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Sample records for ciertas anemias graves

  1. Concurrent reactive arthritis, Graves' disease, and warm autoimmune hemolytic anemia: a case report.

    Science.gov (United States)

    Chiang, Elizabeth; Packer, Clifford D

    2009-08-13

    Warm antibody autoimmune hemolytic anemia is due to the presence of warm agglutinins that react with protein antigens on the surface of red blood cells causing premature destruction of circulating red blood cells. We report the first case of concurrent reactive arthritis, Graves' disease, and autoimmune hemolytic anemia. A 40-year-old man with reactive arthritis, Graves' disease, type 2 diabetes mellitus, mitral valve prolapse, and Gilbert's disease presented with a one month history of jaundice, fatigue, and black stools. After diagnosis of warm autoimmune hemolytic anemia, the patient was started on prednisone 1 mg/kg with rapid improvement in his anemia and jaundice. Our subject's mother and possibly his maternal grandmother also had autoimmune hemolytic anemia, which raises the possibility of hereditary autoimmune hemolytic anemia, a rarely reported condition.

  2. Nutrición y anemias en pacientes graves Nutrition and anaemias in critical illness

    OpenAIRE

    2010-01-01

    Introducción: Realizamos un estudio clínico original sobre nutrición en pacientes graves, que incluye a un grupo heterogéneo típico de pacientes críticos, con/sin anemias, que nos han ingresado en la Unidad de Cuidados Intensivos, UCI. Es difícil individualizar y generalizar la relativa importancia de todos los factores que pueden contribuir a estas anemias en la admisión en la Unidad, incluyendo las deficiencias nutricionales, las alteraciones inflamatorias, la respuesta a las agresiones, la...

  3. Necrose tubular aguda e anemia grave após uso intermitente de rifampicina

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    Eduardo Santos

    2013-03-01

    Full Text Available A rifampicina (RFP pode ser administrada diariamente ou num esquema intermitente. Quando é administrada de forma intermitente pode produzir reações imuno-alérgicas graves. Apresentamos o caso clínico de um pa-ciente que, após tratamento com RFP de forma intermitente para uma infeção por Mycobacterium intracellulare, desenvolveu quadro de necrose tubular aguda, anemia, prolongamento dos tempos de coagulação e citó-lise hepática ligeira. Após suspensão do fármaco houve recuperação em 24h das alterações da coagulação e da citólise hepática, tendo tido no entanto necessidade de hemodiálise por persistência de anúria e uremia, e transfusão de concentrados de eritrócitos pela gravidade da anemia. Teve alta com recuperação de todas as disfunções.

  4. Anemia

    Science.gov (United States)

    ... Hemolytic anemia Idiopathic aplastic anemia Megaloblastic anemia Pernicious anemia Sickle cell anemia Thalassemia Causes Although many parts of the ... anemia Immune hemolytic anemia Iron deficiency anemia Pernicious anemia Sickle cell anemia Vitamin B12 deficiency anemia Review Date 2/ ...

  5. Nutrición y anemias en pacientes graves Nutrition and anaemias in critical illness

    Directory of Open Access Journals (Sweden)

    F. Gallardo

    2010-02-01

    Full Text Available Introducción: Realizamos un estudio clínico original sobre nutrición en pacientes graves, que incluye a un grupo heterogéneo típico de pacientes críticos, con/sin anemias, que nos han ingresado en la Unidad de Cuidados Intensivos, UCI. Es difícil individualizar y generalizar la relativa importancia de todos los factores que pueden contribuir a estas anemias en la admisión en la Unidad, incluyendo las deficiencias nutricionales, las alteraciones inflamatorias, la respuesta a las agresiones, las modificaciones inmunitarias y las complejas relaciones existente entre estos procesos clínicos. Objetivo: Valoración indirecta de la situación nutricional y anemias, en un grupo heterogéneo típico de pacientes críticos. Método/Resultados: Se estudian 202 pacientes ingresados en la UCI, de variada y heterogénea procedencia, y clasificándolos en 3 grupos: control, postoperados y sépticos, realizándose la valoración indirecta de la situación nutricional en base a: la Valoración Global Subjetiva, (VGS, y las determinaciones analíticas nutricionales pronosticas de linfocitos totales, albúmina, y transferrina. También se realizo hemograma y determinaciones de sideremia y ferritinemia a todos ellos. En un 57% de los pacientes, se observo cifras de hemoglobina inferior a 12.5 gr/dl, básicamente en el grupo de postoperados, (68 pacientes y sépticos, (10 pacientes. Y con cifras inferiores a 10 g/dl de hemoglobina, en 25 pacientes mas, (12,3%. Hubo 87 pacientes, 23 de ellos en el grupo control, 58 en los postoperados y 5 sépticos, cuya cifra de hemoglobina era superior a 12,5 g/dl. En cuanto a los indicadores pronósticos nutricionales, (VGS + perfil nutricional, en el grupo control no presentaban anemia ni desnutrición clínico analítica, en los postoperados, anemia y desnutrición leve y en los sépticos, anemia y desnutrición ligera-moderada. Había diferencias significativas entre los pacientes del grupo control y los grupos

  6. Reação leucemoide e anemia hemolítica grave causada por Mycoplasma pneumoniae Leukemoid reaction and severe hemolytic anemia due to Mycoplasma pneumoniae

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    Kléber G. Luz

    2010-02-01

    Full Text Available Hemólise massiva é uma manifestação rara da infecção por Mycoplasma pneumoniae.É desencadeada por crioaglutininas, anticorpos IgM, que surgem sete a dez dias após a infecção em cerca de 50% a 75% dos casos. Hiperleucocitose é também evento incomum e orienta o diagnóstico para etiologia bacteriana ou neoplásica. Relatamos um caso de um homem de 67 anos com pneumonia por Mycoplasma pneumoniae, que apresentou anemia grave e reação leucemoide, diagnosticada por meio do teste de crioaglutininas à beira do leito e dosagem do título de anticorpo anti-mycoplasma. Após início do tratamento adequado, houve melhora importante da anemia e a leucometria foi reduzida de 56.100/mm³ para valores próximos do normal.Massive hemolysis, a rare manifestation of Mycoplasma pneumoniae infection, is due to cold agglutinins (IgM antibodies that appear seven to ten days after the infection in around 50% to 70% of cases. Hyperleukocytosis, suggestive of bacterial or neoplastic etiologies, is also an uncommon event. We report here on the case of a 67-year-old man with Mycoplasma pneumoniae pneumonia who presented with severe anemia and leukemoid reaction as diagnosed by the bedside cold agglutinin test and measurement of anti-mycoplasma antibodies. After beginning appropriate treatment, the anemia improved significantly and the leukocyte count reduced from 56100 /mm³ to close to normal level.

  7. Anemias.

    Science.gov (United States)

    Broadway-Duren, Jacqueline B; Klaassen, Hillary

    2013-12-01

    Anemias continue to present a challenge to the health care profession. Anemia is defined as a reduction in one or more of the RBC indices. Patients presenting with a mild form of anemia may be asymptomatic; however, in more serious cases the anemia can become life threatening. In many cases the clinical presentation also reflects the underlying cause. Anemia may be attributed to various causes, whereas autoimmune RBC destruction may be attributed to intrinsic and extrinsic factors. Laboratory tests are essential in facilitating early detection and differentiation of anemia.

  8. Anemia

    Science.gov (United States)

    ... are affected. Low levels of red blood cells leads to anemia. With low levels of white blood cells, the ... foods they eat. Food fads and dieting can lead to anemia. Talk to your doctor about taking iron pills ( ...

  9. Anemia grave e Helicobacter Pylori: A Propósito de um caso clínico

    OpenAIRE

    Brandão, Carla; Pereira, Susana Aires; Costa, Cristina

    2014-01-01

    Desde que foi identificado em 1983, o Helicobacter pylori (Hp) tem sido considerado como causa major de gastrite crónica e úlcera péptica primária, quer em adultos, quer em crianças.Recentemente, têm sido descritos casos de anemia ferropénica em crianças sem qualquer evidência de perdas hemáticas e com gastrite assintomática por Hp. A anemia é refractária à terapêuticacom ferro e resolve apenas após erradicação do Helicobacter.Os autores descrevem o caso de uma adolescente com anemia ferropén...

  10. Anemia

    Science.gov (United States)

    ... Physician October 01, 2002, http://www.aafp.org/afp/20021001/1217.html)Normocytic Anemia by JR Brill, ... Physician November 15, 2000, http://www.aafp.org/afp/20001115/2255.html) Last Updated: February 2014 This ...

  11. [Graves' ophthalmopathy].

    Science.gov (United States)

    Badelon, Isabelle; Morax, Serge

    2005-01-31

    Graves' ophthalmopathy (GO) is a chronic autoimmune process that affects the retrobulbar tissue and has strong etiological links with graves' disease. Pathogenesis is incompletely understood. Symptoms include proptosis, extraocular muscle dysfunction, eyelid swelling and retraction. In its severe expression, it is a disfiguring and potentially sight threatening disease that profoundly influences and impairs the quality of life of affected individuals. Only a minority of patients develop severe expressions of the disease, requiring aggressive treatments. Glucocorticoids, orbital radiotherapy and decompressive orbital surgery represent a mainstay and a well established treatment for severe and active GO.

  12. Anemia e transfusões de concentrados de hemácias em pacientes graves nas UTI brasileiras (pelo FUNDO-AMIB Transfusion practices in brazilian Intensive Care Units (pelo FUNDO-AMIB

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    Suzana Margareth Lobo

    2006-09-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A anemia é uma condição comum em pacientes graves. A transfusão de hemoderivados aumenta de forma significativa o risco de transmissão de agentes infecciosos e afeta o perfil imunológico. O objetivo deste estudo foi avaliar a incidência de anemia e a prática de transfusão de hemácias em UTI brasileiras. MÉTODO: Estudo prospectivo, multicêntrico, realizado em 19 UTI em um período de duas semanas. A presença de anemia, as indicações e a utilização de concentrados de hemácias, foram avaliadas diariamente. As complicações que ocorreram durante a internação na UTI e após a transfusão da primeira unidade de concentrado de hemácias foram registradas. RESULTADOS: Um total de 33% apresentava anemia na admissão na UTI e esta proporção aumentou para 55% no final de sete dias de internação. Um total de 348 unidades de concentrado de hemácias foi transfundido em 86 pacientes (36,5%. A média de suas unidades por paciente foi 4,1 ± 3,3 U. O nível de hemoglobina limiar para a transfusão de CH foi 7,7 ± 1,1 g/dL. Pacientes transfundidos tinham mais disfunções orgânicas avaliadas pelo escore SOFA (7,9 ± 4,6 versus 5,6 ± 3,8, transfundidos versus não transfundidos, p BACKGROUND AND OBJECTIVES: Anemia of critical illness is a multifactorial condition caused by blood loss, frequent phlebotomies and inadequate production of red blood cells (RBC. Controversy surrounds the most appropriate hemoglobin concentration "trigger" for transfusion of RBC. We aimed to evaluate transfusion practices in Brazilian ICUs. METHODS: A prospective study throughout a 2-week period in 19 Brazilian ICUs. Hemoglobin (Hb level, transfusion rate, organ dysfunction assessment and 28-day mortality were evaluated. Primary indication for transfusion and pretransfusion hemoglobin level were collected for each transfusion. RESULTS: Two hundred thirty-one patients with an ICU length of stay longer than 48h were included. An Hb

  13. Atrophy of the intestinal villi in a post-gastrectomy patient with severe iron deficiency anemia Atrofia de las vellosidades intestinales en un paciente postgastrectomizado con anemia ferropénica grave

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    A. Lizarraga

    2009-10-01

    Full Text Available Background & aims: Iron deficiency anemia is a common complication of gastric surgery that in certain patients can be refractory to treatment with oral iron and needs to be treated parenterally. Methods: A 48-year woman underwent gastric surgery for a gastric ulcer. She was referred to the nutrition unit for the study and treatment of a 3-year iron deficiency anemia refractory to oral iron supplementation. Blood tests, endoscopy and jejunal biopsy were made to study the case. Results: Intestinal villi atrophy in the absence of celiac disease was the result. She was treated with intravenous iron, resolving the villous atrophy and thus oral iron supplementation could be effective. Conclusion: This case illustrates that iron deficiency may cause villous atrophy. In this setting, parenteral iron administration is necessary to correct the haematological and non-hematological alterations associated with this deficiency.Introducción y objetivos: La anemia ferropénica es una complicación frecuente tras la cirugía gástrica que en algunos pacientes puede ser refractaria al tratamiento con hierro oral, siendo necesaria su administración por vía parenteral. Métodos: Presentamos el caso de una mujer de 48 años intervenida de gastrectomía para tratamiento de una úlcera gástrica. Fue remitida a la unidad de nutrición para estudio y tratamiento de una anemia ferropénica de 3 años de evolución refractaria al tratamiento con hierro oral. Para el estudio del caso se realizó analítica y endoscopia digestiva alta con biopsia yeyunal. Resultados: En el estudio realizado la paciente presentaba atrofia de la mucosa yeyunal en ausencia de enfermedad celíaca. Fue tratada con hierro intravenoso desapareciendo la atrofia intestinal, tras lo cual continuamos con suplementos de hierro por vía oral. Conclusión: Este caso ilustra que la deficiencia de hierro puede producir atrofia intestinal. Si esto ocurre, es necesario la suplementación de este metal

  14. [Graves' ophthalmopathy].

    Science.gov (United States)

    Eckstein, A; Dekowski, D; Führer-Sakel, D; Berchner-Pfannschmidt, U; Esser, J

    2016-04-01

    Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease and the full clinical picture can impair the quality of life of the patients considerably. Active inflammation can often be effectively treated by intravenous steroids/immunosuppression, however does not lead to full remission, since inflammation rather quickly results in irreversible fibrosis and increase of orbital fat. Very important is the control of risk factors (smoking cessation, good control of thyroid function, selenium supplementation) to prevent progression to severe stages. Treatment should rely on a thorough assessment of activity and severity of GO. Rehabilitative surgery (orbital decompression, squint surgery, eyelid surgery) is needed in many patients to restore function and appearance. Anti-thyroid-stimulating hormone (TSH) receptor antibodies do specifically occur in these patients and correlate to the course of thyroid and eye disease. The levels of these antibodies can be used for treatment decisions at certain time points of the disease.

  15. Pernicious anemia

    Science.gov (United States)

    ... malabsorption); Anemia - intrinsic factor; Anemia - IF; Anemia - atrophic gastritis ... of pernicious anemia include: Weakened stomach lining (atrophic gastritis) An autoimmune condition in which the body's immune ...

  16. Ciertas propiedades intrínsecas y existencia de puntos fijos para algunos operadores

    OpenAIRE

    Nova González, Lucimar

    2012-01-01

    Se estudiaran propiedades intrínsecas como también existencia de puntos fijos para cierta clase de operadores no necesariamente continuos que contienen a las aplicaciones no-expansivas y a las contracciones como subclases propias.

  17. Las anemias, sin anemia

    OpenAIRE

    Villamarin V., A.; Villamarin C., Maria José

    2011-01-01

    Estudiando las anemias idiopáticas, encontramos dos tipos: la anemia hipócroma megalocítica u enfermedad de Biermer y la anemia hipócroma microcítica o clorosis; en la mayoría de los casos estos dos tipos, se oponen por su figura hematológica, sus manifestaciones clínicas, su evolución y su terapéutica. La anemia de Biermer, tiene por remedio heroico el hígado a altas dosis; la segunda, el hierro en forma química. Pero debemos reconocer que ciertos síntomas son comunes a las anemias idiopátic...

  18. Hemolytic anemia

    Science.gov (United States)

    Anemia - hemolytic ... bones that helps form all blood cells. Hemolytic anemia occurs when the bone marrow isn't making ... destroyed. There are several possible causes of hemolytic anemia. Red blood cells may be destroyed due to: ...

  19. Anemia Due to Excessive Bleeding

    Science.gov (United States)

    ... Anemia Vitamin Deficiency Anemia Anemia of Chronic Disease Aplastic Anemia Autoimmune Hemolytic Anemia Sickle Cell Disease Hemoglobin C, S- ... Anemia Vitamin Deficiency Anemia Anemia of Chronic Disease Aplastic Anemia Autoimmune Hemolytic Anemia Sickle Cell Disease Hemoglobin C, S- ...

  20. Acerca de cierta experiencia de lo histórico en Hegel

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    Francisco Abalo Cea

    2013-08-01

    Full Text Available El siguiente artículo intenta reflexionar acerca de los límites de la Filosofía de la Historia en el pensamiento de Hegel. Con este propósito, el esfuerzo se concentra en la interpretación de una cierta experiencia de lo histórico que nos presenta Hegel en su "Introducción a la Filosofía de la Historia". La exposición que hace el autor exhibe ciertos elementos que están vinculados al tratamiento filosófico del asunto. Por otra parte, se muestra que la misma justificación de la Filosofía de la Historia aparece bosquejada en este pasaje. Por último se introduce la discusión acerca de algunos aspectos problemáticos en el planteamiento hegeliano tomando en cuenta los resultados de esta interpretación.

  1. Atypical Clinical Manifestations of Graves' Disease: An Analysis in Depth

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    Mohamed Osama Hegazi

    2012-01-01

    Full Text Available Over the past few decades, there has been an increase in the number of reports about newly recognized (atypical or unusual manifestations of Graves' disease (GD, that are related to various body systems. One of these manifestations is sometimes the main presenting feature of GD. Some of the atypical manifestations are specifically related to GD, while others are also similarly seen in patients with other forms of hyperthyroidism. Lack of knowledge of the association between these findings and GD may lead to delay in diagnosis, misdiagnosis, or unnecessary investigations. The atypical clinical presentations of GD include anemia, vomiting, jaundice, and right heart failure. There is one type of anemia that is not explained by any of the known etiological factors and responds well to hyperthyroidism treatment. This type of anemia resembles anemia of chronic disease and may be termed GD anemia. Other forms of anemia that are associated with GD include pernicious anemia, iron deficiency anemia of celiac disease, and autoimmune hemolytic anemia. Vomiting has been reported as a presenting feature of Graves' disease. Some cases had the typical findings of hyperthyroidism initially masked, and the vomiting did not improve until hyperthyroidism has been detected and treated. Hyperthyroidism may present with jaundice, and on the other hand, deep jaundice may develop with the onset of overt hyperthyroidism in previously compensated chronic liver disease patients. Pulmonary hypertension is reported to be associated with GD and to respond to its treatment. GD-related pulmonary hypertension may be so severe to produce isolated right-sided heart failure that is occasionally found as the presenting manifestation of GD.

  2. Graves disease (image)

    Science.gov (United States)

    Graves disease is an autoimmune disorder that involves overactivity of the thyroid gland (hyperthyroidism). Hallmarks of the condition are bulging eyes (exophthalmos), heat intolerance, increased energy, difficulty sleeping, diarrhea, and anxiety.

  3. Aplastic Anemia

    Science.gov (United States)

    Aplastic anemia is a rare but serious blood disorder. If you have it, your bone marrow doesn't make ... blood cells. There are different types, including Fanconi anemia. Causes include Toxic substances, such as pesticides, arsenic, ...

  4. Avian anemia's

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    Raukar Jelena

    2005-01-01

    Full Text Available This paper deals with avian anemia's classified by MCHC/MCV and with types of anemia's. Father hematological and immunological research is needed to secure information on hematological parameters in different avian species at their earliest age. Anemia is a common clinical finding in birds because the avian erythrocyte half - life is much shorter than the mammalian. Therefore anemia should be determined as soon as possible. Researchers should standardize hematological parameters for every single avian species.

  5. Graves' ophthalmopathy: interdisciplinary approach

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    O I Vinogradskaya

    2010-12-01

    Full Text Available Graves' ophthalmopathy constitutes a major therapeutic challenge, so specialists of various disci-plines have to combine their forces. According to the last consensus of EUGOGO (European Group On Graves' Orbitopathy the treatment of choice for Graves' ophthalmopathy is pulses of glucocorticoid (GC. Evidence for the superiority of any of the different intravenous (iv glucocorticoid schedules is lacking. Objective: to evaluate the efficacy of two different methylprednisolone pulse therapy schedules in Graves' ophthalmopathy. Materials and Methods: 30 Graves' patients with Graves' ophthalmopathy were subcategorized into two groups: Group A subjects (n = 14 were given iv glucocorticoid daily for 5 days (total 5 g and Group B patients (n = 16 were given iv glucocorticoid weekly for 5 weeks (total 5 g. All patients were examined by the ophthalmologist before and in 1 and 12 weeks after the treatment. Results: We found that in group A visual acuity was significantly higher than in group B at 12 weeks. By 12 week proptosis, diplopia had improved as well as CAS had fallen in two groups but there were no significant differences between the two groups. Conclusion: Both schedules are effective on proptosis, soft tissue swelling. Daily pulse therapy appeared to be more effective on visual acuity. Thereby in case of active Graves' ophthalmopathy associated with impairment of visual acuity, daily pulse therapy is a treatment of choice. But, in spite of improvement, strabismus, diplopia, proptosis have a marked negative effect on quality of life, disturb a lifestyle. In these cases surgery should be considered. After end of our research two patients (3 orbits had bone decompression with a good result. We consider that eye muscle surgery is next needed to restore their binocular vision.

  6. Modeling Graves' Orbitopathy in Experimental Graves' Disease.

    Science.gov (United States)

    Banga, J P; Moshkelgosha, S; Berchner-Pfannschmidt, U; Eckstein, A

    2015-09-01

    Graves' orbitopathy (GO), also known as thyroid eye disease is an inflammatory disease of the orbital tissue of the eye that arises as a consequence of autoimmune thyroid disease. The central feature of the disease is the production of antibodies to the thyrotropin hormone receptor (TSHR) that modulate the function of the receptor leading to autoimmune hyperthyroidism and GO. Over the years, all viable preclinical models of Graves' disease have been incomplete and singularly failed to progress in the treatment of orbital complications. A new mouse model of GO based upon immunogenic presentation of human TSHR A-subunit plasmid by close field electroporation is shown to lead to induction of prolonged functional antibodies to TSHR resulting in chronic disease with subsequent progression to GO. The stable preclinical GO model exhibited pathologies reminiscent of human disease characterized by orbital remodeling by inflammation and adipogenesis. Inflammatory lesions characterized by CD3+ T cells and macrophages were localized in the orbital muscle tissue. This was accompanied by extensive adipogenesis of orbital fat in some immune animals. Surprisingly, other signs of orbital involvement were reminiscent of eyelid inflammation involving chemosis, with dilated and congested orbital blood vessels. More recently, the model is replicated in the author's independent laboratories. The pre-clinical model will provide the basis to study the pathogenic and regulatory roles of immune T and B cells and their subpopulations to understand the initiation, pathophysiology, and progression of GO.

  7. Las creencias irracionales, en relación con ciertas conductas de consumo en adolescentes

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    Miguel Á. Carbonero

    2010-12-01

    Full Text Available Esta investigación se enmarca en un encuadre cognitivo. Considera también el componente fisiológico de la conducta, ya sea como elemento de la misma o como posible causa remota, sobre todo en ciertas patologías. Se somete a análisis la incidencia de las creencias irracionales y de aceptación para ver su relación con las anteriores creencias irracionales y el impacto de ambas en las siguientes áreas: consumo de sustancias psicoactivas y percepción medioambiental en los jóvenes. A su vez, la percepción medioambiental es incluida por la importancia de las conductas en favor de la ecología que aquella promueve, necesarias hoy en día tanto en jóvenes como en adultos para la propia sostenibilidad del planeta. Este trabajo constituye una aportación en la búsqueda de las carencias psicológicas y necesidades emocionales de los adolescentes. Todo resultado positivo en esta línea será considerado como demanda de una atención y formación específica en este ámbito que los jóvenes reclaman en su derecho a recibir una educación integral y de calidad. Sería necesario ayudar a las nuevas generaciones a construir libremente su proyecto existencial para que su vida adquiera un nuevo significado.

  8. Pregnancy Complications: Anemia

    Science.gov (United States)

    ... Close X Home > Complications & Loss > Pregnancy complications > Anemia Anemia E-mail to a friend Please fill in ... anemia at a prenatal care visit . What causes anemia? Usually, a woman becomes anemic (has anemia) because ...

  9. Graves orbitopathy: a perspective.

    Science.gov (United States)

    Perros, Petros; Krassas, Gerasimos E

    2009-06-01

    Advances in the past few years have helped clinicians understand some of the pathogenetic mechanisms of Graves orbitopathy (GO), particularly the role of receptors for TSH and insulin-like growth factor I in the orbit. Optimal treatment strategies have been formulated and published by the European Group on Graves' Orbitopathy, which are hoped to improve the management of patients with this condition. The administration of intravenous pulses of steroids has been established as a superior treatment approach compared with other steroid regimens. In addition, orbital radiotherapy was effective in a subgroup of patients with GO who had eye dysmotility. The use of immunotherapies for the treatment of GO is currently being explored; of these, rituximab has emerged as a promising new agent.

  10. Digging One's Own Grave

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    Arvo Krikmann

    2007-01-01

    Full Text Available The paper aims to demonstrate that some points in the explicationof the figurative expression digging one’s own grave via the concept of blending given by Gilles Fauconnier and Mark Turner are problematic: (1 Not understanding the consequences of one’s deeds is an almost universal presuppositionof and impulse or motivation for actualizing any utterance with a forewarning or gloating content (e.g., proverbs, not the singularity characterizing just the expression of grave-digging as such. (2 The inversion of causal and temporal structure is not the case because of metonymic association between the concepts of the grave and death, as a result of which specific causal and temporal order loses any significance. Many synonymous examples can be given in which the image refers to events before the death, between the death and funeral, as well as those after burial. (3 The source domain needs not to be restricted to natural death and modern civilized funerals but should include also the cases of violent deaths, e.g., the scenario of execution and the scenario of hunting and trapping. Preliminarily, a very brief synopsis of the main phases of development of cognitive linguistic theory of metaphor and some favourite examples of blends, used also in previous works, is provided.

  11. Immune hemolytic anemia

    Science.gov (United States)

    Anemia - immune hemolytic; Autoimmune hemolytic anemia (AIHA) ... for no reason, the condition is called idiopathic autoimmune hemolytic anemia . The antibodies may also be caused by: Complication ...

  12. Pernicious Anemia

    Science.gov (United States)

    ... well, and live normal lives. Without treatment, pernicious anemia can lead to serious problems with the heart, nerves, and other parts of the body. Some of ... INDEX ACCESSIBILITY PRIVACY STATEMENT FOIA NO FEAR ACT OIG ...

  13. Types of Hemolytic Anemia

    Science.gov (United States)

    ... from the NHLBI on Twitter. Types of Hemolytic Anemia There are many types of hemolytic anemia. The ... the condition, but you develop it. Inherited Hemolytic Anemias With inherited hemolytic anemias, one or more of ...

  14. What Is Aplastic Anemia?

    Science.gov (United States)

    ... from the NHLBI on Twitter. What Is Aplastic Anemia? Aplastic anemia (a-PLAS-tik uh-NEE-me-uh) is ... heart, heart failure , infections, and bleeding. Severe aplastic anemia can even cause death. Overview Aplastic anemia is ...

  15. What Causes Anemia?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Causes Anemia? The three main causes of anemia are: Blood ... the blood and can lead to anemia. Aplastic Anemia Some infants are born without the ability to ...

  16. Anemia (For Teens)

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Anemia KidsHealth > For Teens > Anemia Print A A A ... Getting Enough Iron en español Anemia What Is Anemia? Lots of teens are tired. With all the ...

  17. What Is Fanconi Anemia?

    Science.gov (United States)

    ... Living With Clinical Trials Links Related Topics Anemia Aplastic Anemia Blood and Bone Marrow Transplant Congenital Heart Defects ... red blood cells. FA is a type of aplastic anemia . In aplastic anemia, the bone marrow stops making ...

  18. Anemia (For Teens)

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Anemia KidsHealth > For Teens > Anemia A A A What's ... Getting Enough Iron en español Anemia What Is Anemia? Lots of teens are tired. With all the ...

  19. Anemia (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Anemia KidsHealth > For Parents > Anemia Print A A A ... Preventing Iron-Deficiency Anemia en español Anemia About Anemia Anemia happens when the level of healthy red ...

  20. [Radiotherapy for Graves' ophthalmopathy].

    Science.gov (United States)

    Kuhnt, T; Müller, A C; Janich, M; Gerlach, R; Hädecke, J; Duncker, G I W; Dunst, J

    2004-11-01

    Graves' ophthalmopathy (GO) is the most frequent extrathyroidal manifestation of Graves' disease, an autoimmune disorder of the thyroid, whereas the precise pathogenesis still remains unclear. In Hashimoto's thyroiditis the occurrence of proptosis is an extremely rare event. The therapy for middle and severe courses of GO shows in partly disappointing results, although several therapy modalities are possible (glucocorticoid therapy, radiotherapy, antithyroid drug treatment, surgery). All these therapies lead in only 40 - 70 % to an improvement of the pathogenic symptoms. An intensive interdisciplinary cooperation is necessary to satisfy the requirements for the treatment of Graves' ophthalmopathy. As a consequence of the very different results of the few of clinical studies that were accomplished with reference to this topic, treatment by radiotherapy in the management of the disease is presently controversially discussed. In the German-speaking countries the radiotherapy is, however, firmly established as a therapy option in the treatment of the moderate disease classes (class 2-5 according to NO SPECS), especially if diplopia is present. This article describes the sequences, dosages and fractionation schemes as well as the risks and side effects of the radiotherapy. Altogether, radiotherapy is assessed as an effective and sure method. The administration of glucocorticoids can take place before the beginning of or during the radiotherapy. For the success of treatment the correct selection of patients who may possibly profit from a radiotherapy is absolutely essential. By realising that GO proceeds normally over a period of 2-5 years, which is followed by a period of fibrotic alteration, the application of the radiotherapy in the early, active phase is indispensable. A precise explanation for the effects of radiotherapy in treatment of the GO does not exist at present. The determination of the most effective irradiation doses was made from retrospectively evaluated

  1. Fisiopatologia da asma grave

    OpenAIRE

    Todo-Bom, Ana; Mota-Pinto, Anabela

    2006-01-01

    Não tem resumo. Transcreve-se o primeiro parágrafo: A história natural da asma e os condicionalismos de uma evolução para formas moderadas ou graves não está completamente estabelecida. Contudo, quer os factores genéticos quer os factores ambientais, serão determinantes na fisiopatologia e no prognóstico da doença. A asma é, por definição, uma doença inflamatória crónica das vias aéreas caracterizada por uma obstrução brônquica generalizada mas variável que é, pelo menos parcialmente, reve...

