS: The aim of the study was to analyse the foetal outcome in the hospitalised pregnant women with severe anaemia. This is a prospective study carried out at maternity ward of Government G eneral H ospital, Kurnool of Andhra Pradesh, India over a period of one year from October 2007 to September 2008. RESULTS: Total of 9731 deliveries occurred during the study period, 282 (2.89 % were severely anaemic at the time of delivery. Majority of the women w ere of 20 - 24 years age (68.4% with second gravidas 37.5%, term gestation 52.1%, preterm deliveries 47.9%, lower socio - economic status 87.6% and Unbooked cases 67.4% and low birth weight in 53.2% cases, intra uterine growth retardation and intra uterine foetal death contributes to 12.8% and 16.7% cases respectively. A total of 36 (12.8% neonates required admission in neonatal intensive care unit and 16(5.7% of them died. CONCLUSION: Severe anaemia during pregnancy has adverse perinatal outcome in the fo rm of low birth weight, preterm birth, intrauterine growth retardation and intrauterine death. Regular iron supplementation during the antenatal period, management of anaemia and improving the nutritional status of the mother will improve the adverse neona tal outcome and decreases perinatal morbidity and mortality.

  6. Iron deficiency anaemia in Sri Lanka

    International Nuclear Information System (INIS)

    The commonest cause of nutritional anaemia in the Sri Lankan population is iron deficiency. The diets of the population belonging to the lower socio-economic groups contain little food of animal origin. Thus, their diets are deficient in easily absorbable (haem) iron; and are also heavily cereal-based. Therefore interference in the absorption of dietary iron also occurs. Iron-deficiency anaemia is not restricted to the so-called ''vulnerable groups'' in Sri Lanka, however, their greater demands make the problem not only commoner but also more severe. Among pregnant and lactating women anaemia is often associated with folate deficiency. It must also be noted that the low availability of dietary iron is compounded in large population groups. Malaria, presently raging on an epidemic scale is also a major contributory factor to the incidence of anaemia. The purpose of this study was to examine the iron status of pre-school children and pregnant women; to establish normal levels of biochemical indices at different trimesters; to record the effect of iron supplementation during pregnancy; and to record the bioavailability of iron from weaning foods and common adult diets. 6 figs, 14 tabs

  7. Iron incorporation and post-malaria anaemia.

    Directory of Open Access Journals (Sweden)

    Conor P Doherty

    Full Text Available BACKGROUND: Iron supplementation is employed to treat post-malarial anaemia in environments where iron deficiency is common. Malaria induces an intense inflammatory reaction that stalls reticulo-endothelial macrophagal iron recycling from haemolysed red blood cells and inhibits oral iron absorption, but the magnitude and duration of these effects are unclear. METHODOLOGY/PRINCIPAL FINDINGS: We examined the red blood cell incorporation of oral administered stable isotopes of iron and compared incorporation between age matched 18 to 36 months old children with either anaemia post-malaria (n = 37 or presumed iron deficiency anaemia alone (n = 36. All children were supplemented for 30 days with 2 mg/kg elemental iron as liquid iron sulphate and administered (57Fe and (58Fe on days 1 and 15 of supplementation respectively. (57Fe and(58Fe incorporation were significantly reduced (8% vs. 28%: p<0.001 and 14% vs. 26%: p = 0.045 in the malaria vs. non-malaria groups. There was a significantly greater haemoglobin response in the malaria group at both day 15 (p = 0.001 and 30 (p<0.000 with a regression analysis estimated greater change in haemoglobin of 7.2 g/l (s.e. 2.0 and 10.1 g/l (s.e. 2.5 respectively. CONCLUSION/SIGNIFICANCE: Post-malaria anaemia is associated with a better haemoglobin recovery despite a significant depressant effect on oral iron incorporation which may indicate that early erythropoetic iron need is met by iron recycling rather than oral iron. Supplemental iron administration is of questionable utility within 2 weeks of clinical malaria in children with mild or moderate anaemia.

  8. Psychological and physical distress of cancer patients during radiotherapy

    CERN Document Server

    König, A

    2001-01-01

    Purpose: patients undergoing radiotherapy have physical and psychological symptoms related to the underlying disease and the treatment. In order to give the best possible support to the patients, more knowledge about the amount and the changing of distress in the course of radiotherapy is of essentially importance. Methods: The distress was measured in a consecutive sample of cancer patients (n=82) undergoing radiotherapy. Each patient was given the EORTC-QLQ-C30, the HADS and a special questionnaire which ascertain radiotherapy-specific items before starting the radiotherapy, at the onset of radiotherapy, in the third week of radiotherapy and 3 weeks after the end of radiotherapy. Results: within the first week of treatment the psychological distress of the patients is increasing; 98.8 % of the patients are 'moderate distressed', 46 % 'severe distressed'. General physical symptoms seem not to be affected by the radiotherapy, there is no changing. The distress caused by the organization of the radiotherapy is...

  9. PREVALENCE OF ANAEMIA AMONG ADOLESCENT SCHOOL GOING CHILDREN IN GUNTUR

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    Phanindra

    2016-06-01

    Full Text Available BACKGROUND Anaemia is a nutritional problem worldwide and its prevalence is higher in developing countries when compared to the developed countries. Anaemia, a manifestation of under-nutrition and poor dietary intake of iron is a public health problem, not only among pregnant women, infants and young children, but also among adolescents. Recent studies on the prevalence of anaemia have been conducted on preschool children only, so there is a need for more studies related to anaemia among school children. The present study was done to estimate the prevalence of anaemia among school children aged 10-15 years from Guntur, Andhra Pradesh. MATERIALS AND METHODS A cross-sectional study was conducted among 500 school children aged 10 to 15 years. Purposive sampling was used to include 250 boys and 250 girls. Haemoglobin estimation was done by cyanmethaemoglobin method. The severity of anaemia was classified on the basis of WHO criteria into Mild, Moderate and Severe. Data analysis was done by SPSS version 21. RESULTS The overall prevalence of anaemia was 27.4% in the present study. A higher prevalence of anaemia was observed among girls (42.4% than boys (12.4%. The prevalence of mild anaemia was 34.4% and 9.6% among girls and boys respectively. CONCLUSION The prevalence of anaemia is high among school going adolescents. Special emphasis should be given on nutritional supplementation with iron and health education for this age group.

  10. The clinical and radiological features of Fanconi's anaemia pictorial review

    International Nuclear Information System (INIS)

    Fanconi's anaemia is a severe refractory anaemia, associated with congenital malformations in approximately two-thirds of cases. Although these malformations may involve every organ system, suggestive dysmorphic features include growth retardation, radial ray deformities and urinary malformations. These malformations are not specific for Fanconi's anaemia, but should be recognized during pregnancy, or later in childhood, and suggest the possibility of inherited haematopoiesis disorders. De Kerviler, E. (2000)

  11. Mechanisms controlling anaemia in Trypanosoma congolense infected mice.

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    Harry A Noyes

    Full Text Available BACKGROUND: Trypanosoma congolense are extracellular protozoan parasites of the blood stream of artiodactyls and are one of the main constraints on cattle production in Africa. In cattle, anaemia is the key feature of disease and persists after parasitaemia has declined to low or undetectable levels, but treatment to clear the parasites usually resolves the anaemia. METHODOLOGY/PRINCIPAL FINDINGS: The progress of anaemia after Trypanosoma congolense infection was followed in three mouse strains. Anaemia developed rapidly in all three strains until the peak of the first wave of parasitaemia. This was followed by a second phase, characterized by slower progress to severe anaemia in C57BL/6, by slow recovery in surviving A/J and a rapid recovery in BALB/c. There was no association between parasitaemia and severity of anaemia. Furthermore, functional T lymphocytes are not required for the induction of anaemia, since suppression of T cell activity with Cyclosporin A had neither an effect on the course of infection nor on anaemia. Expression of genes involved in erythropoiesis and iron metabolism was followed in spleen, liver and kidney tissues in the three strains of mice using microarrays. There was no evidence for a response to erythropoietin, consistent with anaemia of chronic disease, which is erythropoietin insensitive. However, the expression of transcription factors and genes involved in erythropoiesis and haemolysis did correlate with the expression of the inflammatory cytokines Il6 and Ifng. CONCLUSIONS/SIGNIFICANCE: The innate immune response appears to be the major contributor to the inflammation associated with anaemia since suppression of T cells with CsA had no observable effect. Several transcription factors regulating haematopoiesis, Tal1, Gata1, Zfpm1 and Klf1 were expressed at consistently lower levels in C57BL/6 mice suggesting that these mice have a lower haematopoietic capacity and therefore less ability to recover from

  12. Radiological protection of the radiotherapy patient?

    International Nuclear Information System (INIS)

    We propose that the system and concepts of radiation protection should not be used with reference to radiotherapy patients. We justify this on conceptual grounds. The patient undergoing radiotherapy procedures, as prescribed by the medical practitioner, is protected by the quality assurance system legally required for medical exposures. (author)

  13. Maternal risk factors for childhood anaemia in Ethiopia.

    Science.gov (United States)

    Habte, Dereje; Asrat, Kalid; Magafu, Mgaywa G M D; Ali, Ibrahim M; Benti, Tadele; Abtew, Wubeshet; Tegegne, Girma; Abera, Dereje; Shiferaw, Solomon

    2013-09-01

    A total of 8260 children between the ages of 6-59 months were analyzed to identify the risk factors associated with childhood anaemia in Ethiopia. The overall mean (SD/standard deviation) haemoglobin (Hgb) level among the under-five children was 10.7 (2.2) g/dl and 50.3% were anaemic. Childhood anaemia demonstrated an increasing trend with maternal anaemia levels of mild, moderate and severe anaemia: odds ratio of 1.82, 2.16 and 3.73 respectively (p< 0.01). Children whose mothers had no formal education were 1.38 times more likely to be anaemic (p<0.01). The poorest and poorer wealth index groups had 1.52 and 1.25 increased odds of childhood anaemia respectively (p< 0.01). Childhood anaemia in Ethiopia is a severe public health problem. Maternal anaemia and socio-economic status were found to be associated with anaemia in children. A holistic approach of addressing mothers and children is of paramount importance. PMID:24069773

  14. Cytogenetic profile of aplastic anaemia in Indian children

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    Vineeta Gupta

    2013-01-01

    Interpretation & conclusions: Five (11.9% patients with acquired aplastic anaemia had chromosomal abnormalities. Trisomy was found to be the commonest abnormality. Cytogenetic abnormalities may be significant in acquired aplastic anaemia although further studies on a large sample are required to confirm the findings.

  15. Malaria, anaemia and antimalarial drug resistance in African children

    NARCIS (Netherlands)

    Obonyo, C.O.

    2006-01-01

    Malaria-associated anaemia is a potentially preventable cause of severe morbidity and mortality in children < 5years of age, in areas of high malaria transmission in sub-Saharan Africa. In a cross-sectional study of 3586 children, 80% were anaemic (haemoglobin [Hb]<11g/dL) and 3% had severe anaemia

  16. Cytokine Expression in Homozygous Sickle Cell Anaemia

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    Nnodim Johnkennedy

    2015-01-01

    Full Text Available Background: Sickle cell anaemia is an inherited disease in which the red blood cells become rigid and sticky, and change from being disc-shaped to being crescent-shaped. The change in shape is due to the presence of an abnormal form of haemoglobin. This results in severe pain and damage to some organs. Aim and Objective: The study was carried out to determine the levels of cytokine in sickle cell anemia. Material and Methods: Thirty confirmed sickle cell patients in steady state (HbSS-SS and thirty persons with normal haemoglobin (HbAA as well as sixteen sickle cell disease in crises (HbSS-cr between the ages of 15 to 30 years were selected in this study. Cytokines including interleukin 1 beta (IL- 1β, interleukin 2 (IL- 2, interleukin (IL-6, tumour necrosis factor alpha (TNF-α, and interferon gamma (IFN- λ were measured by commercially available ELISA kits. Results: The results obtained showed that the levels of TNF-α and IL-6 in sickle cell anaemia patients in crisis were significantly elevated when compared with sickle cell in steady state (P<0.05. Similarly, the levels of IL-1β, IL-6, and IFN- λ were significantly increased in sickle cell anaemia stable state when compared to HbAA subjects (P<0.05. Conclusion: This may probably implies that cytokine imbalance is implicated in the pathogenesis of sickle cell crisis. Also, cytokines could be used as an inflammatory marker as well as related marker in disease severity and hence therapeutic intervention.

  17. The Fanconi anaemia pathway: new players and new functions.

    Science.gov (United States)

    Ceccaldi, Raphael; Sarangi, Prabha; D'Andrea, Alan D

    2016-06-01

    The Fanconi anaemia pathway repairs DNA interstrand crosslinks (ICLs) in the genome. Our understanding of this complex pathway is still evolving, as new components continue to be identified and new biochemical systems are used to elucidate the molecular steps of repair. The Fanconi anaemia pathway uses components of other known DNA repair processes to achieve proper repair of ICLs. Moreover, Fanconi anaemia proteins have functions in genome maintenance beyond their canonical roles of repairing ICLs. Such functions include the stabilization of replication forks and the regulation of cytokinesis. Thus, Fanconi anaemia proteins are emerging as master regulators of genomic integrity that coordinate several repair processes. Here, we summarize our current understanding of the functions of the Fanconi anaemia pathway in ICL repair, together with an overview of its connections with other repair pathways and its emerging roles in genome maintenance. PMID:27145721

  18. The Fanconi anaemia pathway: new players and new functions.

    Science.gov (United States)

    Ceccaldi, Raphael; Sarangi, Prabha; D'Andrea, Alan D

    2016-06-01

    The Fanconi anaemia pathway repairs DNA interstrand crosslinks (ICLs) in the genome. Our understanding of this complex pathway is still evolving, as new components continue to be identified and new biochemical systems are used to elucidate the molecular steps of repair. The Fanconi anaemia pathway uses components of other known DNA repair processes to achieve proper repair of ICLs. Moreover, Fanconi anaemia proteins have functions in genome maintenance beyond their canonical roles of repairing ICLs. Such functions include the stabilization of replication forks and the regulation of cytokinesis. Thus, Fanconi anaemia proteins are emerging as master regulators of genomic integrity that coordinate several repair processes. Here, we summarize our current understanding of the functions of the Fanconi anaemia pathway in ICL repair, together with an overview of its connections with other repair pathways and its emerging roles in genome maintenance.

  19. Iron in haemoglobinopathies and rare anaemias

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    John Porter

    2014-12-01

    Full Text Available Iron overload in haemoglobinopathies and rare anaemias may develop from increased iron absorption secondary to hepcidin suppression, and/or from repeated blood transfusions. While the accumulation of body iron load from blood transfusion is inevitable and predictable from the variable rates of transfusion in the different conditions, there are some important differences in the distribution of iron overload and its consequences between these. Transfusion-dependent thalassaemia (TDT is the best described condition in which transfusional overload occurs. Initially iron loads into macrophages, subsquently hepatocytes, and then the endocrine system including the anterior pituiatry and finally the myocardium. The propensity to extrahepatic iron spread increases with rapid transfusion and with inadequate chelation therapy but there is considerable interpatient and interpopulation variability in this tendency. The conduits though which iron is delivered to tissues is through non transferrin iron species (NTBI which are taken into liver, endocrine tissues and myocardium through L-type calcium channells and possibly through other channells. Recent work by the MSCIO group1 suggests that levels of NTBI are determined by three mechanisms: i increasing with iron overload; ii increasing with ineffective erythropoieis; iii and decreasing when level of transferrin iron utilisation is high. In TDT all three mechanisms increase NTBI levels because transferrin iron utilisation is suppressed by hypertransfusion. It is hypothesized that the transfusion regimen and target mean Hb may have a key impact on NTBI levels because high transfusion regimes may suppress the ‘sink’ effect of the erythron though decreased clearance of transferrin iron. In sickle cell disease (SCD without blood transfusion the anaemia results mainly from haemolysis rather than from ineffective erythropoiesis.2 Thus there is a tendency to iron depletion because of urinary iron loss from

  20. Prevalence of Anaemia and Its Epidemiological Determinants in Pregnant Women

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    R.G.Viveki

    2012-07-01

    Full Text Available Background: Nutritional anaemia in pregnant women is one of the India’s major public health problems, despite the fact that this problem is largely preventable & easily treatable. Objectives: 1.To determine the prevalence of anaemia in pregnant women. 2. To assess the epidemiological determinants of anaemia in pregnancy. Methodology: A descriptive case series study was conducted among the pregnant women from second trimester onwards from urban field practice area from 1st March 2010 to 31st July 2010 by using pre-designed, pre-tested, structured schedule. Haemoglobin estimation was done by Sahli’s method & anaemia was graded according to WHO criteria. Statistical analyses were done by percentages and proportions, Mean and Standard Deviation (S.D, Chi-square test. Results: A high prevalence (82.9% of anaemia (Haemoglobin - < 11.0gm/dl was observed among 228 pregnant women. Majority (50.4% had moderate degree of anaemia (Haemoglobin - 7.0 to 10.0 gm/dl and 7.0% had severe anaemia (Haemoglobin - < 7.0 gm/dl. Severity of anaemia was more in 26 years of age, from nuclear families, educated upto secondary level, having vegetarian diet, parity two or more & those in third trimester with two or more abortions, although statistically not significant. However, anaemia prevalence was significantly higher among those subjects from below Class IV socio-economic status, those with less than two years of spacing between previous and index pregnancies & with less than two months IFA tablet consumption. Conclusion: A very high prevalence of anaemia in pregnancy needs mandatory regular supply of IFA tablets to adolescent and pregnant women from 4th month onwards till 3-6 months post-partum along with correction of other nutritional deficiencies and timely intervention for reducing the burden of related diseases.

  1. Anaemia in pregnancy is associated with advanced HIV disease.

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    Vikesh Nandlal

    Full Text Available BACKGROUND: Anaemia is a common clinical finding in HIV infected women and has been associated with advanced disease. The use of antiretroviral drugs such as Zidovudine (ZDV either for prevention of mother to child transmission (MTCT of HIV or used in combination with other antiretrovirals have been implicated in the development or increased severity of anaemia. We report the prevalence, type, severity and incidence of anaemia in a cohort of HIV infected women who initiated antiretroviral prophylaxis or treatment during pregnancy. METHODS AND MATERIALS: This is a retrospective cohort data analysis of 408 HIV infected pregnant women who participated in a breastfeeding intervention study (HPTN 046 Study, ClinicalTrials.gov NCT 00074412 in South Africa. Women initiated zidovudine prophylaxis for PMTCT or triple antiretroviral treatment in pregnancy according to the standard of care. Laboratory and clinical data in pregnancy, <72 hours and 2 weeks postdelivery were extracted from the main database and analysed. RESULTS: The mean Hb concentration was 10.6 g/dL at baseline and 262/408 (64.2% women were diagnosed with anaemia (Hb<11 g/dL in pregnancy, 48/146 (32.9% subsequently developed anaemia intrapartum or postpartum and 89/310 (28.7% of all cases of anaemia remained unresolved by 2 weeks postdelivery. In a univariate analysis, CD4 count and gravidity were significant risk factors for anaemia in pregnancy, RR 1.41; 1.23-1.61 (p<0.001 and 1.10; 1.01-1.18 (p = 0.02 respectively. After adjusting for antiretroviral regimen, age and gravidity in a multivariable analysis, only the CD4 count remains a significant risk factor for anaemia in pregnancy and postdelivery. CONCLUSION: In conclusion, anaemia was most common among women in the advanced stage of HIV infection (CD4<200 cells/mm3. There was no evidence of an association between ZDV or triple ARVs and anaemia.

  2. Anaemia and iron deficiency anaemia among young adolescent girls from the peri urban coastal area of Indonesia.

    Science.gov (United States)

    Kurniawan, Yustina Anie Indriastuti; Muslimatun, Siti; Achadi, Endang L; Sastroamidjojo, Soemilah

    2006-01-01

    Anaemia due to iron deficiency is still a widespread problem. Among adolescent girls, it will bring negative consequences on growth, school performance, morbidity and reproductive performance. This cross sectional study aimed to identify the different nutritional and iron status characteristics of young adolescent girls 10-12 years old with iron deficiency anaemia and anaemia without iron deficiency in the rural coastal area of Indonesia. Anaemic girls (N =133) were recruited out of 1358 girls from 34 elementary schools. Haemoglobin, serum ferritin, serum transferrin receptor and zinc protophorphyrin were determined for iron status, whilst weight and height were measured for their nutritional status. General characteristics and dietary intake were assessed through interview. Out of 133 anaemic subjects, 29 (21.8%) suffered from iron deficiency anaemia, which was not significantly related to age and menarche. About 50% were underweight and stunted indicating the presence of acute and chronic malnutrition. The proportion of thinness was significantly higher (P < 0.05) among subjects who suffered from iron deficiency anaemia (51.7% vs. 29.8%). Furthermore, thin subjects had a 5 fold higher risk of suffering from iron deficiency anaemia (P< 0.05) than non-thin subjects (OR: 5.1; 95%CI 1.34-19.00). Further study was recommended to explore other factors associated with anaemia and iron deficiency anaemia, such as the thalassemia trait and vitamin A deficiency. The current iron-folate supplementation program for pregnant women should be expanded to adolescent girls.

  3. A community based field research project investigating anaemia amongst young children living in rural Karnataka, India: a cross sectional study

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    Black Jim

    2009-02-01

    Full Text Available Abstract Background Anaemia is an important problem amongst young children living in rural India. However, there has not previously been a detailed study of the biological aetiology of this anaemia, exploring the relative contributions of iron, vitamin B12, folate and Vitamin A deficiency, inflammation, genetic haemoglobinopathy, hookworm and malaria. Nor have studies related these aetiologic biological factors to household food security, standard of living and child feeding practices. Barriers to conducting such work have included perceived reluctance of village communities to permit their children to undergo venipuncture, and logistical issues. We have successfully completed a community based, cross sectional field study exploring in detail the causes of anaemia amongst young children in a rural setting. Methods and design A cross sectional, community based study. We engaged in extensive community consultation and tailored our study design to the outcomes of these discussions. We utilised local women as field workers, harnessing the capacity of local health workers to assist with the study. We adopted a programmatic approach with a census rather than random sampling strategy in the village, incorporating appropriate case management for children identified to have anaemia. We developed a questionnaire based on existing standard measurement tools for standard of living, food security and nutrition. Specimen processing was conducted at the Primary Health Centre laboratory prior to transport to an urban research laboratory. Discussion Adopting this study design, we have recruited 415 of 470 potentially eligible children who were living in the selected villages. We achieved support from the community and cooperation of local health workers. Our results will improve the understanding into anaemia amongst young children in rural India. However, many further studies are required to understand the health problems of the population of rural India, and

  4. CLINICAL PROFILE OF ANAEMIA IN A TERTIARY CARE HOSPITAL

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    Ather Akhtar

    2016-04-01

    Full Text Available BACKGROUND Anaemia causes a reduction in the oxygen carrying capacity of the blood resulting in tissue hypoxia. Cardiac output at rest is not usually increased in most chronic anaemia until haemoglobin levels fall below 7 g/dL, but abnormal rise in output with exercise may occur with levels as high as 10 g/dL. The increase in cardiac output has been observed to correlate well with the degree of anaemia. Other compensatory mechanisms to chronic anaemia available to the body include decreased circulation time and increased tissue oxygen uptake. The latter is facilitated by a shift to the right of the oxygen haemoglobin dissociation curve. Cardiomegaly may also be as a result of the increased workload on the heart from the increased viscosity of blood in anaemia patients. Anaemia in the elderly is an extremely common problem that is associated with increased mortality and poorer health-related quality of life, regardless of the underlying cause of the low haemoglobin. A study of anaemia in elderly patients found a wide variation in prevalence, ranging from 2.9% to 61% in men and 3.3% to 41% in women. Higher rates were found in hospitalised patients than in community dwellers. It is easy to overlook anaemia in the elderly, since such symptoms as fatigue, weakness, or shortness of breath may be attributed to the ageing process itself. Our objective is to show the prevalence of anaemia even in a tertiary health care centre. METHODS One hundred patients were identified who were admitted in the Department of Medicine, Deccan College of Medical Sciences. Among the 100 patients, 38 were male and 62 were female. The study was conducted from Jan 2014 To Jan 2015. Patients having haemoglobin less than 10 g% in the medical wards were enrolled in the study. RESULTS Among the 100 patients, 38 were male and 62 were female. The average haemoglobin was 6.4 g%, the lowest being 2.8 g%. Peripheral blood smear showed hypochromic picture in 58, macrocytic picture in

  5. Prolactinoma presenting as chronic anaemia with osteoporosis: a case report

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    Hanley John P

    2010-02-01

    Full Text Available Abstract Introduction Unexplained anaemia is a rare mode of presentation for prolactinoma. We describe a case of a man, with chronic anaemia ascribed to old age. Six years later, he was evaluated and diagnosed with a prolactinoma and resultant osteoporosis. Prolactinoma in old people may present insidiously with chronic anaemia and osteoporosis with or without sexual dysfunction. Case presentation We describe the case of a 70-year-old Caucasian man who presented with mild anaemia and tiredness. His anaemia was investigated and ascribed to senescence. Endocrine causes were not considered or tested for. Six years later, he was again referred. Reassessment and direct questioning revealed long-standing sexual dysfunction. It was also discovered that our patient had fractured his radius twice, with minor trauma, during the preceding year. His serum prolactin was massively increased and a magnetic resonance imaging (MRI scan of the head demonstrated a pituitary mass consistent with a prolactinoma. Dual X-ray absorptiometry revealed osteoporosis. Treatment of the prolactinoma led to a reduction in his serum prolactin with a rise in his haemoglobin to normal levels. This suggested that the prolactinoma was present during the initial presentation and was the cause of his anaemia. Conclusion This case highlights the importance of fully evaluating and investigating unexplained anaemia in older people and that endocrine causes should be considered. Osteoporosis also requires evaluation with secondary causes considered.

  6. Non-Invasive Detection of Anaemia Using Digital Photographs of the Conjunctiva

    OpenAIRE

    Collings, Shaun; Thompson, Oliver; Hirst, Evan; Goossens, Louise; George, Anup; Weinkove, Robert

    2016-01-01

    Background and Aims Anaemia is a major health burden worldwide. Although the finding of conjunctival pallor on clinical examination is associated with anaemia, inter-observer variability is high, and definitive diagnosis of anaemia requires a blood sample. We aimed to detect anaemia by quantifying conjunctival pallor using digital photographs taken with a consumer camera and a popular smartphone. Our goal was to develop a non-invasive screening test for anaemia. Patients and Methods The conju...

  7. Recurrent aphthous ulcers in Fanconi's anaemia: a case report.

    Science.gov (United States)

    Otan, Feyza; Açikgöz, Gokhan; Sakallioglu, Umur; Ozkan, Burcu

    2004-05-01

    Fanconi's anaemia (FA) is an autosomal recessive disorder that is clinically characterized by aplastic anaemia, congenital malformations of the renal, cardiac, skeletal and skin structures, and an increased predisposition to malignancies. Patients with FA often present with bleeding and infection, which are symptoms related to thrombocytopenia and neutropenia. There are few reports of the oral manifestations of FA. We describe oral aphthous ulcerations in two siblings with FA. There was a rapid improvement and healing of ulcers after blood transfusions and increased haemoglobin levels. This may support the role of severe anaemia in oral ulcerations. PMID:15139958

  8. [Severe macrocytic anaemia and secondary hyperparathyroidism in a vegan].

    Science.gov (United States)

    Førland, Elizabeth Siren Bjerga; Lindberg, Mats Jacob Hermansson

    2015-08-10

    Nutritional deficiency anaemia in vegans is common and usually due to lack of vitamin B12, as this vitamin is found almost exclusively in animal-based food products. In this case report we present a 39-year-old male vegan with severe macrocytic anaemia due to vitamin B12 deficiency as well as secondary hyperparathyroidism due to severe vitamin D deficiency. We want to emphasize the importance of a detailed nutritional history for patients with anaemia, and the need for vitamin B12 and vitamin D supplements for people who comply with a vegan diet. PMID:26320356

  9. [Severe macrocytic anaemia and secondary hyperparathyroidism in a vegan].

    Science.gov (United States)

    Førland, Elizabeth Siren Bjerga; Lindberg, Mats Jacob Hermansson

    2015-08-10

    Nutritional deficiency anaemia in vegans is common and usually due to lack of vitamin B12, as this vitamin is found almost exclusively in animal-based food products. In this case report we present a 39-year-old male vegan with severe macrocytic anaemia due to vitamin B12 deficiency as well as secondary hyperparathyroidism due to severe vitamin D deficiency. We want to emphasize the importance of a detailed nutritional history for patients with anaemia, and the need for vitamin B12 and vitamin D supplements for people who comply with a vegan diet.

  10. Diagnostic clues to megaloblastic anaemia without macrocytosis.

    Science.gov (United States)

    Chan, C W J; Liu, S Y H; Kho, C S B; Lau, K H T; Liang, Y S; Chu, W R; Ma, S K E

    2007-06-01

    Masking of the macrocytic expression of megaloblastic anaemia (MA) by coexisting thalassaemia, iron deficiency and chronic illness has been widely reported. We described the haematological and clinical features of 20 Chinese patients with MA presenting with mean corpuscular volume (MCV) values of haemoglobin, MCV, red cell distribution width (RDW), reticulocyte index, platelet count and serum bilirubin. All provided clues to maturation disorders within the marrow. A decision flowchart for the diagnosis of MA without macrocytosis was proposed. In the studied population, by using the parameters of haemoglobin or = 16% and reticulocyte index peripheral blood smear examination in the diagnostic procedures for such patients, as well as the importance of paying attention to patients' medical history, racial background and previous MCV value. PMID:17474892

  11. Treatment for women with postpartum iron deficiency anaemia

    DEFF Research Database (Denmark)

    Markova, Veronika; Norgaard, Astrid; Jørgensen, Karsten Juhl;

    2015-01-01

    BACKGROUND: Postpartum iron deficiency anaemia is caused by bleeding or inadequate dietary iron intake/uptake. This condition is defined by iron deficiency accompanied by a lower than normal blood haemoglobin concentration, although this can be affected by factors other than anaemia and must...... and harms of the available treatment modalities for women with postpartum iron deficiency anaemia. SEARCH METHODS: The Cochrane Pregnancy and Childbirth Group's Trials Register (9 April 2015); the WHO International Clinical Trials Registry Portal (ICTRP), and the Latin-American and Caribbean Health Sciences...... Literature database (LILACS) (8 April 2015) and reference lists of retrieved studies. SELECTION CRITERIA: We included published, unpublished and ongoing randomised controlled trials that compared a treatment for postpartum iron deficiency anaemia with placebo, no treatment, or another treatment...

  12. Effects of a dietary intervention on acute gastrointestinal side effects and other aspects of health-related quality of life: A randomized controlled trial in prostate cancer patients undergoing radiotherapy

    International Nuclear Information System (INIS)

    Purpose: To study the effect of a dietary intervention on acute gastrointestinal side effects and other aspects of health-related quality of life (HRQOL) in prostate cancer patients referred to radiotherapy. Materials and methods: A total of 130 patients were randomly assigned to one of two groups: an intervention group (IG, n = 64), instructed to reduce their intake of insoluble dietary fibres and lactose, a standard care group (SC, n = 66), instructed to continue their normal diet. Gastrointestinal side effects and other aspects of HRQOL were evaluated from baseline up to 2 months after completed radiotherapy, using the EORTC QLQ-C30 and QLQ-PR25 and the study-specific Gastrointestinal Side Effects Questionnaire (GISEQ). A scale indicating adherence to dietary instructions was developed from a Food Frequency Questionnaire (FFQ), with lower scores representing better compliance. Descriptive and inferential statistical analyses were conducted. Results: There was an interaction effect between randomization and time in the FFQ Scores (p < 0.001), indicating that both groups followed their assigned dietary instructions. The dietary intervention had no effect on gastrointestinal side effects or other aspects of HRQOL. During radiotherapy, the percentage of patients with bowel symptoms and bloated abdomen was lower in IG compared to SC, but the between-group differences were not statistically significant. During radiotherapy, the percentage of patients with bowel symptoms, urinary symptoms, pain, fatigue and diminished physical and role functioning increased in both groups. Conclusions: The dietary intervention had no effect on gastrointestinal side effects or other aspects of HRQOL. The tendency towards lower prevalence of bowel symptoms in IG may indicate some positive effect of the dietary intervention, but methodological refinements, clearer results and longer follow-up are needed before the value of diet change can be established with certainty.

  13. Genetic determinants of haemolysis in sickle cell anaemia

    OpenAIRE

    Milton, Jacqueline N.; Rooks, Helen; Drasar, Emma; McCabe, Elizabeth L.; Baldwin, Clinton T.; Melista, Efi; Gordeuk, Victor R; Nouraie, Mehdi; Kato, Gregory R.; Minniti, Caterina; Taylor, James; Campbell, Andrew; Luchtman-Jones, Lori; Rana, Sohail; Castro, Oswaldo

    2013-01-01

    Haemolytic anaemia is variable among patients with sickle cell anaemia and can be estimated by reticulocyte count, lactate dehydrogenase, aspartate aminotransferase and bilirubin levels. Using principal component analysis of these measurements we computed a haemolytic score that we used as a subphenotype in a genome-wide association study. We identified in one cohort and replicated in two additional cohorts the association of a single nucleotide polymorphism in NPRL3 (rs7203560; chr16p13·3) (...

  14. Using clinical signs to diagnose anaemia in African children.

    OpenAIRE

    Luby, S. P.; Kazembe, P.N.; Redd, S. C.; Ziba, C.; Nwanyanwu, O. C.; Hightower, A. W.; C. Franco; Chitsulo, L.; Wirima, J J; Olivar, M. A.

    1995-01-01

    Anaemia is a serious and common problem among young children in sub-Saharan Africa. As a first step towards developing guidelines for its recognition and treatment, we conducted a study to evaluate the ability of health workers to use clinical findings to identify children with anaemia. Health care workers examined a total of 1104 children under 5 years of age at two hospital-based outpatient clinics in rural Malawi. Blood samples were taken to determine haemoglobin concentrations. Pallor of ...

  15. Rare ileal localisation of angiolipoma presenting as chronic haemorrhage and severe anaemia: a case report

    Directory of Open Access Journals (Sweden)

    Della Volpe Nicola

    2008-04-01

    Full Text Available Abstract Introduction Angiolipomas are frequently observed benign tumours. They have a typical vascular component and are often located in subcutaneous tissues, and more rarely, in the gastrointestinal tract. Case presentation We report an uncommon case of an angiolipoma found in the lower portion of the small bowel of an 80-year-old man who was undergoing evaluation for chronic anaemia. A standardised diagnostic pathway was followed. Endoscopic and radiological findings were negative. The diagnosis was finally established with the aid of capsule endoscopy. The case we report is the first in the literature of an angiolipoma without specific painful symptoms. In fact, the patient did not complain of abdominal pain or alvus changes, and abdominal examination did not suggest an expansive process. The endoscopic study performed with the capsule identified the lesion as the cause of the ingravescent anaemia. Intra-operative histological examination of the lesion made it possible to avoid a major surgical procedure and assured a short postoperative course for the patient. Conclusion This report focuses on the importance of correct pre- and/or intra-operative histological diagnosis in order to offer the best therapeutic choice. An angiolipoma was suspected in this case, even though they are rarely located in the ileum.

  16. Study on effects of application of early nutrition support in patients with head and neck cancers undergoing radiotherapy and chemotherapy%早期营养支持在头颈部肿瘤放化疗患者中的应用效果研究

    Institute of Scientific and Technical Information of China (English)

    马艳会; 娄霄; 刘岩杰

    2016-01-01

    Objective:To explore application effects of early nutrition support in patients with head and neck cancers undergo-ing radiotherapy and chemotherapy. Methods: 300 patients with head and neck cancers undergoing radiotherapy and chemotherapy were selected and divided into observation group (150 cases) and control group (150 cases) according to the random number table method. The control group was given the routine nursing intervention, while the observation group was given the early nutrition support based on the routine nursing intervention. After the intervention, the nutritional status, immune index and patients' satisfaction of the two groups were compared. Results:After the radiotherapy and chemotherapy, the nutrition indexes (P<0. 01), immune indexes and total satisfaction rate (P<0. 05) of observation group were significantly better than those of control group. Conclusions:Early nutrition support for the patients with head and neck cancers undergoing radiotherapy and chemotherapy has very positive effects, can improve the nutritional status very well, improve the patients' immune ability and satisfaction, and has a high clinical application and populari-zation value.%目的::探究早期营养支持在头颈部肿瘤放化疗患者中的应用效果。方法:选取300例头颈部肿瘤放化疗患者,采取随机数字表法分为观察组和对照组,每组各150例。对照组患者给予常规护理干预;观察组患者在常规护理基础上进行早期营养支持。对比两组患者干预后患者营养状况、免疫指标及患者满意度。结果:放化疗结束后,两组患者的各项营养指标对比,观察组患者均显著优于对照组(P<0.01);两组患者免疫指标对比,观察组患者明显优于对照组,总满意率明显高于对照组(P<0.05)。结论:早期营养支持对于头颈部肿瘤放化疗患者具有十分重要的影响,可很好改善患者营养状况,增强患者的免疫力,患者

  17. STUDY OF ANAEMIA AS AN INDIVIDUAL RISK FACTOR IN CVA : ISCHEMIC STROKE

    Directory of Open Access Journals (Sweden)

    Prabhu

    2015-07-01

    Full Text Available To identify anaemia as an individual risk factor in CVA patients , in rural population , Chidambaram. In our study a total of 50 patients were identified in a 3 month non - invasive prospective observational study. The risk factors such as anaemia , diabetes , hypertension , smoking and alcohol consumption , were compared. In our study out of 41 males and 9 females the incidence rate of anaemia was found to be more in males than females. Microcytic Hypochromic anaemia and Dimorphic anaemia are the common types of anaemia identified. The stroke incidence rate was found to be more in hypertensive patients , secondary to anaemia and equal in both alcoholic and non - alcoholic patients. Anaemia was found to be the most common risk factor for stroke followed by hypertension in rural population.

  18. Evaluation of Ferric and Ferrous Iron Therapies in Women with Iron Deficiency Anaemia

    OpenAIRE

    Ilhami Berber; Halit Diri; Mehmet Ali Erkurt; Ismet Aydogdu; Emin Kaya; Irfan Kuku

    2014-01-01

    Introduction. Different ferric and ferrous iron preparations can be used as oral iron supplements. Our aim was to compare the effects of oral ferric and ferrous iron therapies in women with iron deficiency anaemia. Methods. The present study included 104 women diagnosed with iron deficiency anaemia after evaluation. In the evaluations performed to detect the aetiology underlying the iron deficiency anaemia, it was found and treated. After the detection of the iron deficiency anaemia aetiolog...

  19. Inflammation and anaemia in a broad spectrum of patients with heart failure

    NARCIS (Netherlands)

    Kleijn, Lennaert; Belonje, Anne M. S.; Voors, Adriaan A.; De Boer, Rudolf A.; Jaarsma, Tiny; Ghosh, Sudip; Kim, Joseph; Hillege, Hans L.; Van Gilst, Wiek H.; van Veldhuisen, Dirk J.; van der Meer, Peter

    2012-01-01

    Aims Anaemia in heart failure (HF) is associated with a poor prognosis. Although inflammation is assumed to be an important cause of anaemia, the association between anaemia and inflammatory markers in patients with HF has not been well established. Methods Data from a multicentre randomised clinica

  20. Haemoglobin status and predictors of anaemia among pregnant women in Mpigi, Uganda

    OpenAIRE

    Ononge, Sam; Campbell, Oona MR; Mirembe, Florence

    2014-01-01

    Background Anaemia in pregnancy is a major public health problem especially in the low-income countries where it is highly prevalent. There has been no recent study in Uganda about the factors associated with anaemia in pregnancy. We aimed to assess the current haemoglobin (Hb) status and factors associated with anaemia (Hb 

  1. Influence of Schistosoma mansoni and hookworm infection intensities on anaemia in Ugandan villages

    NARCIS (Netherlands)

    Chami, G.F.; Bulte, E.H.; Kontoleon, A.A.; Kabatereine, N.B.; Dunne, D.; Fenwick, A.; Tukahebwa, E.M.

    2015-01-01

    Anaemia remains an intractable public health problem in sub-Saharan Africa (SSA), owing largely to its complex and multifactorial causes. The absolute number of anaemia cases has increased by 50% in SSA from the year 1990 to 2010. To administer the appropriate treatment, identification of anaemia at

  2. Pica and refractory iron deficiency anaemia: a case report

    Directory of Open Access Journals (Sweden)

    von Garnier Christophe

    2008-10-01

    Full Text Available Abstract Introduction Iron deficiency is the most common cause of anaemia worldwide. Pica, the ingestion of substances that are inappropriate for consumption, is associated with iron deficiency and may be under-diagnosed. Case presentation A 34-year-old woman presented with iron deficiency anaemia refractory to treatment for more than a decade. The clinical presentation, endoscopic findings and laboratory investigations were consistent with pica. Subsequent geophysical analysis confirmed that the ingested material was kaolin, a negatively charged silicate. Conclusion Prolonged unexplained iron deficiency anaemia should prompt clinicians to remember and inquire about pica. In our patient, this would have averted numerous unnecessary investigations and prevented a decade-long suffering.

  3. Inoperable metastatic giant basal cell trunk carcinoma: radiotherapy can be useful; Carcinome basocellulaire geant du tronc metastatique inoperable: la radiotherapie peut etre utile

    Energy Technology Data Exchange (ETDEWEB)

    Mania, A.; Durando, X.; Lapeyre, M. [Centre Jean-Perrin, Clermont-Ferrand (France); Barthelemy, I. [CHU Estaing, Clermont-Ferrand (France)

    2011-10-15

    The authors evoke some characteristics of the basal cell carcinoma (slow evolution, local morbidity) and report and discuss the case of a giant basal cell trunk carcinoma, associated with several symptoms (pain, bleeding, anaemia), already metastatic at the moment of diagnosis, and locally treated by irradiation. Due to its size and expansion, this carcinoma was considered as inoperable. An external radiotherapy has been performed and resulted in a significant clinical tumour reduction. But the metastatic risk is high in such cases. Radiotherapy is then a therapeutic option for a local treatment with a durable efficiency. Short communication

  4. Pathophysiological mechanisms of severe anaemia in Malawian children.

    Directory of Open Access Journals (Sweden)

    Michaël Boele van Hensbroek

    Full Text Available BACKGROUND: Severe anaemia is a major cause of morbidity and mortality in African children. The aetiology is multi-factorial, but interventions have often targeted only one or a few causal factors, with limited success. METHODS AND FINDINGS: We assessed the contribution of different pathophysiological mechanisms (red cell production failure [RCPF], haemolysis and blood loss to severe anaemia in Malawian children in whom etiological factors have been described previously. More complex associations between etiological factors and the mechanisms were explored using structural equation modelling. In 235 children with severe anaemia (haemoglobin<3.2 mMol/L [5.0 g/dl] studied, RCPF, haemolysis and blood loss were found in 48.1%, 21.7% and 6.9%, respectively. The RCPF figure increased to 86% when a less stringent definition of RCPF was applied. RCPF was the most common mechanism in each of the major etiological subgroups (39.7-59.7%. Multiple aetiologies were common in children with severe anaemia. In the final model, nutritional and infectious factors, including malaria, were directly or indirectly associated with RCPF, but not with haemolysis. CONCLUSION: RCPF was the most common pathway leading to severe anaemia, from a variety of etiological factors, often found in combination. Unlike haemolysis or blood loss, RCPF is a defect that is likely to persist to a significant degree unless all of its contributing aetiologies are corrected. This provides a further explanation for the limited success of the single factor interventions that have commonly been applied to the prevention or treatment of severe anaemia. Our findings underline the need for a package of measures directed against all of the local aetiologies of this often fatal paediatric syndrome.

  5. Beyond anaemia management: evolving role of erythropoietin therapy in neurological disorders, multiple myeloma and tumour hypoxia models.

    Science.gov (United States)

    Boogaerts, Marc; Mittelman, Moshe; Vaupel, Peter

    2005-01-01

    Recombinant human erythropoietin (epoetin) has become the standard of care in the treatment of anaemia resulting from cancer and its treatment, and chronic kidney disease. The discovery that erythropoietin and its receptor are located in regions outside the erythropoietic system has led to interest in the potential role of epoetin in other tissues, such as the central nervous system. Animal studies have shown that systemically applied epoetin can cross the blood-brain barrier, where it reduces tissue injury associated with stroke, blunt trauma and experimental autoimmune encephalomyelitis. Pilot studies in humans have shown that epoetin treatment given within 8 h of stroke reduces infarct size and results in a significantly better outcome when compared with placebo treatment. Studies also suggest that epoetin has the potential to improve cognitive impairment associated with adjuvant chemotherapy in patients with cancer. Anaemia is a major factor causing tumour hypoxia, a condition that can promote changes within neoplastic cells that further tumour survival and malignant progression and also reduces the effectiveness of several anticancer therapies including radiotherapy and oxygen-dependent cytotoxic agents. Use of epoetin to prevent or correct anaemia has the potential to reduce tumour hypoxia and improve treatment outcome. Several therapeutic studies in anaemic animals with experimental tumours have shown a beneficial effect of epoetin on delaying tumour growth. Furthermore, clinical observations in patients with multiple myeloma and animal studies have suggested that epoetin has an antimyeloma effect, mediated via the immune system through activation of CD8+ T cells. Therefore, the role of epoetin may go well beyond that of increasing haemoglobin levels in anaemic patients, although additional studies are required to confirm these promising results. PMID:16244507

  6. EVALUATION OF ANAEMIA USING RED CELL AND RETICULOCYTE PARAMETERS USING AUTOMATED HAEMATOLOGY ANALYSER

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    Vidyadhar Rao

    2016-06-01

    Full Text Available Use of current models of Automated Haematology Analysers help in calculating the haemoglobin contents of the mature Red cells, Reticulocytes and percentages of Microcytic and hypochromic Red cells. This has helped the clinician in reaching early diagnosis and management of Different haemopoietic disorders like Iron Deficiency Anaemia, Thalassaemia and anaemia of chronic diseases. AIM This study is conducted using an Automated Haematology Analyser to evaluate anaemia using the Red Cell and Reticulocyte parameters. Three types of anaemia were evaluated; iron deficiency anaemia, anaemia of long duration and anaemia associated with chronic disease and Iron deficiency. MATERIALS AND METHODS The blood samples were collected from 287 adult patients with anaemia differentiated depending upon their iron status, haemoglobinopathies and inflammatory activity. Iron deficiency anaemia (n=132, anaemia of long duration (ACD, (n=97 and anaemia associated with chronic disease with iron deficiency (ACD Combi, (n=58. Microcytic Red cells, hypochromic red cells percentage and levels of haemoglobin in reticulocytes and matured RBCs were calculated. The accuracy of the parameters was analysed using receiver operating characteristic analyser to differentiate between the types of anaemia. OBSERVATIONS AND RESULTS There was no difference in parameters between the iron deficiency group or anaemia associated with chronic disease and iron deficiency. The hypochromic red cells percentage was the best parameter in differentiating anaemia of chronic disease with or without absolute iron deficiency with a sensitivity of 72.7% and a specificity of 70.4%. CONCLUSIONS The parameters of red cells and reticulocytes were of reasonably good indicators in differentiating the absolute iron deficiency anaemia with chronic disease.

  7. Algorithm for the diagnosis of anaemia without laboratory facilities among small children in a malaria endemic area of rural Tanzania

    DEFF Research Database (Denmark)

    Mogensen, Christian B; Soerensen, Jeff; Bjorkman, Anders;

    2006-01-01

    Anaemia among small children in tropical Africa is common and often caused by infection with Plasmodium falciparum. The diagnosis of anaemia is difficult without a laboratory estimation of haemoglobin. The aim of this study was to examine if clinical findings related to malaria and anaemia would...... help to detect moderate and/or severe anaemia in children in rural Tanzania....

  8. Nutritional Support Route and Nursing Countermeasures of Nasopharyngeal Carcinoma Patients Undergoing Radiotherapy and Chemotherapy%鼻咽癌放化疗患者的营养支持路径及护理对策

    Institute of Scientific and Technical Information of China (English)

    赵精洁; 蒙美好

    2015-01-01

    INasopharyngeal carcinoma is one of the most common head and neck malignant tumor in south China, it can reach more than 70%, radiotherapy is the main treatment. Nutrition support after chemoradio therapy for treatment and rehabilitation in patients with has the vital role. In this paper, the author discusses retrospective analysis for nearly 10 years of application of radiation and chemotherapy nutrition support and nursing intervention in patients with nasopharyngeal carcinoma (NPC), the research progress on the way of nutrition support and nursing countermeasures.%鼻咽癌是我国南方最常见的头颈部恶性肿瘤之一,可达70%以上,放射治疗是主要治疗手段。进行放化疗后的营养支持对于此类患者的治疗与康复具有至关重要的作用。本文笔者探讨性回顾分析近十多年来对于应用放化疗的鼻咽癌患者的营养支持与护理干预,对营养支持的途径及护理对策研究进展进行综述。

  9. Extramedullary haematopoiesis in Thalassaemia: results of radiotherapy: a report of three patients

    Energy Technology Data Exchange (ETDEWEB)

    Pistevou-Gompaki, K.; Paraskevopoulos, P.; Kotsa, K. [Theagenion Cancer Center, Thessaloniki (Greece); Skaragas, G.; Repanta, E. [Saint Paul`s Hospital, Thessaloniki (Greece)

    1996-10-01

    Extramedullary haematopoiesis is sometimes encountered in serve anaemia. Rarely, it may cause neurological symptoms, leading to spinal cord or cauda equina compression. Three patients with thalassaemia intermedia, who developed neurological complications, are described. The diagnoses were based on the clinical findings, computed tomography and magnetic resonance imaging. Small doses of radiotherapy (10-20 Gy in 5-10 fractions) relieved symptoms in all of these patients. Our experience supports the role of radiation therapy as a treatment for this complication. (Author).

  10. Extramedullary haematopoiesis in Thalassaemia: results of radiotherapy: a report of three patients

    International Nuclear Information System (INIS)

    Extramedullary haematopoiesis is sometimes encountered in serve anaemia. Rarely, it may cause neurological symptoms, leading to spinal cord or cauda equina compression. Three patients with thalassaemia intermedia, who developed neurological complications, are described. The diagnoses were based on the clinical findings, computed tomography and magnetic resonance imaging. Small doses of radiotherapy (10-20 Gy in 5-10 fractions) relieved symptoms in all of these patients. Our experience supports the role of radiation therapy as a treatment for this complication. (Author)

  11. Propensity-matched analysis of association between preoperative anemia and in-hospital mortality in cardiac surgical patients undergoing valvular heart surgeries

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    Shreedhar S Joshi

    2015-01-01

    Full Text Available Introduction: Anaemia is associated with increased post-operative morbidity and mortality. We retrospectively assess the relationship between preoperative anaemia and in-hospital mortality in valvular cardiac surgical population. Materials and Methods: Data from consecutive adult patients who underwent valvular repair/ replacement at our institute from January 2010 to April 2014 were collected from hospital records. Anaemia was defined according to WHO criteria (hemoglobin <13g/dl for males and <12g/dl for females. 1:1 matching was done for anemic and non-anemic patients based on propensity for potentially confounding variables. Logistic regression was used to evaluate the relationship between anaemia and in-hospital mortality. MatchIt package for R software was used for propensity matching and SPSS 16.0.0 was used for statistical analysis. Results: 2449 patients undergoing valvular surgery with or without coronary artery grafting were included. Anaemia was present in 37.1% (33.91% among males & 40.88% among females. Unadjusted OR for mortality was 1.6 in anemic group (95% Confidence Interval [95% CI] - 1.041-2.570; p=0.033. 1:1 matching was done on the basis of propensity score for anaemia (866 pairs. Balancing was confirmed using standardized differences. Anaemia had an OR of 1.8 for mortality (95% CI- 1.042 to 3.094, P=0.035. Hematocrit of < 20 on bypass was associated with higher mortality. Conclusion: Preoperative anaemia is an independent risk factor associated with in-hospital mortality in patients undergoing valvular heart surgery.

  12. Cardiac manifestations of sickle cell anaemia in Sudanese children.

    Science.gov (United States)

    Ali, Ghada O M; Abdal Gader, Yahya S; Abuzedi, Elfatih S; Attalla, Bakhieta A I

    2012-01-01

    Sickle cell anaemia (SCA) is one of the commonest chronic hemolytic anaemias in the Sudan; it is a disease with high mortality and morbidity. This study was conducted aiming to observe the clinical pattern of cardiac abnormalities in children with sickle cell anaemia, and to assess the relationship between the cardiac abnormalities and the severity of the disease. The study was conducted in sickle cell disease clinic at Khartoum Children Emergency Hospital. The study group consisted of 289 patients with sickle cell anaemia, age range from 6 months to 18 years. Data were collected using a questionnaire which include full history, clinical examination findings, chest x-rays, and Electro-cardiography. Tachycardia, systolic murmurs, and cardiomegaly were detected in 28%, 61%, and 54% of patients with SCA respectively. Left ventricular dilatation was observed in 51% of the study group, while right ventricular dilatation was observed in 22% of the patients. Left and right atrial dilatations were observed in 16% and 6% of the patients respectively. Contractility, ejection fraction (EF) were found almost always normal in all study subjects. Chamber dilatations were not associated with any abnormality in Left ventricular functions. Hemglobin (Hb) levels correlated negatively with cardiomegaly. Left Ventricular End Diastolic Dimension (LVEDD) correlates negatively with Hb levels and positively with the severity index. Only four patients (1%) had abnormal valves. In conclusion, cardiac abnormalities in patients with SCA correlate with the age of the patients and the severity of the disease. PMID:27493331

  13. Collagenous gastritis : a rare cause of anaemia in childhood

    OpenAIRE

    Vella, Cecil; Pullicino, Edgar; Fearne, Christopher

    2010-01-01

    We report a thirteen year old boy presenting with severe iron deficiency anaemia. Initial extensive investigation failed to reveal an obvious cause. Subsequently a diagnosis of collagenous gastritis was made. To our knowledge this is the first report of a patient with this rare condition in the Maltese Islands.

  14. Prognosis in canine idiopathic immune-mediated haemolytic anaemia

    NARCIS (Netherlands)

    Piek, C.J.

    2011-01-01

    Canine idiopathic immune-mediated haemolytic anaemia (iIMHA) is one of the most frequently occurring immune-mediated diseases in dogs. A gel-based Coombs' test was shown to perform equally well as a classical Coombs' test. Since the gel-based Coombs' test can be commercially produced and is easy and

  15. Pathophysiological Mechanisms of Severe Anaemia in Malawian Children

    NARCIS (Netherlands)

    M.B. van Hensbroek; J.C.J. Calis; K.S. Phiri; R. de Vet; F. Munthali; R. Kraaijenhagen; H. van den Berg; B. Faragher; I. Bates; M.E. Molyneux

    2010-01-01

    Background: Severe anaemia is a major cause of morbidity and mortality in African children. The aetiology is multi-factorial, but interventions have often targeted only one or a few causal factors, with limited success. Methods and Findings: We assessed the contribution of different pathophysiologic

  16. 乳腺癌术后放疗期患者创伤后成长与人格特征的相关性分析%Relationship between post traumatic growth and personality characteristics among patients with breast cancer undergoing postoperative radiotherapy

    Institute of Scientific and Technical Information of China (English)

    童晓丹; 张平; 宋旭红

    2014-01-01

    目的:了解乳腺癌术后放疗期患者心理症状与人格的关系。方法采用问卷调查法,采用艾森克人格问卷( EPQ)和创伤后成长评定量表( PTGI)对169例乳腺癌术后放疗期患者进行调查,了解乳腺癌术后放疗患者的人格状况及成长水平,并采用Pearson相关分析法和多重线性回归法对资料进行统计分析。结果患者PTGI总均分为(65.83±13.28)分,EPQ内外倾向、神经质和精神质3个维度不同得分组间的PTGI得分差异均有统计学意义(F值分别为14.353,9.343,10.534;P<0.01),内外倾向维度与PTGI总分呈正相关(r=0.342,P<0.01),神经质和精神质维度与其呈负相关(r值分别为-0.250,-0.287;P<0.01)。回归分析结果显示,乳腺癌患者的创伤后成长受人格特征内外倾向、神经质、精神质的影响(β值分别为0.343,-0.264,-0.273;P<0.05)。结论乳腺癌术后放疗期患者存在一定程度的创伤后成长,不同人格特征的患者有不同的成长水平。%Objective To understand the relationship between psychological symptoms and personality of breast cancer patients undergoing postoperative radiotherapy .Methods A total of 169 patients with breast cancer undergoing postoperative radiotherapy were investigated with Eysenck personality questionnaire ( EPQ ) and post traumatic growth inventory (PTGI), in order to understand their personality characteristics status and post traumatic growth levels .Pearson correlation analysis and multiple linear regression were used to analyze the data.Results The total score of PTGI was (65.83 ±13.28), and there were statistically significant differences in the PTGI scores among different groups of patients who had different EPQ scores in three dimensions of extraversion, neuroticism and psychoticism (F =14.353,9.343,10.534, respectively; P <0.01).The extraversion of patients was positively

  17. Intravenous versus oral iron supplementation for correction of post-transplant anaemia in renal transplant patients

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    Mudge David W

    2009-06-01

    Full Text Available Abstract Background Post-transplant anaemia remains a common problem after kidney transplantation, with an incidence ranging from nearly 80% at day 0 to about 25% at 1 year. It has been associated with poor graft outcome, and recently has also been shown to be associated with increased mortality. Our transplant unit routinely administers oral iron supplements to renal transplant recipients but this is frequently accompanied by side effects, mainly gastrointestinal intolerance. Intravenous iron is frequently administered to dialysis patients and we sought to investigate this mode of administration in transplant recipients after noticing less anaemia in several patients who had received intravenous iron just prior to being called in for transplantation. Methods This study is a single-centre, prospective, open-label, randomised, controlled trial of oral versus intravenous iron supplements in renal transplant recipients and aims to recruit approximately 100 patients over a 12-month period. Patients will be randomised to receive a single dose of 500 mg iron polymaltose (intravenous iron group or 2 ferrous sulphate slow-release tablets daily (oral iron group. The primary outcome is time to normalisation of haemoglobin post-transplant. Prospective power calculations have indicated that a minimum of 48 patients in each group would have to be followed up for 3 months in order to have a 90% probability of detecting a halving of the time to correction of haemoglobin levels to ≥110 g/l in iron-treated patients, assuming an α of 0.05. All eligible adult patients undergoing renal transplantation at the Princess Alexandra Hospital will be offered participation in the trial. Exclusion criteria will include iron overload (transferrin saturation >50% or ferritin >800 μg/l, or previous intolerance of either oral or intravenous iron supplements. Discussion If the trial shows a reduction in the time to correction of anaemia with intravenous iron or less side

  18. Prone Whole-Breast Irradiation Using Three-Dimensional Conformal Radiotherapy in Women Undergoing Breast Conservation for Early Disease Yields High Rates of Excellent to Good Cosmetic Outcomes in Patients With Large and/or Pendulous Breasts

    International Nuclear Information System (INIS)

    Purpose: To report our institution's experience using prone positioning for three-dimensional conformal radiotherapy (3D-CRT) to deliver post-lumpectomy whole breast irradiation (WBI) in a cohort of women with large and/or pendulous breasts, to determine the rate of acute and late toxicities and, more specifically, cosmetic outcomes. We hypothesized that using 3D-CRT for WBI in the prone position would reduce or eliminate patient and breast size as negative prognostic indicators for toxicities associated with WBI. Methods and Materials: From 1998 to 2006, 110 cases were treated with prone WBI using 3D-CRT. The lumpectomy, breast target volumes, heart, and lung were contoured on all computed tomography scans. A dose of 45–50 Gy was prescribed to the breast volume using standard fractionation schemes. The planning goals were ≥95% of prescription to 95% of the breast volume, and 100% of boost dose to 95% of lumpectomy planning target volume. Toxicities and cosmesis were prospectively scored using the Common Terminology Criteria for Adverse Effects Version 3.0 and the Harvard Scale. The median follow-up was 40 months. Results: The median body mass index (BMI) was 33.6 kg/m2, and median breast volume was 1396 cm3. The worst toxicity encountered during radiation was Grade 3 dermatitis in 5% of our patient population. Moist desquamation occurred in 16% of patients, with only 2% of patients with moist desquamation outside the inframammary/axillary folds. Eleven percent of patients had Grade ≥2 late toxicities, including Grade 3 induration/fibrosis in 2%. Excellent to good cosmesis was achieved in 89%. Higher BMI was associated with moist desquamation and breast pain, but BMI and breast volume did not impact fibrosis or excellent to good cosmesis. Conclusion: In patients with higher BMI and/or large–pendulous breasts, delivering prone WBI using 3D-CRT results in favorable toxicity profiles and high excellent to good cosmesis rates. Higher BMI was associated with

  19. Prone Whole-Breast Irradiation Using Three-Dimensional Conformal Radiotherapy in Women Undergoing Breast Conservation for Early Disease Yields High Rates of Excellent to Good Cosmetic Outcomes in Patients With Large and/or Pendulous Breasts

    Energy Technology Data Exchange (ETDEWEB)

    Bergom, Carmen; Kelly, Tracy; Morrow, Natalya; Wilson, J. Frank [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Walker, Alonzo [Department of Surgery, Medical College of Wisconsin, Milwaukee, WI (United States); Xiang Qun; Ahn, Kwang Woo [Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI (United States); White, Julia, E-mail: jwhite@mcw.edu [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States)

    2012-07-01

    Purpose: To report our institution's experience using prone positioning for three-dimensional conformal radiotherapy (3D-CRT) to deliver post-lumpectomy whole breast irradiation (WBI) in a cohort of women with large and/or pendulous breasts, to determine the rate of acute and late toxicities and, more specifically, cosmetic outcomes. We hypothesized that using 3D-CRT for WBI in the prone position would reduce or eliminate patient and breast size as negative prognostic indicators for toxicities associated with WBI. Methods and Materials: From 1998 to 2006, 110 cases were treated with prone WBI using 3D-CRT. The lumpectomy, breast target volumes, heart, and lung were contoured on all computed tomography scans. A dose of 45-50 Gy was prescribed to the breast volume using standard fractionation schemes. The planning goals were {>=}95% of prescription to 95% of the breast volume, and 100% of boost dose to 95% of lumpectomy planning target volume. Toxicities and cosmesis were prospectively scored using the Common Terminology Criteria for Adverse Effects Version 3.0 and the Harvard Scale. The median follow-up was 40 months. Results: The median body mass index (BMI) was 33.6 kg/m{sup 2}, and median breast volume was 1396 cm{sup 3}. The worst toxicity encountered during radiation was Grade 3 dermatitis in 5% of our patient population. Moist desquamation occurred in 16% of patients, with only 2% of patients with moist desquamation outside the inframammary/axillary folds. Eleven percent of patients had Grade {>=}2 late toxicities, including Grade 3 induration/fibrosis in 2%. Excellent to good cosmesis was achieved in 89%. Higher BMI was associated with moist desquamation and breast pain, but BMI and breast volume did not impact fibrosis or excellent to good cosmesis. Conclusion: In patients with higher BMI and/or large-pendulous breasts, delivering prone WBI using 3D-CRT results in favorable toxicity profiles and high excellent to good cosmesis rates. Higher BMI was

  20. PREVALENCE OF ANAEMIA IN A SEMI-URBAN POPULATION OF PREGNANT WOMEN

    Directory of Open Access Journals (Sweden)

    Suganthi Ramalingam

    2016-05-01

    Full Text Available INTRODUCTION Anaemia is a serious and prominent problem in the developing countries. This study evaluates the prevalence of anaemia in pregnant women attending the outpatient clinic in a semi-urban hospital for a period of six months. MATERIALS AND METHODS Data from a sample of 500 pregnant women was collected and the patients were screened for anaemia on their booking visit in KFMS&R for a period of six months from March-August 2015. Haemoglobin was estimated by cyanmethaemoglobin method using Systronic photocolorimeter on their first antenatal visit. The degree of anaemia was categorised according to ICMR datamild (10-10.99 g/dL, moderate (7-9.99 g/dL, severe (<7 g/dL. RESULTS It was observed that the prevalence of anaemia was 51.8% in the population under study. The prevalence of mild anaemia was 18.53%, that of moderate anaemia was 63.70% and that of severe anaemia was 17.76%. It was also noticed that the prevalence of anaemia was higher in young pregnant women between 17-21 years of age (63.26%. CONCLUSION Anaemia continues to be a major health problem in India and prevention and early diagnosis will significantly reduce maternal and perinatal morbidity and mortality.