  2. Epidemiology of Graves' orbitopathy.

    Science.gov (United States)

    Putta-Manohar, Sudeep; Perros, Petros

    2010-03-01

    Thyroid orbitopathy is a relatively rare disease. Prevalence data are lacking and can only be estimated. The incidence of thyroid orbitopathy has been documented in one American study (16 cases per 100,000 population per year for females and 2.9 cases per 100,000 population for males). Thyroid orbitopathy can affect every race and age group. The majority of patients present in middle age with concurrent thyrotoxicosis due to Graves' disease. The onset of orbitopathy usually coincides with the hyperthyroidism, though the two may be asynchronous by months or sometimes years. A small proportion of patients with thyroid orbitopathy have primary hypothyroidism or are euthyroid. Female patients outnumber males by 2-5 to 1. Smoking increases the risk of thyroid orbitopathy up to 8-fold.

  3. Hashimoto's thyroiditis following Graves' disease.

    Science.gov (United States)

    Umar, Husaini; Muallima, Nur; Adam, John M F; Sanusi, Harsinen

    2010-01-01

    Both Graves' disease and chronic thyroiditis (Hashimoto's thyroiditis) are autoimmune diseases of thyroid gland. Graves' disease is caused by stimulation of TSH receptor located on the thyroid gland by an antibody, which is known as TSH receptor antibody (TRAb). Furthermore, this may lead to hyperplasia and hyperfunction of the thyroid gland. On the contrary, the cause of Hashimoto's thyroiditis is thought due to a TSH stimulation-blocking antibody (TSBAb) which blocks the action of TSH hormone and subsequently brings damage and atrophy to thyroid gland. Approximately 15-20% of patients with Graves' disease had been reported to have spontaneous hypothyroidism resulting from the chronic thyroiditis (Hashimoto's disease). Pathogenesis for chronic thyroiditis following anti-thyroid drug treatment in patients with Graves' disease remains unclear. It has been estimated that chronic thyroiditis or Hashimoto's disease, which occurs following the Graves' disease episode is due to extended immune response in Graves' disease. It includes the immune response to endogenous thyroid antigens, i.e. thyroid peroxidase and thyroglobulin, which may enhance lymphocyte infiltration and finally causes Hashimoto's thyroiditis. We report four cases of chronic thyroiditis (Hashimoto's disease) in patients who have been previously diagnosed with Graves' hyperthyroidism. In three cases, Hashimoto's thyroiditis occurs in 7 to 25 years after the treatment of Grave's disease; while the other case has it only after few months of Grave's disease treatment. The diagnosis of Hashimoto's disease (chronic thyroiditis) was based on clinical manifestation, high TSHs level, positive thyroid peroxidase antibody and thyroglobulin antibody, and supported by positive results of fine needle aspiration biopsy. Moreover, the result of histopathological test has also confirmed the diagnosis in two cases. All cases have been successfully treated by levothyroxine treatment.

  4. Aplastic anemia

    Science.gov (United States)

    ... the number of these blood cell types. Aplastic anemia can be caused by: Use of certain drugs or exposure to toxic chemicals (such as benzene) Exposure to radiation or chemotherapy Autoimmune disorders Pregnancy Viruses Sometimes, the cause is unknown. In this ...

  5. Hemolytic Anemia

    Science.gov (United States)

    ... may require ongoing treatment. Acquired forms of hemolytic anemia may go away if the cause of the condition is found and corrected. Rate This Content: NEXT >> Updated: March 21, 2014 Twitter Facebook YouTube Google+ SITE INDEX ACCESSIBILITY PRIVACY STATEMENT FOIA NO FEAR ACT OIG ...

  6. Graves opthalmopathy and psychoendocrinopathies

    Directory of Open Access Journals (Sweden)

    Ghanem Asaad

    2010-01-01

    Full Text Available Purpose: To assess the psychiatric and endocrinological changes in patients with Graves ophthalmopathy (GO. Design: A prospective, controlled, University Hospital based study Subjects and Methods: The current study comprised 60 patients diagnosed with GO at Mansoura Ophthalmic Center. Thirty five patients of them with moderate to severe GO formed the study group and twenty five patients with negligible to very mild GO formed the control group in the euthyroid state. The study group was further subdivided based on their predominant clinical signs into a proptosis subgroup and a muscle restriction subgroup . Psychiatric changes were assessed with the Middlesex Hospital Questionnaire (MHQ. Biochemical analyses included serum-free thyroxine and thyroid-stimulating hormone (TSH concentrations, TSH receptor antibody (TRAb activity and anti-thyroglobulin particle agglutination (TGPA and antithyroid microsomal particle agglutination (MCPA. Results: The proptosis group reported significantly higher scores on anxiety, depression, and phobia than the muscle restriction group (P< 0.0001. The proptosis and muscle restriction subgroups reported significantly higher scores on all subscales compared to the control group (P < 0.05. The scale scores of depression and phobia showed a positive correlation with scores of anxiety (P< 0.0001. The serum TRAb activity showed a significant correlation with anxiety, phobia and hysteria (P < 0.0001. Conclusion: The psychiatric aspect of GO should be evaluated during routine follow-up and should be considered when making management decisions. Thyroid specific antibodies may be useful in confirming the diagnosis of GO.

  7. Anemia in Pregnancy

    OpenAIRE

    Umran Kucukgoz Gulec; Fatma Tuncay Ozgunen; Ismail Cuneyt Evruke; Suleyman Cansun Demir

    2013-01-01

    Iron deficiency anemia (IDA) is the most frequent form of anemia in pregnant women. Folic acid, vitamin B12 deficiency, and hemoglobinopathies are other causes of anemia in pregnancy. Finding the underlying cause are crucial to the management of the anemia. Anemia is defined as hemoglobin of

  8. [Sideroblastic anemias].

    Science.gov (United States)

    Matthes, T

    2006-01-01

    Sideroblastic anemias are a heterogenous group of disorders characterized by the presence of sideroblasts in the bone marrow aspirate. Current classification schemes distinguish between diseases of the heme synthesis pathway and diseases of other mitochondrial pathways which can either be of primary origin (defects in mitochondrial DNA) or of secondary origin (defects in nuclear DNA). Although several distinct hereditary forms exist, sideroblastic anemias are most frequently acquired diseases and belong to the group of myelodysplastic syndromes with the propensity to develop into overt leukemia. Treatment is mainly supportive (vitamins, blood transfusions, cytokines) and only rarely are bone marrow transplantations performed. The molecular defects of a few hereditary forms have already been elucidated, but the genes involved in the acquired forms are still largely unknown.

  9. APLASTIC ANEMIA

    Directory of Open Access Journals (Sweden)

    Ni Made Dharma Laksmi

    2013-07-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Aplastic Anemia describes a disorder of the clinical syndrome is marked by a deficiency of red blood cells, neutrophils, monocytes and platelets in the absence of other forms of bone marrow damage. Aplastic anemia is classified as a rare disease in developed countries the incidence of 3-6 cases / 1 million inhabitants / year. The exact cause of someone suffering from aplastic anemia also can not be established with certainty, but there are several sources of potential risk factors. Prognosis or course of the disease varies widely aplastic anemia, but without treatment generally gives a poor prognosis /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  10. Folate-deficiency anemia

    Science.gov (United States)

    ... medlineplus.gov/ency/article/000551.htm Folate-deficiency anemia To use the sharing features on this page, please enable JavaScript. Folate-deficiency anemia is a decrease in red blood cells (anemia) ...

  11. Fanconi Anemia Research Fund

    Science.gov (United States)

    ... Support Publications Fundraising News What is the Fanconi Anemia Research Fund? Fanconi anemia is an inherited disease that can lead to ... population. Lynn and Dave Frohnmayer started the Fanconi Anemia Research Fund, in 1989 to find effective treatments ...

  12. Anemia and Pregnancy

    Science.gov (United States)

    ... Advocacy Toolkit Home For Patients Blood Disorders Anemia Anemia and Pregnancy Your body goes through significant changes ... becoming anemic. back to top Is Pregnancy-Related Anemia Preventable? Good nutrition is the best way to ...

  13. Cooley's Anemia Foundation

    Science.gov (United States)

    ... role in their lives. Welcome to the Cooley's Anemia Foundation Website The Cooley's Anemia Foundation is dedicated to serving people afflicted with ... major form of this genetic blood disease, Cooley's anemia/thalassemia major. Our mission is advancing the treatment ...

  14. Anemia - B12 deficiency

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000574.htm Vitamin B12 deficiency anemia To use the sharing features on ... tissues. There are many types of anemia. Vitamin B12 deficiency anemia is a low red blood cell ...

  15. Vitamin Deficiency Anemia

    Science.gov (United States)

    Vitamin deficiency anemia Overview By Mayo Clinic Staff Vitamin deficiency anemia is a lack of healthy red ... you have lower than normal amounts of certain vitamins. Vitamins linked to vitamin deficiency anemia include folate, ...

  16. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... Events Spokespeople Email Alerts E-Newsletters About NHLBI Organization NHLBI Director Budget, Planning, & Legislative Advisory Committees Jobs ... food. Overview Iron-deficiency anemia is a common type of anemia . The term "anemia" usually refers to ...

  17. [Orbital decompression for Graves' ophthalmopathy].

    Science.gov (United States)

    Boulétreau, P; Breton, P; Freidel, M

    2005-04-01

    Graves' ophthalmopathy is a complex orbital condition with a controversial pathogenesis. It is the clinical expression of a discordance between the inextensible orbit and hypertrophic muscular and fatty elements within the orbit responding to immunological stimulation. The relationship between the orbital and its content can be improved by surgical expansion which increases the useful volume of the orbit. This procedure can be combined with lipectomy to decrease the volume of the orbital contents. We briefly recall the history of surgical decompression techniques and present our experience with Graves' ophthalmopathy patients.

  18. Clinical evaluation of Graves ophthalmopathy

    Directory of Open Access Journals (Sweden)

    Janićijević-Petrović Mirjana A.

    2012-01-01

    Full Text Available Introduction. Graves ophthalmopathy is an autoimmune disease, which is the consequence of thyroid dysfunction. Ocular manifestations occur in 50% of patients with Graves disease. The changes occur due to the inflammatory cell infiltration of retrobulbar fat tissue and extraocular muscles. Ultrasonography of eye orbit provides important information about the condition of retrobulbar adipose tissue and the thickness of extraocular muscles. Objective. The aim of our study was to show the clinical significance of orbital ultrasonography in the diagnostics and follow-up of patients with Graves disease. Methods. The authors examined 154 patients with Graves ophthalmopathy at the Clinic of Ophthalmology of the Clinical Centre in Kragujevac during the period 2008–2010. Ophthalmological examination included visual acuity testing (Snellen chart, biomicroscopy and applanation tonometry, direct and indirect ophthalmoscopy, dry eye testing and exophthalmometry (Hertel. Orbital ultrasonography examination and extraorbital muscle measurement was done by ultrasound B-scan. Results. The disease was more frequent in women (79.87% aged from 36–45 years. Most patients had hyperthyreoidism (54.55%. In relation to the duration of the disease, the most frequent clinical signs were bilateral ptosis, conjunctival chemosis and periorbital edema. According to our data the highest number of patients had enlarged medial straight muscle. Conclusion. Graves ophthalmopathy is the most frequent sign of thyroid disease. By orbital ultrasonography we detected extended echogram and measured the thickness of the extraocular muscle. Computerized tomography and magnetic resonance scan were utilized for cases of insufficiently manifested clinical signs of the disease. The advantages of ultrasonography lie in easy handling, patients’ comfort, short time of examination and possibilities of repetition.

  19. Anemia in pregnancy.

    Science.gov (United States)

    Horowitz, Kari M; Ingardia, Charles J; Borgida, Adam F

    2013-06-01

    Hemodynamic changes occur in pregnancy to prepare for expected blood loss at delivery. Physiologic anemia occurs in pregnancy because plasma volume increases more quickly than red cell mass. Anemia is most commonly classified as microcytic, normocytic, or macrocytic. Iron deficiency anemia accounts for 75% of all anemias in pregnancy. Oral iron supplementation is the recommended treatment of iron deficiency anemia in pregnancy. Parenteral iron and erythropoietin can also be used in severe or refractory cases. Outcomes and treatments for other forms of inherited and acquired anemias in pregnancy vary by disease, and include nutritional supplementation, corticosteroids, supportive transfusions, and splenectomy.

  20. ANEMIA AGUDA DE NOVO: O MESMO SINAL, DIFERENTES ETIOLOGIAS

    Directory of Open Access Journals (Sweden)

    Inês Falcão

    2015-12-01

    Conclusão: Na investigação etiológica de uma anemia aguda grave é fundamental a sua caracterização correta com base em todos os parâmetros hematológicos disponíveis. O diagnóstico assertivo é fundamental, atendendo às diferentes implicações no que diz respeito à abordagem, orientação e prognóstico.

  1. Sickle Cell Anemia

    Science.gov (United States)

    Sickle cell anemia is a disease in which your body produces abnormally shaped red blood cells. The cells ... red blood cells. This leads to anemia. The sickle cells also get stuck in blood vessels, blocking blood ...

  2. Sickle cell anemia.

    OpenAIRE

    ŘÍHOVÁ, Tereza

    2013-01-01

    This thesis is about the disease called sickle cell anemia, or drepanocytosis. In this thesis is described the history of the disease, pathophysiology, laboratory features, various clinical features, diferencial diagnosis, quality of life in sickle cell anemia and therapy.

  3. Anemia in the Newborn

    Science.gov (United States)

    ... Doctor About Emotional Struggles Additional Content Medical News Anemia in the Newborn By Arthur E. Kopelman, MD, ... of Prematurity Necrotizing Enterocolitis (NEC) Jaundice in Newborns Anemia in the Newborn Polycythemia in the Newborn Thyroid ...

  4. [Common anemias in neonatology].

    Science.gov (United States)

    Humbert, J; Wacker, P

    1999-01-28

    We describe the four most common groups of neonatal anemia and their treatments, with particular emphasis on erythropoietin therapy. The hemolytic anemias include the ABO incompatibility (much more frequent, nowadays, than the Rh incompatibility, which has nearly disappeared following the use of anti-D immunoglobulin in postpartum Rh-negative mothers), hereditary spherocytosis and G-6-PD deficiency. Among hypoplastic anemias, that caused by Parvovirus B19 predominates, by far, over Diamond-Blackfan anemia, alpha-thalassemia and the rare sideroblastic anemias. "Hemorrhagic" anemias occur during twin-to-twin transfusions, or during feto-maternal transfusions. Finally, the multifactorial anemia of prematurity develops principally as a result of the rapid expansion of the blood volume in this group of patients. Erythropoietin therapy, often at doses much higher than those used in the adult, should be seriously considered in most cases of non-hypoplastic neonatal anemias, to minimise maximally the use of transfusions.

  5. The Anemias of Athletes.

    Science.gov (United States)

    Eichner, Edward R.

    1986-01-01

    Diagnosing anemia in athletes is complicated because athletes normally have a pseudoanemia that needs no treatment. Athletes, however, can develop anemia from iron deficiency or footstrike hemolysis, which require diagnosis and treatment. (Author/MT)

  6. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... or an inability to absorb enough iron from food. Overview Iron-deficiency anemia is a common type ... of the condition. Treatments may include dietary changes, medicines, and surgery. Severe iron-deficiency anemia may require ...

  7. Megaloblastic anemia in pregnancy.

    Science.gov (United States)

    Campbell, B A

    1995-09-01

    Megaloblastic anemia is one of the acquired nutritional anemias that may complicate pregnancy. It is most often secondary to folic acid deficiency because folate requirements are increased during gestation. When the diagnosis of megaloblastic anemia is confirmed, appropriate therapy will initiate a rapid reversal of the anemia process. Because of the association between neural tube defects and folate deficiency, it is recommended that women of reproductive age take folic acid supplementation.

  8. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... the NHLBI on Twitter. What Is Iron-Deficiency Anemia? Español Iron-deficiency anemia is a common, easily ... Featured Video Living With and Managing Iron-Deficiency Anemia 05/18/2011 This video—presented by the ...

  9. Iron deficiency anemia

    Science.gov (United States)

    Anemia - iron deficiency ... iron from old red blood cells. Iron deficiency anemia develops when your body's iron stores run low. ... You may have no symptoms if the anemia is mild. Most of the time, ... slowly. Symptoms may include: Feeling weak or tired more often ...

  10. Iron-Deficiency Anemia

    Science.gov (United States)

    ... the NHLBI on Twitter. What Is Iron-Deficiency Anemia? Español Iron-deficiency anemia is a common, easily ... Featured Video Living With and Managing Iron-Deficiency Anemia 05/18/2011 This video—presented by the ...

  11. Your Guide to Anemia

    Science.gov (United States)

    ... 19 Who Is At Risk for Iron-Deficiency Anemia? Infants and children. Getting enough iron is essential for normal growth ... checkup to see whether they also might have anemia. If you have children or teens who have anemia, talk to them ...

  12. Iron-Deficiency Anemia

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Is Iron-Deficiency Anemia? Español Iron-deficiency anemia is a common, ... Content: NEXT >> Featured Video Living With and Managing Iron-Deficiency Anemia 05/18/2011 This video—presented by ...

  13. Anemia in Chronic Kidney Disease

    Science.gov (United States)

    ... High Blood Pressure Heart Disease Mineral & Bone Disorder Anemia in Chronic Kidney Disease What is anemia? Anemia is a condition in which the body ... function as well as they should. How is anemia related to chronic kidney disease? Anemia commonly occurs ...

  14. PREGO (presentation of Graves' orbitopathy) study

    DEFF Research Database (Denmark)

    Perros, Petros; Žarković, Miloš; Azzolini, Claudio

    2015-01-01

    BACKGROUND/AIMS: The epidemiology of Graves' orbitopathy (GO) may be changing. The aim of the study was to identify trends in presentation of GO to tertiary centres and initial management over time. METHODS: Prospective observational study of European Group On Graves' Orbitopathy (EUGOGO) centres...

  15. Biventricular Takotsubo cardiomyopathy in Graves hyperthyroidism.

    Science.gov (United States)

    Perkins, Matthew J; Schachter, David T

    2014-03-01

    Graves hyperthyroidism is commonly seen in clinical practice and Takotsubo stress cardiomyopathy is an increasingly recognized cardiac complication of physical or emotional stress. We report the rare case of a patient with Graves hyperthyroidism that was complicated by severe biventricular takotsubo cardiomyopathy, which was demonstrated on heart catheterization. After appropriate pharmacologic treatment of her hyperthyroidism, she had complete resolution of her cardiomyopathy.

  16. Dermopathy of Graves' disease: Clinico-pathological correlation.

    Science.gov (United States)

    Reddy, Sagili Vijaya Bhaskar; Gupta, Sushil Kumar; Jain, Manoj

    2012-05-01

    Dermopathy of Graves' disease is a classical, but uncommon extrathyroidal manifestation of Graves' disease. The images of a typical case of dermopathy of Graves' disease are presented along with clinico-pathological correlation.

  17. Laboratory Evaluation of Anemia

    OpenAIRE

    1987-01-01

    The laboratory evaluation of anemia begins with a complete blood count and reticulocyte count. The anemia is then categorized as microcytic, macrocytic or normocytic, with or without reticulocytosis. Examination of the peripheral smear and a small number of specific tests confirm the diagnosis. The serum iron level, total iron-binding capacity, serum ferritin level and hemoglobin electrophoresis generally separate the microcytic anemias. The erythrocyte size-distribution width may be particul...

  18. Iron deficiency anemia

    OpenAIRE

    Naigamwalla, Dinaz Z.; Webb, Jinelle A.; Giger, Urs

    2012-01-01

    Iron is essential to virtually all living organisms and is integral to multiple metabolic functions. The most important function is oxygen transport in hemoglobin. Iron deficiency anemia in dogs and cats is usually caused by chronic blood loss and can be discovered incidentally as animals may have adapted to the anemia. Severe iron deficiency is characterized by a microcytic, hypochromic, potentially severe anemia with a variable regenerative response. Iron metabolism and homeostasis will be ...

  19. How Is Pernicious Anemia Treated?

    Science.gov (United States)

    ... from the NHLBI on Twitter. How Is Pernicious Anemia Treated? Doctors treat pernicious anemia by replacing the missing vitamin B12 in the body. People who have pernicious anemia may need lifelong treatment. The goals of treating ...

  20. How Is Aplastic Anemia Treated?

    Science.gov (United States)

    ... from the NHLBI on Twitter. How Is Aplastic Anemia Treated? Treatments for aplastic anemia include blood transfusions , blood and marrow stem cell ... a transplant. Removing a known cause of aplastic anemia, such as exposure to a toxin, also may ...

  1. Genetics Home Reference: Fanconi anemia

    Science.gov (United States)

    ... Understand Genetics Home Health Conditions Fanconi anemia Fanconi anemia Enable Javascript to view the expand/collapse boxes. Download PDF Open All Close All Description Fanconi anemia is a condition that affects many parts of ...

  2. Inborn anemias in mice

    Energy Technology Data Exchange (ETDEWEB)

    Bernstein, S.E.; Barker, J.E.; Russell, E.S.

    1981-06-01

    hereditary anemias of mice have been the chief objects of investigation. At present under study are four macrocytic anemias, five hemolytic anemias, nonhemolytic microcytic anemia, transitory siderocytic anemia, sex-linked iron-transport anemia, an ..cap alpha..-thalassemia, and a new target-cell anemia. Each of these blood dyscrasias is caused by the action of a unique mutant gene, which determines the structure of different intracellular molecules, and thus controls a different metabolic process. Thus our wide range of different hereditary anemias has considerable potential for uncovering many different aspects of hemopoietic homeostatic mechanisms in the mouse. Each anemia is studied through: (a) characterization of peripheral blood values, (b) determinations of radiosensitivity under a variety of conditions, (c) measurements of iron metabolism and heme synthesis, (d) histological and biochemical study of blood-forming tissue, (e) functional tests of the stem cell component, (f) examination of responses to erythroid stimuli, and (g) transplantation of tissue between individuals of differently affected genotypes.

  3. Anemia in Pregnancy

    Directory of Open Access Journals (Sweden)

    Umran Kucukgoz Gulec

    2013-06-01

    Full Text Available Iron deficiency anemia (IDA is the most frequent form of anemia in pregnant women. Folic acid, vitamin B12 deficiency, and hemoglobinopathies are other causes of anemia in pregnancy. Finding the underlying cause are crucial to the management of the anemia. Anemia is defined as hemoglobin of <11 g/dl in the first and third trimester and <10.5 g/dl in second trimester. According to the literature, anemia, particularly severe anemia (Hb<7g/dl is associated with increased risk of maternal and perinatal mortality and morbidity, and long term adverse effects in the newborn. The association of hemoglobin levels to perinatal outcome has been shown to be U shaped with both high and low hemoglobin levels being associated adverse perinatal outcome such as low birth weight, increased stillbirths. Anemia in pregnancy is a major public health problem. Ideally a woman should have adequate iron stores when she conceives, in order meet to additional requirements of pregnancy. This review focuses on the occurrence, types, maternal and perinatal outcomes, prevention and treatment of anemia during pregnancy. [Archives Medical Review Journal 2013; 22(3.000: 300-316

  4. Anemia in the Elderly

    OpenAIRE

    Sparling, Terence G.

    2013-01-01

    As the population ages, increasing attention has become focused on the prevalence of anemia in elderly individuals. Anemia occurs in more than 10% of individuals who are older than the age of 65 years, and it increases to more than 50% in individuals who are older than the age of 80 years. Although the anemia is typically mild and unlikely to result in symptoms, it is uniformly associated with increased morbidity and mortality as assessed in large cohort studies. Anemia is an independent pred...

  5. Mass Graves, Landscapes of Terror

    Directory of Open Access Journals (Sweden)

    Ferrándiz, Francisco

    2009-06-01

    Full Text Available The recent exhumation of mass graves from the Spanish Civil War and the Post-War years, mostly involving the largely abandoned graves of the Francoist rearguard, have become a central element in contemporary debates about the conflict and the regime following it. In this paper, the complexity and dynamism of this process is analysed, including from political and legal initiatives of great social and media impact to local actions on the ground, at times failed, ephemeral or almost imperceptible, but no less crucial. From the point of view of many of the people involved in the pro-exhumation associations, opening up the graves is part of a basic exercise in justice and ‘dignification’, showing the scope and systematic nature of repression while reverting the ‘infrahuman’ disposition of the executed corpses, a feeling crystallised in the common expression ‘thrown’ or ‘buried like dogs’, used very often to justify the need of carrying out exhumations. Politics of dignification and ‘rehumanization’ of these ‘incorrectly’ buried bodies are incorporating, in the last few months, elements drawn from international law, such as the concept of ‘crimes against humanity’.

    Las exhumaciones de fosas comunes de la Guerra Civil española y la posguerra de la última década, muy especialmente de fosas abandonadas de la retaguardia franquista, se han colocado en un lugar central de los debates contemporáneos sobre la naturaleza y alcance de la contienda y el régimen que surgió de ella. En este artículo, se analiza la complejidad y dinamismo del proceso, que incluye desde iniciativas políticas y judiciales de enorme proyección pública y mediática, como la Ley de la Memoria o el controvertido auto de Garzón sobre los crímenes del franquismo, hasta acciones locales a veces fallidas, imperceptibles o efímeras, pero no menos cruciales. Desde el punto de vista de muchos de los actores sociales implicados en las exhumaciones

  6. [Differential diagnosis of Graves' orbitopathy. Case report].

    Science.gov (United States)

    Erdei, Annamária; Steiber, Zita; Gazdag, Annamária; Bodor, Miklós; Berta, Eszter; Szász, Róbert; Szántó, Antónia; Ujhelyi, Bernadett; Barna, Sándor; Berényi, Ervin; Nagy, V Endre

    2016-02-21

    Graves' orbitopathy is the extrathyroidal manifestation of Graves' disease, which is the most common cause of exophthalmos. As eye symptoms usually coincide with the development of thyrotoxicosis, the diagnosis of the disease is rarely difficult. The aim of the authors was to summarize the differential diagnosis of Graves' orbitopathy based on literature review and presentation of their own four problematic cases on this topic. They conclude that symptoms similar to endocrine orbitopathy are present in other disorders. Endocrinologists need to be aware of these other conditions to avoid treatment failures.

  7. Xiv conferencia : anemias

    OpenAIRE

    Paredes Manrique, Raúl; Camacho Gamba, Jorge

    2012-01-01

    La anemia es la disminución por debajo de lo normal de la Hb. o del número de globulos rojos o del hematocrito, pero es difícil encontrar un cuadro clínico que corresponda a la realidad de la anemia en el cual no estén descendidos los tres elementos.

  8. Living with Anemia

    Science.gov (United States)

    ... by an inherited or chronic disease or trauma. Anemia and Children/Teens Infants and young children have a greater ... birth-weight babies often are watched closely for anemia. Talk with your child's doctor if you're feeding your infant breast ...

  9. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... Blood Tests Blood Transfusion Restless Legs Syndrome Send a link to NHLBI to someone by E-MAIL | ... Iron-Deficiency Anemia? Español Iron-deficiency anemia is a common, easily treated condition that occurs if you ...

  10. Pneumonia grave por "Chlamydia psittaci"

    Directory of Open Access Journals (Sweden)

    MOSCHIONI CRISTIANE

    2001-01-01

    Full Text Available A psitacose, também conhecida como ornitose, é causada pela Chlamydia psittaci; caracteriza-se por doença de início insidioso, sintomas brandos e inespecíficos, lembrando infecção de vias aéreas superiores. Acomete principalmente o pulmão, sendo raramente doença sistêmica e fatal. Descreve-se um caso raro de pneumonia por Chlamydia psittaci que evoluiu para insuficiência respiratória aguda, necessitando de ventilação mecânica. Destaca-se a importância em considerar o diagnóstico, especialmente em casos de pneumonia comunitária que evolui de modo insatisfatório, que não responde à terapia antimicrobiana e cuja epidemiologia é positiva para exposição às aves. O diagnóstico precoce é fundamental devido à excelente resposta terapêutica. O diagnóstico tardio pode levar a curso grave e fatal da doença.

  11. Orbital Volumetry in Graves' Orbitopathy

    DEFF Research Database (Denmark)

    Al-Bakri, Moug; Rasmussen, Åse Krogh; Thomsen, Carsten

    2014-01-01

    .6 cm(3) in controls, 8.7 ± 8.0 cm(3) in GO without DON, and 9.4 ± 3.1 cm(3) in GO with DON. The muscle and fat volumes were higher in patients with GO than in controls (P orbits with and without DON were not significantly different. The volume of the optic nerve were...... similar in the 3 groups. The number of apical, coronal 2 mm thick slices with no fat was 2.9 ± 0.9 in normal orbits, it was 4.1 ± 1.0 in GO orbits without DON and 5.3 ± 0.8 in GO orbits with DON (P = 0.007). Conclusion. Apical muscle enlargement may be more important than orbital fat enlargement......Purpose. We wanted to investigate the relative significance of fat and muscle enlargement in the development of dysthyroid optic neuropathy (DON) in Graves' orbitopathy (GO). Methods. Preoperative coronal CT scans of 13 patients with and without DON who subsequently underwent orbital decompression...