  1. Postmastectomy radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Shikama, Naoto; Koguchi, Masahiko; Sasaki, Shigeru; Kaneko, Tomoki; Shinoda, Atsunori; Nishikawa, Atsushi [Shinshu Univ., Matsumoto, Nagano (Japan). School of Medicine

    2000-10-01

    Since there have been few reports on postmastectomy radiotherapy having a high evidence level in Japan, the significance of postoperative radiotherapy and the irradiation techniques were reviewed based on reports from Western countries. Authors focused on the indications for postoperative irradiation, irradiation methods (irradiation sites, irradiation techniques; prosthetics, methods of irradiating the chest wall and lymph nodes, timing of irradiation), and complications, and discuss them. The factors thought to be adaptable to postmastectomy radiotherapy have been listed. Axillary lymph node metastasis and the size of the primary focus are thought to be important factors in locoregional recurrence. The chest wall and the supraclavicular lymph nodes are the usual sites of irradiation after mastectomy. The irradiation method consists of tangential irradiation of the chest wall and single-field irradiation of the supraclavicular lymph nodes, with 46-50 Gy in fractional doses of 1.8-2 Gy x 5/w is administered for 4.5-5.5 weeks. The timing of irradiation in the West is generally after chemotherapy. Adverse radiation effects include ischemic heart disease, pneumonitis, arm edema, rib fractures, and brachial plexus paralysis. The frequency of these complications is increased by the combined use of chemotherapy or surgery. The breast cancer cure rate in Japan is generally better than in the West. It remains to be determined whether the clinical data from Europe and America are applicable to the treatment of breast cancer in Japan. To address this issue, a clinical investigation should be performed in Japan with close cooperation between surgeons, physicians, pathologists, and radiotherapists. (K.H.)

  2. SPORTS ANAEMIA IN ENDURANCE ATHLETES: A PHYSIOLOGICAL PHENOMENON

    Directory of Open Access Journals (Sweden)

    Anil B Warkar

    2015-07-01

    Full Text Available Endurance athletes require a very efficient oxygen transport system for maximal aerobic power during physical work performance. Many studies carried on endurance athletes suggested low levels of red blood cell markers leading to misconception of existence of so called sports anaemia in athletes. Sometimes athletes are on needless iron supplementation and are concern about anaemia. The main objectives of the study were to investigate the red cell population markers and to study the sports anaemia phenomenon in endurance athletes and the underlying responses responsible for ot. 60 male endurance track and field runners age group 18-21 were selected from the local city based club named Vasant Desai Krida Sangh Akola and were compared with the age, height sex matched non athletes students of Govt. Medical College Akola. The seven red blood cell markers were studied from the blood samples taken from the cubital vein under standard conditions. The blood variables for both the groups were analyzed with an automatic cell counter. The mean values of Hb(12.27 gm% +/- 0.782, RBC count in(3.64millions per cu mm+/-0.52, hematocrit ( 41.58 % +/- 1.32, mean corpuscular Hb conc (MCHC 29.49% +/- 1.198 were all very significantly lower ( p<0.0001 as compare to controls. Whereas the plasma volume (58.412% +/- 1.32, Mean Corpuscular volume (MCV 115.06 cu microns+/- 11.54, Mean Hb conc (MCH 33.998 picogms+/- 2.608, were significantly increased in endurance athletes. Though decrease in Hb conc, Low RBC count and less hematocrit in endurance athletes indicate presence of anaemia in them but it’s not a true anaemia as it is also confirmed by MCV, MCH, MCHC values between the two groups. The significant differences between the groups are due to the response to endurance training leading to hemo dilutional anaemia caused by plasma volume expansion which increases the blood volume in endurance athletes helping them for better oxygen supply and aerobic power needed

  3. Possibilities and limits of radiotherapy in larynx carcinoma. Moeglichkeiten und Grenzen der Radiotherapie des Larynxkarzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Fietkau, R.; Sauer, R. (Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik und Poliklinik)

    1992-01-01

    Early stage glottic carcinoma can be treated with primary radiotherapy reaching equally good results compared to primary surgery; for supraglottic carcinoma surgery offers only slight advantages over primary radiotherapy. Tumor control for recurrences is considerably improved by salvage surgery. The use of primary radiotherapy allows improved or at least preserved voice and reduced rated of acute complications and late treatment sequelae. However, treatment duration is longer and probably more expensive compared to function preservation microlaryngoscopic surgery. Which treatment approach is chosen, depends in individual patient factors and specific conditions in the clinical setting. In any case, primary radiotherapy deserves a stronger say in the early stage tumor situation. In our institution early stage supraglottic carcinoma undergo primary surgery. Advanced carcinomas (T2b and more) are rarely suited for primary radiotherapy with the exception of some very confined T3 tumors. Surgical approaches should be favoured, since they provide a detailed pathological tumor staging including R-classification, which would be lacking using primary radiotherapy. There are clear reasons to treat the lymph nodes for glottic carcinomas stage T2b and more and for all supraglottic carcinomas with radiotherapy. Specific risk factors are: tumor at the margins of the incision (R1), infiltration of the cartilage and pre-epiglottic space, paratracheal and subglottic extension more than 1 cm, perineural invasion, grade III and IV as well as emergency tracheostomy. Postoperative radiotherapy should be given to the lymph nodes for all positive neck-dissections. New therapeutic approaches are on the horizon, which may improve thee results of radiotherapy even for advanced larynx carcinomas, like hyperfractionation radiotherapy and simultaneous radio-chemotherapy combined enoral resection and postoperative radiotherapy may yield larynx preservation even for advanced stages. (orig./MG).

  4. A review of anaemia of inflammatory disease in dogs and cats.

    Science.gov (United States)

    Chikazawa, S; Dunning, M D

    2016-07-01

    Anaemia of inflammatory disease is a common cause of anaemia in routine veterinary practice. It is most often mild to moderate, normocytic, normochromic and non-regenerative. Shortened red cell life span, inhibition of iron metabolism and impaired bone marrow response to erythropoietin all contribute to its development. Although anaemia of inflammatory disease is a well-known cause of anaemia in dogs and cats, there is a lack of epidemiological information because specific diagnostic criteria have not been established in veterinary species. Anaemia of inflammatory disease is associated with a poor outcome in various disease states in human medicine; however, its clinical significance and treatment in veterinary medicine are not well understood. This review article describes anaemia of inflammatory disease in dogs and cats and considers its potential significance. PMID:27385622

  5. Low plasma concentrations of interleukin 10 in severe malarial anaemia compared with cerebral and uncomplicated malaria

    DEFF Research Database (Denmark)

    Kurtzhals, J A; Adabayeri, V; Goka, B Q;

    1998-01-01

    BACKGROUND: Severe anaemia is a major complication of malaria but little is known about its pathogenesis. Experimental models have implicated tumour necrosis factor (TNF) in induction of bone-marrow suppression and eythrophagocytosis. Conversely, interleukin 10 (IL-10), which mediates feed......-back regulation of TNF, stimulates bone-marrow function in vitro and counteracts anaemia in mice. We investigated the associations of these cytokines with malarial anaemia. METHODS: We enrolled 175 African children with malaria into two studies in 1995 and 1996. In the first study, children were classified...... as having severe anaemia (n=10), uncomplicated malaria (n=26), or cerebral anaemia (n=41). In the second study, patients were classified as having cerebral malaria (n=33) or being fully conscious (n=65), and the two groups were subdivided by measured haemoglobin as normal (>110 g/L), moderate anaemia (60...

  6. WE-G-BRD-06: Variation in Dynamic Positron Emission Tomography Imaging of Tumor Hypoxia in Early Stage Non-Small Cell Lung Cancer Patients Undergoing Stereotactic Body Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kelada, O [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); Department of Medical Physics in Radiation Oncology, German Cancer Research Center, Heidelberg (Germany); Decker, R; Rockwell, S; Carlson, D [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); Zheng, M; Huang, Y; Xia, Y; Gallezot, J; Liu, C; Carson, R [Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT (United States); Oelfke, U [Department of Medical Physics in Radiation Oncology, German Cancer Research Center, Heidelberg (Germany)

    2014-06-15

    Purpose: Tumor hypoxia is correlated with treatment failure. To date, there are no published studies investigating hypoxia in non-small cell lung cancer (NSCLC) patients undergoing SBRT. We aim to use 18F-fluoromisonidazole (18F-FMISO) positron emission tomography (PET) imaging to non-invasively quantify the tumor hypoxic volume (HV), to elucidate potential roles of reoxygenation and tumor vascular response at high doses, and to identify an optimal prognostic imaging time-point. Methods: SBRT-eligible patients with NSCLC tumors >1cm were prospectively enrolled in an IRB-approved study. Computed Tomography and dynamic PET images (0–120min, 150–180min, and 210–240min post-injection) were acquired using a Siemens BiographmCT PET/CT scanner. 18F-FMISO PET was performed on a single patient at 3 different time points around a single SBRT delivery of 18 Gy and HVs were compared using a tumor-to-blood ratio (TBR)>1.2 and rate of influx (Ki)>0.0015 (Patlak). Results: Results from our first patient showed substantial temporal changes in HV following SBRT. Using a TBR threshold >1.2 and summed images 210–240min, the HVs were 19%, 31% and 13% of total tumor volume on day 0, 2 (48 hours post-SBRT), and 4 (96 hours post-SBRT). The absolute volume of hypoxia increased by nearly a factor of 2 after 18 Gy and then decreased almost to baseline 96 hours later. Selected imaging timepoints resulted in temporal changes in HV quantification obtained with TBR. Ki, calculated using 4-hour dynamic data, evaluated HVs as 22%, 75% and 21%, respectively. Conclusions: ith the results of only one patient, this novel pilot study highlights the potential benefit of 18F-FMISO PET imaging as results indicate substantial temporal changes in tumor HV post-SBRT. Analysis suggests that TBR is not a robust parameter for accurate HV quantification and heavily influenced by imaging timepoint selection. Kinetic modeling parameters are more sensitive and may aid in future treatment individualization

  7. Prohepcidin Levels in Refractory Anaemia Caused by Lead Poisoning

    Directory of Open Access Journals (Sweden)

    Jayantha Arnold

    2008-02-01

    Full Text Available Recent research evidence suggests a central role for hepcidin in iron homeostasis. Hepcidin is a hormone synthesized in the liver. Hepcidin is also thought to play a vital role in the pathogenic mechanism of anaemia in patients with inflammation or chronic disease. A 38-year-old female who presented with recurrent abdominal pain was found to have raised urinary porphyrins and a blood lead level of 779 µg/l. Her haemoglobin level was 8.3 g/dl. Her MCV was normal. Serum ferritin, B12 and folate were normal. Her serum prohepcidin level was 2,489 ng/ml (normal <450 ng/ml . To our knowledge, this is the first report of raised prohepcidin levels in a patient with anaemia of chronic disease resulting from lead poisoning.

  8. Hereditary anaemias: genetic basis, clinical features, diagnosis, and treatment*

    OpenAIRE

    1982-01-01

    The hereditary anaemias present a major genetic health problem that contributes considerably to childhood mortality and morbidity in many developing countries. This article summarizes recent scientific and technical advances in knowledge concerning the genes involved and their interaction to produce major haemoglobinopathies, the clinical pictures of these conditions, and their diagnostic criteria. Though there is no definitive cure, supportive treatment for the haemoglobinopathies has improv...

  9. Etiology of increased incidence of megaloblastic anaemia in district gilgit

    International Nuclear Information System (INIS)

    To identify the etiological factors responsible for increased incidence of megaloblastic anaemia in district Gilgit. A retrospective analysis of sixty one patients (n=61) was done who were diagnosed as patients of chronic anaemia. They were referred for bone marrow examination. Out of these, twenty two cases (n=22) were diagnosed as megaloblastic anaemia. Serum samples of all the patients were sent to AFIP for estimation of B12 and folate levels. A detailed history with special emphasis on dietary habits was noted. Patients included in the study were either retired Armed Forces personal (n=6) who had been living in district Gilgit for over period of five years. Other patients (n=16) were serving Army personal who had been serving in district Gilgit for over one year. Out of twenty two patients (n=22), only three (n=3, 13.6 %) had poor dietary history. A total of sixteen (n=16, 72.7%) patients had diarrhoea .Out of these sixteen, ten patients (n=10, 62.5%) had vegetative forms of gardia lamblia in their stools specimens. All (n=10) patients, who had giardiasis, had dyspeptic symptoms as their initial complaints. Twenty two serum samples were sent to AFIP for Vit B12 and folate level estimation. A total of seven patients (n=7, 31.8%) had low Vit B12 levels, while one patient (n=1, 4.5 %) had decreased level of both Vit B12 and folate. Chronic giardiasis and dietary insufficiency may be a major cause for increased incidence of megaloblastic anaemia in district Gilgit. (author)

  10. Risk factors and birth outcomes of anaemia in early pregnancy in a nulliparous cohort.

    Directory of Open Access Journals (Sweden)

    Gwinyai Masukume

    Full Text Available Anaemia in pregnancy is a major public health and economic problem worldwide, that contributes to both maternal and fetal morbidity and mortality.The aim of the study was to calculate the prevalence of anaemia in early pregnancy in a cohort of 'low risk' women participating in a large international multicentre prospective study (n = 5 609, to identify the modifiable risk factors for anaemia in pregnancy in this cohort, and to compare the birth outcomes between pregnancies with and without anaemia in early gestation.The study is an analysis of data that were collected prospectively during the Screening for Pregnancy Endpoints study. Anaemia was defined according to the World Health Organization's definition of anaemia in pregnancy (haemoglobin < 11g/dL. Binary logistic regression with adjustment for potential confounders (country, maternal age, having a marital partner, ethnic origin, years of schooling, and having paid work was the main method of analysis.The hallmark findings were the low prevalence of anaemia (2.2%, that having no marital partner was an independent risk factor for having anaemia (OR 1.34, 95% CI 1.01-1.78, and that there was no statistically significant effect of anaemia on adverse pregnancy outcomes (small for gestational age, pre-tem birth, mode of delivery, low birth weight, APGAR score < 7 at one and five minutes. Adverse pregnancy outcomes were however more common in those with anaemia than in those without.In this low risk healthy pregnant population we found a low anaemia rate. The absence of a marital partner was a non-modifiable factor, albeit one which may reflect a variety of confounding factors, that should be considered for addition to anaemia's conceptual framework of determinants. Although not statistically significant, clinically, a trend towards a higher risk of adverse pregnancy outcomes was observed in women that were anaemic in early pregnancy.

  11. Use of whole gut perfusion to investigate gastrointestinal blood loss in patients with iron deficiency anaemia.

    OpenAIRE

    Ferguson, A; Brydon, W G; Brian, H; Williams, A.; Mackie, M J

    1996-01-01

    Iron deficiency anaemia may be due to occult bleeding into the gut. However, although clinical investigations may show a high frequency of gastrointestinal tract disease in these patients, the cause-effect relationship between the lesions detected and anaemia remain uncertain. This study aimed to establish whether lesions detected by endoscopy or imaging of the gastrointestinal tract in patients with unexplained iron deficiency anaemia are bleeding continuously. Routine clinical tests were pe...

  12. Observation of Lung Tumour Mobility during Breathing Cycle in Patients Undergoing Radiotherapy%呼吸运动对肺癌放疗中肺位移度的观察

    Institute of Scientific and Technical Information of China (English)

    尤光贤; 蒋先明; 文强; 徐慧云; 叶瑞智

    2013-01-01

    目的 对肺癌患者三维适形调强放疗中呼吸运动对肺移动度的影响进行观察研究,明确肿瘤靶区的勾画标准.方法 对137名已确诊肺部病灶的肺癌患者行CT定位扫描和靶区勾画.对肿瘤在X、Y两个方向的运动幅度数据进行收集和统计,对男女差异进行比较.结果 位于肺下叶部位的肿瘤因呼吸运动而引起的X,Y方向上位移均较上中叶肿瘤明显,差异均有统计学意义(P<0.05).男性上中叶部位肿瘤在X轴和Y轴方向的平均位移分别为(2.09±0.31)mm和(3.82±1.18)mm,与女性上中叶肿瘤在相应方向上的位移(3.06±0.82)mm和(5.59±1.08) mm相比,差异均有统计学意义(P<0.05).在下叶部位肿瘤的位移差异上,X轴方向上男性与女性差异不大(P>0.05),而Y轴方向男性明显小于女性,分别为(9.39±2.48)mm和(11.82±3.47) mm,差异有统计学意义(P<0.05).结论 呼吸运动所引起的肿瘤位移男性普遍较女性小,且下叶位移较上中叶位移幅度明显.%Objective To explore the effect of respiratory movement on lung tumour mobility in lung cancer patients undergoing intensity-modulated radiation therapy (IMRT),and make sure the outline of gross tumor volume.Methods CT scout view and outline of gross tumor volume were performed in 137 patients with lung cancer.The lung tumor displacement at X,Y axis were recorded and compared between men and women.Results The tumor motion was small for lower-lobe tumors as compared to upper-and middle-lobe tumors at any axis(P < 0.05).On the gender difference,the displacement of the tumor at superior and middle lobe in the men at X,Y were(2.09 ±0.31)mm and (3.82 ±1.18) mm,greater than those in women(3.06 ±0.82)mm and (5.59 ± 1.08) mm,all the difference were statistical significant (P < 0.05).The gender difference between the men and women has no statistical significance with displacement of the tumor at inferior lobe of lung at X axis,but at Y axis the displacement was

  13. A retrospective study of the prevalence of anaemia in pregnancy at booking in Niger Delta, Nigeria.

    Science.gov (United States)

    Okoh, Dorathry Adaunwo; Iyalla, Caroline; Omunakwe, Hannah; Iwo-Amah, Rose Sitonma; Nwabuko, Collins

    2016-07-01

    We reviewed the records of antenatal clinic attendees over a period of 9 years to determine the prevalence of anaemia at booking. The laboratory records of 8751 out of a total of 37,506 pregnant women who booked for antenatal care between 2004 and 2013 at the BMSH were reviewed. The effects of maternal age, educational status, parity, gestational age, haemoglobin genotype and infections on the prevalence of anaemia were investigated. The prevalence of anaemia at booking was 69.6%, most of whom had moderate anaemia. Anaemia was significantly prevalent in the 10-19 year age group, and in women with secondary education, in their 2nd trimester and with SS genotype. Anaemia also increased with gestational age, this however was not statistically significant. There was no statistical difference between those who are human immunodeficiency virus (HIV) positive and had anaemia and those who are HIV negative who also had anaemia. This study shows that anaemia in pregnant women is still unacceptably high considering the consequences and despite interventions on the ground to reduce prevalence. There is a need to review the intervention measures with emphasis on programmes that would increase awareness among pregnant women and the general public. PMID:27110932

  14. Anaemia and long term mortality in heart failure patients: a retrospective study

    DEFF Research Database (Denmark)

    Charlot, Mette; Torp-Pedersen, Christian; Valeur, Nana;

    2010-01-01

    Anaemia has been demonstrated as a risk factor in patients with heart failure over periods of a few years, but long term data are not available. We examined the long-term risk of anaemia in heart failure patients during 15 years of follow-up.......Anaemia has been demonstrated as a risk factor in patients with heart failure over periods of a few years, but long term data are not available. We examined the long-term risk of anaemia in heart failure patients during 15 years of follow-up....

  15. Locoregional radiotherapy in patients with distant metastases of nasopharyngeal carcinoma at diagnosis

    Institute of Scientific and Technical Information of China (English)

    Ming-Yuan Chen; Li Zhang; Ming-Huang Hong; Hai-Qiang Mai; Chao-Nan Qian; Rou Jiang; Ling Guo; Xiong Zou; Qing Liu; Rui Sun; Fang Qiu; Zhong-Jun Xia; Hui-Qiang Huang

    2013-01-01

    Systemic chemotherapy is the basic palliative treatment for metastatic nasopharyngeal carcinoma (NPC); however, it is not known whether locoregional radiotherapy targeting the primary tumor and regional lymph nodes affects the survival of patients with metastatic NPC. Therefore, we aimed to retrospectively evaluate the benefits of locoregional radiotherapy. A total of 408 patients with metastatic NPC were included in this study. The mortality risks of the patients undergoing supportive treatment and those undergoing chemotherapy were compared with that of patients undergoing locoregional radiotherapy delivered alone or in combination with chemotherapy. Univariate and multivariate analyses were conducted. The contributions of independent factors were assessed after adjustment for covariates with significant prognostic associations (P<0.05). Both locoregional radiotherapy and systemic chemotherapy were identified as significant independent prognostic factors of overall survival (OS). The mortality risk was similar in the group undergoing locoregional radiotherapy alone and the group undergoing systemic chemotherapy alone [multi-adjusted hazard ratio (HR) = 0.9, P = 0.529]; this risk was 60% lower than that of the group undergoing supportive treatment (HR = 0.4, P = 0.004) and 130% higher than that of the group undergoing both systemic chemotherapy and locoregional radiotherapy (HR = 2.3, P < 0.001). In conclusion, locoregional radiotherapy, particularly when combined with systemic chemotherapy, is associated with improved survival of patients with metastatic NPC.

  16. Relationship of anaemia and morbidities among children aged 5-14 years in a resettlement area, Delhi

    OpenAIRE

    Pankaj Motilal Kasdekar; Josyula Prasuna; Anika Sulania; Sanjeev Kumar Rasania; Nidhi Dwivedi

    2015-01-01

    Partnership for Child Development (1998), “The anthropometric status of school children in five countries in the Partnership for Child Development”. Proceedings of the Nutrition Society 57: 149- 158.World Health Organization. Anaemia. WHO (2010).World Health Organization (WHO). WHO global database on anaemia: Worldwide prevalence of anaemia 1993-2005. Ge¬neva: WHO, 2008a. [Cited 2014 Aug 24]. Available from: URL: http://www.who. int/vmnis/anaemia/prevalence/en/index. htmlWorld Health Organiza...

  17. Cortical sinovenous thrombosis in a child with nephrotic syndrome and iron deficiency anaemia.

    Directory of Open Access Journals (Sweden)

    Meena A

    2000-07-01

    Full Text Available Cortical sinovenous thrombosis in a child with nephrotic syndrome and iron deficiency anaemia is described. The most probable mechanism for the hypercoagulable state was thrombocytosis associated with iron deficiency anaemia. The other possible contributing factor might have been the diuretic therapy during the phase of relapse.

  18. A rare adverse reaction to ethambutol: drug-induced haemolytic anaemia.

    Science.gov (United States)

    Nicolini, A; Perazzo, A; Gatto, P; Piroddi, I M G; Barlascini, C; Karamichali, S; Strada, P

    2016-05-01

    Anti-tuberculosis drugs seldom cause serious haematological side effects. However, among these drugs, isoniazid and rifampicin, especially when administered intermittently, may very rarely be linked to acute autoimmune haemolytic anaemia. Ethambutol (EMB) can cause dose-related retrobulbar neuritis. In this paper, we present the first reported case of acute fatal autoimmune haemolytic anaemia due to EMB. PMID:27084828

  19. Does recombinant human erythropoietin accelerate correction of post-ulcer-bleeding anaemia A pilot study

    OpenAIRE

    Ladas, Spiros D.; Polymeros, Dimitrios; Pagonis, Thomas; Triantafyllou, Konstantinos; Paspatis, Gregorios; Hatziargiriou, Maria; Raptis, Sotirios A.

    2004-01-01

    AIM: Anaemia caused by acute upper gastrointestinal bleeding is treated with blood transfusion or iron, but patients usually face a two-month recovery period from post-haemorrhage anaemia. This prospective, randomised, open, pilot study was designed to investigate whether recombinant human erythropoietin (Epoetin) therapy accelerate haematocrit increase in the post-bleeding recovery period.

  20. Erythropoiesis-stimulating agents for anaemia in chronic heart failure patients

    NARCIS (Netherlands)

    Ngo, Katherine; Kotecha, Dipak; Walters, Julia A. E.; Manzano, Luis; Palazzuoli, Alberto; van Veldhuisen, Dirk J.; Flather, Marcus

    2010-01-01

    Background Chronic heart failure (CHF) is a leading cause of morbidity and mortality worldwide. Anaemia is a common (12-55%) co-morbid condition and is associated with worsening symptoms and increased mortality. Anaemia is treatable and can be targeted in the treatment of patients with CHF. Erythrop

  1. Effect of different iron sources on the alleviation of nutritional anaemia in common sole (Solea solea)

    NARCIS (Netherlands)

    Kals, J.; Blonk, R.J.W.; Mheen, van der H.W.; Schrama, J.W.; Verreth, J.A.J.

    2016-01-01

    Sole fed commercial pellets suffers from a nutritional anaemia. The hypotheses tested are: (1) the nutritional anaemia in sole fed commercial pellets is caused by an iron deficiency; (2) the assumed iron deficiency is due to inadequate absorption of iron; (3) an increase in absorption due to a highe

  2. PREVALENCE OF ANAEMIA IN PREGNANT WOMEN ATTENDING A PRIMARY HEALTH CENTRE IN BARPETA DISTRICT, ASSAM

    Directory of Open Access Journals (Sweden)

    Dhritishna

    2016-05-01

    Full Text Available BACKGROUND Anaemia in pregnancy has serious adverse effects on the health of the mother and the developing foetus. OBJECTIVES The study aims to estimate the prevalence of anaemia in pregnant woman attending the Nagaon Primary Health Centre (PHC in Barpeta district, Assam. METHODS A cross-sectional study was carried out from 1 April, 2014 to 1 May, 2014. 100 pregnant women attending Nagaon PHC were interviewed using a predesigned and pretested interview schedule followed by a short clinical examination for pallor and laboratory estimation of haemoglobin. Sahli’s (Acid Haematin method was used for haemoglobin estimation. Haemoglobin level below the cut-off 11 g/dL was used to label a pregnant woman as anaemic and further classified as mild (10-10.9 g/dL, moderate anaemia (7-9.9 g/dL and severe anaemia (<7 g/dL. RESULTS 77% women were suffering from anaemia. Out of these, 57 %were mildly anaemic and 20% were moderately anaemic. Women of younger age groups, greater parity, a gap less than 3 years between subsequent pregnancies, less education and practising Hinduism had a greater prevalence of anaemia. CONCLUSION Awareness about the serious consequences that anaemia can lead to and advocacy of a proper iron-rich diet, regular intake of IFA tablets and purification of water to prevent infestation by parasites can help in reduction of anaemia.

  3. Pallor as a sign of anaemia in small Tanzanian children at different health care levels

    DEFF Research Database (Denmark)

    Mogensen, Christian B; Sørensen, Jeff E; Bjorkman, Anders;

    2006-01-01

    Anaemia is a major complication of Plasmodium falciparum malaria among small children in sub-Saharan Africa. We studied the performance of the Integrated Management of Childhood Illness (IMCI) recommended assessment of no/some/severe pallor as predictor of anaemia in health surveys at community...

  4. Sociodemographic factors associated with anaemia in pregnancy at booking for antenatal care.

    Science.gov (United States)

    Adanikin, A I; Awoleke, J O

    2016-01-01

    Late patronage of antenatal care by women in low-resource areas makes timely intervention at correcting anaemia difficult. This study aimed to identify modifiable sociodemographic factors that predict anaemia before commencing antenatal care and make appropriate recommendation. A survey of sociodemographic features and haemoglobin concentrations of 232 women booking for antenatal care was conducted. Anaemia was diagnosed in 119 (51.3%), of which 87 (37.5%) had mild anaemia and 32 (13.8%) were moderately anaemic. There was no severe anaemia. Anaemia was highest among respondents who were 35 years of age, Muslims, of Igbo ethnicity (64.3%), single (55.0%), student/unemployed (58.8%), nulliparous (57.3%) and those who registered at 21 weeks' gestation (54.2%). Only occupation of the woman showed association with anaemia before antenatal care (p 0.007). A personal source of income may reduce anaemia in pregnancy; and it is advisable to have a social welfare package for unemployed pregnant women. PMID:26214716

  5. The additive burden of iron deficiency in the cardiorenal-anaemia axis : scope of a problem and its consequences

    NARCIS (Netherlands)

    Klip, IJsbrand T.; Jankowska, Ewa A.; Enjuanes, Cristina; Voors, Adriaan A.; Banasiak, Waldemar; Bruguera, Jordi; Rozentryt, Piotr; Polonski, Lech; van Veldhuisen, Dirk J.; Ponikowski, Piotr; Comin-Colet, Josep; van der Meer, Peter

    2014-01-01

    Aims Iron deficiency (ID), anaemia, and chronic kidney disease (CKD) are common co-morbidities in chronic heart failure (CHF) and all independent predictors of unfavourable outcome. The combination of anaemia and CKD in CHF has been described as the cardiorenal-anaemia syndrome. However, the role of

  6. The role of vitamin A in nutritional anaemia: a study in pregnant women in West Java, Indonesia.

    NARCIS (Netherlands)

    Suharno, D.

    1994-01-01

    Nutritional anaemia affects 50-70% of pregnant women in the developing world where vitamin A deficiency is also a problem. Since previous studies have indicated that vitamin A deficiency can be involved in the aetiology of nutritional anaemia, the role of vitamin A deficiency in nutritional anaemia

  7. Prevalence and risk factors of anaemia among children aged between 6 months and 14 years in Kenya.

    Directory of Open Access Journals (Sweden)

    Oscar Ngesa

    Full Text Available Anaemia is one of the significant public health problems among children in the world. Understanding risk factors of anaemia provides more insight to the nature and types of policies that can be put up to fight anaemia. We estimated the prevalence and risk factors of anaemia in a population-based, cross-sectional survey.Blood samples from 11,711 children aged between 6 months and 14 years were collected using a single-use, spring-loaded, sterile lancet to make a finger prick. Anaemia was measured based on haemoglobin concentration level. The generalized linear model framework was used to analyse the data, in which the response variable was either a child was anemic or not anemic.The overall prevalence of anaemia among the children in Kenya was estimated to be 28.8%. Across each band of age within which the definition of anaemia remained constant (0–4, 5–11, and 12–14 years old, the prevalence of anaemia declined with each year of age. [corrected]. The risk of anaemia was significantly higher in male than female children. Mothers with secondary and above education had a protective effect on the risk of anaemia on their children. Malaria diagnosis status of a child was positively associated with risk anaemia.Controlling co-morbidity of malaria and improving maternal knowledge are potential options for reducing the burden of anaemia.

  8. Epidemiological Profile of Anaemia among Rural School Going Adolescents of District Bareilly, India

    Directory of Open Access Journals (Sweden)

    Ajay Kumar Agarwal, Hari Shankar Joshi, Syed Esam Mahmood, Arun Singh, Mahendra Sharma

    2015-01-01

    Results: The overall prevalence of anaemia was 58.67%. Prevalence of anaemia was significantly higher among the females (65.11%. Higher prevalence of anaemia was found among adolescents aged between 10-14 years (59.58%, Hindus (62.04%, middle socio-economic class (78.89% and joint families (59.63%. Higher prevalence was also found among those adolescents whose mothers and fathers were educated upto primary level (58.87% and 60.83% respectively. Conclusion: High prevalence of anaemia was found, especially among the female adolescents. Adequate food consumption and regular intake of iron and vitamin C rich foods during early childhood period, de-worming, food fortification, supplementary feeding and nutrition education of parents can prevent nutritional anaemia in adolescents. "

  9. Hazard classification of chemicals inducing haemolytic anaemia: An EU regulatory perspective

    DEFF Research Database (Denmark)

    Muller, A.; Jacobsen, Helene; Healy, E.;

    2006-01-01

    Haemolytic anaemia is often induced following prolonged exposure to chemical substances. Currently, under EU Council Directive 67/548/EEC, substances which induce such effects are classified as dangerous and assigned the risk phrase R48 'Danger of serious damage to health by prolonged exposure......! Whilst the general classification criteria for this endpoint are outlined in Annex VI of this Directive, they do not provide specific information to assess haemolytic anaemia. This review produced by the EU Working Group on Haemolytic Anaemia provides a toxicological assessment of haemolytic anaemia...... and proposes criteria that can be used in the assessment for classification of substances which induce such effects. An overview of the primary and secondary effects of haemolytic anaemia which can occur in rodent repeated dose toxicity studies is given. A detailed analysis of the toxicological significance...

  10. Stereotactic body radiotherapy in lung cancer: an update

    Energy Technology Data Exchange (ETDEWEB)

    Abreu, Carlos Eduardo Cintra Vita; Ferreira, Paula Pratti Rodrigues; Moraes, Fabio Ynoe de; Neves Junior, Wellington Furtado Pimenta; Carvalho, Heloisa de Andrade, E-mail: heloisa.carvalho@hc.fm.usp.br [Hospital Sirio-Libanes, Sao Paulo, SP (Brazil). Departamento de Radioterapia; Gadia, Rafael [Hospital Sirio-Libanes, Brasilia, DF (Brazil). Departamento de Radioterapia; Universidade de Sao Paulo (USP), Sao Paulo, SP (Brazil). Departamento de Radiologia e Oncologia. Servico de Radioterapia

    2015-07-15

    For early-stage lung cancer, the treatment of choice is surgery. In patients who are not surgical candidates or are unwilling to undergo surgery, radiotherapy is the principal treatment option. Here, we review stereotactic body radiotherapy, a technique that has produced quite promising results in such patients and should be the treatment of choice, if available. We also present the major indications, technical aspects, results, and special situations related to the technique. (author)

  11. Patients with hip prosthesis: radiotherapy treatment planning considerations

    International Nuclear Information System (INIS)

    The number of patients with hip prosthesis undergoing radiotherapy for pelvic cancer worldwide is increasing. This might be of importance depending on the materials in the prosthesis and whether any of the treatment fields are involved in the prosthesis. Radiotherapy planning involving the pelvic region of patients having total hip prosthesis has been found to be difficult due to the effect of the prosthesis on the dose distribution. This review is intended to project dosimetric considerations and possible solutions to this uncommon problem

  12. Haemolytic anaemia secondary to arsenic poisoning: a case report

    Science.gov (United States)

    Carvalho, Catarina; Friões, Fernando; Araújo, José P; Almeida, Jorge; Azevedo, Ana

    2009-01-01

    We report the case of a 56-year-old white man who presented at the Emergency Department for evaluation of dark-red urine. Rapid development of acute renal failure and haemolytic anaemia initially elicited the hypothesis of a haemolytic-uremic syndrome. A previous exposure to a gas mixture containing arsenic and copper was later recognized as the probable aetiology while other differential diagnoses were excluded. Chelating treatment was promptly initiated before laboratorial confirmation of arsenic and copper poisoning. Renal and haematological recovery was gradually observed and the patient survived with no sequelae. PMID:19918480

  13. Study of sickle cell anaemia with clinical and hematological correlation

    Directory of Open Access Journals (Sweden)

    Vasundhara M.

    2016-01-01

    Results: Males were 154 and females were 146. Degree of anaemia was severe in females when compared to males. Of 52 cases subjected for electrophoresis 36 were homozygous, 15 were heterozygous and 1 case Sickle thalassemia. 7 cases showed HbF above 5%. Conclusions: Most of the patients were under 40 yrs suggesting decreased survival after that age. An increased level of HbF was associated with better prognosis suggesting the need to target at drugs which increase HbF. [Int J Res Med Sci 2016; 4(1.000: 246-251

  14. Haemolytic anaemia secondary to arsenic poisoning: a case report.

    Science.gov (United States)

    Correia, Nuno; Carvalho, Catarina; Friões, Fernando; Araújo, José P; Almeida, Jorge; Azevedo, Ana

    2009-08-11

    We report the case of a 56-year-old white man who presented at the Emergency Department for evaluation of dark-red urine. Rapid development of acute renal failure and haemolytic anaemia initially elicited the hypothesis of a haemolytic-uremic syndrome. A previous exposure to a gas mixture containing arsenic and copper was later recognized as the probable aetiology while other differential diagnoses were excluded. Chelating treatment was promptly initiated before laboratorial confirmation of arsenic and copper poisoning. Renal and haematological recovery was gradually observed and the patient survived with no sequelae.

  15. Radiotherapy: what are the patients' needs

    International Nuclear Information System (INIS)

    Although there is a substantial body of research into the impact of cancer therapies such as surgery and chemotherapy, little is known about the experiences of cancer patients receiving radiotherapy. Serial interviews with 39 patients undergoing radical radiotherapy to the oral cavity revealed that misunderstandings and groundless fears about this form of treatment were widespread. A majority were unprepared for the severity and duration of their side-effects. These results suggest that written information for patients about radiotherapy and its side-effects should be made available routinely. There is also scope for nutritional support. Finally, as a supplement to out-patient attendance, informal contact with the hospital in the immediate post-treatment phase would provide invaluable reassurance to patients. (author)

  16. PET/CT Based Dose Planning in Radiotherapy

    DEFF Research Database (Denmark)

    Berthelsen, Anne Kiil; Jakobsen, Annika Loft; Sapru, Wendy;

    2011-01-01

    radiotherapy planning with PET/CT prior to the treatment. The PET/CT, including the radiotherapy planning process as well as the radiotherapy process, is outlined in detail. The demanding collaboration between mould technicians, nuclear medicine physicians and technologists, radiologists and radiology......This mini-review describes how to perform PET/CT based radiotherapy dose planning and the advantages and possibilities obtained with the technique for radiation therapy. Our own experience since 2002 is briefly summarized from more than 2,500 patients with various malignant diseases undergoing...... technologists, radiation oncologists, physicists, and dosimetrists is emphasized. We strongly believe that PET/CT based radiotherapy planning will improve the therapeutic output in terms of target definition and non-target avoidance and will play an important role in future therapeutic interventions in many...

  17. Radiotherapy for Hodgkin lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Specht, Lena [Rigshospitalet Copenhagen Univ. (Denmark). Depts. of Oncology and Haematology; Yahalom, Joachim (eds.) [Memorial Sloan-Kettering Cancer, New York, NY (United States). Dept. of Radiation Oncology

    2011-07-01

    This book deals in detail with all aspects of the best practice in modern radiotherapy for Hodgkin lymphoma. It provides the background and rationale for the inclusion of radiotherapy in today's combined-modality approach, including special clinical situations such as Hodgkin lymphoma in children, in the pregnant patient, and in the elderly. Radiotherapy planning using state-of-the-art imaging, target definition, planning software, and treatment equipment is expounded in detail. Acute and long-term side effects of radiotherapy are analyzed, and the implications for modern radiotherapy approaches in Hodgkin lymphomas are explained. (orig.)

  18. Radiotherapy for Hodgkin lymphoma

    International Nuclear Information System (INIS)

    This book deals in detail with all aspects of the best practice in modern radiotherapy for Hodgkin lymphoma. It provides the background and rationale for the inclusion of radiotherapy in today's combined-modality approach, including special clinical situations such as Hodgkin lymphoma in children, in the pregnant patient, and in the elderly. Radiotherapy planning using state-of-the-art imaging, target definition, planning software, and treatment equipment is expounded in detail. Acute and long-term side effects of radiotherapy are analyzed, and the implications for modern radiotherapy approaches in Hodgkin lymphomas are explained. (orig.)

  19. Infectious salmon anaemia virus (ISAV) mucosal infection in Atlantic salmon.

    Science.gov (United States)

    Aamelfot, Maria; McBeath, Alastair; Christiansen, Debes H; Matejusova, Iveta; Falk, Knut

    2015-01-01

    All viruses infecting fish must cross the surface mucosal barrier to successfully enter a host. Infectious salmon anaemia virus (ISAV), the causative agent of the economically important infectious salmon anaemia (ISA) in Atlantic salmon, Salmo salar L., has been shown to use the gills as its entry point. However, other entry ports have not been investigated despite the expression of virus receptors on the surface of epithelial cells in the skin, the gastrointestinal (GI) tract and the conjunctiva. Here we investigate the ISAV mucosal infection in Atlantic salmon after experimental immersion (bath) challenge and in farmed fish collected from a confirmed outbreak of ISA in Norway. We show for the first time evidence of early replication in several mucosal surfaces in addition to the gills, including the pectoral fin, skin and GI tract suggesting several potential entry points for the virus. Initially, the infection is localized and primarily infecting epithelial cells, however at later stages it becomes systemic, infecting the endothelial cells lining the circulatory system. Viruses of low and high virulence used in the challenge revealed possible variation in virus progression during infection at the mucosal surfaces. PMID:26490835

  20. Anaemia among Female Undergraduates Residing in the Hostels of University of Sri Jayewardenepura, Sri Lanka

    Directory of Open Access Journals (Sweden)

    Gayashan Chathuranga

    2014-01-01

    Full Text Available Anaemia is a major public health problem that has affected around 25% of the world’s population. An analytical cross-sectional study was performed on 313 female undergraduates residing in hostels of University of Sri Jayewardenepura, Sri Lanka, during year 2011. Objective of this study was to determine prevalence and contributing factors to anaemia among the study population. Haemoglobin concentration was assayed using cyanomethaemoglobin method. A pretested self-administered questionnaire was used to retrieve information regarding dietary habits and personal factors of participants. Descriptive statistical methods, chi-square test, and independent sample t-test were used to analyze data. Of the 302 females, 17.5% (n=53 had mild anaemia and 7.9% (n=24 had moderate anaemia. Severely anaemic individuals were not observed. Participants’ dietary habits and personal factors were not significantly associated with prevalence of anaemia (whether a participant is a vegetarian or not (P=0.525, drinking tea within one hour of a meal (P=0.775, frequency of consumption of red meat, fish, and eggs (P=0.499, antihelminthic treatment within past year (P=0.792, and menorrhagia (P=0.560. Anaemia in the study population is below the average for Sri Lankan data. Diet and selected medical conditions were not a causative factor for anaemia in this population.

  1. Prevalence and socio-demographic factors affecting anaemia in pregnant women of Dibrugarh District, Assam, India

    Directory of Open Access Journals (Sweden)

    Indrani Gogoi

    2016-06-01

    Full Text Available Background: Anaemia is the most common nutritional deficiency observed globally. Anaemia worsens during pregnancy leading to adverse maternal and fetal outcome. Dibrugarh district has the highest maternal mortality in the country, one of the major factor being anaemia during pregnancy. Aims & Objectives: To assess the prevalence and socio-demographic determinants of anaemia in pregnant women of Dibrugarh District. Material & Methods: A community based, cross-sectional study was conducted in a block selected randomly. Study period was for the period from May’2015 to February’2016. Study sample included 290 participants. Results: Prevalence of anaemia among study participants was found to be 73.1%. (Mild 10%, moderate 43.1 % and severe 20%. Mean haemoglobin of study subjects was 9.07±2.26 g/dl. Average age of the study subjects was 23.24±4. Majority (27.2% had their education upto primary school level and belong to class IV socioeconomic status. Univariate analysis and multiple logistic regression analysis shows educational qualification, socioeconomic status and type of housing are statistically associated with anaemia during pregnancy. Conclusion: Anaemia is rampant in the community needing urgent action to prevent morbidity amongst both mother and child

  2. Prevalence of anaemia and its socio demographic determinants among pregnant women in Bareilly district, Uttar Pradesh

    Directory of Open Access Journals (Sweden)

    Paramatma Singh

    2014-12-01

    Full Text Available Background: About one-third of the global population is anaemic. WHO has estimated that prevalence of anaemia in pregnant women is 18% in developed countries and relatively high 56% in developing countries. Prevalence of anaemia in South East Asian countries is highest in the world. WHO estimates that even among the South East Asian countries, India has the highest prevalence of anaemia. Aims & Objectives: To determine the prevalence of anaemia among pregnant women and to determine association of anaemia with its socio-demographic factors. Material & Methods: A descriptive cross sectional study was conducted among pregnant women 2nd trimester onwards who came to ante natal clinic of obstetrics and gynaecology department during January-March 2014 by using pre-designed, pretested schedule. A total of 300 pregnant women were clinically examined. Written consent was taken. Haemoglobin estimation was done by Cyanmethaemoglobin method and anaemia was graded according to WHO criteria. Statistical analysis was done using Microsoft Excel 2007 and SPSS Version 17. Results: Overall prevalence of anaemia among the pregnant women was found to be 58.3%. It was seen that 31% of women were illiterate and 38.7% of them belong to upper middle class. Factors such as level of education of women, occupation and consumption of Iron Folic Acid were found to be significantly associated with prevalence of anaemia in pregnancy. Conclusion: A very high prevalence of anaemia in pregnancy needs awareness about late marriage, birth spacing, one or two child norm, antenatal care, green leafy vegetable in diet, mandatory regular supply of IFA tablets to adolescent and pregnant women along with correction of other nutritional deficiencies.

  3. PREVALENCE OF ANAEMIA AMONG CHILDREN AGED 12 YEARS AND YOUNGER IN NORTH EAST INDIA

    Directory of Open Access Journals (Sweden)

    Rajkumari Rupabati

    2016-02-01

    Full Text Available BACKGROUND AND OBJECTIVE Anaemia is one of the most important public health problem among children. The infants, preschool children, adolescents and pregnant women are at highest risk of nutritional anaemia. The aim of this study was to evaluate the prevalence of anaemia and its correlation to age, gender, haemoglobin values and magnitude of anaemia among the children of North East India. METHODS A cross sectional study was conducted in a tertiary care hospital between October 2013 to September 2014. A total of 500 children in the age group 0 to 12 years were enrolled after obtaining written informed consent from the parents. Haemoglobin estimation was done by Sahli’s method using finger prick blood samples. As per WHO recommendation, haemoglobin values below 11 gm/dl was considered anaemic. Statistical data were analysed. RESULTS The overall prevalence of anaemia was 71.2% with males having 5.2%higher than females. The majority of age group comprises 1 to ≤5 years (36.0% and 83.3% of them were anaemic. The highest value of haemoglobin estimated was 14.8 gm/dl with the lowest value of 5.2 gm/dl. The mean haemoglobin level was 10.76±1.21 gm/dl. 53.4% children were mildly anaemic. Both male and female children were affected more with mild anaemia than other types of anaemia. CONCLUSION Our results suggest that all the children should be screened for anaemia irrespective of age and sex as the prevalence is high. Early intervention and appropriate measures should be taken to prevent from anaemia and its associated diseases.

  4. Aplastic anaemia after exposure to a weed killer, 2-methyl-4-chlorphenoxyacetic acid.

    Science.gov (United States)

    Palva, H L; Koivisto, O; Palva, I P

    1975-01-01

    A 64-year-old farmer developed aplastic anaemia after exposure to 2-methyl-4-chlorphenoxyactic acid while spraying weed killer. Muscular weakness, haemorrhagic gastritis and slight signs of liver damage occurred at the same time. All these symptoms, including blood dyscrasia , are consistent with those described as toxic effects of chlorphenoxyacetic acids in animal experiments. A causal relationship between aplastic anaemia and the 2-methyl-4-chlorphenoxyacetic acid thus seems probable. The anaemia was reversible, but the case serves as a warning that careful safety measures are required during the use of chlorphenoxyacetic acids and related compounds. PMID:804793

  5. Characterization of the equine infectious anaemia virus S2 protein.

    Science.gov (United States)

    Yoon, S; Kingsman, S M; Kingsman, A J; Wilson, S A; Mitrophanous, K A

    2000-09-01

    S2 is an accessory protein of equine infectious anaemia virus (EIAV), the function of which is unknown. In order to gain insight into the function of S2, the intracellular localization of the protein, its interaction with viral proteins and its incorporation into viral particles have been investigated. Immunolocalization of S2 revealed punctate staining in the cytoplasm and the S2 protein co-precipitated with the EIAV Gag precursor. Despite overexpression of S2 through the use of a codon-optimized sequence, there was no preferential association of S2 with EIAV particles. These data suggest that S2 may function to organize the Gag protein during particle assembly in the cytoplasm but that it is unlikely to be involved in the early stages of the virus life-cycle. PMID:10950976

  6. Role of malaria induced oxidative stress on anaemia in pregnancy

    Institute of Scientific and Technical Information of China (English)

    Akanbi OM; Odaibo AB; Olatoregun R; Ademowo AB

    2010-01-01

    Objective:To assess the role of oxidative stress on anaemia in pregnancy.Methods:Blood samples were collected from pregnant and non-pregnant women who came for antenatal clinic and medical check at Comprehensive Health Center, Akungba-Akoko and Iwaro General Hospital in Akoko Area of Ondo State, Nigeria. Thick and thin blood films were prepared and used for malaria parasite counts. Haemoglobin level was determined by colorimetric method using Drabkin's solution. Oxidative status was determined using malondiadelhyde level as an indicator of lipid peroxidation, while ascorbic acid and reduced glutathione levels were measured by standard spectrophotometric methods.Results: Mean parasite density was significantly higher in pregnant women than non-pregnant women (P<0.05). Haemoglobin level was significantly reduced in malaria positive pregnant and non-pregnant women than malaria negative (8.3-10.0 g/dL) (P<0.05). The oxidative status indicated that malondialdehyde(MDA) was significantly increased in pregnant [(2.5±0.7) nmol/mL] than non-pregnant women [(1.8±0.1) nmol/mL] (P<0.05), while Vit C and superoxide dismutase(SOD) levels were significantly reduced in pregnant than non-pregnant women(P<0.05). There was an inverse correlation between Hb and MDA levels in pregnant women studied. Positive correlation was observed between the mean MDA level and parasite density (r = 0.53). The Hb level decreased as the parasite density and MDA level increased in pregnant women.Conclusions:This study shows that oxidative stress, caused by malaria infection could be part of the contributing factors responsible for anaemia in pregnancy.

  7. Radiotherapy of Cervical Cancer.

    Science.gov (United States)

    Vordermark, Dirk

    2016-01-01

    Curative-intent radical radiotherapy of cervical cancer consists of external-beam radiotherapy, brachytherapy, and concomitant chemotherapy with cisplatin. For each element, new developments aim to improve tumor control rates or treatment tolerance. Intensity-modulated radiotherapy (IMRT) has been shown to reduce gastrointestinal toxicity and can be used to selectively increase the radiotherapy dose. Individualized, image-guided brachytherapy enables better adaptation of high-dose volumes to the tumor extension. Intensification of concomitant or sequential systemic therapy is under evaluation. PMID:27614991

  8. Warm Autoimmune Haemolytic Anaemia and autoimmune hepatitis in an asymptomatic carrier of hepatitis B virus

    International Nuclear Information System (INIS)

    Warm antibody autoimmune haemolytic anaemia, a rare disease (0.2-1 per 100,000 populations), is due to the presence of warm agglutinins that react with protein antigens on the surface of red blood cells causing their premature destruction. Here, we present a case report of a 10 year old girl who came with features of haemolytic anaemia and history of blood transfusion since 3 years. On admission, laboratory test revealed that she had autoimmune hepatitis type 1 and was also an asymptomatic carrier of hepatitis B virus with positive HBs Ag. Steroid therapy resulted in clinical and laboratory remission. Direct antiglobulin test was negative after anaemia resolution, hepatitis B virus antigenemia persisted. To our knowledge, warm antibody autoimmune hemolytic anaemia has not previously been described in association with autoimmune hepatitis and asymptomatic carrier state of hepatitis B virus. (author)

  9. Haemolytic anaemia as first manifestation of Wilson's disease: a report of two cases.

    Science.gov (United States)

    Santra, Gouranga; Paul, Rudrajit; Choudhury, Partha Sarathi; Ghosh, Sumit Kr; De, Dibyendu; Das, Shubhabrata

    2014-10-01

    Wilson's disease can have different manifestations like jaundice, cirrhosis of liver, extrapyramidal symptoms and dementia. Haemolytic anaemia may occur but it is commonly associated with florid manifestation of liver disease. Sometimes, liver cell necrosis can release huge free copper ions in blood, giving rise to oxidant damage to erythrocytes. Oxidative damage to cell membrane, haemoglobin and erythrocyte metabolism causes haemolytic crisis. In some cases, liver involvement is subclinical, but nonetheless, free copper is released from necrosed hepatocytes and causes oxidative damage to erythrocytes.We had two cases of Wilson's disease with initial presentation as severe haemolytic anaemia and no other clinical feature suggestive of Wilson's disease was present. In unclear cause of haemolytic anaemia, especially in adolescents or young adults, Wilson's disease should be considered. As Wilson disease is rare and its initial presentation with haemolytic anaemia is rarer, high level of suspicion is required to diagnose it.

  10. Milk versus medicine for the treatment of iron deficiency anaemia in hospitalised infants

    OpenAIRE

    Wall, C.; Grant, C.; Taua, N; C. Wilson; Thompson, J.

    2005-01-01

    Aims: To compare iron fortified follow-on milk (iron follow-on), iron fortified partially modified cows' milk (iron milk), and iron medicine for the treatment of iron deficiency anaemia (IDA) in hospitalised infants.

  11. Mucosal regeneration during radiotherapy

    International Nuclear Information System (INIS)

    Background and purpose: Regeneration of the aerodigestive mucosa is known to occur during conventionally fractionated radiotherapy. The circumstances surrounding its time of onset and magnitude are not well understood, however. Material and methods: Mucosal reactions were observed in 100 patients undergoing conventionally fractionated treatment at 2 Gy/day over 7 weeks and 88 receiving accelerated treatment at 1.8 Gy twice daily over 3(1(2)) weeks on the Trans Tasman Radiation Oncology Group head and neck cancer trials. Similar observations in 61 patients treated palliatively at dose rates between 0.8 and 240 Gy/h using ten 3.0-4.2 Gy fractions over 2 weeks are compared. Results: Several findings emerged from these studies: 1. Reactions evolved more quickly at oropharyngeal sites than in the hypopharynx. 2. Reactions at both sites evolved more rapidly at greater rates of dose accumulation. 3. The timing of reactions suggested the presence of a strong regenerative mucosal response that started before the manifestation of 'patchy' (grade II) mucosal reactions. 4. The regenerative response was strong enough to 'make good' damage accumulated at a rate of 2 Gy/day in over a third of cases. 5. The linear quadratic model without time correction failed to provide an adequate prediction of the frequency or intensity of mucosal reactions produced by any of the regimes. A simple model of the regenerative response is presented. Conclusions: This study suggests that the timing and magnitude of the regenerative response vary between sites and individuals but are linked to the amount of epithelial cellular depletion occurring during treatment

  12. Prevalence of anaemia among different physiological groups in the rural areas of Maharashtra

    OpenAIRE

    Nimmathota Arlappa; Meshram, Indrapal I; Nagalla Balakrishna; Rachkula Harikumar; Kodavanti Mallikharjuna Rao; Avula Laxmaiah

    2014-01-01

    Introduction: Anaemia continues to be a major public health nutritional problem in India, and has adverse health and economic implications. Objective: The objective of the study was to assess the prevalence of anaemia among different physiological groups in the state of Maharashtra. Methodology: A community based cross-sectional study adopting multistage stratified random sampling procedure was carried out in rural Maharashtra. Information of socio-demographic particulars was collected with p...

  13. Recombinant Human Erythropoietin as an Alternative to Blood Transfusion in Cancer-Related Anaemia

    OpenAIRE

    Andreas Engert

    2000-01-01

    As physicians become more aware of the need to treat anaemia in their patients with cancer, they have to consider 2 treatment options: red blood cell transfusion or recombinant human erythropoietin [epoetin alfa; epoetin beta]. Healthcare systems are under increasing pressure to lower costs while maintaining quality of care; therefore, treatment of cancer-related anaemia requires a disease management strategy aimed at achieving optimal clinical and economic outcomes. Although blood transfusio...

  14. NUTRITIONAL ANAEMIA AMONG CURRENTLY MARRIED FEMALES IN THE REPRODUCTIVE AGE GROUP IN RURAL JAMMU

    Directory of Open Access Journals (Sweden)

    Vridhee

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND: More than one - third of world’s women are a naemic with majority residing in developing countries and that too in rural areas. The most highly affected population in the decreasing order is pregnant women, school age children, non - pregnant women and preschool children. Nutritional anaemia has recent ly been ranked as the third leading problem among the women of reproductive age group. Most of the studies conducted so far have focused on pregnant ladies only so it was decided to take all the females in the reproductive age group as the study subjects. AIMS: To find out the prevalence of nutritional anaemia among married females of reproductive age group i.e., 15 - 49 years of age in a rural area of Jammu District. SETTINGS AND DESIGN : Across - sectional study was undertaken in rural settings. METHODS AND M ATERIAL: House to house visits were made and288married females in the reproductive age group were interviewed and their blood samples were taken for necessary haematological investigations which were done at GMC Jammu. STATISTICAL ANALYSIS : Percentages an d chi - square test . RESULTS AND CONCLUSION : More than 90% of the females were suffering from anaemia. Majority of them were having microcytic hypochromic blood picture. More than 50% of the subjects were having moderate anaemia as per WHO classification. Nu tritional anaemia was seen in 70.47% of the study subjects while the remaining females were having either no anaemia or anaemia due to other medical reasons. The prevalence of nutritional anaemia was even more among pregnant and lactating females and this finding was found to be statistically significant.

  15. Addressing Female Iron-Deficiency Anaemia in India: Is Vegetarianism the Major Obstacle?

    OpenAIRE

    Anu Rammohan; Niyi Awofeso; Marie-Claire Robitaille

    2012-01-01

    Objectives. We examined the influence of vegetarian diet on the risk of developing anaemia among Indian women and suggest initiatives for addressing diet-related iron-deficiency anaemia. Methods. We analysed data on diet, social class, and haemoglobin levels from the nationally representative Indian National Family and Health Survey 2005/06 for a sample of 81,301 women aged 15–49 years using logistic regression models. Results. After controlling for individual-level factors and household leve...

  16. Anaemia among Female Undergraduates Residing in the Hostels of University of Sri Jayewardenepura, Sri Lanka

    OpenAIRE

    Gayashan Chathuranga; Thushara Balasuriya; Rasika Perera

    2014-01-01

    Anaemia is a major public health problem that has affected around 25% of the world's population. An analytical cross-sectional study was performed on 313 female undergraduates residing in hostels of University of Sri Jayewardenepura, Sri Lanka, during year 2011. Objective of this study was to determine prevalence and contributing factors to anaemia among the study population. Haemoglobin concentration was assayed using cyanomethaemoglobin method. A pretested self-administered questionnaire wa...

  17. A Study of Awareness of Nutrition & Anaemia among College Going Students of Mahila College of Bhavnagar

    OpenAIRE

    Harshad Patel, Harsha Solanki, Vibha Gosalia, Falguni Vora, M. P. Singh

    2013-01-01

    Background: The lives of young population are characterized by limited education, lack of knowledge pertaining to health aspects & also limited influence on decisions affecting their lives. Thus, awareness is one major factor for development of this group of population. Aim & Objectives: 1) To study awareness regarding nutrition & anaemia amongst young college going students. 2) To assess the impact of health awareness programme on knowledge of nutrition & anaemia. Mat...

  18. Influence of Schistosoma mansoni and Hookworm Infection Intensities on Anaemia in Ugandan Villages.

    Directory of Open Access Journals (Sweden)

    Goylette F Chami

    Full Text Available The association of anaemia with intestinal schistosomiasis and hookworm infections are poorly explored in populations that are not limited to children or pregnant women.We sampled 1,832 individuals aged 5-90 years from 30 communities in Mayuge District, Uganda. Demographic, village, and parasitological data were collected. Infection risk factors were compared in ordinal logistic regressions. Anaemia and infection intensities were analyzed in multilevel models, and population attributable fractions were estimated.Household and village-level predictors of Schistosoma mansoni and hookworm were opposite in direction or significant for single infections. S. mansoni was found primarily in children, whereas hookworm was prevalent amongst the elderly. Anaemia was more prevalent in individuals with S. mansoni and increased by 2.86 fold (p-value<0.001 with heavy S. mansoni infection intensity. Individuals with heavy hookworm were 1.65 times (p-value = 0.008 more likely to have anaemia than uninfected participants. Amongst individuals with heavy S. mansoni infection intensity, 32.0% (p-value<0.001 of anaemia could be attributed to S. mansoni. For people with heavy hookworm infections, 23.7% (p-value = 0.002 of anaemia could be attributed to hookworm. A greater fraction of anaemia (24.9%, p-value = 0.002 was attributable to heavy hookworm infections in adults (excluding pregnant women as opposed to heavy hookworm infections in school-aged children and pregnant women (20.2%, p-value = 0.001.Community-based surveys captured anaemia in children and adults affected by S. mansoni and hookworm infections. For areas endemic with schistosomiasis or hookworm infections, WHO guidelines should include adults for treatment in helminth control programmes.

  19. Japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the DOPPS

    OpenAIRE

    Akizawa, Tadao; Ronald L Pisoni; Akiba, Takashi; Saito, Akira; Fukuhara, Shunichi; Asano, Yasushi; Hasegawa, Takeshi; Port, Friedrich K; Kurokawa, Kiyoshi

    2008-01-01

    Background. Japanese haemodialysis (HD) patients not only have a very low mortality and hospitalization risk but also low haemoglobin (Hb) levels. Internationally, anaemia is associated with mortality, hospitalization and health-related quality of life (QoL) measures of HD patients. Methods. Longitudinal data collected from 1999 to 2006 from 60 to 64 representative Japanese dialysis units participating in the Dialysis Outcomes and Practice Patterns Study (DOPPS) were used to describe anaemia ...

  20. Morphological differentiation of severe aplastic anaemia from hypocellular refractory cytopenia of childhood

    DEFF Research Database (Denmark)

    Baumann, Irith; Führer, Monika; Behrendt, Sonja;

    2012-01-01

    To evaluate the reproducibility and reliability of the histomorphological criteria differentiating severe aplastic anaemia (SAA) and hypoplastic refractory cytopenia of childhood (RCC), the most frequently acquired hypocellular bone marrow conditions of childhood.......To evaluate the reproducibility and reliability of the histomorphological criteria differentiating severe aplastic anaemia (SAA) and hypoplastic refractory cytopenia of childhood (RCC), the most frequently acquired hypocellular bone marrow conditions of childhood....

  1. Prevalence of anaemia among different physiological groups in the rural areas of Maharashtra

    Directory of Open Access Journals (Sweden)

    Nimmathota Arlappa

    2014-09-01

    Full Text Available Introduction: Anaemia continues to be a major public health nutritional problem in India, and has adverse health and economic implications. Objective: The objective of the study was to assess the prevalence of anaemia among different physiological groups in the state of Maharashtra. Methodology: A community based cross-sectional study adopting multistage stratified random sampling procedure was carried out in rural Maharashtra. Information of socio-demographic particulars was collected with pretested questionnaire. A finger prick blood sample of 20 µL was collected from the subjects. Haemoglobin was estimated using cyanmethemoglobin method. Results: The overall prevalence of anaemia was 59%, 61%, 76% and 73% among pre-school children, adolescent girls, pregnant women and lactating mothers, respectively. Logistic regression analysis revealed that the risk of anaemia was two times higher among pregnant and lactating women and among the subjects belonged to scheduled caste and scheduled tribe communities. Conclusion: Anaemia is a severe public health problem among pre-school children and women of different physiological groups in rural Maharashtra. Therefore, there is a need to strengthen the existing national nutritional anaemia control programme and the community is encouraged to consume iron rich foods through health and nutrition education and information, education and communication (IEC activities.

  2. Quantitative analysis of mechanisms that govern red blood cell age structure and dynamics during anaemia.

    Directory of Open Access Journals (Sweden)

    Nicholas J Savill

    2009-06-01

    Full Text Available Mathematical modelling has proven an important tool in elucidating and quantifying mechanisms that govern the age structure and population dynamics of red blood cells (RBCs. Here we synthesise ideas from previous experimental data and the mathematical modelling literature with new data in order to test hypotheses and generate new predictions about these mechanisms. The result is a set of competing hypotheses about three intrinsic mechanisms: the feedback from circulating RBC concentration to production rate of immature RBCs (reticulocytes in bone marrow, the release of reticulocytes from bone marrow into the circulation, and their subsequent ageing and clearance. In addition we examine two mechanisms specific to our experimental system: the effect of phenylhydrazine (PHZ and blood sampling on RBC dynamics. We performed a set of experiments to quantify the dynamics of reticulocyte proportion, RBC concentration, and erythropoietin concentration in PHZ-induced anaemic mice. By quantifying experimental error we are able to fit and assess each hypothesis against our data and recover parameter estimates using Markov chain Monte Carlo based Bayesian inference. We find that, under normal conditions, about 3% of reticulocytes are released early from bone marrow and upon maturation all cells are released immediately. In the circulation, RBCs undergo random clearance but have a maximum lifespan of about 50 days. Under anaemic conditions reticulocyte production rate is linearly correlated with the difference between normal and anaemic RBC concentrations, and their release rate is exponentially correlated with the same. PHZ appears to age rather than kill RBCs, and younger RBCs are affected more than older RBCs. Blood sampling caused short aperiodic spikes in the proportion of reticulocytes which appear to have a different developmental pathway than normal reticulocytes. We also provide evidence of large diurnal oscillations in serum erythropoietin levels

  3. Training logbook for radiotherapy.

    NARCIS (Netherlands)

    Hunter, R.; Maciejewski, B.; Leer, J.W.H.; Kinay, M.; Heeren, G.

    2004-01-01

    AIM: To develop a structured logbook for trainees in the medical specialty of radiotherapy with Europe that records the increasing experience throughout their training period. MATERIAL AND METHODS: A working party appointed by the European Board of Radiotherapy developed a draft version of a Europea

  4. [Radiotherapy of skin cancers].

    Science.gov (United States)

    Hennequin, C; Rio, E; Mahé, M-A

    2016-09-01

    The indications of radiotherapy for skin cancers are not clearly defined because of the lack of randomised trials or prospective studies. For basal cell carcinomas, radiotherapy frequently offers a good local control, but a randomized trial showed that surgery is more efficient and less toxic. Indications of radiotherapy are contra-indications of surgery for patients older than 60, non-sclerodermiform histology and occurring in non-sensitive areas. Adjuvant radiotherapy could be proposed to squamous cell carcinomas, in case of poor prognostic factors. Dose of 60 to 70Gy are usually required, and must be modulated to the size of the lesions. Adjuvant radiotherapy seems beneficial for desmoplastic melanomas but not for the other histological types. Prophylactic nodal irradiation (45 to 50Gy), for locally advanced tumours (massive nodal involvement), decreases the locoregional failure rate but do not increase survival. Adjuvant radiotherapy (50 to 56Gy) for Merckel cell carcinomas increases also the local control rate, as demonstrated by meta-analysis and a large epidemiological study. Nodal areas must be included, if there is no surgical exploration (sentinel lymph node dissection). Kaposi sarcomas are radiosensitive and could be treated with relatively low doses (24 to 30Gy). Also, cutaneous lymphomas are good indications for radiotherapy: B lymphomas are electively treated with limited fields. The role of total skin electron therapy for T-lymphomas is still discussed; but palliative radiotherapy is very efficient in case of cutaneous nodules. PMID:27522189

  5. Targeted tumor radiotherapy

    Directory of Open Access Journals (Sweden)

    Unak Perihan

    2002-01-01

    Full Text Available Targeted tumor radiotherapy is selectively delivery of curative doses of radiation to malignant sites. The aim of the targeted tumor radiotherapy is to use the radionuclides which have high LET particle emissions conjugated to appropriate carrier molecules. The radionuclides are selectively collected by tumor cells, depositing lethal doses to tumor cells while no admission occur to normal cells. In theory, targeted radiotherapy has several advantages over conventional radiotherapy since it allows a high radiation dose to be administered without causing normal tissue toxicity, although there are some limitations in the availability of appropriate targeting agents and in the calculations of administered doses. Therefore, for routine clinical applications more progress is still needed. In this article, the potential use of targeted tumor radiotherapy is briefly reviewed. More general aspects and considerations, such as potential radionuclides, mechanisms of tumor targeting was also outlined.

  6. To understand radiotherapy

    International Nuclear Information System (INIS)

    Dealing with the use of radiotherapy for adults, this guide indicates when a radiotherapy is suggested, how it acts, how the treatment is chosen, which are the professionals involved. It describes how an external radiotherapy takes place and its various techniques, the different types of side effects (general, specific to the treated zone, late effects). It indicates which organs can be treated by curie-therapy, the different curie-therapy treatment modalities, how a curie-therapy takes place and which are its side effects. It outlines how to better cope with radiotherapy (how to be supported, the important role of relatives, everyday life questions, rights). It indicates and comments the different measures adopted for the safety and quality of radiotherapy

  7. STUDY OF PREVALENCE OF ANAEMIA AND IMPACT OF IRON SUPPLEMENTATION IN SCHOOL CHILDREN

    Directory of Open Access Journals (Sweden)

    Chinnatambi Narayanan

    2016-02-01

    Full Text Available Anaemia is the most widespread nutrition problem in the world and has predominance in developing countries like India, particularly in children and women. The magnitude of anaemia has been well-documented in pregnant women and infants, but there is scarce data on the prevailing occurrence of anaemia in school children. The current study was undertaken to know the point prevalence of anaemia and the comparative effectiveness of twice a week iron supplementation program to daily supplementation program in enhancing the hemoglobin levels in children aged 10-14 years with different grades of anemia in high schools in and around Kakinada, East Godavari district, Andhra Pradesh. METHODS A total of 400 children in the age group of 10-14 years were included in this study from both government and private schools by random sampling. After estimating the point prevalence of anaemia by Sahli’s method all the children were given a single dose anti-helminthic and the children who were anaemic were further randomly divided into two subgroups A and B and allotted to either a daily or a twice weekly iron supplementation regimen respectively. The haemoglobin was again assessed after three months. RESULTS Point prevalence of anaemia among these children was 95.75%. Prevalence of anaemia was significantly higher amongst girls (97.8% as compared to boys (93.9%. Prevalence of anaemia was nearly equal in government (96% and private (95.5% schools. Mean improvement in Hb% of 2.23gm% and 1.98gm% was seen in daily and weekly twice iron groups respectively with no significant difference between two groups. Reduction in prevalence of anemia was 86% in daily iron and 80% in weekly twice iron regimen group. Daily iron group experienced more side effects (15.1% when compared to weekly twice iron group (8.1%. CONCLUSION This study shows that the point prevalence of anaemia in school children is high. Supervised iron and folic acid therapy twice a week is as effective as

  8. Prognostic analysis of refractory anaemia in adult myelodysplastic syndromes

    Institute of Scientific and Technical Information of China (English)

    WANG Xiao-qin; CHEN Zi-xing; CHEN Shu-chang; LIN Guo-wei; JI Mei-rong; LIANG Jian-ying; LIU Dun-dan; LI De-gao; MA Yan

    2008-01-01

    Background Patients with myelodysplastic syndrome (MDS) display a very diverse pattem. In this study, we investigated prognostic factors and survival rate in adult patients with MDS refractory anaemia (MDS-RA) diagnosed according to French-American-British classification and evaluated the International Prognostic Scoring System (IPSS) for Chinese patients.Methods A multi-center study on diagnosis of MDS-RA was conducted to charactedze the clinical features of Chinese MDS patients. The morphological criteria for the diagnosis of MDS-RA were first standardized. Clinical data of 307 MDS-RA patients collected from Shanghai, Suzhou and Beijing from 1995 to 2006 were analyzed using Kaplan-Meier curve, log rank and Cox regression model.Results The median age of 307 MDS-RA cases was 52 years. The frequency of 2 or 3 lineage cytopenias was 85.6%. Abnormal karyotype occurred in 35.7% of 235 patients. There were 165 cases (70.2%) in the good IPSS cytogenetic subgroup, 44 cases (18.7%) intermediate and 26 cases (11.1%) poor. IPSS showed 20 (8.5%) categodzed as low dsk,195 cases (83.0%) as intermediate-I risk and 20 cases (8.5%) as intermediate-ll dsk. The 1-, 2-, 3-, 4- and 5-year survival rates were 90.8%, 85.7%, 82.9%, 74.9% and 71.2% respectively. Fifteen cases (4.9%) transformed to acute myeloid leukaemia (median time 15.9 months, range 3-102 months). Lower white blood ceil count (<1.5x109/L), platelet count (<30x109/L) and cytogenetic abnormalities were independent prognostic factors by multivariate analysis, but age (≥65 years), IPSS cytogenetic subgroup and IPSS risk subgroup were not independent prognostic factors associated with survival time.Conclusions Chinese patients were younger, and had lower incidence of cytogenetic abnormalities, more severe cytopenias but a more favourable prognosis than Western patients. The major prognostic factors were lower white blood cell count, lower platelet count and fewer abnormal karyotypes. The intemational prognostic scodng

  9. Advances of Precise Radiotherapy for Lung Cancer

    OpenAIRE

    Xin WANG; Xu, Feng; Wei, Yuquan

    2011-01-01

    At present lung tumor radiation therapy has entered the accurate radiotherapy era. Precise radiotherapy includes intensity modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT) and stereotactic body radiotherapy (SBRT). During the process of implementing precise radiotherapy, these problems should be fully considered to ensure executing precise radiotherapy accurately: patient positioning, controlling of the lung tumor motion, selecting of image techniques, PTV margin, dose prescrip...

  10. Pathogenesis of the erythroid failure in Diamond Blackfan anaemia.

    Science.gov (United States)

    Sieff, Colin A; Yang, Jing; Merida-Long, Lilia B; Lodish, Harvey F

    2010-02-01

    Diamond Blackfan anaemia (DBA) is a severe congenital failure of erythropoiesis. Despite mutations in one of several ribosome protein genes, including RPS19, the cause of the erythroid specificity is still a mystery. We hypothesized that, because the chromatin of late erythroid cells becomes condensed and transcriptionally inactive prior to enucleation, the rapidly proliferating immature cells require very high ribosome synthetic rates. RNA biogenesis was measured in primary mouse fetal liver erythroid progenitor cells; during the first 24 h, cell number increased three to fourfold while, remarkably, RNA content increased sixfold, suggesting an accumulation of an excess of ribosomes during early erythropoiesis. Retrovirus infected siRNA RPS19 knockdown cells showed reduced proliferation but normal differentiation, and cell cycle analysis showed a G1/S phase delay. p53 protein was increased in the knockdown cells, and the mRNA level for p21, a transcriptional target of p53, was increased. Furthermore, we show that RPS19 knockdown decreased MYB protein, and Kit mRNA was reduced, as was the amount of cell surface KIT protein. Thus, in this small hairpin RNA murine model of DBA, RPS19 insufficient erythroid cells may proliferate poorly because of p53-mediated cell cycle arrest, and also because of decreased expression of the key erythroid signalling protein KIT.

  11. Anaemia and Iron Homeostasis in a Cohort of HIV-Infected Patients: A Cross-Sectional Study in Ghana

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    Christian Obirikorang

    2016-01-01

    Full Text Available Aim. We determined the prevalence of anaemia and evaluated markers of iron homeostasis in a cohort of HIV patients. Methods. A comparative cross-sectional study on 319 participants was carried out at the Tamale Teaching Hospital from July 2013 to December 2013, 219 patients on HAART (designated On-HAART and 100 HAART-naive patients. Data gathered include sociodemography, clinical history, and selected laboratory assays. Results. Prevalence of anaemia was 23.8%. On-HAART participants had higher CD4/CD3 lymphocyte counts, Hb, HCT/PCV, MCV, MCH, iron, ferritin, and TSAT (P<0.05. Hb, iron, ferritin, and TSAT decreased from grade 1 to grade 3 anaemia and CD4/CD3 lymphocyte count was lowest in grade 3 anaemia (P<0.05. Iron (P=0.0072 decreased with disease severity whilst transferrin (P=0.0143 and TIBC (P=0.0143 increased with disease severity. Seventy-six (23.8% participants fulfilled the criteria for anaemia, 86 (26.9% for iron deficiency, 41 (12.8% for iron deficiency anaemia, and 17 (5.3% for iron overload. The frequency of anaemia was higher amongst participants not on HAART (OR 2.6 for grade 1 anaemia; OR 3.0 for grade 3 anaemia. Conclusion. In this study population, HIV-associated anaemia is common and is related to HAART status and disease progression. HIV itself is the most important cause of anaemia and treatment of HIV should be a priority compared to iron supplementation.

  12. Role of malnutrition and parasite infections in the spatial variation in children’s anaemia risk in northern Angola

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    Ricardo J. Soares Magalhães

    2013-05-01

    Full Text Available Anaemia is known to have an impact on child development and mortality and is a severe public health problem in most countries in sub-Saharan Africa. We investigated the consistency between ecological and individual-level approaches to anaemia mapping by building spatial anaemia models for children aged ≤15 years using different modelling approaches. We aimed to (i quantify the role of malnutrition, malaria, Schistosoma haematobium and soil-transmitted helminths (STHs in anaemia endemicity; and (ii develop a high resolution predictive risk map of anaemia for the municipality of Dande in northern Angola. We used parasitological survey data for children aged ≤15 years to build Bayesian geostatistical models of malaria (PfPR≤15, S. haematobium, Ascaris lumbricoides and Trichuris trichiura and predict small-scale spatial variations in these infections. Malnutrition, PfPR≤15, and S. haematobium infections were significantly associated with anaemia risk. An estimated 12.5%, 15.6% and 9.8% of anaemia cases could be averted by treating malnutrition, malaria and S. haematobium, respectively. Spatial clusters of high risk of anaemia (>86% were identified. Using an individual-level approach to anaemia mapping at a small spatial scale, we found that anaemia in children aged ≤15 years is highly heterogeneous and that malnutrition and parasitic infections are important contributors to the spatial variation in anaemia risk. The results presented in this study can help inform the integration of the current provincial malaria control programme with ancillary micronutrient supplementation and control of neglected tropical diseases such as urogenital schistosomiasis and STH infections.

  13. IRON, VITAMIN B12 AND FOLATE DEFICIENCY IN ADOLESCENTS HAVING NUTRITIONAL ANAEMIA

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    Rajendra

    2014-09-01

    Full Text Available BACKGROUND: Adolescence is the formative period of life when the maximum amount of physical, psychological and behavioral changes takes place and this is a vulnerable period in the human life cycle for the development of nutritional anaemia, which has been constantly neglected by public health programs. The prevalence of anaemia is disproportionately high in developing countries than developed countries. It has mainly been ascribed to poverty, inadequate diet, certain diseases, pregnancy and lactation, and poor access to health services in developing countries Prevalence of anaemia in adolescents in India have been reported in limited studies available from 16.25% to 96.5%. Nutritional anaemia constitutes the most important cause of anaemia in adolescents. It is mainly due to deficiency of Iron, Vitamin B12 and Folate. Megaloblastic Anaemia resulting from deficiency of folate and B12 appears to be increasing over the last two decades. AIMS AND OBJECTIVES: 1.To study the types of nutritional anemia in adolescents (10-18 yrs. attending the hospital and correlate severity of nutritional anemia with serum levels of ferritin, Vit B12 & folate. 2. And also to determine demographic, socio-economic & nutritional factors for nutritional anemia in adolescents. STUDY DESIGN: A cross sectional study was conducted in selected sample of 200 subjects. SETTINGS: The study was conducted in the Department of General Medicine, Azeezia Medical College; during November 2011 to April 2013, as a cross-sectional observational study. MATERIALS AND METHODS: Subjects were selected based on the inclusion criteria set and evaluated with aid of laboratory investigation of blood samples collected from subjects. RESULTS AND CONCLUSION: Present study was undertaken to find out etiology and socio-demographic correlates of nutritional anaemia in adolescents. And it was found out that Folate deficiency was the most common followed by Vitamin B12 deficiency & then irons deficiency

  14. Bilateral Rhegmatogenous Retinal Detachment during External Beam Radiotherapy

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    Takako Hidaka

    2016-06-01

    Full Text Available Herein, we report a case of nontraumatic bilateral rhegmatogenous retinal detachment (RRD during external beam radiotherapy for nonocular tumor, presented as an observational case study in conjunction with a review of the relevant literature. A 65-year-old male was referred to our hospital due to bilateral RRD. He underwent a biopsy for a tumor of the left frontal lobe 4 months prior to presentation, and the tumor had been diagnosed as primary central nerve system B-cell type lymphoma. He received chemotherapy and external beam radiotherapy for 1 month. There were no traumatic episodes. Bilateral retinal detachment occurred during a series of radiotherapies. Simultaneous nontraumatic bilateral retinal detachment is rare. The effects of radiotherapy on ocular functionality, particularly in cases involving retinal adhesion and vitreous contraction, may include RRD. Thus, it is necessary to closely monitor the eyes of patients undergoing radiotherapy, particularly those undergoing surgery for retinal detachment and those with a history of photocoagulation for retinal tears, a relevant family history, or risk factors known to be associated with RRD.

  15. CD4+ T Lymphocytes count in sickle cell anaemia patients attending a tertiary hospital

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    Omotola Toyin Ojo

    2014-01-01

    Full Text Available Background: Sickle cell haemoglobin (HbS is the commonest abnormal haemoglobin and it has a worldwide distribution. Reports have shown that patients with sickle cell anaemia (HbSS have an increased susceptibility to infection leading to increased morbidity and mortality. Impaired leucocyte function and loss of both humoral and cell-mediated immunity are some of the mechanisms that have been reported to account for the immunocompromised state in patients with sickle cell disease. This study was carried out to determine the CD4+ T lymphocytes count in patients with sickle cell anaemia. Materials and Methods: A comparative cross-sectional study of 40 sickle cell anaemia patients in steady state (asymptomatic for at least 4 weeks attending haematology clinic and 40 age and sex-matched healthy HbA control were recruited into the study. Both HbS patients and the controls were HIV negative. The blood samples obtained were analyzed for CD4+ T cell by Flow cytometry. Results: The study found that there was no significant difference in the number of CD4+ T lymphocyte count between individuals with sickle cell anaemia and HbA (1016 ± 513 cells/μL vs 920 ± 364cells/μL. Conclusion: It is recommended that the functionality of CD4+ T lymphocyte should be considered rather than the number in further attempt to elucidate the cellular immune dysfunction in patients with sickle cell anaemia.

  16. Incidence of nutritional anaemia among the under five children attending Ahmed Gasim hospital

    International Nuclear Information System (INIS)

    A survey was carried out in Khartoum North Ahmed Gasim specialist Hospital for children to identify aetiological factors that lead to incidence of nutritional anaemia among children under under five years of age. The sample consists of 192 patients taken from the hospital wards (experimental group), and 60 healthy children taken from out patient vaccination department of same hospital. A questionnaire was used as a tool for collection data regarding children and their families with emphasis to general information, socio-economic information, dietary information, anthropometric information, medical history and laboratory investigations including haemoglobin, hematocrit (PCV)%, peripheral blood picture, serum ferritin, serum folate and serum B12. Results show no correlation between anaemia and age R(0.1048) p12 deficiency. Some children affected had mixed deficiency anaemia (3.182). Iron deficiency without anaemia was common among healthy children (control) 22.8%. Some recommendations were set for the improvement of the existing situation e.g. health education, nutrition education with emphasis on intake of supplements and weaning diets rich in iron and folate. Follow up and surveillance program to compact nutritional anaemia should be adopted.(Author)

  17. The effect of iron fortification and de-worming on anaemia and iron status of Vietnamese schoolchildren

    NARCIS (Netherlands)

    Thi, Le H.; Brouwer, I.A.; Khan, N.C.; Burema, J.; Kok, F.J.

    2007-01-01

    Previous data from Vietnam show that anaemia is highly prevalent among schoolchildren, who are considered not to be iron deficient. Trichuris infection doubled the risk of anaemia. The present study aimed to evaluate the hypothesis that de-worming is more effective than iron fortification in an anae

  18. Successful allogeneic stem cells transplantation in severe aplastic anaemia complicated by dengue fever

    International Nuclear Information System (INIS)

    Aplastic anaemia is characterized by severe compromise of haematopoiesis and hypocellular bone marrow. Haemorrhagic episodes in patients with aplastic anemia occur usually secondary to thrombocytopenia and require frequent support with platelet concentrates and other blood products. Infection with dengue virus (particularly dengue sero type-2 of South Asian genotype) is associated with dengue haemorrhagic fever. Dengue infection further worsens the disease process in patients with aplastic anaemia due to uncontrolled haemorrhagic diathesis and major organ failure, which may prove fatal in these already immunocompromised patients, if not treated in time. Recent epidemics of dengue haemorrhagic fever has not only affected the southern region of our country but also spread to other areas of the country. With this background, we report a case of aplastic anaemia complicated by dengue haemorrhagic fever who achieved successful engraftment after allogeneic stem cell transplantation from sibling brother and is having normal healthy post transplant life. (author)

  19. Neurological Deficits of an Rps19(Arg67del) Model of Diamond-Blackfan Anaemia.

    Science.gov (United States)

    Kubik-Zahorodna, A; Schuster, B; Kanchev, I; Sedláček, R

    2016-01-01

    Diamond-Blackfan anaemia is a rare disease caused by insufficient expression of ribosomal proteins and is characterized by erythroid hypoplasia often accompanied by growth retardation, congenital craniofacial and limb abnormalities. In addition, Diamond-Blackfan anaemia patients also exhibit a number of behavioural abnormalities. In this study we describe the behavioural effects observed in a new mouse mutant carrying a targeted single amino acid deletion in the ribosomal protein RPS19. This mutant, created by the deletion of arginine 67 in RPS19, exhibits craniofacial, skeletal, and brain abnormalities, accompanied by various neurobehavioural malfunctions. A battery of behavioural tests revealed a moderate cognitive impairment and neuromuscular dysfunction resulting in profound gait abnormalities. This novel Rps19 mutant shows behavioural phenotypes resembling that of the human Diamond-Blackfan anaemia syndrome, thus creating the possibility to use this mutant as a unique murine model for studying the molecular basis of ribosomal protein deficiencies. PMID:27643579

  20. Long-term clearance of [57Co]cyanocobalamin in vegans and pernicious anaemia.

    Science.gov (United States)

    Amin, S; Spinks, T; Ranicar, A; Short, M D; Hoffbrand, A V

    1980-01-01

    1. Whole-body counting has been used to monitor the clearance of [57Co]cyanocobalamin in normal subjects, vegans and patients with pernicious anaemia. After oral administration of 57Co-labelled cyanocobalamin (1 microgram/1 muCi), subjects were counted for radioactivity monthly for a maximum period of 1 year. 2. The results obtained were consistent with a monoexponential clearance model and a least squares fit showed that there was no significant difference between the mean clearance rates for the vegans and normal subjects. 3. The patients with pernicious anaemia cleared the vitamin significantly more quickly than the normal control subjects. 4. This may be due to failure to reabsorb biliary vitamin B12 in pernicious anaemia because of the absence of intrinsic factor.

  1. Anemia de Fanconi: Consideraciones actuales Updating Fanconi’s anaemia

    Directory of Open Access Journals (Sweden)

    M. Sagaseta de Ilurdoz

    2003-04-01

    Full Text Available La anemia de Fanconi (AF es un síndrome de inestabilidad cromosómica, autosómico recesivo, caracterizado por una hipersensibilidad del DNA a agentes clastogénicos. Clínicamente presenta una insuficiencia medular progresiva, diversas anomalías congénitas e incremento en la predisposición a padecer enfermedades malignas. Se han definido ocho grupos de complementación y se han clonado los genes correspondientes a seis de ellos. Recientes avances en biología molecular han permitido investigar la relación entre el genotipo de AF y la naturaleza y severidad del fenotipo clínico. El tratamiento de la AF es también objeto de una intensa investigación que actualmente se centra en el trasplante de progenitores hematopoyéticos, con éxito especialmente en caso de donante hermano HLA-idéntico, y en la terapia génica todavía en fase de investigación clínica.Fanconi’s anaemia (FA is an autosomal recessive syndrome associated with chromosomal instability, and hypersensitivity of the DNA to claustrogenic agents. Clinically it presents a progressive marrow insufficiency, different congenital anomalies and an predisposition to malignancy. Eight complementation groups have been defined and the genes corresponding to six of them have been cloned. Recent advances in molecular biology have made it possible to investigate the relationship between the FA genotype and the nature and severity of the clinical phenotype. The treatment of FA is also the object of intense research that is currently centred on the transplant of hematopoyetic progenitors, especially successful in cases of an HLA-identical brother or sister donor, and in gene therapy, which is still in the phase of clinical research.

  2. A swollen knee in a patient with refractory anaemia

    Directory of Open Access Journals (Sweden)

    P. Bordin

    2013-05-01

    Full Text Available CASE REPORT A 63-year old man with refractory anaemia with excess of blasts and a history of heart failure, diabetes and hyperuricaemia, presented with pain, warmth and swelling in the left knee. Blood sample showed white cell blood count 3,840/μL (normal formula, haemoglobin 7.1 g/dL, platelets 117,000/L, eritrosedimentation rate 66 mm/h, normal serum creatinine and uric acid. He had no history of neutropenia, fever or recurrent infections. X-ray of the knee did not show any erosion or lytic lesion. Arthrocentesis produced turbid fluid, with elevated cell count (81,000/μL, mainly polimorphonuclear cells, no urate crystals, normal chemical pattern, sterile culture. Synovial fluid smear showed a huge neutrophilic cellularity with scattered mononuclear cells looking like medullar myeloid blasts. The microscopic examination identified a myeloid infiltration as the cause of arthritis. DISCUSSION AND CONCLUSIONS Rheumatic phenomena in myelodysplastic syndromes have a prevalence of 10% and include vasculitis, neuropaties, glomerulonephritis, lupus-like syndrome, inflammatory bowel disease, lung infiltrates and arthritis. The pathogenesis is usually autoimmune, as in all paraneoplastic syndromes. In our case, arthritis was due to a direct invasion of blasts. This phenomenon is rarely observed in acute leukemias and was not described yet in myelodysplastic syndromes. Synovial fluid analysis is critical to define the ethiology of an articular effusion, microscopical examination is strongly recommended but it is not always carried out. This case shows how simple diagnostic tests can easily disclose rare conditions.

  3. TO STUDY THE CLINICAL SPECTRUM AND HAEMATOLOGICAL ABNORMALITIES IN PATIENTS OF MACROCYTIC ANAEMIA

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    Daljinderjit

    2015-06-01

    Full Text Available BACKGROUND : Folate and vitamin12 deficiency have been known to cause megaloblastic anaemia. Megaloblastic anaemia is not uncommon in India , but data are insufficient regarding its prevalence , causative factors and precipitating factors. AIMS & OBJECTIVES : To evaluate the clinic o - haematological profile in patients of macrocytic anaemia. MATERIAL AND METHODS : In the present study , 50 patients of >20years of age with hemoglobin 95 fl and PBF showing macrocytosis and pancytopenia were included. Detailed history with clinical examination was performed and investigations (Bone Marrow aspiration , Serum Folate and cobalamin assays were carried out. RESULTS : The peak incidence of megaloblas tic anaemia was in the age group of 41 - 50 years (48% , with male preponderance (71% . ( The predominant symptoms were fatigue (54% followed by low grade fever (52% , breathlessness (50% , and mild jaundice (22% . ( Physicalfindingswere pallor (88 % , hepatomegaly (80% , knuckle hyperpigmentation (68% , glossitis (50% , peripheral neuropathy (28% and mild icterus was the least common finding in 22% of patients. 64% patients of macrocytic anaemia were found to be lactovegetarian. Cobalamin deficiency wa s present in maximum patients (50% , followed by combined cobalamin and folate deficiency in 34% and folate deficiency in 16% of patients. Bonemarrowsmears revealed megaloblastic picture in 58% of patients and 42% patients had non - megaloblastic bone marrow picture. C ONCLUSION : Megaloblastic anaemia must be considered in the differential diagnosis of patients presenting with pyrexia of unknown origin , mild ic terus or pancytopenia. Therefore , the early screening for cobalamin and folic acid deficiency can lead to improvement in the wellbeing and prolongs the life of people in our community.

  4. Can an integrated approach reduce child vulnerability to anaemia? Evidence from three African countries.

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    Kendra Siekmans

    Full Text Available Addressing the complex, multi-factorial causes of childhood anaemia is best done through integrated packages of interventions. We hypothesized that due to reduced child vulnerability, a "buffering" of risk associated with known causes of anaemia would be observed among children living in areas benefiting from a community-based health and nutrition program intervention. Cross-sectional data on the nutrition and health status of children 24-59 mo (N=2405 were obtained in 2000 and 2004 from program evaluation surveys in Ghana, Malawi and Tanzania. Linear regression models estimated the association between haemoglobin and immediate, underlying and basic causes of child anaemia and variation in this association between years. Lower haemoglobin levels were observed in children assessed in 2000 compared to 2004 (difference -3.30 g/L, children from Tanzania (-9.15 g/L and Malawi (-2.96 g/L compared to Ghana, and the youngest (24-35 mo compared to oldest age group (48-59 mo; -5.43 g/L. Children who were stunted, malaria positive and recently ill also had lower haemoglobin, independent of age, sex and other underlying and basic causes of anaemia. Despite ongoing morbidity, risk of lower haemoglobin decreased for children with malaria and recent illness, suggesting decreased vulnerability to their anaemia-producing effects. Stunting remained an independent and unbuffered risk factor. Reducing chronic undernutrition is required in order to further reduce child vulnerability and ensure maximum impact of anaemia control programs. Buffering the impact of child morbidity on haemoglobin levels, including malaria, may be achieved in certain settings.

  5. Can an integrated approach reduce child vulnerability to anaemia? Evidence from three African countries.

    Science.gov (United States)

    Siekmans, Kendra; Receveur, Olivier; Haddad, Slim

    2014-01-01

    Addressing the complex, multi-factorial causes of childhood anaemia is best done through integrated packages of interventions. We hypothesized that due to reduced child vulnerability, a "buffering" of risk associated with known causes of anaemia would be observed among children living in areas benefiting from a community-based health and nutrition program intervention. Cross-sectional data on the nutrition and health status of children 24-59 mo (N=2405) were obtained in 2000 and 2004 from program evaluation surveys in Ghana, Malawi and Tanzania. Linear regression models estimated the association between haemoglobin and immediate, underlying and basic causes of child anaemia and variation in this association between years. Lower haemoglobin levels were observed in children assessed in 2000 compared to 2004 (difference -3.30 g/L), children from Tanzania (-9.15 g/L) and Malawi (-2.96 g/L) compared to Ghana, and the youngest (24-35 mo) compared to oldest age group (48-59 mo; -5.43 g/L). Children who were stunted, malaria positive and recently ill also had lower haemoglobin, independent of age, sex and other underlying and basic causes of anaemia. Despite ongoing morbidity, risk of lower haemoglobin decreased for children with malaria and recent illness, suggesting decreased vulnerability to their anaemia-producing effects. Stunting remained an independent and unbuffered risk factor. Reducing chronic undernutrition is required in order to further reduce child vulnerability and ensure maximum impact of anaemia control programs. Buffering the impact of child morbidity on haemoglobin levels, including malaria, may be achieved in certain settings. PMID:24598692

  6. Impact of socio demographic factors on the severity of maternal anaemia

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    Ambarisha Bhandiwad

    2016-03-01

    Conclusions: Anaemia in pregnancy is associated with several social and demographic factors. Strategies must be taken from the conceptional level itself by providing proper antenatal counseling and women should be economically empowered and good antenatal care must be made available and accessible to all of them. Even with routine iron prophylaxis in pregnancy, still the prevalence of anaemia is high, so should we consider one or two doses of routine parenteral iron therapy for all pregnant women? [Int J Reprod Contracept Obstet Gynecol 2016; 5(3.000: 868-872

  7. Severe chronic iron deficiency anaemia secondary to Trichuris dysentery syndrome - a case report.

    Science.gov (United States)

    Azira N, M S; Zeehaida, M

    2012-12-01

    Trichuris dysentery syndrome is caused by Trichuris trichiura which contributes to one of the most common helminthic infections in the world. It is associated with heavy colonic infection that manifests as mucoid diarrhoea, rectal bleeding, rectal prolapse, iron deficiency anaemia, and finger clubbing. Here, we report a case of trichuris dysentery syndrome complicated with severe chronic iron deficiency anaemia in a 4-year-old girl who required blood transfusion. The nematode was visualized on stool microscopic and colonoscopic examination. A longer duration of anti-helminthic treatment is required to achieve effective and better outcome.

  8. Advice concerning radiotherapy

    International Nuclear Information System (INIS)

    Dutch National cancer incidence figures were calculated by using the reliable data on cancer incidence in the Eindhoven area and population forecasts and information obtained from the Central Bureau of Statistics. Several radiotherapy departments suffer from under capacity (a lack of resources and understaffing). Data have also shown that 35% of cancer patients receive radiotherapy, instead of 50%. Calculations have been made by the committee on the present and future needs with regard to equipment and staff. In 1983, the number of megavoltage therapy units amounted to 38, but should have been 65. It should be 80 in 1990 and 90 in 2000. Since building and installing such equipment is a lengthy process a considerable effort is needed to make up for the arrears. The committee advocates the extension of the system of regional cooperation in cancer care (comprehensive cancer centres), in which radiotherapy departments play a crucial role. Working parties from the committee provided a comprehensive description of current radiotherapy practice with reference to physical, technical, clinical and management aspects. Another working party assessed the results of cancer treatment with regard to many different tumour sites. Recent and expected developments were analysed or indicated. The Radiotherapy Committee commissioned an external team to conduct a project to achieve a picture of future developments using methods different to those of the committee's. An interim advice has been added on this subject. (Auth.)

  9. [Prostate cancer external beam radiotherapy].

    Science.gov (United States)

    de Crevoisier, R; Pommier, P; Latorzeff, I; Chapet, O; Chauvet, B; Hennequin, C

    2016-09-01

    The prostate external beam radiotherapy techniques are described, when irradiating the prostate or after prostatectomy, with and without pelvic lymph nodes. The following parts are presented: indications of radiotherapy, total dose and fractionation, planning CT image acquisition, volume of interest delineation (target volumes and organs at risk) and margins, Intensity modulated radiotherapy planning and corresponding dose-volume constraints, and finally Image guided radiotherapy. PMID:27516051

  10. Intensity-modulated stereotactic body radiotherapy for stage I non-small cell lung cancer

    OpenAIRE

    Kim, Min-Jeong; Yeo, Seung-Gu; KIM, EUN SEOK; MIN, CHUL KEE; SE AN, PYUNG

    2012-01-01

    This study aimed to investigate the clinical outcomes of intensity-modulated radiotherapy (IMRT)-based stereotactic body radiotherapy (SBRT) for patients with stage I non-small cell lung cancer (NSCLC). A prospective database of 16 consecutive patients receiving SBRT for pathologically-proven and peripherally-located stage I NSCLC was reviewed. Fifteen patients were medically inoperable and one patient refused to undergo surgery. The median age of the patients was 76 years (range, 69–86). Tre...

  11. Histological changes in the human prostate after radiotherapy and salvage high intensity focused ultrasound

    OpenAIRE

    Chalasani, Venu; Martinez, Carlos H; Williams, Andrew K.; Kwan, Kevin; Chin, Joseph L.

    2010-01-01

    The histological changes (both macroscopic and microscopic) in the prostate following the combination of external beam radiotherapy and salvage high intensity focused ultrasound (HIFU) have not been previously described. This article describes the case of a 65-year-old male who presented with recurrent localized prostate cancer after undergoing external beam radiotherapy for low-risk prostate cancer. He was treated with salvage HIFU, and 4 weeks later presented with symptoms and signs consist...

  12. Late bilateral temporal lobe necrosis after conventional radiotherapy. Case report

    Energy Technology Data Exchange (ETDEWEB)

    Hoshi, Michio; Hayashi, Toshiyuki; Kagami, Hiroshi; Murase, Ikurou; Nakatsukasa, Masashi [Saiseikai Utsunomiya Hospital (Japan)

    2003-04-01

    A 63-year-old woman presented with radionecrosis in the bilateral temporal lobes manifesting as dementia about 30 years after undergoing conventional radiotherapy for pituitary adenoma. Computed tomography and magnetic resonance (MR) imaging showed edema and cystic lesions in both temporal lobes. The mass in the left temporal lobe was excised. MR imaging 12 days after surgery showed reduced edema. Her dementia had improved. Radionecrosis usually occurs between several months and a few years after radiotherapy. The incidence of radionecrosis is estimated as 5%, but may be higher with longer follow-up periods. Clinical reports have suggested that larger total doses of radiation are associated with earlier onset of delayed necrosis and the fractional dose is the most significant factor causing cerebral radionecrosis. Radionecrosis can occur long after conventional radiotherapy or stereotactic radiosurgery using a linac-based system or a gamma knife unit. (author)

  13. Nanoparticle-guided radiotherapy

    DEFF Research Database (Denmark)

    2012-01-01

    The present invention relates to a method and nano-sized particles for image guided radiotherapy (IGRT) of a target tissue. More specifically, the invention relates to nano-sized particles comprising X-ray-imaging contrast agents in solid form with the ability to block x-rays, allowing for simult......The present invention relates to a method and nano-sized particles for image guided radiotherapy (IGRT) of a target tissue. More specifically, the invention relates to nano-sized particles comprising X-ray-imaging contrast agents in solid form with the ability to block x-rays, allowing...... for simultaneous or integrated external beam radiotherapy and imaging, e.g., using computed tomography (CT)....

  14. [Definition of accurate planning target volume margins for esophageal cancer radiotherapy].

    Science.gov (United States)

    Lesueur, P; Servagi-Vernat, S

    2016-10-01

    More than 4000 cases of esophagus neoplasms are diagnosed every year in France. Radiotherapy, which can be delivered in preoperative or exclusive with a concomitant chemotherapy, plays a central role in treatment of esophagus cancer. Even if efficacy of radiotherapy no longer has to be proved, the prognosis of esophagus cancer remains unfortunately poor with a high recurrence rate. Toxicity of esophageal radiotherapy is correlated with the irradiation volume, and limits dose escalation and local control. Esophagus is a deep thoracic organ, which undergoes cardiac and respiratory motion, making the radiotherapy delivery more difficult and increasing the planning target volume margins. Definition of accurate planning target volume margins, taking into account the esophagus' intrafraction motion and set up margins is very important to be sure to cover the clinical target volume and restrains acute and late radiotoxicity. In this article, based on a review of the literature, we propose planning target volume margins adapted to esophageal radiotherapy.

  15. Xerostomia induced by radiotherapy

    Directory of Open Access Journals (Sweden)

    Alimi D

    2015-08-01

    Full Text Available David Alimi Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USAWe read with great interest the excellent review on xerostomia induced by radiotherapy, by Pinna et al.1 The authors should be congratulated for a very detailed review of the physiopathology, clinical symptoms, and therapeutic management of an extremely difficult condition. Although we agree that the use of anticholinergic medication represents treatment, it requires the patient to have residual salivary gland function. Unfortunately, it is well established that in most cases radiotherapy destroys most of the salivary gland and associated salivary secretions.     

  16. Clinical Dilemma in the Treatment of a Patient with Microangiopathic Haemolytic Anaemia, Thrombocytopaenia and Severe Hypertension

    OpenAIRE

    Gomes, D.; Viegas, V.; Castro, I.

    2010-01-01

    While haemolytic uraemic syndrome in children is predominantly associated with Shiga toxin -producing Escherichia coli (typically 0157:H7), some cases occur without associated diarrhoea, or as the manifestation of an underlying disorder other than infection. Haemolytic uraemic syndrome is characterised by microangiopathic anaemia, thrombocytopaenia and renal failure, on occasion accompanied by severe hypertension. Malignant hypertension is a syndrome that sometimes exhibits the same ...

  17. Subclinical anaemia of chronic disease in adult patients with cystic fibrosis.

    LENUS (Irish Health Repository)

    O'connor, T M

    2012-02-03

    Patients with chronic hypoxaemia develop secondary polycythaemia that improves oxygen-carrying capacity. Therefore, normal haemoglobin and haematocrit values in the presence of chronic arterial hypoxaemia in cystic fibrosis constitute \\'relative anaemia\\'. We sought to determine the cause of this relative anaemia in patients with cystic fibrosis. We studied haematological indices and oxygen saturation in healthy volunteers (n=17) and in adult patients with cystic fibrosis (n=15). Patients with cystic fibrosis had lower resting arterial oxygen saturation when compared with normal volunteers (P<0.0001), and exercise led to a greater reduction in arterial oxygen saturation (P<0.0001). However, haemoglobin and haematocrit values in patients with cystic fibrosis did not significantly differ from normal volunteers. Serum iron (P=0.002), transferrin (P=0.02), and total iron-binding capacity (P=0.01) were lower in patients with cystic fibrosis. There were no significant differences in serum ferritin, percentage iron saturation, serum erythropoietin or red cell volume between the groups. The data presented demonstrate a characteristic picture of anaemia of chronic disease in adult patients with cystic fibrosis, except for normal haemoglobin and haematocrit values. Normal haemoglobin and haematocrit values in patients with cystic fibrosis appear to represent a combination of the effects of arterial hypoxaemia promoting polycythaemia, counterbalanced by chronic inflammation promoting anaemia of chronic disease.

  18. Serum Iron Status of Under-Five Children with Sickle Cell Anaemia in Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    S. O. Akodu

    2013-01-01

    Full Text Available Background. Iron status in patients with sickle cell anaemia is a matter of continuing investigation. Objective. This paper aims to determine the serum iron status of under-five, sickle cell anaemia patients. Methods. The study spanned from December 2009 to February 2010 at the Consultant Outpatient Clinics involving 97 HbSS subjects and 97 age- and sex-matched HbAA controls. Biochemical iron status was assayed in subjects and controls. Results. Age range of the children was seven months to five years, with a mean of 30.6 (±15.97 months. Irrespective of gender, mean serum iron values were higher in HbAA controls than their HbSS counterparts but the observed difference was not significant ( and 0.111, resp.. The mean total iron binding capacity values of males and females were also not significantly different for sickle cell anaemia subjects and controls (. Males and females with HbAA had significantly lower serum ferritin when compared with their HbSS counterparts. Irrespective of gender, mean transferrin saturation was lower in HbSS subjects but the difference was not statistically significant (. Conclusion. Children with sickle cell anaemia have higher serum ferritin than controls, implying relatively higher iron content in the reticuloendothelial cells.

  19. Guidelines on anaemia : effect on primary-care midwives in The Netherlands

    NARCIS (Netherlands)

    Offerhaus, P; Fleuren, M; Wensing, M

    2005-01-01

    Objective: to assess the adherence and perceived barriers for implementation of a clinical-practice guideline on anaemia, which was the first national guideline for primary-care midwifery in The Netherlands. Design: cross-sectional survey study. Setting: primary-care midwifery in The Netherlands. Pa

  20. Guidelines on anaemia: effect on primary-care midwives in The Netherlands.

    NARCIS (Netherlands)

    Offerhaus, P.M.; Fleuren, M.; Wensing, M.J.P.

    2005-01-01

    OBJECTIVE: To assess the adherence and perceived barriers for implementation of a clinical-practice guideline on anaemia, which was the first national guideline for primary-care midwifery in The Netherlands. DESIGN: Cross-sectional survey study. SETTING: Primary-care midwifery in The Netherlands. PA

  1. Evaluation of Ferric and Ferrous Iron Therapies in Women with Iron Deficiency Anaemia

    Directory of Open Access Journals (Sweden)

    Ilhami Berber

    2014-01-01

    Full Text Available Introduction. Different ferric and ferrous iron preparations can be used as oral iron supplements. Our aim was to compare the effects of oral ferric and ferrous iron therapies in women with iron deficiency anaemia. Methods. The present study included 104 women diagnosed with iron deficiency anaemia after evaluation. In the evaluations performed to detect the aetiology underlying the iron deficiency anaemia, it was found and treated. After the detection of the iron deficiency anaemia aetiology and treatment of the underlying aetiology, the ferric group consisted of 30 patients treated with oral ferric protein succinylate tablets (2 × 40 mg elemental iron/day, and the second group consisted of 34 patients treated with oral ferrous glycine sulphate tablets (2 × 40 mg elemental iron/day for three months. In all patients, the following laboratory evaluations were performed before beginning treatment and after treatment. Results. The mean haemoglobin and haematocrit increases were 0.95 g/dL and 2.62% in the ferric group, while they were 2.25 g/dL and 5.91% in the ferrous group, respectively. A significant difference was found between the groups regarding the increase in haemoglobin and haematocrit values (P<0.05. Conclusion. Data are submitted on the good tolerability, higher efficacy, and lower cost of the ferrous preparation used in our study.

  2. Evaluation of ferric and ferrous iron therapies in women with iron deficiency anaemia.

    Science.gov (United States)

    Berber, Ilhami; Diri, Halit; Erkurt, Mehmet Ali; Aydogdu, Ismet; Kaya, Emin; Kuku, Irfan

    2014-01-01

    Introduction. Different ferric and ferrous iron preparations can be used as oral iron supplements. Our aim was to compare the effects of oral ferric and ferrous iron therapies in women with iron deficiency anaemia. Methods. The present study included 104 women diagnosed with iron deficiency anaemia after evaluation. In the evaluations performed to detect the aetiology underlying the iron deficiency anaemia, it was found and treated. After the detection of the iron deficiency anaemia aetiology and treatment of the underlying aetiology, the ferric group consisted of 30 patients treated with oral ferric protein succinylate tablets (2 × 40 mg elemental iron/day), and the second group consisted of 34 patients treated with oral ferrous glycine sulphate tablets (2 × 40 mg elemental iron/day) for three months. In all patients, the following laboratory evaluations were performed before beginning treatment and after treatment. Results. The mean haemoglobin and haematocrit increases were 0.95 g/dL and 2.62% in the ferric group, while they were 2.25 g/dL and 5.91% in the ferrous group, respectively. A significant difference was found between the groups regarding the increase in haemoglobin and haematocrit values (P ferrous preparation used in our study. PMID:25006339

  3. Cold autoimmune haemolytic anaemia secondary to Epstein Barr virus infection presenting with peripheral gangrene; case report

    Directory of Open Access Journals (Sweden)

    Karunarathne Suneth

    2012-04-01

    Full Text Available Abstract A sixty year old male presented with dark urine, symptomatic anaemia and peripheral gangrene following cold exposure. Investigations revealed that he had haemolysis and serological evidence of recent Epstein Barr virus infection. Although acrocyanosis is commonly associated with cold agglutinin disease, gangrene is a rare complication. Management of secondary cold agglutinin disease is mainly supportive.

  4. Iron deficiency and malaria as determinants of anaemia in African children

    NARCIS (Netherlands)

    Verhoef, H.

    2001-01-01

    Approximately three quarters of east African children <5 y of age suffer from anaemia, which is due, at least in part, to malaria and iron deficiency. In children in areas of seasonal malaria, the benefits of iron supplementation may not outweigh possible inherent risks of adverse effects caused

  5. HIF prolyl hydroxylase inhibitors for the treatment of renal anaemia and beyond.

    Science.gov (United States)

    Maxwell, Patrick H; Eckardt, Kai-Uwe

    2016-03-01

    Small-molecule stabilizers of hypoxia inducible factor (HIF) are being developed for the treatment of renal anaemia. These molecules inhibit prolyl hydroxylase domain-containing (PHD) enzymes, resulting in HIF activation and increased production of erythropoietin. Currently, renal anaemia is treated with recombinant human erythropoietin or related analogues, referred to as conventional erythropoiesis stimulating agents (ESAs). Advantages of PHD enzyme inhibitors over conventional ESAs include their oral administration and their simpler - and potentially cheaper - production. Importantly, inhibition of PHD enzymes is likely to have a range of consequences other than increasing levels of erythropoietin, and these effects could be beneficial - for instance by reducing the need for parenteral iron - but might in some instances be harmful. Several companies are currently testing PHD enzyme inhibitors in patients with renal anaemia and have reported clear evidence of efficacy without serious safety concerns. A central question that current studies are beginning to address is whether using PHD enzyme inhibitors will influence hard end points, including mortality and the rate of cardiovascular events. In terms of approaches to therapy, the exquisite specificity of conventional ESAs is a striking contrast to the pleiotropic effects of activating HIF. Excitingly, PHD inhibitors could also be useful for conditions besides renal anaemia, such as protection from ischaemic injury. PMID:26656456

  6. Anaemia is associated with shorter leucocyte telomere length in patients with chronic heart failure

    NARCIS (Netherlands)

    Wong, Liza S. M.; Huzen, Jardi; van der Harst, Pim; de Boer, Rudolf A.; Codd, Veryan; Westenbrink, B. Daan; Benus, Germaine F. J. D.; Voors, Adriaan A.; van Gilst, Wiek H.; Samani, Nilesh J.; Jaarsma, Tiny; van Veldhuisen, Dirk J.

    2010-01-01

    Aims Anaemia is highly prevalent and associated with poor prognosis in patients with chronic heart failure (CHF). Reduced erythroid proliferation capacity of haematopoietic progenitor cells is associated with reduced telomere length, a marker of cellular ageing. We hypothesize that short telomere le

  7. A Study of Awareness of Nutrition & Anaemia among College Going Students of Mahila College of Bhavnagar

    Directory of Open Access Journals (Sweden)

    Harshad Patel, Harsha Solanki, Vibha Gosalia, Falguni Vora, M. P. Singh

    2013-01-01

    Full Text Available Background: The lives of young population are characterized by limited education, lack of knowledge pertaining to health aspects & also limited influence on decisions affecting their lives. Thus, awareness is one major factor for development of this group of population. Aim & Objectives: 1 To study awareness regarding nutrition & anaemia amongst young college going students. 2 To assess the impact of health awareness programme on knowledge of nutrition & anaemia. Materials & Method: Present cross-sectional study was con-ducted among representative group of 68 young girls from Mrs. N.C.Gandhi & Mrs. B.V.Gandhi Mahila Arts & Commerce College, Bhavnagar city. Pre test was carried out before beginning the programme followed by post test to assess the impact of health awareness programme. Health Awareness programme was carried out by Department of PSM, Government Medical College of Bhavnagar on 24th January 2012 on Nutrition & anaemia. Results: The knowledge of girls regarding health aspects im-proved significantly after intervention. There was a considerable increase in the awareness levels of girls with regard to knowledge of nutrition & anaemia. Conclusion: The informative & educable intervention definitely has a positive effect on awareness levels which would eventually encourage expansion of knowledge & positive health habits.

  8. Acute myocardial infarction in sickle cell anaemia associated with severe hypoxia.

    OpenAIRE

    Saad, S. T.; ARRUDA, V R; Junqueira, O. O.; Schelini, F. A.; Coelho, O. B.

    1990-01-01

    A 17 year old boy with sickle cell anaemia presented with acute myocardial infarction associated with severe hypoxia and reticulocytopenia. Ischaemic heart disease is rare in sickle cell anemia and in this case it is possible that the acute episode of hypoxia led to myocardial infarction.