  12. Factores genéticos en casos graves de gripe (H1N1 2009

    Directory of Open Access Journals (Sweden)

    Francesc Calafell i Majó

    2011-01-01

    Full Text Available La pandemia de gripe (H1N1 2009 generó una serie de cuestiones, entre las cuales estuvo que entre un 25 y un 30% de los casos graves de gripe no presentaron ningún factor de riesgo obvio. Hipotetizamos que un elemento que puede contribuir a la respuesta son factores de riesgo gené ticos del huésped involucrados en la mala progresió n de la enfermedad. Varios indicios nos llevaron a esta hipótesis: estudios de agregación familiar en islandeses y mormones de Utah muestran una cierta heredabilidad de la mortalidad por gripe; se conocen casi 300 genes humanos necesarios para la replicació n del virus de la gripe; y los pacientes más graves de gripe (H1N12009 mostraron una desregulació n del sistema inmune adaptativo. Estamos abordando este problema mediante un diseñ o caso-control (casos hospitalizados de gripe (H1N12009 confirmados contra casos ambulatorios, tambié n confirmados para (H1N12009, en el que se genotiparán más de un milló n de polimorfismos de cambios de nucleó tido (SNPs y de variació n de número de copia (CNVs en casos y controles.

  13. Evaluation of Macrocytic Anemias.

    Science.gov (United States)

    Green, Ralph; Dwyre, Denis M

    2015-10-01

    Macrocytic anemia, defined as a mean cell volume (MCV) ≥100 fL in adults, has a narrow differential diagnosis that requires evaluation of the peripheral blood smear as well as additional laboratory testing taken in conjunction with clinical information that includes patient history and physical examination findings. This review is an update on the approach to a patient with macrocytic anemia with attention paid to the differentiation of megaloblastic and non-megaloblastic macrocytic anemias. Critical to the determination of the diagnosis is the judicious use of laboratory testing and the evaluation of those findings in conjunction with the patient medical, surgical, and medication history.

  14. Iron deficiency decreases hemolysis in sickle cell anemia Anemia ferropriva diminui hemólise em anemia falciforme

    Directory of Open Access Journals (Sweden)

    Oswaldo Castro

    2009-02-01

    Full Text Available A woman with homozygous sickle cell disease developed severe iron deficiency due to long-standing uterine bleeding. At this point, the serum lactic dehydrogenase level was normal and the reticulocyte count was only minimally elevated. This suggested that the low red cell hemoglobin concentration that resulted from iron deficiency also decreased Hb S polymerization and lowered the hemolytic rate. Iron replacement led first to a substantially improved hemoglobin concentration with only a minimal increase in the hemolytic rate and secondarily to a modest further improvement in the hemoglobin concentration and a marked increase in the hemolytic rate. The hematologic changes observed in this patient, and those in other iron deficient sickle cell patients reported in the literature, suggest that it may be appropriate to consider the induction of an intermediate iron deficient stage as experimental treatment in adult sickle cell patients.Uma mulher com anemia falciforme homozigose para a Hb S evoluiu com anemia ferropriva grave devido a sangramento uterino prolongado. A dosagem de dehidrogenase lática era normal e a contagem de reticulócitos estava levemente aumentada. Isto sugere que concentrações baixas de hemoglobina, que resulta de anemia ferropriva, também diminuem a polimeração de Hb S e reduz a taxa de hemólise. O complemento de ferro levou, primeiramente, a uma concentração substancialmente maior de hemoglobina com apenas um aumento mínimo na taxa hemolítica e subsequentemente a um aumento leve adicional na concentração da hemoglobina e um aumento notável na taxa hemolítica. As mudanças hematológicas observadas nesta paciente e aquelas em outras pacientes com anemia falciforme e também deficientes de ferro relatadas na literatura sugerem que pode ser interessante considerar a indução de deficiência de ferro como tratamento experimental em pacientes adultos com anemia falciforme.

  15. What Is Anemia?

    Science.gov (United States)

    ... Treatment will depend on the cause of the anemia and how severe it is. Rate This Content: NEXT >> Updated: May 18, 2012 Twitter Facebook YouTube Google+ SITE INDEX ACCESSIBILITY PRIVACY STATEMENT FOIA NO FEAR ACT OIG ...

  16. What Causes Aplastic Anemia?

    Science.gov (United States)

    ... blood and bone marrow diseases, such as aplastic anemia. // Non Object? Updated: August 22, 2012 Twitter Facebook YouTube Google+ SITE INDEX ACCESSIBILITY PRIVACY STATEMENT FOIA NO FEAR ACT OIG ...

  17. Living with Fanconi Anemia

    Science.gov (United States)

    ... from the NHLBI on Twitter. Living With Fanconi Anemia Improvements in blood and marrow stem cell transplants ... November 1, 2011 Twitter Facebook YouTube Google+ SITE INDEX ACCESSIBILITY PRIVACY STATEMENT FOIA NO FEAR ACT OIG ...

  18. Living with Aplastic Anemia

    Science.gov (United States)

    ... blood and bone marrow diseases, such as aplastic anemia. // Non Object? Updated: August 22, 2012 Twitter Facebook YouTube Google+ SITE INDEX ACCESSIBILITY PRIVACY STATEMENT FOIA NO FEAR ACT OIG ...

  19. How Is Anemia Treated?

    Science.gov (United States)

    ... such as beef or liver), as well as chicken, turkey, pork, fish, and shellfish. Nonmeat foods that ... cause of anemia. Some of these medicines include: Antibiotics to treat infections. Hormones to treat heavy menstrual ...

  20. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... chest pain, and other symptoms. Severe iron-deficiency anemia can lead to heart problems, infections, problems with growth and development in children, and other complications. Infants and young children and ...

  1. Equine Infectious Anemia

    OpenAIRE

    Hoopes, Karl H.

    2017-01-01

    This fact sheet gives information on equine infectious anemia, a blood-borne infectious viral disease of horses, donkeys, and mules. It describes transmission, clinical disease, diagnosis and control.

  2. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... CAUSES WHO IS AT RISK SIGNS & SYMPTOMS DIAGNOSIS TREATMENTS PREVENTION LIVING WITH CLINICAL TRIALS LINKS Related Topics ... Doctors usually can successfully treat iron-deficiency anemia. Treatment will depend on the cause and severity of ...

  3. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... Digg. Share this page from the NHLBI on Facebook. Add this link to the NHLBI to my ... Deficiency Anemia article. Updated: March 26, 2014 Twitter Facebook YouTube Google+ SITE INDEX ACCESSIBILITY PRIVACY STATEMENT FOIA ...

  4. Nutritional anemia and AIDS

    OpenAIRE

    Ruíz, Óscar; Instituto de Investigaciones Clínicas, UNMSM; Díaz, David; Instituto de Investigaciones Clínicas, Facultad de Medicina, UNMSM, y Hospital Nacional Dos de Mayo; Castillo, Óscar; Instituto de Investigaciones Clínicas, UNMSM; Reyes, Rafael; Instituto de Investigaciones Clínicas, UNMSM; Marangoni, Manuela; Programa PROCETSS, Hospital Nacional Dos de Mayo; Ronceros, Gerardo; Instituto de Investigaciones Clínicas, Facultad de Medicina, UNMSM

    2013-01-01

    Objectives: To determine the type of anemia most frequent in patients with AIDS and the various degrees of anemia. Material and methods: One hundred patients 18 to 60 year-old infected with human immune deficiency virus (HIV) with residence in Lima and Callao were studied from January to December 2001 for blood count bone marrow aspiration, serum iron, transferrin, ferritin, folate and vitamin B12 levels. Samples were evaluated at the “Dos de Mayo” Hospital Clinical Pathology Department. Resu...

  5. Mouse models of Fanconi anemia

    Energy Technology Data Exchange (ETDEWEB)

    Parmar, Kalindi; D' Andrea, Alan [Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 44 Binney Street, Boston, MA 02115 (United States); Niedernhofer, Laura J., E-mail: niedernhoferl@upmc.edu [Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine and Cancer Institute, 5117 Centre Avenue, Hillman Cancer Center, Research Pavilion 2.6, Pittsburgh, PA 15213-1863 (United States)

    2009-07-31

    Fanconi anemia is a rare inherited disease characterized by congenital anomalies, growth retardation, aplastic anemia and an increased risk of acute myeloid leukemia and squamous cell carcinomas. The disease is caused by mutation in genes encoding proteins required for the Fanconi anemia pathway, a response mechanism to replicative stress, including that caused by genotoxins that cause DNA interstrand crosslinks. Defects in the Fanconi anemia pathway lead to genomic instability and apoptosis of proliferating cells. To date, 13 complementation groups of Fanconi anemia were identified. Five of these genes have been deleted or mutated in the mouse, as well as a sixth key regulatory gene, to create mouse models of Fanconi anemia. This review summarizes the phenotype of each of the Fanconi anemia mouse models and highlights how genetic and interventional studies using the strains have yielded novel insight into therapeutic strategies for Fanconi anemia and into how the Fanconi anemia pathway protects against genomic instability.

  6. [Neonatal hyperthyroidism and maternal Graves disease].

    Science.gov (United States)

    Ben Ameur, K; Chioukh, F Z; Marmouch, H; Ben Hamida, H; Bizid, M; Monastiri, K

    2015-04-01

    The onset of Graves disease during pregnancy exposes the neonate to the risk of hyperthyroidism. The newborn must be monitored and treatment modalities known to ensure early treatment of the newborn. We report on the case of an infant born at term of a mother with Graves disease discovered during pregnancy. He was asymptomatic during the first days of life, before declaring the disease. Neonatal hyperthyroidism was confirmed by hormonal assays. Hyperthyroidism was treated with antithyroid drugs and propranolol with a satisfactory clinical and biological course. Neonatal hyperthyroidism should be systematically sought in infants born to a mother with Graves disease. The absence of clinical signs during the first days of life does not exclude the diagnosis. The duration of monitoring should be decided according to the results of the first hormonal balance tests.

  7. Prevalencia de Anemia Nutricional en el Embarazo, en centros de salud Sarcobamba y Solomon Klein Enero 2010 – 2011

    Directory of Open Access Journals (Sweden)

    Diego Armando Cabezas Garcia

    2012-06-01

    Full Text Available La anemia nutricional durante el embarazo es consecuencia de una dieta inadecuada y bajo contenido de hierro, el cual es un alto factor de riesgo para la salud materno infantil.Con el presente estudio se determinó la prevalencia de la anemia nutricional materna en los Centros de salud Solomon Klein y el de Sarcobamba en el periodo de enero del 2010 a enero del 2011. Es un estudio retrospectivo tipo descriptivo transversal donde se utilizó las variables de niveles de hemoglobina y grado de anemia. Se revisaron 98 Historias clínicas prenatales, en el centro de Sarcobamba ,137 en el centro Solomon Klein de mujeres embarazadas que asistieron a sus tres controles y se realizaron una prueba hematológica. La prevalencia de anemia nutricional en mujeres embarazadas fue de 40,8%, los niveles de anemia fueron 65,3% anemia leve, el 28,7% anemia moderada y el 5,9% anemia grave. Por lo tanto se concluye que la anemia nutricional en el embarazo aún sigue teniendo una alta prevalencia en los centros de primer nivel y sigue siendo uno de los retos en salud materna infantil que se debe vencer en los controles prenatales con un tratamiento oportuno y eficaz.

  8. Immune-mediated hemolytic anemia - report of three cases / Anemia hemolítica imunomediada em cães - relato de três casos

    Directory of Open Access Journals (Sweden)

    Luciana Curotto Nolasco de Carvalho

    Full Text Available Immune-mediated hemolytic anemia (IMHA is a common type of anemia in dogs and cats. The disease é most common in middle-aged female dogs, especially American Cocker Spaniel. The clinical signs are associated with severe anemia. There is no pathognomonic test for IMHA, but the presence of hemolytic anemia in a young adult or middle age, autoagglutination and spherocytosis or positive results of Coombs test, elimination of any other underlying cause of anemia and an appropriate response to immunosuppressive therapy are suggestive of it. The aim of the present paper is to report of three cases of serious IMHA, and highlighting the therapeutic modalities and prognosis associated with them.A anemia hemolítica imunomediada (AHIM é um tipo comum de anemia em cães e gatos. A doença é mais comum em fêmeas caninas de meia-idade, especialmente Cocker Spaniel Americano. Os sinais clínicos estão associados com a anemia severa. Não há achados patognomônicos, mas a presença de anemia hemolítica em um cão jovem ou de meia idade, auto-aglutinação e esferócitos ou teste de Coombs positivo, eliminação de outros diagnósticos diferenciais e a resposta apropriada a terapia imunossupressora indicam AHIM. Apesar de inúmeras opções terapêuticas, os índices de mortalidade permanecem elevados. O objetivo do presente trabalho é relatar três casos graves de AHIM, ressaltando as modalidades terapêuticas e o prognóstico associado a elas.

  9. Megaloblastic anemia in Japan

    Directory of Open Access Journals (Sweden)

    Taguchi,Hirokuni

    1978-08-01

    Full Text Available Since 1903, 744 cases of megaloblastic anemia have been reported in Japan: 490 cases of pernicious anemia; 95 cases associated with pregnancy; 66 cases after gastrectomy; 22 cases of megaloblastic anemia of infants; 21 cases of folic acid deficiency other than pregnancy and 19 cases of vitamin B12 malabsorption after ileal resection. It is generally agreed among hematologists in Japan that pernicious anemia is relatively rare, as in other Asian countries. The diagnosis of pernicious anemia in Japan is usually made by stained marrow films, radioisotopic assay of serum vitamin B12, Schilling test and good response to vitamin B12 therapy. Serum folate level, intrinsic factor or its antibody, methylmalonic acid excretion, formiminoglutamic acid excretion and deoxyuridine suppression test are performed only at a small number of laboratories. The drugs of choice are hydroxocobalamin, deoxyadenosylcobalamin and methylcobalamin. Cyanocobalamin has nearly disappeared from commercial sources in Japan. Vitamin B12 administration is common in patients with neurological disorders. Megaloblastic anemia due to folic acid deficiency is extremely rare in Japan. Low serum folate levels are frequently observed among patients receiving anticonvulsants or in pregnant women, but in such samples megaloblastic anemia is almost never detected. The folic acid content of hospital diets indicates that satisfactory amounts of folate are taken in Japan. The intake of folic acid from rice is well over the minimum daily requirement of folate. Other factors in folic acid deficiency, such as food taboos, severe alcoholism and malabsorption syndrome are not frequently found in Japanese. The inadequate intake of folate was the critical factor in most reported cases.

  10. Could Anemia Cause Hearing Loss?

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_162793.html Could Anemia Cause Hearing Loss? Iron deficiency might keep ear ... Hearing loss may be linked to iron deficiency anemia -- a combination of low levels of iron and ...

  11. Aplastic Anemia & MDS International Foundation

    Science.gov (United States)

    ... Menu Donate I'm Like You. "The Aplastic Anemia and MDS International Foundation is helping patients like ... cope with bone marrow failure disease." Diseases Aplastic Anemia Myelodysplastic Syndromes (MDS) Paroxysmal Nocturnal Hemoglobinuria (PNH) Related ...

  12. Bilateral carpal tunnel syndrome in Graves' disease.

    Science.gov (United States)

    Manganelli, P; Pavesi, G; Salaffi, F

    1987-01-01

    Carpal tunnel syndrome (CTS) may be associated with endocrinopathies, such as hypothyroidism and acromegaly. A direct relationship between CTS and hyperthyroidism has recently been suggested. We now report a case in which bilateral CTS developed after treatment of Graves' disease, thus, questioning the possibility of a relationship between these two disease processes.

  13. Iron refractory iron deficiency anemia

    OpenAIRE

    De Falco, Luigia; Sanchez, Mayka; Silvestri, Laura; Kannengiesser, Caroline; Muckenthaler, Martina U; Iolascon, Achille; Gouya, Laurent; Camaschella, Clara; Beaumont, Carole

    2013-01-01

    Iron refractory iron deficiency anemia is a hereditary recessive anemia due to a defect in the TMPRSS6 gene encoding Matriptase-2. This protein is a transmembrane serine protease that plays an essential role in down-regulating hepcidin, the key regulator of iron homeostasis. Hallmarks of this disease are microcytic hypochromic anemia, low transferrin saturation and normal/high serum hepcidin values. The anemia appears in the post-natal period, although in some cases it is only diagnosed in ad...

  14. Mouse models of Fanconi anemia

    OpenAIRE

    Parmar, Kalindi; D'Andrea, Alan; Niedernhofer, Laura J.

    2009-01-01

    Fanconi anemia is a rare inherited disease characterized by congenital anomalies, growth retardation, aplastic anemia and an increased risk of acute myeloid leukemia and squamous cell carcinomas. The disease is caused by mutation in genes encoding proteins required for the Fanconi anemia pathway, a response mechanism to replicative stress, including that caused by genotoxins that cause DNA interstrand crosslinks. Defects in the Fanconi anemia pathway lead to genomic instability and apoptosis ...

  15. [Autoimmune hemolytic anemia in children].

    Science.gov (United States)

    Becheur, M; Bouslama, B; Slama, H; Toumi, N E H

    2015-01-01

    Autoimmune hemolytic anemia is a rare condition in children which differs from the adult form. It is defined by immune-mediated destruction of red blood cells caused by autoantibodies. Characteristics of the autoantibodies are responsible for the various clinical entities. Classifications of autoimmune hemolytic anemia include warm autoimmune hemolytic anemia, cold autoimmune hemolytic anemia, and paroxysmal cold hemoglobinuria. For each classification, this review discusses the epidemiology, etiology, clinical presentation, laboratory evaluation, and treatment options.

  16. DIAGNOSIS LABORATORIK ANEMIA DEFISIENSI BESI

    OpenAIRE

    Dina Sophia Margina; Sianny Herawati; I W P Sutirta Yasa

    2014-01-01

    Iron deficiency anemia is a decreament of iron level in the body. Iron deficiency anemiais oftenly seen, especially in the tropical countries or the third world country thatassociated with social economic rate. Iron deficiency anemia happens in more than onethird world’s population. Iron deficiency anemia can be caused by chronic hemorrhage,low intake of iron, absorption disturbance, and increasement of demand. To diagnose irondeficiency anemia, laboratoric examination is needed. The treatmen...

  17. Anemia in People with Cancer

    Science.gov (United States)

    ... Managing Cancer-related Side Effects Low Blood Counts Anemia in People With Cancer What is anemia? When you don’t have enough healthy red ... the symptoms that bother people most. What causes anemia? There are many different reasons a person with ...

  18. How Is Fanconi Anemia Diagnosed?

    Science.gov (United States)

    ... from the NHLBI on Twitter. How Is Fanconi Anemia Diagnosed? People who have Fanconi anemia (FA) are born with the disorder. They may ... questions about: Any personal or family history of anemia Any surgeries you’ve had related to the ...

  19. How Is Aplastic Anemia Diagnosed?

    Science.gov (United States)

    ... from the NHLBI on Twitter. How Is Aplastic Anemia Diagnosed? Your doctor will diagnose aplastic anemia based on your medical and family histories, a ... your primary care doctor thinks you have aplastic anemia, he or she may refer you to a ...

  20. Severe Anemia in Malawian Children

    NARCIS (Netherlands)

    Calis, J.C.J.; Kamija, S.P.; Faragher, E.B.; Brabin, B.J.; Bates, I.; Cuevas, L.E.; Haan, de R.J.; Phiri, A.I.; Malange, P.; Khoka, M.; Hulshof, P.J.M.; Lieshout, L.; Beld, M.G.H.M.; Teo, Y.Y.; Rockett, K.A.; Richardson, A.; Kwiatkowski, D.P.; Molyneux, M.E.; Hensbroek, van M.B.

    2008-01-01

    Background Severe anemia is a major cause of sickness and death in African children, yet the causes of anemia in this population have been inadequately studied. Methods We conducted a case¿control study of 381 preschool children with severe anemia (hemoglobin concentration,

  1. Aplastic Anemia and Myelodysplastic Syndromes

    Science.gov (United States)

    ... have aplastic anemia. Most new cases of aplastic anemia in children are due to inherited bone marrow failure syndromes. MDS are typically diagnosed between the ages of 70 and 80 years. Although a cause is not found in most cases of aplastic anemia and MDS, the diseases may be triggered by ...

  2. Severe gangrene by cold agglutinemia Gangrena grave causada por crioaglutinina

    Directory of Open Access Journals (Sweden)

    Perla Vicari

    2004-03-01

    Full Text Available The cold agglutinin syndrome is a haemolytic disorder usually manifested by acrocyanosis and Raynaud's phenomenon. Gangrene is an uncommon complication, usually associated with infections or B-cell lymphoproliferative diseases. We present a case of fulminant gangrene of fingers, toes, and nose in a 77-year-old woman with atypical pneumonia and acute renal failure. The diagnosis of haemolytic anaemia with cold agglutinin syndrome was done and the treatment with antibiotics and corticosteroids was effective. However, amputation of all the toes on both feet could not be avoided. Clinical aspects of cold agglutinemia, transient or chronic, are briefly discussed. We conclude that, in the presence of cold agglutinin syndrome, the treatment should be promptly initiated in order to avoid complications such as extensive gangrene.Doença da aglutinina a frio é uma patologia caracterizada pela produção de anticorpos contra antígenos específicos da membrana eritrocitária, geralmente de classe IgM, que aglutinam hemácias em temperaturas abaixo de 32º C. Relatamos um caso de gangrena e insuficiência renal em uma mulher de 77 anos com pneumonia atípica. Anemia hemolítica secundária a crioaglutininas foi observada. O tratamento com antibióticos e corticóides foi eficaz com regressão do quadro, porém foi necessária a amputação de todos os dedos do pé (falanges bilateralmente, preservando o restante dos pés (tarsos e metatarsos. Anemia hemolítica secundária a crioaglutininas manifesta-se freqüentemente por acrocianose e fenômeno de Raynaud. Gangrena é uma complicação incomum dessa doença, principalmente quando secundária a etiologia infecciosa, sendo observada apenas em pacientes com altos títulos persistentes. Está correlacionada freqüentemente com causa infecciosa (Mycoplasma spp, vírus Epstein-Barr, citomegalovírus, vírus Influenza A, adenovírus, Legionella spp, linfoproliferativas B e idiopáticas. Suspeita clínica de

  3. Evaluation of anemia in children.

    Science.gov (United States)

    Janus, Jennifer; Moerschel, Sarah K

    2010-06-15

    Anemia is defined as a hemoglobin level of less than the 5th percentile for age. Causes vary by age. Most children with anemia are asymptomatic, and the condition is detected on screening laboratory evaluation. Screening is recommended only for high-risk children. Anemia is classified as microcytic, normocytic, or macrocytic, based on the mean corpuscular volume. Mild microcytic anemia may be treated presumptively with oral iron therapy in children six to 36 months of age who have risk factors for iron deficiency anemia. If the anemia is severe or is unresponsive to iron therapy, the patient should be evaluated for gastrointestinal blood loss. Other tests used in the evaluation of microcytic anemia include serum iron studies, lead levels, and hemoglobin electrophoresis. Normocytic anemia may be caused by chronic disease, hemolysis, or bone marrow disorders. Workup of normocytic anemia is based on bone marrow function as determined by the reticulocyte count. If the reticulocyte count is elevated, the patient should be evaluated for blood loss or hemolysis. A low reticulocyte count suggests aplasia or a bone marrow disorder. Common tests used in the evaluation of macrocytic anemias include vitamin B12 and folate levels, and thyroid function testing. A peripheral smear can provide additional information in patients with anemia of any morphology.

  4. Sickle Cell Anemia Bibliography.

    Science.gov (United States)

    Christy, Steven C.

    Presents sources for the acquisition of medical, social, psychological, educational, and practical knowledge of sickle cell anemia. The materials listed are designed to help parents, educators, and public service workers. Materials include journal articles, films, brochures, slides, and fact sheets. The usual bibliographic information is given.…

  5. Anemia and School Participation

    Science.gov (United States)

    Bobonis, Gustavo J.; Miguel, Edward; Puri-Sharma, Charu

    2006-01-01

    Anemia is among the most widespread health problems for children in developing countries. This paper evaluates the impact of a randomized health intervention delivering iron supplementation and deworming drugs to Indian preschool children. At baseline, 69 percent were anemic and 30 percent had intestinal worm infections. Weight increased among…

  6. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... a lower than normal number of red blood cells. Red blood cells carry oxygen and remove carbon dioxide (a waste ... Anemia also can occur if your red blood cells don't contain enough hemoglobin (HEE-muh-glow- ...

  7. Twin anemia polycythemia sequence

    NARCIS (Netherlands)

    Slaghekke, Femke

    2014-01-01

    In this thesis we describe that Twin Anemia Polycythemia Sequence (TAPS) is a form of chronic feto-fetal transfusion in monochorionic (identical) twins based on a small amount of blood transfusion through very small anastomoses. For the antenatal diagnosis of TAPS, Middle Cerebral Artery – Peak Syst

  8. Anemia (For Parents)

    Science.gov (United States)

    ... rich foods to a child's diet or reducing milk intake. If your teenage daughter is anemic and has heavy or irregular menstrual periods, the doctor may prescribe hormonal treatment to help regulate the bleeding. Folic acid and vitamin B12 supplements may be recommended for anemia due to ...

  9. Sickle cell anemia

    Science.gov (United States)

    ... Anemia - sickle cell; Hemoglobin SS disease (Hb SS); Sickle cell disease Images Red blood cells, sickle cell Red blood cells, normal Red blood ... multiple sickle cells Red blood cells, sickle cells Red blood cells, sickle and ... Heeney MM, Ware RE. Sickle cell disease. In: Orkin SH, Fisher DE, Ginsburg D, Look ...

  10. Autoimmune Hemolytic Anemia.

    Science.gov (United States)

    Liebman, Howard A; Weitz, Ilene C

    2017-03-01

    Autoimmune hemolytic anemia is an acquired autoimmune disorder resulting in the production of antibodies directed against red blood cell antigens causing shortened erythrocyte survival. The disorders can present as a primary disorder (idiopathic) or secondary to other autoimmune disorders, malignancies, or infections. Treatment involves immune modulation with corticosteroids and other agents.

  11. Multidisciplinary approach to anemia

    Directory of Open Access Journals (Sweden)

    Anca Ghiațău

    2015-08-01

    Full Text Available Introduction: We present the case of a 65 years- old woman who was admitted with a severe macrocytic anemia Hb= 5.7g/dl and diffuse bone pain. Biologically she has moderate thrombocytopenia 35 000/µl, a hepatic cytolysis and cholestatic syndrome. Material and method: The patient was extensively evaluated before presentation for a mild iron - deficiency anemia for which she underwent endoscopic examination of the upper and lower gastrointestinal tract- normal. The bone marrow aspiration on admission revealed a marked hyperplasia of the erythroblastic line with ~50% basophilic erythroblasts suggesting a regenerative erythroid hyperplasia. These changes along with the marked reticulocytosis on the peripheral blood smear oriented us towards a hemolytic anemia; Folic acid, vitamin B12, autoimmune tests and hemolytic tests were all normal. We continued the investigations with a thoraco-abdominopelvic computed tomography which identified diffuse demineralization, vertebral compactation and pelvic stress fractures. The breast examination revealed a right breast nodule, but the breast ultrasonography pleaded for benignity. Lacking a clear definitive diagnosis we decided to perform a bone marrow biopsy. Results: The osteo- medullary biopsy pointed towards a medullar invasion from a lobular mammary carcinoma; In these circumstances we performed an ultrasound guided biopsy of the right mammary lump thus histologically confirming a tumoral invasion of the bone marrow with subsequent anemia. The patient started chemotherapy in the Oncology ward. Conclusion: The particularity of this case consists in the pattern of anemia, which initially seemed iron deficient and afterwards macrocytic – apparently hemolytic and was actually due to the tumoral medullar invasion and also the nonspecific ultrasonographic appearance of the breast tumor.

  12. Diagnosis and classification of Graves' disease.

    Science.gov (United States)

    Menconi, Francesca; Marcocci, Claudio; Marinò, Michele

    2014-01-01

    Graves' disease (GD) is an autoimmune disorder involving the thyroid gland, typically characterized by the presence of circulating autoantibodies that bind to and stimulate the thyroid hormone receptor (TSHR), resulting in hyperthyroidism and goiter. Organs other than the thyroid can also be affected, leading to the extrathyroidal manifestations of GD, namely Graves' ophthalmopathy, which is observed in ~50% of patients, and Graves' dermopathy and acropachy, which are quite rare. Presumably, the extrathyroidal manifestations of GD are due to autoimmunity against antigens common to the thyroid and other affected organs. Although its exact etiology remains to be completely understood, GD is believed to result from a complex interaction between genetic susceptibility and environmental factors. Clinically, GD is characterized by the manifestations of thyrotoxicosis as well as by its extrathyroidal features when present, the latter making the diagnosis almost unmistakable. In the absence of ophthalmopathy, the diagnosis is generally based on the association of hyperthyroidism and usually diffuse goiter confirmed with serum anti-TSHR autoantibodies (TRAbs). Hyperthyroidism is generally treated with anti-thyroid drugs, but a common long term treatment strategy in patients relapsing after a course of anti-thyroid drugs (60-70%), implies the use of radioactive iodine or surgery.

  13. [Anemia in the elderly].

    Science.gov (United States)

    Maerevoet, M; Sattar, L; Bron, D; Gulbis, B; Pepersack, T

    2014-09-01

    Anaemia is a problem that affects almost 10% over 65 years and 20% over 85 years. There is no physiological anaemia in the elderly. Any anaemia expresses the existence of a pathological process, regardless of its severity. Anaemia in the elderly is always associated with a poor prognosis that is in terms of mortality, morbidity and risk of fragility. The diagnostic approach to anemia in the elderly is the same as in younger individual. There are many causes of anaemia; anaemia balance is a complex diagnostic process. Most anaemias are due to a deficiency, chronic inflammation or comorbidity. However, in the elderly, the etiology of anaemia is often multifactorial. In a number of cases remain unexplained anaemia. In a number of cases, anemia remain unexplained. Treatment of anaemia is the treatment of the cause, but specific therapeutic aspects to the elderly should be considered, as among other martial substitution or use of erythropoietin (EPO).