  9. Prevention of post-operative anaemia in hip and knee arthroplasty - a systematic review

    DEFF Research Database (Denmark)

    Khan, Nissa; Troelsen, Anders; Husted, Henrik

    2015-01-01

    and minimised the length of stay. A similar result was found for fibrin spray in total hip arthroplasty. However, for total knee arthroplasty, the outcome was blurred. Tourniquet use was uniformly not significant in the measured parameters. CONCLUSIONS: Tranexamic acid is useful in managing anaemia and blood...

  10. Hazard classification of chemicals inducing haemolytic anaemia: An EU regulatory perspective.

    NARCIS (Netherlands)

    Muller, Andre; Jacobsen, Helene; Healy, Edel; McMickan, Sinead; Istace, Fréderique; Blaude, Marie-Noëlle; Howden, Peter; Fleig, Helmut; Schulte, Agnes

    2006-01-01

    Haemolytic anaemia is often induced following prolonged exposure to chemical substances. Currently, under EU Council Directive 67/548/EEC, substances which induce such effects are classified as dangerous and assigned the risk phrase R48 'Danger of serious damage to health by prolonged exposure.' Whi

  11. Severe anaemia is not associated with HIV-1 env gene characteristics in Malawian children

    Directory of Open Access Journals (Sweden)

    Kachala David

    2008-02-01

    Full Text Available Abstract Background Anaemia is the most common haematological complication of HIV and associated with a high morbidity and a poor prognosis. The pathogenesis of HIV-associated anaemia is poorly understood and may include a direct effect of HIV on erythropoiesis. In vitro studies have suggested that specific HIV strains, like X4 that uses the CXCR4 co-receptor present on erythroid precursors, are associated with diminished erythropoiesis. This co-receptor affinity is determined by changes in the hypervariable loop of the HIV-1 envelope genome. In a previous case-control study we observed an association between HIV and severe anaemia in Malawian children that could not be fully explained by secondary infections and micronutrient deficiencies alone. We therefore explored the possibility that alterations in the V1-V2-V3 fragment of HIV-1 were associated with severe anaemia. Methods Using peripheral blood nucleic acid isolates of HIV-infected children identified in the previous studied we assessed if variability of the V1-V2-V3 region of HIV and the occurrence of X4 strains were more common in HIV-infected children with (cases, n = 29 and without severe anaemia (controls, n = 30. For 15 cases bone marrow isolates were available to compare against peripheral blood. All children were followed for 18 months after recruitment. Results Phylogenetic analysis showed that HIV-1 subtype C was present in all but one child. All V1-V2-V3 characteristics tested: V3 charge, V1-V2 length and potential glycosylation sites, were not found to be different between cases and controls. Using a computer model (C-PSSM four children (7.8% were identified to have an X4 strain. This prevalence was not different between study groups (p = 1.00. The V3 loop characteristics for bone marrow and peripheral blood isolates in the case group were identical. None of the children identified as having an X4 strain developed a (new episode of severe anaemia during follow up. Conclusion

  12. Anaemia in a phase 2 study of a blood stage falciparum malaria vaccine

    Directory of Open Access Journals (Sweden)

    Guindo Aldiouma

    2011-01-01

    Full Text Available Abstract Background A Phase 1-2b study of the blood stage malaria vaccine AMA1-C1/Alhydrogel was conducted in 336 children in Donéguébougou and Bancoumana, Mali. In the Phase 2 portion of the study (n = 300, no impact on parasite density or clinical malaria was seen; however, children who received the study vaccine had a higher frequency of anaemia (defined as haemoglobin Methods To further investigate the possible impact of vaccination on anaemia, additional analyses were conducted including patients from the Phase 1 portion of the study and controlling for baseline haemoglobin, haemoglobin types S or C, alpha-thalassaemia, G6PD deficiency, and age. A multiplicative intensity model was used, which generalizes Cox regression to allow for multiple events. Frailty effects for each subject were used to account for correlation of multiple anaemia events within the same subject. Intensity rates were calculated with reference to calendar time instead of time after randomization in order to account for staggered enrollment and seasonal effects of malaria incidence. Associations of anaemia with anti-AMA1 antibody were further explored using a similar analysis. Results A strong effect of vaccine on the incidence of anaemia (risk ratio [AMA1-C1 to comparator (Hiberix]= 2.01, 95% confidence interval [1.26,3.20] was demonstrated even after adjusting for baseline haemoglobin, haemoglobinopathies, and age, and using more sophisticated statistical models. Anti-AMA1 antibody levels were not associated with this effect. Conclusions While these additional analyses show a robust effect of vaccination on anaemia, this is an intensive exploration of secondary results and should, therefore, be interpreted with caution. Possible mechanisms of the apparent adverse effect on haemoglobin of vaccination with AMA1-C1/Alhydrogel and implications for blood stage vaccine development are discussed. The potential impact on malaria-associated anaemia should be closely

  13. Post prostatectomy radiotherapy: our experience

    International Nuclear Information System (INIS)

    Full text: Background: Between 2000 and 2005, at Vidt Medical Center, 85 patients were treated with 3D and IMRT radiotherapy after undergoing radical prostatectomy for localized prostate adenocarcinoma. Objective: To evaluate biochemical recurrence and specific disease free survival and global survival. Materials and method: These patients were divided into two groups: those who engaged in what is called adjuvant therapy (20 patients), who after surgery had increased risk factors and / or persistence of the disease. These risk factors were positive margins, seminal vesicles involvement, capsule infiltration or persistent PSA. The other group were 65 patients referred to as rescue therapy: they were those that presented PSA increase after having undetectable levels as observed nadir after surgery, understanding > 0.2 ng / ml as a high value or palpable nodule on rectal touch with or without positive biopsy. Follow up was between 24 and 84 months, the dose delivered was between 6500 - 7000 cGy. Also evaluated the early and late toxicity, urinary and rectal, according to RTOG criteria. Conclusion: The results obtained confirm the benefits of postoperative radiation therapy for both groups of patients, showing a more favorable trend on those treated with adjuvant therapy. (authors)

  14. Screening of aplastic anaemia-related genes in bone marrow CD4+ T cells by suppressive subtractive hybridization

    Institute of Scientific and Technical Information of China (English)

    ZHENG Miao; LIU Wen-li; FU Jin-rong; SUN Han-ying; ZHOU Jian-feng; XU Hui-zhen

    2007-01-01

    Background CD4+ T cells play a crucial role in the pathogenesis of aplastic anaemia. However, the mechanisms of over-proliferation, activation, infiltration of bone marrow and damage to haematopoietic cells of CD4+ T cells in aplastic anaemia are unclear. Therefore, we screened differentially expressed genes of bone marrow CD4+ T cells of aplastic anaemia patients and normal donors by suppressive subtractive hybridization to investigate the pathogenesis of aplastic anaemia.Methods The bone marrow mononuclear cells of a first visit aplastic anaemia patient and a healthy donor of the same age and sex were isolated using lymphocyte separating medium by density gradient centrifugation. With the patients as "tester" and donor as "driver", their CD4+T cells were separated with magnetic bead sorting and a cDNA library established by suppressive subtractive hybridization. Then 15 of the resulting subtracted cDNA clones were randomly selected for DNA sequencing and homological analysis. With semiquantitative RT-PCR, bone marrow samples from 20 patients with aplastic anaemia and 20 healthy donors assessed the expression levels of differentially expressed genes from SSH library.Results PCR detected 89 clones in the library containing an inserted fragment of 100 bp to 700 bp. Among 15 sequenced clones, 12 were known genes including 3 repeated genes. Compared with normal donors, there were 9/12 genes over-expressed in bone marrow CD4+T cells of patients with aplastic anaemia. The effects of these genes included protein synthesis, biology oxidation, signal transduction, proliferative regulation and cell migration. Not all these genes had been reported in the mechanisms of haematopoietic damage mediated by CD4+ T cells in aplastic anaemia.Conclusions Screening and cloning genes, which regulate functions of CD4+ T cells, are helpful in elucidating the mechanisms of over proliferation, activation, infiltrating bone marrow and damaging haematopoietic cells of CD4+ T cells in

  15. Association between anaemia, iron deficiency anaemia, neglected parasitic infections and socioeconomic factors in rural children of West Malaysia.

    Directory of Open Access Journals (Sweden)

    Romano Ngui

    Full Text Available BACKGROUND: Given that micronutrient deficiency, neglected intestinal parasitic infections (IPIs and poor socioeconomic status are closely linked, we conducted a cross-sectional study to assess the relationship between IPIs and nutritional status of children living in remote and rural areas in West Malaysia. METHODS/FINDINGS: A total of 550 children participated, comprising 520 (94.5% school children aged 7 to 12 years old, 30 (5.5% young children aged 1 to 6 years old, 254 (46.2% boys and 296 (53.8% girls. Of the 550 children, 26.2% were anaemic, 54.9% iron deficient and 16.9% had iron deficiency anaemia (IDA. The overall prevalence of helminths was 76.5% comprising Trichuris trichiura (71.5%, Ascaris lumbricoides (41.6% and hookworm infection (13.5%. It was observed that iron deficiency was significantly higher in girls (p = 0.032 compared to boys. Univariate analysis demonstrated that low level of mother's education (OR = 2.52; 95% CI = 1.38-4.60; p = 0.002, non working parents (OR = 2.18; 95% CI = 2.06-2.31; p = 0.013, low household income (OR = 2.02; 95% CI = 1.14-3.59; p = 0.015, T. trichiura (OR = 2.15; 95% CI = 1.21-3.81; p = 0.008 and A. lumbricoides infections (OR = 1.63; 95% CI = 1.04-2.55; p = 0.032 were significantly associated with the high prevalence of IDA. Multivariate analysis confirmed that low level of mother's education (OR = 1.48; 95 CI% = 1.33-2.58; p<0.001 was a significant predictor for IDA in these children. CONCLUSION: It is crucial that a comprehensive primary health care programme for these communities that includes periodic de-worming, nutrition supplement, improved household economy, education, sanitation status and personal hygiene are taken into consideration to improve the nutritional status of these children.

  16. Advances of Precise Radiotherapy for Lung Cancer

    Directory of Open Access Journals (Sweden)

    Xin WANG

    2011-11-01

    Full Text Available At present lung tumor radiation therapy has entered the accurate radiotherapy era. Precise radiotherapy includes intensity modulated radiotherapy (IMRT, image-guided radiotherapy (IGRT and stereotactic body radiotherapy (SBRT. During the process of implementing precise radiotherapy, these problems should be fully considered to ensure executing precise radiotherapy accurately: patient positioning, controlling of the lung tumor motion, selecting of image techniques, PTV margin, dose prescription and reporting, arrangement of beams, controlling of dose volume and treatment delivering.

  17. A Comparative Study of Alternate Iron and Folic Acid Supplementation Regimes in Childhood Anaemia

    Directory of Open Access Journals (Sweden)

    Bhuwan R Sharma

    2014-02-01

    Full Text Available Introduction: The prevalence of anaemia among children less than five years of age in India is around 70%. Anaemia in young children puts them at a higher risk of experiencing health problems such as stunted growth, mental retardation, and increased susceptibility to infectious diseases. The present study was undertaken to evaluate the effectiveness of IFA supplementation (daily vs. biweekly vs. weekly regime on haemoglobin levels of young children. Materials and Methods: A total 740 children in age group of six months to five years were included in this community based interventional study using Systemic random sampling. The children having mild to moderate anaemia were then divided into three groups A, B and C by simple random sampling and were given Iron and Folic acid supplementation daily, biweekly and weekly respectively. Follow up data was collected after 3 months and analysed using appropriate tests. Results: Prevalence of Anaemia was 91.1% among study participants. Comparison after 3 months showed significant change in haemoglobin levels in all three groups with mean improvement of 1.31 gm%, 0.89 gm% and 0.85 gm% in group A, B and C respectively. However, no significant difference was noted among the groups in pre as well as post intervention phase. Conclusion: Weekly regime is as effective as daily or biweekly regime in improving haemoglobin levels in children. Moreover, it has better compliance, lesser side effects and cost of therapy. So, the same should be recommended for prophylaxis as well as treatment of mild to moderate anaemia cases. [Natl J Med Res 2014; 4(1.000: 33-36

  18. Prevalence, types, risk factors and clinical correlates of anaemia in older people in a rural Ugandan population.

    Directory of Open Access Journals (Sweden)

    Joseph O Mugisha

    Full Text Available BACKGROUND: Studies conducted in high income countries have shown that anaemia is a common medical condition among older people, but such data are scarce in Africa. The objectives of this study were to estimate the prevalence, types, risk factors and clinical correlates of anaemia in older people. METHODS: Participants were aged (≥ 50 years recruited from a general population cohort from January 2012 to January 2013. Blood samples were collected for assessing hemoglobin, serum ferritin, serum vitamin B12, serum folate, C-reactive protein, malaria infection and stool samples for assessment of hookworm infection. HIV status was assessed using an algorithm for HIV rapid testing. Questionnaires were used to collect data on sociodemographic characteristics and other risk factors for anaemia. RESULTS: In total, 1449 people participated (response rate 72.3%. The overall prevalence of anaemia was 20.3 % (95% CI 18.2-22.3%, and this was higher for males (24.1%, 95% CI=20.7-27.7% than females (17.5%, 95% CI=15.0-20.1%. In males, the prevalence of anaemia increased rapidly with age almost doubling between 50 and 65 years (p-trend<0.001. Unexplained anaemia was responsible for more than half of all cases (59.7%. Anaemia was independently associated with infections including malaria (OR 3.49, 95% CI 1.78-6.82, HIV (OR 2.17, 1.32-3.57 heavy hookworm infection (OR 3.45, 1.73-6.91, low fruit consumption (OR 1.55, 1.05-2.29 and being unmarried (OR 1.37 , 95% CI 1.01-1.89. However, the odds of anaemia were lower among older people with elevated blood pressure (OR 0.47, 95% CI 0.29-0.77. CONCLUSION: Anaemia control programmes in Uganda should target older people and should include interventions to treat and control hookworms and educational programs on diets that enhance iron absorption. Clinicians should consider screening older people with HIV or malaria for anaemia. Further studies should be done on unexplained anaemia and serum ferritin levels that predict

  19. A comparison of mantle versus involved-field radiotherapy for Hodgkin's lymphoma: reduction in normal tissue dose and second cancer risk

    OpenAIRE

    Xu Tony; Pintilie Melania; Brenner David J; Tsang Richard W; Sachs Rainer K; Heydarian Mostafa; Tran Tu; Koh Eng-Siew; Chung June; Paul Narinder; Hodgson David C

    2007-01-01

    Abstract Background Hodgkin's lymphoma (HL) survivors who undergo radiotherapy experience increased risks of second cancers (SC) and cardiac sequelae. To reduce such risks, extended-field radiotherapy (RT) for HL has largely been replaced by involved field radiotherapy (IFRT). While it has generally been assumed that IFRT will reduce SC risks, there are few data that quantify the reduction in dose to normal tissues associated with modern RT practice for patients with mediastinal HL, and no es...

  20. Periodontal aspects of patients subjected to the radiotherapy in region of head and neck

    International Nuclear Information System (INIS)

    Mouth cancer is the sixth most frequent type in the world's population, affecting mostly developing countries. The treatment of choice for this neoplasm is the surgery associated with radiotherapy and / or chemotherapy, which often cause mouth adverse effects. The periodontal reaction to the suffering irradiation morphological and histological alterations decreased the ability of repairing and increased vulnerability to infections. The mouth conditions of the patients who will undergo cancer therapy should be assessed prior to initiation of treatment, mainly to prevent complications. This study aimed to do a literature review on the development of periodontal disease in patients undergoing radiotherapy in head and neck region

  1. Radiotherapy for craniopharyngioma.

    Science.gov (United States)

    Aggarwal, Ajay; Fersht, Naomi; Brada, Michael

    2013-03-01

    Radiotherapy remains the mainstay of multidisciplinary management of patients with incompletely resected and recurrent craniopharyngioma. Advances in imaging and radiotherapy technology offer new alternatives with the principal aim of improving the accuracy of treatment and reducing the volume of normal brain receiving significant radiation doses. We review the available technologies, their technical advantages and disadvantages and the published clinical results. Fractionated high precision conformal radiotherapy with image guidance remains the gold standard; the results of single fraction treatment are disappointing and hypofractionation should be used with caution as long term results are not available. There is insufficient data on the use of protons to assess the comparative efficacy and toxicity. The precision of treatment delivery needs to be coupled with experienced infrastructure and more intensive quality assurance to ensure best treatment outcome and this should be carried out within multidisciplinary teams experienced in the management of craniopharyngioma. The advantages of the combined skills and expertise of the team members may outweigh the largely undefined clinical gain from novel radiotherapy technologies.

  2. Bowel disease after radiotherapy

    International Nuclear Information System (INIS)

    The clinical presentation, operative findings and outcome in 40 patients who required surgery for bowel disease after radiotherapy are presented. The type of presentation varied according to the time after radiotherapy. In the first month, many patients had a proctitis but none required surgery. Five patients were operated on within one month, 2 for radiation-induced acute ileitis and 3 for exacerbations of pre-existing disease (diverticular disease 2, ulcerative colitis 1). The commonest time of presentation was between 3 and 18 months after radiotherapy, when 20 patients needed surgery for bowel disease caused by radiation-induced local ischaemia. Twelve of these patients had chronic perforation, 6 had severe rectal bleeding and 2 had painful anorectal ulceration. Fifteen patients presented between 2 and 24 years after radiotherapy, usually with incomplete intestinal obstruction due to a fibrous stricture, but 2 patients had rectal carcinoma. Wide resection of the involved bowel was the principal method of treatment but any anastomosis was protected by a proximal defunctioning stoma. There was no operative mortality but 10 patients have died subsequently. The danger of dismissing these patients as having incurable malignancy is stressed because, although the condition is infrequent, it is usually amenable to adequate surgery. (author)

  3. Quality assurance in radiotherapy

    International Nuclear Information System (INIS)

    Good radiotherapy results and safety of treatment require the radiation to be optimally applied to a specified target area and the correct dose. According to international recommendations, the average uncertainty in therapeutic dose should not exceed 5%. The need for high precision in therapeutic dose requires quality assurance covering the entire radiotherapy process. Besides the physical and technical characteristics of the therapy equipment, quality assurance must include all radiotherapy equipment and procedures that are significant for the correct magnitude and precision of application of the therapeutic dose. The duties and responsibilities pertaining to various stages of treatment must also be precisely defined. These requirements may be best implemented through a quality system. The general requirements for supervision and quality assurance of medical radiation apparatus are prescribed in section 40 of the Radiation Act (592/1991, amendment 1142/1998) and in sections 18 and 32 of the Decree of the Ministry of Social Affairs and Health on the medical use of radiation (423/2000). Guide ST 2.2 imposes requirements on structural radiation shielding of radiotherapy equipment and the premises in which it is used, and on warning and safety arrangements. Guide ST 1.1 sets out the general safety principles for radiation practices and regulatory control procedure for the use of radiation. Guide ST 1.6 provides general requirements for operational measures in the use of radiation. This Guide sets out the duties of responsible parties (the party running a radiation practice) in respect of arranging and maintaining radiotherapy quality assurance. The principles set out in this Guide and Guide ST 6.3 may be applied to radionuclide therapy

  4. [Radiotherapy of breast cancer].

    Science.gov (United States)

    Hennequin, C; Barillot, I; Azria, D; Belkacémi, Y; Bollet, M; Chauvet, B; Cowen, D; Cutuli, B; Fourquet, A; Hannoun-Lévi, J M; Leblanc, M; Mahé, M A

    2016-09-01

    In breast cancer, radiotherapy is an essential component of the treatment. After conservative surgery for an infiltrating carcinoma, radiotherapy must be systematically performed, regardless of the characteristics of the disease, because it decreases the rate of local recurrence and by this way, specific mortality. Partial breast irradiation could not be proposed routinely but only in very selected and informed patients. For ductal carcinoma in situ, adjuvant radiotherapy must be also systematically performed after lumpectomy. After mastectomy, chest wall irradiation is required for pT3-T4 tumours and if there is an axillary nodal involvement, whatever the number of involved lymph nodes. After neo-adjuvant chemotherapy and mastectomy, in case of pN0 disease, chest wall irradiation is recommended if there is a clinically or radiologically T3-T4 or node positive disease before chemotherapy. Axillary irradiation is recommended only if there is no axillary surgical dissection and a positive sentinel lymph node. Supra and infra-clavicular irradiation is advised in case of positive axillary nodes. Internal mammary irradiation must be discussed case by case, according to the benefit/risk ratio (cardiac toxicity). Dose to the chest wall or the breast must be between 45-50Gy with a conventional fractionation. A boost dose over the tumour bed is required if the patient is younger than 60 years old. Hypofractionation (42.5 Gy in 16 fractions, or 41.6 Gy en 13 or 40 Gy en 15) is possible after tumorectomy and if a nodal irradiation is not mandatory. Delineation of the breast, the chest wall and the nodal areas are based on clinical and radiological evaluations. 3D-conformal irradiation is the recommended technique, intensity-modulated radiotherapy must be proposed only in case of specific clinical situations. Respiratory gating could be useful to decrease the cardiac dose. Concomitant administration of chemotherapy in unadvised, but hormonal treatment could be start with

  5. Bilateral macular haemorrhages secondary to hepatitis-associated aplastic anaemia, treated with Nd:YAG laser posterior hyaloidotomy.

    Science.gov (United States)

    Ranganath, Akshatha; Mariatos, George; Thakur, Shakti

    2011-01-01

    Hepatitis-associated aplastic anaemia (HAAA) is an uncommon but distinct variant of aplastic anaemia in which pancytopenia and bone marrow failure appears 2-3 months after an acute attack of hepatitis. Although bilateral vision loss may rarely be the initial presentation of aplastic anaemia, no such report is known in HAAA. Here the authors report such a case presenting with large premacular subhyaloid haemorrhages secondary to severe anaemia and thrombocytopenia. Anaemic hypoxic damage to the vessel wall together with increased cardiac output and low platelet counts are interacting causal factors in the development of bleeding. Though these haemorrhages are benign and usually improve spontaneously, the presence of blood may cause permanent macular changes before it resolves. Posterior hyaloidotomy enabled rapid resolution of premacular subhyaloid haemorrhage thereby restoring vision and preventing need for vitreo-retinal surgery. These patients should be advised to refrain from valsalva manoeuvres, ocular rubbing and vigorous exercise to prevent ocular morbidity. PMID:22674943

  6. Anaemia is an independent predictor of mortality in patients with left ventricular systolic dysfunction following acute myocardial infarction

    DEFF Research Database (Denmark)

    Valeur, Nana; Nielsen, Olav Wendelboe; McMurray, John J V;

    2006-01-01

    BACKGROUND: In patients with chronic heart failure (HF), mortality is inversely related to haemoglobin (hgb) concentration. We investigated the prognostic importance of anaemia in patients with acute myocardial infarction (AMI) and left ventricular systolic dysfunction (LVSD) with and without HF...

  7. The influence of anaemia on stroke prognosis and its relation to N-terminal pro-brain natriuretic peptide

    DEFF Research Database (Denmark)

    Nybo, M; Kristensen, S R; Mickley, H;

    2007-01-01

    Anaemia is a negative prognostic factor for patients with heart failure and impaired renal function, but its role in stroke patients is unknown. Furthermore, anaemia has been shown to influence the level of N-terminal pro-brain natriuretic peptide (NT-proBNP), but this is only investigated...... in patients with heart failure, not in stroke patients. Two-hundred-and-fifty consecutive, well-defined ischemic stroke patients were investigated. Mortality was recorded at 6 months follow-up. Anaemia was diagnosed in 37 patients (15%) in whom stroke severity was worse than in the non-anaemic group, whilst...... the prevalence of renal affection, smoking and heart failure was lower. At 6 months follow-up, 23 patients were dead, and anaemia had an odds ratio of 4.7 when adjusted for age, Scandinavian Stroke Scale and a combined variable of heart and/or renal failure and/or elevation of troponin T using logistic...

  8. Preoperative anaemia and newly diagnosed cancer 1 year after elective total hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Jørgensen, C. C.; Jans; Kehlet, H.;

    2015-01-01

    BACKGROUND: Preoperative anaemia is a well-established risk factor for use of blood transfusions and postoperative morbidity. Consequently, focus on preoperative evaluation of haemoglobin levels is increasing. In this context, iron deficiency anaemia may be a symptom of undiscovered...... gastrointestinal (GI) cancer requiring further investigation. However, the association between preoperative anaemia and cancer 1 year after elective total hip (THA) and total knee arthroplasty (TKA) is unknown. We evaluated 1-year cancer diagnoses, particularly GI cancers, in anaemic and non-anaemic THA and TKA......·3%) and 79 (1·6%) new cancers in anaemic and non-anaemic patients, respectively (OR: 1·38; 95% CI: 0·81-2·35, P = 0·228). After propensity matching of 661 anaemic and 1305 non-anaemic patients, we found no association between preoperative anaemia and cancer (OR: 0·94; 95% CI: 0·51-1·73, P = 0·837) or with GI...

  9. Accuracy and reliability of pallor for detecting anaemia: a hospital-based diagnostic accuracy study.

    Directory of Open Access Journals (Sweden)

    Ashwini Kalantri

    Full Text Available BACKGROUND: Anaemia is a common disorder. Most health providers in resource poor settings rely on physical signs to diagnose anaemia. We aimed to determine the diagnostic accuracy of pallor for anaemia by using haemoglobin as the reference standard. METHODOLOGY/PRINCIPAL FINDINGS: In May 2007, we enrolled consecutive patients over 12 years of age, able to consent and willing to participate and who had a haemoglobin measurement taken within a day of assessment of clinical pallor from outpatient and medicine inpatient department of a teaching hospital. We did a blind and independent comparison of physical signs (examination of conjunctivae, tongue, palms and nailbed for pallor and the reference standard (haemoglobin estimation by an electronic cell counter. Diagnostic accuracy was measured by calculating likelihood ratio values and 95% confidence intervals (CI at different haemoglobin thresholds and area under the receiver operating characteristic curve. Two observers examined a subset of patients (n = 128 to determine the inter-observer agreement, calculated by kappa statistics. We studied 390 patients (mean age 40.1 [SD 17.08] years; of whom 48% were women. The haemoglobin was <7 g/dL in 8% (95% confidence interval, 5, 10 patients; <9 g/dL in 21% (17, 26 patients and <12 g/dL in 64% (60, 70 patients. Among patients with haemoglobin <7 g/dL, presence of severe tongue pallor yielded a LR of 9.87 (2.81, 34.6 and its absence yielded a LR of 0. The tongue pallor outperformed other pallor sites and was also the best discriminator of anaemia at haemoglobin thresholds of 7 g/dL and 9 g/dL (area under the receiver operating characteristic curves (ROC area = 0.84 [0.77, 0.90] and 0.71[0.64, 0.76] respectively. The agreement between the two observers for detection of anaemia was poor (kappa values = 0.07 for conjunctival pallor and 0.20 for tongue pallor. CONCLUSIONS/SIGNIFICANCE: Clinical assessment of pallor can rule out and modestly rule in severe

  10. Prevalence of iron deficiency anaemia among blood donors in Sokoto, North Western, Nigeria

    Directory of Open Access Journals (Sweden)

    Buhari Hauwa Ali

    2015-04-01

    Full Text Available Objective: To investigate the prevalence and socio-demographic factors associated with iron deficiency anaemia among blood donors in Sokoto, North Western, Nigeria using a combination of haemoglobin haematocrit and serum ferritin measurements. Methods: One hundred and fifty consecutively recruited whole blood donors, comprising of 148 (98.7% family replacement donors and 2 (1.3% voluntary non-remunerated donors aged 18-60 years and mean age 39±21 years constituted the subjects for this study. The full blood count was carried out using Mythic 22 CT fully automated haematology analyser (Orphee SA, Switzerland. Serum was tested for ferritin using a human ferritin enzyme immunoassay kitACCU Diag™ ELISA Ferritin kit (Diagnostic Automation/Cortez Diagnostic Inc. California, USA. Results: The prevalence of anaemia (haemoglobin<11.0 g/dL was evident in 24 (16% and iron deficiency anaemia (serum ferritin<12 ng/mL+haemoglobin<11 g/dL in 5 (10% of donors. The haemoglobin and ferritin levels was significantly lower among regular voluntary remunerated blood donors (13.50±0.00 and 34.88±0.00 compared to family replacement donors (14.10±2.40 and 74.12±45.20 respectively (P=0.01 and 0.05 respectively. The mean haemoglobin and ferritin level was compared among donors based on gender. The haemoglobin and ferritin was significantly higher among male donors (14.20±2.00, 78.02±49.10 compared to female donors (12.35±2.5 and 42.20±32.13 (P=0.01. The mean haemoglobin and ferritin level was compared among donors based on occupational groups. The haemoglobin and ferritin was significantly higher among civil servants compared to farmers and students (P=0.01. Conclusions: Iron deficiency anaemia is prevalent among blood donors in Sokoto, North Western, Nigeria. There is need to include routine ferritin in the blood donor testing protocol in the area to enable the diagnosis of donors with latent iron deficiency anaemia to facilitate iron supplementation for

  11. Prevalence of iron deficiency anaemia among blood donors in Sokoto, North Western, Nigeria

    Institute of Scientific and Technical Information of China (English)

    Buhari Hauwa Ali; Yeldu Mohammed Haruna; Erhabor Osaro; Imrana Sani; Abubakar Wase; Onuigwe Festus; Okwesili Augustine; Isaac Zama; Yakubu Abdulrahaman; Dallatu Kabiru

    2015-01-01

    Objective: To investigate the prevalence and socio-demographic factors associated with iron deficiency anaemia among blood donors in Sokoto, North Western, Nigeria using a combination of haemoglobin haematocrit and serum ferritin measurements. Methods: One hundred and fifty consecutively recruited whole blood donors, comprising of 148 (98.7%) family replacement donors and 2 (1.3%) voluntary non-remunerated donors aged 18-60 years and mean age 39±21 years constituted the subjects for this study. The full blood count was carried out using Mythic 22 CT fully automated haematology analyser (Orphee SA, Switzerland). Serum was tested for ferritin using a human ferritin enzyme immunoassay kit-ACCU Diag™ ELISA Ferritin kit (Diagnostic Automation/Cortez Diagnostic Inc. California, USA). Results: The prevalence of anaemia (haemoglobin<11.0 g/dL) was evident in 24 (16%) and iron deficiency anaemia (serum ferritin<12 ng/mL+haemoglobin<11 g/dL) in 5 (10%) of donors. The haemoglobin and ferritin levels was significantly lower among regular voluntary remunerated blood donors (13.50±0.00 and 34.88±0.00) compared to family replacement donors (14.10±2.40 and 74.12±45.20) respectively (P=0.01 and 0.05 respectively). The mean haemoglobin and ferritin level was compared among donors based on gender. The haemoglobin and ferritin was significantly higher among male donors (14.20±2.00, 78.02±49.10) compared to female donors (12.35±2.5 and 42.20±32.13) (P=0.01). The mean haemoglobin and ferritin level was compared among donors based on occupational groups. The haemoglobin and ferritin was significantly higher among civil servants compared to farmers and students (P=0.01). Conclusions: Iron deficiency anaemia is prevalent among blood donors in Sokoto, North Western, Nigeria. There is need to include routine ferritin in the blood donor testing protocol in the area to enable the diagnosis of donors with latent iron deficiency anaemia to facilitate iron supplementation for regular

  12. Radiotherapy of bronco-pulmonary cancer; Radiotherapie des cancers brochopulmonaires

    Energy Technology Data Exchange (ETDEWEB)

    Bourry, N.; Millardet, C.; Lapeyre, M.; Verrelle, P.; Gross, E.; Champeaux-Orange, E.; Lahbabi, K.; Galland, S.; Chomy, F.; Lagarde, P.; Blanchard, P

    2007-11-15

    Six oral communications as follow: tomography by positron emission with {sup 18}F-FDG and target volume determination in the non at small cells bronchi cancers: interest and limit; adjuvant radiotherapy in the non at small cells pulmonary cancers; pulmonary stereotaxic radiotherapy; the chemoradiotherapy of locally evolved bronco-pulmonary cancers; the mesothelioma: place of radiotherapy; predictive factors of the toxicity and the care of complications of thorax irradiation. (N.C.)

  13. Radiotherapy of cutaneous lymphomas; Radiotherapie des lymphomes cutanes

    Energy Technology Data Exchange (ETDEWEB)

    Kirova, Y.M.; Piedbois, Y.; Pan, Q.; Guo, J.P.; Le Bourgeois, J.P. [Hopital Henri-Mondor, 94 - Creteil (France). Dept. de cancerologie

    1999-03-01

    Radiotherapy plays an important role in the treatment of cutaneous lymphomas. In the treatment of Mycosis fungoides, total skin electron beam radiation therapy is efficient for patients with limited and superficial forms of the disease. Radiotherapy is also efficient for the locally advanced forms of non-epidermo-tropic lymphomas. The palliative radiotherapy is indicated for advanced, nodular and treatment resistant forms of cutaneous lymphomas and for voluminous lymphadenopathies. (authors)

  14. The impact of renal insufficiency and anaemia on survival in patients with cardiovascular disease: a cohort study.

    LENUS (Irish Health Repository)

    Anderson, Jocelyn

    2009-01-01

    BACKGROUND: The simultaneous occurrence of cardiovascular disease (CVD), kidney disease, and anaemia is associated with increased morbidity and mortality. In the community setting, little data exists about the risk associated with milder levels of anaemia when it is present concurrently with CVD and chronic kidney disease (CKD). The aim of this study was to establish the prevalence of CKD and anaemia in patients with CVD in the community and to examine whether the presence of anaemia was associated with increased morbidity and mortality. METHODS: This study was designed as a retrospective cohort study and involved a random sample of 35 general practices in the West of Ireland. A practice-based sample of 1,609 patients with established cardiovascular disease was generated in 2000\\/2001 and followed for five years. The primary endpoint was death from any cause. Statistical analysis involved using one-way ANOVA and Chi-squared tests for baseline data and Cox proportional-hazards models for mortality data. RESULTS: Of the study sample of 617 patients with blood results, 33% (n = 203) had CKD while 6% (n = 37) had CKD and anaemia. The estimated risk of death from any cause, when compared to patients with cardiovascular disease only, was almost double (HR = 1.98, 95% CI 0.99 to 3.98) for patients with both CVD and CKD and was over 4 times greater (HR = 4.33, 95% CI 1.76 to 10.68) for patients with CVD, CKD and anaemia. CONCLUSION: In patients with cardiovascular disease in the community, chronic kidney disease and anaemia occur commonly. The presence of chronic kidney disease carries an increased mortality risk which increases in an additive way with the addition of anaemia. These results suggest that early primary care diagnosis and management of this high risk group may be worthwhile.

  15. Prevalence and Factors Associated with Severe Anaemia amongst Under-Five Children Hospitalized at Bugando Medical Centre, Mwanza, Tanzania.

    OpenAIRE

    Simbauranga, Rehema H; Kamugisha, Erasmus; Hokororo, Adolfine; Benson R Kidenya; Makani, Julie

    2015-01-01

    Background Anaemia is a major public health problem in developing countries, contributing significantly to morbidity and mortality amongst children under-five years of age. About 43 % of under-fives are anaemic worldwide, and two-thirds reside in sub-Saharan Africa. Even where blood transfusion is available for treatment there is still a significant case fatality rate ranging between 6 and 18 %. This study aimed to determine the prevalence and morphological types of anaemia, as well as factor...

  16. Bone marrow suppression and severe anaemia associated with persistent Plasmodium falciparum infection in African children with microscopically undetectable parasitaemia

    DEFF Research Database (Denmark)

    Helleberg, Marie; Goka, Bamenla Q; Akanmori, Bartholomew D;

    2005-01-01

    BACKGROUND: Severe anaemia can develop in the aftermath of Plasmodium falciparum malaria because of protracted bone marrow suppression, possibly due to residual subpatent parasites. MATERIALS AND METHODS: Blood was collected from patients with recent malaria and negative malaria microscopy......, complete eradication of parasites may prevent subsequent development of anaemia. Severely anaemic children may benefit from antimalarial treatment if antigen tests are positive, even when no parasites can be demonstrated by microscopy....

  17. Hypericum perforatum and neem oil for the management of acute skin toxicity in head and neck cancer patients undergoing radiation or chemo-radiation: a single-arm prospective observational study

    OpenAIRE

    Franco, Pierfrancesco; Potenza, Ilenia; Moretto, Francesco; Segantin, Mattia; Grosso, Mario; Lombardo, Antonello; Taricco, Daniela; Vallario, Patrizia; Filippi, Andrea Riccardo; Rampino, Monica; Ricardi, Umberto

    2014-01-01

    Background Radiation dermatitis is common in patients treated with combined radiotherapy and chemotherapy for head and neck malignancies. Its timely and adequate management is of uttermost importance for both oncological outcomes and global quality of life. We prospectively evaluated the role of hypericum perforatum and neem oil (Holoil®; RIMOS srl, Mirandola, Italy) in the treatment of acute skin toxicity for patients undergoing radiotherapy or chemo-radiotherapy for head and neck cancer. Me...

  18. External audit in radiotherapy dosimetry

    International Nuclear Information System (INIS)

    Quality audit forms an essential part of any comprehensive quality assurance programme. This is true in radiotherapy generally and in specific areas such as radiotherapy dosimetry. Quality audit can independently test the effectiveness of the quality system and in so doing can identify problem areas and minimize their possible consequences. Some general points concerning quality audit applied to radiotherapy are followed by specific discussion of its practical role in radiotherapy dosimetry, following its evolution from dosimetric intercomparison exercises to routine measurement-based on-going audit in the various developing audit networks both in the UK and internationally. Specific examples of methods and results are given from some of these, including the Scottish+ audit group. Quality audit in radiotherapy dosimetry is now well proven and participation by individual centres is strongly recommended. Similar audit approaches are to be encouraged in other areas of the radiotherapy process. (author)

  19. Radiotherapy for aggressive fibromatosis

    International Nuclear Information System (INIS)

    Purpose/Objective: To evaluate local control with radiotherapy for aggressive fibromatosis. Materials and Methods: Fifty-three patients with histologically confirmed aggressive fibromatosis were treated with radiotherapy at the University of Florida between March 1975 and June 1992. The minimum length of follow-up was 2 years; 88% of patients had follow-up for at least 5 years. Thirty-nine patients had lesions in an extremity and 14 patients had lesions in the trunk. Twenty-nine patients were treated for gross disease. Patients were treated with total doses between 35 Gy and 70 Gy; 83% of patients received 50 Gy to 60 Gy. Results: Local control was achieved in 23 of 29 patients (79%) treated for postoperative microscopic residual disease. Local control was achieved in 21 of 24 patients (88%) treated for gross disease; gross disease was controlled in 8 of 8 patients with previously untreated lesions, and in 13 of 16 patients treated for postoperative gross residual and recurrent disease. Overall, aggressive fibromatosis was locally controlled in 83% of treated patients. All 9 treatment failures occurred with extremity lesions 4 to 68 months after initiation of treatment. Of the 9 recurrences, 4 were out-of-field, 3 were in-field, and 4 occurred at the margin of the irradiated field. Salvage was successful in 8 of 9 patients in whom salvage was attempted with surgery alone or combined with postoperative radiotherapy. A functional limb was maintained in 38 of 39 patients with extremity or limb girdle lesions. The most serious complication of treatment was pathologic fracture, which occurred in 3 of 53 treated patients; all 3 fractures healed with conservative management. Conclusion: Radiotherapy is a valuable adjunct to surgery in the management of aggressive fibromatosis and can be used alone in patients with unresectable or inoperable disease

  20. Xerostomia induced by radiotherapy

    OpenAIRE

    Alimi, David

    2015-01-01

    David Alimi Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USAWe read with great interest the excellent review on xerostomia induced by radiotherapy, by Pinna et al.1 The authors should be congratulated for a very detailed review of the physiopathology, clinical symptoms, and therapeutic management of an extremely difficult condition. Although we agree that the use of anticholinergic medication represents treatment, it requires the patient to have resi...

  1. Clinically and/or Serologically Misleading Findings Surrounding Immune Haemolytic Anaemias.

    Science.gov (United States)

    Salama, Abdulgabar

    2015-09-01

    Autoimmune haemolytic anaemias (AIHAs) are well-characterized disorders. They can be differentiated from one another and from other non-immune haemolytic anaemias by clinical, laboratory and serological testing. However, several misleading clinical presentations and/or serological findings may result in misinterpretation, delay and/or misdiagnosis. Such failures are avoidable by adequate clinical and serological experience of the responsible physicians and serologists or, at least, by an optimised bidirectional communication. As long as this has not been achieved, unpleasant failures are to be expected. A true diagnosis of AIHA can neither be verified by clinical nor serological findings alone. Thus, a collective clinical and serological picture remains obligatory for fulfilling the criteria of optimal diagnosis and therapy. Ultimately, the majority of pioneer scientific and practical work in this field stems from scientists who were simultaneously involved in both the clinic and serology.

  2. Mathematical analysis of /sup 51/Cr-labelled red cell survival curves in congenital haemolytic anaemias

    Energy Technology Data Exchange (ETDEWEB)

    Kasfiki, A.G.; Antipas, S.E.; Dimitriou, P.A.; Gritzali, F.A.; Melissinos, K.G.

    1982-04-01

    The parameters of /sup 51/Cr labelled red cell survival curves were calculated in 26 patients with homozygous ..beta..-thalassaemia, 8 with sickle-cell anaemia and 3 with s-..beta..-thalassaemia, using a non-linear weighted least squares analysis computer program. In thalassaemic children the calculated parameters denote that the shorting of the mean cell life is due to early senescence alone, while there is some evidence that in thalassaemic adults additional extracellular destruction mechanisms participate as well. Red cell survival curves from patients with sickle-cell anaemia and s-..beta..-thalassaemia resemble each other, while their parameters indicate an initial rapid loss of radioactivity, early senescence and the presence of extracellular red cell destruction factors.

  3. Mathematical analysis of 51Cr-labelled red cell survival curves in congenital haemolytic anaemias

    International Nuclear Information System (INIS)

    The parameters of 51Cr labelled red cell survival curves were calculated in 26 patients with homozygous β-thalassaemia, 8 with sickle-cell anaemia and 3 with s-β-thalassaemia, using a non-linear weighted least squares analysis computer program. In thalassaemic children the calculated parameters denote that the shorting of the mean cell life is due to early senescence alone, while there is some evidence that in thalassaemic adults additional extracellular destruction mechanisms participate as well. Red cell survival curves from patients with sickle-cell anaemia and s-β-thalassaemia resemble each other, while their parameters indicate an initial rapid loss of radioactivity, early senescence and the presence of extracellular red cell destruction factors. (orig.)

  4. Joint modeling of Anaemia and Malaria in children under five in Nigeria.

    Science.gov (United States)

    Adebayo, Samson B; Gayawan, Ezra; Heumann, Christian; Seiler, Christian

    2016-05-01

    Malaria and anaemia which jointly account for high proportion of morbidity and mortality among young children in developing countries have been individually studied using binary regression model. We adopt geoadditive latent variable model for binary/ordinal indicators to analyze the influence of variables of different types on the morbidity among young children in Nigeria. Latent variable models allow for the analysis of multidimensional response variables that reveal the indicator's underlying relationship that are caused by the latent variables. We extend the structural model to a semi-parametric geoadditive model in order to quantify the joint spatial structure of morbidity from malaria and anaemia. Findings revealed substantial geographical variations and the generated maps can guide policy makers and donors on how to prudently utilize the scarce resources for designing more cost-effective interventions. PMID:27246277

  5. Detection of some anaemia types in human blood smears using neural networks

    Science.gov (United States)

    Elsalamony, Hany A.

    2016-08-01

    The identification process based on measuring the level of haemoglobin and the classification of red blood cells using microscopic examination of blood smears is the principal way to diagnose anaemia. This paper presents a proposed algorithm for detecting some anaemia types like sickle and elliptocytosis and trying to count them with healthy ones in human red blood smears based on the circular Hough transform and some morphological tools. Some cells with unknown shapes (not platelets or white cells) also have been detected. The extracted data from the detection process has been analyzed by neural network. The experimental results have demonstrated high accuracy, and the proposed algorithm has achieved the highest detection of around 98.9% out of all the cells in 27 microscopic images. Effectiveness rates up to 100%, 98%, and 99.3% have been achieved by using neural networks for sickle, elliptocytosis and cells with unknown shapes, respectively.

  6. Fulminant limb and retroperitoneal necrotizing fasciitis in a 15-year-old girl with Fanconi anaemia.

    LENUS (Irish Health Repository)

    O'Regan, Kevin

    2012-01-31

    Necrotizing fasciitis (NF) is an uncommon soft-tissue infection in children that carries a high mortality rate. We present a 15-year-old girl with chronic pancytopenia secondary to Fanconi anaemia who developed extensive NF of the lower limb, which unfortunately resulted in a fatal outcome. Immunodeficiency is a known risk factor for the development of this condition. The findings in this case demonstrate that patients with Fanconi anaemia may be susceptible to NF and that the clinical course may be more aggressive due to underlying immunosuppression. Prompt diagnosis of NF is vital in order to initiate appropriate treatment and to optimize patient outcome. Radiological investigation demonstrated extensive soft-tissue gas and destruction affecting the entire lower limb, abdominal wall and retroperitoneum, which led to timely definitive diagnosis and management.

  7. Fulminant limb and retroperitoneal necrotizing fasciitis in a 15-year-old girl with Fanconi anaemia.

    LENUS (Irish Health Repository)

    O'Regan, Kevin

    2009-10-01

    Necrotizing fasciitis (NF) is an uncommon soft-tissue infection in children that carries a high mortality rate. We present a 15-year-old girl with chronic pancytopenia secondary to Fanconi anaemia who developed extensive NF of the lower limb, which unfortunately resulted in a fatal outcome. Immunodeficiency is a known risk factor for the development of this condition. The findings in this case demonstrate that patients with Fanconi anaemia may be susceptible to NF and that the clinical course may be more aggressive due to underlying immunosuppression. Prompt diagnosis of NF is vital in order to initiate appropriate treatment and to optimize patient outcome. Radiological investigation demonstrated extensive soft-tissue gas and destruction affecting the entire lower limb, abdominal wall and retroperitoneum, which led to timely definitive diagnosis and management.

  8. Reproductive behaviour of families segregating for Cooley's anaemia before and after the availability of prenatal diagnosis.

    OpenAIRE

    Gamberini, M. R.; Lucci, M; Vullo, C; Anderson, B; Canella, R; Barrai, I

    1991-01-01

    The reproductive behaviour of couples with heterozygous beta thalassaemia, with at least one affected child, was investigated for the period 1955 to 1984 and was compared to the behaviour of control couples matched for age, age at marriage, and presence of at least one child. The comparisons were made as a function of knowledge of the risk and availability of prenatal diagnosis and abortion. It was found that the couples segregating for Cooley's anaemia, before knowledge of the risk, had a hi...

  9. Anaemia, haemoglobin level and cause-specific mortality in people with and without diabetes.

    OpenAIRE

    Andre Pascal Kengne; Sébastien Czernichow; Mark Hamer; G David Batty; Emmanuel Stamatakis

    2012-01-01

    BACKGROUND: Both anaemia and cardiovascular disease (CVD) are common in people with diabetes. While individually both characteristics are known to raise mortality risk, their combined influence has yet to be quantified. In this pooling project, we examined the combined impact of baseline haemoglobin levels and existing CVD on all-cause and CVD mortality in people with diabetes. We draw comparison of these effects with those apparent in diabetes-free individuals. METHODS/PRINCIPAL FINDINGS: A ...

  10. Prevalence of anaemia among pregnant women in rural India: a longitudinal observational study

    Directory of Open Access Journals (Sweden)

    Mishu Mangla

    2016-10-01

    Conclusions: There is a significantly high prevalence of anaemia among pregnant women in rural areas of India. Our study has also enlisted a few socio demographic factors that contribute to such high prevalence of this disease. Programs focused on target population need to be planned and implemented with active participation of locals. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3500-3505

  11. Cost benefits of low dose subcutaneous erythropoietin in patients with anaemia of end stage renal disease.

    OpenAIRE

    Stevens, M E; Summerfield, G P; Hall, A.A.; Beck, C. A.; Harding, A.J.; Cove-Smith, J.R.; Paterson, A. D.

    1992-01-01

    OBJECTIVE--To assess the cost benefits of low dose subcutaneous recombinant human erythropoietin in correcting the anaemia of end stage renal disease. DESIGN--Three year retrospective study. SETTING--Subregional nephrology service serving a mixed urban and rural population of 800,000. SUBJECTS--60 patients with symptoms of anaemic end stage renal disease treated with erythropoietin (43 receiving haemodialysis; 11 receiving continuous ambulatory peritoneal dialysis; two with predialysis end st...

  12. Response of anaemia in rheumatoid arthritis to treatment with subcutaneous recombinant human erythropoietin.

    OpenAIRE

    Gudbjörnsson, B; Hällgren, R; Wide, L; Birgegård, G

    1992-01-01

    Eleven patients with chronic inflammatory arthritides and haemoglobin concentrations less than 105 g/l with symptoms from their anaemia were treated with a dose of 250 IU/kg/week of recombinant human erythropoietin for six weeks. The treatment was given as subcutaneous injections five days a week. All patients had active inflammatory disease. Nine patients responded to treatment with an increase in haemoglobin of more than 15 g/l. The mean (SD) haemoglobin concentration increased from 93.0 (8...

  13. Effect of herbo-mineral formulation EHb in experimental anaemia in rodents.

    Science.gov (United States)

    Satyan, K S; Agrawala, S K; Chauhan, S; Ghosal, S R

    2001-07-01

    EHb-a herbo-mineral formulations of iron (ferrous form) produced a significantly higher and dose dependent increase in the haemoglobin level, as compared to Fefol (a non-complex-chelated iron preparation). Also, EHb did not produce any overt toxicity or gastric irritation at these dose levels. The results suggest that EHb can be of a better choice in the treatment of anaemia than any other commercially available chelated iron preparations. PMID:12019760

  14. Severe haemolytic anaemia after replacement of the mitral valve by a St Jude medical prosthesis.

    OpenAIRE

    Feld, H; Roth, J

    1989-01-01

    Severe haemolytic anaemia developed in a 33 year old patient after the mitral valve was replaced with a St Jude medical prosthesis. This was the patient's third thoracotomy. She had already had a mitral commissurotomy and a mitral valve bioprosthesis. The patient had an E+ antibody to red blood cells as well as a paraprosthetic leak. The haemolysis became less severe once the population of E+ red cells was completely haemolysed. However, the patient continued to require transfusions to remain...

  15. Amifostine Protection Against Mitomycin-induced Chromosomal Breakage in Fanconi Anaemia Lymphocytes

    OpenAIRE

    Lopes, Miriam T. P.; Salas, Carlos E.; Fernanda S. G. Kehdy; Camelo, Ricardo M.

    2008-01-01

    Fanconi anaemia (FA) is a rare genetic chromosomal instability syndrome caused by impairment of DNA repair and reactive oxygen species (ROS) imbalance. This disease is also related to bone marrow failure and cancer. Treatment of these complications with radiation and alkylating agents may enhance chromosomal breakage. We have evaluated the effect of amifostine (AMF) on basal and mitomycin C (MMC)-induced chromosomal breakage in FA blood cells using the micronucleus assay. The basal micronucle...

  16. Haemolytic anaemia complicating the concurrent use of allopurinol & azathioprine after kidney transplantation

    OpenAIRE

    Neeraj Dhaun; Catherine Hanna; Maria Squires; Simon Watson

    2013-01-01

    Gout is a common problem in renal transplant recipients but often difficult to treat. Allopurinol can be combined with azathioprine but clinicians should be aware of the need for dose reduction, the potential to measure azathioprine breakdown products and the possible side effects of this combination. Leucopenia is a known side effect but this case report shows that haemolytic anaemia can also occur. [Int J Basic Clin Pharmacol 2013; 2(3.000): 330-332

  17. Haemolytic anaemia complicating the concurrent use of allopurinol & azathioprine after kidney transplantation

    Directory of Open Access Journals (Sweden)

    Neeraj Dhaun

    2013-06-01

    Full Text Available Gout is a common problem in renal transplant recipients but often difficult to treat. Allopurinol can be combined with azathioprine but clinicians should be aware of the need for dose reduction, the potential to measure azathioprine breakdown products and the possible side effects of this combination. Leucopenia is a known side effect but this case report shows that haemolytic anaemia can also occur. [Int J Basic Clin Pharmacol 2013; 2(3.000: 330-332

  18. Gastric antral vascular ectasia--a cause of refractory anaemia in systemic sclerosis.

    Science.gov (United States)

    Busteed, S; Silke, C; Molloy, C; Murphy, M; Molloy, M G

    2001-01-01

    Recurrent gastrointestinal haemorrhage is an uncommon manifestation of systemic sclerosis. We report a case of gastrointestinal bleeding due to gastric antral vascular ectasia (GAVE) in a patient with systemic sclerosis. Failure to recognise the condition as a cause of gastrointestinal bleeding may delay the instigation of appropriate treatment. GAVE should be considered in the differential diagnosis of anaemia in patients with autoimmune conditions such as systemic sclerosis and primary biliary cirrhosis. PMID:11837631

  19. The Bacterial Overgrowth Syndrome is Uncommon in Pernicious Anaemia: Results of a Follow-up Study

    OpenAIRE

    Stockbrügger, R. W.; Armbrecht, U.; Rode, J. W.; Teall, A J; Oberholzer, V. G.; Croker, J R; Cotton, P B

    2011-01-01

    It is still uncertain whether upper gastrointestinal bacterial overgrowth in patients with permanent achlorhydria causes malassimilation in more than just the occasional case. In an attempt to clarify this, 19 patients with pernicious anaemia who had undergone a thorough investigation 6.6 y (mean) previously, were reinvestigated with clinical history, upper GI endoscopy including multiple duodenal biopsies, microbial cultures of gastric juice and duodenal mucosa, a xylose absorption test, and...

  20. Immune-mediated haemolytic anaemia : possible association with Ancylostoma caninum infection in three dogs : case report

    OpenAIRE

    Lobetti, R. G.; T. Schoeman

    2001-01-01

    Immune-mediated haemolytic anaemia (IMHA) may be primary or secondary. In primary IMHA, no underlying cause can be found, whereas secondary IMHA is triggered by an underlying cause, such as neoplasia, infectious diseases, or drugs. This paper describes 3 dogs with typical signs of IMHA that was possibly associated with the intestinal parasite Ancylostoma caninum. As intestinal helminths can be difficult to diagnose on faecal examination, it would be pertinent to performmultiple faecal examina...

  1. Gastric antral vascular ectasia--a cause of refractory anaemia in systemic sclerosis.

    LENUS (Irish Health Repository)

    Busteed, S

    2012-02-03

    Recurrent gastrointestinal haemorrhage is an uncommon manifestation of systemic sclerosis. We report a case of gastrointestinal bleeding due to gastric antral vascular ectasia (GAVE) in a patient with systemic sclerosis. Failure to recognise the condition as a cause of gastrointestinal bleeding may delay the instigation of appropriate treatment. GAVE should be considered in the differential diagnosis of anaemia in patients with autoimmune conditions such as systemic sclerosis and primary biliary cirrhosis.

  2. PREVALENCE AND ASSOCIATED RISK FACTORS OF ANAEMIA IN PREGNANCY IN A TERTIARY CARE RURAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    Sridevi

    2015-08-01

    Full Text Available Anaemia is a global public health problem particularly in developing countries. A major contributory factor to maternal and fetal mortality and morbidity. AIM AND OBJECTIVES : To find the prevalence and seve rity of anaemia and evaluate the multiple causal factors among pregnant women. MATERIALS AND METHODS : A cross sectional study was conducted in pregnant women attending outpatient department of Obstetrics and Gynaecology from J uly 1 st 2013 to J une 30 th 2015 Rajah Muthiah Medical College and Hospital , a tertiary care rural hospital in C hidambaram . A pre - designed Performa was utilized to obtain relevant information about demographic and patients’ obstetric characteristics. They were screened for anaemia using cyanmethemoglobin method during their first antenatal visit. RESULTS : The prevalence of anaemia was found to be (1202/1434 83.8% of which mild 27.2%, moderate 60.3% and severe was 12.5% ( A ccording to WHO criteria based on Hb level. Majority were between 20 - 25yrs of age (87861.2% in third trimester (95666.7% were unbooked (91263.5%, illiterate (67747.3% and belonged to low socioeconomic class (109276.1%. Multiparity (92864.7%, pregnancy spacing interval less than 1yr (38841.8%, poor nutrition (6724 6.8% were the most common risk factors. CONCLUSION : In our study, the prevalence rate is still very high in spite of the various preventive strategies as awareness is less among the population . Major factors responsible were multiparity, illiteracy, povert y, late antenatal booking, inadequate spacing between pregnancies. Adequate antenatal care and proper education helps to increase the awareness.

  3. PREVALENCE OF ANAEMIA AMONG RURAL PRE-SCHOOL CHILDREN OF MAHARASHTRA, INDIA

    Directory of Open Access Journals (Sweden)

    N Arlappa

    2012-03-01

    Full Text Available Background: Anaemia continues to be a severe public health nutritional problem in India affecting all physiological groups, even after the National Nutritional Anaemia Prophylaxis Programme has been in operation for more than three decades. Objective: To assess the prevalence of anaemia among rural pre-school (1-5-years children of Maharashtra. Methods: A community based cross-sectional study was carried by National Nutrition Monitoring Bureau (NNMB covering a total of 404 (Boys-243; Girls-161 pre-school children. Information of socio-demographic particulars was obtained and the finger prick blood samples were collected for the estimation of haemoglobin levels by cyanmethmoglobin method. Results: The result shows that 59.2 % (CI: 54.4-64.0 of the rural pre-school children of Maharashtra were anaemic, and the prevalence was significantly (p40% among rural pre-school children of Maharashtra. Therefore, appropriate intervention measures such as supplementary iron & folic acid, periodic deworming and health & nutrition education should be strengthened. The community needs to be encouraged to diversify their diets by consuming iron rich foods.

  4. Giant Brunner’s gland adenoma as an unusual cause of anaemia: report of a case

    International Nuclear Information System (INIS)

    Brunner’s gland adenoma (BGA) is a rare benign duodenal tumour proliferating from Brunner’s glands. Here, we present a giant BGA leading to anaemia, with its clinical, endoscopic, radiological, surgical and pathological findings. A 48-year-old Turkish man complained of a six months history of vague epigastric discomfort, loss of appetite and nausea after meals without vomiting. The physical examination had no unremarkable finding. Laboratory findings, including liver function tests, were within normal limits except a hypochromic, microcytic anaemia. The upper gastrointestinal endoscopic examination revealed a lobulated, red, polypoid tumour with a smooth surface covered with normal mucosa. The tumour was located on the anterior surface of duodenal bulb and had a wide base measuring 3.5 × 4 cm in size. Endoscopic ultrasonography revealed a submucosal polypoid mass located at the anterior surface of duodenal bulb. The endoscopic excision was tried but was not successful. The patient was operated and transduodenal polypectomy was done. The postoperative period was uneventful and the pathologic diagnosis was assessed as Brunner’s gland adenoma. During the follow-up period, the endoscopic examination was normal at 12th month postoperatively. BGA is a rare benign cause of anaemia that can be treated with excellent results

  5. Correlation between Blood Lead Levels and Anaemia in Commercial Enamel Paint Industry Workers

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    I. Mazumdar

    2016-07-01

    Full Text Available Background: Lead causes acute, sub-acute or chronic poisoning through occupational exposure along with decrease in some trace elements like iron, whose absorption, distribution, metabolism and elimination being affected. Iron deficiency is a serious problem especially in developing countries and lead toxicity can augment anaemia directly by decreasing absorption of Iron and also by inhibiting enzymes of heme synthesis. Aim and Objectives: To assess haematological indices and serum iron and ferritin levels in Enamel paint industry workers who are exposed to very high Lead levels due to their occupation, and determine iron deficiency anaemia. Materials and Methods: Blood lead concentration was measured by Atomic Absorption Spectrophotometric (AAS method. Haematological tests were performed using cell counter to measure haemoglobin, red blood cell and white blood cell count, etc. Mean corpuscular volume, mean corpuscular haemoglobin and mean corpuscular haemoglobin concentration were calculated. Serum ferritin and iron levels were assayed by chemilumenescence and spectrophotometric methods respectively. Results: All the parameters measured and calculated were found to be altered in paint workers as compared to healthy controls, with significant increase in blood lead level and decrease in the haematological as well as other analyte values. Conclusion: There seems to be a direct relationship between chronic lead exposure and the haematological disturbances, resulting in iron deficiency anaemia. Hence awareness about this association should be increased and protective measures should be implied accordingly.

  6. The effects of co-infection with human parvovirus B19 and Plasmodium falciparum on type and degree of anaemia in Ghanaian children

    Institute of Scientific and Technical Information of China (English)

    Kwabena Obeng Duedu; Kwamena William Coleman Sagoe; Patrick Ferdinand Ayeh-Kumi; Raymond Bedu Affrim; Theophilus Adiku

    2013-01-01

    Objective:To determin the extent to which parvovirus B19 (B19V) and co-infection of B19V and malaria contribute to risk of anaemia in children. Methods: B19V DNA and malaria parasites were screened for 234 children at the PML Children’s Hospital in Accra. The role of B19V and co-infection with B19V and malaria in anaemia was evaluated by analysing full blood cell counts, malaria and B19V DNA results from these children. Results: The prevalence of B19V, malaria and co-infection with B19V and malaria was 4.7%, 41.9%and 2.6%, respectively. Malaria posed a greater risk in the development of mild anaemia compared to severe anaemia (OR=5.28 vrs 3.15) whereas B19V posed a higher risk in the development of severe anaemia compared to mild anaemia (OR=4.07 vrs 1.00) from a non-anaemic child. Persons with co-infection with B19V and malaria had 2.23 times the risk (95%CI=0.40-12.54) of developing severe anaemia should they already have a mild anaemia. The degree of anaemia was about three times affected by co-infection (Pillai’s trace=0.551, P=0.001) as was affected by malaria alone (Pillai’s trace=0.185, P=0.001). B19V alone did not significantly affect the development of anaemia in a non-anaemic child. Microcytic anaemia was associated with B19V and co-infection with B19V and malaria more than normocytic normochromic anaemia. Conclusions: B19V was associated with malaria in cases of severe anaemia. The association posed a significant risk for exacerbation of anaemia in mild anaemic children. B19V and co-infection with B19V and malaria may be associated with microcytic anaemia rather than normocytic normochromic anaemia as seen in cases of B19V infection among persons with red cell abnormalities.

  7. [Functional iron deficiency, inflammation and fatigue after radiotherapy].

    Science.gov (United States)

    Grellier, Noémie; Deray, Gilbert; Yousfi, Amani; Khodari, Wassim; Bouaita, Ryan; Belkacemi, Yazid

    2015-09-01

    Radiation therapy is associated with a fatigue in the majority of patients with a relative variability according to the type of the tumour, comorbidities, associated treatments and the extent of the irradiation. Its origin is multifactorial. One explanation described is that fatigue could be related to the inflammation caused by irradiation exposure. One of the suspected mechanisms is a functional iron deficiency following pro-inflammatory cytokines synthesis, particularly the interleukins 1 and 6. This phenomenon is accompanied by a reduced availability of iron, while iron reserves are normal or increased. Thus, iron inaccessibility induces lower coefficient of transferrin saturation, which can lead to a non-regenerative normocytic or microcytic anaemia. The availability of iron is controlled by hepcidin that is synthesized in the liver as a response to radiation-induced inflammatory. The presence of hepcidin blocks iron absorption in the intestine and decreases its recycling from senescent red blood cells. A direct relationship between elevated levels of hepcidin, inflammation markers and radiation-induced side effects have been reported. The aim of the article is to review the literature related to fatigue in radiotherapy and understand the mechanisms involved or worsening its occurrence to consider better care and improve patients' quality.

  8. Coeliac disease as the cause of resistant sideropenic anaemia in children with Down's syndrome: Case report

    Directory of Open Access Journals (Sweden)

    Pavlović Momčilo

    2010-01-01

    Full Text Available Introduction. Coeliac disease (CD is a permanent intolerance of gluten, i.e. of gliadin and related proteins found in the endosperm of wheat, rye and barley. It is characterized by polygenic predisposition, autoimmune nature, predominantly asymptomatic or atypical clinical course, as well as by high prevalence in patients with Down's syndrome (DS and some other diseases. Outline of Cases. We are presenting a girl and two boys, aged 6-7 (X=6.33 years with DS and CD recognized under the feature of sideropenic anaemia resistant to oral therapy with iron. Beside mental retardation, low stature and the morphological features characteristic of DS, two patients had a congenital heart disease; one ventricular septal defect and the other atrioventricular canal. In two patients, trisomy on the 21st chromosome pair (trisomy 21 was disclosed in all cells, while one had a mosaic karyotype. All three patients had classical laboratory parameters of sideropenic anaemia: blood Hb 77-89 g/l (X=81.67, HCT 0.26-0.29% (X=0.28, MCV 69-80 fl (X=73, MCH 24.3-30 pg (X=26.77 and serum iron 2-5 μmol/L (X=4.0. Beside anaemia and in one patient a mild isolated hypertransaminasemia (AST 67 U/l, ALT 62 U/l, other indicators of CD were not registered in any of the children. In addition, in all three patients, we also detected an increased level of antibodies to tissue transglutaminase (atTG of IgA class (45-88 U/l so that we performed endoscopic enterobiopsy in order to reliably confirm the diagnosis of CD. In all three patients, the pathohistological finding of the duodenal mucosa specimen showed mild to moderate destructive enteropathy associated with high intraepithelial lymphocyte infiltration, cryptic hyperplasia and lympho-plasmocytic infiltration of the stroma. In all three patients, the treatment with a strict gluten-free diet and iron therapy applied orally for 3-4 months resulted in blood count normalization and the correction of sideropenia. Serum level of the at

  9. Prevention of the recurrence of anaemia in Gambian children following discharge from hospital.

    Directory of Open Access Journals (Sweden)

    Kalifa A Bojang

    Full Text Available BACKGROUND: In malaria endemic countries, children who have experienced an episode of severe anaemia are at increased risk of a recurrence of anaemia. There is a need to find ways of protecting these at risk children from malaria and chemoprevention offers a potential way of achieving this objective. METHODS: During the 2003 and 2004 malaria transmission seasons, 1200 Gambian children with moderate or severe anaemia (Hb concentration <7 g/dL were randomised to receive either monthly sulfadoxine-pyrimethamine (SP or placebo until the end of the malaria transmission season in which they were enrolled, in a double-blind trial. All study subjects were treated with oral iron for 28 days and morbidity was monitored through surveillance at health centres. The primary endpoint was the proportion of children with moderate or severe anaemia at the end of the transmission season. Secondary endpoints included the incidence of clinical episodes of malaria during the surveillance period, outpatient attendances, the prevalence of parasitaemia and splenomegaly, nutritional status at the end of the malaria transmission season and compliance with the treatment regimen. RESULTS: The proportions of children with a Hb concentration of <7 g/dL at the end of the malaria transmission season were similar in the two study groups, 14/464 (3.0% in children who received at least one dose of SP and 16/471 (3.4% in those who received placebo, prevalence ratio 0.89 (0.44,1.8 P = 0.742. The protective efficacy of SP against episodes of clinical malaria was 53% (95% CI 37%, 65%. Treatment with SP was safe and well tolerated; no serious adverse events related to SP administration were observed. Mortality following discharge from hospital was low among children who received SP or placebo (6 in the SP group and 9 in the placebo group respectively. CONCLUSIONS: Intermittent treatment with SP did not reduce the proportion of previously anaemic children with moderate or severe anaemia

  10. Anaemia among pregnant women at the booking clinic of a teaching hospital in south-western Nigeria

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    Okunade K.S

    2014-07-01

    Full Text Available Background: Anaemia in pregnancy is a global public health challenge. It is the commonest medical disorder of pregnancy and a major cause of morbidity and mortality in most developing countries. Aim: This study aimed at assessing the prevalence of anaemia in pregnancy and to identify the confounding socio-demographic factors. Methods: This is a cross-sectional descriptive study designed to determine the socio-demographic characteristics and prevalence of anaemia among pregnant women at their booking antenatal visit in a teaching hospital in South-western Nigeria. Pregnant women were enrolled for the study by consecutive sampling method at their first antenatal visit and the packed cell volume (PCV was used to assess level of anaemia. Socio-demographic information was obtained from the case records of the enrolled women. Results: One hundred and thirty-eight (27.6% of the 500 enrolled women were found to be anaemic at the time of antenatal booking. Anaemia were more prevalent among primigravidae (33.9% than the multigravidae (25.3%, although this difference was not statistically significant (P=0.079. Anaemia was higher among women with no formal education, those unemployed, single mothers and women with sickle cell traits. Conclusion: Anaemia in pregnancy remains a major health challenge in Nigeria with primigravidae identified as being those at most risk. So also are pregnant teenagers and women that book late for antenatal care (ANC. It is therefore important to educate women on early ANC booking and the need for compliance with prescribed medications in pregnancy.

  11. MOSFET Dosimetry for Evaluation of Gonad Shielding during Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hwi Young; Choi, Yun Seok; Park, So Yeon; Park, Yang Kyun [Seoul National University College of Medicine, Seoul (Korea, Republic of); Ye, Sung Joon [Seoul National University, Seoul (Korea, Republic of)

    2011-03-15

    In order to confirm feasibility of MOSFET modality in use of in vivo dosimetry, evaluation of gonad shielding in order to minimize gonadal dose of patients undergoing radiotherapy by using MOSFET modality was performed. Gonadal dose of patients undergoing radiotherapy for rectal cancer in the department of radiation oncology of Seoul National University Hospital since 2009 was measured. 6 MV and 15 MV photon beams emitted from Varian 21EX LINAC were used for radiotherapy. In order to minimize exposed dose caused by the scattered ray not only from collimator of LINAC but also from treatment region inside radiation field, we used box.shaped lead shielding material. The shielding material was made of the lead block and consists of 7.5 cm x 9.5 cm x 5.5 cm sized case and 9 cm x 9.5 cm x 1 cm sized cover. Dosimetry for evaluation of gonad shielding was done with MOSFET modality. By protecting with gonad shielding material, average gonadal dose of patients was decreased by 23.07% compared with reference dose outside of the shielding material. Average delivered gonadal dose inside the shielding material was 0.01 Gy. By the result of MOSFET dosimetry, we verified that gonadal dose was decreased by using gonad shielding material. In compare with TLD dosimetry, we could measure the exposed dose easily and precisely with MOSFET modality.

  12. Radiotherapy of presenile spinal osteoporosis

    International Nuclear Information System (INIS)

    Painfull conditions of presenile spinal osteoporosis may no longer respond to medication or physical therapy. Analgesic radiotherapy coupled with mild physical therapy and if necessary supported by orthopedic measures frequently results in pain relief and physical stability. Fifty-two cases of osteoporosis and osteoporotic spinal fractures illustrate how better longterm results are achieved by increasing the customary dosage and speeding up radiotherapy. (orig.)

  13. Plan optimization for stereotactic radiotherapy

    NARCIS (Netherlands)

    J.A. de Pooter (Jacobus Abraham)

    2008-01-01

    textabstractCancer is one of the leading causes of death in the world. Next to surgery and chemotherapy, radiotherapy is one of the most used treatment modalities for cancer. About 50% of the patients with cancer will be treated with radiotherapy during the management of their disease. In radiothera

  14. Parvovirus B19 infection and severe anaemia in Kenyan children: a retrospective case control study

    Directory of Open Access Journals (Sweden)

    Tuju James

    2010-04-01

    Full Text Available Abstract Background During acute Human parvovirus B19 (B19 infection a transient reduction in blood haemoglobin concentration is induced, due to a 5-7 day cessation of red cell production. This can precipitate severe anaemia in subjects with a range of pre-existing conditions. Of the disease markers that occur during B19 infection, high IgM levels occur closest in time to the maximum reduction in haemoglobin concentration. Previous studies of the contribution of B19 to severe anaemia among young children in Africa have yielded varied results. This retrospective case/control study seeks to ascertain the proportion of severe anaemia cases precipitated by B19 among young children admitted to a Kenyan district hospital. Methods Archival blood samples from 264 children under 6 years with severe anaemia admitted to a Kenyan District Hospital, between 1999 and 2004, and 264 matched controls, were tested for B19 IgM by Enzyme Immunosorbent Assay and 198 of these pairs were tested for B19 DNA by PCR. 536 samples were also tested for the presence of B19 IgG. Results 7 (2.7% cases and 0 (0% controls had high B19 IgM levels (Optical Density > 5 × cut-off value (McNemar's exact test p = 0.01563, indicating a significant association with severe anaemia. The majority of strongly IgM positive cases occurred in 2003. 10/264 (3.7% cases compared to 5/264 (1.9% controls tested positive for B19 IgM. This difference was not statistically significant, odds ratio (OR = 2.00 (CI95 [0.62, 6.06], McNemar's exact test p = 0.3018. There was no significant difference between cases and controls in the B19 IgG (35 (14.8% vs 32 (13.6%, OR = 1.103 (CI95 [0.66, 1.89], McNemar's exact test, p = 0.7982, or the detection of the B19 DNA (6 (3.0% vs 5 (2.5%, OR = 1.2 (CI95 [0.33, 4.01], McNemar's exact test p = 1. Conclusions High B19 IgM levels were significantly associated with severe anaemia, being found only among the cases. This suggests that 7/264 (2.7% of cases of severe

  15. Radiotherapy for eyelid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Saika, Kazumi [Yokohama City Univ. (Japan). School of Medicine

    2001-05-01

    Some studies on radiotherapy for eyelid cancer have been reported, but the optimal radiation doses for different histological types and tumor sizes have not been detailed. So I studied the optimal radiation doses in radiotherapy for eyelid cancer. The patients were fourteen and histological diagnoses were made on the basis of biopsies or surgery before radiotherapy. Surgical cut margins were positive in 10 cases. In 5 of these cases, tumors were visible. There were 9 sebaceous adenocarcinomas (SAC), 4 squamous cell carcinomas (SCC), and 1 basal cell carcinoma (BCC). In 13 of 14 cases, radiation was applied to eyelids in which tumor-surgical cut margin distances were 3 mm or less. The eyeballs were covered with lead or tungsten shields, and the eyelids were irradiated with a total dose of 50 to 66.6 Gy. In 5 cases, radiation was applied prophylactically for ipsilateral pre-auricle lymph node areas. 11 of 13 cases were locally controlled. I gave greater radiation doses for SAC than for SCC or BCC. I also gave greater doses for in visible tumors than for invisible ones. In the acute phase dermatitis, inflammation of the cornea, conjunctivitis, etc. occurred but they were mild. Later reactions were decreased cilia, dry eye, inflammation of cornea, conjunctivitis, discomfort of the scar, etc. Cataracts were also seen, but they were of senile origen. Because 81.8% of the tumors were controlled, this radiation method was useful with salvage therapies to select an optimal radiation dose according to the differences among histological types and tumor sizes. 60% of visible tumors were also controlled so I think that radical therapy using radiation alone is possible. (author)

  16. Effect of fractionated regional external beam radiotherapy on peripheral blood cell count

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to assess the need for obtaining weekly complete blood count (CBC) values and to identify the pattern of changes in CBC during regional conventional fractionated radiotherapy. Methods and Materials: A retrospective analysis of CBC data on 299 adult cancer patients who received definitive conventional radiotherapy to head and neck (n=95), chest (n=96), and pelvis (n=108) was performed. Temporal patterns and magnitude of change in white blood cells, neutrophils, lymphocytes, and platelets during radiotherapy were examined. Results: There were statistically significant declines in all counts, albeit not clinically significant. Notable differences between disease sites were found. The greatest weekly interval change in counts occurred during the first week of radiotherapy for all groups of patients. The mean WBC nadir values during treatment were 5.8 for head and neck, 6.8 for chest, and 5.4 for pelvis. The nadirs for all counts occurred toward the middle-to-end of radiotherapy. Lymphocytes were found to be more sensitive to radiotherapy than other leukocyte subcomponents. Conclusion: Our study suggests that weekly CBC monitoring is not necessary for all patients undergoing standard fractionated radiotherapy. Baseline blood counts may be used to determine an optimal schedule for monitoring CBCs in patients receiving conventional radiation alone. Reduced monitoring of CBC may result in significant financial savings

  17. Radiotherapy Reduced Salivary Flow Rate and Might Induced C. albicans Infection

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    Nadia Surjadi

    2013-07-01

    Full Text Available Radiotherapy has impact in oral health especially on the secretion capacity of the salivary glands. Another impact is the increase of Candida albicans colony. Objectives: To evaluate salivary flow in relation with Candida albicans colony in head and neck cancer patients during and after radiotherapy. Methods: Twenty-four head and neck cancer patients in Dharmais Cancer Hospital, Jakarta who were undergoing radiotherapy or had undergone radiotherapy and 24 match healthy volunteers were included in the study. Clinical observation carried out by collecting unstimulated salivary flow rate and followed by culture of Candida in Saboraud agar medium. Data were analyzed statistically by Chi-square. Results: Nasopharynx cancer was the most frequent type of head and neck cancers (87.5% followed by tongue cancer (12.5% and and found in 41-50 years old patients and 51-60 years old patients respectively, with male predilection compare to female (17:7. Approxiamtely 87.5% of subjects showed decreased salivary flow rate (1.01-1.50mL/10min during and after radiotherapy. However, 91.7% of cancer patients had increased C.albicans colony during and after radiotherapy compared to control (p=0.00. Conclusion: This study showed that radiotherapy induced hyposalivation and might increase the C.albicans colony.  

  18. Chronic fatigue in cancer patients treated with radiotherapy

    International Nuclear Information System (INIS)

    Fatigue is one of the most prevalent and profound symptoms related to both malignancy and anti-neoplastic treatment. It is being reported in 60% to 80% of cancer patients. We review the correlation between the cancer-related fatigue syndrome and radiotherapy. In patients undergoing radiotherapy, fatigue is often cumulative and may reach its peak during the last weeks of treatment. The presence of fatigue prior to therapy initiation is the most important predictive factor of the occurrence of radiotherapy-related cancer fatigue syndrome. Occasionally, fatigue persists for a prolonged period of months and even years beyond radiotherapy. Anemia may be one of major causative factors responsible for the development of the cancer-related fatigue syndrome. Fatigue has an enormous physical, mental, emotional, and economic impact on cancer patients, their families and care-providers. The treatment of radiation-related fatigue remains unknown. The initial approach should cover efforts aimed at the correction of potential etiologies, especially anemia. Education concerning fatigue greatly benefits some patients. It seems that exercise may be beneficial in relieving fatigue, bearing in mind that the exercise program for cancer patients should be initiated gradually and significantly individualized. (author)

  19. Does tadalafil prevent erectile dysfunction in patients undergoing radiation therapy for prostate cancer?

    Directory of Open Access Journals (Sweden)

    Luca Incrocci

    2014-10-01

    Full Text Available A recently published paper addressed the interesting topic of prevention of erectile dysfunction (ED with tadalafil, a phosphodiesterase-type 5 inhibitor (PDE5i in patients undergoing radiation therapy for localized prostate cancer. [1] Tadalafil 5 mg or placebo was administered once-daily for 24 weeks in patients undergoing external-beam radiotherapy (EBRT or brachytherapy (BT for prostate cancer. This randomized trial did not show superior efficacy of the active drug compared with placebo 4-6 weeks after stopping the study drug. Furthermore, patients younger than 65 years did not respond significantly better than older patients.

  20. Breast cancer radiotherapy: controversies and prospectives

    Institute of Scientific and Technical Information of China (English)

    YU Jin-ming; WANG Yong-sheng

    2008-01-01

    @@ Despite consensus on breast cancer radiotherapy, there are still some controversies over post-mastectomy radiotherapy (PMRT) in patients with 1-3 positive lymph nodes, accelerated partial breast irradiation (APBI), appropriate sequence of radiotherapy, chemotherapy and hormonal treatment, and radiotherapy after preoperative systemic therapy.

  1. Fertility impairment in radiotherapy.

    Science.gov (United States)

    Biedka, Marta; Kuźba-Kryszak, Tamara; Nowikiewicz, Tomasz; Żyromska, Agnieszka

    2016-01-01

    Infertility as a result of antineoplastic therapy is becoming a very important issue due to the growing incidence of neoplastic diseases. Routinely applied antineoplastic treatments and the illness itself lead to fertility disorders. Therapeutic methods used in antineoplastic treatment may cause fertility impairment or sterilization due to permanent damage to reproductive cells. The risk of sterilization depends on the patient's sex, age during therapy, type of neoplasm, radiation dose and treatment area. It is known that chemotherapy and radiotherapy can lead to fertility impairment and the combination of these two gives an additive effect. The aim of this article is to raise the issue of infertility in these patients. It is of growing importance due to the increase in the number of children and young adults who underwent radiotherapy in the past. The progress in antineoplastic therapy improves treatment results, but at the same time requires a deeper look at existential needs of the patient. Reproductive function is an integral element of self-esteem and should be taken into account during therapy planning. PMID:27647982

  2. Incidence of anaemia among the female tea garden workers in a tea plantation in upper Assam, India.

    Science.gov (United States)

    Das, Bhaskar; Sengupta, Bani; Chakrabarti, Sila; Rudra, Tapas; Sengupta, Sarthak

    2012-02-01

    Nutritional anaemia is the most common type and cause of anaemia. Tea garden workers constitute approximately 1/5th of population in the state of Assam. Reports indicate higher prevalence of undernutrition in this population. The present study was designed to focus on the incidence of anaemia among the female tea garden workers and to examine the effect of iron with vitamin B12 and folic acid supplementation in them. Two hundred and forty-four female tea garden workers who could be persuaded to participate in the study were sampled for haemoglobin typing by agarose gel electrophoresis (pH 8.9). Their haematological parameters were measured on automated cell counter to read Hb, RBC, MCV, MCH and MCHC. BMI was calculated from weight/height in metre2. The study revealed 182 anaemic (11.0 g/dl were studied as controls. Level of haemoglobin was rechecked after 3 months by Sahli's method. Based on the size of red blood cells it was observed that the workers suffered from all three forms of anaemia viz, microcytic, normocytic and macrocytic. There was a significant rise in haemoglobin concentration when the anaemic individuals took iron with vitamin B12 and folic acid supplement for three consecutive months supported by two doses of anthelminthic drug. The present study showed that nutritional anaemia is a major problem in the female tea garden workers and arrangement of supplementation therapy is utmost necessary to improve their general condition and work efficiency. PMID:23029840

  3. Prevalence of anaemia and associated factors among children below five years of age in Cape Verde, West Africa.

    Science.gov (United States)

    Semedo, Rosa M L; Santos, Marta M A S; Baião, Mirian R; Luiz, Ronir R; da Veiga, Gloria V

    2014-12-01

    This study estimated the prevalence of anaemia and associated factors in a probability sample of 993 chil- dren aged 6-59 months in Cape Verde, West Africa. Odds ratio (OR) and 95% confidence interval (95% CI) were estimated from a hierarchical model for multiple analysis to assess the association between anaemia and explanatory variables. The prevalence of anaemia was 51.8% (95% CI 47.7-55.8). Children who resided within poor household conditions (OR 1.99; 95% CI 1.06-3.71) were below 24 months of age (OR 3.23; 95% CI 2.03-5.15) and recently experienced diarrhoea (OR 1.58; 95% CI 0.99-2.50) were at high risk of anaemia. Anaemia should be considered a serious public-health concern in Cape Verde, mainly for chil- dren below 24 months. Further, special consideration should be given to children who have experienced recent diarrhoea and belong to families residing in poor household conditions. PMID:25895198

  4. A significant association between intestinal helminth infection and anaemia burden in children in rural communities of Edo state, Nigeria

    Directory of Open Access Journals (Sweden)

    Favour Osazuwa

    2011-01-01

    Full Text Available Background : Anaemia is estimated to affect half the school-age children and adolescents in developing countries. Aim: This study aimed to determine the prevalence of anaemia and evaluate the relationship of intestinal helminth infection on the anaemia status of children in the rural communities of Evbuomore, Isiohor, and Ekosodin. in the Ovia North East local government area of Edo State, Nigeria. Subjects and Methods : Faecal samples and blood samples were obtained from 316 children aged 1-15 years. Faecal samples were examined using standard parasitological techniques, and anaemia was defined as blood haemoglobin <11 g/dL. Results : Of the 316 children, 38.6% were anaemic: 75.9% of children in Evbuomore, 42.3% in Isiohor and 26.8% in Ekosodin. The overall parasite prevalence in the three communities were: Ascaris lumbricoides (75.6%, hookworm (16.19% and Trichuris trichiura (7.3%. Malnutrition was patent; 37.0% of the children were stunted, 19.3% wasted, and 44.0% underweight. There was a statistically significant association between hookworm and Ascaris lumbricoides infection and anaemia (P < .001. Serum ferritin levels were more sensitive than haemoglobin in detecting anemia and were correlated with intestinal helminth infection. Conclusion : Intestinal helminth infection in a concomitant state of malnutrition is observed in this population. Intervention programmes should be aimed at control of intestinal helminth infection and iron supplementation.

  5. A significant association between intestinal helminth infection and anaemia burden in children in rural communities of Edo state, Nigeria

    Directory of Open Access Journals (Sweden)

    Favour Osazuwa

    2011-01-01

    Full Text Available Background: Anaemia is estimated to affect half the school-age children and adolescents in developing countries. Aim: This study aimed to determine the prevalence of anaemia and evaluate the relationship of intestinal helminth infection on the anaemia status of children in the rural communities of Evbuomore, Isiohor, and Ekosodin. in the Ovia North East local government area of Edo State, Nigeria. Subjects and Methods: Faecal samples and blood samples were obtained from 316 children aged 1-15 years. Faecal samples were examined using standard parasitological techniques, and anaemia was defined as blood haemoglobin <11 g/dL. Results: Of the 316 children, 38.6% were anaemic: 75.9% of children in Evbuomore, 42.3% in Isiohor and 26.8% in Ekosodin. The overall parasite prevalence in the three communities were: Ascaris lumbricoides (75.6%, hookworm (16.19% and Trichuris trichiura (7.3%. Malnutrition was patent; 37.0% of the children were stunted, 19.3% wasted, and 44.0% underweight. There was a statistically significant association between hookworm and Ascaris lumbricoides infection and anaemia (P < .001. Serum ferritin levels were more sensitive than haemoglobin in detecting anemia and were correlated with intestinal helminth infection. Conclusion: Intestinal helminth infection in a concomitant state of malnutrition is observed in this population. Intervention programmes should be aimed at control of intestinal helminth infection and iron supplementation.

  6. Associations between mild-to-moderate anaemia in pregnancy and helminth, malaria and HIV infection in Entebbe, Uganda.

    Science.gov (United States)

    Muhangi, Lawrence; Woodburn, Patrick; Omara, Mildred; Omoding, Nicholas; Kizito, Dennison; Mpairwe, Harriet; Nabulime, Juliet; Ameke, Christine; Morison, Linda A; Elliott, Alison M

    2007-09-01

    It is suggested that helminths, particularly hookworm and schistosomiasis, may be important causes of anaemia in pregnancy. We assessed the associations between mild-to-moderate anaemia (haemoglobin >8.0 g/dl and Mansonella perstans 21.3%, Schistosoma mansoni 18.3%, Strongyloides 12.3%, Trichuris 9.1%, Ascaris 2.3%, asymptomatic Plasmodium falciparum parasitaemia 10.9% and HIV 11.9%. Anaemia showed little association with the presence of any helminth, but showed a strong association with malaria (adjusted odds ratio (AOR) 3.22, 95% CI 2.43-4.26) and HIV (AOR 2.46, 95% CI 1.90-3.19). There was a weak association between anaemia and increasing hookworm infection intensity. Thus, although highly prevalent, helminths showed little association with mild-to-moderate anaemia in this population, but HIV and malaria both showed a strong association. This result may relate to relatively good nutrition and low helminth infection intensity. These findings are pertinent to estimating the disease burden of helminths and other infections in pregnancy. [Clinical Trial No. ISRCTN32849447]. PMID:17555783

  7. Advances in radiotherapy

    International Nuclear Information System (INIS)

    Radiation therapy is in the midst of a rebirth largely driven by the use of computers for treatment planning and beam delivery. The first edge of this renaissance was the advent of three-dimensional conformal radiation therapy (3-D CRT). This was enabled by the widespread availability and utilization of three-dimensional imaging such as computed tomography and magnetic resonance scanning, themselves products of the computer revolution. For the first time this allowed radiation oncologists to segment and visualize the tumor in association with it neighboring sensitive soft-tissue structures. Software tools to visualize the beam paths through the body enabled the beam directions and beam shapes to be manually optimized. Simultaneously, improved dose calculations utilizing the CT images of the patient anatomy produced more accurate distributions of dose. The dose was delivered with custom-shaped blocks or recently collimators with multiple leaves that allow complex shaped fields to be delivered without the need for block fabrication. In the last couple of decades new treatment delivery methodologies have emerged. The first has been stereotactic radiosurgery (SRS) or stereotactic radiotherapy (SRT) which is the purview of neurosurgeons (who call it SRS) as well as radiation oncologists (who usually call it SRT). SRS and SRT are premised on multiple beams focusing on one location typically with circular aperture collimators but increasingly with fields shaped by multi-leaved collimators. Often only a single treatment session (the usual for SRS) is used when the treatment volume is small, but for larger lesions several treatment sessions, or fractions, are used (most often for SRT) to allow for normal tissue repair. The new equipment market for SRS and SRT is about 10% of the total for radiation therapy. Intensity-modulated radiation therapy (IMRT) is the latest treatment methodology and its adoption has been extremely rapid, particularly in the United States. IMRT uses

  8. Non-targeted effects of ionising radiation and radiotherapy.

    Science.gov (United States)

    Sjostedt, Svetlana; Bezak, Eva

    2010-09-01

    Modern radiobiology is undergoing rapid change due to new discoveries contradicting the target concept which is currently used to predict dose-response relationships. Thus relatively recently discovered radiation-induced bystander effects (RIBEs), that include additional death, mutation and radio-adaptation in non-irradiated cells, change our understanding of the target concept and broadens its boundaries. This can be significant from a radioprotection point of view and also has the potential to reassess radiation damage models currently used in radiotherapy. This article reviews briefly the general concepts of RIBEs such as the proposed underlying mechanisms of signal induction and propagation, experimental approaches and biological end points used to investigate these phenomena. It also summarises several mathematical models currently proposed in an attempt to quantify RIBE. The main emphasis of this article is to review and highlight the potential impact of the bystander phenomena in radiotherapy. PMID:20857259

  9. Hypnotherapy in radiotherapy patients: A randomized trial

    International Nuclear Information System (INIS)

    Purpose: To determine whether hypnotherapy reduces anxiety and improves the quality of life in cancer patients undergoing curative radiotherapy (RT). Methods and materials: After providing written informed consent, 69 patients were randomized between standard curative RT alone (36 controls) and RT plus hypnotherapy (33 patients). Patients in the hypnotherapy group received hypnotherapy at the intake, before RT simulation, before the first RT session, and halfway between the RT course. Anxiety was evaluated by the State-Trait Anxiety Inventory DY-1 form at six points. Quality of life was measured by the Rand Medical Outcomes Study 36-item Health Survey (SF-36) at five points. Additionally, patients answered a questionnaire to evaluate their experience and the possible benefits of this research project. Results: No statistically significant difference was found in anxiety or quality of life between the hypnotherapy and control groups. However, significantly more patients in the hypnotherapy group indicated an improvement in mental (p < 0.05) and overall (p < 0.05) well-being. Conclusion: Hypnotherapy did not reduce anxiety or improve the quality of life in cancer patients undergoing curative RT. The absence of statistically significant differences between the two groups contrasts with the hypnotherapy patients' own sense of mental and overall well-being, which was significantly greater after hypnotherapy. It cannot be excluded that the extra attention by the hypnotherapist was responsible for this beneficial effect in the hypnotherapy group. An attention-only control group would be necessary to control for this effect

  10. Effect of Yangyin Humo Decoction(养阴护膜饮) on Oral Mucomembranous Reaction to Radiotherapy*

    Institute of Scientific and Technical Information of China (English)

    戴安伟; 李张艳; 王良花; 李胜业; 杨华

    2009-01-01

    Objective:To observe the effect of Yangyin Humo Decoction(养阴护膜饮,YHD)on oral mucomembranous reaction in patients with head-neck tumor undergoing radiotherapy.Methods:Fortytwo patients with head-neck tumor undergoing radiotherapy were randomized equally into two groups.The conventional Western medical treatment was administered to all,including intravenous dripping of 2%lidocaine 20 mL,dexamethasone 5 mg,gentamycin 80 000 units,vitamin B_(12) 5 mg,dissolved in saline 250 mL,and 5% sodium bicarbonate soluti...

  11. Radiotherapy in a public health

    International Nuclear Information System (INIS)

    The aim of our publication is to evaluate the state of radiotherapy, its role and place in oncology and in the public health system, in order to plan necessities. The cost and economical effectiveness are objectives of the current evaluation. Radiotherapy is strongly dependant of introducing new technologies and the need of gross capital investments. However, their relative cost is reduced due to their long-term use. Because of the serious delay of Bulgaria from the world standards in radiotherapy, the analysis is based on the data published in the scientific literature. The main tendencies and ideas for development are based on the analysis of The Swedish Council on Technology Assessment in Health Care (SBU) and the ESTRO QUARTS project. We use Swedish model for estimating the expenses, having in mind the conditions in Bulgaria (salary, management, patient cares). The main conclusions are: 1) Radiotherapy is basic curative and palliative method in oncology; 2) Bulgarian radiotherapy is at one of the last places in Europe (therapeutic units are 30 years old average, despite their recommended exploitation of 12-20 years); 3) In contradiction to the world tendencies delay grows during the last 10 years; 4) In countries with low or average GDP radiotherapy should be prioritized, due to its low cost in comparison to the other treatment methods in oncology; 5) The need of radiotherapy will continue to grow, this necessitate not only replacement of the old machines but increasing their number 3 times during the next few years; 6) It is necessary to form a modern radiotherapy centers, equipped with at least two compatible units, based on the currently existing radiotherapy departments. (authors)

  12. Chest wall desmoid tumours treated with definitive radiotherapy: a plan comparison of 3D conformal radiotherapy, intensity-modulated radiotherapy and volumetric-modulated arc radiotherapy

    OpenAIRE

    Liu, Jia; Ng, Diana; Lee, James; Stalley, Paul; Hong, Angela

    2016-01-01

    Purpose Definitive radiotherapy is often used for chest wall desmoid tumours due to size or anatomical location. The delivery of radiotherapy is challenging due to the large size and constraints of normal surrounding structures. We compared the dosimetry of 3D conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc radiotherapy (VMAT) to evaluate the best treatment option. Methods and materials Ten consecutive patients with inoperable chest wall de...

  13. A randomised controlled trial on the Four Pillars Approach in managing pregnant women with anaemia in Yogyakarta-Indonesia: a study protocol

    NARCIS (Netherlands)

    Widyawati, W.; Jans, S.; Bor, H.; Siswishanto, R.; Dillen, J. van; Lagro-Janssen, A.

    2014-01-01

    BACKGROUND: Anaemia is a common health problem among pregnant women and a contributing factor with a major influence on maternal mortality in Indonesia. The Four Pillars Approach is a new approach to anaemia in pregnancy, combining four strategies to improve antenatal and delivery care. The primary

  14. Elevation of HbA1C in Non-diabetic Hypothyroid Individuals: Is Anaemia the Connecting Link? -A Preliminary Study

    OpenAIRE

    Christy, Alap L.; Manjrekar, Poornima; Babu, Ruby P.; M.S., Rukmini; Hegde, Anupama

    2013-01-01

    Aim: Studies have shown elevated HbA1C in non-diabetic hypothyroid patients. Hypothyroid patients often show anaemia as an associated feature which is an another condition showing falsely elevated A1C. Hence this study is aimed to investigate whether elevated A1C in hypothyroidism can be attributed to anaemia.

  15. Design of the Reduction of Events with Darbepoetin alfa in Heart Failure (RED-HF) : a Phase III, anaemia correction, morbidity-mortality trial

    NARCIS (Netherlands)

    McMurray, John J. V.; Anand, Inder S.; Diaz, Rafael; Maggioni, Aldo P.; O'Connor, Christopher; Pfeffer, Marc A.; Polu, Krishna R.; Solomon, Scott D.; Sun, Yan; Swedberg, Karl; Tendera, Michal; van Veldhuisen, Dirk J.; Wasserman, Scott M.; Young, James B.

    2009-01-01

    Patients with heart failure (HF) and anaemia have greater functional impairment, worse symptoms, increased rates of hospital admission, and a higher risk of death, compared with non-anaemic HF patients. Whether correcting anaemia can improve outcomes is unknown. The Reduction of Events with Darbepoe

  16. Anaemia in chronic heart failure is not only related to impaired renal perfusion and blunted erythropoietin production, but to fluid retention as well

    NARCIS (Netherlands)

    Westenbrink, B. Daan; Visser, Folkert W.; Voors, Adriaan A.; Smilde, Tom D. J.; Lipsic, Erik; Navis, Gerjan; Hillege, Hans L.; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    2007-01-01

    Aims Anaemia is prevalent in the chronic heart failure (CHF) population, but its cause is often unknown. The present study aims to investigate the relation between anaemia, renal perfusion, erythropoietin production, and fluid retention in CHF patients. Methods and results We studied 97 patients wit

  17. Adaptive Motion Compensation in Radiotherapy

    CERN Document Server

    Murphy, Martin J

    2011-01-01

    External-beam radiotherapy has long been challenged by the simple fact that patients can (and do) move during the delivery of radiation. Recent advances in imaging and beam delivery technologies have made the solution--adapting delivery to natural movement--a practical reality. Adaptive Motion Compensation in Radiotherapy provides the first detailed treatment of online interventional techniques for motion compensation radiotherapy. This authoritative book discusses: Each of the contributing elements of a motion-adaptive system, including target detection and tracking, beam adaptation, and pati

  18. Factors contributing to the development of anaemia in Plasmodium falciparum malaria: what about drug-resistant parasites?

    DEFF Research Database (Denmark)

    Quashie, Neils Ben; Akanmori, Bartholomew D; Ofori-Adjei, David;

    2006-01-01

    A major manifestation of complicated malaria especially among children is severe anaemia, the pathogenesis of which is not well understood. Among other factors, suppression of the bone marrow's response to erythropoietin, which is rapidly reversed after successful treatment of the malaria, has been...... implicated in its pathogenesis. Since resolution of malaria restores erythropoiesis, we hypothesized that drug-resistant strains of Plasmodium falciparum would increase the risk of severe anaemia developing from initially uncomplicated malaria. Using both in vivo and in vitro drug-sensitivity tests we...... compared the prevalence of drug-resistant malaria between severe malarial anaemia SA and non-anaemic malaria NAM patients. Assessment of treatment outcome using the WHO in vivo criteria showed no significant difference in parasite resistance between the two groups. The mean parasite clearance time was also...

  19. Impact of combined intermittent preventive treatment of malaria and helminths on anaemia, sustained attention, and recall in Northern Ghanaian schoolchildren

    DEFF Research Database (Denmark)

    Opoku, Ernest Cudjoe; Olsen, Annette; Browne, Edmund;

    2016-01-01

    albendazole plus praziquantel compared to albendazole plus praziquantel on anaemia, sustained attention, and recall in schoolchildren. DESIGN: This three-arm, open-label intervention study was carried out in Ghana among class three schoolchildren. Artemether-lumefantrine and albendazole were co...... reductions of 62.8 and 59.2% in Study Arm 1 from 24.2 to 9.0%, p0.05). Meanwhile, anaemia prevalence reduced significantly (p... by 38.4% (from 19.8 to 12.2%), 20.7% (from 26.6 to 21.1%), and 36.0% (from 28.3 to 18.1%) in Study Arms 1, 2, and 3, respectively. Although the interventions had no significant effects on Hb levels, anaemia prevalence reduced insignificantly by 38.4 and 20.7% in Study Arms 1 and 2, respectively...

  20. Nutritional anaemia in 11-year-old schoolchildren in the western Cape.

    Science.gov (United States)

    Lamparelli, R D; van der Westhuyzen, J; Steyn, N P; Baynes, R D; MacFarlane, B J; Green, A; Bothwell, T H

    1988-04-16

    A nutritional anaemia survey was carried out on 610 11-year-old coloured, black and white schoolchildren in urban and rural communities in the western Cape. The mean (+/- 1 SD) haemoglobin concentration was 13.0 +/- 1.2 g/dl. The coloured and black subgroups considered together had a significantly lower mean haemoglobin concentration than the white subgroup (12.8 +/- 1.2 g/dl v. 13.4 +/- 1.0 g/dl) (F = 37.47; P less than 0.0001). The urban population as a whole had a significantly lower geometric mean (1 SD range) serum ferritin concentration than the rural population (25.6 (13.5-48.6) micrograms/l v. 34.1 (21.3-54.6) micrograms/l) (F = 42.94; P less than 0.0001). The lowest geometric mean serum ferritin values were found in the urban coloured (23.1 (11.5-46.4) micrograms/l) and urban black schoolchildren (23.7 (13.2-42.6) micrograms/l), with figures of less than 12 micrograms/l in 11.7% and 12.5% respectively. Although 28% of the children had red cell folate values below the recommended lower limit of normal (175 ng/ml), probability plot analysis of the data suggested that folate deficiency was not a major problem in the study population. The calculated daily iron and folate intakes were below the age-related recommended dietary allowance (RDA) in all the subgroups, yet anaemia was relatively uncommon. These findings suggest that the RDA values are too high. Overall the prevalence of nutritional anaemia was low and only the urban coloured subgroup showed significant second populations with low haemoglobin and serum ferritin measurements.

  1. Hyperglycaemic Environment: Contribution to the Anaemia Associated with Diabetes Mellitus in Rats Experimentally Induced with Alloxan

    Directory of Open Access Journals (Sweden)

    Oseni Bashiru Shola

    2015-01-01

    Full Text Available Background. Diabetes mellitus characterized by hyperglycaemia presents with various complications amongst which anaemia is common particularly in those with overt nephropathy or renal impairment. The present study has examined the contribution of the hyperglycaemic environment in diabetic rats to the anaemia associated with diabetes mellitus. Method. Sixty male albino rats weighing 175–250 g were selected for this study and divided equally into control and test groups. Hyperglycaemia was induced with 170 kgbwt−1 alloxan intraperitoneally in the test group while control group received sterile normal saline. Blood samples obtained from the control and test rats were assayed for packed cell volume (PCV, haemoglobin (Hb, red blood cell count (RBC, reticulocyte count, glucose, plasma haemoglobin, potassium, and bilirubin. Result. Significant reduction (P<0.01 in PCV (24.40±3.87 versus 40.45±3.93 and haemoglobin (7.81±1.45 versus 13.39±0.40 with significant increase (P<0.01 in reticulocyte count (12.4±1.87 versus 3.69±0.47, plasma haemoglobin (67.50±10.85 versus 34.20±3.83, and potassium (7.04±0.75 versus 4.52±0.63 was obtained in the test while plasma bilirubin showed nonsignificant increase (0.41±0.04 versus 0.24±0.06. Conclusion. The increased plasma haemoglobin and potassium levels indicate an intravascular haemolytic event while the nonsignificant increased bilirubin showed extravascular haemolysis. These play contributory roles in the anaemia associated with diabetes mellitus.

  2. Increased microerythrocyte count in homozygous alpha(+-thalassaemia contributes to protection against severe malarial anaemia.

    Directory of Open Access Journals (Sweden)

    Freya J I Fowkes

    2008-03-01

    Full Text Available BACKGROUND: The heritable haemoglobinopathy alpha(+-thalassaemia is caused by the reduced synthesis of alpha-globin chains that form part of normal adult haemoglobin (Hb. Individuals homozygous for alpha(+-thalassaemia have microcytosis and an increased erythrocyte count. Alpha(+-thalassaemia homozygosity confers considerable protection against severe malaria, including severe malarial anaemia (SMA (Hb concentration 1.1 x 10(12/l as a result of the reduced mean cell Hb in homozygous alpha(+-thalassaemia. In addition, children homozygous for alpha(+-thalassaemia require a 10% greater reduction in erythrocyte count than children of normal genotype (p = 0.02 for Hb concentration to fall to 50 g/l, the cutoff for SMA. We estimated that the haematological profile in children homozygous for alpha(+-thalassaemia reduces the risk of SMA during acute malaria compared to children of normal genotype (relative risk 0.52; 95% confidence interval [CI] 0.24-1.12, p = 0.09. CONCLUSIONS: The increased erythrocyte count and microcytosis in children homozygous for alpha(+-thalassaemia may contribute substantially to their protection against SMA. A lower concentration of Hb per erythrocyte and a larger population of erythrocytes may be a biologically advantageous strategy against the significant reduction in erythrocyte count that occurs during acute infection with the malaria parasite Plasmodium falciparum. This haematological profile may reduce the risk of anaemia by other Plasmodium species, as well as other causes of anaemia. Other host polymorphisms that induce an increased erythrocyte count and microcytosis may confer a similar advantage.

  3. Radiotherapy on hidradenocarcinoma

    Directory of Open Access Journals (Sweden)

    Issam Lalya

    2011-01-01

    Full Text Available Context: Clear cell Hidradenocarcinoma is a rare carcinoma arising from sweat glands. It is an aggressive tumor that most metastasizes to regional lymph nodes and distant viscera; surgery with safe margins is the mainstay of treatment. Case Report: We report a case of 68-year-old woman who presented with an invasive clear cell hidradenocarcinoma situated in the left parotid area which recurred 5 months after surgery, this recurrence was managed successfully by high-dose irradiation of the tumor bed (66 Gy and regional lymphatic chains (50 Gy, after a follow-up of more than 15 months, the patient is in good local control without significant toxicity. Conclusion: Post operative radiotherapy allows better local control and should be mandatory when histological features predictive of recurrence are present: positive margins, histology poorly differentiated, perineural invasion, vascular and lymphatic invasion, lymph node involvement, and extracapsular spread.

  4. Radiotherapy on hidradenocarcinoma

    Directory of Open Access Journals (Sweden)

    Issam Lalya

    2011-01-01

    Full Text Available Context : Clear cell Hidradenocarcinoma is a rare carcinoma arising from sweat glands. It is an aggressive tumor that most metastasizes to regional lymph nodes and distant viscera; surgery with safe margins is the mainstay of treatment. Case Report: We report a case of 68-year-old woman who presented with an invasive clear cell hidradenocarcinoma situated in the left parotid area which recurred 5 months after surgery, this recurrence was managed successfully by high-dose irradiation of the tumor bed ( 66 Gy and regional lymphatic chains (50 Gy, after a follow-up of more than 15 months, the patient is in good local control without significant toxicity. Conclusion : Post operative radiotherapy allows better local control and should be mandatory when histological features predictive of recurrence are present: positive margins, histology poorly differentiated, perineural invasion, vascular and lymphatic invasion, lymph node involvement, and extracapsular spread.

  5. Anatomical imaging for radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Evans, Philip M [Joint Physics Department, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey SM2 5PT (United Kingdom)], E-mail: phil.evans@icr.ac.uk

    2008-06-21

    The goal of radiation therapy is to achieve maximal therapeutic benefit expressed in terms of a high probability of local control of disease with minimal side effects. Physically this often equates to the delivery of a high dose of radiation to the tumour or target region whilst maintaining an acceptably low dose to other tissues, particularly those adjacent to the target. Techniques such as intensity modulated radiotherapy (IMRT), stereotactic radiosurgery and computer planned brachytherapy provide the means to calculate the radiation dose delivery to achieve the desired dose distribution. Imaging is an essential tool in all state of the art planning and delivery techniques: (i) to enable planning of the desired treatment, (ii) to verify the treatment is delivered as planned and (iii) to follow-up treatment outcome to monitor that the treatment has had the desired effect. Clinical imaging techniques can be loosely classified into anatomic methods which measure the basic physical characteristics of tissue such as their density and biological imaging techniques which measure functional characteristics such as metabolism. In this review we consider anatomical imaging techniques. Biological imaging is considered in another article. Anatomical imaging is generally used for goals (i) and (ii) above. Computed tomography (CT) has been the mainstay of anatomical treatment planning for many years, enabling some delineation of soft tissue as well as radiation attenuation estimation for dose prediction. Magnetic resonance imaging is fast becoming widespread alongside CT, enabling superior soft-tissue visualization. Traditionally scanning for treatment planning has relied on the use of a single snapshot scan. Recent years have seen the development of techniques such as 4D CT and adaptive radiotherapy (ART). In 4D CT raw data are encoded with phase information and reconstructed to yield a set of scans detailing motion through the breathing, or cardiac, cycle. In ART a set of

  6. MRI assisted radiotherapy planning

    International Nuclear Information System (INIS)

    To obtain the optimal radiation field, an MR simulation system (MRSS) has been developed. The system consists of an MR unit, a work station and a laser marking system. Phantom study concerned geographic distortion and the total accuracy of MRSS, the former revealed the result lesser than 1 mm within 90 mm-distance between MR slices and Center of magnetic field, the latter showed maximal errors 2 mm in the field size, and 3 mm in the iso-center. This system was applied to 15 patients with intracranial or head and neck lesions and all procedures were smoothly performed. To evaluate the usefulness of MRSS, 6 radiation oncologists compared the difference between MRSS and CT simulation system in setting radiation field. The results were satisfactory especially in cases with lesions the extent of which was unclear on CT images. It was considered that this system could support the radiotherapy planning for intracranial or head and neck lesions. (author)

  7. [Hepatic tumors and radiotherapy].

    Science.gov (United States)

    Rio, E; Mornex, F; Peiffert, D; Huertas, A

    2016-09-01

    Recent technological developments led to develop the concept of focused liver radiation therapy. We must distinguish primary and secondary tumors as the indications are restricted and must be discussed as an alternative to surgical or medical treatments. For hepatocellular carcinoma 5 to 10cm (or more), a conformational radiation with or without intensity modulation is performed. Stereotactic body radiotherapy (SBRT) is being evaluated and is increasingly proposed as an alternative to radiofrequency ablative treatment for primary or secondary tumors (typically less than 5cm). Tumor (and liver) movements induced by respiratory motions must be taken into account. Strict dosimetric criteria must be met with particular attention to the dose-volume histograms to liver and the hollow organs, including cases of SBRT. PMID:27521035

  8. Anaemia and associated risk factors among pregnant women in Gilgel Gibe dam area, Southwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Getachew Million

    2012-12-01

    Full Text Available Abstract Background Anaemia is known to be one of the outcomes of parasitic infection and it may result in impaired cognitive development, reduced physical work capacity and in severe cases increased risk of mortality, particularly during the prenatal period. The aim of this study was to determine the prevalence and associated risk factors of anaemia among pregnant women in Gilgel-Gibe dam area, southwestern Ethiopia. Methods A cross-sectional community based study was conducted on 388 pregnant women living in three districts around Gilgel Gibe Dam area, southwestern Ethiopia. Socio-demographic and socio-economic data were collected from each participant. A single stool sample was also collected from each selected pregnant woman. Haemoglobin concentration was determined by the cyanmethemoglobin method. Plasmodium infection prevalence and intensity were assessed with thin and thick blood film examination. Results Of the total 388 study participants, 209 (53.9% were anaemic. Pregnant woman who were rural residents (Adjusted odds ratio (AOR = 1.62, 95% C.I: 1.02-2.62, P= 0.042, not using insecticide treated nets (ITNs during the study period (AOR = 2.84, 95% C.I: 1.33-6.05, p = 0.007, those who were Plasmodium malaria infected (AOR = 11.19, 95% C.I: 3.31-37.7, p= 0.01 and those with Soil Transmitted Helminth (STH infections (AOR=1.82, 95% C.I: 1.16-2.87, p=0.001 had higher odds of being anaemic than those who were urban residents, using ITNs, free of Plasmodium malaria and Soil transmitted helminth infection, respectively. There was a significant correlation between increasing hookworm parasite load (r = −.110, PAscaris lumbricoides (r = −.122, P Trichuris trichiura (r = −.025, P Conclusion The high prevalence of anaemia indicates it is currently a serious health problem of pregnant women living in Gilgel Gibe Dam area. Plasmodium malaria and soil transmitted helminth infections were significantly associated with anaemia. Antenatal care

  9. Intravenous iron sucrose therapy for moderate to severe anaemia in pregnancy

    Directory of Open Access Journals (Sweden)

    Alka Kriplani

    2013-01-01

    Full Text Available Background & objectives: Iron deficiency anaemia (IDA is the most common nutritional deficiency in pregnancy. Prophylactic oral iron is recommended during pregnancy to meet the increased requirement. In India, women become pregnant with low baseline haemoglobin level resulting in high incidence of moderate to severe anaemia in pregnancy where oral iron therapy cannot meet the requirement. Pregnant women with moderate anaemia are to be treated with parentral iron therapy. This study was undertaken to evaluate the response and effect of intravenous iron sucrose complex (ISC given to pregnant women with IDA. Methods: A prospective study was conducted (June 2009 to June 2011 in the department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi. One hundred pregnant women with haemoglobin between 5-9 g% with diagnosed iron deficiency attending antenatal clinic were given intravenous iron sucrose complex in a dose of 200 mg twice weekly schedule after calculating the dose requirement. Results: The mean haemoglobin raised from 7.63 ± 0.61 to 11.20 ± 0.73 g% (P<0.001 after eight wk of therapy. There was significant rise in serum ferritin levels (from 11.2 ± 4.7 to 69 ± 23.1 μg/l (P<0.001. Reticulocyte count increased significantly after two wk of starting therapy (from 1.5 ± 0.6 to 4.6±0.8%.Other parameters including serum iron levels and red cell indices were also improved significantly. Only one woman was lost to follow up. No major side effects or anaphylactic reactions were noted during study period. Interpretation & conclusions: Parentral iron therapy was effective in increasing haemoglobin, serum ferritin and other haematological parameters in pregnant women with moderate anaemia. Intravenous iron sucrose can be used in hospital settings and tertiary urban hospitals where it can replace intramuscular therapy due to injection related side effects. Further, long-term comparative studies are required to recommend its

  10. Aplastic anaemia preceding acute lymphoblastic leukaemia in an adult with isolated deletion of chromosome 9q.

    LENUS (Irish Health Repository)

    Kelly, Kevin

    2008-12-01

    Aplastic anaemia (AA) can precede acute lymphoblastic leukaemia (ALL) in 2% of children but this is rarely reported to occur in adults. A 21-year-old male presented with bone marrow failure and bone marrow biopsy showed a profoundly hypocellular marrow. He recovered spontaneously but represented 2 months later when he was diagnosed with pre-B acute lymphoblastic leukaemia. Chromosomal examination revealed 46,XY,del(9)(q13q34). To the best of our knowledge this is the first case to be reported of aplasia preceding ALL with 9q minus as the sole chromosomal abnormality.

  11. Prevalence of Malaria Infection and Risk Factors Associated with Anaemia among Pregnant Women in Semiurban Community of Hazaribag, Jharkhand, India.

    Science.gov (United States)

    Sohail, Mohammad; Shakeel, Shayan; Kumari, Shweta; Bharti, Aakanksha; Zahid, Faisal; Anwar, Shadab; Singh, Krishn Pratap; Islam, Mazahirul; Sharma, Ajay Kumar; Lata, Sneh; Ali, Vahab; Adak, Tridibes; Das, Pradeep; Raziuddin, Mohammad

    2015-01-01

    The escalating burden, pathogenesis, and clinical sequel of malaria during pregnancy have combinatorial adverse impact on both mother and foetus that further perplexed the situation of diagnosis, treatment, and prevention. This prompted us to evaluate the status of population at risk of MIP in Hazaribag, Jharkhand, India. Cross-sectional study was conducted over a year at Sadar Hospital, Hazaribag. Malaria was screened using blood smear and/or RDT. Anaemia was defined as haemoglobin concentration. Pretested questionnaires were used to gather sociodemographic, clinical, and obstetrical data. The prevalence of MIP was 5.4% and 4.3% at ANC and DU, and 13.2% malaria was in women without pregnancy. Interestingly, majority were asymptomatically infected with P. vivax (over 85%) at ANC and DU. Peripheral parasitemia was significantly associated with fever within past week, rural origin of subjects, and first/second pregnancies in multivariate analysis, with the highest risk factor associated with fever followed by rural residence. Strikingly in cohort, anaemia was prevalent in 86% at ANC as compared to 72% at DU, whereas severe anaemia was 13.6% and 7.8% at ANC and DU. Even more anaemia prevalence was observed in MIP group (88% and 89% at ANC and DU), whereas severe anaemia was 23% and 21%, respectively. In view of observed impact of anaemia, parasitemia and asymptomatic infection of P. vivax during pregnancy and delivery suggest prompt diagnosis regardless of symptoms and comprehensive drug regime should be offered to pregnant women in association with existing measures in clinical spectrum of MIP, delivery, and its outcome. PMID:26783526

  12. Anaemia, its determinants and effect of different interventions amongst tea tribe adolescent girls living in Dibrugarh district of Assam

    Directory of Open Access Journals (Sweden)

    Tulika Goswami Mahanta

    2014-12-01

    Full Text Available Background: Nutritional anaemia, one of the major public health problems in India is associated with lower productivity, higher sickness rate and absenteeism having inter-generational effect. Morbidity during adolescent has implication on future safe motherhood, optimum growth and development of foetus and children. Aims and Objective: To assess, prevalence and determinants of anaemia and effect of different interventions amongst tea tribe adolescent girls. Materials & Methods: A community based intervention study was conducted covering 16 tea estates of Dibrugarh District, Assam. Variables includes socio-demographic, environmental, anthropometry, history of present and past illness, clinical examination and laboratory investigation including haemoglobin, serum ferritin, haemoglobin typing and routine stool examination. Interventions given were weekly IFA supplementation, dietary diversification, health promotion by monthly NHED, cooking demonstration, cooking competition and kitchen garden promotion and counselling to improve IFA compliance and remove barriers was done. SPSS and EpiInfo software, used to calculate of rates, ratios, chi-square test, Fisher Exact test and multiple logistic regression analysis. Results: Enrolments were 802, with mean age, 14.8 years. Anaemia prevalence was 96.3% with median serum ferritin, 22.9 ng/ml. Prevalence of Sickle cell anaemia was,12% and helminthiasis 84.20%.  History of passage of worms (9.1%, night blindness (5.6%, weakness (62.1%, loss of appetite (37.5%, gum bleeding (23.6%, loose motion (13%, loss of weight (9.9%, menstrual problem (19.3% was common. Following intervention mean haemoglobin difference was 1.48 gm/dl with 13.5% difference in prevalence. Associated morbidities showed significant reduction following active intervention. Conclusions: High anaemia prevalence requires urgent attention to avoid preventable morbidities. Implementation of different intervention in an integrated manner was

  13. Prevalence of Malaria Infection and Risk Factors Associated with Anaemia among Pregnant Women in Semiurban Community of Hazaribag, Jharkhand, India

    Science.gov (United States)

    Sohail, Mohammad; Shakeel, Shayan; Kumari, Shweta; Bharti, Aakanksha; Zahid, Faisal; Anwar, Shadab; Singh, Krishn Pratap; Islam, Mazahirul; Sharma, Ajay Kumar; Lata, Sneh; Ali, Vahab; Adak, Tridibes; Das, Pradeep; Raziuddin, Mohammad

    2015-01-01

    The escalating burden, pathogenesis, and clinical sequel of malaria during pregnancy have combinatorial adverse impact on both mother and foetus that further perplexed the situation of diagnosis, treatment, and prevention. This prompted us to evaluate the status of population at risk of MIP in Hazaribag, Jharkhand, India. Cross-sectional study was conducted over a year at Sadar Hospital, Hazaribag. Malaria was screened using blood smear and/or RDT. Anaemia was defined as haemoglobin concentration. Pretested questionnaires were used to gather sociodemographic, clinical, and obstetrical data. The prevalence of MIP was 5.4% and 4.3% at ANC and DU, and 13.2% malaria was in women without pregnancy. Interestingly, majority were asymptomatically infected with P. vivax (over 85%) at ANC and DU. Peripheral parasitemia was significantly associated with fever within past week, rural origin of subjects, and first/second pregnancies in multivariate analysis, with the highest risk factor associated with fever followed by rural residence. Strikingly in cohort, anaemia was prevalent in 86% at ANC as compared to 72% at DU, whereas severe anaemia was 13.6% and 7.8% at ANC and DU. Even more anaemia prevalence was observed in MIP group (88% and 89% at ANC and DU), whereas severe anaemia was 23% and 21%, respectively. In view of observed impact of anaemia, parasitemia and asymptomatic infection of P. vivax during pregnancy and delivery suggest prompt diagnosis regardless of symptoms and comprehensive drug regime should be offered to pregnant women in association with existing measures in clinical spectrum of MIP, delivery, and its outcome. PMID:26783526

  14. Prevalence of Malaria Infection and Risk Factors Associated with Anaemia among Pregnant Women in Semiurban Community of Hazaribag, Jharkhand, India

    Directory of Open Access Journals (Sweden)

    Mohammad Sohail

    2015-01-01

    Full Text Available The escalating burden, pathogenesis, and clinical sequel of malaria during pregnancy have combinatorial adverse impact on both mother and foetus that further perplexed the situation of diagnosis, treatment, and prevention. This prompted us to evaluate the status of population at risk of MIP in Hazaribag, Jharkhand, India. Cross-sectional study was conducted over a year at Sadar Hospital, Hazaribag. Malaria was screened using blood smear and/or RDT. Anaemia was defined as haemoglobin concentration. Pretested questionnaires were used to gather sociodemographic, clinical, and obstetrical data. The prevalence of MIP was 5.4% and 4.3% at ANC and DU, and 13.2% malaria was in women without pregnancy. Interestingly, majority were asymptomatically infected with P. vivax (over 85% at ANC and DU. Peripheral parasitemia was significantly associated with fever within past week, rural origin of subjects, and first/second pregnancies in multivariate analysis, with the highest risk factor associated with fever followed by rural residence. Strikingly in cohort, anaemia was prevalent in 86% at ANC as compared to 72% at DU, whereas severe anaemia was 13.6% and 7.8% at ANC and DU. Even more anaemia prevalence was observed in MIP group (88% and 89% at ANC and DU, whereas severe anaemia was 23% and 21%, respectively. In view of observed impact of anaemia, parasitemia and asymptomatic infection of P. vivax during pregnancy and delivery suggest prompt diagnosis regardless of symptoms and comprehensive drug regime should be offered to pregnant women in association with existing measures in clinical spectrum of MIP, delivery, and its outcome.