  14. Thiamine– Responsive Megaloblastic Anemia Syndrome

    Directory of Open Access Journals (Sweden)

    F Motavaselian

    2009-01-01

    Full Text Available Thiamine Responsive megaloblastic anemia in DIDMOA (Wolfram syndrome has an autosomal- recessive mode of inheritance . Megaloblastic anemia and sideroblastic anemia is accompanied by diabetes insipidus (DI, diabetes mellitus (DM ,optic atrophy (OA and deafness (D. Neutropenia and thrombocytopenia are also present. We report a 7 month old girl with congenital macrocytic anemia; a rare clinical feature of Wolfram,s syndrome with increased plasma levels of blood glucose, both of which dramatically responded to administration of thiamine in large doses . The patient also had neurosensorial deafness, but no improvement was observed in the deafness. We presented the case because thiamine-responsive megaloblastic anemia is a rare clinical presentation of Wolfram syndrome and after institution of treatment with thiamine, the anemia and hyperglycemia returned to normal.

  15. Iron deficiency anemia in pregnancy.

    Science.gov (United States)

    Di Renzo, Gian Carlo; Spano, Filippo; Giardina, Irene; Brillo, Eleonora; Clerici, Graziano; Roura, Luis Cabero

    2015-11-01

    Anemia is the most frequent derailment of physiology in the world throughout the life of a woman. It is a serious condition in countries that are industrialized and in countries with poor resources. The main purpose of this manuscript is to give the right concern of anemia in pregnancy. The most common causes of anemia are poor nutrition, iron deficiencies, micronutrients deficiencies including folic acid, vitamin A and vitamin B12, diseases like malaria, hookworm infestation and schistosomiasis, HIV infection and genetically inherited hemoglobinopathies such as thalassemia. Depending on the severity and duration of anemia and the stage of gestation, there could be different adverse effects including low birth weight and preterm delivery. Treatment of mild anemia prevents more severe forms of anemia, strictly associated with increased risk of fetal-maternal mortality and morbidity.

  16. Understanding anemia of chronic disease.

    Science.gov (United States)

    Fraenkel, Paula G

    2015-01-01

    The anemia of chronic disease is an old disease concept, but contemporary research in the role of proinflammatory cytokines and iron biology has shed new light on the pathophysiology of the condition. Recent epidemiologic studies have connected the anemia of chronic disease with critical illness, obesity, aging, and kidney failure, as well as with the well-established associations of cancer, chronic infection, and autoimmune disease. Functional iron deficiency, mediated principally by the interaction of interleukin-6, the iron regulatory hormone hepcidin, and the iron exporter ferroportin, is a major contributor to the anemia of chronic disease. Although anemia is associated with adverse outcomes, experimental models suggest that iron sequestration is desirable in the setting of severe infection. Experimental therapeutic approaches targeting interleukin-6 or the ferroportin-hepcidin axis have shown efficacy in reversing anemia in either animal models or human patients, although these agents have not yet been approved for the treatment of the anemia of chronic disease.

  17. Analysis of CT scatnning for Graves'ophthalmopathy%Graves'眼病的CT扫描分析

    Institute of Scientific and Technical Information of China (English)

    傅德生; 许雪亮; 向前; 鲍捷; 杨春霖; 易文殊; 丁凤奎

    2003-01-01

    目的探讨CT扫描在Graves'眼病诊断中的应用价值.方法回顾性分析191例Craves,眼病CT影像资料.结果CT扫描显示眼外肌肥厚151例,眼球突出74例,眶尖密度增高50例,视神径增粗17例,筛骨纸板压迫征4例,结论因CT阳性发现率高,可作为Graves'眼病诊断的常规方法.

  18. [Anemia: guidelines comparison].

    Science.gov (United States)

    Del Vecchio, Lucia

    2009-01-01

    The development of recombinant human erythropoietin and its introduction into the market in the late 1980s has significantly improved the quality of life of patients with chronic kidney disease (CKD) and reduced the need for blood transfusions. Starting from a cautious target, a progressive increase in the recommended hemoglobin levels has been observed over the years, in parallel with an increase in the obtained levels. This trend has gone together with the publication of findings of observational studies showing a relationship between the increase in hemoglobin levels and a reduction in the mortality risk, with the conduction of clinical trials testing the effects of complete anemia correction, and with the compilation of guidelines on anemia control in CKD patients by scientific societies and organizations. In the last two years, evidence of a possible increase in the mortality risk in those patients who were randomized to high hemoglobin levels has resulted in a decrease in the upper limit of the recommended Hb target to be obtained with erythropoietin stimulating agents (ESA), and consequently in a narrowing of the target range. Comparison of guidelines on anemia control in CKD patients is an interesting starting point to discuss single recommendations, strengthen their importance, or suggest new topics of research to fill up important gaps in knowledge.

  19. Management of Iron Deficiency Anemia

    OpenAIRE

    Jimenez, Kristine; Kulnigg-Dabsch, Stefanie; Gasche, Christoph

    2015-01-01

    Anemia affects one-fourth of the world’s population, and iron deficiency is the predominant cause. Anemia is associated with chronic fatigue, impaired cognitive function, and diminished well-being. Patients with iron deficiency anemia of unknown etiology are frequently referred to a gastroenterologist because in the majority of cases the condition has a gastrointestinal origin. Proper management improves quality of life, alleviates the symptoms of iron deficiency, and reduces the need for blo...

  20. Iron-Deficiency Anemia (For Parents)

    Science.gov (United States)

    ... Your 1- to 2-Year-Old Iron-Deficiency Anemia KidsHealth > For Parents > Iron-Deficiency Anemia Print A ... common nutritional deficiency in children. About Iron-Deficiency Anemia Every red blood cell in the body contains ...

  1. Special Issues for People with Aplastic Anemia

    Science.gov (United States)

    ... Menu Donate Special Issues for People with Aplastic Anemia Because you have aplastic anemia , everyday events can ... bleeding, such as contact sports. Pregnancy and Aplastic Anemia Pregnancy is possible for women who have been ...

  2. Drug-induced immune hemolytic anemia

    Science.gov (United States)

    Immune hemolytic anemia secondary to drugs; Anemia - immune hemolytic - secondary to drugs ... Drugs that can cause this type of hemolytic anemia include: Cephalosporins (a class of antibiotics), most common ...

  3. Iron-Deficiency Anemia (For Parents)

    Science.gov (United States)

    ... Your 1- to 2-Year-Old Iron-Deficiency Anemia KidsHealth > For Parents > Iron-Deficiency Anemia A A ... common nutritional deficiency in children. About Iron-Deficiency Anemia Every red blood cell in the body contains ...

  4. Anemia of Chronic Liver Diseases

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hyun Chung; Lee, Jhung Sang; Koh, Chang Soon; Lee, Mun Ho [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1971-09-15

    The pathogenetic mechanisms of anemia in patients with chronic liver disease were observed. Seventeen patients with moderate to advanced hepatic diseases were studied by various methods. Only patients without previous blood loss were included : 14 had cirrhosis, 2 had active chronic hepatitis, and one had inferior vena cava obstruction with associated liver cirrhosis. The followings were the results: 1. The anemia based on red blood cell count, Hb., and Ht. was found in 76.5-78.6% of the patients. 2. Red cell indices indicated that normo-macrocytic and normochromic anemia was present is the majority of the patients. 3. No evidence of megaloblastic anemia was found on the basis of the morphological examinations. 4. Serum iron, TIBC, % saturation and iron content in the bone marrow indicated that iron deficiency anemia was present in about half of the patients. 5. In the view of the erythrocyte dynamics, primary increase in the red cell destruction was ascribed to the cause of the anemia. 6. Decrease in the red cell survival time was not correlated with MCV, % saturation and S.L. ratio. Also, hemoglobin level was not correlated with MCV, % saturation and T{sub 50} Cr. Therefore, multiple causes may be involved in the pathogenesis of the anemia. 7. Anemia as determined by the red cell volume was found in only 60% of the patients. It may be possible that hemodilutional anemia is present.

  5. Iron Deficiency Anemia in Pregnancy.

    Science.gov (United States)

    Breymann, Christian

    2015-10-01

    Anemia is a common problem in obstetrics and perinatal care. Any hemoglobin below 10.5 g/dL can be regarded as true anemia regardless of gestational age. Reasons for anemia in pregnancy are mainly nutritional deficiencies, parasitic and bacterial diseases, and inborn red blood cell disorders such as thalassemias. The main cause of anemia in obstetrics is iron deficiency, which has a worldwide prevalence between estimated 20%-80% and consists of a primarily female population. Stages of iron deficiency are depletion of iron stores, iron-deficient erythropoiesis without anemia, and iron deficiency anemia, the most pronounced form of iron deficiency. Pregnancy anemia can be aggravated by various conditions such as uterine or placental bleedings, gastrointestinal bleedings, and peripartum blood loss. In addition to the general consequences of anemia, there are specific risks during pregnancy for the mother and the fetus such as intrauterine growth retardation, prematurity, feto-placental miss ratio, and higher risk for peripartum blood transfusion. Besides the importance of prophylaxis of iron deficiency, the main therapy options for the treatment of pregnancy anemia are oral iron and intravenous iron preparations.

  6. ANEMIA SEL SABIT

    Directory of Open Access Journals (Sweden)

    Gede Agus Suwiryawan

    2013-09-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Anemia is a form of blood disorder most often occurs in the community. Sickle cell anemia is anemia due to hemoglobinopathy caused by a change in the amino acid-6 of the ? globin chain. Sickle cell anemia is common in tropical areas of Africa and some parts of the region Saudi Arabia, India and the Mediterranean as well as black people in America. In addition there are also careers in various European countries. In pathophysiology, there are amino acid change from glutamic acid to valine in the ?-globin chain that causes red blood cells become sickle-shaped when deoxygenatied, but still be able to return to its normal shape when experiencing oxygenation. When the red blood cell membrane have been amended, the polymerization of red blood cells has become irreversible. Clinical picture seen in sickle cell anemia can be divided into two, namely: acute and chronic. Diagnosis can be done is to distinguish between heterozygous or homozygous sickle cell. Treatment provided in accordance with the clinical picture appears. Treatment that can be done is by blood transfusion, bone marrow transplant, anti-sickling drug delivery, and drug delivery to trigger the synthesis of HbF. Treatment still in the development stage is to use stem cells. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  7. Tratamiento de la osteoporosis grave con teriparatide

    Directory of Open Access Journals (Sweden)

    Marcelo A. Sarli

    2013-10-01

    Full Text Available El objetivo de este trabajo retrospectivo fue evaluar el tratamiento de la osteoporosis grave con teriparatide (PTH y comparar nuestros resultados con los publicados en la literatura médica. Se incluyeron cuarenta y seis pacientes, cuarenta y dos mujeres y cuatro varones, edad: 69.15 ± 9.43 años. Seis eran vírgenes de tratamiento y cuarenta tratados previamente con bisfosfonatos. Treinta y dos pacientes habían tenido 93 fracturas de las cuales 86 vertebrales. Cuarenta y seis recibieron PTH 6 meses, 29 pacientes durante 12 meses y 20 completaron los 18 meses sugeridos. La densidad mineral ósea (DMO de columna lumbar aumentó significativamente desde el primer control a los 6 meses (p < 0.0001. La DMO de cuello de fémur alcanzó un incremento significativo al final del tratamiento (p = 0.002. La osteocalcina aumentó significativamente al mes, seguido por el ß crosslaps (beta-CTx, prueba en suero al tercer mes y la fosfatasa alcalina ósea, regresando los marcadores de recambio óseo a niveles basales a los 18 meses. Las calcemias y las calciurias no se modificaron significativamente, pero 8 pacientes tuvieron hipercalcemias leves y tres hipercalciurias asintomáticas. El tratamiento fue bien tolerado y no se registraron efectos adversos graves que requirieran suspender el tratamiento. En conclusión, la PTH es una alternativa útil y segura para el tratamiento de la osteoporosis grave. Nuestros resultados concuerdan con los previamente publicados en la literatura médica.

  8. Hemolytic anemia caused by chemicals and toxins

    Science.gov (United States)

    ... This list is not all-inclusive. Alternative Names Anemia - hemolytic - caused by chemicals or toxins References Michel M. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Schafer ...

  9. Hipoxia após traumatismos crânio-encefálicos graves

    Directory of Open Access Journals (Sweden)

    R. A. Frowein

    1964-09-01

    Full Text Available Após traumatismos crânio-encefálicos graves ocorre hipoxia cerebral, não apenas nas primeiras horas mas também durante vários dias da fase aguda. A saturação arterial de O2 é muitas vêzes normal, mas, com mais freqüência do que se supõe, existe anemia; como conseqüência do aumento da pressão intracraniana, da hipotensão arterial ou da alcalose respiratória, diminui o afluxo sangüíneo ao encéfalo, baixando a tensão do O2 celular, o que é demonstrado pela diminuição da tensão de O2 no sangue venoso provindo do encéfalo. Por isso, no tratamento da fase aguda pós-traumática deve-se, ao lado da normalização da pressão intracraniana, manter a pressão arterial, evitar a hiperventilação pulmonar mediante a administração de neuroplégicos e impedir a anemia mediante transfusões de sangue.

  10. Warm autoimmune hemolytic anemia.

    Science.gov (United States)

    Naik, Rakhi

    2015-06-01

    Warm autoimmune hemolytic anemia (AIHA) is defined as the destruction of circulating red blood cells (RBCs) in the setting of anti-RBC autoantibodies that optimally react at 37°C. The pathophysiology of disease involves phagocytosis of autoantibody-coated RBCs in the spleen and complement-mediated hemolysis. Thus far, treatment is aimed at decreasing autoantibody production with immunosuppression or reducing phagocytosis of affected cells in the spleen. The role of complement inhibitors in warm AIHA has not been explored. This article addresses the diagnosis, etiology, and treatment of warm AIHA and highlights the role of complement in disease pathology.

  11. 75 FR 65030 - Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation

    Science.gov (United States)

    2010-10-21

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation AGENCY: National Park Service, Interior. ACTION: Native American Graves Protection and... nominations for two members of the Native American Graves Protection and Repatriation Review Committee....

  12. 75 FR 13140 - Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation

    Science.gov (United States)

    2010-03-18

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation AGENCY: National Park Service, Interior. ACTION: Native American Graves Protection and... nominations for one member of the Native American Graves Protection and Repatriation Review Committee....

  13. Current insights into animal models of Graves' disease and orbitopathy.

    Science.gov (United States)

    Wiesweg, B; Johnson, K T M; Eckstein, A K; Berchner-Pfannschmidt, U

    2013-08-01

    Graves' disease (GD) is a systemic autoimmune disease that is characterized by hyperthyroidism, orbitopathy and in rare cases dermopathy. Graves' orbitopathy (GO) is an inflammatory disease of eye and orbit which occurs in about 30-60% of patients. Hyperthyroidism occurs due to the presence of stimulating TSHR-autoantibodies (TRAbs) leading to increased serum levels of thyroid hormones. Attempts to induce Graves' disease in mice by immunization against the hTSHR or its variants have resulted in production of TRAbs that stimulate thyroid follicular cells to increase thyroid hormone secretion. Graves' like orbital changes, such as inflammation, adipogenesis and muscle fibrosis are more difficult to induce. In this review we summarize different methods used to induce murine Graves'-like disease and their impact on murine orbits.

  14. Anemia como problema de saúde pública: uma realidade atual Anemia as a public health problem: the current situation

    Directory of Open Access Journals (Sweden)

    Malaquias Batista Filho

    2008-12-01

    Full Text Available Em 1990, as Nações Unidas promoveram a Reunião de Cúpula de Nova Iorque, onde foram traçadas metas para o decênio vindouro, dentre as quais, a redução de um terço na prevalência das anemias nas mulheres em idade fértil. Porém, apesar de percentual modesto, indícios epidemiológicos apontam no sentido inverso, ou seja, indicam a crescente e grave ocorrência de anemia em diferentes regiões do mundo, inclusive no Brasil. Ao reunir esses informes, constata-se que a anemia continua, desde a antiguidade, a ser uma das entidades nosológicas mais prevalentes e difundidas nas populações humanas. A partir daí surge uma série de questionamentos ainda sem respostas em relação às reais prevalência e etiopatogenia do problema, ao grau de implantação e à efetividade das medidas de controle.In 1990, the United Nations held a World Summit in New York, in which goals for the upcoming decade were established. One of these goals was a one-third reduction in the prevalence of anemia among women at childbearing age. Despite this modest percentage, epidemiological indicators point to the opposite direction, indicating an increasing occurrence of anemia in different regions of the world, including in Brazil. These data show that anemia has continued since the antiquity to be one of the most prevalent and widespread diseases in human populations. Thus, a number of questions without answers arise regarding the actual prevalence and etiopathogenesis of the problem as well as with respect to the degree of implantation and the effectiveness of control measures.

  15. Radiologia contrastada do timo na miastenia grave

    Directory of Open Access Journals (Sweden)

    José Lamartine de Assis

    1964-03-01

    Full Text Available Foram estudados 20 casos de miastenia grave mediante exame radiológico simples para evidenciar a persistência ou hipertrofia do timo e estudar, comparativamente, os resultados dêste método propedêutico com o uso do enfisema do mediastino seguido de pneumografia e/ou planigrafia. Com tal procedimento foi possível mostrar, em 18 dos casos, a persistência ou hipertrofia do timo. Em alguns casos foram analisados os diversos aspectos radiológicos do timo em suas relações com as medidas terapêuticas, adotadas em particular com o uso do ACTH, radioterapia e/ou timectomia; neste particular, os autores não puderam tirar conclusões definitivas por ser pequeno o número de casos estudados.

  16. Radiotherapy in the management of Graves` ophthalmopathy

    Energy Technology Data Exchange (ETDEWEB)

    Sakata, Koh-ichi; Hareyama, Masato; Oouchi, Atsushi; Shidou, Mitsuo; Nagakura, Hisayasu; Morita, Kazuo; Osanai, Hajime; Ohtsuka, Kenji; Hinoda, Yuji [Sapporo Medical Univ. (Japan). School of Medicine

    1998-06-01

    To report the results of radiotherapy for patients with failure, adverse reactions or relative contraindications to the use of steroids or immunosuppressants, by using newly developed quantitative indexes. Fourteen female and six male patients with Graves` ophthalmopathy were treated with radiotherapy between 1989 and 1996. Prior to radiotherapy, eight patients received treatment with prednisone, four received immunosuppressants and four received a combination of both. Four patients with contraindications to steroids were initially managed with radiotherapy. Most of the patients received a dose of 24-28 Gy in 2 Gy fractions. We used the newly developed motility limitation index to assess extraocular motility. Treatment was well tolerated. There have been no late complications. All 12 patients with soft tissue signs such as edema, irritation, tearing and pain were improved. Proptosis did not improve or improved only slightly, 3 mm at best. However, proptosis in all but two has been stabilized and has not deteriorated in the follow-up period. Most of the patients have experienced an improvement of eye-muscle motility. Extraocular muscles that work for elevation were impaired more severely than the other muscles and this tended to remain. Of the 16 patients using steroids before or when radiotherapy was initiated, 15 were tapered off and only one patient required additional steroids, thus sparing the majority from steroid adverse reactions. Radiotherapy was effective in preventing exacerbations of active inflammatory ophthalmopathy in patients with Graves` disease with minimal morbidity and thus eliminated the adverse reactions associated with protracted corticosteroid use. The newly developed motility limitation index was useful in detecting delicate changes in motility of individual extraocular muscles. (author)

  17. Outcome of Very Long-Term Treatment with Antithyroid Drugs in Graves' Hyperthyroidism Associated with Graves' Orbitopathy

    NARCIS (Netherlands)

    L. Elbers; M. Mourits; W. Wiersinga

    2011-01-01

    Background: It is still debated which treatment modality for Graves' hyperthyroidism (GH) is most appropriate when Graves' orbitopathy (GO) is present. The preference in our center has been always to continue antithyroid drugs for GH (as the block-and-replace [B-R] regimen) until all medical and/or

  18. Severe autoimmune hemolytic anemia with renal neoplasm.

    Science.gov (United States)

    Rhodes, Emily C; Parikh, Sahil P; Bhattacharyya, Nishith

    2014-02-01

    Autoimmune hemolytic anemia is a type of hemolytic anemia characterized by autoantibodies directed against red blood cells shortening their survival. When autoimmune hemolytic anemia is secondary to a paraneoplastic process, severe anemia can occur leading to significant morbidity and even mortality. Here we discuss the literature and present the case of a child with autoimmune hemolytic anemia from a paraneoplastic syndrome secondary to a renal tumor.

  19. Anemia in the general population

    DEFF Research Database (Denmark)

    Martinsson, Andreas; Andersson, Charlotte; Andell, Pontus

    2014-01-01

    Low hemoglobin concentration is associated with increased mortality, but there is disagreement with regard to the clinical definition of anemia. We aimed to evaluate the prevalence, clinical correlates and association with total and cause-specific long-term mortality across the hemoglobin...... distribution and for previously proposed definitions of anemia. Blood hemoglobin concentration and mean corpuscular volume was measured in participants of the Malmö diet and cancer study-a prospective cohort study, and related to baseline characteristics and outcomes during follow-up. Primary endpoints were...... of anemia, hazard ratio: 1.36, 1.94 and 2.16 for hemoglobin

  20. Complement in hemolytic anemia.

    Science.gov (United States)

    Brodsky, Robert A

    2015-01-01

    Complement is increasingly being recognized as an important driver of human disease, including many hemolytic anemias. Paroxysmal nocturnal hemoglobinuria (PNH) cells are susceptible to hemolysis because of a loss of the complement regulatory proteins CD59 and CD55. Patients with atypical hemolytic uremic syndrome (aHUS) develop a thrombotic microangiopathy (TMA) that in most cases is attributable to mutations that lead to activation of the alternative pathway of complement. For optimal therapy, it is critical, but often difficult, to distinguish aHUS from other TMAs, such as thrombotic thrombocytopenic purpura; however, novel bioassays are being developed. In cold agglutinin disease (CAD), immunoglobulin M autoantibodies fix complement on the surface of red cells, resulting in extravascular hemolysis by the reticuloendothelial system. Drugs that inhibit complement activation are increasingly being used to treat these diseases. This article discusses the pathophysiology, diagnosis, and therapy for PNH, aHUS, and CAD.

  1. ANEMIA DAN ANEMIA GIZI BESI PADA KEHAMILAN: HUBUNGANNYA DENGAN ASUPAN PROTEIN DAN ZAT GIZI MIKRO

    OpenAIRE

    Nur Handayani Utami; Bunga CH. Rosha

    2015-01-01

    Anemia masih menjadi permasalahan kesehatan pada wanita hamil. Zat besi dianggap sebagai salah satu zat gizi mikro yang berperan terhadap terjadinya anemia. Kekurangan gizi besi dalam tingkat lanjut dapat menyebabkan anemia, yang disebut sebagai anemia gizi besi. Tujuan studi ini adalah untuk menganalisis perbedaan antara asupan protein dan gizi mikro serta menghitung odd ratio (OR) kejadian anemia dan anemia gizi besi akibat asupan protein dan gizi mikro pada wanita hamil di lokasi studi. An...

  2. Graves' Disease that Developed Shortly after Surgery for Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Hea Min Yu

    2013-09-01

    Full Text Available Graves' disease is an autoimmune disorder that may present with various clinical manifestations of hyperthyroidism. Patients with Graves' disease have a greater number of thyroid nodules and a higher incidence of thyroid cancer compared with patients with normal thyroid activity. However, cases in which patients are diagnosed with recurrence of Graves' disease shortly after partial thyroidectomy for thyroid cancer are very rare. Here we report a case of hyperthyroid Graves' disease that occurred after partial thyroidectomy for papillary thyroid cancer. In this case, the patient developed hyperthyroidism 9 months after right hemithyroidectomy, and antithyroglobulin autoantibody and thyroid stimulating hormone receptor stimulating autoantibody were positive. Therefore, we diagnosed Graves' disease on the basis of the laboratory test results and thyroid ultrasonography findings. The patient was treated with and maintained on antithyroid drugs. The mechanism of the recurrence of Graves' disease in this patient is still unclear. The mechanism may have been the improper response of the immune system after partial thyroidectomy. To precisely determine the mechanisms in Graves' disease after partial thyroidectomy, further studies based on a greater number of cases are needed.

  3. How Is Hemolytic Anemia Treated?

    Science.gov (United States)

    ... G6PD) deficiency can avoid substances that may trigger anemia. For example, avoid fava beans, naphthalene (a substance found in some moth balls), and certain ... INDEX ACCESSIBILITY PRIVACY STATEMENT FOIA NO FEAR ACT OIG ...

  4. Malarial anemia and STAT6

    OpenAIRE

    Robson, Kathryn J.H.; Weatherall, David J

    2009-01-01

    Understanding the mechanisms behind malarial anemia should lead to new approaches to the management and treatment of children. In this perspective article Drs. Robson and Weatherall examine the pathophysiology of this condition. See related article on page 195.

  5. Concomitant Graves' disease and Hashimoto's thyroiditis, presenting as primary hypothyroidism.

    LENUS (Irish Health Repository)

    Cronin, C C

    2012-02-03

    Hypothyroidism in patients with Graves\\' disease is usually the result of ablative treatment. We describe a 58 year old man with Graves\\' ophthalmopathy and pre-tibial myxoedema, who presented with spontaneous primary hypothyroidism. Circulating TSH receptor antibody activity was increased, while thyroid microsomal antibody was detectable in titres greater than one in one hundred thousand. It is likely that the TSH receptor antibody of Graves\\' disease was ineffective in stimulating hyperthyroidism because of concomitant thyroid destruction due to Hashimoto\\'s disease. Alternatively, primary hypothyroidism could have resulted from the effects of a circulating TSH receptor blocking antibody.

  6. Sexuality and sickle cell anemia

    Directory of Open Access Journals (Sweden)

    Viviane de Almeida Côbo

    2013-01-01

    Full Text Available BACKGROUND: Sickle cell disease, the most common hereditary blood disease in the world, is the result of an atypical hemoglobin called S (Hb S which, when homozygous (Hb SS is the cause of sickle cell anemia. Changes of puberty, correlated with a delayed growth spurt, begin late in both male and female sickle cell anemia individuals with repercussions on sexuality and reproduction. The objectives of this exploratory and descriptive study were to characterize the development of sexuality in adults with sickle cell anemia by investigating the patient's perception of their sex life, as well as the information they had and needed on this subject. METHODS: Twenty male and female sickle cell anemia patients treated at the Hemocentro Regional de Uberaba (UFTM with ages between 19 and 47 years old were enrolled. A socioeconomic questionnaire and a semi-structured interview on sexuality, reproduction and genetic counseling were applied. RESULTS: This study shows that the sickle cell anemia patients lacked information on sexuality especially about the risks of pregnancy and the possible inheritance of the disease by their children. Moreover, the sexual life of the patients was impaired due to pain as well as discrimination and negative feelings experienced in close relationships. CONCLUSION: The health care of sickle cell anemia patients should take into account not only the clinical aspects of the disease, but also psychosocial aspects by providing counseling on sexuality, reproduction and genetics, in order to give this population the possibility of a better quality of life.

  7. Anemia ferropriva e estado nutricional de crianças com idade de 12 a 60 meses do município de Viçosa, MG Iron deficiency anemia and nutritional status of children aged 12 to 60 months in the city of Viçosa, MG, Brazil

    Directory of Open Access Journals (Sweden)

    Adriana da Silva Miranda

    2003-06-01

    Full Text Available Este estudo transversal abrangeu crianças com idade de 12 a 60 meses assistidas pelo serviço público de saúde do município de Viçosa, objetivando avaliar a prevalência de anemia e anemia grave, e a relação entre o estado nutricional e a anemia ferropriva, nessas crianças. Para o diagnóstico de anemia, foi utilizado o beta-hemoglobinômetro (Hemocue, considerando o ponto de corte proposto pela Organização Mundial da Saúde de 11,0 g/dL para anemia, e para a anemia grave considerou-se 9,5g/dL. Das 171 crianças atendidas, 63,2% estavam anêmicas e 43,5% destas apresentavam anemia grave. Analisando o estado nutricional, encontrou-se uma alta porcentagem de crianças desnutridas, sendo considerados os índices de peso/idade, peso/estatura e estatura/idade (11,7%, 7,0% e 5,8%, respectivamente. Observou-se alta prevalência de anemia entre as faixas etárias mais precoces. Não foi verificada associação entre anemia e estado nutricional. Torna-se, portanto, necessário trabalhar de forma preventiva a anemia, bem como alertar os profissionais da área de saúde quanto ao diagnóstico precoce, profilaxia e tratamento.This cross sectional study included children aged 12 to 60 months attended by the public health service in the city of Viçosa, state of Minas Gerais. The objective was to evaluate the prevalences of anemia and serious anemia, the hemoglobin levels and the relation between nutritional status and iron deficiency anemia in these children. For the diagnosis of anemia, (Hemocue was used, and the cutoff point of 11.0 g/dL proposed by the World Health Organization for anemia, and was adopted serious anemia, was adopted 9,5g/dL. A total of 171 children was evaluated; 62.2% were anemic and 43.5% of these were seriously anemic. Analyzing the nutritional status, a high percentage of under nourished children was found, according to the indexes weight/age, weight/height and height/age (11.7%, 7.0% and 5.8%, respectively. A high

  8. Mieloma Múltiplo e anemia Multiple Myeloma and anemia

    Directory of Open Access Journals (Sweden)

    Rodolfo D. Cançado

    2007-03-01

    Full Text Available Anemia é uma complicação comum em pacientes com mieloma múltiplo (MM e ocorre em mais de 2/3 dos pacientes. Anemia de doença crônica, deficiência de eritropoetina (EPO devido à insuficiência renal e efeito mielossupressivo da quimioterapia são os principais mecanismos patofisiológicos que contribuem para o desenvolvimento de anemia no MM. Nos pacientes que obtêm remissão completa com tratamento quimioterápico, anemia usualmente se normaliza. Nos pacientes que não respondem ou apresentam recaída do mieloma, anemia freqüentemente persiste. As opções de tratamento dos pacientes anêmicos com MM incluem transfusões de hemácias e EPO recombinante humana. Essa proteína é biologicamente equivalente à EPO endógena e sua administração promove aumento dos valores de hemoglobina por tempo mais prolongado sem os riscos das transfusões de sangue. Vários estudos têm relatado melhora significante da eritropoese, redução da necessidade transfusional e melhora da qualidade de vida com o uso da EPO como tratamento a longo prazo da anemia associada ao mieloma. Nesse artigo, propomos o tratamento da anemia do MM baseado nas recomendações propostas pela Sociedade Americana de Hematologia (ASH em conjunto com a Sociedade Americana de Oncologia Clínica (ASCO, pela Organização Européia para Pesquisa e Tratamento do Câncer (EORTC, pelo IMF (Internacional Myeloma Foundation e pelo NCCN (National Comprehensive Cancer Network.Anemia is a common complication in patients with multiple myeloma (MM occurring in more than two thirds of all patients. Anemia of chronic diseases, erythropoietin (EPO deficiency due to renal impairment and the myelosuppressive effect of chemotherapy are the most important pathophysiological mechanisms contributing to the development of anemia in MM. In patients who achieve complete remission after chemotherapy, anemia usually normalizes. Non-responders and relapsing myeloma patients often continue to suffer

  9. What Are the Signs and Symptoms of Anemia?

    Science.gov (United States)

    ... Twitter. What Are the Signs and Symptoms of Anemia? The most common symptom of anemia is fatigue ( ... mild symptoms or none at all. Complications of Anemia Some people who have anemia may have arrhythmias ( ...