  15. Antenatal Iron Supplementation Regimens for Pregnant Women in Rural Vietnam and Subsequent Haemoglobin Concentration and Anaemia among Their Infants.

    Directory of Open Access Journals (Sweden)

    Thach Duc Tran

    Full Text Available Little evidence about the effects of antenatal iron supplementation on infant anaemia is available. The aim was to compare effects on six-month-old infants' Haemoglobin (Hb concentration and anaemia of daily iron-folic acid (IFA, twice-weekly IFA with or without other micronutrients (MMN and usual antenatal care in rural Vietnam.Secondary data analysis from: a prospective population-based observational study (OS which examined effects of antenatal psychosocial factors, anaemia and iron deficiency on infant development and health; and a three-arm cluster randomised trial (CRT of different antenatal iron supplementation regimens. In the OS 497 women (<20 weeks gestation from 50 randomly-selected communes participated, and in the CRT 1,258 pregnant women (<16 weeks gestation in 104 communes were allocated randomly to trial arms. The main outcome was six-month-old infant Hb concentration. Baseline data included women's socio-demographic characteristics, reproductive health, Hb and serum ferritin. Mean differences in infant Hb and odds ratios of infant anaemia between CRT arms and OS were calculated by multivariable regression models, controlling for baseline differences and clustering, using robust standard errors. Infant anaemia prevalence was 68.6% in the OS, 47.2% daily IFA, 53.5% weekly IFA, and 50.3% MMN conditions. After adjustment, mean infant haemoglobin levels in daily IFA (mean difference = 0.95 g/dL; 95%CI 0.7-11.18; weekly IFA (0.91; 95%CI 0.69-1.12 and MMN (1.04; 95%CI 0.8-1.27 were higher than in the OS. After adjustment there were lower odds ratios of anaemia among infants in the daily IFA (OR = 0.31; 95% CI 0.22-0.43, weekly IFA (0.38; 95%CI 0.26-0.54 and MMN (0.33; 95%CI 0.23-0.48 groups than in the OS.Infant anaemia is a public health problem in Vietnam and other resource-constrained countries. All supplementation regimens could have clinically significant benefits for Hb and reduce anaemia risk among six-month-old infants

  16. Elevated levels of nitric oxide and low levels of haptoglobin are associated with severe malarial anaemia in African children

    DEFF Research Database (Denmark)

    Gyan, Ben; Kurtzhals, Jørgen; Akanmori, Bartholomew D;

    2002-01-01

    Severe malarial anaemia (SA) is a major complication of malaria and an important cause of child mortality and morbidity. However, the pathogenesis behind SA is poorly understood. Nitric oxide (NO) is known to play a protective role against clinical malaria but is also suggested to have a pathogenic...... was there any correlation between parasitaemias and neopterin levels. The low haptoglobin and high levels of NO in this SA group may contribute to haemolysis. Taken together our results support the hypothesis that immune-mediated erythrocyte destruction is involved in the pathogenesis of malarial anaemia....

  17. A phase III randomized trial comparing glucocorticoid monotherapy versus glucocorticoid and rituximab in patients with autoimmune haemolytic anaemia

    DEFF Research Database (Denmark)

    Birgens, Henrik; Frederiksen, Henrik; Hasselbalch, Hans Carl;

    2013-01-01

    The impact of first-line treatment with the anti-CD 20 chimeric monoclonal antibody rituximab in patients with warm-antibody reactive autoimmune haemolytic anaemia (WAIHA) is unknown. We report the first randomized study of 64 patients with newly diagnosed WAIHA who received prednisolone and ritu......The impact of first-line treatment with the anti-CD 20 chimeric monoclonal antibody rituximab in patients with warm-antibody reactive autoimmune haemolytic anaemia (WAIHA) is unknown. We report the first randomized study of 64 patients with newly diagnosed WAIHA who received prednisolone...

  18. Stereotactic radiotherapy for vestibular schwannoma

    DEFF Research Database (Denmark)

    Muzevic, Dario; Legcevic, Jelena; Splavski, Bruno;

    2014-01-01

    BACKGROUND: Vestibular schwannomas (acoustic neuromas) are common benign tumours that arise from the Schwann cells of the vestibular nerve. Management options include observation with neuroradiological follow-up, microsurgical resection and stereotactic radiotherapy. OBJECTIVES: To assess...

  19. Non-invasive anesthesia for children undergoing proton radiation therapy

    International Nuclear Information System (INIS)

    Background: Proton therapy is a newer modality of radiotherapy during which anesthesiologists face specific challenges related to the setup and duration of treatment sessions. Purpose: Describe our anesthesia practice for children treated in a standalone proton therapy center, and report on complications encountered during anesthesia. Materials and methods: A retrospective review of anesthetic records for patients ⩽18 years of age treated with proton therapy at our institution between January 2006 and April 2013 was performed. Results: A total of 9328 anesthetics were administered to 340 children with a median age of 3.6 years (range, 0.4–14.2). The median daily anesthesia time was 47 min (range, 15–79). The average time between start of anesthesia to the start of radiotherapy was 7.2 min (range, 1–83 min). All patients received Total Intravenous Anesthesia (TIVA) with spontaneous ventilation, with 96.7% receiving supplemental oxygen by non-invasive methods. None required daily endotracheal intubation. Two episodes of bradycardia, and one episode each of; seizure, laryngospasm and bronchospasm were identified for a cumulative incidence of 0.05%. Conclusions: In this large series of children undergoing proton therapy at a freestanding center, TIVA without daily endotracheal intubation provided a safe, efficient, and less invasive option of anesthetic care

  20. Indications for Salivary Gland Radiotherapy.

    Science.gov (United States)

    Thomson, David J; Slevin, Nick J; Mendenhall, William M

    2016-01-01

    There is an established role for post-operative radiotherapy in the treatment of benign and malignant salivary gland tumours. For benign disease, the addition of radiotherapy improves local tumour control in cases with incomplete excision, involved surgical margins or multi-focal disease recurrence. After capsule rupture or spillage alone, surveillance should usually be advised. For malignant disease, post-operative radiotherapy is recommended for an advanced tumour stage, high-grade tumour, perineural or lympho-vascular invasion, close or positive resection margins, extra-parotid extension or lymph node involvement. The main benefit is increased loco-regional tumour control, although this may translate into a modest improvement in survival. The possible late side effects of parotid bed irradiation include skin changes, chronic otitis externa, sensorineural hearing loss, osteoradionecrosis and secondary malignancy. Severe complications are rare, but patients should be counselled carefully about the risks. Primary radiotherapy is unlikely to be curative and is reserved to cases in which resection would cause unacceptable functional or cosmetic morbidity or would likely result in subtotal resection (R2) or to patients with distant metastases to gain local tumour control. There are provisional data on the use of charged particle radiotherapy in this setting. Some patients may benefit from synchronous chemotherapy with radiotherapy, but this group is not defined, and data from comparative prospective studies are required before routine clinical use of this treatment. PMID:27093301

  1. Cormic Index Profile of Children with Sickle Cell Anaemia in Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Samuel Olufemi Akodu

    2014-01-01

    Full Text Available Background. Sickle cell disorders are known to have a negative effect on linear growth. This could potentially affect proportional growth and, hence, Cormic Index. Objective. To determine the Cormic Index in the sickle cell anaemia population in Lagos. Methodology. A consecutive sample of 100 children with haemoglobin genotype SS, aged eight months to 15 years, and 100 age and sex matched controls (haemoglobin genotype AA was studied. Sitting height (upper segment and full length or height were measured. Sitting height was then expressed as a percentage of full length/height (Cormic Index. Results. The mean Cormic Index decreased with age among primary subjects (SS and AA controls. The overall mean Cormic Index among primary subjects was comparable to that of controls (55.0±4.6% versus 54.5±5.2%; 54.8±4.5% versus 53.6±4.9% in boys and girls, respectively. In comparison with AA controls, female children with sickle cell anaemia who were older than 10 years had a significantly lower mean Cormic Index. Conclusion. There was a significant negative relationship between Cormic Index and height in subjects and controls irrespective of gender. Similarly, a significant negative correlation existed between age, sitting height, subischial leg length, weight, and Cormic Index in both subjects and controls.

  2. Oxpentifylline versus placebo in the treatment of erythropoietin-resistant anaemia: a randomized controlled trial

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    Fassett Robert G

    2008-08-01

    Full Text Available Abstract Background The main hypothesis of this study is that Oxpentifylline administration will effectively treat erythropoietin- or darbepoietin-resistant anaemia in chronic kidney disease patients. Methods/design Inclusion criteria are adult patients with stage 4 or 5 chronic kidney disease (including dialysis patients with significant anaemia (haemoglobin ≤ 110 g/L for at least 3 months for which there is no clear identifiable cause and that is unresponsive to large doses of either erythropoietin (≥ 200 IU/kg/week or darbepoetin (≥ 1 μg/kg/week. Patients will be randomized 1:1 to receive either placebo (1 tablet daily or oxpentifylline (400 mg daily per os for a period of 4 months. During this 4 month study period, haemoglobin measurements will be performed monthly. The primary outcome measure will be the difference in haemoglobin level between the 2 groups at the end of the 4 month study period, adjusted for baseline values. Secondary outcome measures will include erythropoiesis stimulating agent dosage, Key's index (erythropoiesis stimulating agent dosage divided by haemoglobin concentration, and blood transfusion requirement. Discussion This investigator-initiated multicentre study has been designed to provide evidence to help nephrologists and their chronic kidney disease patients determine whether oxpentifylline represents a safe and effective strategy for treating erythropoiesis stimulating agent resistance in chronic kidney disease. Trial Registration Australian New Zealand Clinical Trials Registry Number ACTRN12608000199314.

  3. Drug induced immune haemolytic anaemia in the Berlin Case-Control Surveillance Study.

    Science.gov (United States)

    Garbe, Edeltraut; Andersohn, Frank; Bronder, Elisabeth; Klimpel, Andreas; Thomae, Michael; Schrezenmeier, Hubert; Hildebrandt, Martin; Späth-Schwalbe, Ernst; Grüneisen, Andreas; Mayer, Beate; Salama, Abdulgabar; Kurtal, Hanife

    2011-09-01

    Drug-induced immune haemolytic anaemia is a rare but serious condition. This study investigated the possibility of drug aetiology of immune haemolytic anaemia (IHA) in 134 patients with new onset of IHA who were identified in the Berlin Case-Control Surveillance Study between 2000 and 2009. Single drugs related to IHA in three or more patients and assessed more than once as a certain or probable cause of IHA in a standardized causality assessment included diclofenac, fludarabine, oxaliplatin, ceftriaxone and piperacillin. In a case-control study including all 124 IHA cases developed in outpatient care and 731 controls, significantly increased odds ratios (OR) were observed for beta-lactam antibiotics (OR=8·8; 95% confidence interval [CI] 3·2-25·2), cotrimoxazole (OR=6·5; CI 1·1-37·9), ciprofloxacin (OR=6·9, CI 1·3-38·5), fludarabine (OR=22·2; CI: 2·8-454·5) and lorazepam (OR=5·3; CI: 1·2-21·2). Excluding new onset cases with a chronic IHA disease course, an increased risk became also apparent for diclofenac with an OR of 3·1 (CI 1·3-7·0). This is the first case-control study investigating drugs as risk factors for IHA. It corroborates an increased risk for several drugs that have been implicated as a cause of IHA in the standardized causality assessment of individual cases. PMID:21749359

  4. [Glucose-6-phosphate dehydrogenase (G6PD) deficiency--a cause of anaemia in pregnant women].

    Science.gov (United States)

    Kuliszkiewicz-Janus, Małgorzata; Zimny, Anna

    2003-11-01

    Glucose-6-phosphate dehydrogenase (G6PD) is one of the most important cytoprotective enzymes for oxidative stress. The WHO classification of G6PD deficiency, based on enzyme activity and clinical significance, distinguishes five variants. Chronic haemolytic process is rare and the main factors causing haemolysis are: infections, substances derived from plants, drugs with high oxidation-reduction potential, stress, ketoacidosis in diabetes and surgery operations. We report two cases of women belonging to the class 3 of the WHO classification in whom haemolysis occured during pregnancy. One of the patients developed two incidents of haemolytic anaemia. The cause of the first episode, nine months before pregnancy, was probably infection of the urinary tract caused by Escherichia coli, but the influence of the drugs also cannot be excluded. Because of the genetic background of this enzymopathy we also examined members of the patients, families but did not find any evidence of G6PD deficiency among them. The reported cases indicate that haemolytic anaemia caused by G6PD deficiency may occur during pregnancy what can lead to many not only haematological but also serious obstetrical complications such as infertility, fetus malformations and even its death. We also draw attention to several difficulties in diagnosing G6PD deficiency especially during haemolysis. PMID:16737003

  5. Gene therapy and radiotherapy in malignant tumor

    International Nuclear Information System (INIS)

    Tumor treatment is one of the most important fields in medical research. Nowadays, a novel method which is combined gene therapy with radiotherapy plays an important role in the field of cancer research, and mainly includes immune gene therapy combined with radiotherapy, suicide gene therapy or tumor suppressor gene therapy combined with radiotherapy, antiangiogenesis gene therapy combined with radiotherapy and protective gene therapy combined with radiotherapy based on the technical features. This review summarized the current status of combined therapies of gene therapy and radiotherapy and possible mechanism. (authors)

  6. Radioprotectors in Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Nair, C.K.K. [Bhabha Atomic Research Centre, Mumbai (India); Parida, D.K.; Nomura, Taisei

    2001-03-01

    This review article focuses on clinically relevant radioprotectors and their mechanisms of radioprotection. Radiotherapy is the most common modality of human cancer therapy. Obtaining optimal results requires a judicious balance between the total dose of radiotherapy delivered and the threshold limit of critical surrounding normal tissues, and the normal tissues need to be protected against radiation injury to obtain better tumor control by using a higher dose. For this reason, radiation-protective agents play an important role in clinical radiotherapy. Radiation-protective agents can be classified into three groups: radioprotectors, adaptogens, and absorbents. The first group generally consists of sulfhydryl compounds and other antioxidants. They include several myelo-, entero-, and cerebro-protectors. Adaptogens act as promotors of radioresistance. They are natural protectors that offer chemical protection against low levels of ionizing radiation. Absorbents protect organs from internal radiation and chemicals. They include drugs that prevent incorporation of radioiodine by the thyroid gland and absorption of radionuclides. This article thoroughly describes the properties, mechanisms of action, and perspectives on clinical application of the following categories of radioprotectors: sulfhydryl compounds (e.g., cysteine, cysteamine, glutathione, AET, WR 2127, and other WR-compounds), antioxidants (e.g., tempace, Hoechst 33342, vitamin A, E, and C, TMG, melatonin), angiotensin-converting enzyme (ACE) inhibitors (e.g., captopril, elanopril, penicillamine, pentoxifylline, L-158, 809), cytoprotective agents (mesna, dexrazoxane, and amifostin), metalloelements (e.g., manganese chloride, cadmium salts, bismuth subnitrate), immunomodulators (gamma-interferon, polysaccharides AM5, AM218, heat-killed lactobacillus cells, broncho-vaxom, trehalose dicorynomycolate, and AS101), lipopolysaccharides and prostaglandins, plant extracts and compounds isolated from plants (curcmin

  7. Prevention of erectile dysfunction after radiotherapy for prostate cancer

    Directory of Open Access Journals (Sweden)

    Izak Faiena

    2014-12-01

    Full Text Available With increasing scrutiny of prostate cancer (PCa diagnosis and treatment, much attention has been given to the morbidity caused by radical prostatectomy (RP and/or radiotherapy (RT. One of the most common side-effects of either treatment is erectile dysfunction (ED. [1] Approximately, 40% of patients will experience ED after RT for PCa. The post-RT ED causes significant patient dissatisfaction with cancer treatment as well as decrease in patient and partner psychosocial function. [2] To address this issue in patients undergoing RT, Pisansky et al. [3] conducted a prospective, randomized, double-blinded, placebo-controlled trial to assess the efficacy of a phosphodiesterase enzyme-5 inhibitor (PDE5i, tadalafil, as a preventive measure for patients undergoing RT for PCa and found no difference in erectile function between the control and treatment groups.

  8. Automatization in radiotherapy

    International Nuclear Information System (INIS)

    Data-processing in external radiotherapy has to be adapted to each local situation, taking into account the patients to be treated, the irradiation equipment, the data-processing centers available locally, regionally, and nationally, and the rentability of the data-processing system required. It should be recalled that most dosimetric methods used today can be treated manually, and the question of rentability has to be kept in mind when deciding to buy a data-processing system. The radiotherapist should, therefore, prepare a list of costs for each situation, and verify the validity of each programme proposed by the supplier. It is difficult to make a definite choice between the presently available systems. The radiotherapist has to choose in relation to his activity, his availability and the systems available to him. It can sometimes be more advantageous to have a terminal linked to a large computer, rather than to readapt a series of programmes for a data-processing system available locally: many such solutions, though original, cannot be 'exported'. It should be recalled that a large number of dosimetries can be obtained manually, and on the rare occasions when the aid of a computer is essential, the assistance of better equipped neighbouring centers can be obtained. The decision as to whether a data-processing system needs to be acquired has to take all these imperatives into account

  9. West Syndrome in an Infant with Vitamin B[subscript 12] Deficiency in the Absence of Macrocytic Anaemia

    Science.gov (United States)

    Erol, Ilknur; Alehan, Fusun; Gumus, Ayten

    2007-01-01

    Vitamin B[subscript 12] deficiency in infants often produces haematological and neurological deficits, including macrocytic anaemia, neurodevelopmental delay or regression, irritability, weakness, hypotonia, ataxia, apathy, tremor, and seizures. The diagnosis of vitamin B[subscript 12] deficiency can be difficult when the typical macrocytic…

  10. Good agreement of conventional and gel-based direct agglutination test in immune-mediated haemolytic anaemia

    NARCIS (Netherlands)

    Piek, C.J.; Teske, E.; van Leeuwen, M.W.; Day, M.J.

    2012-01-01

    Abstract Background The aim of this study was to compare a gel-based test with the traditional direct agglutination test (DAT) for the diagnosis of immune-mediated haemolytic anaemia (IMHA). Methods Canine (n = 247) and feline (n = 74) blood samples were submitted for DAT testing to two laboratories

  11. Intermittent administration of iron and sulfadoxine-pyrimethamine to control anaemia in Kenyan children : a randomised controlled trial

    NARCIS (Netherlands)

    Verhoef, H.; West, C.E.; Nzyuko, S.M.; Vogel, de S.; Valk, van der R.; Wanga, M.A.; Kuijsten, A.; Veenemans, J.; Kok, F.J.

    2002-01-01

    Background Iron supplementation is recommended for children at high risk of anaemia, but its benefits may not outweigh the associated risk of malaria in areas of seasonal transmission. We investigated the effect on haemoglobin concentrations of intermittent administration of iron supplements and sul

  12. A case of anaemia in a neonatal warthog (Phacochoerus aethiopicus) and evaluation of serum-soluble iron in warthogs.

    Science.gov (United States)

    Kenny, D E; Braselton, W E; Taylor, R A; Morgan, T; Hesky, R B

    2002-09-01

    A 38-day-old male warthog (Phacochoerus aethiopicus) with marked anaemia (haematocrit = 14 %) presented to the Denver Zoological Gardens hospital with ataxia, tachypnoea, suspected stunted growth and cardiomegaly. The piglet demonstrated some features consistent with both iron deficiency anaemia and autoimmune haemolytic anaemia. Serum-soluble iron was below the level of detection (< 8.96 micromol/l). Iron deficiency anaemia is a well recognised entity in domestic swine reared on concrete and denied access to soil. Fifteen captive warthogs were subsequently evaluated for serum soluble iron content (mean = 21.62 +/- 4.36 micromol/l as well as 5 neonatal warthog piglets that required hand-rearing. Only 1 of 5 neonatal warthog piglets had measurable serum soluble iron (9.50 micromol/l). These data suggest that warthogs are similar to domestic swine and are born with low iron stores. Some form of iron supplementation should be considered for captive neonatal warthog piglets, especially if they are reared on concrete. PMID:12515305

  13. Markers of inflammation and activation of coagulation are associated with anaemia in antiretroviral-treated HIV disease

    DEFF Research Database (Denmark)

    Borges, Álvaro H; Weitz, Jeffrey I; Collins, Gary;

    2014-01-01

    OBJECTIVE: The objective of this study is to determine the relationship between inflammatory interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP)] and coagulation (D-dimer) biomarkers and the presence and type of anaemia among HIV-positive individuals. DESIGN: A cross-sectional st......OBJECTIVE: The objective of this study is to determine the relationship between inflammatory interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP)] and coagulation (D-dimer) biomarkers and the presence and type of anaemia among HIV-positive individuals. DESIGN: A cross......-sectional study. METHODS: Combination antiretroviral therapy (cART)-treated adults participating in an international HIV trial with haemoglobin and mean corpuscular volume (MCV) measurements at entry were categorized by presence of anaemia (haemoglobin ≤14 g/dl in men and ≤12 g/dl in women) and, for those...... with anaemia, by type [microcytic (MCV 100 fl)]. We analysed the association between inflammation (IL-6 and hsCRP) and coagulation (D-dimer) and haemoglobin, controlling for demographics (age, race and sex), BMI, HIV plasma RNA levels, CD4⁺ T-cell counts (nadir...

  14. Anaemia in patients with HIV-associated tuberculosis in South Africa: predictive/prognostic value, aetiologies and treatment

    NARCIS (Netherlands)

    A.D. Kerkhoff

    2016-01-01

    Tuberculosis remains the leading cause of death among people living with HIV in sub-Saharan Africa and worldwide. The clinical presentation in such patients is often so non-specific that much tuberculosis remains unsuspected, undiagnosed and is therefore untreated prior to death. Anaemia is one of t

  15. Sustained postoperative anaemia is associated with an impaired outcome after coronary artery bypass graft surgery : insights from the IMAGINE trial

    NARCIS (Netherlands)

    Westenbrink, B. Daan; Kleijn, Lennaert; de Boer, Rudolf A.; Tijssen, Jan G.; Warnica, Wayne J.; Baillot, Richard; Rouleau, Jean L.; van Gilst, Wiek H.

    2011-01-01

    Objective To investigate the association between sustained postoperative anaemia and outcome after coronary artery bypass graft (CABG) surgery. Design Retrospective analysis of the IMAGINE trial, which tested the effect of the ACE inhibitor quinapril on cardiovascular events after CABG. Setting Thor

  16. Selective breeding can increase resistance of Atlantic salmon to furunculosis, infectious salmon anaemia and infectious pancreatic necrosis

    DEFF Research Database (Denmark)

    Kjøglum, Sissel; Henryon, Mark; Aasmundstad, Torunn;

    2008-01-01

    We reasoned that by challenging large numbers of Atlantic salmon families with the causative agents of furunculosis, infectious salmon anaemia (ISA) and infectious pancreatic necrosis (IPN), we could show unequivocally that resistance to these diseases expresses moderate-to-high levels of additive...

  17. Immune haemolytic anaemia associated with ampicillin dependent warm antibodies and high titre cold agglutinins in a patient with Mycoplasma pneumonia

    DEFF Research Database (Denmark)

    Mickley, H; Sørensen, P G

    1984-01-01

    A case of severe immune haemolytic anaemia in a 54-year-old man suffering from Mycoplasma pneumonia is presented. A strongly positive direct Coombs test with erythrocyte bound IgG, C3d and C4 was demonstrated during the haemolytic process. Further, serologic investigations revealed ampicillin...

  18. The association between malaria parasitaemia, erythrocyte polymorphisms, malnutrition and anaemia in children less than 10 years in Senegal

    DEFF Research Database (Denmark)

    Tine, Roger C K; Ndiaye, Magatte; Hansson, Helle Holm;

    2012-01-01

    BACKGROUND:Malaria and anaemia (Haemoglobin= 11 g/dl. For each participant, a physical examination was done and anthropometric data collected prior to a biological assessment which included: malaria parasitaemia infection, intestinal worm carriage, G6PD deficiency, sickle cell disorders, and alph...

  19. THE STUDY OF ANAEMIA & ITS RELATED SOCIO - DEMOGRAPHIC FACTORS AMONGST PREGNANT WOMEN IN RURAL COMMUNITY OF UTTAR PRADESH

    Directory of Open Access Journals (Sweden)

    Shams Khan

    2014-01-01

    Full Text Available BACKGROUND: Anaemia in pregnant women is one of India’s major public health problems and is a major factor responsible for low birth weight. One fifth of the maternal deaths occurred worldwide due to anemia . OBJECTIVES: To find out prevalence of anaemia in pregnant women and it s association with socio demographic factors. Study Design: Cross sectional study. SETTING : The study was conducted in village Khera at RHTC , Rama Medical College Hospital and Research Centre , G h aziabad. MATERIAL & METHODS: The study was carried from Oct 2012 to June 2013. A total of 321 pregnant women with gestational period between 12 to 20 weeks were registered. H a emoglobin was estimated and peripheral smear examination was carried out. Statistical Analysis: Chi - Squar e test. RESULTS: A high prevalence of anaemia (79.75% was observed in pregnant women. Majority of the primipara were moderately anaemic (58.38% and were less than 20 years of age. 37% of multipara pregnant women were severely anaemic . Occurrence of anaemia in pregnancy was found to be inversely proportional to the socioeconomic class. Statistic ally significant association (P< 0.05 were found amongst anaemic pregnant women with their age , parity and socioeconomic class.

  20. Small animal radiotherapy research platforms

    International Nuclear Information System (INIS)

    Advances in conformal radiation therapy and advancements in pre-clinical radiotherapy research have recently stimulated the development of precise micro-irradiators for small animals such as mice and rats. These devices are often kilovolt x-ray radiation sources combined with high-resolution CT imaging equipment for image guidance, as the latter allows precise and accurate beam positioning. This is similar to modern human radiotherapy practice. These devices are considered a major step forward compared to the current standard of animal experimentation in cancer radiobiology research. The availability of this novel equipment enables a wide variety of pre-clinical experiments on the synergy of radiation with other therapies, complex radiation schemes, sub-target boost studies, hypofractionated radiotherapy, contrast-enhanced radiotherapy and studies of relative biological effectiveness, to name just a few examples. In this review we discuss the required irradiation and imaging capabilities of small animal radiation research platforms. We describe the need for improved small animal radiotherapy research and highlight pioneering efforts, some of which led recently to commercially available prototypes. From this, it will be clear that much further development is still needed, on both the irradiation side and imaging side. We discuss at length the need for improved treatment planning tools for small animal platforms, and the current lack of a standard therein. Finally, we mention some recent experimental work using the early animal radiation research platforms, and the potential they offer for advancing radiobiology research. (topical review)

  1. Small animal radiotherapy research platforms

    Science.gov (United States)

    Verhaegen, Frank; Granton, Patrick; Tryggestad, Erik

    2011-06-01

    Advances in conformal radiation therapy and advancements in pre-clinical radiotherapy research have recently stimulated the development of precise micro-irradiators for small animals such as mice and rats. These devices are often kilovolt x-ray radiation sources combined with high-resolution CT imaging equipment for image guidance, as the latter allows precise and accurate beam positioning. This is similar to modern human radiotherapy practice. These devices are considered a major step forward compared to the current standard of animal experimentation in cancer radiobiology research. The availability of this novel equipment enables a wide variety of pre-clinical experiments on the synergy of radiation with other therapies, complex radiation schemes, sub-target boost studies, hypofractionated radiotherapy, contrast-enhanced radiotherapy and studies of relative biological effectiveness, to name just a few examples. In this review we discuss the required irradiation and imaging capabilities of small animal radiation research platforms. We describe the need for improved small animal radiotherapy research and highlight pioneering efforts, some of which led recently to commercially available prototypes. From this, it will be clear that much further development is still needed, on both the irradiation side and imaging side. We discuss at length the need for improved treatment planning tools for small animal platforms, and the current lack of a standard therein. Finally, we mention some recent experimental work using the early animal radiation research platforms, and the potential they offer for advancing radiobiology research.

  2. Nutrición y anemias en pacientes graves Nutrition and anaemias in critical illness

    Directory of Open Access Journals (Sweden)

    F. Gallardo

    2010-02-01

    postoperados y sépticos, en cuanto a la cifra de hemoglobina, hierro, linfocitos totales, transferrina y albúmina. Se hizo una correlación estadística entre la sideremia y la albúmina, existiendo significación estadística. (Coef Rho de Spearman 0,277. Conclusión: La valoración de la anemia y de la situación nutricional y el tratamiento ferroterapico, como inmunonutriente, pudiera ser beneficioso para la integridad del sistema inmune y su capacidad de defensa ante las agresiones, en pacientes graves ingresados en la UCI.Introduction: We made a clinical study, about nutrition in seriously ill patients, which includes a typical heterogeneous group of critical ill patients, with/without anaemia's, that have been admitted to Intensive Care Unit, ICU. It is difficult to individualize and to generalize the relative importance of all the factors that can contribute to these anaemia's in the admission to the Unit, including nutritional deficiencies, inflammatory alterations, the immune response to aggressions, inmunitary modifications and the complex relations existing between these clinic processes. Objective: Indirect valuation of the nutritional situation and anaemia's, in a typical heterogeneous group of critical ill patients. Method/Results: We studied 202 patients admitted to ICU, of varied and heterogeneous origin, classifying them in 3 groups: control, post surgery and septic group's, becoming the indirect valuation of the nutritional situation on the basis of: Global Subjective Valuation, (VGS and the nutritional analytical determinations of total lymphocytes, albumin, and transferrin. Also we made hemogram and determinations of sideremia and ferritinemia to all of them. In 57% of the patients, we observed levels haemoglobin 12.5 g/dl. Regarding the nutritional prognoses indicators, (VGS + nutritional profile, in the control group's, they did not present anaemia nor analytical clinical under nourishment, in the post surgery group's, anaemia and slight under

  3. Radiotherapy and skin tumors; Radiotherapie et tumeurs curanees

    Energy Technology Data Exchange (ETDEWEB)

    Calitchi, E.; KIrova, Y.; Le bourgeois, J.P. [Hopital Henri-Mondor, 94 - Creteil (France)

    1998-09-01

    Radiotherapy plays an important role in treatment of skin tumours. For skin carcinomas, external irradiation (kilo-voltage X-rays or electrons according to clinical characteristics) is more valuable than interstitial brachytherapy, which is recommended for tumours of the lip and of the nasal vestibule. In mycosis fungoides, total cutaneous electron beam radiation therapy is efficient for patients with limited superficial plaques. In the classical form of Kaposi`s sarcoma, radiotherapy can achieve local control-whereas it obtains good palliative results in the epidemic form. (author)

  4. Technological advances in radiotherapy for esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Milan; Vosmik; Jiri; Petera; Igor; Sirak; Miroslav; Hodek; Petr; Paluska; Jiri; Dolezal; Marcela; Kopacova

    2010-01-01

    Radiotherapy with concurrent chemotherapy and surgery represent the main treatment modalities in esophageal cancer.The goal of modern radiotherapy approaches,based on recent technological advances,is to minimize post-treatment complications by improving the gross tumor volume definition (positron emission tomography-based planning),reducing interfraction motion (image-guided radiotherapy) and intrafraction motion (respiratory-gated radiotherapy),and by better dose delivery to the precisely defined planning ...

  5. A 3-marker index improves the identification of iron disorders in CKD anaemia.

    Directory of Open Access Journals (Sweden)

    Lucile Mercadal

    Full Text Available BACKGROUND: Iron disorders are common and complex in chronic kidney disease (CKD. We sought to determine whether a 3-marker index would improve the classification of iron disorders in CKD anaemia. METHODS: We studied the association between Hb level and iron indexes combining 2 or 3 of the following markers: serum ferritin (<40 ng/mL, transferrin saturation (TSAT<20% and total iron binding capacity (TIBC<50 µmol/L in 1011 outpatients with non-dialysis CKD participating in the Nephrotest study. All had glomerular filtration rates measured (mGFR by (51Cr-EDTA renal clearance; 199 also had hepcidin measures. RESULTS: The TSAT-TIBC-ferritin index explained Hb variation better than indexes combining TSAT-TIBC or ferritin-TSAT. It showed hypotransferrinaemia and non-inflammatory functional iron deficiency (ID to be more common than either absolute or inflammatory ID: 20%, 19%, 6%, and 2%, respectively. Hb was lower in all abnormal, compared with normal, iron profiles, and decreased more when mGFR was below 30 mL/min/1.73 m(2 (interaction p<0.0001. In patients with mGFR<30 mL/min/1.73 m(2, the Hb decreases associated with hypotransferrinaemia, non-inflammatory functional ID, and absolute ID were 0.83±0.16 g/dL, 0.51±0.18 and 0.89±0.29, respectively. Compared with normal iron profiles, hepcidin was severely depressed in absolute ID but higher in hypotransferrinaemia. CONCLUSIONS: The combined TSAT-TIBC-ferritin index identifies hypotransferrinaemia and non-inflammatory functional ID as the major mechanisms of iron disorders in CKD anaemia. Both disorders were associated with a greater decrease in Hb when mGFR was <30 mL/min/1.73 m(2. Taking these iron profiles into account may be useful in stratifying patients in clinical trials of CKD anaemia and might improve the management of iron therapy.

  6. Estimation of eye absorbed doses in head & neck radiotherapy practices using thermoluminescent detectors

    Directory of Open Access Journals (Sweden)

    Gh Bagheri

    2011-09-01

    Full Text Available  Determination of eye absorbed dose during head & neck radiotherapy is essential to estimate the risk of cataract. Dose measurements were made in 20 head & neck cancer patients undergoing 60Co radiotherapy using LiF(MCP thermoluminescent dosimeters. Head & neck cancer radiotherapy was delivered by fields using SAD & SSD techniques. For each patient, 3 TLD chips were placed on each eye. Head & neck dose was about 700-6000 cGy in 8-28 equal fractions. The range of eye dose is estimated to be (3.49-639.1 mGy with a mean of maximum dose (98.114 mGy, which is about 3 % of head & neck dose. Maximum eye dose was observed for distsnces of about 3 cm from edge of the field to eye.

  7. [Carcinoma of the cervix uteri--the morphological changes after preoperative radiotherapy].

    Science.gov (United States)

    Veselinova, T; Ivanova, R; Gorchev, G; Tsvetkov, Ch

    1998-01-01

    A retrospective morphological research is made on 11 patients with squamous cell carcinoma of the cervix for a three-years period of time (1995-1997). Preoperative radiotherapy (intracavitary radiotherapy with Cs and/or external radiation) is carried out. A control group of 10 patients with cancer of uterine cervix without preoperative radiotherapy is also studied. All of the women undergo a wider hysterectomy by the method of Piver class IV. The radiation alterations in the tumor and the surrounding normal uterine tissues are also researched. A full regression of the tumor Ts size. There are demonstrative changes in the tumor and surrounding normal tissues, which are the prove the answer to the ionizing irradiation.

  8. Hyperthermia and radiotherapy

    International Nuclear Information System (INIS)

    Combined hyperthermia (HT 45 min once or twice per week) and low dose radiotherapy (LDRT 30-34.5 Gy in 2-3 weeks) have been given to 182 locally recurrent or metastatic superficial tumours in 133 patients. Tumour response was analysed in 137 tumours in 100 patients. The overall complete response (CR) was 50% with a median duration (DCR) of 13±3 months. When mammary carcinoma, representing 62% of the treated tumours, were analysed, CR was 62% with a DCR of 14±4 months. In a comparative, non-randomized study, on 34 matched tumour pairs in 24 patients, treatment was given with LDRT+HT to the larger and the same LDRT to the smaller tumour, the patients acting as their own control. A significant difference in CR was obtained in favour of the combined treatment (p=0.0013 all diagnosis and p=0.0027 mammary carcinoma). There was no significant difference in DCR between the two modalities. No significant difference in CR was seen when tumours were randomely treated with HT once (CR 56%) or twice (CR 69%) per week combined with the same LDRT. Predictive factors for CR, multivariately analysed (15 parameters), in mammary carcinoma recurring in earlier irradiated regions, were; the present LDRT absorbed dose (p=0.02) and the average minimum temperature in the best HT session (p=0.03). Significant skin toxicity was seen in 28% of all the 182 heated regions. Prognostic factors for skin damage, multivariately analysed, were; the extension of the heated region (p=0.007) and the highest average maximum temperature in any of the HT sessions (p=0.04). Pain was in some way correlated to severe toxicity but was not considered to be an optimal monitor for HT as many patients with severe and moderate pain were without any serious skin reactions, while slight or no pain sometimes were associated with severe reactions. 401 refs

  9. Dosimetry in radiotherapy. V.2

    International Nuclear Information System (INIS)

    A series of symposia on dosimetry in medicine and biology have been held by the IAEA in co-operation with WHO. The present symposium was the first one focusing on ''Dosimetry in Radiotherapy''. The papers presented reflected the different steps in the calibration chain such as the calibration standards established by the National Standards Laboratories and the conversion of the reading of calibrated instruments to the desired quantity, i.e. absorbed dose to water at a reference point in the user's beam at the radiotherapy clinic. The programme further examined the procedures necessary for optimization of the treatment of the patient, such as treatment planning methods, dose distribution studies, new techniques of dose measurement, improvements in the physical dose distributions/conformation therapy and special problems involved in total body treatments. Results of quality assurance in radiotherapy were presented from local hospitals as well as from national and international studies. Refs, figs and tabs

  10. Dosimetry in radiotherapy. V.1

    International Nuclear Information System (INIS)

    A series of symposia on dosimetry in medicine and biology have been held by the IAEA in co-operation with WHO. The present symposium was the first one focusing on ''Dosimetry in Radiotherapy''. The papers presented reflected the different steps in the calibration chain such as the calibration standards established by the National Standards Laboratories and the conversion of the reading of calibrated instruments to the desired quantity, i.e. absorbed dose to water at a reference point in the user's beam at the radiotherapy clinic. The programme further examined the procedures necessary for optimization of the treatment of the patient, such as treatment planning methods, dose distribution studies, new techniques of dose measurement, improvements in the physical dose distributions/conformation therapy and special problems involved in total body treatments. Results of quality assurance in radiotherapy were presented from local hospitals as well as from national and international studies. Refs, figs and tabs

  11. Computerised tomography in radiotherapy planning

    International Nuclear Information System (INIS)

    This study evaluates the effectiveness of computed tomography as an adjunct to radiotherapy planning. Until recently, acquisition of accurate data concerning tumour anatomy lagged behind other developments in radiotherapy. With the advent of computer-tomography (CT), these data can be displayed and transmitted to a treatment planning computer. It is concluded that the greatest inaccuracies in the radiation treatment of patients are to be found in both the inadequate delineation of the target volume within the patient and changes in body outline relative to the target volume over the length of the irradiated volume. The technique was useful in various subgroups (pelvic, intra-thoracic and chest-wall tumours) and for those patients being treated palliatively. With an estimated improvement in cure rate of 4.5% and cost-effective factors of between 3.3 and 5, CT-assisted radiotherapy planning appears to be a worthwhile procedure. (orig.)

  12. Anaemia and thrombocytopenia in patients with prostate cancer and bone metastases

    Directory of Open Access Journals (Sweden)

    Pawinski Adam

    2010-06-01

    Full Text Available Abstract Background The purpose of this study was to determine the incidence, risk factors and prognostic impact of anaemia and thrombocytopenia in patients with bone metastases (BM from prostate cancer. Methods Retrospective cohort study including 51 consecutive patients treated at a community hospital. Twenty-nine patients (57% received taxotere after diagnosis of BM. Results Haemoglobin (Hb ≤ 12.0 g/dL at BM detection was associated with shorter overall survival. During follow-up, 25 patients (49% experienced episodes with Hb 9/L. All of these had previously received blood transfusion. Median interval from Hb 9/L was 2.5 months. Survival after thrombocytopenia was short (3 weeks to 4 months. Haematuria and subdural haematoma were among the causes of death. Conclusions We found high rates of significant bone marrow failure in treatment-refractory patients. Both Hb 9/L predict for unfavourable survival.

  13. Intestinal parasitic infections and anaemia among pregnant women in the highlands of Papua New Guinea.

    Science.gov (United States)

    Phuanukoonnon, Suparat; Michael, Audrey; Kirarock, Wendy S; Pomat, William S; van den Biggelaar, Anita H J

    2013-01-01

    This study determined the prevalence of intestinal parasitic infections and associations with risk factors among pregnant women in their second or third trimester in Goroka, Eastern Highlands Province, Papua New Guinea. Among the 201 pregnant women enrolled in this study, 163 (81%) were infected with one or more intestinal parasites. Infections with protozoan parasites (65%) were more prevalent than infections with nematodes (31%); protozoan infections included Entamoeba histolytica (43%), Giardia lamblia (39%) and Pentatrichomonas hominis (14%), and nematode infections included hookworm (18%), Ascaris lumbricoides (14%), Strongyloides stercoralis (3%) and Trichuris trichiura (2%). Factors associated with higher risk of intestinal parasitic infections in pregnancy included being a primigravida for protozoan-only infections and education limited to primary school for nematode infections. Altitude-adjusted haemoglobin levels were assessed at the beginning of labour for 110 women, with 69 (63%) found to be anaemic (haemoglobin < 11 g/dl). There were no associations found between being infected in pregnancy and anaemia. PMID:26288929

  14. Asymptomatic Malaria Correlates with Anaemia in Pregnant Women at Ouagadougou, Burkina Faso

    Directory of Open Access Journals (Sweden)

    Zoenabo Douamba

    2012-01-01

    Full Text Available Sub-Saharan Africa records each year about thirty-two million pregnant women living in areas of high transmission of Plasmodium falciparum causing malaria. The aim of this study was to carve out the prevalence of asymptomatic malaria among pregnant women and to emphasize its influence on haematological markers. The prevalence of Plasmodium falciparum asymptomatic infection among pregnant women was 30% and 24% with rapid detection test (RDT and microscopy, respectively. The prevalence of P. falciparum asymptomatic malaria was reduced among pregnant women using sulfadoxine-pyrimethamine's intermittent preventive treatment and 61% of them were anaemic. Anaemia was significantly more common in women infected with P. falciparum compared with the uninfected pregnant women. Most of the women had normal levels of homocysteine and low levels of folate, respectively. Therefore, the systematic diagnosis of malaria should be introduced to pregnant women as a part of the antenatal care.

  15. The Iron Status of Sickle Cell Anaemia Patients in Ilorin, North Central Nigeria

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    Musa A. Sani

    2015-01-01

    Full Text Available Objectives. Sickle cell anaemia (SCA is one of the commonest genetic disorders in the world. It is characterized by anaemia, periodic attacks of thrombotic pain, and chronic systemic organ damage. Recent studies have suggested that individuals with SCA especially from developing countries are more likely to be iron deficient rather than have iron overload. The study aims to determine the iron status of SCA patients in Ilorin, Nigeria. Methods. A cross-sectional study of 45 SCA patients in steady state and 45 non-SCA controls was undertaken. FBC, blood film, sFC, sTfR, and sTfR/log sFC index were done on all subjects. Results. The mean patients’ serum ferritin (589.33 ± 427.61 ng/mL was significantly higher than the mean serum ferritin of the controls (184.53 ± 119.74 ng/mL. The mean serum transferrin receptor of the patients (4.24 ± 0.17 μg/mL was higher than that of the controls (3.96 ± 0.17 μg/mL (p=0.290. The mean serum transferrin receptor (sTfR/log serum ferritin index of the patients (1.65 ± 0.27 μg/mL was significantly lower than that of the control (1.82 ± 0.18 μg/mL (p=0.031. Conclusion. Iron deficiency is uncommon in SCA patients and periodic monitoring of the haematological, biochemical, and clinical features for iron status in SCA patients is advised.

  16. Haematopoietic stem cell transplantation in Nigerian sickle cell anaemia children patients

    Directory of Open Access Journals (Sweden)

    Antonella Isgro

    2015-01-01

    Full Text Available Background: Sickle cell anaemia (SCA remains associated with high risks of morbidity and early death. Children with SCA are at high risk for ischaemic stroke and transient ischaemic attacks, secondary to intracranial arteriopathy involving carotid and cerebral arteries. Allogeneic haematopoietic stem cell transplantation (HSCT is the only curative treatment for SCA. We report our experience with transplantation in a group of patients with the Black African variant of SCA. Patients and Methods: This study included 31 consecutive SCA patients who underwent bone marrow transplantation from human leukocyte antigen (HLA-identical sibling donors between 2010 and 2014 following a myeloablative-conditioning regimen. Results: The median patient age was 10 years (range 2-17 years. Before transplantation, 14 patients had recurrent, painful, vaso-occlusive crisis; ten patients had recurrent painful crisis in association with acute chest syndrome; three patients experienced ischaemic stroke and recurrent vaso-occlusive crisis; two patients experienced ischaemic stroke; one patient exhibited leukocytosis; and one patient exhibited priapism. Of the 31 patients, 28 survived without sickle cell disease, with Lansky/Karnofsky scores of 100. All surviving patients remained free of any SCA-related events after transplantation. Conclusion: The protocols used for the preparation to the transplant in thalassaemia are very effective also in the other severe haemoglobinopathy as in the sickle cell anaemia with 90% disease free survival. Today, if a SCA patient has a HLA identical family member, the cellular gene therapy through the transplantation of the allogeneic haemopoietic cell should be performed. Tomorrow, hopefully, the autologous genetically corrected stem cell will break down the wall of the immunological incompatibility.

  17. Evidence that plasma concentration rather than dose per kilogram body weight predicts ribavirin-induced anaemia.

    Science.gov (United States)

    Lindahl, K; Schvarcz, R; Bruchfeld, A; Ståhle, L

    2004-01-01

    Ribavirin in combination with interferon alpha-2 or pegylated interferon is the standard treatment for chronic hepatitis C. The current dosage recommendations for ribavirin are based on body weight (bw). Ribavirin is mainly eliminated by the kidneys and we have recently shown that ribavirin plasma concentrations are determined primarily by renal function. It is therefore reasonable to hypothesize that side-effects of ribavirin, i.e. anaemia, should be more closely related to plasma concentrations of ribavirin than to the dose per kg bw. A total of 108 consecutive patients eligible for treatment of chronic hepatitis C were studied. Ribavirin concentrations in plasma were measured by high-performance liquid chromatography (HPLC)-UV after solid-phase extraction in trough samples taken 4, 8 and 12 weeks after the treatment commenced. A total of 213 samples were obtained and the change in the haemoglobin level and the creatinine concentration was measured in addition to ribavirin. The dose of ribavirin per kg bw did not correlate with the drop in haemoglobin level induced by ribavirin. The concentration of ribavirin was non-linearly related to the drop in the haemoglobin level as revealed by fitting a standard Hill equation type dose-response curve. The half maximal drop in haemoglobin was obtained at 4.4 microm. The results from this study suggest that the anaemia induced by ribavirin depends primarily on the concentration of ribavirin, and not on the dose per kg bw. This lends further support to the idea that ribavirin should be dosed according to renal function.

  18. Defective lipid metabolism in sickle cell anaemia subjects in vaso-occlusive crisis

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    Kehinde Sola Akinlade

    2014-01-01

    Full Text Available Background: Abnormal lipid homeostasis has been reported in sickle cell anaemia (SCA as well as in other haematological disorders. However, there is little information on the lipid profile of SCA subjects in vaso-occlusive crisis (VOC. This study determined the lipid profile of adult SCA subjects in VOC and in steady state (SSCA. Materials and Methods: Fifty-eight (58 adults with HbSS (30 in steady state and 28 in vaso-occlusive crisis and 24 age-matched healthy individuals with HbAA genotype were recruited into this study. Standard methods were used for the determination of blood pressure (BP, packed cell volume (PCV, total white blood cell count (WBC and haemoglobin phenotype. After an overnight fast, 5 ml of venous blood was obtained from each SSCA and the controls while samples were collected upon admission in the VOC group. Plasma lipid profile was determined using enzymatic method. Differences between two groups were determined using independent Student′s t-test or Man-Whitney U as appropriate. P-values less than 0.05 were considered significant. Results: Plasma total cholesterol (TC and high density lipoprotein (HDL were significantly lower while the ratio of triglyceride (TG to HDL (TG/HDL was significantly higher in SSCA compared with the controls. Low density lipoprotein (LDL and TC were significantly lower in SCA subjects in VOC compared with controls. However, TC, TG, LDL and TG/HDL were significantly lower while HDL was significantly higher in VOC compared with SSCA. Conclusion: Sickle cell anaemia subjects have defective fasting lipid metabolism which becomes pronounced with VOC.

  19. Photoscanning of the Spleen Using Heat-Treated Cr51-Labelled Erythrocytes in Congenital Haemolytic Anaemias

    International Nuclear Information System (INIS)

    The delineation of the spleen by photoscanning after the intravenous injection of heat-treated Cr51-labelled erythrocytes is valuable when investigating congenital haemolytic anaemias, especially thalassaemia, a disease which is recognized as one of the most important public health problems in Greece. Heat-treated Cr51-labelled erythrocytes were prepared as follows: blood was taken from the subject by venepuncture and delivered into a sterile bottle containing acid-citrate-dextrose. The red cells were separated by centrifugation and the plasma discarded. 50 - 150 μc Cr51-chromate was added to the red cells and the mixture allowed to stand for 30 min at room temperature. The labelled cells were washed once with saline and re-suspended in saline. The suspension was heated at 49.5°C for one hour. The heated cells were washed once with saline and re-suspended in saline. The suspension was then injected intravenously into the subject. Scanning was performed one hour later. Cases of thalassaemia major, sickle cell haemoglobin/thalassaemia and thalassaemia trait have been investigated by this method. All the cases studied, with the exception of one carrier of thalassaemia trait, whose spleen was not palpable, showed varying degrees of splenomegaly. The size and configuration of the spleen could be well demonstrated. A constant finding in spleen scans on patients with congenital haemolytic anaemia, not observed in scans on normal subjects, was the presence of regions of lower average radioactivity throughout the organ. The interpretation of this finding is discussed. (author)

  20. Does recombinant human erythropoietin accelerate correction of post-ulcer-bleeding anaemia? A pilot study

    Institute of Scientific and Technical Information of China (English)

    Spiros D. Ladas; Dimitrios Polymeros; Thomas Pagonis; Konstantinos Triantafyllou; Gregorios Paspatis; Maria Hatziargiriou; Sotirios A.Raptis

    2004-01-01

    AIM: Anaemia caused by acute upper gastrointestinal bleeding is treated with blood transfusion or iron, but patients usually face a two-month recovery period from posthaemorrhage anaemia. This prospective, randomised, open,pilot study was designed to investigate whether recombinant human erythropoietin (Epoetin) therapy accelerate haematocrit increase in the post-bleeding recovery period.METHODS: We studied hospitalised patients admitted because of acute ulcer bleeding or haemorrhagic gastritis,who had a haematocrit of 27-33% and did not receive blood transfusions. One day after the endoscopic confirmation of cessation of bleeding, they were randomised either to erythropoietin (20 000 IU Epoetin alfa subcutaneously, on days 0, 4 and 6) plus iron (100 mg im, on days 1- 6, (G1) or iron only (G2). Haematocrit was measured on days 0, 6, 14,30, 45, and 60, respectively.RESULTS: One patient from G1 and two from G2 were lost to follow-up. Therefore, 14 and 13 patients from G1 and G2respectively were analysed. Demographic characteristics, serum iron, ferritin, total iron binding capacity, reticulocytes, and haematocrit were not significantly different at entry to the study.Median reticulocyte counts were significantly different between groups on day six (G1: 4.0, 3.0-6.4 vsG2: 3.5, 2.1-4.4%,P=0.03) and median haematocrit on day fourteen [G1: 35.9,30.7-41.0 vsG2: 32.5, 29.5-37.0% (median, range), P=0.04].CONCLUSION: Erythropoietin administration significantly accelerates correction of anemia after acute ulcer bleeding.The haematocrit gain is equivalent to one unit of transfused blood two weeks after the bleeding episode.

  1. Molecular characterization of two different strains of haemotropic mycoplasmas from a sheep flock with fatal haemolytic anaemia, concomitant Anaplasma ovis infection

    OpenAIRE

    Hornok, Sándor; Meli, Marina L; Erdős, András; Hajtós, István; Lutz, Hans; Hofmann-Lehmann, Regina

    2009-01-01

    Molecular characterization of two different strains of haemotropic mycoplasmas from a sheep flock with fatal haemolytic anaemia, concomitant Anaplasma ovis infection HUNGARY (Hornok, Sandor) HUNGARY Received: 2008-08-03 Revised: 2008-10-27 Accepted: 2008-10-29

  2. DETECTION OF A RARE BLOOD GROUP “BOMBAY (OH PHENOTYPE” IN A POST CAESAREAN PREGNANCY WITH ANAEMIA - A RARE CASE REPORT FROM EASTERN INDIA

    Directory of Open Access Journals (Sweden)

    Anindya Kumar

    2013-10-01

    Full Text Available ABSTRACT: The Bombay blood group is a very rare blood group discovered almost 60 years back. We report here, a high risk case of Post Caesarean pregnancy with anaemia with Bombay Blood Group

  3. Treatment practice for IBD-associated anaemia remains out of tune with recommendations - A two year follow-up survey in five European countries

    DEFF Research Database (Denmark)

    Stein, Jürgen; Bager, Palle; Befrits, Ragnar;

    Background: In 2009, a survey on anaemia management in patients with inflammatory bowel disease (IBD) revealed that treatment practice is not in line with treatment recommendations. Despite a high prevalence of severe anaemia and absolute iron deficiency, most patients received oral instead...... of intravenous (i.v.) iron. Since additional data on effective correction of anaemia with i.v. iron emerged in the meantime (FERGIcor), a new survey was performed in 2011 to evaluate whether treatment practice changed. Methods: Gastroenterologists in France, Germany, Spain, UK and Switzerland completed...... questionnaires (Jun-Aug 2011) on patient demographics, blood tests at diagnosis and therapies for the last five IBD patients treated for anaemia within six months. Results are totals over all patients and ranges across countries. Results: 142 gastroenterologists (97 hospital-based only) reported 710 cases of IBD...

  4. Construction of a remote radiotherapy planning system

    International Nuclear Information System (INIS)

    We constructed a remote radiotherapy planning system, and we examined the usefulness of and faults in our system in this study. Two identical radiotherapy planning systems, one installed at our institution and the other installed at an affiliated hospital, were used for radiotherapy planning. The two systems were connected by a wide area network (WAN), using a leased line. Beam data for the linear accelerator at the affiliated hospital were installed in the two systems. During the period from December 2001 to December 2002, 43 remote radiotherapy plans were made using this system. Data were transmitted using a file transfer protocol (FTP) software program. The 43 radiotherapy plans examined in this study consisted of 13 ordinary radiotherapy plans, 28 radiotherapy plans sent to provide assistance for medical residents, and 2 radiotherapy plans for emergency cases. There were ten minor planning changes made in radiotherapy plans sent to provide assistance for medical residents. Our remote radiotherapy planning system based on WAN using a leased line is useful for remote radiotherapy, with advantages for both radiation oncologists and medical residents. (author)

  5. Thalassaemic osteoarthropathy treated with radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Davies, A.N. (King' s Coll. Hospital, London (United Kingdom))

    1993-11-01

    Patients with beta thalassaemia may develop a specific osteoarthropathy involving the feet. A number of different treatments for this condition have been tried, including rest, analgesia and hypertransfusion. We report a case of a patient with thalassaemic osteoarthropathy who responded to radiotherapy after failing conventional treatment. (author).

  6. Computerised tomography in radiotherapy planning

    NARCIS (Netherlands)

    P.C. Badcock (Peter)

    1983-01-01

    textabstractSuccessful radiotherapy practice depends on the irradiation of tumours such that their destruction follows without unacceptable damage of the surrounding normal tissues. Until recently the accurate acquisition of data concerning the tumour anatomy lagged behind other developments in radi

  7. CHRONIC ENTERITIS IN PATIENTS UNDERGOING PELVIC RADIOTHERAPY: PREVALENCE, RISK FACTORS AND ASSOCIATED COMPLICATIONS.

    Science.gov (United States)

    Hernández-Moreno, Ana; Vidal-Casariego, Alfonso; Calleja-Fernández, Alicia; Kyriakos, Georgios; Villar-Taibo, Rocío; Urioste-Fondo, Ana; Cano-Rodríguez, Isidoro; Ballesteros-Pomar, María D

    2015-11-01

    Introducción: la radiacion de los tumores de la cavidad pelvica puede provocar mucositis a nivel intestinal. El objetivo de nuestro estudio fue determinar la prevalencia, los factores de riesgo y las complicaciones de la enteritis radica cronica en los pacientes tratados con radioterapia pelvica. Pacientes y métodos: estudio transversal sobre 150 pacientes tratados con radioterapia pelvica durante el ano 2008 debido a un cancer de prostata, cervix, endometrio o recto. Se interrogo a los pacientes sobre la presencia de sintomas sugestivos de enteritis y sobre cambios en el peso habitual y modificaciones en su dieta. Los parametros considerados como posibles factores de riesgo de enteritis cronica (sexo, edad, tratamiento antitumoral, enteritis aguda previa y tipo de tumor) se analizaron con metodos univariantes y multivariantes. Resultados: el estudio incluyo finalmente a 100 pacientes, el 84% varones, con una mediana de edad de 72,3 anos. Se encontro una prevalencia de enteritis radica cronica del 20%, en la mayoria de grado 1 (45%). Por otra parte, el 10% referian una perdida de peso ≥ 5 kg, el 3% habian requerido hospitalizacion debido a diarrea incoercible o a obstruccion intestinal, y el 11% habian modificado su patron de alimentacion habitual, reduciendo principalmente el consumo de verduras, legumbres y dulces. Se encontro asociacion entre la enteritis radica cronica y el sexo masculino, la edad, la enteritis radica aguda previa y la quimioterapia, pero solo esta resulto asociarse de forma independiente con el desarrollo de enteritis radica cronica despues del analisis multivariante (OR = 3,59 [95% CI 1,20–10,73]). Conclusión: la enteritis cronica es una entidad frecuente en los pacientes tratados con radioterapia pelvica, sobre todo cuando se asocia con quimioterapia. La tasa de complicaciones por esta patologia es baja, pero un numero importante de pacientes realiza modificaciones en su dieta habitual para aliviar o evitar la sintomatologia derivada de aquella.

  8. STOMATOLOGIC STATUS IN PATIENTS WITH MALIGNANT NEOPLASMS OF MAXILLOFACIAL REGION UNDERGOING CHEMOTHERAPY AND RADIOTHERAPY

    Directory of Open Access Journals (Sweden)

    Olga Shpulina

    2013-06-01

    Full Text Available The aim of this study was to evaluate the early acute side effects following radiation and chemotherapy in patients with head and neck cancer (HNC, namely: to ascertain main patient complaints; to investigate saliva properties and to determine the microecology of the oral cavity in patient with HNC before and after radiation and chemotherapy. Eighteen patients with HNC which were prescribed gamma therapy on two buccal submandibular fields combined with close-focus roentgenotherapy and methotrexate as a cytostatic were examined. It was established that 3 weeks after the radio- and chemotherapy 100 % of patients pointed at xerostomia, dysgeusia, disturbances during speech, burning, pricking and itching in oral cavity. After cancer treatment the speed of salivation decreased two times and pH was 15 % lower than before radio and chemotherapy. Anti-cancer treatment caused significant decrease of lysozyme level (34 % lower and secretory immunoglobulin A (1,5 times lower in patients with HNC. After radio and chemotherapy different fungi of Candida genus from oral cavity were inoculated in high concentrations (from 4,0 ± 0.07 to 6,9 ± 0.07 lg CFU/ml, such as С. Аlbicans, C. Kruzei, С. Tropicalis, C. Stellatoidea.Thus significant negative changes from the side of speed and character of salivation, decrease of saliva pH, depression of both non-specific and specific components of immune defense and high contamination of oral mucosa with fungi of Candida genus considerably worsenpost-cancer rehabilitation.

  9. Management of predictable pain using fentanyl pectin nasal spray in patients undergoing radiotherapy

    OpenAIRE

    Bell, Brent

    2013-01-01

    Brent C Bell, E Brian Butler Department of Radiation Oncology, Houston Methodist Hospital, The Texas Medical Center, Houston, TX, USA Background: Studies report the need for improved pain management in the radiation oncology setting. Many patients with well controlled background pain experience breakthrough pain in cancer (BTPc) that can interrupt their treatment schedule with a potentially negative impact on outcomes. BTPc can be unpredictable and predictable; both types of pain can be mana...

  10. Relationship of anaemia and morbidities among children aged 5-14 years in a resettlement area, Delhi

    Directory of Open Access Journals (Sweden)

    Pankaj Motilal Kasdekar

    2015-06-01

    Full Text Available Partnership for Child Development (1998, “The anthropometric status of school children in five countries in the Partnership for Child Development”. Proceedings of the Nutrition Society 57: 149- 158.World Health Organization. Anaemia. WHO (2010.World Health Organization (WHO. WHO global database on anaemia: Worldwide prevalence of anaemia 1993-2005. Ge¬neva: WHO, 2008a. [Cited 2014 Aug 24]. Available from: URL: http://www.who. int/vmnis/anaemia/prevalence/en/index. htmlWorld Health Organization (WHO. Health in Asia and the Pacific: Reproductive health, child and adolescent health, nutrition, and health for older persons. Geneva: WHO, 2008b. [Cited 2014 Jul 6]. Available from: URL: http://www.wpro.who.int/publica-tions/Health+in+Asia+and+the+Pacific. Html. National Family Health Survey (NFHS-3 (2005-06, Nutrition in India, Ministry of Health and Family Welfare Government of India,World Health Organisation. Criteria Anaemia 1985; WHO.World Bank.Rema N, Vasanthamani G. Prevalence of nutritional and lifestyle disorders among school going children in urban and rural areas of Coimbatore, Tamilnadu: Indian Journal of Science and Technology 2011; Vol. 4 (2.Bhoite R, et al. Magnitude of malnutrition and Iron deficiency anaemia among rural school children: Asian J Exp Biol Sci 2003; Vol 2(2: 354-361.Handa R, Ahamad F, Prasad R, “Assessment of nutritional status of 7-10    Years School going children of Allahabad District”. Middle-East Journal of Scientific Research 2008; 3(3:109-115.Verma A, et al. Factors influencing anaemia among girls of school going age (6-18 years from the slums of Ahmedabad city. IJCM 2004; Vol 29 (1.Hasan I, Zulkifle M, A study of malnutrition in government school children in the field area of azad nagar Bangalore, India. (MD thesis.2010.Dept. of preventive and social medicine; National Institute of Unani Medicine.Ananthakrishnan S, Pani SP, Nalini P. A comprehensive study of morbidity in school age children. Indian

  11. Similar Treatment Outcomes for Radical Cystectomy and Radical Radiotherapy in Invasive Bladder Cancer Treated at a United Kingdom Specialist Treatment Center

    International Nuclear Information System (INIS)

    Purpose: To conduct a retrospective analysis within a large university teaching hospital, comparing outcomes between patients receiving either radical surgery or radiotherapy as curative treatment for bladder cancer. Patients and Methods: Between March 1996 and December 2000, 169 patients were treated radically for muscle-invasive bladder cancer. Data were collected from patient notes. Statistical analyses were performed using Kaplan-Meier methods and Cox proportional hazards regression analysis to compare radiotherapy and surgical outcome data. Results: There was no difference in overall, cause-specific, and distant recurrence-free survival at 5 years between the two groups, despite the radiotherapy group being older (median age, 75.3 years vs. 68.2 years). There were 31 local bladder recurrences in the radiotherapy group (24 solitary), but there was no significant difference in distant recurrence-free survival. In a more recent (2002-2006) cohort, the median age of radiotherapy patients but not the cystectomy patients was higher than in the 1996-2000 cohort (78.4 years vs. 75.3 years for radiotherapy and 67.9 years vs. 68.2 years for surgery). Conclusions: Although the patients undergoing radical cystectomy were significantly younger than the radiotherapy patients, treatment modality did not influence survival. Bladder cancer patients are an increasingly elderly group. Radical radiotherapy is a viable treatment option for these patients, with the advantage of organ preservation

  12. Palliative radiotherapy: current status and future directions.

    Science.gov (United States)

    Sharma, Sonam; Hertan, Lauren; Jones, Joshua

    2014-12-01

    For nearly 100 years, palliative radiotherapy has been a time-efficient, effective treatment for patients with metastatic or advanced cancer in any area where local tumors are causing symptoms. Short courses including a single fraction of radiotherapy may be effective for symptom relief with minimal side effects and maximization of convenience for patient and family. With recent advances in imaging, surgery, and other local therapies as well as systemic cancer therapies, palliative radiotherapy has been used frequently in patients who may not yet have symptoms of advanced or metastatic cancer. In this setting, more prolonged radiotherapy courses and advanced radiotherapy techniques including intensity-modulated radiotherapy (IMRT) or stereotactic radiotherapy (SRT) may be useful in obtaining local control and durable palliative responses. This review will explore the use of radiotherapy across the spectrum of patients with advanced and metastatic cancer and delineate an updated, rational approach for the use of palliative radiotherapy that incorporates symptoms, prognosis, and other factors into the delivery of palliative radiotherapy. PMID:25499634

  13. Impact of anaemia on lung function and exercise capacity in patients with stable severe chronic obstructive pulmonary disease

    OpenAIRE

    Guo, Jian; Zheng, Cong; Xiao, Qiang; Gong, Sugang; Zhao, Qinhua; Wang, Lan; He, Jing; Yang, Wenlan; Shi, Xue; Sun, Xingguo; Liu, Jinming

    2015-01-01

    Objective This study intended to search for potential correlations between anaemia in patients with severe chronic obstructive pulmonary disease (COPD; GOLD stage III) and pulmonary function at rest, exercise capacity as well as ventilatory efficiency, using pulmonary function test (PFT) and cardiopulmonary exercise testing (CPET). Setting The study was undertaken at Shanghai Pulmonary Hospital, a tertiary-level centre affiliated to Tongji University. It caters to a large population base with...

  14. Iron deficiency anaemia in pre-school (1- 6 years) in Al Shigla area (Khartoum State) :Prevalence and Aetiology

    International Nuclear Information System (INIS)

    iron deficiency anaemia (IDA) is a public health problem throughout the world. Childhood iron deficiency anaemia. A prospective survey (systematic, cluster sampling) was carried out among pre-school children in Alshigla area (Khartoum State), to study the prevalence and aetological factors of IDA. 170 children selected for general nutritional evaluation, 110 of them for haemoglobin levels and morphological classification of anaemia, 70 for further investigations(serum iron, unsaturated iron binding capacity, total iron binding capacity). The population at Alshigla were living in poor condition 85.3% relied on water brought by tankers which showed poor hygienic standard, 90% lived in extended families 54.1% had income level less than LS 3000/day irrespective of family size or mode of spending. A sample of 170 children showed (84.1%) normal nutritional status with 4.7% severe cases with high consumption of cereals low meat, fish and poultry group and vitamin C(22.9%). Disease episodes showed 67.7% had diarrhoea, 22.4% had giardia, 12.9% had malaria and 10.6% had worm infestation. This most probably due to unsanitary living condition. Haemoglobin analysis using Enzyme Linked Immunosorbent assay technique (ELISA) for 110 of the children, showed high prevalence of anaemia (96.4%), 66% prevalence of IDA. Further haematological investigations of 50 of the children confirmed them as IDA cases.Thus the high prevalence of IDA in Alshigla was multi-factorial, inadequate take of dietary iron and of vitamin C, high intake of cereals and legumes, low intake of meat, poultry and fish group (MPF),and high tea consumption, thus food provides inadequate supply of iron and were rich in inhibitors of iron absorption. In addition episodes of diseases that may influence food (hence iron) utilisation contributed to the prevalence of IDA

  15. Prevalence of Anaemia among Pregnant Women at Booking in the University of Uyo Teaching Hospital, Uyo, Nigeria

    Directory of Open Access Journals (Sweden)

    Olujimi A. Olatunbosun

    2014-01-01

    Full Text Available Background. Anaemia with an estimated prevalence of 35–75% among pregnant women is a major cause of maternal deaths in Nigeria. Objective. To determine the prevalence of anaemia, associated sociodemographic factors and red cell morphological pattern among pregnant women during booking at the University Teaching Hospital, Uyo. Material and Methods. A cross-sectional analytical study of 400 women at the booking clinic over a 16-week period. The packed cell volume and red cell morphology of each pregnant woman were determined. Their biodata, obstetric and medical histories, and results of other routine investigations were obtained with questionnaires and analyzed with SPSS Package version 17.0. Results. The mean packed cell volume was 31.8% ±3.2 and 54.5% of the women were anaemic. The commonest blood picture was microcytic hypochromia and normocytic hypochromia suggesting iron deficiency anaemia. Anaemia was significantly and independently related to a history of fever in the index pregnancy (OR=0.4; P=0.00; 95% CI=0.3–0.7, HIV positive status (OR=0.2; P=0.01; 95% CI=0.1–0.6, and low social class (OR=0.3; P=0.00; 95% CI=0.2–0.7. Conclusion. Women need to be economically empowered and every pregnant woman should be encouraged to obtain antenatal care, where haematinics supplementation can be given and appropriate investigations and treatment of causes of fever and management of HIV can be instituted.

  16. Effects of Vitamin A Supplementation on Iron Status Indices and Iron Deficiency Anaemia: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Hesham M. Al-Mekhlafi

    2013-12-01

    Full Text Available Iron deficiency anaemia (IDA is the most common nutritional deficiency in the world including developed and developing countries. Despite intensive efforts to improve the quality of life of rural and aboriginal communities in Malaysia, anaemia and IDA are still major public health problems in these communities particularly among children. A randomized, double-blind, placebo-controlled trial was conducted on 250 Orang Asli (aboriginal schoolchildren in Malaysia to investigate the effects of a single high-dose of vitamin A supplementation (200,000 IU on iron status indices, anaemia and IDA status. The effect of the supplement was assessed after 3 months of receiving the supplements; after a complete 3-day deworming course of 400 mg/day of albendazole tablets. The prevalence of anaemia was found to be high: 48.5% (95% CI = 42.3, 54.8. Moreover, 34% (95% CI = 28.3, 40.2 of the children had IDA, which accounted for 70.1% of the anaemic cases. The findings showed that the reduction in serum ferritin level and the increments in haemoglobin, serum iron and transferrin saturation were found to be significant among children allocated to the vitamin A group compared to those allocated to the placebo group (p < 0.01. Moreover, a significant reduction in the prevalence of IDA by almost 22% than prevalence at baseline was reported among children in the vitamin A group compared with only 2.3% reduction among children in the placebo group. In conclusion, vitamin A supplementation showed a significant impact on iron status indices and IDA among Orang Asli children. Hence, providing vitamin A supplementation and imparting the knowledge related to nutritious food should be considered in the efforts to improve the nutritional and health status of these children as a part of efforts to improve the quality of life in rural and aboriginal communities.

  17. Effects of vitamin A supplementation on iron status indices and iron deficiency anaemia: a randomized controlled trial.

    Science.gov (United States)

    Al-Mekhlafi, Hesham M; Al-Zabedi, Ebtesam M; Al-Maktari, Mohamed T; Atroosh, Wahib M; Al-Delaimy, Ahmed K; Moktar, Norhayati; Sallam, Atiya A; Abdullah, Wan Ariffin; Jani, Rohana; Surin, Johari

    2013-12-31

    Iron deficiency anaemia (IDA) is the most common nutritional deficiency in the world including developed and developing countries. Despite intensive efforts to improve the quality of life of rural and aboriginal communities in Malaysia, anaemia and IDA are still major public health problems in these communities particularly among children. A randomized, double-blind, placebo-controlled trial was conducted on 250 Orang Asli (aboriginal) schoolchildren in Malaysia to investigate the effects of a single high-dose of vitamin A supplementation (200,000 IU) on iron status indices, anaemia and IDA status. The effect of the supplement was assessed after 3 months of receiving the supplements; after a complete 3-day deworming course of 400 mg/day of albendazole tablets. The prevalence of anaemia was found to be high: 48.5% (95% CI=42.3, 54.8). Moreover, 34% (95% CI=28.3, 40.2) of the children had IDA, which accounted for 70.1% of the anaemic cases. The findings showed that the reduction in serum ferritin level and the increments in haemoglobin, serum iron and transferrin saturation were found to be significant among children allocated to the vitamin A group compared to those allocated to the placebo group (pchildren in the vitamin A group compared with only 2.3% reduction among children in the placebo group. In conclusion, vitamin A supplementation showed a significant impact on iron status indices and IDA among Orang Asli children. Hence, providing vitamin A supplementation and imparting the knowledge related to nutritious food should be considered in the efforts to improve the nutritional and health status of these children as a part of efforts to improve the quality of life in rural and aboriginal communities.

  18. Mechanism of anaemia in rheumatoid arthritis: demonstration of raised interleukin 1 beta concentrations in anaemic patients and of interleukin 1 mediated suppression of normal erythropoiesis and proliferation of human erythroleukaemia (HEL) cells in vitro.

    OpenAIRE

    Maury, C P; Andersson, L C; Teppo, A M; Partanen, S. (Sari); Juvonen, E

    1988-01-01

    The pathogenesis of the anaemia associated with rheumatoid disease is unclear. It has previously been shown that the degree of the anaemia correlates with the severity of the inflammatory disease and that serum from patients with arthritis inhibits erythropoiesis. This study was designed to examine whether interleukin 1 could be a mediator of the anaemia in rheumatoid arthritis. Radioimmunoassay of interleukin 1 beta in serum showed that patients with rheumatoid arthritis and associated anaem...

  19. Impact of Pentoxifylline and Vitamin E on Ribavirin-Induced Haemolytic Anaemia in Chronic Hepatitis C Patients: An Egyptian Survey

    Directory of Open Access Journals (Sweden)

    M. Assem

    2011-01-01

    Full Text Available Background/Aim. We evaluate the impact of combined pentoxifylline and high-dose vitamins E to standard antiviral treatment on RBV-induced haemolytic anaemia. Patients and Methods. Selected 200 naïve chronic HCV patients, were randomized to receive either the standard antiviral therapy (peginterferon α-2b and RBV plus pentoxifylline (800 mg and high-dose vitamin E (1000 iu daily (combined group or received standard antiviral therapy plus placebo only (control group. They were followed up during treatment course and for 6 months posttreatment to assess the occurrence of anaemia and virological response, respectively. Results. RBV dose modification due to anaemia were significantly less in combined group (8.5 versus 21.5%. P<.05.Withdrawal, secondary to sever anemia (Hb<8.5 gm%, was recorded only in 6 (28.6% patients of the control group. Both (ETR and (SVR were significantly higher in combined group than control group by both intention-to-treat analysis (71 versus 56%, P<.05 and 66 versus 49%, P<.05 and per-protocol analysis (85.5 versus 70.9%, P<.05 and 79.5 versus 62%, P<.05. Conclusion. Pentoxifylline and vitamin E can ameliorate RBV-associated haemolysis; improve compliance and virologic clearance when combined with the standard antiviral therapy in patients with chronic hepatitis C.

  20. Seasonal intermittent preventive treatment for the prevention of anaemia and malaria in Ghanaian children: a randomized, placebo controlled trial.

    Directory of Open Access Journals (Sweden)

    Margaret Kweku

    Full Text Available BACKGROUND: Malaria and anaemia are the leading causes of morbidity and mortality in children in sub-Saharan Africa. We have investigated the effect of intermittent preventive treatment with sulphadoxine-pyrimethamine or artesunate plus amodiaquine on anaemia and malaria in children in an area of intense, prolonged, seasonal malaria transmission in Ghana. METHODS: 2451 children aged 3-59 months from 30 villages were individually randomised to receive placebo or artesunate plus amodiaquine (AS+AQ monthly or bimonthly, or sulphadoxine-pyrimethamine (SP bimonthly over a period of six months. The primary outcome measures were episodes of anaemia (Hb1 year old when they received IPTc compared to the placebo group. However the incidence of malaria in the post intervention period was higher in children who were <1 year old when they received AS+AQ monthly compared to the placebo group. INTERPRETATION: IPTc is safe and efficacious in reducing the burden of malaria in an area of Ghana with a prolonged, intense malaria transmission season. TRIAL REGISTRATION: ClinicalTrials.gov NCT00119132.

  1. Bladder Preservation for Localized Muscle-Invasive Bladder Cancer: The Survival Impact of Local Utilization Rates of Definitive Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: This study examines the management and outcomes of muscle-invasive bladder cancer in the United States. Methods and Materials: Patients with muscle-invasive bladder cancer diagnosed between 1988 and 2006 were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Patients were classified according to three mutually exclusive treatment categories based on the primary initial treatment: no local management, radiotherapy, or surgery. Overall survival was assessed with Kaplan-Meier analysis and Cox models based on multiple factors including treatment utilization patterns. Results: The study population consisted of 26,851 patients. Age, sex, race, tumor grade, histology, and geographic location were associated with differences in treatment (all p < 0.01). Patients receiving definitive radiotherapy tended to be older and have less differentiated tumors than patients undergoing surgery (RT, median age 78 years old and 90.6% grade 3/4 tumors; surgery, median age 71 years old and 77.1% grade 3/4 tumors). No large shifts in treatment were seen over time, with most patients managed with surgical resection (86.3% for overall study population). Significant survival differences were observed according to initial treatment: median survival, 14 months with no definitive local treatment; 17 months with radiotherapy; and 43 months for surgery. On multivariate analysis, differences in local utilization rates of definitive radiotherapy did not demonstrate a significant effect on overall survival (hazard ratio, 1.002; 95% confidence interval, 0.999–1.005). Conclusions: Multiple factors influence the initial treatment strategy for muscle-invasive bladder cancer, but definitive radiotherapy continues to be used infrequently. Although patients who undergo surgery fare better, a multivariable model that accounted for patient and tumor characteristics found no survival detriment to the utilization of definitive radiotherapy. These results support continued

  2. Decommissioning of Radiotherapy Facilities

    International Nuclear Information System (INIS)

    Radiotherapy units containing high activity sealed radioactive sources of 60Co or 137Cs are mainly use for medical, research or calibration applications. After several half-lives of decay, the radionuclide source has to be changed or the unit is decommissioned if no longer required. Before starting a decommissioning project it is very important to look for documents relating to any sources held or installed in equipment. In general this should be no problem because the recommended working life of such sealed radioactive sources is limited to 10 or a maximum of 15 years. These time periods are short in comparison with other facilities like research laboratories or small reactors. These documents (source certificates) will be very helpful to plan the decommissioning because they say everything about the original activity of the source at a reference date, the type of the source and the manufacturer. The next step may be to contact the machine supplier or the source manufacturer, but be aware that neither may still be in existence or may have changed their type of business. In such cases, it is recommended to contact national or international sealed source manufacturers or suppliers for help. Sometimes it is also helpful to contact colleagues in other hospitals or research centres to ask for information about specialists in this topic. In general it is not useful, and even very dangerous, to try to decommission such a unit without expert help It is essential to have specialist tools and shielded containers to recover the source out of the unit. It is strongly recommended to invite the source removal specialist for a site visit to review the situation before starting any decommissioning process. A further problem can occur, if the source must be transported to a national storage centre or even an international storage facility, as the source must be packaged to meet international transport requirements. The end state of such a project should be an empty room where the

  3. Proton Radiotherapy for Pediatric Sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Ladra, Matthew M.; Yock, Torunn I., E-mail: tyock@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA 02114 (United States)

    2014-01-14

    Pediatric sarcomas represent a distinct group of pathologies, with approximately 900 new cases per year in the United States alone. Radiotherapy plays an integral role in the local control of these tumors, which often arise adjacent to critical structures and growing organs. The physical properties of proton beam radiotherapy provide a distinct advantage over standard photon radiation by eliminating excess dose deposited beyond the target volume, thereby reducing both the dose of radiation delivered to non-target structures as well as the total radiation dose delivered to a patient. Dosimetric studies comparing proton plans to IMRT and 3D conformal radiation have demonstrated the superiority of protons in numerous pediatric malignancies and data on long-term clinical outcomes and toxicity is emerging. In this article, we review the existing clinical and dosimetric data regarding the use of proton beam radiation in malignant bone and soft tissue sarcomas.

  4. Radiotherapy in osseous metastasizing carcinoid

    International Nuclear Information System (INIS)

    In an 51-year old patient with a disseminately metastasizing bronchus carcinoid, percutaneous radiotherapy was employed as a palliative measure against most severe pain in the region of bone metastases. In all irradiated regions (entire vertebral column and both shoulders) good pain relief was achieved in 2 weeks, lasting until the end of the follow-up period (18 months after irradiation), by application of 30 Gy photon radiation. Correlated with the subjective pain relief was a reduction of the required quantity of analgesics, a reduction of the greatly increased activity of alkaline phosphatase in the serum, and roentgenological sclerosing of the metastatic bone lesions. This case report is intended to point to the possibility of employing radiotherapy in similar cases where medication has finally proved futile, since the rare reports in literature are mostly negative. (orig.)

  5. The Information Needs of New Radiotherapy Patients: How to Measure? Do They Want to Know Everything? And if Not, Why?

    Energy Technology Data Exchange (ETDEWEB)

    Zeguers, Maaike; Haes, Hanneke C.J.M. de [Department of Medical Psychology, Academic Medical Centre, Amsterdam (Netherlands); Zandbelt, Linda C. [Department of Quality and Process Innovation, Academic Medical Centre, Amsterdam (Netherlands); Hoeven, Claartje L. ter; Franssen, Sanne J. [Department of Medical Psychology, Academic Medical Centre, Amsterdam (Netherlands); Geijsen, Debbie D.; Koning, Caro C.E. [Department of Radiation Oncology, Academic Medical Centre, Amsterdam (Netherlands); Smets, Ellen M.A., E-mail: e.m.smets@amc.uva.nl [Department of Medical Psychology, Academic Medical Centre, Amsterdam (Netherlands)

    2012-01-01

    Purpose: To establish 1) further psychometric properties of the information preference for radiotherapy patients scale (IPRP); 2) what information new radiotherapy patients want to receive; 3) which patients have a lower information need. Methods and Materials: Eligible patients (n = 159; response rate 54%) of 15 radiation oncologists completed the IPRP and provided background characteristics before their first radiotherapy consultation. Exclusion criteria were: age <18 years, having undergone radiotherapy before, unable to read and write Dutch, cognitive problems or a brain tumor. Results: Reliability (Cronbach's alpha 0.84-0.97) and concurrent validity (r from .39 to .57, p < 0.001) of the subscales of the IPRP were good. New radiotherapy patients want extensive information about their disease, treatment, procedures, side effects, and prognosis (mean scores between 4.1 and 4.4 on a scale from 1 to 5) but less information about psychosocial issues (mean = 3.4). Patients who are older and male, have lung or rectal cancer, more difficulty understanding and a higher trait anxiety level, need less information. Conclusions: The IPRP can reliably and validly address information needs of patients undergoing radiation treatment. Most new radiotherapy patients want much information. Yet, information giving should be tailored according to their background, understanding and anxiety.

  6. Investigation of a Patient Reported Outcome tool to assess radiotherapy-related toxicity prospectively in patients with lung cancer

    International Nuclear Information System (INIS)

    Background and purpose: There is a paucity of data regarding the feasibility and relevance of Patient Reported Outcome (PRO) tools to assess radiotherapy-related toxicity in lung cancer. Material and methods: From January to June 2013, lung cancer patients undergoing thoracic radiotherapy/chemo-radiotherapy completed nine patient-adapted Common Terminology Criteria for Adverse Events (CTCAE), the European Organisation for Research and Treatment of Cancer Quality of Life (QoL) questionnaire and the Hospital Anxiety and Depression Scale (HADS) at baseline, the end of radiotherapy and at follow-up. Clinicians completed the same CTCAE items and agreement between patients’ and clinicians’ reporting was assessed using weighted kappa coefficients. QoL and HADS scores were correlated with the patients’ and clinicians’ reported toxicity. Results: 70/116 patients completed the questionnaires for at least one time point excluding baseline. Agreement between patients’ and clinicians’ reported toxicity ranged from slight to substantial. Most discrepancies were within one grade and patients reported greater severity than clinicians for most symptoms. QoL and HADS scores were more strongly correlated with the patients’ compared to clinicians’ matching toxicity reports. The PRO tool was found to be statistically reliable. Conclusions: The use of a PRO tool in lung cancer radiotherapy is feasible, reliable and acceptable to patients. PROs should be integrated in future clinical trials evaluating new radiotherapy approaches to assess toxicity

  7. The Information Needs of New Radiotherapy Patients: How to Measure? Do They Want to Know Everything? And if Not, Why?

    International Nuclear Information System (INIS)

    Purpose: To establish 1) further psychometric properties of the information preference for radiotherapy patients scale (IPRP); 2) what information new radiotherapy patients want to receive; 3) which patients have a lower information need. Methods and Materials: Eligible patients (n = 159; response rate 54%) of 15 radiation oncologists completed the IPRP and provided background characteristics before their first radiotherapy consultation. Exclusion criteria were: age <18 years, having undergone radiotherapy before, unable to read and write Dutch, cognitive problems or a brain tumor. Results: Reliability (Cronbach’s alpha 0.84–0.97) and concurrent validity (r from .39 to .57, p < 0.001) of the subscales of the IPRP were good. New radiotherapy patients want extensive information about their disease, treatment, procedures, side effects, and prognosis (mean scores between 4.1 and 4.4 on a scale from 1 to 5) but less information about psychosocial issues (mean = 3.4). Patients who are older and male, have lung or rectal cancer, more difficulty understanding and a higher trait anxiety level, need less information. Conclusions: The IPRP can reliably and validly address information needs of patients undergoing radiation treatment. Most new radiotherapy patients want much information. Yet, information giving should be tailored according to their background, understanding and anxiety.

  8. Experiment on radiotherapy of postnatal mastitis

    International Nuclear Information System (INIS)

    The results of radiotherapy of postnatal mastitis in 78 women are presented. It is shown that the radiotherapy is the method of choice. Application of radiotherapy at different stages of disease promotes either complete resolution of infiltration (1-2 irradiations) or stipulates the decrease in temperature, abatement of pains and improvement of general state (at the presence of purulent fusion of mammary tissue). X-ray therapy of postnatal mastitis has does not affect the lactational function of mammary gland

  9. Risk-adapted targeted intraoperative radiotherapy versus whole-breast radiotherapy for breast cancer

    DEFF Research Database (Denmark)

    Vaidya, Jayant S; Wenz, Frederik; Bulsara, Max;

    2014-01-01

    The TARGIT-A trial compared risk-adapted radiotherapy using single-dose targeted intraoperative radiotherapy (TARGIT) versus fractionated external beam radiotherapy (EBRT) for breast cancer. We report 5-year results for local recurrence and the first analysis of overall survival....

  10. Single fraction radiotherapy versus multiple fraction radiotherapy for bone metastases in prostate cancer patients: comparative effectiveness

    International Nuclear Information System (INIS)

    External beam radiotherapy (EBRT) is an effective treatment for symptomatic bone metastases from a variety of primary malignancies. Previous meta-analyses and systematic reviews have reported on the efficacy of EBRT on bone metastases from multiple primaries. This review is focused on the comparative effectiveness of single fraction radiotherapy versus multiple fraction radiotherapy for bone metastases in prostate cancer patients

  11. Use of CME to impact self-reported changes in the evaluation and management of anaemia in geriatric patients

    Directory of Open Access Journals (Sweden)

    Kathleen Farmer

    2015-05-01

    Full Text Available Objective. The Third US National Health and Nutrition Examination Survey (NHANES III prompted the recognition of geriatric anaemia as a public health concern since ~10% of people aged 65 years or older were anaemic. The objective of this study was to design and implement a continuing medical education (CME event that motivates and guides Primary Care Health Practitioners (PCHPs to adopt medical practices that improve outcomes among geriatric patients with anaemia by employing effective diagnostic workup. Research design and methods. A total of 4196 PCHPs participated in 11 highly interactive 75-minute live conferences conducted throughout the US from 2011 through 2013 that featured case-based interactive discussions on the workup of microcytic, normocytic, and macrocytic anaemia by a PCHP and local haematologist expert. A standardised diagnostic algorithm for geriatric anaemia was used and distributed as a handout at the live activity. A reinforcing mobile application based on this algorithm was introduced in 2012. Main outcome measures. Data from participants were gathered immediately after the event, 10–12 weeks post-event, and 1–3 years post-event. Outcomes were evaluated according to Moore's levels. Chi-squared analyses compared the proportion of respondents who committed to one or more of the five major behavioural changes over time. Results. The Chi-squared test analysed data from each of the three timelines for five medical behavioural changes. A comparison of participants’ responses showed that there was a significant increase in the proportion of responders committing to behavioural change #1, “Avoid indiscriminant use of erythropoiesis-stimulating agents” and #5, “Refer patients with unexplained mild anaemia to a haematologist” from post-event to 1–3 years (p<0.001 (see Table 2. The proportion of respondents who committed to the other three behavioural changes remained consistent over time, suggesting that actual change

  12. Prevalence of anaemia and its associated factors in African children at one and three years residing in the Capricorn District of Limpopo Province, South Africa

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    Ramoteme L. Mamabolo

    2014-02-01

    Full Text Available Objective: The present study evaluated the prevalence of anaemia and its determinants in one- and three-year-old children from the Capricorn District of Limpopo Province, South Africa. Methods: A prospective cohort study conducted in rural villages in the Capricorn District of Limpopo Province, South Africa. At birth, a cohort of 219 children was followed until they were one and three years of age. Data collected included the children’s anthropometric measurements, blood for biochemical analysis (full blood count, ferritin, folate and vitamin B12 and socio-demographic status.Results: At one year, anaemia (Hb < 11 g/dL was present in 52% of the children, decreasing to 22% by the third year. Iron deficiency (ferritin < 12 µg/mL was common in these children (39% and 33% at one year and three years, respectively particularly in the presence of anaemia. Folate and vitamin B12 deficiencies (< 5 ng/mL and < 145 pg/mL, respectively were common at one year, with the children accumulating enough vitamin B12 by three years; however, folate deficiency levels remained fairly constant between the two time points.Conclusion: There was a high prevalence of anaemia in the study participants at one year and three years of age. Factors that increased the risk of anaemia at three years were: a mother with only a primary school education, anaemia at one year, male gender, overweight, and combined overweight and stunting. Protective factors against anaemia were having a younger mother who served as the main caregiver.

  13. Immediate side effects of large fraction radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Devereux, S.; Hatton, M.Q.F.; Macbeth, F.R. [Glasgow Western Infirmary (United Kingdom)

    1997-09-01

    The use of hypofractionated radiotherapy regiments is becoming more widely recognized in the palliation of non-small cell lung carcinoma (NSCLC). Anecdoctal reports of chest pain, rigors and fevers in the hours that follow radiotherapy led us to perform a survey estimating the frequency and severity of these symptoms following treatment to the thorax. We conclude that patients receiving palliative radiotherapy for bronchial carcinoma often develop significant symptoms in the hours following treatment. The timing and duration suggest a relationship with the radiotherapy, and we feel that patients should be warned of the possible occurrence of these symptoms. (author).

  14. Targeting IAP proteins in combination with radiotherapy

    International Nuclear Information System (INIS)

    The efficacy of radiotherapy critically depends on the activation of intrinsic cell death programs in cancer cells. This implies that evasion of cell death, a hallmark of human cancers, can contribute to radioresistance. Therefore, novel strategies to reactivate cell death programs in cancer cells are required in order to overcome resistance to radiotherapy. Since Inhibitor of Apoptosis (IAP) proteins are expressed at high levels in multiple cancers and block cell death induction at a central point, therapeutic targeting of IAP proteins represents a promising approach to potentiate the efficacy of radiotherapy. The current review discusses the concept of targeting IAP proteins in combination with radiotherapy

  15. Efeito da radioterapia na função pulmonar e na fadiga de mulheres em tratamento para o câncer de mama Efecto de la radioterapia en la función pulmonar y en la fatiga de mujeres en tratamiento para el cáncer de mama Effect of radiotherapy on pulmonary function and fatigue of women undergoing treatment for breast cancer

    Directory of Open Access Journals (Sweden)

    Dayane Evellyn dos Santos

    2013-03-01

    Full Text Available O presente estudo comparou a função pulmonar e a fadiga de mulheres antes e após a radioterapia (RT adjuvante para tratamento do câncer de mama, e correlacionou a função pulmonar com a dose de radiação e fadiga. Foi conduzido um estudo observacional longitudinal envolvendo 20 mulheres. A função pulmonar foi avaliada pela espirometria (ClementClarke® e manovacuometria (GlobalMed®, modelo MVD 300, e a fadiga pelo Functional Assessment of Cancer Therapy Fatigue (FACT-F. Todas as avaliações foram realizadas antes da primeira sessão e uma semana após o término da RT adjuvante. Para a análise estatística foram utilizados os testes Wilcoxon Signed Rank Test e correlação de Spearman, adotando-se nível de significância pEl presente estudio comparó la función pulmonar y la fatiga de mujeres antes y después de la radioterapia (RT como ayudante para el tratamiento del cáncer de mama, y se correlacionó la función pulmonar con la dosis de radiación y fatiga. Fue realizado un estudio observacional longitudinal involucrando 20 mujeres. La función pulmonar fue evaluada por espirometría (ClementClarke® y manovacuometría (GlobalMed®, modelo MVD 300 y, la fatiga fue evaluada por la Functional Assessment of Cancer Therapy Fatigue (FACT-F. Todas las evaluaciones fueron realizadas antes de la primera sesión y una semana después del término de la RT. Para el análisis estadístico fueron utilizados los tests Wilcoxon Signed Rank Test y correlación de Spearman, adoptando un nivel de significancia pThis study compared the pulmonary function and fatigue in patients before and after adjuvant radiotherapy (RT and correlated the pulmonary function with the radiotherapy dose and fatigue. A longitudinal and observational study was conducted involving 20 women. Pulmonary function was evaluated by digital lung spirometry (ClementClarke® and manometry (GlobalMed®, model MVD 300 and fatigue was analyses by the Functional Assessment of

  16. Intracellular proteins of feline immunodeficiency virus and their antigenic relationship with equine infectious anaemia virus proteins.

    Science.gov (United States)

    Egberink, H F; Ederveen, J; Montelaro, R C; Pedersen, N C; Horzinek, M C; Koolen, M J

    1990-03-01

    Feline immunodeficiency virus (FIV) grown in cat lymphocyte and thymocyte cultures was labelled with L-[35S]methionine or [3H]glucosamine and virus-coded proteins were identified using immunoprecipitation. Polypeptides with apparent Mr values of 15K, 24K, 43K, 50K, 120K and 160K were detected. An additional polypeptide of 10K was detected by Western blot analysis. The two highest Mr species sometimes appeared as one band, of which only the 120K polypeptide was glycosylated. In the presence of tunicamycin gp120 was no longer detectable and a non-glycosylated precursor of 75K was found instead. Pulse-chase experiments suggested that the smaller polypeptides p24 and p15 are cleavage products of both p160 and p50. Western blot analysis using a rabbit serum directed against p26 of equine infectious anaemia virus (EIAV) and an anti-EIAV horse serum from a field case of infection revealed a cross-reactivity with p24 of FIV. Cat sera collected late after experimental FIV infection recognized p26 of EIAV, indicating a reciprocal cross-reactivity. PMID:1690264

  17. Awareness, Knowledge, and Acceptance of Haematopoietic Stem Cell Transplantation for Sickle Cell Anaemia in Nigeria

    Science.gov (United States)

    Kagu, Modu Baba; Wakama, Tamunomieibi; Babadoko, Aliyu Ahmadu; Damulak, Dapus Obadiah; Ocheni, Sunday; Asuquo, Marcus Inyama

    2016-01-01

    Background. Sickle cell anaemia (SCA) is an inherited condition whose clinical manifestations arise from the tendency of haemoglobin to polymerize and deform red blood cells into characteristic sickle shape. Allogeneic bone marrow transplantation offers a cure. The aim of this study was to determine the level of awareness, knowledge, and acceptance of this beneficial procedure in Nigeria. Materials and Methods. This multicentre cross-sectional study was conducted in 7 tertiary hospitals in Nigeria in 2015. Approval was obtained from each institution's research and ethics committee. A pretested structured questionnaire was administered to respondents aged 18 years and above and to the parents or guardians of those below 18 years of age. Results. There were 265 respondents comprising 120 males and 145 females. One hundred and seventy-one (64.5%) respondents were aware of BMT for the treatment of SCA. About 67.8% (116 of 171) of those who were aware believed SCA can be cured with BMT (p = 0.001) and 49.7% (85 of 171) of the respondents accepted BMT (p = 0.001). Conclusion. Awareness of BMT in Nigeria is low when compared with reports from developed countries. The knowledge is poor and acceptance is low. With adequate information, improved education, and psychological support, more Nigerians will embrace BMT.

  18. Hematological Indices of Sickle Cell Anaemia Patients with Pulmonary Tuberculosis in Northern Nigeria.

    Directory of Open Access Journals (Sweden)

    Sagir G. Ahmed

    2010-06-01

    Full Text Available Nigeria has the fourth highest prevalence of TB and the highest prevalence of Sickle cell anaemia (SCA in the world. SCA patients have impaired immunity and are vulnerable to TB. Hence, we studied the haematological indices of SCA patients with TB in Nigeria. A total of 23 SCA patients with TB were studied in parallel with equal number of age and sex matched SCA patients without TB. SCA patients with TB had significantly lower haematocrit, higher level of circulating sickle cells (CSCs and similar level of reticulocyte count in comparison to patients without TB. SCA patients with TB had significantly higher mean WBC count associated with higher frequency of neutrophilia in comparison to those without TB. Monocytosis and eosinopenia were exclusively found in SCA patients with TB at frequencies of 52% and 65% respectively. Lymphocyte and basophil counts were normal in all patients with and without TB. Mean platelet counts were high in both patient groups but the frequency of thrombocytosis was significantly higher in patients with TB. SCA patients with TB had significantly higher mean ESR than their counterparts without the infection. The findings of this study  revealed that TB in SCA patients was associated with rising level of CSCs, falling level of haematocrit, sub-optimal reticulocytosis, neutrophilia, monocytosis, thrombocytosis, eosinopenia and rising level of ESR. Hence, SCA patients presenting with these haematological indices should be investigated for TB.

  19. Anaemia, hypothyroidism and immune suppression associated with polychlorinated biphenyl exposure in bottlenose dolphins (Tursiops truncatus).

    Science.gov (United States)

    Schwacke, Lori H; Zolman, Eric S; Balmer, Brian C; De Guise, Sylvain; George, R Clay; Hoguet, Jennifer; Hohn, Aleta A; Kucklick, John R; Lamb, Steve; Levin, Milton; Litz, Jenny A; McFee, Wayne E; Place, Ned J; Townsend, Forrest I; Wells, Randall S; Rowles, Teresa K

    2012-01-01

    Polychlorinated biphenyls (PCBs), persistent chemicals widely used for industrial purposes, have been banned in most parts of the world for decades. Owing to their bioaccumulative nature, PCBs are still found in high concentrations in marine mammals, particularly those that occupy upper trophic positions. While PCB-related health effects have been well-documented in some mammals, studies among dolphins and whales are limited. We conducted health evaluations of bottlenose dolphins (Tursiops truncatus) near a site on the Georgia, United States coast heavily contaminated by Aroclor 1268, an uncommon PCB mixture primarily comprised of octa- through deca-chlorobiphenyl congeners. A high proportion (26%) of sampled dolphins suffered anaemia, a finding previously reported from primate laboratory studies using high doses of a more common PCB mixture, Aroclor 1254. In addition, the dolphins showed reduced thyroid hormone levels and total thyroxine, free thyroxine and triiodothyronine negatively correlated with PCB concentration measured in blubber (p = 0.039, dolphins when compared with previously sampled reference sites, and therefore probably did not contribute to the observed correlations. Our results clearly demonstrate that dolphins are vulnerable to PCB-related toxic effects, at least partially mediated through the endocrine system. The severity of the effects suggests that the PCB mixture to which the Georgia dolphins were exposed has substantial toxic potential and further studies are warranted to elucidate mechanisms and potential impacts on other top-level predators, including humans, who regularly consume fish from the same marine waters.

  20. Decreasing iron-related indexes without anaemia in a patient with genetic haemochromatosis.

    Science.gov (United States)

    Conti, Clara Benedetta; Baccarin, Alessandra; Conte, Dario; Fraquelli, Mirella

    2015-10-01

    Present case report refers to a 48-year-old man with genetic haemochromatosis (C282Y mut/mut) diagnosed at the age of 26. After aggressive iron depleting regimen carried out up to normalization of iron-related indexes, he received a maintenance regimen based on regular phlebotomies for about 20 years. In 2014, a marked reduction of both serum ferritin and transferrin saturation percent, without concomitant anaemia, was noted on two different occasions at 5-month interval. An obscure occult GI bleeding was suspected, but both upper and lower GI tract endoscopy were negative for abnormal findings, as also was a detailed abdominal US scan. The persistence of low iron-related indexes prompted the physicians to perform a videocapsule endoscopy, which showed an ulcerative bleeding lesion in the small bowel, not confirmed however by both anterograde and retrograde double-balloon enteroscopy. Further MRI and PET allowed the identification of a 3.5 cm large lesion, located outside the small bowel wall, suspected to be a gastrointestinal stromal tumour (GIST). A further laparoscopic procedure allowed the resection of 10 cm of midileum, which included the mass, fully consistent with GIST at pathology. PMID:26210325

  1. A replication competent lentivirus (RCL) assay for equine infectious anaemia virus (EIAV)-based lentiviral vectors.

    Science.gov (United States)

    Miskin, J; Chipchase, D; Rohll, J; Beard, G; Wardell, T; Angell, D; Roehl, H; Jolly, D; Kingsman, S; Mitrophanous, K

    2006-02-01

    Lentiviral vectors are being developed to satisfy a wide range of currently unmet medical needs. Vectors destined for clinical evaluation have been rendered multiply defective by deletion of all viral coding sequences and nonessential cis-acting sequences from the transfer genome. The viral envelope and accessory proteins are excluded from the production system. The vectors are produced from separate expression plasmids that are designed to minimize the potential for homologous recombination. These features ensure that the regeneration of the starting virus is impossible. It is a regulatory requirement to confirm the absence of any replication competent virus, so we describe here the development and validation of a replication competent lentivirus (RCL) assay for equine infectious anaemia virus (EIAV)-based vectors. The assay is based on the guidelines developed for testing retroviral vectors, and uses the F-PERT (fluorescent-product enhanced reverse transcriptase) assay to test for the presence of a transmissible reverse transcriptase. We have empirically modelled the replication kinetics of an EIAV-like entity in human cells and devised an amplification protocol by comparison with a replication competent MLV. The RCL assay has been validated at the 20 litre manufacturing scale, during which no RCL was detected. The assay is theoretically applicable to any lentiviral vector and pseudotype combination. PMID:16208418

  2. Serological and molecular detection of chicken anaemia virus in Iranian poultry flocks.

    Science.gov (United States)

    Gholami-Ahangaran, Majid

    2015-01-01

    Despite chicken being the main natural host for chicken anaemia virus (CAV), other birds may be infected by this virus too. In this study we examined chickens, turkeys, and quails for serological and molecular detection of CAV in Iran. For this study, we used 375 sera and thymus samples from broiler chickens, 100 sera and blood samples from turkeys, and 250 thymus samples from quails. The sample were collected from all over Iran between 2009 and 2010. Serum samples were examined using ELISA. DNA was extracted from thymus and blood samples and was analysed for the presence of the VP2 gene of CAV by polymerase chain reaction. Results showed that 69.07% of chickens were positive for antibody to CAV. In chickens, 58.4% were positive for CAV VP2 gene. The prevalence of CAV infection in quails was 15%, based on CAV VP2 gene detection. In turkey flocks, all turkeys (100%) were negative with respect to detection of VP2 CAV gene and CAV antibodies. It was concluded that, for the span of the time considered in this study, CAV has circulated in broiler chickens and quails throughout Iran.

  3. Localised Infection of Atlantic Salmon Epithelial Cells by HPR0 Infectious Salmon Anaemia Virus.

    Directory of Open Access Journals (Sweden)

    Maria Aamelfot

    Full Text Available Infectious salmon anaemia (ISA is an important, systemic viral disease of farmed Atlantic salmon, Salmo salar L. Endothelial cells are the main target cells for highly virulent HPR-deleted ISA virus (ISAV types. Here we examine the pathogenesis of non-virulent ISAV HPR0 infections, presenting evidence of an epithelial tropism for this virus type, including actual infection and replication in the epithelial cells. Whereas all HPR0 RT-qPCR positive gills prepared for cryosection tested positive by immunohistochemistry (IHC and immunofluorescent labelling, only 21% of HPR0 RT-qPCR positive formalin-fixed paraffin-embedded gills were IHC positive, suggesting different methodological sensitivities. Only specific epithelial cell staining was observed and no staining was observed in endothelial cells of positive gills. Furthermore, using an ISAV segment 7 RT-PCR assay, we demonstrated splicing of HPR0, suggesting initial activation of the replication machinery in the epithelial gill cells. Immunological responses were investigated by the expression of interferon-related genes (e.g. Mx and γIP and by ELISA for presence of anti-ISAV antibodies on samples taken sequentially over several months during an episode of transient HPR0 infection. All fish revealed a variable, but increased expression of the immunological markers in comparison to normal healthy fish. Taken together, we conclude that HPR0 causes a localized epithelial infection of Atlantic salmon.

  4. Extracellular microvesicle microRNAs in children with sickle cell anaemia with divergent clinical phenotypes.

    Science.gov (United States)

    Khalyfa, Abdelnaby; Khalyfa, Ahamed A; Akbarpour, Mahzad; Connes, Phillippe; Romana, Marc; Lapping-Carr, Gabrielle; Zhang, Chunling; Andrade, Jorge; Gozal, David

    2016-09-01

    Sickle cell anaemia (SCA) is the most frequent genetic haemoglobinopathy, which exhibits a highly variable clinical course characterized by hyper-coagulable and pro-inflammatory states, as well as endothelial dysfunction. Extracellular microvesicles are released into biological fluids and play a role in modifying the functional phenotype of target cells. We hypothesized that potential differences in plasma-derived extracellular microvesicles (EV) function and cargo from SCA patients may underlie divergent clinical trajectories. Plasma EV from SCA patients with mild, intermediate and severe clinical disease course were isolated, and primary endothelial cell cultures were exposed. Endothelial cell activation, monocyte adhesion, barrier disruption and exosome cargo (microRNA microarrays) were assessed. EV disrupted the endothelial barrier and induced expression of adhesion molecules and monocyte adhesion in a SCA severity-dependent manner compared to healthy children. Microarray approaches identified a restricted signature of exosomal microRNAs that readily distinguished severe from mild SCA, as well as from healthy children. The microRNA candidates were further validated using quantitative real time polymerase chain reaction assays, and revealed putative gene targets. Circulating exosomal microRNAs may play important roles in predicting the clinical course of SCA, and in delineation of individually tailored, mechanistically-based clinical treatment approaches of SCA patients in the near future. PMID:27161653

  5. Observations on the pathogenesis of anaemia in fascioliasis and on immunoglobulin metabolism

    International Nuclear Information System (INIS)

    Proline, an excretory/secretory product of liver flukes, was investigated as a possible mediator of anaemia through haemolysis or dyshaemopoiesis in fluke infected animals. Infusion of 700 μmol proline per rabbit per day for 14 days did not significantly alter the halflife (t1/2) of 51Cr labelled erythrocytes nor did it interfere with plasma clearance and utilization of 59Fe in rabbits. Consequently, it was concluded that proline did not interfere with haemoglobin synthesis or induced haemolysis in rabbits at test dose level. The metabolism of radiolabelled IgG was also investigated in calves infected with Fasciola gigantica. In two calves given 1,000 metacercariae of F. gigantica ten weeks earlier, the mean t1/2 of 125I labelled IgG was 74 h, compared with 100 h in uninfected controls. The faecal clearance of 125I labelled IgG was correspondingly higher among infected calves, indicating that serum IgG was being lost into the gut in excessive quantities, probably via the bile. (author). 20 refs, 4 tabs

  6. Recommendations for centres of expertise in rare anaemias. The ENERCA White Book

    Directory of Open Access Journals (Sweden)

    Joan-Lluis Vives Corrons

    2014-12-01

    Full Text Available The Community added value of Centres of Expertise (CoE and European Reference Networks (ERN is particularly high for rare diseases (RD due to the rarity of these conditions, which implies both a small number of patients and scarcity of expertise within a single country. Gathering expertise at the European level is therefore, paramount in order to ensure equal access to accurate information, appropriate and timely diagnosis and high quality clinical care and follow up for patients with rare diseases. This applies particularly to rare anaemias due to the high number of different rare diseases that constitute this group. In this context, the European Network for Rare and Congenital Anaemias (ENERCA, co-financed by the European Commission, was created in 2002 with the aim of prevention and management of rare anaemias (RA and the development and promotion of policies to improve the well-being of European Union citizens. The ENERCA White Book is a position paper, developed as a deliverable of the ENERCA (phase 3 project that intends to contribute to the creation of a ERN in RA (ERN-RA by preparation of the recommendations and, in particular, the definition of the criteria that CoE, local centres (LC and their interrelations have to fulfil as healthcare providers. It has been nourished by all the activities that have been performed over the past ten years within the ENERCA framework. The White Book is addressed to authorities in charge of the identifying CoE, as an essential requirement for the official recognition of the ERN, to European and national health authorities, Healthcare centres and health professionals, as well as to all other stakeholders interested in RA. It is also addressed to the patients, as a way to empower their community in this process. One particular characteristic of the White Book is the integration of the three main aspects of a CoE: a ethical and legal frameworks to ensure the non-discrimination and non-stigmatisation of rare

  7. Evolutionary mechanisms involved in the virulence of infectious salmon anaemia virus (ISAV), a piscine orthomyxovirus

    International Nuclear Information System (INIS)

    Infectious salmon anaemia virus (ISAV) is an orthomyxovirus causing a multisystemic, emerging disease in Atlantic salmon. Here we present, for the first time, detailed sequence analyses of the full-genome sequence of a presumed avirulent isolate displaying a full-length hemagglutinin-esterase (HE) gene (HPR0), and compare this with full-genome sequences of 11 Norwegian ISAV isolates from clinically diseased fish. These analyses revealed the presence of a virulence marker right upstream of the putative cleavage site R267 in the fusion (F) protein, suggesting a Q266 → L266 substitution to be a prerequisite for virulence. To gain virulence in isolates lacking this substitution, a sequence insertion near the cleavage site seems to be required. This strongly suggests the involvement of a protease recognition pattern at the cleavage site of the fusion protein as a determinant of virulence, as seen in highly pathogenic influenza A virus H5 or H7 and the paramyxovirus Newcastle disease virus

  8. Correlates of Anaemia and Worm Infestation among Rural Pregnant Women: A Cross Sectional Study from Bengal

    Directory of Open Access Journals (Sweden)

    Sinjita Dutta, Sita Chatterjee, Debasish Sinha, Bobby Pal, Mausumi Basu, Aparajita Dasgupta

    2013-01-01

    Objectives: To find out the preva-lence of worm infestation and anaemia among pregnant women along with their socio-demographic characteristics, dietary habits and state of personal hygiene and elicit the association, if any, with anemia and worm infestation Materials and methods: A cross-sectional study was carried out among pregnant mothers attending the antenatal clinic at Nasibpur Union Health Center. All antenatal mothers who came for antenatal checkup for the first time to the health centre on two prefixed days of the week during the study period were interviewed. The reports of their stool and haemoglobin examination were followed up. Results: 82% of the pregnant women were suffering from anemia.25% of the study population had worm infestation. Age at marriage, green leafy vegetable, fruit and flesh food intake of at least 4 days a week, use of lemon with food most of the time, avoiding the practice of eating last in the family, handwashing with soap and water before eating and use of footwear outside the house were statically significant with hemoglobin concentration. Only religion and handwashing practice with soap and water before eating had statistically significant association with worm infestation. Conclusion: The study showed that certain protective factors like diet and personal hygiene if addressed at the time of antenatal checkup can reduce the number of cases of anemia significantly.

  9. Awareness, Knowledge, and Acceptance of Haematopoietic Stem Cell Transplantation for Sickle Cell Anaemia in Nigeria

    Directory of Open Access Journals (Sweden)

    Adewumi Adediran

    2016-01-01

    Full Text Available Background. Sickle cell anaemia (SCA is an inherited condition whose clinical manifestations arise from the tendency of haemoglobin to polymerize and deform red blood cells into characteristic sickle shape. Allogeneic bone marrow transplantation offers a cure. The aim of this study was to determine the level of awareness, knowledge, and acceptance of this beneficial procedure in Nigeria. Materials and Methods. This multicentre cross-sectional study was conducted in 7 tertiary hospitals in Nigeria in 2015. Approval was obtained from each institution’s research and ethics committee. A pretested structured questionnaire was administered to respondents aged 18 years and above and to the parents or guardians of those below 18 years of age. Results. There were 265 respondents comprising 120 males and 145 females. One hundred and seventy-one (64.5% respondents were aware of BMT for the treatment of SCA. About 67.8% (116 of 171 of those who were aware believed SCA can be cured with BMT (p=0.001 and 49.7% (85 of 171 of the respondents accepted BMT (p=0.001. Conclusion. Awareness of BMT in Nigeria is low when compared with reports from developed countries. The knowledge is poor and acceptance is low. With adequate information, improved education, and psychological support, more Nigerians will embrace BMT.

  10. Oral changes in individuals undergoing hematopoietic stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Regina Haddad Barrach

    2015-04-01

    Full Text Available INTRODUCTION: Patients undergoing hematopoietic stem cell transplantation receive high doses of chemotherapy and radiotherapy, which cause severe immunosuppression.OBJECTIVE: To report an oral disease management protocol before and after hematopoietic stem cell transplantation.METHODS: A prospective study was carried out with 65 patients aged > 18 years, with hematological diseases, who were allocated into two groups: A (allogeneic transplant, 34 patients; B (autologous transplant, 31 patients. A total of three dental status assessments were performed: in the pre-transplantation period (moment 1, one week after stem cell infusion (moment 2, and 100 days after transplantation (moment 3. In each moment, oral changes were assigned scores and classified as mild, moderate, and severe risks.RESULTS: The most frequent pathological conditions were gingivitis, pericoronitis in the third molar region, and ulcers at the third moment assessments. However, at moments 2 and 3, the most common disease was mucositis associated with toxicity from the drugs used in the immunosuppression.CONCLUSION: Mucositis accounted for the increased score and potential risk of clinical complications. Gingivitis, ulcers, and pericoronitis were other changes identified as potential risk factors for clinical complications.

  11. Evaluation of 14 patients performed radiotherapy due to Kaposi sarcoma

    Directory of Open Access Journals (Sweden)

    Fatma Teke

    2015-09-01

    Full Text Available Methods: The patients undergoing radiotherapy (RT because of the KS between the years 2005-2012 in Radiation Oncology Department of Dicle University Hospital were included. All patients underwent RT with different dose-fractionation schemes to increase quality of life and to palliate the symptoms. Patients with lesions in multiple regions underwent RT in the same or different dates. Responses to radiotherapy were recorded as complete or partial response. Results: Fourteen patients received radiotherapy because of f KS were evaluated retrospectively. Twenty two different regions of 14 patients underwent RT . Only one patient (4.5% was performed RT to glans penis as a third region while performed to the two regions in six patients (27.3%. At irradiations, 6 MV and 10 MV photon energies with 6 MeV, 9 MeV and 12 MeV electron energy were used. Water phantom or bolus material was used to obtain a homogeneous dose distribution in the photon irradiation. RT dose administered to a total of 22 different regional was median 800 cGy (Range: 800-3000 cGy. Median number of RT fractions was 1 (Range: 1-10. When treatment response were evaluated stable disease was present in the 4 (18.1% regions. Partial response was achieved in eight (36.4% regions, complete response in 10 (45.5%. RT-related common lymphedema in the feet and legs was observed in the four (57.3% regions in the acute period. Complication of pain was present in two (28.7% regions. Conclusion: RT is an appropriate and effective treatment regimen in the palliative treatment of KS lesions. Excellent response rates of skin lesions may be obtained by RT. Lesions and symptoms such as itching may be lost after RT. Side effects such as edema and pain may be relieved by supportive treatment.