  10. Genetics Home Reference: iron-refractory iron deficiency anemia

    Science.gov (United States)

    ... refractory iron deficiency anemia iron-refractory iron deficiency anemia Enable Javascript to view the expand/collapse boxes. ... All Close All Description Iron-refractory iron deficiency anemia is one of many types of anemia , which ...

  11. Injuria renal aguda en la sepsis grave Acute kidney injury in severe sepsis

    Directory of Open Access Journals (Sweden)

    Hernán Trimarchi

    2009-06-01

    Full Text Available La sepsis afecta al 40% de los pacientes críticos, siendo su mortalidad de aproximadamente un 30% en el caso de la sepsis grave, y de 75% con injuria renal aguda, la cual sucede en el 20-51% de los casos. Se realizó un estudio prospectivo, observacional, longitudinal, en 80 pacientes sépticos graves en el lapso de 1 año para determinar el desarrollo de injuria renal aguda y su relación con la mortalidad; correlacionar antecedentes clínicos y variaciones del laboratorio con la mortalidad; determinar la tasa de mortalidad de la sepsis grave; relacionar óbito y foco séptico primario; evaluar la predictibilidad de mortalidad según niveles de creatinina de ingreso y sus variaciones finales. Se definieron dos grupos: Obito (n = 25 y No-óbito (n = 55. Analizados según la creatinina de ingreso, 39 tenían valores normales de creatinina (10 óbitos y 41 la presentaban elevada (15 óbitos; según la creatinina de egreso, 48 presentaron creatinina normal y fallecieron 7, mientras que 32 tenían daño renal agudo, de los cuales 18 fallecieron. De los 25 pacientes fallecidos, el 72% presentaron daño renal. De éstos, 7 pacientes vivos y 2 fallecidos requirieron hemodiálisis. El foco primario más frecuente fue el respiratorio (26.4%. El desarrollo de daño renal es un alto predictor de mortalidad en la sepsis, independientemente de los valores iniciales de creatinina. Edad más avanzada, hipertensión arterial, score APACHE más elevado, anemia más grave, hipoalbuminemia, hiperfosfatemia e hiperkalemia se asociaron a mayor mortalidad. La mortalidad global fue 31.3%. La imposibilidad de identificar el foco séptico primario se asoció a mayor mortalidad. El foco respiratorio se relacionó a mayor riesgo de requerir hemodiálisis.Sepsis affects 40% of critically ill patients, with a reported mortality of approximately 30% in severe sepsis, raising to 75% when acute kidney injury ensues, which occurs in about 20-51% of cases. The present study

  12. Orbital dissection defatting technique for Graves disease.

    Science.gov (United States)

    Hecht, S D; Guibor, P; Wolfley, D; Wiggs, E O

    1984-04-01

    Five patients with Graves disease and bilateral proptosis were treated with different incisional approaches. They all underwent orbital decompression by removal of the anterior medial orbital walls, the anterior ethmoidal sinuses, the orbital floors, and multiple incisions of the orbital periosteums . The defatting technique, which consists of applying manual anterior orbital pressure with alternate removing of small lobules of fat, was added when it was intraoperatively decided by Hertel exophthalmometer measurement that more decompression was needed. It is estimated that one-third more reduction in proptosis resulted. An average total decrease in proptosis of 9 mm per orbit occurred. Both visual accuities and visual fields returned to normal. The only important complication was the development of hypertropia in down gaze in one patient. A potential value of this technique is its use with orbital floor decompression alone. It may be possible to avoid removing the medial and lateral walls of the orbit, thereby decreasing complications. Defatting may also be a valuable addition in those rare cases where all decompression techniques available are needed to affect an adequate decompression.

  13. Miastenia grave distal: relato de caso

    Directory of Open Access Journals (Sweden)

    Scola Rosana Herminia

    2003-01-01

    Full Text Available Relatamos o caso de uma mulher de 30 anos com quadro de fraqueza muscular nos membros inferiores com predomínio distal com início há 7 anos. Na evolução apresentou fraqueza muscular nos membros superiores. O exame físico mostrava nervos cranianos sem alterações, hipotrofia bilateral de quadriceps e interósseos dos pés, redução da força muscular mais intensa em tibiais anteriores e interósseos dorsais dos pés e reflexos tendinosos globalmente hipoativos. Foi realizado teste de estimulação repetitiva que mostrou decremento maior que 10% no nervo fibular e ulnar. A dosagem de anticorpos anti-receptor de acetilcolina foi positiva. Tomografia computadorizada de tórax foi normal. Dosagem de hormônios tireoidianos mostrou evidências laboratoriais de hipertireoidismo, porém sem manifestações clínicas. Foi iniciado tratamento com piridostigmina havendo melhora importante do quadro clínico. A fraqueza distal é um sintoma inicial raro na miastenia grave (MG. Contudo, a MG deve entrar no diagnóstico diferencial de doenças que cursam com fraqueza muscular distal de membros superiores ou inferiores.

  14. ENFERMEDADES GRAVES CON DIAGNÓSTICO PRENATAL

    Directory of Open Access Journals (Sweden)

    Carmen María Samaniego Fernández

    2012-01-01

    Full Text Available El objetivo de este artículo es presentar la información publicada hasta el momento sobre la supervivencia, las secuelas y la calidad de vida de las enfermedades mencionadas por la declaración de la Comisión de Bioética de la Sociedad Española de Ginecología y Obstetricia (SEGO como extremadamente graves e incurables, subsidiarias de interrupción voluntaria del embarazo más allá de las veintidós semanas de edad gestacional, según lo contemplado por la Ley Orgánica 2/2010 de Salud Sexual y Reproductiva y de la Interrupción Voluntaria del Embarazo. Los profesionales sanitarios deben conocer los aspectos médicos, los avances terapéuticos y el pronóstico de dichas enfermedades, siendo un deber ético transmitir dicha información a los progenitores.

  15. Historic Sites and Grave Markers at Litttle Bighorn Battlefield, Montana

    Data.gov (United States)

    National Park Service, Department of the Interior — This is a vector point file showing the historic sites and grave markers at Little Bighorn Battlefield National Monument (LIBI). The coordinates for this dataset...

  16. Graves' Disease Associated with Cerebrovascular Disease and Antiphospholipid Antibody Syndrome

    Directory of Open Access Journals (Sweden)

    Ines Khochtali

    2010-01-01

    have increased risk for developing thromboembolic accidents, which are favoured by a simultaneous presence of antiphospholipid antibodies syndrome. in this paper, we describe the case of a patient with Graves' disease, who developed strokes with antiphospholipid antibodies syndrome.

  17. CASE REPORT : GRAVE'S DISEASE PRESENTING AS PARANOID SCHIZOPHRENIA

    OpenAIRE

    Singh, S. K.; Hatwal, A.; Agarwal, J.K.; Bajpai, H.S.; Sharma, I

    1989-01-01

    SUMMARY The case of a 37 year old male is described who initially presented as paranoid schizophrenia unresponsive to anti-psychotic drug treatment and subsequently developed features of Grave's disease. Treatment with carbimazole alone improved his psychiatric symptoms.

  18. Paracentral Corneal Dellen:A Rare Sign of Graves Ophthalmopathy

    Institute of Scientific and Technical Information of China (English)

    Jianhua Yan; Zhongyao Wu

    2003-01-01

    Purpose: To report a rare sign, paracentral corneal dellen that developed in a middleaged female patient with Graves ophthalmopathy.Methods:A paracentral corneal dellen developed in the left eye in a 42-year-old woman who was diagnosed as Graves ophthalmopathy. The patient had remarkable upper eyelid retraction, upper eyelid lag and upward motility restriction. The Graves ophthalmopathy was classified as Grade V according to NOSPECS classification.Results:Local artificial tear film and 0.3% Tobramycin eye drops were administered to both eyes.Twenty-four hours later, the left corneal dellen disappeared.Conclusions:Graves ophthalmopathy can lead to paracentral corneal dellen because of severe upper eyelid retraction and upward motility restriction of the eye in spite of the lack of lagophthalmos. Artificial tear drop and antibiotic eye drop therapy helped even though the patient did not have corneal exposure.

  19. Successful treatment of Graves disease in pregnancy with Lugol's iodine.

    Science.gov (United States)

    Jamieson, A; Semple, C G

    2000-02-01

    We report a case of Grave's disease in pregnancy complicated by intolerance of standard antithyroid drug therapy. We describe the success of prolonged use of organic iodine as a primary treatment prior to surgical intervention.

  20. Orbital metastases from neuroendocrine carcinoma, masquerading as graves orbitopathy.

    Science.gov (United States)

    Sira, Mano; Clauss, Ralf P; Maclean, Chris; Rose, Geoffrey E

    2010-04-01

    We describe a patient with metastases from neuroendocrine carcinoma masquerading as Graves ophthalmopathy. This rare tumour possibly has a propensity for orbital spread, and we postulate a mechanism evoking the 'seed and soil' hypothesis.

  1. Fanconi anemia and radiation

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Asako; Komatsu, Kenshi [Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology

    1999-09-01

    Aplastic Fanconi anemia (FA) accompanying malformation was firstly reported in 1927. This review concerns the recent findings on FA. FA belongs to the chromosomal instability syndrome and its detailed molecular mechanism is still unknown. The disease has been defined to be highly sensitive to radiation, however, which is quite an important problem since irradiation with a large dose of radiation is required before its radical treatment (bone marrow transplantation). FA cells are also mitomycin C-sensitive and FA patients are said to be the mosaic of the sensitive and normal cells. This enables to classify FA into 8 types of A-H groups, whose genotypes (FAA-FAH, FANCA-FANCH) are becoming clear. However, the intracellular function of the FANC-expressed protein, although known to form a big complex, is not elucidated yet. There is an abnormality in DNA processing such as re-linkage of the double strand-broken DNA in FA cells. FA causal gene FANCG is found identical to XRCC9 which is associated to high sensitivity to radiation. Analysis of FANC genes will provide useful findings on molecular mechanism of DNA-repair. (K.H.)

  2. Preclinical models of Graves' disease and associated secondary complications.

    Science.gov (United States)

    Moshkelgosha, Sajad; So, Po-Wah; Diaz-Cano, Salvador; Banga, J Paul

    2015-01-01

    Autoimmune thyroid disease is the most common organ-specific autoimmune disorder which consists of two opposing clinical syndromes, Hashimoto's thyroiditis and Graves' (hyperthyroidism) disease. Graves' disease is characterized by goiter, hyperthyroidism, and the orbital complication known as Graves' orbitopathy (GO), or thyroid eye disease. The hyperthyroidism in Graves' disease is caused by stimulation of function of thyrotropin hormone receptor (TSHR), resulting from the production of agonist antibodies to the receptor. A variety of induced mouse models of Graves' disease have been developed over the past two decades, with some reproducible models leading to high disease incidence of autoimmune hyperthyroidism. However, none of the models show any signs of the orbital manifestation of GO. We have recently developed an experimental mouse model of GO induced by immunization of the plasmid encoded ligand binding domain of human TSHR cDNA by close field electroporation that recapitulates the orbital pathology in GO. As in human GO patients, immune mice with hyperthyroid or hypothyroid disease induced by anti-TSHR antibodies exhibited orbital pathology and chemosis, characterized by inflammation of orbital muscles and extensive adipogenesis leading to expansion of the orbital retrobulbar space. Magnetic resonance imaging of the head region in immune mice showed a significant expansion of the orbital space, concurrent with proptosis. This review discusses the different strategies for developing mouse models in Graves' disease, with a particular focus on GO. Furthermore, it outlines how this new model will facilitate molecular investigations into pathophysiology of the orbital disease and evaluation of new therapeutic interventions.

  3. Human lymphocyte antigens (HLA) and Graves' disease in Turkey.

    Science.gov (United States)

    Orhan, Y; Azezli, A; Carin, M; Aral, F; Sencer, E; Molvalilar, S

    1993-09-01

    To evaluate the association of HLA types with Turkish patients with Graves' disease, HLA typing, clinical findings, and thyroid antibodies were correlated. The HLA types, clinical findings (ophthalmopathy and age at onset), and thyroid stimulating hormone (TSH) receptor (TRAb) and antithyroid microsomal antibodies (MAb) were analyzed. Seventy Turkish patients with Graves' disease and 306 control subjects were assessed. Serological HLA typing was performed in HLA A, B, C, DR, and DQ loci. There was a significantly increased prevalence of HLA B8, B49, DR3, DR4, and DR10 in Graves' disease. The association of Graves' disease with HLA DR3 was found to be less strong than previously described. The HLA DR4 antigen may contribute to the predisposition of Graves' disease in Turkey. The results suggest that HLA B7, B13, DR7, DQw2, and DQw3 may confer a protective effect for Graves' disease in Turkey. Patients carrying HLA B12, B18, and B44 haplotypes had a tendency to develop the disease at a later age. The difference from the other studies may be the result of the selection of the controls; in part, of the variability in serological typing reagents; and, also, of the rather weak HLA associations with the disease.

  4. Anemia y enfermedad inflamatoria intestinal Anemia and inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    F. de la Morena

    2008-05-01

    Full Text Available La anemia es una de las complicaciones más comunes de la enfermedad inflamatoria intestinal. La alta frecuencia de valores bajos de hemoglobina en estos enfermos provoca en muchas ocasiones una infravaloración por parte del médico de esta circunstancia, lo que se traduce en la falta de un tratamiento eficaz. Por otro lado, el carácter complejo de los mecanismos de producción de la anemia en la enfermedad inflamatoria intestinal con frecuencia plantea dudas acerca del tratamiento más adecuado. La identificación correcta de los pacientes con anemia así como la instauración del tratamiento más idóneo serán los dos pilares fundamentales para la mejoría de la calidad de vida de los enfermos. El uso correcto de los suplementos de hierro y las nuevas formulaciones de hierro parenteral, con o sin eritropoyetina asociada, han revolucionado nuestro abordaje de esta complicación evolutiva de la enfermedad inflamatoria intestinalAnemia is a most common complication of inflammatory bowel disease. A high frequency of low hemoglobin values in these patients often leads physicians to subestimate this condition, which translates into ineffective treatment. On the other hand, the complex nature of anemia-inducing mechanisms in inflammatory bowel disease frequently raises doubt about the most appropriate therapy. A correct identification of patients with anemia, and adequate therapy are the essential pillars for improved quality of life. The right use of iron supplementation, and novel parenteral iron formulations, either with or without associated erythropoietin, have revolutionized our approach of this complication in the course of inflammatory bowel disease

  5. Classification of anemia for gastroenterologists.

    Science.gov (United States)

    Moreno Chulilla, Jose Antonio; Romero Colás, Maria Soledad; Gutiérrez Martín, Martín

    2009-10-07

    Most anemia is related to the digestive system by dietary deficiency, malabsorption, or chronic bleeding. We review the World Health Organization definition of anemia, its morphological classification (microcytic, macrocytic and normocytic) and pathogenic classification (regenerative and hypo regenerative), and integration of these classifications. Interpretation of laboratory tests is included, from the simplest (blood count, routine biochemistry) to the more specific (iron metabolism, vitamin B12, folic acid, reticulocytes, erythropoietin, bone marrow examination and Schilling test). In the text and various algorithms, we propose a hierarchical and logical way to reach a diagnosis as quickly as possible, by properly managing the medical interview, physical examination, appropriate laboratory tests, bone marrow examination, and other complementary tests. The prevalence is emphasized in all sections so that the gastroenterologist can direct the diagnosis to the most common diseases, although the tables also include rare diseases. Digestive diseases potentially causing anemia have been studied in preference, but other causes of anemia have been included in the text and tables. Primitive hematological diseases that cause anemia are only listed, but are not discussed in depth. The last section is dedicated to simplifying all items discussed above, using practical rules to guide diagnosis and medical care with the greatest economy of resources and time.

  6. Who Is at Risk for Anemia?

    Science.gov (United States)

    ... history of inherited anemia, such as sickle cell anemia or thalassemia Rate This Content: NEXT >> Updated: May 18, 2012 Twitter Facebook YouTube Google+ SITE INDEX ACCESSIBILITY PRIVACY STATEMENT FOIA NO FEAR ACT OIG ...

  7. Undetectable Glycosylated Hemoglobin in Autoimmune Hemolytic Anemia

    OpenAIRE

    Mitani, Noriyuki; Taguchi, Akihiko; Sakuragi, Shizu; Matsui, Kumiko; Tanaka, Yoshinori; Matsuda, Kazuhiro; Shinohara, Kenji

    2005-01-01

    We encountered two cases of autoimmune hemolytic anemia (AIHA) with undetectable glycosylated hemoglobin (HbA1C) level at diagnosis. Hemolytic anemia improved by administration of prednisolone (PSL) and HbA1C became measurable after response.

  8. FastStats: Anemia or Iron Deficiency

    Science.gov (United States)

    ... this? Submit What's this? Submit Button NCHS Home Anemia or Iron Deficiency Recommend on Facebook Tweet Share ... visits Number of visits to emergency departments with anemia as the primary hospital discharge diagnosis: 146,000 ...

  9. Genetics Home Reference: congenital dyserythropoietic anemia

    Science.gov (United States)

    ... Understand Genetics Home Health Conditions CDA congenital dyserythropoietic anemia Enable Javascript to view the expand/collapse boxes. ... PDF Open All Close All Description Congenital dyserythropoietic anemia ( CDA ) is an inherited blood disorder that affects ...

  10. Anemia caused by low iron - children

    Science.gov (United States)

    ... Disorders of iron and copper metabolism, the sideroblastic anemias, and lead toxicity. In: Orkin SH, Fisher DE, Ginsburg D, ... Philadelphia, PA: Elsevier; 2016:chap 455. Read More Anemia Hemoglobin Lead poisoning Review Date 2/11/2016 Updated by: ...

  11. Retkulocyte production index in various anemia

    OpenAIRE

    Setyawati, Setyawati

    2015-01-01

    Background: Reticulocyte production index (IPR) is used to determine the classification of functional anemia. More specific laboratory parameters are used in managing patient. There were some inappropriate of IPR correlation with the diagnosis of anemia in clinical practice.Objectives: The study was designed to know normal hematocrit in Sardjito General Hospital, to determine IPR in various anemia and to compare with standard IPR and final diagnosis in anemia. Methods: Observational study was...

  12. Manifestasi Anemia Pernisiosa Di Rongga Mulut

    OpenAIRE

    Nona Aini

    2008-01-01

    Anemia pernisiosa adalah salah satu penyakit kronis berupa berkurangnya produksi sel darah merah akibat defisiensi vitamin 812 dan asam folat, Salah satu fungsi vitamin 812 adalah untuk pembentukan sel darah merah di dalam sum-sum tulang menjadi aktif. Akibat defisiensi vitamin 812 dapat menyebabkan terganggunya sintesa DNA dan RNA. Terganggunya sintesa DNA akan menyebabkan anemia di sum-sum tulang dalam bentuk anemia makrositik dan di dalam darah dalam bentuk anemia megaloblastik. Sedangk...

  13. Iron deficiency anemia in children.

    Science.gov (United States)

    Subramaniam, Girish; Girish, Meenakshi

    2015-06-01

    Iron deficiency is not just anemia; it can be responsible for a long list of other manifestations. This topic is of great importance, especially in infancy and early childhood, for a variety of reasons. Firstly, iron need is maximum in this period. Secondly, diet in infancy is usually deficient in iron. Thirdly and most importantly, iron deficiency at this age can result in neurodevelopmental and cognitive deficits, which may not be reversible. Hypochromia and microcytosis in a complete blood count (CBC) makes iron deficiency anemia (IDA) most likely diagnosis. Absence of response to iron should make us look for other differential diagnosis like β thalassemia trait and anemia of chronic disease. Celiac disease is the most important cause of true IDA not responding to oral iron therapy. While oral ferrous sulphate is the cheapest and most effective therapy for IDA, simple nonpharmacological and pharmacological measures can go a long way in prevention of iron deficiency.

  14. Pernicious Anemia with Autoimmune Hemolytic Anemia: A Case Report and Literature Review

    OpenAIRE

    Sri Lakshmi Hyndavi Yeruva; Raj Pal Manchandani; Patricia Oneal

    2016-01-01

    Pernicious anemia is a common cause of vitamin B12 deficiency. Here, we discuss a case of a young woman who presented with severe anemia along with a history of iron deficiency anemia. After a review of her clinical presentation and laboratory data, we identified an autoimmune hemolytic anemia and a concomitant pernicious anemia. The concurrence of both these hematological diagnoses in a patient is rare.

  15. Pernicious Anemia with Autoimmune Hemolytic Anemia: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Sri Lakshmi Hyndavi Yeruva

    2016-01-01

    Full Text Available Pernicious anemia is a common cause of vitamin B12 deficiency. Here, we discuss a case of a young woman who presented with severe anemia along with a history of iron deficiency anemia. After a review of her clinical presentation and laboratory data, we identified an autoimmune hemolytic anemia and a concomitant pernicious anemia. The concurrence of both these hematological diagnoses in a patient is rare.

  16. Syngeneic transplantation in aplastic anemia

    DEFF Research Database (Denmark)

    Gerull, Sabine; Stern, Martin; Apperley, Jane

    2013-01-01

    Aplastic anemia is usually treated with immunosuppression or allogeneic transplant, depending on patient and disease characteristics. Syngeneic transplant offers a rare treatment opportunity with minimal transplant-related mortality, and offers an insight into disease mechanisms. We present here...... a retrospective analysis of all syngeneic transplants for aplastic anemia reported to the European Group for Blood and Marrow Transplantation. Between 1976 and 2009, 88 patients received 113 transplants. Most transplants (n=85) were preceded by a conditioning regimen, 22 of these including anti-thymocyte globulin...

  17. Anemia and survival in human immunodeficiency virus

    DEFF Research Database (Denmark)

    Lundgren, Jens Dilling; Mocroft, Amanda

    2003-01-01

    The prospective, multicenter cohort study EuroSIDA has previously reported on predictors and outcomes of anemia in patients infected with human immunodeficiency virus. In a Cox proportional-hazards model with serial measures of CD4+ cell count, plasma viral load, and degrees of anemia fitted...... as time-dependent variables, the relative hazard of death increased markedly for patients with anemia versus no anemia. A clinical scoring system was developed and validated for patients receiving highly active antiretroviral therapy using the most recent laboratory measures. Mild and severe anemia were...... independently (Panemia. The mechanisms underlying why hemoglobin is such a strong prognostic...

  18. Hubungan Anemia Defisiensi Besi Terhadap Gangguan Konsentrasi

    OpenAIRE

    Meutirani, Riska

    2015-01-01

    Iron deficiency anemia is dedecrease in the number of red blood cells caused by too little iron. Iron deficiency anemia is the most common form of anemia. About 20% of women, 50% of pregnant womenand 3% of men do not have enough iron on their body. Anemia develops slowly after the normal iron stores in the body and bone marrowhave run out. In general, womwn have smaller stores of iron than men because they lose more through menstruation. Iron deficiency anemia may also be caused by poor absor...

  19. Color-flow Doppler sonography in Graves disease: "thyroid inferno".

    Science.gov (United States)

    Ralls, P W; Mayekawa, D S; Lee, K P; Colletti, P M; Radin, D R; Boswell, W D; Halls, J M

    1988-04-01

    Graves disease is a common diffuse abnormality of the thyroid gland usually characterized by thyrotoxicosis. We performed color-flow Doppler sonography in 16 patients with Graves disease and compared the results with those in 15 normal volunteers and 14 patients with other thyroid diseases (eight with multinodular goiter, four with focal masses, and two with papillary thyroid carcinoma). All 16 Graves disease patients exhibited a pulsatile pattern we call "thyroid inferno." This pattern consists of multiple small areas of intrathyroidal flow seen diffusely throughout the gland in both systole and diastole. In systole, both high-velocity flow (color coded white) and lower velocity flow (color coded red and blue) were noted. In diastole, fewer areas of flow and lower velocity flow were noted. Patients with Graves disease also exhibited color flow around the periphery of the gland. The inferno pattern did not occur in normal subjects or in patients with other thyroid diseases. On occasion, focal areas of intrathyroidal flow were detected in patients with multinodular goiter and focal thyroid masses. High-resolution gray-scale images did not show the small vascular channels from which the flow signal originated. Color-flow Doppler sonography shows promise as a cost-effective, noninvasive technique for diagnosing Graves disease.

  20. La pretensión de objetividad como una estrategia para obligar. LA CONSTRUCCIÓN DE CIERTA CULTURA DE HERMENÉUTICA CONSTITUCIONAL HACIA FINES DEL SIGLO XX

    Directory of Open Access Journals (Sweden)

    Jaime Bassa Mercado

    2013-01-01

    Full Text Available El presente trabajo explica cómo la interpretación constitucional tiene una dimensión política, en la que se relaciona determinada hermenéutica con el proyecto político plasmado en la Carta durante la dictadura. Se trabaja una referencia al período codificador del siglo XIX, donde se aprecia una relación entre un proyecto político plasmado normativamente y ciertas estrategias destinadas a protegerlo, como las reglas de interpretación de la ley. Parte del constitucionalismo chileno, concreta- mente durante las primeras décadas de la Carta vigente, muestra su compromiso con una estructura similar: un catálogo de derechos fundamentales casi sin modificaciones junto a criterios de interpretación constitucional que petrifican su contenido.

  1. Hereditary sideroblastic anemia: pathophysiology and gene mutations.

    Science.gov (United States)

    Harigae, Hideo; Furuyama, Kazumichi

    2010-10-01

    Sideroblastic anemia is characterized by anemia with the emergence of ring sideroblasts in the bone marrow. Ring sideroblasts are erythroblasts characterized by iron accumulation in perinuclear mitochondria due to impaired iron utilization. There are two forms of sideroblastic anemia, i.e., inherited and acquired sideroblastic anemia. Inherited sideroblastic anemia is a rare and heterogeneous disease caused by mutations of genes involved in heme biosynthesis, iron-sulfur (Fe-S) cluster biogenesis, or Fe-S cluster transport, and mitochondrial metabolism. The most common inherited sideroblastic anemia is X-linked sideroblastic anemia (XLSA) caused by mutations of the erythroid-specific δ-aminolevulinate synthase gene (ALAS2), which is the first enzyme of heme biosynthesis in erythroid cells. Sideroblastic anemia due to SLC25A38 gene mutations, which is a mitochondrial transporter, is the next most common inherited sideroblastic anemia. Other forms of inherited sideroblastic anemia are very rare, and accompanied by impaired function of organs other than hematopoietic tissue, such as the nervous system, muscle, or exocrine glands due to impaired mitochondrial metabolism. Moreover, there are still significant numbers of cases with genetically undefined inherited sideroblastic anemia. Molecular analysis of these cases will contribute not only to the development of effective treatment, but also to the understanding of mitochondrial iron metabolism.

  2. Sickle Cell Anemia (For Teens)

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Sickle Cell Disease KidsHealth > For Teens > Sickle Cell Disease Print ... Stay Well? en español Anemia falciforme What Is Sickle Cell Disease? Sickle cell disease is a blood disorder ...

  3. Cooley's Anemia: A Psychosocial Directory.

    Science.gov (United States)

    National Center for Education in Maternal and Child Health, Washington, DC.

    The directory is intended to aid patients and their families who are coping with the genetic disorder of Cooley's anemia. A brief review of the disease covers background, genetics, symptoms, effect on the patient, treatment, and current research. The next section looks at psychosocial needs at various times (time of diagnosis, infancy and toddler…

  4. Acquired aplastic anemia in children.

    Science.gov (United States)

    Hartung, Helge D; Olson, Timothy S; Bessler, Monica

    2013-12-01

    This article provides a practice-based and concise review of the etiology, diagnosis, and management of acquired aplastic anemia in children. Bone marrow transplantation, immunosuppressive therapy, and supportive care are discussed in detail. The aim is to provide the clinician with a better understanding of the disease and to offer guidelines for the management of children with this uncommon yet serious disorder.

  5. Management of Iron Deficiency Anemia

    Science.gov (United States)

    Jimenez, Kristine; Kulnigg-Dabsch, Stefanie

    2015-01-01

    Anemia affects one-fourth of the world’s population, and iron deficiency is the predominant cause. Anemia is associated with chronic fatigue, impaired cognitive function, and diminished well-being. Patients with iron deficiency anemia of unknown etiology are frequently referred to a gastroenterologist because in the majority of cases the condition has a gastrointestinal origin. Proper management improves quality of life, alleviates the symptoms of iron deficiency, and reduces the need for blood transfusions. Treatment options include oral and intravenous iron therapy; however, the efficacy of oral iron is limited in certain gastrointestinal conditions, such as inflammatory bowel disease, celiac disease, and autoimmune gastritis. This article provides a critical summary of the diagnosis and treatment of iron deficiency anemia. In addition, it includes a management algorithm that can help the clinician determine which patients are in need of further gastrointestinal evaluation. This facilitates the identification and treatment of the underlying condition and avoids the unnecessary use of invasive methods and their associated risks. PMID:27099596

  6. Iron deficiency anemia in children

    OpenAIRE

    Pochinok, T. V.