  12. Pulmonary function following adjuvant chemotherapy and radiotherapy for breast cancer and the issue of three-dimensional treatment planning

    International Nuclear Information System (INIS)

    Background and purpose: The frequency and grade of pulmonary complications following adjuvant radiotherapy for breast cancer are still debated. This study focuses on loss of pulmonary function. Materials and methods: We have measured the reduction of pulmonary function 5 months following radiotherapy in 144 node-positive stage II breast cancer patients by using pulmonary function tests. Results: No deterioration of pulmonary function was detected among the patients who were treated with local radiotherapy. On the contrary, there was a mean increase in diffusion capacity by 7% (P=0.004) following radiotherapy, which most likely was explained by the adjuvant chemotherapy administered prior to the baseline pulmonary function tests. Patients undergoing loco-regional radiotherapy showed a mean reduction in diffusion capacity by 5% (P<0.001) and in vital capacity by 3% (P=0.001). The subset of patients (9%) who were diagnosed with severe pulmonary complications needing cortisone treatment had significantly larger mean paired differences in vital capacity (-0.446 L, -15% (equivalent to 15 years of normal ageing or the loss of 3/4 of a lung lobe)) compared to the patients who were asymptomatic (-0.084 L) (P<0.05). When the effects of potential confounding factors and different radiotherapy techniques were tested on the reduction of pulmonary function by stepwise multiple regression analysis, a significant correlation was found only to loco-regional radiotherapy including the lower internal mammary lymph nodes. Conclusions: We conclude that a clinically important reduction of pulmonary function is seen in the subset of patients who are diagnosed with severe pulmonary complication following loco-regional radiotherapy for breast cancer. The results of this study warrant further studies based on individual lung dose volume histograms. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  13. Quality audit of Philippine radiotherapy centers

    International Nuclear Information System (INIS)

    A quality audit program for Philippine radiotherapy centers was developed under the IAEA Coordinated Research Project entitled Development of Quality Assurance Programme for Radiation Therapy Dosimetry in Developing Countries. The program includes annual conduct of on-site visits and a TLD based dose assurance program using mailed dosimeters. An external audit group (EAG) was organized for the implementation of the project. The group is officially recognized under Department Order Nos. 365-C and 365-D s. 2001 signed by the Secretary of Health on November 20, 2001. The members of the group are medical physicists and radiation oncologists from both private and government institutions who have had extensive training and experience in radiotherapy. The members of the Measuring Group are the BHDT-SSDL and PNRI- SSDL A quality audit manual was prepared as guide for the EAG. An audit report form for on-site visits was developed and tested by the EAG in the field. It contains vital information on manpower, workload, equipment, dosimetry, safety, quality assurance, regulation, comments and recommendations for the improvement of the service. A copy of this report is being provided to the hospital administration during the exit conference of the team. A total of nineteen (19) radiotherapy centers were visited from January 2000 - January 2002. It includes all operational facilities, those with newly installed teletherapy equipment and those undergoing source replacement before the machines were used for clinical application. The centers have at least one (1) medical physicist. Only one (1) radiotherapy facility (Co-60) has not yet been provided with an in-house dosimetry equipment and fourteen (14) centers have computerized treatment planning systems. A total of nineteen (19) Co-60 machines had been evaluated for performance, two (2) of which had been replaced, three (3) are non-operational and due for decommissioning. Two (2) units were imported to the country as refurbished

  14. Application of the Method Risk Matrix to Radiotherapy. Main Principles

    International Nuclear Information System (INIS)

    The published fundamental principles of security, and basic international standards of security for ionizing radiation safety, contain requirements of protection for patients undergoing medical exposure. In accordance with these requirements and fulfilling its responsibility to provide for the application of these rules, the IAEA has been working intensively in the prevention of accidental exposures in radiotherapy, and this has resulted in a series of technical reports on the lessons learned from the research done in very serious events, and also in teaching materials shared for regional courses and accessible on the website for the protection of patients. The lessons learned are necessary but not sufficient, as we continue receiving information about new types of accidental exposures and not all may have been published. We need a more proactive approach, with a systematic, comprehensive and structured manner, to try to find out in advance what other errors may happen, to prevent or detect them early. Among these approaches are the method of the 'risk matrix', which by its relative simplicity can be applied to all radiotherapy service.

  15. Evaluation of xerostomia and taste disturbance after radiotherapy of patients with head and neck lesion

    International Nuclear Information System (INIS)

    Because of high sensitivity to radiation, radiotherapy to the head and neck cancer is often conducted for purposes of functional preservation. However, the salivary glands and oral cavity must be included in the irradiation field. Thus, an inflammatory reaction of the oral mucosa to the radiotherapy is inevitable, and xerostomia, taste disturbance, and pain appear in the early stage of the treatment. These side effects sometimes cause not only interrupt or change planned treatment but also influence patients' Quality of Life after treatment. Thus, we conducted, in the form of questionnaire surveys, subjective and objective evaluations in respect to xerostomia and taste disturbance, and assessed the usefulness of the evaluations. The subjects were 40 patients who had received the radiotherapy in the major salivary glands, such as parotid glands, and almost the whole tongue, but who had not undergo a resection of the major salivary glands or tongue. The degree of damage to the salivary glands and taste were evaluated, subjectively and objectively. The subjective evaluation was conducted by questionnaires given to the patients. As for the objective evaluation, xerostomia was evaluated by measuring the salivary amount, while the taste disturbance was examined in 27 patients using taste disks. The results showed a positive correlation, indicating that the evaluation of xerostomia and taste disturbance using questionnaires is useful. The salivary amount was the least at six months after the radiotherapy, then increased gradually, and 24 months later, improved to a level similar to that seen immediately after the radiotherapy. The taste disturbance also improved gradually over the 24 months following radiotherapy. (author)

  16. Nutritional Interventions in Head and Neck Cancer Patients Undergoing Chemoradiotherapy: A Narrative Review

    Directory of Open Access Journals (Sweden)

    Maurizio Bossola

    2015-01-01

    Full Text Available The present review aimed to define the role of nutritional interventions in the prevention and treatment of malnutrition in HNC patients undergoing CRT as well as their impact on CRT-related toxicity and survival. Head and neck cancer patients are frequently malnourished at the time of diagnosis and prior to the beginning of treatment. In addition, chemo-radiotherapy (CRT causes or exacerbates symptoms, such as alteration or loss of taste, mucositis, xerostomia, fatigue, nausea and vomiting, with consequent worsening of malnutrition. Nutritional counseling (NC and oral nutritional supplements (ONS should be used to increase dietary intake and to prevent therapy-associated weight loss and interruption of radiation therapy. If obstructing cancer and/or mucositis interfere with swallowing, enteral nutrition should be delivered by tube. However, it seems that there is not sufficient evidence to determine the optimal method of enteral feeding. Prophylactic feeding through nasogastric tube or percutaneous gastrostomy to prevent weight loss, reduce dehydration and hospitalizations, and avoid treatment breaks has become relatively common. Compared to reactive feeding (patients are supported with oral nutritional supplements and when it is impossible to maintain nutritional requirements enteral feeding via a NGT or PEG is started, prophylactic feeding does not offer advantages in terms of nutritional outcomes, interruptions of radiotherapy and survival. Overall, it seems that further adequate prospective, randomized studies are needed to define the better nutritional intervention in head and neck cancer patients undergoing chemoradiotherapy.

  17. Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ja Young; Kim, Sung Hwan; Kim, Ki Won; Park, Dong Choon; Yoon, Joo Hee; Yoon, Sei Chul [St. Vincent' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of); Yu, Mina [St. Mary' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

  18. Radiotherapy and Brachytherapy : Proceedings of the NATO Advanced Study Institute on Physics of Modern Radiotherapy & Brachytherapy

    CERN Document Server

    Lemoigne, Yves

    2009-01-01

    This volume collects a series of lectures presented at the tenth ESI School held at Archamps (FR) in November 2007 and dedicated to radiotherapy and brachytherapy. The lectures focus on the multiple facets of radiotherapy in general, including external radiotherapy (often called teletherapy) as well as internal radiotherapy (called brachytherapy). Radiotherapy strategy and dose management as well as the decisive role of digital imaging in the associated clinical practice are developed in several articles. Grouped under the discipline of Conformal Radiotherapy (CRT), numerous modern techniques, from Multi-Leaf Collimators (MLC) to Intensity Modulated RadioTherapy (IMRT), are explained in detail. The importance of treatment planning based upon patient data from digital imaging (Computed Tomography) is also underlined. Finally, despite the quasi- totality of patients being presently treated with gamma and X-rays, novel powerful tools are emerging using proton and light ions (like carbon ions) beams, bound to bec...

  19. Design of a technique for the radiotherapy treatment of patients of prostate with bilateral prosthetic hip; Diseno de una tecnica para el tratamiento radioterapico de pacientes de prostata con protesis bilateral de cadera

    Energy Technology Data Exchange (ETDEWEB)

    Camacho, C.; Perez-Alija, J.; Olivares, S.; Loscos, S.; Pedro, A.

    2013-07-01

    The design of the plan of treatment of patients who have to undergo radical radiotherapy of prostate and that incorporate some sort of hip prosthesis is usually complex. the case of a patient's prostatic bed with bilateral hip prosthesis to assess radical radiotherapy to the 70Gy in bed. The objective of this paper is to present the chosen technique designed for this treatment. (Author)

  20. Hyperfractionated Accelerated Radiotherapy (HART) with maintenance chemotherapy for metastatic (M1–3) Medulloblastoma – A safety/feasibility study

    International Nuclear Information System (INIS)

    Background and purpose: To evaluate feasibility and toxicity of Hyperfractionated Accelerated Radiotherapy (HART) 1.24 Gy b.i.d. followed by chemotherapy for M1–3 Medulloblastoma (MB). The aim of HART was to use hyperfractionation to improve therapeutic ratio combined with acceleration to minimise tumour cell repopulation during radiotherapy (RT). Materials and methods: Between February 2002 and May 2008, 34 eligible patients (22 male, 12 female) aged 3–15 years (median 7) with metastatic MB (M1–9; M2–3, M3–22) received HART with a craniospinal radiotherapy (CSRT) dose of 39.68 Gy followed by 22.32 Gy boost to the whole posterior fossa and 9.92 Gy metastatic boosts. The 8th and subsequent patients received vincristine (VCR) 1.5 mg/m2 weekly × 8 doses over 8 weeks starting during the 1st week of RT. Maintenance chemotherapy comprised 8 six-weekly cycles of VCR 1.5 mg/m2 weekly × 3, CCNU 75 mg/m2 and cisplatin 70 mg/m2. Results: Median duration of HART was 34 days (range 31–38). Grade 3–4 toxicities included mucositis (8), nausea (10), anaemia (5), thrombocytopaenia (2), leucopaenia (24). With 4.5-year median follow-up, 3-year EFS and OS were 59% and 71%, respectively. Of 10 relapses, 1 was outside the central nervous system (CNS), 1 posterior fossa alone and 8 leptomeningeal with 3 also associated with posterior fossa. Conclusion: HART with or without VCR was well tolerated and may have a place in the multi-modality management of high-risk MB

  1. Radiotherapy versus combined modality in early stages

    DEFF Research Database (Denmark)

    Specht, L; Carde, P; Mauch, P;

    1992-01-01

    In early stage Hodgkin's disease the optimal choice of treatment for the individual patient is still an unresolved issue. So far, twenty-two randomized trials of radiotherapy alone versus radiotherapy plus combination chemotherapy have been carried out worldwide. The preliminary results of a glob...

  2. Effect of ionizing radiation on the taste function of patients submitted to head and neck radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Amaro Ilidio Vespasiano [Universidade Estadual de Campinas (UNICAMP), SP (Brazil); Galante, Celio [Santa Casa de Misericordia de Belo Horizonte, MG (Brazil). Div. de Radioterapia; Manzi, Flavio Ricardo, E-mail: manzi@pucminas.b [Pontificia Universidade Catolica de Minas Gerais (PUC-MG), Belo Horizonte, MG (Brazil)

    2011-09-15

    Objective: to evaluate the effects of ionizing radiation on the taste function in patients submitted to radiotherapy in the head and neck region. Materials and methods: twenty patients diagnosed with head and neck tumors and undergoing treatment in the Division of Radiotherapy at Santa Casa de Misericordia de Belo Horizonte, MG, Brazil, were selected. For their taste function testing, four solutions were manipulated with salt (NaCl), sugar (sucrose), citric acid (for acidity), and urea (for bitterness), at three different (low, medium and high) concentrations. Weekly tests were performed during the first three weeks of radiotherapy, with random administration of the solutions (three drops each) respecting the order of their concentration levels (low, medium and high). After the application of each solution, the patient reported which flavor he/she tasted. Results: a statistically significant difference was observed in the loss of taste function as the results in the 1st and 4th weeks of treatment were compared, with salty solution at the three concentration levels, with the sweet solution at low and medium concentrations, and with the sour and bitter solutions, only at low concentration. Conclusion: ionizing radiation alters the taste function of patients submitted to head and neck radiotherapy. (author)

  3. Effect of ionizing radiation on the taste function of patients submitted to head and neck radiotherapy

    International Nuclear Information System (INIS)

    Objective: to evaluate the effects of ionizing radiation on the taste function in patients submitted to radiotherapy in the head and neck region. Materials and methods: twenty patients diagnosed with head and neck tumors and undergoing treatment in the Division of Radiotherapy at Santa Casa de Misericordia de Belo Horizonte, MG, Brazil, were selected. For their taste function testing, four solutions were manipulated with salt (NaCl), sugar (sucrose), citric acid (for acidity), and urea (for bitterness), at three different (low, medium and high) concentrations. Weekly tests were performed during the first three weeks of radiotherapy, with random administration of the solutions (three drops each) respecting the order of their concentration levels (low, medium and high). After the application of each solution, the patient reported which flavor he/she tasted. Results: a statistically significant difference was observed in the loss of taste function as the results in the 1st and 4th weeks of treatment were compared, with salty solution at the three concentration levels, with the sweet solution at low and medium concentrations, and with the sour and bitter solutions, only at low concentration. Conclusion: ionizing radiation alters the taste function of patients submitted to head and neck radiotherapy. (author)

  4. Testicular dose in prostate cancer radiotherapy. Impact on impairment of fertility and hormonal function

    Energy Technology Data Exchange (ETDEWEB)

    Boehmer, D.; Badakhshi, H.; Budach, V. [Dept. of Radiation Oncology, Charite - Univ. Clinic - Campus Mitte, Berlin (Germany); Kuschke, W.; Bohsung, J. [Dept. of Medical Physics, Charite - Univ. Clinic - Campus Mitte, Berlin (Germany)

    2005-03-01

    Purpose: to determine the dose received by the unshielded testicles during a course of 20-MV conventional external-beam radiotherapy for patients with localized prostate cancer. Critical evaluation of the potential impact on fertility and hormonal impairment in these patients according to the literature. Patients and methods: the absolute dose received by the testicles of 20 randomly selected patients undergoing radiotherapy of prostate cancer was measured by on-line thermoluminescence dosimetry. Patients were treated in supine position with an immobilization cushion under their knees. A flexible tube, containing three calibrated thermoluminescence dosimeters (TLDs) was placed on top or underneath the testicle closest to the perineal region with a day-to-day alternation. The single dose to the planning target volume was 1.8 Gy. Ten subsequent testicle measurements were performed on each patient. The individual TLDs were then read out and the total absorbed dose was calculated. Results: the mean total dose ({+-} standard deviation) measured in a series of 10 subsequent treatment days in all patients was 49 cGy ({+-} 36 cGy). The calculated projected doses made on a standard series of 40 fractions of external-beam radiotherapy were 196 cGy ({+-} 145 cGy). The results of this study are appraised with the available data in the literature. Conclusion: the dose received by the unshielded testes can be assessed as a risk for permanent infertility and impairment of hormonal function in prostate cancer patients treated with external-beam radiotherapy. (orig.)

  5. Effect of radiotherapy on the immunocompetence in patients with bronchogenic carcinoma and laryngeal cancer

    International Nuclear Information System (INIS)

    We evaluated the immunocompetence of 80 patients with bronchogenic carcinoma and 17 patients with laryngeal cancer undergoing radiotherapy, using collectively many types of immunological parameters. In patients with bronchogenic carcinoma, no significant difference was seen with PHA and PPD skin tests, but the reactivity of PHA skin tests gradually decreased in the course of treatment. It was assumed that radiotherapy might not interfere with the recognition of antigen. Lymphocyte blastoid transformations with PHA, Con A and PWM were all inhibited significantly. Since these three mitogens can stimulate the different groups of lymphocyte, the inhibition to the proliferative function of lymphocyte due to radiotherapy would seem to cover a wide area, including T and B lymphocyte. Concerning the comparative radiosensitivity of T and B lymphocyte, no significant result was obtained. However, in the dose of 20Gy the percentage of T lymphocyte decreased, while the percentage of B lymphocyte increased. The percentage of early rosetts, one subset of T cell, decreased more sensitively than that of T cell, but there was no significant difference. Immunocompetence of cases in stage III, which was significantly high before treatment, decreased to the same level as those in stage IV according to the treatment. In patients with laryngeal cancer, lymphocyte counts and reactivity of PHA skin tests were not influenced by radiotherapy, and then reactivity of PPD skin tests and lymphocyte blastoid transformations with PHA and Con A tended to increase instead. (J.P.N.)

  6. Successful radiotherapy of facial angiosarcoma.

    Science.gov (United States)

    Gkalpakiotis, S; Arenberger, P; Vohradnikova, O; Arenbergerova, M

    2008-11-01

    Cutaneous angiosarcoma of the face and scalp is a rare malignant vascular tumor that affects mostly Caucasian elderly males. At present, connections concerning the etiology of this neoplasm with radiation therapy, exposure to environmental carcinogens and chronic lymphedema have been described. Due to the difficult histologic evaluation, high local recurrence and tendency to early metastasing, angiosarcoma poses generally a very poor prognosis. We report the case of an 80-year-old patient who experienced successful removal of large, exophytic growing angiosarcoma of the face achieved with radiotherapy with long-term relapse-free survival. PMID:18986458

  7. Basic radiotherapy physics and biology

    CERN Document Server

    Chang, David S; Das, Indra J; Mendonca, Marc S; Dynlacht, Joseph R

    2014-01-01

    This book is a concise and well-illustrated review of the physics and biology of radiation therapy intended for radiation oncology residents, radiation therapists, dosimetrists, and physicists. It presents topics that are included on the Radiation Therapy Physics and Biology examinations and is designed with the intent of presenting information in an easily digestible format with maximum retention in mind. The inclusion of mnemonics, rules of thumb, and reader-friendly illustrations throughout the book help to make difficult concepts easier to grasp. Basic Radiotherapy Physics and Biology is a

  8. Quality and safety in radiotherapy

    CERN Document Server

    Pawlicki, Todd

    2010-01-01

    The first text to focus solely on quality and safety in radiotherapy, this work encompasses not only traditional, more technically oriented, quality assurance activities, but also general approaches of quality and safety. It includes contributions from experts both inside and outside the field to present a global view. The task of assuring quality is no longer viewed solely as a technical, equipment-dependent endeavor. Instead, it is now recognized as depending on both the processes and the people delivering the service. Divided into seven broad categories, the text covers: Quality Management

  9. Adolescents with sickle cell anaemia: Experience in a private tertiary hospital serving a tertiary institution

    Directory of Open Access Journals (Sweden)

    Sarah John-Olabode

    2015-01-01

    Full Text Available Background: Many adolescents with sickle cell disease (SCD have adjustment difficulties in the transition period from paediatric care to the adult system because they find themselves in unfamiliar waters where they have to learn to manage themselves. The aim of this study is to evaluate the prevalent crises and morbidities associated with SCD in adolescents in Babcock University Teaching Hospital (BUTH, to also assess the level of knowledge of these adolescents about SCD and to determine their emotional response to the disease. Materials and Methods: This was a retrospective review of case notes of adolescents with sickle cell anaemia that were seen in BUTH, from May 2013 to April 2014. Data extracted from the case notes was entered into a Microsoft (MS Excel and analysed using descriptive statistics. Results were presented in tables. Results: A total of 50 subjects were seen in the department during this study period. Vaso-occlusive crises in the form of bone pains (93.1% were the commonest crises encountered. Associated morbidities were malaria 34 (85%, tonsilitis 1 (2.5%, pneumonia 1 (2.5%, leg ulcer 1 (2.5%, azotaemia 1 (2.5% and subarachnoid haemorrhage 2 (5%. Majority (88% had adequate knowledge about general health maintenance while knowledge on nutrition and appropriate analgesia use is still inadequate. Eleven (22% had symptoms of depression, four (8% had suicidal ideation while one (2% had a history of attempted suicide. Conclusion: This study emphasizes the importance of psychosocial intervention as part of a comprehensive health management for people with SCD.

  10. Amifostine Protection Against Mitomycin-induced Chromosomal Breakage in Fanconi Anaemia Lymphocytes

    Directory of Open Access Journals (Sweden)

    Miriam T. P. Lopes

    2008-08-01

    Full Text Available Fanconi anaemia (FA is a rare genetic chromosomal instability syndrome caused by impairment of DNA repair and reactive oxygen species (ROS imbalance. This disease is also related to bone marrow failure and cancer. Treatment of these complications with radiation and alkylating agents may enhance chromosomal breakage. We have evaluated the effect of amifostine (AMF on basal and mitomycin C (MMC-induced chromosomal breakage in FA blood cells using the micronucleus assay. The basal micronuclei count was higher among FA patients than healthy subjects. Pre-treatment with AMF significantly inhibited micronucleation induced by MMC in healthy subjects (23.4 ± 4.0 – MMC vs 12.3 ± 2.9 – AMF →MMC MN/1000CB, p < 0.01, one way ANOVA as well as in FA patients (80.0 ± 5.8 – MMC vs 40.1 ± 5.8 – AMF →MMC MN/1000CB, p < 0.01, ANOVA. Release of ROS by peripheral blood mononuclear cells treated with AMF →MMC and measured by chemoluminometry showed that AMF-protection was statistically higher among FA patients than in healthy individuals. Based on these results we suggest that AMF prevents chromosomal breakage induced by MMC, probably by its antioxidant effect.

  11. Integrity of the iron transport process in mice with X-linked anaemia

    International Nuclear Information System (INIS)

    The defect in iron (Fe) absorption in X-linked anaemia (sla) remains an enigma; absorption of a tracer dose of Fe is impaired in mice raised on an iron-containing cube diet but not in those raised on an iron-deficient diet. Because cobalt (Co) shares a similar intestinal transport pathway with Fe, a study was made of the effect of iron deficient diet on Co absorption. The duodenum of sla and genetically normal mice was perfused for 30 min with labelled solutions containing Co or Fe. Co uptake and transfer were similar in sla and normals fed cubes whereas Fe uptake and transfer were less in sla than in normals. The iron deficient diet caused an increase in the uptake and transfer of Co and Fe in sla and normals. When Co and Fe were perfused together in sla fed deficient diet, the uptake and transfer of each metal was less than when perfused alone. The distribution of Fe and Co in subcellular mucosal fractions was determined by a differential centrifugation technique. Deficient diet resulted in a directionally similar change in the subcellular distribution of Co and Fe in sla and normals. The increase in Co as well as Fe absorption in the sla on an iron deficient diet to the same high level found in genetically normal animals, and the inhibitory effect of each metal on the absorption of the other suggests that the absorption defect in sla is unlikely to be due to a primary defect in the function of the transport carrier. (author)

  12. Anaemia, Serum Iron Concentrations and δ-Aminolevulinate Dehydratase Activity in Laying Hens Infected Naturally by Salmonella Gallinarum.

    Science.gov (United States)

    Machado, A C; Boiago, M M; do Carmo, G M; Bottari, N B; Araujo, D N; Giuriatti, J; Morsch, V M; Schetinger, M R C; Casagrande, R A; Wisser, C S; Stefani, L M; Alves, M S; Da Silva, A S

    2016-07-01

    The aim of this study was to evaluate anaemia, serum iron concentrations and δ-aminolevulinate dehydratase (ALA-D) activity in laying hens infected naturally by Salmonella Gallinarum and having severe hepatic lesions. Liver and serum samples were collected from 27 laying hens (20 infected and seven uninfected). The δ-ALA-D activity, haematocrit and serum iron concentrations were evaluated. There were significant decreases in δ-ALA-D activity, haematocrit and serum iron concentrations (P hens may be related to reduction in δ-ALA-D activity and serum iron concentrations, since both are important for haemopoiesis. PMID:27262503

  13. A prospective, cross-sectional study of anaemia and peripheral iron status in antiretroviral naïve, HIV-1 infected children in Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Hussey Gregory D

    2002-02-01

    Full Text Available Abstract Background Anaemia is a common manifestation of paediatric HIV infection. Although there are many causes, anaemia of chronic diseases is the most frequent type. In poor countries iron deficiency is widespread. It is probable that many HIV-infected children in these countries are also iron deficient. This study describes the relationship between paediatric HIV infection and anaemia, and documents the peripheral iron status of antiretroviral naive, HIV-infected children. Methods Sixty children were evaluated prospectively. Investigations included CD4+ count, haemoglobin concentration (Hb, red blood cell (RBC morphology, and iron studies. Results Anaemia was present in 73% of children. Compared to mild HIV infection, median Hb was lower in children with moderate clinical infection (104 g/L v 112 g/L, p = 0.04 and severe clinical infection (96 g/L v 112 g/L, p = 0.006, and more children with severe infection were anaemic (92% v 58%, 0.04. There was a significant relationship between immunological status and Hb. 68% had abnormal RBC morphology. Significantly more children with moderate and severe disease, and severe immunosuppression had abnormal RBC morphology. 52% were iron-depleted, 20% had iron-deficient erythropoiesis and 18% iron deficiency anaemia (IDA. 16% (7/44 of anaemic children had microcytosis and hypochromia. Median soluble transferrin receptor concentration was significantly higher in those with microcytic hypochromic anaemia (42.0 nmol/L v 30.0 nmol/L, p = 0.008. Conclusions Both the proportion of anaemic children and the median Hb were associated with disease status. Iron depletion and IDA are major problems in HIV-infected children in South Africa.

  14. Quality control programme for radiotherapy

    International Nuclear Information System (INIS)

    A 3 years pilot programme started in January 2000 with 33 philanthropic cancer institutions that provides medical services to 60% of the patients from the national social security system. Brazil has today 161 radiotherapy services (144 operating with megavoltage equipment). These 33 institutions are distributed over 19 Brazilian states. The aim of this programme is: To create conditions to allow the participants to apply the radiotherapy with quality and efficacy; To promote up dating courses for the physicians, physicists and technicians of these 33 Institutions. With the following objectives: To recommend dosimetric and radiological protection procedures in order to guarantee the tumor prescribed dose and safe working conditions; To help in establishing and implementing these procedures. The main activities are: local quality control evaluations, postal TLD audits in reference conditions, postal TLD audits in off axis conditions and training. The local quality control program has already evaluated 22 institutions with 43 machines (25 Co-60 and 18 linear accelerators). In these visits we perform dosimetric, electrical, mechanical and safety tests. As foreseen, we found more problems among the old Co-60 machines i.e., field flatness, size, symmetry and relative output factors; lasers positioning system alignment; optical distance indicator; radiation and light field coincidence; optical and mechanical distance indicators agreement, than among the linear accelerators i.e., field flatness and size; lasers positioning system alignment; tray interlocking and wedge filter factors

  15. Craniospinal radiotherapy in adult medulloblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Selek, U.; Zorlu, F.; Hurmuz, P.; Cengiz, M.; Gurkaynak, M. [Hacettepe Univ., Ankara (Turkey). Dept. of Radiation Oncology; Turker, A. [Hacettepe Univ., Ankara (Turkey). Dept. of Internal Medicine; Soylemezoglu, F. [Hacettepe Univ., Ankara (Turkey). Dept. of Pathology

    2007-05-15

    Purpose: To evaluate the outcome and prognostic factors of adult patients with medulloblastoma. Patients and Methods: 26 adult medulloblastoma patients with a median age of 27 were subjected to craniospinal radiotherapy. A dose of 30.6 Gy with 1.8 Gy/fraction/day was prescribed to M0 patients, while 36 Gy were to be applied in patients with positive cerebrospinal liquor findings. The posterior fossa was boosted to 54 Gy. While 20 patients underwent external-beam radiotherapy alone, only six received sequential adjuvant chemotherapy. Results: Male/female ratio was 1.2. Preradiotherapy Karnofsky performance status was recorded as median 100%. 50% were classified as poor risk (n = 10, subtotal resection; n = 3, M+). The median follow-up time was 46.5 months. The 5-year actuarial survival rates for recurrence-free, distant metastasis-free, disease-free, and overall survival were 82.5%, 90.8%, 73.5%, and 89.7%, respectively. Patient characteristics, treatment factors and tumor characteristics failed to show any significance in univariate analysis. Grade 3 or 4 late morbidities were not observed. Conclusion: Yet, the current standard of care seems to remain craniospinal irradiation after maximal surgical resection of the primary neoplasm without clear indications for adjuvant chemotherapy. (orig.)

  16. Optimization of human cancer radiotherapy

    CERN Document Server

    Swan, George W

    1981-01-01

    The mathematical models in this book are concerned with a variety of approaches to the manner in which the clinical radiologic treatment of human neoplasms can be improved. These improvements comprise ways of delivering radiation to the malignan­ cies so as to create considerable damage to tumor cells while sparing neighboring normal tissues. There is no unique way of dealing with these improvements. Accord­ ingly, in this book a number of different presentations are given. Each presentation has as its goal some aspect of the improvement, or optimization, of radiotherapy. This book is a collection of current ideas concerned with the optimization of human cancer radiotherapy. It is hoped that readers will build on this collection and develop superior approaches for the understanding of the ways to improve therapy. The author owes a special debt of thanks to Kathy Prindle who breezed through the typing of this book with considerable dexterity. TABLE OF CONTENTS Chapter GENERAL INTRODUCTION 1. 1 Introduction 1...

  17. Safety Profile of Amnion-Derived Cellular Cytokine Solution (ACCS) Following Topical Skin Application in Patients Receiving Breast Radiotherapy

    OpenAIRE

    Trombetta, Mark; Julian, Thomas B.; Wickerham, D. Lawrence; Steed, David L.

    2015-01-01

    Objective: To establish a safety profile for amnion-derived cellular cytokine solution following topical application in patients undergoing whole breast radiotherapy for breast cancer. Materials and Methods: Twenty female patients with early-stage breast cancer were enrolled in 2 separate cohorts of an institutional review board–approved phase I protocol. Cohort 1 consisted of 10 patients who received topical amnion-derived cellular cytokine solution to the breast immediately following the fi...

  18. Accuracy of an Automatic Patient-Positioning System Based on the Correlation of Two Edge Images in Radiotherapy

    OpenAIRE

    Yoon, Myonggeun; Cheong, Minho; Kim, Jinsung; Shin, Dong Ho; Park, Sung Yong; Lee, Se Byeong

    2010-01-01

    We have clinically evaluated the accuracy of an automatic patient-positioning system based on the image correlation of two edge images in radiotherapy. Ninety-six head & neck images from eight patients undergoing proton therapy were compared with a digitally reconstructed radiograph (DRR) of planning CT. Two edge images, a reference image and a test image, were extracted by applying a Canny edge detector algorithm to a DRR and a 2D X-ray image, respectively, of each patient before positioning...

  19. Spinal cord stimulators and radiotherapy: First case report and practice guidelines

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    Walsh Lorraine

    2011-10-01

    Full Text Available Abstract Spinal cord stimulators (SCS are a well-recognised treatment modality in the management of a number of chronic neuropathic pain conditions, particularly failed back syndrome and radiculopathies. The implantable pulse generator (IPG component of the SCS is designed and operates in a similar fashion to that of a cardiac pacemaker. The IPG consists of an electrical generator, lithium battery, transmitter/receiver and a minicomputer. When stimulated, it generates pulsed electrical signals which stimulate the dorsal columns of the spinal cord, thus alleviating pain. Analogous to a cardiac pacemaker, it can be potentially damaged by ionising radiation from a linear accelerator, in patients undergoing radiotherapy. Herein we report our clinical management of the first reported case of a patient requiring adjuvant breast radiotherapy who had a SCS in situ. We also provide useful practical recommendations on the management of this scenario within a radiation oncology department.

  20. Spinal cord stimulators and radiotherapy: First case report and practice guidelines

    International Nuclear Information System (INIS)

    Spinal cord stimulators (SCS) are a well-recognised treatment modality in the management of a number of chronic neuropathic pain conditions, particularly failed back syndrome and radiculopathies. The implantable pulse generator (IPG) component of the SCS is designed and operates in a similar fashion to that of a cardiac pacemaker. The IPG consists of an electrical generator, lithium battery, transmitter/receiver and a minicomputer. When stimulated, it generates pulsed electrical signals which stimulate the dorsal columns of the spinal cord, thus alleviating pain. Analogous to a cardiac pacemaker, it can be potentially damaged by ionising radiation from a linear accelerator, in patients undergoing radiotherapy. Herein we report our clinical management of the first reported case of a patient requiring adjuvant breast radiotherapy who had a SCS in situ. We also provide useful practical recommendations on the management of this scenario within a radiation oncology department

  1. Anaemia and zidovudine-containing antiretroviral therapy in paediatric antiretroviral programmes in the IeDEA Paediatric West African Database to evaluate AIDS

    Directory of Open Access Journals (Sweden)

    Lorna A Renner

    2013-09-01

    Full Text Available Introduction: There is a risk of anaemia among HIV-infected children on antiretroviral therapy (ART containing zidovudine (ZDV recommended in first-line regimens in the WHO guidelines. We estimated the risk of severe anaemia after initiation of a ZDV-containing regimen in HIV-infected children included in the IeDEA West African database. Methods: Standardized collection of data from HIV-infected children (positive PCR<18 months or positive serology ≥18 months followed up in HIV programmes was included in the regional IeDEA West Africa collaboration. Ten clinical centres from seven countries contributed (Benin, Burkina Faso, Côte d'Ivoire, Gambia, Ghana, Mali and Senegal to this collection. Inclusion criteria were age <16 years and starting ART. We explored the data quality of haemoglobin documentation over time and the incidence and predictors of severe anaemia (Hb<7g/dL per 100 child-years of follow-up over the duration of first-line antiretroviral therapy. Results: As of December 2009, among the 2933 children included in the collaboration, 45% were girls, median age was five years; median CD4 cell percentage was 13%; median weight-for-age z-score was−2.7; and 1772 (60.4% had a first-line ZDV-containing regimen. At baseline, 70% of the children with a first-line ZDV-containing regimen had a haemoglobin measure available versus 76% in those not on ZDV (p≤0.01: the prevalence of severe anaemia was 3.0% (n=38 in the ZDV group versus 10.2% (n=89 in those without (p<0. 01. Over the first-line follow-up, 58.9% of the children had ≥1 measure of haemoglobin available in those exposed to ZDV versus 60.4% of those not (p=0.45. Severe anaemia occurred in 92 children with an incidence of 2.47 per 100 child-years of follow-up in those on a ZDV-containing regimen versus 4.25 in those not (p≤0.01. Adjusted for age at ART initiation and first-line regimen, a weight-for-age z-score ≤−3 was a strong predictor associated with a 5.59 times risk of

  2. Customized mold radiotherapy with prosthetic apparatus for oral cancers

    International Nuclear Information System (INIS)

    Eight patients (6 males, 2 females; median age, 78 years; age range, 31-94 years) were treated by mold radiotherapy with a prosthetic apparatus for oral cancers between October 2006 and March 2013. The primary sites were the tongue in 3 cases, hard palate and buccal mucosa in 2 cases each, and oral floor in 1 case. The type of treatment consisted of radical radiotherapy and palliative radiotherapy in 2 cases each, and preoperative radiotherapy, postoperative radiotherapy, additional radiotherapy after external beam radiotherapy and systemic chemotherapy in 1 case each. Patients received 40-50 Gy in 8-10 fractions with mold radiotherapy. Two patients who received radical radiotherapy showed no signs of recurrence or metastasis. The present therapy contributed to patients' palliative, postoperative, and preoperative therapy. Mold radiotherapy with a prosthetic appliance was performed safely and was a useful treatment for several types of oral cancer. (author)

  3. The development of radiotherapy in Slovenia

    International Nuclear Information System (INIS)

    The historical data on the development of radiotherapy in Slovenia are presented from its first use in this county in 1902 until the present. The Institute of Oncology in Ljubljana was established in 1938 with the intention of providing a sound development of radium and roentgen cancer treatment. After World War II, the development of radiotherapy was dynamic, which is evident from the data on new radiation sources in external beam therapy (accelerators, telecobalt units), in brachytherapy (various sealed radioisotopes) as well as in the introduction of therapy with unsealed radioisotopes. In 1947, a Chair of Oncology and Radiotherapy was instituted at the Medical Faculty of the University of Ljubljana (with the seat at the Institute of Oncology). In 1955, radiotherapy and oncology were officially recognized as separate branches of medicine requiring special obligatory postgraduate residency training. Within the Medical Society of Slovenia, the Section for Radiotherapy was established in 1987. The following year, the Section for Radiotherapy of Slovenia became a member of the European Society for Therapeutic Radiology and Oncology. Considering the size of population of Slovenia (nearly 2 million), it was reasonable that by this time radiotherapy became almost completely concentrated in one central institution, the Institute of Oncology, whose core and cohesive activity were represented in the multidisciplinary cancer treatment approach

  4. Stem cell transplantation from HLA-matched related donor for Fanconi's anaemia: a retrospective review of the multicentric Italian experience on behalf of AIEOP-GITMO.

    Science.gov (United States)

    Dufour, C; Rondelli, R; Locatelli, F; Miano, M; Di Girolamo, G; Bacigalupo, A; Messina, C; Porta, F; Balduzzi, A; Iorio, A P; Buket, E; Madon, E; Pession, A; Dini, G; Di Bartolomeo, P

    2001-03-01

    Twenty-seven consecutive Italian patients with Fanconi's anaemia (FA) underwent stem cell transplantation (SCT) from an HLA-matched related donor in 10 Italian centres of the Associazione Italiana Ematologia ed Oncologia Pediatrica (AIEOP), Gruppo Italiano di Trapianto di Midollo Osseo (GITMO). Twenty-two patients (81.5%) were conditioned with low-dose (median 20 mg/kg) cyclophosphamide (Cy) and thoraco-abdominal or total body irradiation (median dose 500 cGy), five patients (18.5%) with high-dose Cy (median 120 mg/kg). Graft-vs.-host disease (GVHD) prophylaxis was carried out with cyclosporin A in 26 cases; methotrexate (MTX) was added in eight cases. One patient received MTX alone. The median follow-up was 36 months. Ninety-two percent of patients (25 out of 27) engrafted, grade II and III acute GVHD occurred in 28% and 8% of patients, respectively, with chronic GVHD in 12.5%. Conditioning-related toxicity was mild: 4% of patients had grade III mucositis, 7.4% had grade II haemorrhagic cystitis, 14.8% had grade III liver toxicity and 11.1% had grade III renal toxicity. Transplant-related mortality at 12 months was 19.2%, survival at 36 months was 81.5%, with a median Karnofsky score of 100%. No late tumours occurred after a mean follow-up of the survivors of 5 years. None of the studied variables significantly affected the survival, including conditioning regimen, acute GVHD and clinical non-haematological phenotype. Among the studied variables, only conditioning regimens containing high-dose Cy and the presence of genital abnormalities were significantly (P < 0.05) associated with an increased rate of acute GVHD. Our study demonstrates that the Italian FA patients undergoing SCT from an HLA-matched related donor have a very good outcome. These patients, when compared with others of different ethnic origin who underwent allogeneic bone marrow transplantation, showed a less severe non-haematological phenotype, raising the possibility that this milder phenotype may

  5. [Current status and perspectives of radiotherapy for esophageal cancer].

    Science.gov (United States)

    Wu, S X; Wang, L H

    2016-09-23

    Esophageal cancer is one of the most common cancers in China. More than 80% of esophageal cancer patients are diagnosed at a late stage and are not eligible for surgery. Radiotherapy is one of the most important modalities in esophageal cancer treatment. Here we reviewed the advances in esophageal cancer radiotherapy and radiotherapy-based combined-modality therapy, such as optimization of radiation dose and target volume, application of precise radiotherapy technique and the integration of radiotherapy with chemotherapy and targeted therapy.

  6. Radiotherapy in the management of early breast cancer

    OpenAIRE

    Wang, Wei

    2013-01-01

    Radiotherapy is an indispensible part of the management of all stages of breast cancer. In this article, the common indications for radiotherapy in the management of early breast cancer (stages 0, I, and II) are reviewed, including whole-breast radiotherapy as part of breast-conserving treatment for early invasive breast cancer and pre-invasive disease of ductal carcinoma in situ, post-mastectomy radiotherapy, locoregional radiotherapy, and partial breast irradiation. Key clinical studies tha...

  7. Adjuvant radiotherapy for gallbladder cancer: A dosimetric comparison of conformal radiotherapy and intensity-modulated radiotherapy

    Institute of Scientific and Technical Information of China (English)

    Xiao-Nan Sun; Qi Wang; Ben-Xing Gu; Yan-Hong Zhu; Jian-Bin Hu; Guo-Zhi Shi; Shu Zheng

    2011-01-01

    AIM: To assess the efficacy and toxicity of conformal radiotherapy (CRT) and compare with intensity-modulated radiotherapy (IMRT) in the treatment of gallbladder cancer.METHODS: Between November 2003 and January 2010, 20 patients with gallbladder cancer were treated with CRT with or without chemotherapy after surgical resection. Preliminary survival data were collected and examined using both Kaplan-Meier and actuarial analysis. Demographic and treatment parameters were collected. All patients were planned to receive 46-56 Gy in 1.8 or 2.0 Gy per fraction. CRT planning was compared with IMRT.RESULTS: The most common reported acute toxicities requiring medication (Radiation Therapy Oncology Group, Radiation Therapy Oncology Group Grade2) were nausea (10/20 patients) and diarrhea (3/20).There were no treatment-related deaths. Compared with CRT planning, IMRT significantly reduced the volume of right kidney receiving > 20 Gy and the volume of liver receiving > 30 Gy. IMRT has a negligible impact on the volume of left kidney receiving > 20 Gy. The 95% of prescribed dose for a planning tumor volume using either 3D CRT or IMRT planning were 84.0% ±6.7%, 82.9% ± 6.1%, respectively (P > 0.05).CONCLUSION: IMRT achieves similar excellent target coverage as compared with CRT planning, while reducingthe mean liver dose and volume above threshold dose. IMRT offers better sparing of the right kidney compared with CRT planning, with a significantly lower mean dose and volume above threshold dose.

  8. Magnitude of fatigue in cancer patients receiving radiotherapy and its short term effect on quality of life

    Directory of Open Access Journals (Sweden)

    Janaki M

    2010-01-01

    Full Text Available Background : Fatigue is one of the most common, ongoing symptoms reported by patients undergoing radiotherapy and has profound effects on the quality of life. Aims : This study attempts to identify the magnitude of fatigue and its implication on the quality of life during radiotherapy. Methods and Materials : A prospective study was conducted from March 2004 to September 2005, on 90 patients with histologically proven cancer, receiving radiotherapy. Pretreatment and weekly assessment of fatigue and QOL was done during radiation treatment using Brief Fatigue Inventory Scale and EORTC QLQ C30 respectively and repeated one month after completion of radiotherapy. All the scores were measured in the 0 to 100 scale. Statistical Methods Used : Trimean, SPSS 11.0 and Sysstat 8.0 were used for statistical analysis. Results : Fatigue was present in 87.8% of patients initially and increased gradually over the course of radiotherapy and peaked in the last week. However at follow up it was nearing the pretreatment level. There was significant reduction in the functional scores ( P < 0.001 of QOL (physical, role and emotional function, which returned to pretreatment level at follow up. In the seventh week impairment of cognitive function (P=0.059 was noted. Significant reduction of social function (P < 0.001 at second week and global health status (P < 0.001 at fifth week was noted while financial difficulty was seen from second week onwards. Conclusion : Fatigue is transiently increased by radiotherapy before reaching pretreatment level after few weeks of completion of radiotherapy. QOL is also affected by fatigue which follows the same pattern.

  9. Radiotherapy for solitary plasmacytoma and multiple myeloma

    International Nuclear Information System (INIS)

    Solitary plasmacytoma and multiple myeloma require a differentiated radiotherapy. The irradiation for plasmacytoma with an adequate total dose (medullary 40-50 Gy or extramedullary 50-60 Gy) leads to a high degree of local control with a low rate of side effects. In cases of multiple myeloma radiotherapy will achieve effective palliation, both in terms of recalcification as well as reduction of neurological symptoms and analgesia. In terms of analgesia the rule is the higher the single dose fraction the faster the reduction of pain. As part of a conditioning treatment prior to stem cell transplantation radiotherapy contributes to the establishment of a graft versus myeloma effect (GVM). (orig.)

  10. Radiotherapy versus combined modality in early stages

    DEFF Research Database (Denmark)

    Specht, L.; Carde, P.; Mauch, P.;

    1992-01-01

    In early stage Hodgkin's disease the optimal choice of treatment for the individual patient is still an unresolved issue. So far, twenty-two randomized trials of radiotherapy alone versus radiotherapy plus combination chemotherapy have been carried out worldwide. The preliminary results of a global...... be reduced, and that the stress of experiencing a relapse is avoided in many patients. The major argument against the use of chemotherapy up front is: that by careful staging and selection of patients and by careful radiotherapy techniques the number of patients exposed to potentially toxic chemotherapy may...

  11. Prophylactic treatment of mycotic mucositis in radiotherapy of patients with head and neck cancers

    Energy Technology Data Exchange (ETDEWEB)

    Koc, M.; Aktas, E. [Ataturk Univ., Erzurum (Turkey). Medical School

    2003-02-01

    Patients undergoing radiotherapy for head and neck cancer are at increased risk of developing oral candidiasis. The objective of this study was to investigate the clinical Candida mucositis and interruptions in radiotherapy in patients suffering from head and neck cancer, receiving fluconazole in comparison with a control group without specific prophylaxis. Eighty consecutive patients were randomized in a prospective double-blind trial of prophylactic oral fluconazole or treatment with the same drug when mycotic infections appeared. Adult head and neck cancer patients who were undergoing treatment with radiotherapy and/or chemotherapy, radiotherapeutic coverage of the entire oropharynx and oral cavity at least 3 cm anterior to the retromolar trigone and receiving a total dose of more than 6000 cGy and Karnofsky Performance Status (KPS) >70 were included in the study. Group A received radiation therapy plus fluconazole (Fluzole 100 mg/day) starting from the sixth irradiation session throughout the treatment; 40 patients in group B received the same baseline treatment, but were given fluconazole only when mycotic infections appeared. We evaluated 37 patients in group A and the first 37 patients were evaluated in group B. Three of the patients in group A (8.1%) and 14 of the patients in group B (37.8%) demonstrated clinical candidasis. Radiotherapy was interrupted in all of these patients. The differences between the two groups were statistically significant with respect to clinical candidiasis (P=0.005). The median discontinuation time was 5 days (range, 3-7 days) in group A and 7 days (range, 4-10 days) in group B. The median dose resulting in clinical candidiasis was 3200 cGy (range, 2200-5800 cGy) in all groups. In the fluconazole group it was 4200 cGy and in the control group 2800 cGy. These results suggest that patients undergoing head and neck radiation therapy are at risk of developing candidiasis and that fluconazole may be used to reduce the frequency of

  12. Prophylactic treatment of mycotic mucositis in radiotherapy of patients with head and neck cancers

    International Nuclear Information System (INIS)

    Patients undergoing radiotherapy for head and neck cancer are at increased risk of developing oral candidiasis. The objective of this study was to investigate the clinical Candida mucositis and interruptions in radiotherapy in patients suffering from head and neck cancer, receiving fluconazole in comparison with a control group without specific prophylaxis. Eighty consecutive patients were randomized in a prospective double-blind trial of prophylactic oral fluconazole or treatment with the same drug when mycotic infections appeared. Adult head and neck cancer patients who were undergoing treatment with radiotherapy and/or chemotherapy, radiotherapeutic coverage of the entire oropharynx and oral cavity at least 3 cm anterior to the retromolar trigone and receiving a total dose of more than 6000 cGy and Karnofsky Performance Status (KPS) >70 were included in the study. Group A received radiation therapy plus fluconazole (Fluzole 100 mg/day) starting from the sixth irradiation session throughout the treatment; 40 patients in group B received the same baseline treatment, but were given fluconazole only when mycotic infections appeared. We evaluated 37 patients in group A and the first 37 patients were evaluated in group B. Three of the patients in group A (8.1%) and 14 of the patients in group B (37.8%) demonstrated clinical candidasis. Radiotherapy was interrupted in all of these patients. The differences between the two groups were statistically significant with respect to clinical candidiasis (P=0.005). The median discontinuation time was 5 days (range, 3-7 days) in group A and 7 days (range, 4-10 days) in group B. The median dose resulting in clinical candidiasis was 3200 cGy (range, 2200-5800 cGy) in all groups. In the fluconazole group it was 4200 cGy and in the control group 2800 cGy. These results suggest that patients undergoing head and neck radiation therapy are at risk of developing candidiasis and that fluconazole may be used to reduce the frequency of

  13. A Comparative Study of Prevalence of Iron Deficiency Anaemia in Antenatal Women from Urban and Rural Area of Pune, India

    Directory of Open Access Journals (Sweden)

    Kundap RP

    2016-05-01

    Material and Methods: A cross sectional study was conducted in urban and rural health training centres of a medical college in Pune. The antenatal women were the study subjects. A total of 180 ANC cases were recruited and studies from both the field practice area attending the outpatient clinics. Sociodemographic profile was recorded and anaemia was assessed using recently done haemoglobin reports in the present pregnancy. The study duration was 6 months. GCP and ethical guidelines were followed as advised for human studies. Results: The prevalence of IDA in the study population was 66%. (rural=81%, urban=51%. IDA prevalence was 54% in primigravida and the prevalence increased as gravid status increased. Iron deficiency anaemia was seen statistically significantly associated with residence, illiteracy, type of diet, and gravida status of the pregnant women. Conclusion: IDA has strong relation with residence (urban/rural, literacy level, social status, monthly income and dietary habits. " [Natl J Community Med 2016; 7(5.000: 351-354

  14. Prevalence of chicken infectious anaemia virus (CIAV) in commercial poultry flocks of northern India: a serological survey.

    Science.gov (United States)

    Bhatt, P; Shukla, S K; Mahendran, M; Dhama, K; Chawak, M M; Kataria, J M

    2011-10-01

    Globally, the chicken infectious anaemia virus (CIAV) has gained much importance as an immunosuppressive and economically important emerging pathogen of poultry. In recent years, the virus has been detected and isolated from poultry flocks of India. The present study reports the first sero-epidemiological investigation of the presence of CIAV infection in poultry flocks of the country. A total of 404 serum samples were collected from chicken flocks of eleven poultry farms, which contain a total of 0.34 million birds from four Northern states, suspected of having chicken infectious anaemia (CIA). Screening of the sera samples using a commercially available enzyme-linked immunosorbent assay (ELISA) kit revealed 351 serum samples (86.88%) to be positive for CIAV antibodies. A high CIAV prevalence rate recorded in the present investigation, along with earlier virus detection reports, indicates the widespread distribution of the virus and that CIAV should be considered an economically important poultry pathogen affecting poultry industry of India. Extensive nationwide epidemiological studies are suggested for revealing the economic impact of CIA and to initiate further research along with devising and adapting suitable prevention and control strategies especially the use of suitable vaccines for safeguarding poultry health and production in the country.

  15. Risk factors of post renal transplant anaemia among Sudanese patients, a study in three renal transplant centres

    Directory of Open Access Journals (Sweden)

    Elmusharaf Khalifa

    2011-08-01

    Full Text Available Abstract Background There is a relative lack of recent information about late post kidney transplantation anaemia (PTA, especially in the developing countries; data are scarce about the prevalence and risk factors of PTA. Sudan was a leading country in Africa and Arab world in kidney transplantation. The first kidney transplantation in Sudan was in 1973. Methods This is a cross-sectional hospital analytic study enrolling all kidney transplanted recipients following in the transplant referral clinics at Ahmed Gassim, Selma and Ibn Sina Hospitals, Khartoum/Sudan, in the period from 1/8/2010 to 1/9/2010, clinical and laboratory data were obtained from 114 patients, anaemia was defined as Hb levels of Results The study showed that 39.5% of the patients were anaemic. Univariate analysis showed that late PTA is significantly associated with not using Erythropoietin (EPO in the pre-transplant period (p = Conclusion The study concluded that late PTA is common and under recognized. Risk factors for late PTA include renal dysfunction, history of rejection, longer duration of transplantation and not using EPO in the pre-transplant period. Renal dysfunction and not using EPO in the pre-transplant period are major predictors of late PTA.

  16. Serum copeptin and cortisol do not accurately predict sickle cell anaemia vaso-occlusive crisis as C-reactive protein.

    Directory of Open Access Journals (Sweden)

    Kehinde Sola Akinlade

    Full Text Available OBJECTIVE: This study assessed the diagnostic performance and prognostic properties of C-reactive protein (CRP, copeptin and cortisol in individuals with sickle cell anaemia (SCA. DESIGN: Prospective case-control study. METHODS: Sixty consecutive SCA subjects (18-40 years comprising 30 subjects in the steady state and 30 subjects in vaso-occlusive crisis (VOC were recruited into this study. Thirty (30 apparently healthy individuals with HbAA genotype served as controls. ELISA was used for the determination of serum levels of copeptin, CRP and cortisol. Data obtained were statistically analyzed using the Student's t-test and Mann Whitney U as appropriate and P<0.05 was considered significant. RESULTS: SCA subjects in VOC had significantly lower copeptin level and significantly higher CRP level compared with controls. However, serum levels of copeptin, cortisol and CRP were significantly higher in SCA subjects in VOC compared with SCA subjects in steady state. Furthermore, CRP had the widest Area under the ROC curve (AUROC than copeptin and cortisol. No significant difference was observed in the levels of copeptin, CRP and cortisol when SCA subjects in VOC who were hospitalized for less ≤ 5 days were compared with subjects who had longer stays. CONCLUSION: It could be concluded that C-reactive protein has a superior diagnostic performance for vaso-occlusive crisis in individuals with sickle cell anaemia and that C-reactive protein, cortisol and copeptin are not good prognostic markers in SCA subjects in vaso-occlusive crisis.

  17. Cardiovascular Risk Profiles amongst Women in a Multiethnic Population in Inner City Britain: A Potential Impact of Anaemia

    Directory of Open Access Journals (Sweden)

    Julia Chackathayil

    2013-01-01

    Full Text Available The risk of diabetes is markedly reduced in men with iron deficiency anaemia (IDA. The nature of this relationship in women is not clear, nor is there information about the influence of ethnicity, given the increased susceptibility of diabetes amongst South Asians and Afro-Caribbeans. We reviewed 3563 patients with a diagnosis of anaemia from 2000 to 2007. The age-adjusted prevalence of vitamin B12 deficiency and IDA was calculated, together with cardiovascular comorbidities amongst Caucasians, South Asians, and Afro-Caribbeans. The prevalence of vitamin B12 deficiency (women only or IDA was markedly higher in South Asians compared to Caucasians and Afro-Caribbeans. Among women with IDA, diabetes was more prevalent among South Asians (45%, 95% CI 39.0–51.0 compared to Caucasians (3.0%, 2.1–4.0; P<0.001. Among South Asian women with vitamin B12 deficiency, the prevalence of diabetes was reduced 8.5% (5.2–12.0. South Asian women with vitamin B12 deficiency had a higher prevalence of myocardial infarction (MI and ischemic heart disease (IHD, but this relationship was reversed in IDA. IDA is associated with a greater prevalence of diabetes in South Asian women, but it is not coordinated by a greater risk of macrovascular complications. Given the cardiovascular impact of diabetes in South Asians, this association merits further study in relation to its pathophysiological implication.

  18. Bone marrow suppression and severe anaemia associated with persistent Plasmodium falciparum infection in African children with microscopically undetectable parasitaemia

    Directory of Open Access Journals (Sweden)

    Rodriques Onike

    2005-12-01

    Full Text Available Abstract Background Severe anaemia can develop in the aftermath of Plasmodium falciparum malaria because of protracted bone marrow suppression, possibly due to residual subpatent parasites. Materials and methods Blood was collected from patients with recent malaria and negative malaria microscopy. Detection of the Plasmodium antigens, lactate dehydrogenase (Optimal®, aldolase and histidine rich protein 2 (Now malaria® were used to differentiate between patients with (1 no malaria, (2 recent cleared malaria, (3 persistent P. falciparum infection. Red cell distribution width (RDW, plasma levels of soluble transferrin receptor (sTfR and erythropoietin (EPO were measured as markers of erythropoiesis. Interleukin (IL 10 and tumour necrosis factor (TNFα were used as inflammation markers. Results EPO was correlated with haemoglobin, irrespective of malaria (R = -0.36, P P. falciparum infection, but not recent malaria without residual parasites, was associated with bone marrow suppression i.e., low RDW (P Conclusion In the treatment of malaria, complete eradication of parasites may prevent subsequent development of anaemia. Severely anaemic children may benefit from antimalarial treatment if antigen tests are positive, even when no parasites can be demonstrated by microscopy.

  19. Intravenous iron supplementation in the anaemia of renal and cardiac failure--a double-edged sword?

    Science.gov (United States)

    Slotki, Itzchak

    2005-07-01

    The anaemia of chronic kidney disease (CKD) is efficiently corrected with a combination of recombinant erythropoietin (rhEPO) and intravenous iron supplementation. Recently, patients with severe cardiac failure and anaemia have also been shown to benefit from this treatment. However, iron excess may lead to the production of free radicals and has been incriminated in the pathogenesis of atherosclerosis and increased risk of infection, the two major causes of death in end-stage renal disease. The exact risk of excess iron supplementation has not been defined and, in the absence of sensitive and specific indicators of iron overload, the risk remains difficult to quantify. There is increasing epidemiological evidence incriminating iron overload as a risk factor in CKD, but direct evidence is still hard to obtain. The precise role of iron is complicated further by the complex inter-relationships between iron metabolism and the inflammatory process characteristic of CKD. The recent discovery of the antimicrobial peptide, hepcidin, may shed light on these inter-relationships. New methods for quantifying non-transferrin-bound (or labile plasma) iron may help in the future to identify patients at risk for toxicity from excess iron supplementation. PMID:16024827

  20. Single fraction radiotherapy versus multiple fraction radiotherapy for bone metastases in prostate cancer patients: comparative effectiveness

    Directory of Open Access Journals (Sweden)

    Yoon F

    2014-11-01

    Full Text Available Frederick Yoon,1 Gerard C Morton2 1Simcoe Muskoka Regional Cancer Centre, Royal Victoria Regional Health Centre, Barrie, ON, Canada; 2Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada Abstract: External beam radiotherapy (EBRT is an effective treatment for symptomatic bone metastases from a variety of primary malignancies. Previous meta-analyses and systematic reviews have reported on the efficacy of EBRT on bone metastases from multiple primaries. This review is focused on the comparative effectiveness of single fraction radiotherapy versus multiple fraction radiotherapy for bone metastases in prostate cancer patients. Keywords: radiotherapy, bone, metastases, prostate, comparative effectiveness