    2016-01-01

    In the article the role of iron in the human body is highlighted. The mechanism of development of iron deficiency states, their consequences and the basic principles of diagnosis and correction of children of different ages are shown.Key words: children, iron deficiency anemia, treatment.

  7. [Neuropsychiatric manifestations ushering pernicious anemia].

    Science.gov (United States)

    Mrabet, S; Ellouze, F; Ellini, S; Mrad, M F

    2015-12-01

    Biermer disease or pernicious anemia is an autoimmune atrophic gastritis characterized by the lack of secretion of gastric intrinsic factor. This leads to an insufficient absorption of vitamin B12 in the ileum. Clinical manifestations are mainly hematologic. Neuropsychiatric manifestations are known but are less frequent especially early in the disease. Inaugural neuropsychiatric arrays are rare and various thus making diagnosis difficult. In this article, we report through two clinical cases different neuropsychiatric manifestations revealing pernicious anemia. Mrs. C.O., aged 56, presented after surgery for gallstones, an acute psychiatric array associated with gait disorders. She had no history of neurological or psychiatric problems. The psychiatric interview revealed delirious syndrome, depressive symptoms and anxiety. Neurological examination noted a flaccid paraplegia with peripheral neuropathic syndrome and myoclonus in the upper limbs. At the full blood count, a macrocytosis (VGM: 112.2fl) without anemia was found. The level of vitamin B12 in the blood was low. Cerebro-spinal MRI was suggestive of a neuro-Biermer and showed hyper signal in the cervical cord on T2-weighted sagittal section. In axial section, hyper signal appears at the posterior columns in the form of V. There were no brain abnormalities. A sensorimotor axonal polyneuropathy was diagnosed. The patient received vitamin B12 intramuscularly for ten days associated with neuroleptic treatment. Mrs. R.M., aged 40, was brought to the psychiatry consultation for acute behavioral disorders progressively worsening over a month. An anxiety syndrome, depressive syndrome and delirious syndrome were identified. Neurological examination showed a posterior cordonal syndrome with quadripyramidal syndrome. Full blood count showed a macrocytic anemia. Serum B12 level was collapsed. Cerebro-spinal MRI was normal. She received vitamin B12 with clinical and biological improvement. Features of pernicious anemia

  8. Psicopatologia Fundamental: de una cierta transmision

    Directory of Open Access Journals (Sweden)

    Flora Singer

    Full Text Available La psicopatología fundamental, conformada a partir del trabajo universitario y teórico de Pierre Fédida, se constituye como punto de encuentro de diferentes disciplinas en relación al sufrimiento humano, y plantea interrogantes metodológicas, entre otras, cómo establecer un diálogo que articule distintos recortes teóricos, y de qué manera tratar las diferencias relativas. El tema de las diferencias está presente tanto por el lado de los métodos de investigación y de intercambio, como por el de la concepción de una estructura institucional que acoja esas diferencias. El psicoanálisis puede hacer contribuciones a estos temas, en la medida en que se ve confrontado a una doble alteridad: tópica – la relación conciencia/inconsciente – e intersubjetiva, ya que es condición del dispositivo analítico poder acoger la subjetividad del otro en tanto radicalmente otro. Hay una homología estructural entre los niveles intrapsíquico, intersubjetivo, interteórico e interdisciplinario en lo que hace a una epistemología de la alteridad. El saber en psicoanálisis escapa a toda tentativa de institucionalización pues es propio a la alteridad de su objeto resistir y dejar siempre un resto. De manera similar, la psicopatología pundamental tampoco se adecua a una institucionalización del saber. Es un espacio vacío – khôra – que acoge movimientos metafóricos inherentes a la producción de saber, y al no-saber que en forma complementaria lo acompaña. El “nombre del padre” opera así, no como fidelidad a una letra, sino como habilitación a la creación y soporte de lo figurable a venir, a partir del acto fundacional de khôra.

  9. Esclerodermia, tireoidite e miastenia grave: estudo de um caso

    Directory of Open Access Journals (Sweden)

    Antonio L. dos Santos Werneck

    1993-11-01

    Full Text Available Uma paciente de 36 anos com miastenia grave desenvolveu após dois anos intolerância ao frio, o que conduziu ao diagnóstico de tireoidite de Hashimoto. Quatro anos mais tarde apresentou pele espessada nas mãos (esclerodermia limitada. O quadro clínico e os exames complementares encaminharam o diagnóstico para a forma CREST de esclerodermia sistêmica progressiva. Discute-se a dificuldade diagnóstica da esclerodermia, assim como suas síndromes de superposição. Doença de Hashimoto e miastenia grave constituem associação pouco frequente. A presença de esclerodermia e miastenia grave é rara. Não encontramos na literatura a coincidência destas três doenças.

  10. Clinical experience of radiation therapy for Graves` ophthalmopathy

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Takeo; Mitsuhashi, Norio; Nagashima, Hisako; Sakurai, Hideyuki; Murata, Osamu; Ishizeki, Kei; Shimaya, Sanae; Hayakawa, Kazushige; Niibe, Hideo [Gunma Univ., Maebashi (Japan). School of Medicine

    1996-11-01

    The effect of radiation therapy for Graves` ophthalmopathy was evaluated. Ten patients with Graves` ophthalmopathy were treated with radiation therapy between 1992 and 1993 in Gunma University Hospital. All patients had a past history of hyperthyroidism and received 2,000 cGy to the retrobulbar tissues in 20 fractions. Nine of ten patients were treated with radiation therapy after the failure of corticosteroids. Six patients (60%) showed good or excellent responses. The exophthalmos type was more responsive to radiation therapy than the double vision type in this series. Two of five patients with the exophthalmos type demonstrated excellent responses, and their symptoms disappeared almost completely. The improvement of symptoms appeared within 3-6 months, and obvious clinical effects were demonstrated after 6 months of radiotherapy. Radiation therapy was well tolerated, and we have not observed any side effects of radiation therapy. In conclusion, radiation therapy is effective treatment for Graves` ophthalmopathy. (author)

  11. An update on the medical treatment of Graves' hyperthyroidism.

    Science.gov (United States)

    Marinò, Michele; Latrofa, Francesco; Menconi, Francesca; Chiovato, Luca; Vitti, Paolo

    2014-11-01

    Medical treatment of Graves' hyperthyroidism is based on the use of thionamides; namely, methimazole and propylthiouracil. In the past, methimazole was preferred by European endocrinologists, whereas propylthiouracil was the first choice for the majority of their North American colleagues. However, because of the recent definition of a better side-effect profile, methimazole is nowadays the first choice world while. Although thionamides are quite effective for the short-term control of Graves' hyperthyroidism, a relatively high proportion of patients relapses after thionamide withdrawal. Other possible medical treatments, include iodine and compounds containing iodine, perchlorate, lithium (as an adjuvant in patients undergoing radioiodine therapy), β-adrenergic antagonists, glucocorticoids, and some new molecules still under investigation. Management of Graves' hyperthyroidism using thionamides as well as the other available medical treatments is here reviewed in detail, with a special mention of situations such as pregnancy and lactation, as well as neonatal and fetal thyrotoxicosis.

  12. Consumo de leite de vaca e anemia ferropriva na infância Cow's milk consumption and iron deficiency anemia in children

    Directory of Open Access Journals (Sweden)

    Maria A. A. Oliveira

    2005-10-01

    Full Text Available OBJETIVO: Revisar aspectos do consumo de leite de vaca associados à anemia na infância. FONTES DOS DADOS: As informações foram coletadas a partir de artigos publicados nas 2 últimas décadas, pesquisados nas bases de dados Lilacs e MEDLINE, livros técnicos e publicações de organizações internacionais. SÍNTESE DOS DADOS: A anemia ferropriva é um grave problema de saúde pública nos países em desenvolvimento. Até os 6 meses de idade, o leite materno supre as necessidades de ferro das crianças nascidas a termo. A partir daí, torna-se necessária a ingestão de uma alimentação complementar rica em ferro. Considerando a importância da dieta na determinação da anemia e o alto consumo de leite de vaca na infância, discute-se neste artigo a relação desse alimento com a deficiência de ferro. A introdução precoce ou a substituição do leite materno por leite de vaca pode ocasionar problemas gastrintestinais e alérgicos. Além disso, esse alimento apresenta baixa biodisponibilidade e densidade de ferro, excesso de proteínas e minerais, especialmente cálcio, interferindo na absorção do ferro de outros alimentos, e associa-se às micro-hemorragias intestinais, principalmente nas crianças menores. CONCLUSÕES: A utilização do leite de vaca em detrimento de outros alimentos ricos em ferro biodisponível constitui um risco para o desenvolvimento da anemia. O estímulo ao aleitamento materno exclusivo até os 6 meses de vida e sua continuidade até pelo menos 24 meses, juntamente com uma dieta complementar rica em ferro são medidas de grande importância para a prevenção da anemia e de suas conseqüências na infância.OBJECTIVE: To thoroughly investigate the association between the consumption of cow's milk and anemia in childhood. SOURCES OF DATA: The information was gathered from papers catalogued in Lilacs and MEDLINE and published during the last two decades, and also from textbooks and publications by international

  13. Messiniense: compleja y grave crisis ecologica

    Directory of Open Access Journals (Sweden)

    Aguirre, E.

    2003-08-01

    yacimientos de mamíferos fósiles en España y otras regiones con importantes novedades, entre ellas diversos intercambios intercontinentales, en el mismo intervalo cronológico añaden cuestiones de interés además de obligar a la correlación entre la estratigrafía basada en series marinas y la biostratigrafía continental. A las singularidades de estas series se añade el descubrimiento reciente de homínidos fósiles con indicios de bipedia en edades comprendidas en este intervalo. En el mismo se han datado graves eventos paleogeográficos, geodinámicos, paleoambientales y paleoclimáticos, que empezaron a investigarse hace 40 años como la «Crisis de Salinidad del Mediterráneo*, y sobre cuyo desarrollo e interacciones se han publicado diversos modelos más o menos incompletos: aislamiento del mediterráneo, descenso global del nivel del mar, acreción continental y orogenia, glaciación, deterioro de la cubierta vegetal. Una interpretación de la secuencia de eventos en estos diversos campos de estudio de Historia de la Tierra y de la Vida, y sus interacciones, puede trazarse con una calibración del orden de los cien mil años.

  14. Comparative evaluation of oculometric variables in graves' ophthalmopathy

    Directory of Open Access Journals (Sweden)

    Hélio Amante Miot

    2009-01-01

    Full Text Available OBJECTIVES: To estimate oculometric parameters of Graves' ophthalmopathy in comparison to healthy eyes using digital photography and digital image analysis. INTRODUCTION: Graves' ophthalmopathy is the main cause of eye proptosis. Because these protrusions cause clinically perceived distortions in orbital architecture, digital photographs can be used to detect and quantify these changes. METHODS: We carried out a cross-sectional study comprising 12 healthy volunteers and 15 Graves' ophthalmopathy patients with the purpose of evaluating the use of simple, non-invasive digital photography to estimate oculometric parameters of Graves' ophthalmopathy and compare them with the parameters of unaffected eyes. Facial photographs of cases and controls were taken in a standardized manner. Oculometric parameters were compared between the groups and then correlated to proptometer measures. RESULTS: All estimated oculometric variables showed significant differences between the groups, in particular with regard to mediopupilar aperture, lateral height, distance from the iris edge to the lateral boundary of the palpebral fissure, and distance from the higher point of the iris to the lateral limit of the palpebral fissure. The product of medial aperture and horizontal palpebral fissure also revealed greater discrepancy between the groups. Proptometer measures showed significant linear correlation between the distance from the iris edge to the lateral boundary of the palpebral fissure and between the distance from the higher point of the iris to the lateral limit of palpebral fissure (p<0.05. CONCLUSIONS: Comparative analysis of oculometric parameters in Graves' ophthalmopathy suggests that eye proptosis is related to an asymmetric increase in lateral oculometric measures. Standardized digital photographs can be used in clinical practice to objectively estimate oculometric parameters of Graves' ophthalmopathy patients.

  15. Hipertrigliceridemia familiar grave durante a gestação

    OpenAIRE

    Casulari Luiz Augusto; Wesgueber Myrian; Silva Ricardo Cassiano B.; Soares Henrique F.; Domingues Lucilia

    2001-01-01

    A presença de hipertrigliceridemia grave durante a gravidez é rara, mas comporta grande possibilidade de desenvolver complicações, como a pancreatite aguda, que coloca em risco a mãe e o feto. Apresentamos o relato da evolução da gestação de uma paciente portadora de hipertrigliceridemia grave que havia apresentado pancreatite aguda dois meses antes da fecundação. Foi tratada durante o pré-natal com dieta e 3,0 g de ácidos graxos de cadeia ômega-3 (ácidos eicosapentaenóico 14% e docosahexaenó...

  16. Thymic Hyperplasia Presenting as a Neck Mass in Graves Disease

    Directory of Open Access Journals (Sweden)

    Serkan Yener

    2009-06-01

    Full Text Available We describe a female patient who presented with Graves disease and a neck mass. Radiological characteristics of the mass suggested thymic hyperplasia. She was treated with methimazole, and because the mass did not regress after six months of therapy, the patient had total thyroidectomy and thymectomy. Pathological examination was consistent with chronic lymphocytic thyroiditis and thymic hyperplasia. Microscopic changes in the thymus can be detected in one third of patients with Graves disease, but massive enlargement is rare. It has been reported that regression occurs in most patients after a euthyroid state has been achieved; however, in some patients, thymectomy may be indicated. Turk Jem 2009; 13: 11-2

  17. Peripartum cardiomyopathy in a patient with Graves' disease.

    Science.gov (United States)

    Kajiya, Takashi; Lee, Souki; Yamashita, Makoto; Sasaki, Yuichi; Kamizono, Yusuke; Imamura, Masakazu; Toyonaga, Koichi; Toda, Hitoshi; Koriyama, Nobuyuki; Tei, Chuwa

    2010-11-05

    Peripartum cardiomyopathy (PPCM) is a rare life-threatening cardiomyopathy of unknown etiology that occurs during the peripartum period in previously healthy women. Autoimmune and viral factors have been suggested to be involved in PPCM. Here we describe a patient with Graves' disease, which is one of the organ-specific autoimmune diseases, who developed acute heart failure due to PPCM at 2 weeks after her first delivery. The patient recovered completely with conservative treatment for heart failure. An association between PPCM and Graves' disease has not been reported before. PPCM may be an organ-specific autoimmune disease, so the coexistence of other autoimmune diseases should be considered in PPCM patients.

  18. Treating the thyroid in the presence of Graves' ophthalmopathy

    DEFF Research Database (Denmark)

    Hegedüs, Laszlo; Bonnema, Steen J; Smith, Terry J

    2012-01-01

    The etiology of Graves' orbitopathy (GO) remains enigmatic. Optimal therapeutic choices for the hyperthyroidism associated with Graves' disease (GD) in the presence of GO remain controversial. Whether antithyroid drugs (ATDs), radioiodine (RAI), or thyroidectomy should be favored in such patients...... - independent of extent - do not influence the natural course of GO. RAI can cause de novo development or progression of GO, which is largely preventable with oral steroid prophylaxis. In patients with mild GO, the thyroid treatment is largely independent of GO. Moderate to severe GO should be treated promptly...

  19. Auto-estima na forma inativa da oftalmopatia de Graves Inactive Graves' ophthalmopathy and self-esteem

    Directory of Open Access Journals (Sweden)

    Carlos Henrique de Toledo Magalhães

    2008-04-01

    Full Text Available OBJETIVOS: Avaliar a auto-estima dos pacientes com oftalmopatia de Graves na fase inativa. MÉTODOS: Foram avaliados 30 pacientes portadores de oftalmopatia de Graves, eutireoideanos, na fase inativa, com idade variando entre 26 e 65 anos, média 43 ± 11,0 anos, denominado grupo estudo e 39 indivíduos que não apresentavam oftalmopatia de Graves, com idade variando entre 18 e 67 anos, média de 41 ± 13,4 anos, selecionados na população geral denominado grupo controle. Para avaliar a auto-estima foi utilizada a escala de auto-estima Rosenberg Unifesp-EPM aplicada por meio de entrevista. Os valores dos escores de auto-estima nos dois grupos estudados foram comparados pelo teste não paramétrico de Mann-Whitney. O mesmo teste foi aplicado com objetivo de comparar os resultados obtidos no grupo oftalmopatia de Graves considerando a gravidade da doença. RESULTADOS: Não foi observada alteração com significância estatística na auto-estima dos pacientes com oftalmopatia de Graves (p=0,057. O grupo estudo apresentou, em média, valores inferiores de auto-estima, comparado ao grupo controle. Não houve diferença da auto-estima entre os pacientes dos subgrupos leve e moderado-grave (P=0,2710. CONCLUSÃO: A oftalmopatia de Graves na fase inativa não afetou a auto-estima dos pacientes, no grupo estudado.PURPOSE: To assess the self-esteem of Graves' ophthalmopathy patients in the inactive phase. METHODS: Thirty euthyroid patients were evaluated in the inactive phase of disease with age ranging from 26 to 65 years, average of 43 ± 11,0 years, called study group and 39 individuals without Graves' ophthalmopathy with age ranging from 18 to 67 years, average of 41 ± 13,4 years, selected from the general population called control group. To evaluate the self-esteem the Rosenberg UNIFESP/EPM self-esteem scale, applied by means of an interview, was utilized. The self-esteem scores in the two studied groups were compared by means of the non

  20. Anemia in peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Laušević Mirjana

    2006-01-01

    Full Text Available A normocytic normochromic anemia is one of the first signs of renal failure. Since anemia increases morbidity and mortality, its elimination is one of the essential objectives of the treatment. Human recombinant erythropoietin (rHuEPO has changed the therapeutical approach to anemia. The aim of the present study was to compare efficacy of anemia correction in peritoneal dialysis patients depending on treatment and dialysis modality. The study is the retrospective analysis of 64 patients who presented to our Clinic in 2003. Eighteen (28.13% patients were treated with rHuEPO, 14 (28% underwent continuous ambulatory peritoneal dialysis (CAPD, 2 (100% - automated peritoneal dialysis (APD and 2 (33.3% - intermittent peritoneal dialysis (IPD. Mean hemoglobin level was 98.6±17.82 g/l in patients treated with rHuEPO versus 98.81±15.14 g/I in patients without rHuEPO treatment. Erythropoietin requirements were 3392.85±1211.77 IU/week. AII patients received iron supplementation during rHuEPO therapy. Mean serum ferritin levels were 463.41 ±360 μg/l. Transferrin saturation (TSAT was 0.35±0.16%. No difference of serum iron and TSAT levels was found between CAPD and IPD patients. The degree of anemia significantly differed between CAPD and IPD patients. A total of 17.11% of PD patients were given blood transfusions, most frequently during the first three months after the onset of dialysis. Our conclusion is that the number of patients receiving rHuEPO should be increased, as 50% of our patients should be substituted, while only 28% are being treated. As 50% of patients receiving rHuEPO failed to reach target Hgb levels, higher EPO doses should be considered. Iron stores should be continuously monitored, particularly in patients receiving rHuEPO, since iron deficiency is an important problem for patients undergoing peritoneal dialysis, especially during erythropoietin therapy. Oral iron supplementation is satisfactory in the majority of patients, and

  1. PERBEDAAN TINGKAT PENGETAHUAN ANEMIA REMAJA PUTRI SEKOLAH MENENGAH UMUM ANEMIA DAN NON ANEMIA DI ENAM DATI II PROPINSI JAWA BARAT

    OpenAIRE

    Edwi Saraswati; Iman Sumarno

    2012-01-01

    Telah dilakukan survei cepat tentang prevalensi anemia dan pengetahuan anemia pada remaja putri SMU di enam Dati II di Propinsi Jawa Barat. Remaja putri merupakan generasi penerus yang perlu diperhatikan, karena kelak menjadi ibu dan atau tenaga pekerja. Terhadap remaja putri sampel dilakukan pemeriksaan Hb dan pengumpulan data mengenai pengetahuan remaja putri tentang anemia. Informasi ini sangat berguna sebagai dasar penetapan prioritas program kesehatan dan gizi pada kelompok remaja putri ...

  2. 78 FR 22292 - Native American Graves Protection and Repatriation Review Committee: Notice of Nomination...

    Science.gov (United States)

    2013-04-15

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Notice of.... SUMMARY: The National Park Service is soliciting nominations for one member of the Native American Graves... nominations submitted by Indian tribes, Native Hawaiian organizations, and traditional Native...

  3. 77 FR 65406 - Native American Graves Protection and Repatriation Review Committee: Notice of Nomination...

    Science.gov (United States)

    2012-10-26

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Notice of.... SUMMARY: The National Park Service is soliciting nominations for one member of the Native American Graves... nominations submitted by Indian tribes, Native Hawaiian organizations, and traditional Native...

  4. Fetal Outcome pada Kehamilan Aterm Anemia dan Tidak Anemia di RS Achmad Mochtar Bukittinggi

    Directory of Open Access Journals (Sweden)

    Daulat Azhari

    2016-01-01

    Full Text Available AbstrakAnemia pada kehamilan merupakan faktor resiko gangguan pada fetal outcome dan memiliki komplikasi yang meningkatkan maternal dan perinatal mortality. Tujuan penelitian ini adalah menentukan perbedaan fetal outcome pada kehamilan aterm dengan anemia dan tidak anemia..Penelitian ini menggunakan data sekunder dengan rancangan cross sectional. Total sampel adalah 110 yang terdiri dari 55 ibu hamil aterm dengan anemia dan 55 ibu hamil aterm tidak anemia. Tekhnik pengambilan sampel adalah consecutive sampling dan analisis data menggunakan tes Mann- Whitney. Hasil uji diperoleh rerata berat badan lahir bayi pada ibu hamil aterm anemia adalah 3097,27 gr± 366,93 gr, yang sedikit lebh rendah dibandingkan pada ibu hamil aterm tidak anemia 3200,55 gr± 343,02 gr dengan nilai p= 0,214. Rerata APGAR skor pada menit pertama pada kelompok anemia adalah 7,04± 1,39, yang sedikit lebih rendah jika dibandingkan pada ibu hamil aterm tidak anemia 7.36± 0,65 dengan nilai p= 0,480. Rerata APGAR skor pada menit kelima pada kelompok anemia 8,11± 1,20 sedikit lebih rendah dibandingkan ibu hamil aterm tidak anemia 8,40± 0,62 dengan nilai p= 0,483. Rerata panjang badan lahir pada kelompok anemia adalah 48,58 cm± 1,52 cm hampir tidak memiliki perbedaan dibandingkan ibu hamil aterm tidak anemia 48,89 cm± 1,56 cm  dengan nilai p=0,310. Disimpulkan bahwa tidak ada perbedaan berat badan lahir, APGAR skor menit pertama dan kelima, dan panjang badan lahir pada kehamilan aterm dengan anemia dan tidak anemia.Kata kunci: berat badan lahir, APGAR skor, panjang badan lahir,  wanita hamil aterm dengan anemia AbstractAnemia in pregnancy is a risk factor of fetal outcome disorder and it have complication that increase of matenal and perinatal mortality. The objective of this study was to determine the differences of fetal outcome between aterm pregnant women with anemia and non anemia.This research uses secondary data by using cross sectional study design. Total sample is

  5. Graves' Disease Associated with Cerebrovascular Disease and Antiphospholipid Antibody Syndrome

    OpenAIRE

    2010-01-01

    Thyroid disorders are commonly associated with coagulopathy. Patients with hyperthyroidism have increased risk for developing thromboembolic accidents, which are favoured by a simultaneous presence of antiphospholipid antibodies syndrome. in this paper, we describe the case of a patient with Graves' disease, who developed strokes with antiphospholipid antibodies syndrome.

  6. Treatment of Graves' hyperthyroidism: evidence-based and emerging modalities

    DEFF Research Database (Denmark)

    Hegedüs, Laszlo

    2009-01-01

    Currently there are three well-established treatment options for hyperthyroid Graves' disease (GD): antithyroid drug therapy with thionamides (ATD), radioactive iodine treatment with (131)I, and thyroid surgery. This article reviews the current evidence so the reader can evaluate advantages...

  7. Selenium and the Course of Mild Graves' Orbitopathy

    NARCIS (Netherlands)

    C. Marcocci; G.J. Kahaly; G.E. Krassas; L. Bartalena; M. Prummel; M. Stahl; M.A. Altea; M. Nardi; S. Pitz; K. Boboridis; P. Sivelli; G. von Arx; M.P. Mourits; L. Baldeschi; W. Bencivelli; W. Wiersinga

    2011-01-01

    Background Oxygen free radicals and cytokines play a pathogenic role in Graves' orbitopathy. Methods We carried out a randomized, double-blind, placebo-controlled trial to determine the effect of selenium (an antioxidant agent) or pentoxifylline (an antiinflammatory agent) in 159 patients with mild

  8. Radiotherapy for Graves' orbitopathy : randomised placebo-controlled study

    NARCIS (Netherlands)

    Mourits, MP; van Kempen-Harteveld, ML; Garcia, MBG; Koppeschaar, HPF; Tick, L; Terwee, CB

    2000-01-01

    Background The best treatment (steroids, irradiation, or both) for moderately severe Graves' orbitopathy, a self-limiting disease is not known. We tested the efficacy of external beam irradiation compared with sham-irradiation. Methods In a double-blind randomised clinical trial, 30 patients with mo

  9. Measuring disease activity to predict therapeutic outcome in Graves' ophthalmopathy

    NARCIS (Netherlands)

    Terwee, C.B.; Prummel, M.F.; Gerding, M.N.; Kahaly, G.J.; Dekker, F.W.; Wiersinga, W.M.

    2005-01-01

    OBJECTIVE: The concept of disease activity in Graves' ophthalmopathy (GO) might explain why as many as one-third of patients do not respond to immunosuppressive treatment, because only patients in the active stage of disease are expected to respond. The hypothesis was adopted that a parameter used t

  10. A patient with Graves' disease, thrombocytopenia and chronic hepatitis B.

    OpenAIRE

    Szeto, C C; Chow, C C; Ko, G. T.; K. Y. LI; Yeung, V. T.; Cockram, C S

    1997-01-01

    A 22-year-old Chinese man, a HBsAg carrier, presented with relapse of thyrotoxic Graves' disease complicated by thrombocytopenia and hepatitis. Platelet count and liver enzymes gradually improved following successful treatment of the thyrotoxicosis with radioactive iodine. Possible pathogenetic links and therapeutic implications are discussed.

  11. Graves' disease: thyroid function and immunologic activity

    Energy Technology Data Exchange (ETDEWEB)

    Gossage, A.A.R.; Crawley, J.C.W.; Copping, S.; Hinge, D.; Himsworth, R.L.

    1982-11-01

    Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of (/sup 9/-9..mu..Tc)pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity - TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p<0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination.

  12. Graves' disease: thyroid function and immunologic activity

    Energy Technology Data Exchange (ETDEWEB)

    Gossage, A.A.; Crawley, J.C.; Copping, S.; Hinge, D.; Himsworth, R.L.

    1982-11-01

    Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of (/sup 99m/Tc)pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity--TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p less than 0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination.

  13. Anemias Hereditárias

    OpenAIRE

    Ferreira, Fátima; Carvalho, Fernanda; Costa, Vítor; Farinha, Nuno; Gil-da-Costa, M.ª João; Norton, Lucília; Reis, Ilidia Lima

    2014-01-01

    Os autores efectuam a revisão das anemias hereditárias da consulta de hematologia pediátrica do Hospital S. João no período compreendido entre 1982 e 1995. Dividem-nas em três grandes grupos: Hemoglobinopatias, Doenças da Membrana do glóbulo rubro e Enzimopatias. Calculam a sua frequência relativa, os parâmetros clínicos e analíticos relevantes no diagnóstico, a abordagem terapêutica e respectiva evolução.Destacam a especificidade desta consulta em que as anemias hereditárias correspondem a 4...

  14. Fanconi anemia - learning from children

    Directory of Open Access Journals (Sweden)

    Johanna Svahn

    2011-06-01

    Full Text Available Fanconi Anemia (FA is a rare autosomic recessive and X-linked disease with chromosomal instability after exposure to crosslinking agents as the hallmark. Clinical features of FA are somatic malformations, progressive bone marrow failure and cancer proneness, however there is wide clinical heterogeneity. The symptom most frequently and early associated with morbidity and mortality is progressive pancytopenia in the first decade of life although acute myelogenous leukemia (AML or myelodysplastic syndrome (MDS can appear before aplastic anemia. Squamous cell carcinoma (SCC of the head-neck, intestinal or genital tract has a very high incidence in FA and can appear at young age. This paper will focus on treatment of bone marrow failure in FA.

  15. Anemia del paciente crítico y quirúrgico: tratamiento con hierro intravenoso Anemia in critically ill and surgical patient: treatment with intravenous iron

    Directory of Open Access Journals (Sweden)

    M.ª Cortés-Berdonces

    2012-02-01

    Full Text Available Introducción: La anemia es la anomalía hematológica y analítica más frecuente entre los pacientes críticos y quirúrgicos. Habitualmente se trata con transfusión de sangre alogénica (TSA, la cuál está relacionada con aumento de la morbimortalidad, por lo que se plantea la búsqueda de alternativas para el tratamiento de la anemia grave. Objetivos: Valorar la posible utilidad de la terapia con hierro intravenoso en pacientes con enfermedad crítica o quirúrgica que presentan anemia. Métodos: Revisión de los trabajos publicados con hierro intravenoso en este tipo de pacientes. Búsqueda en la base de datos Medline (www.ncvi.nlm.nih.gov y búsqueda manual. Resultado y discusión: El tratamiento con hierro intravenoso no es suficiente para tratar la anemia del paciente crítico. Su asociación a eritropoyetina sí puede tener un efecto sobre la tasa de transfusiones aunque no se ha demostrado que mejore la morbimortalidad ni la estancia hospitalaria. En cirugía digestiva o traumatológica no hay evidencia que apoye el tratamiento sistemático pericirugía con hierro intravenoso, pudiendo encontrarse beneficio cuando se utiliza junto con eritropoyetina. La utilización de hierro intravenoso solo o asociado a EPO en el postoperatorio no ha demostrado ser útil para una corrección rápida de la anemia, disminuir la estancia hospitalaria ni disminuir la mortalidad.Background: Anemia is a common condition among surgical and critically ill patients and it is usually treated with allogenic blood transfusion (ABT. As ABT is associated with increased morbidity and mortality, alternative therapies for anemia in these patients are actively investigated. Objectives: To asses the potential usefulness of intravenous iron therapy in critically-ill or surgical patients with anemia. Methods: Review of published papers with intravenous iron in these patients. Bibliographical search on database Medline (www.ncvi.nlm.nih.gov. Results and discussion

  16. Thymoma with Autoimmune Hemolytic Anemia

    OpenAIRE

    Kensuke Suzuki; Minehiko Inomata; Shiori Shiraishi; Ryuji Hayashi; Kazuyuki Tobe

    2014-01-01

    A 38-year-old Japanese male was referred to our hospital with abnormal chest X-ray results and severe Coombs-positive hemolytic anemia. He was diagnosed with a stage IV, WHO type A thymoma and was treated with oral prednisolone (1 mg/kg/day) and subsequent chemotherapy. After chemotherapy, the patient underwent surgical resection of the thymoma. Hemolysis rapidly disappeared and did not return after the discontinuation of oral corticosteroids. Corticosteroid therapy may be preferable to chemo...

  17. Iron, Anemia, and Iron Deficiency Anemia among Young Children in the United States

    OpenAIRE

    Gupta, Priya M.; Perrine, Cria G.; Zuguo Mei; Scanlon, Kelley S.

    2016-01-01

    Iron deficiency and anemia are associated with impaired neurocognitive development and immune function in young children. Total body iron, calculated from serum ferritin and soluble transferrin receptor concentrations, and hemoglobin allow for monitoring of the iron and anemia status of children in the United States. The purpose of this analysis is to describe the prevalence of iron deficiency (ID), anemia, and iron deficiency anemia (IDA) among children 1–5 years using data from the 2007–201...

  18. Estimated red blood cell thickness in microcytic anemia due to iron deficiency anemia and thalassemia

    Directory of Open Access Journals (Sweden)

    Viroj Wiwanitkit

    2009-05-01

    Full Text Available "nAnemia is one of the most common hematological disorders that are still the present in all countries around the world. Microcytic anemia is a specific kind of anemia presenting with small red blood cell. In this paper, the author discusses on the estimated red blood cell thickness, a new proposed parameter, comparing between that of iron deficiency anemia and thalassemia and further extrapolate on the clinical implication.

  19. Diamond-Blackfan anemia and nutritional deficiency-induced anemia in children.

    Science.gov (United States)

    Gelbart, David

    2014-04-01

    Diamond-Blackfan anemia is a rare, inherited disease that characteristically presents as a chronic, normochromic macrocytosis due to red cell lineage bone marrow failure. Although studies are elaborating on the genetic basis for its associated comorbidities, little has been published comparing this anemia to other chronic anemias that have similar laboratory results in children. This article offers a global perspective of the disease and compares it with anemia due to vitamin B12 and folate deficiency in children.

  20. Prevalencia de anemia y deficiencia de hierro en escolares jujeños de 12 años Prevalence of anemia and iron deficiency in 12 year old school children from Jujuy

    Directory of Open Access Journals (Sweden)

    María C. Buys

    2005-04-01

    Full Text Available La deficiencia de hierro es una de las deficiencias de micronutrientes más comunes. Los adolescentes son un grupo vulnerable. Un reconocimiento oportuno puede prevenir una anemia ferropénica, etapa final y grave de dicha deficiencia, insuficientemente conocida en nuestro país. El objetivo de este estudio fue determinar los valores hematológicos en adolescentes y conocer las prevalencias de anemia y deficiencia de hierro. Definidas como a anemia: hematocrito (Hto Iron deficiency is highly frequent among adolescents. Its early detection can prevent the development of a ferropenic anemia, a serious condition. The problem has not been well studied in our country. The purpose of this work was to determine the frequency of iron deficiency and anemia in adolescents. The criteria considered were: hematocrit below 38%, b saturation transferrin below 16%, c ferritin below 15 ng/ml. The study was carried out in 2.265 schoolchildren, 12 years old, of both sexes, in urban and periurban areas in the city of San Salvador de Jujuy (1.250 a.s.l.. The following parameters were measured: hematocrit as well as serum iron and total iron binding capacity, both by colorimetric method. Ferritin was measured by ELISA. Anemia was not found. Iron deficiency as estimated by the iron functional component, was found in 25% of girls and 21% of boys and, through iron stores, in 28% of girls and 18% of boys. Iron deficiency stores in both sexes is the more relevant alteration, indicating that the population sample here studied constitutes a highly vulnerable group. The early detection of iron deficiency will help physical and intellectual development so that adequate sanitary policies are necessary for its prevention.

  1. Role of Complement in Autoimmune Hemolytic Anemia

    OpenAIRE

    Berentsen, Sigbjørn

    2015-01-01

    Summary The classification of autoimmune hemolytic anemias and the complement system are reviewed. In autoimmune hemolytic anemia of the warm antibody type, complement-mediated cell lysis is clinically relevant in a proportion of the patients but is hardly essential for hemolysis in most patients. Cold antibody-mediated autoimmune hemolytic anemias (primary cold agglutinin disease, secondary cold agglutinin syndrome and paroxysmal cold hemoglobinuria) are entirely complement-mediated disorder...

  2. The Clinical Pictures of Autoimmune Hemolytic Anemia

    OpenAIRE

    Packman, Charles H.

    2015-01-01

    Summary Autoimmune hemolytic anemia is characterized by shortened red blood cell survival and a positive Coombs test. The responsible autoantibodies may be either warm reactive or cold reactive. The rate of hemolysis and the severity of the anemia may vary from mild to severe and life-threatening. Diagnosis is made in the laboratory by the findings of anemia, reticulocytosis, a positive Coombs test, and specific serologic tests. The prognosis is generally good but renal failure and death some...

  3. Anemia in children with chronic kidney disease

    OpenAIRE

    Koshy, Susan M.; Geary, Denis F.

    2007-01-01

    Anemia is a common feature of chronic kidney disease, but the management of anemia in children is complex. Erythropoietin and supplemental iron are used to maintain hemoglobin levels. The National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) clinical practice guidelines for the management of anemia specifically in children were recently published. Pediatric nephrologists are encouraged to use current clinical practice guidelines and best evidence in conjunction wit...

  4. Anemia and iron deficiency in heart failure.

    Science.gov (United States)

    Gil, Victor M; Ferreira, Jorge S

    2014-01-01

    Heart failure is a common problem and a major cause of mortality, morbidity and impaired quality of life. Anemia is a frequent comorbidity in heart failure and further worsens prognosis and disability. Regardless of anemia status, iron deficiency is a common and usually unidentified problem in patients with heart failure. This article reviews the mechanisms, impact on outcomes and treatment of anemia and iron deficiency in patients with heart failure.

  5. Child with aplastic anemia: Anesthetic management

    OpenAIRE

    Manpreet Kaur; Babita Gupta; Aanchal Sharma; Sanjeev Sharma

    2012-01-01

    Aplastic anemia is a rare heterogeneous disorder of hematopoietic stem cells causing pancytopenia and marrow hypoplasia with the depletion of all types of blood cells. This results in anemia, neutropenia and thrombocytopenia, which pose a challenge to both surgical and anesthetic management of such cases. We report a child with aplastic anemia who sustained traumatic ulcer on the arm and underwent split-thickness skin grafting under general anesthesia. There are only two case reports on anest...

  6. An unusual cause of anemia and encephalopathy

    OpenAIRE

    Sanjeev Kumar Sharma; Dharma Choudhary; Anil Handoo; Gaurav Dhamija; Gaurav Kharya; Vipin Khandelwal; Mayank Dhamija; Sweta Kothari

    2015-01-01

    The authors present here an interesting case of recent onset anemia that was associated with an encephalopathy of the unusual cause.Although severe anemia can theoretically result in anemic hypoxia and can then lead to hypoxic encephalopathy, it is not a primary cause of encephalopathy. More frequently anemia can contribute together with other multiple causes of encephalopathy, such as infections, metabolic abnormalities, trauma, hepatic dysfunction, hypertension, toxins.

  7. 78 FR 21410 - Native American Graves Protection and Repatriation Review Committee: Meetings

    Science.gov (United States)

    2013-04-10

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meetings AGENCY... Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of two meetings of the Native American Graves... Advisory Committee Act, 5 U.S.C. Appendix (1988), of two meetings of the Native American Graves...

  8. 77 FR 23196 - Native American Graves Protection and Repatriation Act Regulations

    Science.gov (United States)

    2012-04-18

    ... Office of the Secretary 43 CFR Part 10 RIN 1024-AD99 Native American Graves Protection and Repatriation... Secretary of the Interior (Secretary) is responsible for implementation of the Native American Graves... implementing the Native American ] Graves Protection and Repatriation Act for purposes of factual accuracy...

  9. 77 FR 65407 - Native American Graves Protection and Repatriation Review Committee: Notice of Nomination...

    Science.gov (United States)

    2012-10-26

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Notice of.... SUMMARY: The National Park Service is soliciting nominations for one member of the Native American Graves... Review Committee was established by the Native American Graves Protection and Repatriation Act of...

  10. Genetics Home Reference: X-linked sideroblastic anemia and ataxia

    Science.gov (United States)

    ... linked sideroblastic anemia and ataxia X-linked sideroblastic anemia and ataxia Enable Javascript to view the expand/ ... Open All Close All Description X-linked sideroblastic anemia and ataxia is a rare condition characterized by ...

  11. Genetics Home Reference: X-linked sideroblastic anemia

    Science.gov (United States)

    ... Conditions X-linked sideroblastic anemia X-linked sideroblastic anemia Enable Javascript to view the expand/collapse boxes. ... Open All Close All Description X-linked sideroblastic anemia is an inherited disorder that prevents developing red ...

  12. Do You Know about Sickle Cell Anemia? (For Kids)

    Science.gov (United States)

    ... X-ray Do You Know About Sickle Cell Anemia? KidsHealth > For Kids > Do You Know About Sickle ... stay in the hospital. What Causes Sickle Cell Anemia? Sickle cell anemia is an inherited (say: in- ...

  13. Do You Know about Sickle Cell Anemia? (For Kids)

    Science.gov (United States)

    ... Operating Room? Do You Know About Sickle Cell Anemia? KidsHealth > For Kids > Do You Know About Sickle ... stay in the hospital. What Causes Sickle Cell Anemia? Sickle cell anemia is an inherited (say: in- ...

  14. [Anemia in patients with rheumatoid arthritis].

    Science.gov (United States)

    Wahle, M

    2012-12-01

    One of the most frequent extra-articular organ manifestations in rheumatoid arthritis (RA) is anemia. As anemia in RA patients may result in severe symptoms and aggravation of other disease manifestations (e.g. arteriosclerosis), the influence on the course of RA is profound. However, the importance of anemia in RA patients is frequently underestimated. The etiology of anemia in RA is complex. Anemia of inflammation (AI) and iron deficiency anemia, alone or in combination are the most frequent forms of anemia in RA. Changes in iron metabolism are the leading causes of anemia in RA patients and mainly induced by the altered synthesis and function of hepcidin and ferroportin. Hepcidin, a peptide produced in the liver and immunocompetent cells, impairs the expression of ferroportin on iron-secreting cells, thus reducing iron bioavailability. The typical changes of iron metabolism and hepcidin synthesis in RA are induced by proinflammatory cytokines, primarily interleukin-6. Hence, the treatment of RA with cytokine antagonists has significant therapeutic implications on anemia in the context of inflammation and impaired iron metabolism.

  15. Child with aplastic anemia: Anesthetic management

    Directory of Open Access Journals (Sweden)

    Manpreet Kaur

    2012-01-01

    Full Text Available Aplastic anemia is a rare heterogeneous disorder of hematopoietic stem cells causing pancytopenia and marrow hypoplasia with the depletion of all types of blood cells. This results in anemia, neutropenia and thrombocytopenia, which pose a challenge to both surgical and anesthetic management of such cases. We report a child with aplastic anemia who sustained traumatic ulcer on the arm and underwent split-thickness skin grafting under general anesthesia. There are only two case reports on anesthetic considerations in aplastic anemia patients in the literature. The anesthetic management is challenging because of the rarity of the disease, associated pancytopenia and immunosuppression.

  16. Treatment of anemia with darbepoetin alfa in systolic heart failure

    DEFF Research Database (Denmark)

    Swedberg, Karl; Young, James B; Anand, Inder S

    2013-01-01

    Patients with systolic heart failure and anemia have worse symptoms, functional capacity, and outcomes than those without anemia. We evaluated the effects of darbepoetin alfa on clinical outcomes in patients with systolic heart failure and anemia.......Patients with systolic heart failure and anemia have worse symptoms, functional capacity, and outcomes than those without anemia. We evaluated the effects of darbepoetin alfa on clinical outcomes in patients with systolic heart failure and anemia....

  17. Necrose cerebelar extensa na anemia falciforme: relato de um caso

    Directory of Open Access Journals (Sweden)

    Luciano de Souza Queiroz

    1978-12-01

    Full Text Available É relatado o caso de um paciente de 6 meses de idade, de cor parda, internado por gastroenterocolite aguda, desnutrição e desidratação. Apesar do tratamento, a criança apresentou septicemia, com picos febris de até 38,6ºC, vindo a óbito no 12º dia de internação. Na necrópsia, além de broncopneumonia bilateral, observou-se hemorragia subaracnóidea fronto-parietal bilateral e extensa necrose recente da face inferior de ambos hemisférios cerebelares. Estes achados neuropatológicos foram clinicamente silenciosos. Ao exame histopatológico, nas áreas de necrose cerebelar, observaram-se numerosas hemácias falcizadas em hemorragias petequiais e, em menor quantidade, no interior de capilares. O interesse do presente caso prende-se à extrema raridade das necroses cerebelares na anemia falciforme. O mecanismo patogenético da necrose não ficou claro visto que não foram encontradas tromboses em artérias ou capilares. Provavelmente atuaram fatores coadjuvantes, tais como o estado infeccioso grave e a febre, além da anóxia provocada pela broncopneumonia.

  18. Contribución de Graells a la posición de España en el primer convenio internacional para la protección de ciertas especies de la fauna silvestre (1902

    Directory of Open Access Journals (Sweden)

    Ferrero-García, J. J.

    2012-12-01

    Full Text Available The process followed by Spain to decide whether it should subscribe the International Convention for the Protection of Birds Useful to Agriculture, signed in 1902 is described. The fundamental role played by Mariano de la Paz Graells, one of the foremost Spanish naturalists of the 19th century, in the technical review and acceptance of the draft agreement, drawn up in 1895, is highlighted. Furthermore, a critical analysis of Graells’s position in relation to this so-called first international convention for the conservation of certain wildlife species, has been carried out.

    Se describe el proceso que siguió España para decidir si debía suscribir el Convenio Internacional para la Protección de las Aves Útiles a la Agricultura, firmado en 1902. Se pone de manifiesto el papel fundamental que tuvo Mariano de la Paz Graells, uno de los más importantes naturalistas españoles del siglo XIX, en el examen técnico y aceptación del proyecto de dicho convenio, redactado en 1895. Además, se ha realizado un análisis crítico de la postura de Graells en relación con la que puede calificarse como la primera convención internacional para la conservación de ciertas especies de la fauna silvestre.

  19. Diagnosis of iron deficiency anemia in children of Northeast Brazil Diagnóstico de anemia por deficiencia de hierro en niños del Noreste de Brasil Diagnóstico de anemia por deficiência de ferro em crianças do Nordeste do Brasil

    Directory of Open Access Journals (Sweden)

    Antonio Geraldo Cidrão Carvalho

    2010-06-01

    Full Text Available OBJECTIVE: To diagnose iron deficiency anemia in children. METHODS: The study was conducted with a sample of 301 children aged six to 30 months attending public daycare centers in the city of Recife, Northeast Brazil, in 2004. The diagnoses of anemia were based on a combination of different hematological and biochemical parameters: hemoglobin, mean corpuscular volume, ferritin, C-reactive protein, transferrin saturation and transferrin receptor. The chi-square test and ANOVA were used in the statistical analysis. RESULTS: Of all children studied, 92.4% had anemia (Hb OBJETIVO: Diagnosticar anemia por deficiencia de hierro en niños. MÉTODOS: El estudio fue desarrollado con una muestra de 301 niños con edades entre seis y 30 meses, usuarios de guarderías públicas de Recife, Noreste de Brasil, en 2004. Para el diagnóstico de la anemia se utilizó la combinación de diferentes parámetros hematológicos y bioquímicos: hemoglobina, volumen corpuscular promedio, ferritina, proteína C-reactiva, saturación de la transferrina y receptor de la transferrina. Para el análisis estadístico se empleó la prueba de chi-cuadrado y ANOVA. RESULTADOS: Del total de niños, 92,4% tenían anemia (HbOBJETIVO: Diagnosticar anemia por deficiência de ferro em crianças. MÉTODOS: O estudo foi desenvolvido com uma amostra de 301 crianças com idade entre seis e 30 meses, usuárias de creches públicas de Recife, PE, em 2004. Para o diagnóstico da anemia utilizou-se a combinação de diferentes parâmetros hematológicos e bioquímicos: hemoglobina, volume corpuscular médio, ferritina, proteína C-reativa, saturação da transferrina e receptor da transferrina. Para a análise estatística empregou-se o teste do qui-quadrado e ANOVA. RESULTADOS: Do total de crianças, 92,4% tinha anemia (Hb < 110g/L e 28,9% apresentou anemia moderada/grave (Hb<90g/L. Níveis mais baixos de hemoglobina foram observados em crianças de seis a 17 meses. Encontrou-se defici

  20. [Metallosis: A Rare Cause of Autoimmune Hemolytic Anemia].

    Science.gov (United States)

    Duarte, Joana; Correia, Lurdes; Simão, Adélia; Figueiredo, António; Carvalho, Armando

    2015-01-01

    primeira revisão cirúrgica. O desbridamento cirúrgico pôs em comunicação esta coleção com os tecidos adjacentes e com a circulação sistémica, desencadeando efeitos sistémicos graves, como anemia hemolítica auto-imune. Desconhece-se o potencial de toxicidade de cada um dos elementos metálicos desta prótese, não estando ainda disponíveis testes laboratoriais de detecção.Conclusão: A metalose é uma causa rara de anemia hemolítica auto-imune.

  1. Future Prospects for the Treatment of Graves' Hyperthyroidism and Eye Disease.

    Science.gov (United States)

    Neumann, S; Place, R F; Krieger, C C; Gershengorn, M C

    2015-09-01

    Although there are adequate therapies for Graves' hyperthyroidism, mild to moderate Graves' orbitopathy (GO) is usually treated symptomatically whereas definitive therapy is reserved for severe, vision-threatening GO. Importantly, none of the treatment regimens for Graves' disease used today are directed at the pathogenesis of the disease. Herein, we review some aspects of what is known about the pathogenesis of these 2 major components of Graves' disease, specifically the apparent important roles of the TSH and IGF-1 receptors, and thereafter describe future therapeutic approaches directed at these receptors. We propose that targeting these receptors will yield effective and better tolerated treatments for Graves' disease, especially for GO.

  2. Risk factors associated with anemia, iron deficiency and iron deficiency anemia in rural Nepali pregnant women.

    Science.gov (United States)

    Makhoul, Zeina; Taren, Douglas; Duncan, Burris; Pandey, Pooja; Thomson, Cynthia; Winzerling, Joy; Muramoto, Myra; Shrestha, Ram

    2012-05-01

    We conducted a cross sectional study to investigate risk factors associated with severe anemia [hemoglobin (Hb) iron status among Nepali pregnant women. Socio-demographic, anthropometric, health and dietary data were collected from 3,531 women living in the southeastern plains of Nepal. Stool samples were analyzed for intestinal helminthes. Dark adaptation was assessed using the Night Vision Threshold Test (NVTT). Hb levels were measured in all subjects to detect anemia and the soluble transferrin receptor (sTfR) was measured among a subsample of 479 women. The iron status categories were: 1) normal (Hb> or = 11.0 g/dl and sTfR anemia without iron deficiency (Hbiron deficiency without anemia (Hb > or = 11.0 g/dl and sTfR>8.5 mg/l); and 4) iron deficiency anemia (IDA): (Hb8.5 mg/l). Factors associated with severe anemia and poor iron status were determined using logistic regression. Hookworm infection increased the risk for developing severe anemia [adjusted odds ratio (AOR): 4.26; 95% CI 1.67-10.89; piron deficiency with and without anemia. Intake of iron supplements as tablets and/or tonic was protective against severe anemia, anemia without iron deficiency and IDA. Dietary heme iron was significantly associated with iron deficiency without anemia (RRR: 0.1; 95% CI 0.02-0.47; panemia and associated nutrient deficiencies.

  3. 伊朗 Graves 眼病的临床特点%Clinical features of Graves' ophthalmopathy in Iran

    Institute of Scientific and Technical Information of China (English)

    Ali Sadeghi Tari; Mohammad Taher Rajabi; Khalil Hamzedust; Seyed Ziaeddin Tabatabaie; Abolfazl Kasai

    2007-01-01

    AIM:To determine the clinical characteristics of a prospective study of patients with Graves' ophthalmopathy.METHODS:We reviewed clinical manifestations,and medical records of 103 patients in whom Graves' ophthalmopathy WaS diagnosed between 2003 and 2005.RESULTS:Among 103 patients with Graves' ophthalmopathy,48(46.6%)male and 55(53.3%)female(F:M=1.1),with mean age of 45 (range;18-73) years,95 (92.2%)patients had Graves' hyperthyroidism,3(2.9%) had primary hypothyroidism,and 5 (4.8%) were euthyroid.The mean duration of ocular symptoms was 13.2 (range 2-95) months) while the mean duration of dysthyroid symptoms was 39.4(range 6-180) months.Unilaterality was occurred in 12 patients.Eyelid retraction was present in 90 patients (87%),whereas the approximate frequency of exophthalmos was 77.6%(80 patients);restrictive extraocular myopathy.29% (30 patients);evidence of extraocular enlargement on CT-scan in 52 patients of 70 patients (74%) that was evaluated,and optic nerve dysfunction,5.8%(6 patients).22(21%)patients hadglaucoma associated with Graves' ophthalmopathy that 7 (6.7%)of them were normal-tension glaucoma.CONCLUSION:Eyelid retraction Was the most common clinical sign of Graves' ophthalmopathy in our patients.Larger prospective studies are suggested to evaluate both the prevalenoe and possible racial difference in its dinical presentation in Iranian population.%目的:研究分析伊朗 Graves 眼病患者的临床特点.方法:回顾分析 2003/2005 年确诊为 Graves 眼病的103例患者临床资料.结果:在103例 Graves 眼病患者中,48例(46.6%)为男性,55例(53.3%)为女性(男女比例为1.1).年龄18-73(平均45)岁,95例(92.2%)表现为甲状腺机能亢进,3例(2.9%)表现为原发性甲状腺机能减退,5例(4.8%)甲状腺机能正常.出现眼部症状的时间为2~95 (平均3.2)mo,而表现出甲状腺功能障碍的时间为6~180(平均39.4)mo.12例患者单眼发病,90例(87%)患者有眼睑退缩,80例(77.6%)患者

  4. Case 40. Misdiagnosis of refractory macrocytic anemia.

    Science.gov (United States)

    Stringaris, Kate; Bain, Barbara

    2008-11-01

    A diagnosis of myelodysplastic syndrome, refractory anemia subtype, was made in an elderly Indian woman on the basis of a refractory macrocytic anemia with normal vitamin B(12) and folate assays, normal thyroid function, essentially normal liver function and normal cytogenetic analysis. Disease evolution revealed that the diagnosis was erroneous.

  5. Silent Infarcts with Sickle Cell Anemia

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-01-01

    Full Text Available The effect of transfusion therapy on the risk for new silent infarct or stroke in children with sickle cell anemia and abnormal transcranial Doppler (TCD ultrasonography was determined at the University of Miami, FL, and other centers in the STOP trial (Stroke Prevention in Sickle Cell Anemia.

  6. The Student with Sickle Cell Anemia.

    Science.gov (United States)

    Tetrault, Sylvia M.

    1981-01-01

    Sickle cell anemia is the most common and severe of inherited chronic blood disorders. In the United States, sickle cell anemia is most common among the Black population. Among the most commonly occurring symptoms are: an enlarged spleen, episodes of severe pain, easily contracted infections, skin ulcers, and frequent urination. (JN)

  7. 9 CFR 311.34 - Anemia.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Anemia. 311.34 Section 311.34 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY ORGANIZATION... CERTIFICATION DISPOSAL OF DISEASED OR OTHERWISE ADULTERATED CARCASSES AND PARTS § 311.34 Anemia. Carcasses...

  8. Anemia and survival in human immunodeficiency virus

    DEFF Research Database (Denmark)

    Lundgren, Jens Dilling; Mocroft, Amanda

    2003-01-01

    The prospective, multicenter cohort study EuroSIDA has previously reported on predictors and outcomes of anemia in patients infected with human immunodeficiency virus. In a Cox proportional-hazards model with serial measures of CD4+ cell count, plasma viral load, and degrees of anemia fitted...

  9. Anemia in pregnancy:laboratory diagnostic procedures

    OpenAIRE

    Panova, Gordana

    2010-01-01

    Anemia is common condition in pregnancy and laboratory diagnostic procedures are essential for its detection and categorization. Complete blood count, serum iron, TIBC and ferritin are basic clinical laboratory parameters that provide information about iron status of mother’s body and possible presence of anemia.

  10. Salmonella osteomyelitis by sickle cell anemia

    Energy Technology Data Exchange (ETDEWEB)

    Rausch, H.; Tran, V.T.; Boeckmann, U.

    1985-10-01

    Case report of a 28 year old black sickle cell anemia patient with salmonella osteomyelitis of the radius. Aside from sickle cell anemia patients this skeletal complication of enteric salmonellosis is an extreme rarity. Description of the typical roentgenological features includes intracortical fissures and sequestration.

  11. Duodenal Amyloidosis Masquerading as Iron Deficiency Anemia

    Science.gov (United States)

    Hurairah, Abu

    2016-01-01

    The present study is a unique illustration of duodenal amyloidosis initially manifesting with iron deficiency anemia. It underscores the importance of clinical suspicion of amyloidosis while performing upper gastrointestinal endoscopy with a biopsy to establish the definite diagnosis in patients with unexplained iron deficiency anemia. PMID:27625911

  12. Habitat Evaluation Procedures Report; Graves Property - Yakama Nation.

    Energy Technology Data Exchange (ETDEWEB)

    Ashley, Paul; Muse, Anthony

    2008-02-01

    A habitat evaluation procedures (HEP) analysis was conducted on the Graves property (140 acres) in June 2007 to determine the number of habitat units to credit Bonneville Power Administration (BPA) for providing funds to acquire the property as partial mitigation for habitat losses associated with construction of McNary Dam. HEP surveys also documented the general ecological condition of the property. The Graves property was significantly damaged from past/present livestock grazing practices. Baseline HEP surveys generated 284.28 habitat units (HUs) or 2.03 HUs per acre. Of these, 275.50 HUs were associated with the shrubsteppe/grassland cover type while 8.78 HUs were tied to the riparian shrub cover type.

  13. Doenças da tireoide e miastenia grave

    Directory of Open Access Journals (Sweden)

    J. Lamartine de Assis

    1984-09-01

    Full Text Available Os autores estudam o comportamento da tireóide em um grupo de 304 pacientes com miastenia grave, constatando 15 casos de tireopatias, sendo 9 de hipertireoidismo, um de hipotireoidismo e 5 de bócio sem alterações da função tireoidiana. Nenhum paciente era proveniente de região de bócio endêmico e não havia bócio familiar. A tireotoxicose, que foi a disfunção mais frequente, foi estudada quanto a sua prevalência em pacientes miastênicos, quanto a sua influência sobre os sintomas da miastenia grave e quanto à época do seu aparecimento.

  14. Transplante renal na anemia falciforme

    OpenAIRE

    Friedrisch, Joao Ricardo; Barros, Elvino José Guardão; Manfro, Roberto Ceratti; Bittar,Christina Matzenbacher; Silla, Lucia Mariano da Rocha

    2003-01-01

    Embora a anemia falciforme e as síndromes falciformes freqüentemente causem várias alterações funcionais renais, não é comum a insuficiência renal terminal. Nestes casos, o transplante renal é uma alternativa que se acompanha de resultados comparáveis aos obtidos em receptores sem hemoglobinopatias. Esta estratégia terapêutica tem sido, no entanto, pouco relatada para portadores de hemoglobinopatia SC. Este relato descreve a evolução de dois pacientes portadores de hemoglobinopatia SC que for...

  15. Colonic lymphangiomatosis associated with anemia

    Institute of Scientific and Technical Information of China (English)

    Woo Chul Chung; Hye-Kang Kim; Jin Young Yoo; Jeong Rok Lee; Kang-Moon Lee; Chang Nyol Paik; U-Im Jang; Jin Mo Yang

    2008-01-01

    lymphangioma is an uncommon malformation of lymphatic system.Multiple colonic lymphangioma named as lymphangiomatosis is considered an extremely rare disease.Although lymphangioma is a benign tumor and most colonic lymphangiomas do not cause symptoms and do not require treatment,resection of lymphangioma is necessary in the presence of symptoms such as abdominal pain,bleeding,intussusceptions.We report a case of colonic lymphangiomatosis in a man who presented with abdominal discomfort and anemia,which was diagnosed and treated with endoscopic snare polyperctomy.

  16. Graves' hyperthyroidism and moderate alcohol consumption: evidence for disease prevention

    DEFF Research Database (Denmark)

    Carle, A.; Bülow Pedersen, I.; Knudsen, N.

    2013-01-01

    BACKGROUND: We recently demonstrated that moderate alcohol consumption is associated with a considerable reduction in the risk of autoimmune hypothyroidism, similar to findings in other autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis. We aimed to study a possible....... CONCLUSIONS: Moderate alcohol consumption is associated with a considerable reduction in the risk of Graves' disease with hyperthyroidism - irrespective of age and sex. Autoimmune thyroid disease seems to be much more dependent on environmental factors than hitherto anticipated....

  17. Unexplained Aspects of Anemia of Inflammation

    Directory of Open Access Journals (Sweden)

    Elizabeth A. Price

    2010-01-01

    Full Text Available Anemia of inflammation (AI, also known as anemia of chronic inflammation or anemia of chronic disease was described over 50 years ago as anemia in association with clinically overt inflammatory disease, and the findings of low plasma iron, decreased bone marrow sideroblasts and increased reticuloendothelial iron. Pathogenic features underlying AI include a mild shortening of red cell survival, impaired erythropoietin production, blunted responsiveness of the marrow to erythropoietin, and impaired iron metabolism mediated by inflammatory cytokines and the iron regulatory peptide, hepcidin. Despite marked recent advances in understanding AI, gaps remain, including understanding of the pathogenesis of AI associated with “noninflammatory” or mildly inflammatory diseases, the challenge of excluding iron deficiency anemia in the context of concomitant inflammation, and understanding more precisely the contributory role of hepcidin in the development of AI in human inflammatory diseases.

  18. Hipertrigliceridemia familiar grave durante a gestação

    Directory of Open Access Journals (Sweden)

    Casulari Luiz Augusto

    2001-01-01

    Full Text Available A presença de hipertrigliceridemia grave durante a gravidez é rara, mas comporta grande possibilidade de desenvolver complicações, como a pancreatite aguda, que coloca em risco a mãe e o feto. Apresentamos o relato da evolução da gestação de uma paciente portadora de hipertrigliceridemia grave que havia apresentado pancreatite aguda dois meses antes da fecundação. Foi tratada durante o pré-natal com dieta e 3,0 g de ácidos graxos de cadeia ômega-3 (ácidos eicosapentaenóico 14% e docosahexaenóico 11,13%. Os níveis de triglicerídeos foram mantidos abaixo de 800 mg/dl, sendo este limite considerado seguro para evitar o desenvolvimento de pancreatite aguda. A gestação evoluiu, sem intercorrências, para parto vaginal, a termo. O recém-nato não apresentou alterações morfológicas ao nascimento. Concluímos que, nesta paciente grávida e portadora de hipertrigliceridemia grave, uma dieta adequada e o emprego de ácidos graxos de cadeia ômega-3 foram eficazes em prevenir a pancreatite aguda. Esta abordagem terapêutica pode ser uma alternativa para as gestantes portadoras de hipertrigliceridemia familiar.

  19. PREVALENCE OF ANEMIA AMONG THE GENERAL POPULATION O F MALWA (M.P., INDIA

    Directory of Open Access Journals (Sweden)

    Prakash

    2013-01-01

    Full Text Available ABSTRACT: BACKGROUND: Anemia is highly prevalent in infants, children and females of reproductive age group because of increase demand of iron and micronutrients. Studies from different geographical areas have been published from time to time regarding its prevalence in different age groups, but there are very few studies published from central India. With this background we started our study to asses prevalence of anemia in general population of malwa region of Madhya Pradesh, so that in future we can intervene early in high risk groups and prevent complications. AIMS: As very few study have been published regarding th e prevalence of Anemia in Madhya Pradesh ,our present study aims to assess the prevalence of anemia in the general population of Malwa region of Madhya Pradesh . MATERIALS & METHODS : In this study, 1645 cases were selected randomly from the a ttendants of patients coming to different OPDs of Sri Aurobindo institute of medical sciences Indore, Madhya Pradesh from January 2011 to January 2012, including both sexes and from diff erent age group. Pregnant woman and elderly (>60 yr were excluded in this study. The s tudy recorded the Hemoglobin, Red cell indices, Peripheral blood smear examination and used these parameters to classify anemia morphologically. RESULTS: Out of 1645 cases selected randomly from apparently n ormal people, 740(44.98% people were found to be anemic out of them 426 (25.90% were female and 314 (19.08%were male, with a male to female ra tio of 1:1.35.Maximum cases were found to be in age group of 20-40 years 474/740(64.19%. CONCLUSION : In our study we found ORIGINAL ARTICLE Journal of Evolution of Medical and Dental Sciences/ Volume 2/ Issue 1/ January 7, 2013 Pag e-47 44.98% of clinically normal subjects to be anemic t hat to more common in age group of 20- 39yr.These are productive years of life, Thus by ear ly screening, proper diagnosis we can intervene early and can prevent further anemia relat ed grave

  20. New target for immunotherapy of Graves ophthalmopathy%Graves 眼病免疫治疗的新靶点

    Institute of Scientific and Technical Information of China (English)

    王坚

    2010-01-01

    @@ Graves 眼病(Graves ophthalmopathy,GO) 或称甲状腺相关性眼病(thyroid associated ophthalmopathy,TAO)是长期以来困扰内分泌医师的常见病症之一,目前尚无理想的治疗方法,常用免疫调节、球后放射照射、眼眶减压术等疗法.GO 的发病机制尚未完全明了,目前认为细胞免疫和体液免疫共同参与了GO 的发生和发展.

  1. Insuficiencia mitral grave posvalvuloplastia mitral percutánea

    Directory of Open Access Journals (Sweden)

    Julio C. Echarte Martínez

    2010-01-01

    Full Text Available RESUMENIntroducciónLa valvuloplastia mitral percutánea es en la actualidad el tratamiento de elección en pacientesportadores de estenosis mitral de etiología reumática si la anatomía es apropiada.La insuficiencia mitral grave posvalvuloplastia continúa siendo un desafío.ObjetivoDeterminar las causas de insuficiencia mitral grave posvalvuloplastia mitral.Material y métodosSe realizaron 110 valvuloplastias mitrales percutáneas en forma consecutiva en 107 pacientes(3 repetidas por reestenosis en el Instituto de Cardiología y Cirugía Cardiovascular deCuba, entre el 17 de junio de 1998 y el 30 de junio de 2004 (106 por el método de Inoue y 4por Multitrack; el tiempo de evolución promedio fue de 24,6 meses (máximo 72 y mínimo1,93 meses. La insuficiencia mitral se clasificó por ecocardiografía Doppler en leve si elárea regurgitante era menor de 4 cm2, moderada si era de 4-8 cm2. y grave si era > 8 cm2 ypor ventriculografía izquierda según los criterios de Sellers. Para lograr correlación entre laclasificación por ecocardiografía Doppler color de tres grados y la de Sellers (cuatro gradosla insuficiencia mitral 1+ se consideró leve, 2+ y 3+ moderada y 4+, grave.ResultadosSe produjeron cinco insuficiencias mitrales graves posprocedimiento (4,54% del total. Tresde ellas necesitaron reemplazo valvular mitral por rotura de la valva anterior. Las dos restantesse encuentran bajo tratamiento médico.ConclusiónLos mecanismos de producción de la insuficiencia mitral posvalvuloplastia mitral percutáneason multifactoriales. Puede ocurrir en manos expertas.REV ARGENT CARDIOL 2010;78:222-227.

  2. Anemia of Chronic Disease and Iron Deficiency Anemia in Inflammatory Bowel Diseases: Pathophysiology, Diagnosis, and Treatment.

    Science.gov (United States)

    Murawska, Natalia; Fabisiak, Adam; Fichna, Jakub

    2016-05-01

    Anemia coexists with inflammatory bowel disease (IBD) in up to two-thirds of patients, significantly impairing quality of life. The most common types of anemia in patients with IBD are iron deficiency anemia and anemia of chronic disease, which often overlap. In most cases, available laboratory tests allow successful diagnosis of iron deficiency, where difficulties appear, recently established indices such as soluble transferrin-ferritin ratio or percentage of hypochromic red cells are used. In this review, we discuss the management of the most common types of anemia in respect of the latest available data. Thus, we provide the mechanisms underlying pathophysiology of these entities; furthermore, we discuss the role of hepcidin in developing anemia in IBD. Next, we present the treatment options for each type of anemia and highlight the importance of individual choice of action. We also focus on newly developed intravenous iron preparations and novel, promising drug candidates targeting hepcidin. Concurrently, we talk about difficulties in differentiating between the true and functional iron deficiency, and discuss tools facilitating the process. Finally, we emphasize the importance of proper diagnosis and treatment of anemia in IBD. We conclude that management of anemia in patients with IBD is tricky, and appropriate screening of patients regarding anemia is substantial.

  3. Iron Deficiency, Anemia and Mortality in Renal Transplant Recipients

    NARCIS (Netherlands)

    Eisenga, Michele F.; Minovic, Isidor; Berger, Stefan P.; Kootstra-Ros, Jenny E.; van den Berg, Else; Riphagen, Ineke J.; Navis, Gerjan; van der Meer, Peter; Bakker, Stephan J. L.; Gaillard, Carlo A. J. M.

    2016-01-01

    Anemia, iron deficiency anemia (IDA), and iron deficiency (ID) are highly prevalent in renal transplant recipients (RTR). Anemia is associated with poor outcome, but the role of ID is unknown. Therefore, we aimed to investigate the association of ID, irrespective of anemia, with all-cause mortality

  4. Iron Deficiency, Anemia and Mortality in Renal Transplant Recipients

    NARCIS (Netherlands)

    Eisenga, Michele F; Minovic, Isidor; Berger, Stefan P; Kootstra-Ros, Jenny E; van den Berg, Else; Riphagen, Ineke J; Navis, Gerjan; van der Meer, Peter; Bakker, Stephan J L; Gaillard, Carlo A J M

    2016-01-01

    Anemia, iron deficiency anemia (IDA) and iron deficiency (ID) are highly prevalent in renal transplant recipients (RTR). Anemia is associated with poor outcome, but the role of ID is unknown. Therefore, we aimed to investigate the association of ID, irrespective of anemia, with all-cause mortality i

  5. Estudos sôbre a anemia produzida em cães por benzoato de estradiol

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    W. O. Cruz

    1944-08-01

    Full Text Available A anemia que se processa em caes quando se administra grandes doses de benzoato de estradiol, nao parece ser produzida por processes conhecidos de destrui?ao intra-organica. Esta substantia paraliza os fenomenos de rege¬nerate hematica, parece interferir por processo desconhecido na fisiologia sanguinea, produz graves lesoes na rede circulatoria que irriga a mucosa do intestino, principalmente jejuno, ocasipnando nesse orgao «extravasamento variavel de sangue, fator seguramente coadjuvante na formação da anemia.The characteristic findings in the pathological picture presented by 60 dogs when administered large doses of estradiol benzoate subcutaneously in an oil vehicle are: thrombocytopenia, aplastic anemia, which follows a brief latent period, intestinal tract haemorrhages, haemorrhagic lesions occurring principally in the mucosa of the jejunum, followed by prostration and death generally within 1 to 3 weeks. Irregular findings are leucocytosis, purpuric skin lesions, visceral haemorrhages and pyoid bone marrow. The total circulating hemoglobin was determined in 9 dogs before and after the anemia was established, thus verifying the total hemoglobin loss. The blood loss through intestinal haemorrhages during the observation period was determined by benzidine test. The quantity of hemoglobin recovered from the feces in the form of hematin varied between 30 and 70% of the total hemoglobin which disappeared from the circulation. In order to ascertain the degree of intra-organic blood destruction the bilirubin eliminated in the urine of dogs with gall-bladder renal type of fis¬tula was determined daily and these values compared with those obtained for normal animals. The blood destruction as measured by this method was practically nil. An attempt was made to determine whether the presence of large quan¬tities of blood in the intestine might exert a paralyzing effect on the regene¬ration of hemoglobin in dogs rendered anemic through

  6. The cardio-renal anemia syndrome

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    Dimković Siniša

    2007-01-01

    Full Text Available Introduction. The problem of anemia in congestive heart failure and chronic kidney disease was thought to be insignificant for a long period of time. Recent investigations pointed out that the problem of anemia should be defined in the context of the cardio-renal anemia syndrome. A positive feedback mechanism indicates that cardio-renal anemia syndrome is due to an interaction between congestive heart failure, chronic renal failure and anemia. The aim of the study was to present the possible pathophysiological mechanisms of this syndrome, epidemiological characteristics and therapeutic results of the former investigations. Results. The results of the retrospective and prospective controlled trails have shown that management of anemia with subcutaneous administration of recombinant human erythropoietin together with intravenous iron infusion for at least 3-6 months lead to: relief of symptoms (improved NYHA functional class; increased left ventricular ejection fraction; reduced cardiovascular morbidity and mortality; reduced number of rehospitalizations; reduced requirements for usual therapeutic agents (especially diuretics; and improved renal function. Conclusion. In patients with heart and kidney disease anemia should be routinely identified and appropriately treated. Subcutaneous recombinant erythropoietin and intravenous iron may significantly improve overall survival and quality of life of these patients. .

  7. [Sideropenic anemia in infants and toddlers].

    Science.gov (United States)

    Jakovljević, G; Votava-Raić, A; Tjesić-Drinković, D; Rajić, L; Femenić-Kes, R; Konja, J; Goluza, I; Bilić, E; Leskovar, V

    2001-01-01

    Iron-deficiency anemia is the most common anemia in infants. In the routine pediatric care this problem is encountered every day. Numerous factors in infancy (low birth weight, rapid growth, insufficient nutrition) are involved in the development of iron-deficiency anemia, and they must be considered when establishing diagnosis, counselling parents, and prescribing oral iron preparations. Data on 119 patients aged up to two years treated in the Division of Gastroenterology and Nutrition, Pediatric Department, University Hospital Centre Zagreb Salata between 1994 and 1999, were analyzed. We were prompted to do so because of great frequency of iron-deficiency anemia as one of associated diagnoses, and unfortunately often the only diagnosis requiring hospitalization. Out of 119 patients with iron-deficiency anemia, nine (7.7%) patients (four premature newborns and three from twin pregnancy) had to receive transfusion of erythrocyte concentrate due to very bad general condition and low red blood count, accompanied by clinical signs of anemic hypoxia. We also analyzed prenatal and perinatal history, socioeconomic living conditions of these children, i.e. their nutrition, and if they had previously received oral iron preparations. Some of the results, such as inadequate alimentation with flour, as well as insufficient prophylaxis of iron deficiency, which were found in most cases of severe anemia, point to the need of paying greater attention to this problem, better parents education, and more adequate screening for iron deficiency anemia.

  8. Iron deficiency anemia in the elderly

    Directory of Open Access Journals (Sweden)

    Indra Kurniawan

    2011-02-01

    Full Text Available The numbers of older people in the world have been growing rapidly. Anemia is the most common hematologic problem encountered in older adults. However, anemia should not be accepted as an inevitable consequence of aging. Anemia in the elderly signifies an underlying disease. Iron Defi ciency Anemia (IDA is being one of the most common causes of anemia in older people. IDA in the elderly is often associated with such non specific symptoms. The diagnosis of IDA is typically based on laboratory results. Hence, the utilization of the various laboratory tests plays an important role for the diagnosis of IDA. The presence of IDA in the elderly is usually related with gastrointestinal disorders. Thus,  gastrointestinal evaluation should be contemplated in all patients with IDA unless there is a history of clinically important non gastrointestinal blood loss. Older people with IDA should have iron supplementation both to correct anemia and to replenish body iron stores. However, the underlying cause should always be treated to prevent further iron loss. (Med J Indones 2011; 20:71-7Keywords: anemia, elderly, gastrointestinal, iron deficiency

  9. Inborn anemias in mice: (Annual report, 1981-1982)

    Energy Technology Data Exchange (ETDEWEB)

    Bernstein, S.E.

    1982-07-19

    Hereditary anemias of mice are the chief objects of investigation, specificially four macrocytic anemias, 3 types of hemolytic anemia, nonhemolytic microcytic anemia, transitory siderocytic anemia, sex-linked iron-transport anemia, the autoimmune hemolytic anemia of NZB mice, an ..cap alpha..-thalassemia and a new hypochromic anemia with hemochromatosis. New types of anemia may be analyzed as new mutations appear. Three new mutations have been identified during the past 18 months. These anemias are studied through characterization of peripheral blood values, determinations of radiosensitivity under a variety of conditions, measurements of iron metabolism and heme synthesis, study of normal and abnormal erythrocyte membrane proteins, histological and biochemical characterization of blood-forming tissue, functional tests of the stem-cell component, examination of responses to erythroid stimuli, and transplantation of tissue and parabiosis between individuals of differently affected genotypes. 31 refs.

  10. Prevalence of anemia in children 1 to 12 years of age: results from a nationwide probabilistic survey in Mexico

    Directory of Open Access Journals (Sweden)

    Villalpando Salvador

    2003-01-01

    Full Text Available OBJECTIVE: To describe the epidemiology and analyze factors associated with iron deficiency anemia in a probabilistic sample of the Encuesta Nacional de Nutrición 1999 (ENN-99 [National Nutritional Survey 1999 (NNS-99]. MATERIAL AND METHODS: The sample included 8 111 children aged 1 to 12 years, and was nationaly representative by rural and urban strata and by four geographical regions. Capillary hemoglobin was measured using a portable photometer (HemoCue. The analysis of the determining factors of anemia was performed by odds ratios derived from a logistic regression model and multiple regression models. RESULTS: The prevalence of anemia was 50% in infants <2 years of age, with no significant differences between urban and rural strata or among regions. It varied between 14 and 22% in 6-11 year-old children and was higher in the South region and among the indigenous children. Dietary intake of iron was 50% of the recommended daily allowance in children <2 years of age, but not in older children. Phytate (»500-800 mg/d and tannin (»19 mg/d intakes were very high in children over 7 years of age. Hemoglobin was positively associated with nutritional status of children (p=0.01, socioeconomic status (p range 0.05-0.001, duration of lactation in children under 2 years of age (p=0.1, and iron and calcium intake (p=0.02, but not with folic acid or vitamin B12 intake. Hemoglobin was negatively associated with maternal education (p=0.01 in older children, but not in those under 2 years of age. CONCLUSIONS: We present evidence of an alarming national epidemic of anemia, particularly marked in children 12 to 24 months of age. The control of anemia should be considered as an urgent national concern given its grave consequences on the physical and mental development of these children and on their long-term health.

  11. Anemia

    Science.gov (United States)

    ... B-12 (meat and dairy), and folic acid (citrus juices, dark green leafy vegetables, legumes, and fortified ... ASH Meeting on Lymphoma Biology ASH Workshop on Genome Editing Publications Blood The Hematologist ASH Clinical News ...

  12. Correlates of anemia in pregnant women

    Directory of Open Access Journals (Sweden)

    Ranjana Singh

    2015-09-01

    Full Text Available Background: Anemia during pregnancy is a global public health challenge facing the world today. Prevalence of anemia in pregnancy in all the age groups is higher in India as compared to other developing countries. Objective: This study is aimed at determining the magnitude and to explore the socio-demographic and other correlates of anemia among pregnant women. Methodology: This descriptive study with cross-sectional design was conducted in a tertiary care hospital. Pregnant who were attending antenatal clinic for a period of one year were comprised the study material. Correlation between variables was analyzed using the chi-square and odd ratio. Results: Three hundred and thirty eight pregnant women were registered for the present study, whose age ranged from 16 to 45 years with a mean age of 26.08 years. Majority (81.95% participants were found to be anemic. It was observed that anemia was more prevalent in pregnant women age groups i.e. 25-29 years and 30+years i.e. 86.67% and 86.21% respectively. Anemia was 82.92% in women were belonging to Hindu and others religion and 82.24% in women having vegetarian diet. Maximum prevalence (83.93% of anemia was observed in women who were booked for antenatal care in the 3rd trimester of pregnancy. The prevalence of anemia is higher (>85% in women having parity two or more, but this association was not statistically significant. Very few (6.21% were found to be severely anemic as compared to women who were moderately anemic (43.19%. Multiple logistic regression analysis of these factors showed that possibility of anemia is less in women who belong to rural area and it is highly significant. Analysis further showed significant association between anemia and type of diet and other factors like women having parity 1 and 4. Conclusion: The prevalence of anemia amongst the pregnant participants was very high. The socio-demographic and obstetrics factors were found to be associated with anemia. To prevent

  13. Prevalence of pernicious anemia in patients with macrocytic anemia and low serum B12

    OpenAIRE

    2014-01-01

    Objective: The current research evaluated the prevalence of pernicious anemia (PA) in patients with macrocytic anemia (high MCV) and low serum B12 in Riyadh. Methods: Blood testing was done in 77 patients (males: 45.5%, females: 54.5%) with macrocytic anemia; 84 patients; (males: 23.8%, females: 76.2%) with low serum B12 and 30 healthy subjects. Complete blood count, differential count, folic acid, vitamin B12, intrinsic factor, gastric parietal cell antibodies and holotranscobalamin II were ...

  14. Immune-mediated hemolytic anemia.

    Science.gov (United States)

    Rosse, Wendell F; Hillmen, Peter; Schreiber, Alan D

    2004-01-01

    Hemolytic anemia due to immune function is one of the major causes of acquired hemolytic anemia. In recent years, as more is known about the immune system, these entities have become better understood and their treatment improved. In this section, we will discuss three areas in which this progress has been apparent. In Section I, Dr. Peter Hillmen outlines the recent findings in the pathogenesis of paroxysmal nocturnal hemoglobinuria (PNH), relating the biochemical defect (the lack of glycosylphosphatidylinositol [GPI]-linked proteins on the cell surface) to the clinical manifestations, particularly hemolysis (and its effects) and thrombosis. He discusses the pathogenesis of the disorder in the face of marrow dysfunction insofar as it is known. His major emphasis is on innovative therapies that are designed to decrease the effectiveness of complement activation, since the lack of cellular modulation of this system is the primary cause of the pathology of the disease. He recounts his considerable experience with a humanized monoclonal antibody against C5, which has a remarkable effect in controlling the manifestations of the disease. Other means of controlling the action of complement include replacing the missing modulatory proteins on the cell surface; these studies are not as developed as the former agent. In Section II, Dr. Alan Schreiber describes the biochemistry, genetics, and function of the Fc gamma receptors and their role in the pathobiology of autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura due to IgG antibodies. He outlines the complex varieties of these molecules, showing how they vary in genetic origin and in function. These variations can be related to three-dimensional topography, which is known in some detail. Liganding IgG results in the transduction of a signal through the tyrosine-based activation motif and Syk signaling. The role of these receptors in the pathogenesis of hematological diseases due to IgG antibodies is

  15. [A simple algorithm for anemia].

    Science.gov (United States)

    Egyed, Miklós

    2014-03-09

    The author presents a novel algorithm for anaemia based on the erythrocyte haemoglobin content. The scheme is based on the aberrations of erythropoiesis and not on the pathophysiology of anaemia. The hemoglobin content of one erytrocyte is between 28-35 picogram. Any disturbance in hemoglobin synthesis can lead to a lower than 28 picogram hemoglobin content of the erythrocyte which will lead to hypochromic anaemia. In contrary, disturbances of nucleic acid metabolism will result in a hemoglobin content greater than 36 picogram, and this will result in hyperchromic anaemia. Normochromic anemia, characterised by hemoglobin content of erythrocytes between 28 and 35 picogram, is the result of alteration in the proliferation of erythropoeisis. Based on these three categories of anaemia, a unique system can be constructed, which can be used as a model for basic laboratory investigations and work-up of anaemic patients.

  16. Sideroblastic anemias: variations on imprecision in diagnostic criteria, proposal for an extended classification of sideroblastic anemias.

    Science.gov (United States)

    Koc, S; Harris, J W

    1998-01-01

    Sideroblastic anemias are caused by a diversity of hereditary, congenital, or acquired disorders. Criteria used in describing sideroblastic anemias vary widely among standard medical textbooks and even so have been imprecisely applied in the literature. Recent discoveries concerning the basic pathophysiologic mechanisms involving the molecular biology of nuclear and mitochondrial DNA, erythroid ALA synthase (ALAS-2), and iron transport have made the classification of sideroblastic anemias very complex. We recommend a more precise evaluation and documentation of the components that characterize the sideroblastic abnormality and propose an extended classification of the sideroblastic anemias.

  17. Treatment of severe Graves eye disease%严重Graves眼病的治疗

    Institute of Scientific and Technical Information of China (English)

    吕新生

    2000-01-01

    @@ Graves眼病分型 Graves眼病是一种眼眶内的眼外肌和眶后脂肪结缔组织受累的自身免疫性疾病,是导致眼球突出的常见疾病.Hall等将Graves眼病分为Graves病眼型(Graves' ophthalmopathy)和眼型Graves病(ophthalmopathy Graves' disease,orbital Graves' disease).

  18. Anemia ferropriva em crianças de 6 a 12 meses atendidas na rede pública de saúde do município de Viçosa, Minas Gerais Iron deficiency anemia in 6 to 12-month-old infants attended at the public health service of Viçosa, Minas Gerais, Brazil

    Directory of Open Access Journals (Sweden)

    Danielle Góes da SILVA

    2002-09-01

    Full Text Available Este estudo teve como objetivos verificar a prevalência de anemia em lactentes de 6 a 12 meses atendidos na rede pública de saúde do município de Viçosa, MG e analisar alguns possíveis fatores de risco. As informações foram obtidas através de questionário aplicado aos responsáveis pela criança e através da verificação de medidas antropométricas e da dosagem de hemoglobina por hemoglobinômetro portátil. No diagnóstico de anemia, utilizou-se o ponto de corte de 11 g/dL. A prevalência de anemia ferropriva nas 204 crianças estudadas foi 60,8%, e 55,6% dos casos de anemia eram graves. A média da hemoglobina foi 9,28±1,07 nos anêmicos e 12,07±0,89 mg/dL nos não-anêmicos. A baixa escolaridade paterna e a idade materna mostraram associação estatística com a anemia (pThis study aimed at verifying the prevalence of anemia in 6 to 12-month-old infantsattended at the public health service of the city of Viçosa, state of Minas Gerais, and analyzing some possible risk factors. Information was obtained through questionnaire applied to those responsible for the infants and through the verification of the anthropometric measures and the hemoglobin dosage by portable hemoglobinometer. In diagnosing anemia, a 11g/dL cutoff point was used. The prevalence of iron deficiency anemia in a total of 204 infants reached 60.8%, and 55.6% of the cases of anemia were serious. The hemoglobin average was 9.28±1.07 mg/dL in anemic infants, and 12.07± 0.89 mg/dL in non-anemic ones. The father's low school level and the mother's age showed statistical association with anemia (p<0.05. A high prevalence and severity of the anemia was found, emphasizing the need for prevention and control of this disease in the city of Viçosa.

  19. Violencia en la pareja hacia mujeres con transtorno mental grave

    OpenAIRE

    González Cases, Juan Carlos

    2012-01-01

    Este estudio tiene como objetivo principal analizar la prevalencia y características de la violencia de pareja hacia mujeres con un trastorno mental grave. La muestra consta de 142 mujeres mayores de 18 años, que en algún momento de su vida adulta habían tenido una relación de pareja y que estaban en atención en recursos públicos de salud mental de la Comunidad de Madrid. A través de entrevista se aplicaron cuestionarios validados para la medición de violencia psicológica, sexual y física. Ad...

  20. Esclerodermia, tireoidite e miastenia grave: estudo de um caso

    OpenAIRE

    Antonio L. dos Santos Werneck; Tamara Checcacci-Balod; Graça Tuma

    1993-01-01

    Uma paciente de 36 anos com miastenia grave desenvolveu após dois anos intolerância ao frio, o que conduziu ao diagnóstico de tireoidite de Hashimoto. Quatro anos mais tarde apresentou pele espessada nas mãos (esclerodermia limitada). O quadro clínico e os exames complementares encaminharam o diagnóstico para a forma CREST de esclerodermia sistêmica progressiva. Discute-se a dificuldade diagnóstica da esclerodermia, assim como suas síndromes de superposição. Doença de Hashimoto e miastenia gr...

  1. Anemia of Inflammation and Chronic Disease

    Science.gov (United States)

    ... and Prevention website. www.cdc.gov/chronicdisease/overview/index.htm . Updated August 13, 2012. Accessed July 24, 2013. [3] Besarab A, Coyne DW. Iron supplementation to treat anemia in patients with chronic kidney disease. Nature Reviews ...

  2. Iron-Deficiency Anemia and Stroke

    OpenAIRE

    J Gordon Millichap

    2007-01-01

    The prevalence of iron-deficiency anemia (IDA) in young children at the time of stroke and in age-matched healthy controls was compared in a case-control study conducted at the Hospital for Sick Children, Toronto, Canada.

  3. Role of Complement in Autoimmune Hemolytic Anemia.

    Science.gov (United States)

    Berentsen, Sigbjørn

    2015-09-01

    The classification of autoimmune hemolytic anemias and the complement system are reviewed. In autoimmune hemolytic anemia of the warm antibody type, complement-mediated cell lysis is clinically relevant in a proportion of the patients but is hardly essential for hemolysis in most patients. Cold antibody-mediated autoimmune hemolytic anemias (primary cold agglutinin disease, secondary cold agglutinin syndrome and paroxysmal cold hemoglobinuria) are entirely complement-mediated disorders. In cold agglutinin disease, efficient therapies have been developed in order to target the pathogenic B-cell clone, but complement modulation remains promising in some clinical situations. No established therapy exists for secondary cold agglutinin syndrome and paroxysmal cold hemoglobinuria, and the possibility of therapeutic complement inhibition is interesting. Currently, complement modulation is not clinically documented in any autoimmune hemolytic anemia. The most relevant candidate drugs and possible target levels of action are discussed.

  4. [Anemia in obstetrics and gynecological surgery].

    Science.gov (United States)

    Gredilla Díaz, E

    2015-06-01

    Iron deficiency is more common in women due to uterine bleeding, which affects them throughout their fertile life. Additionally, iron needs increase physiologically during pregnancy and breastfeeding. Pregnant women therefore constitute one of the risk groups for iron deficiency. During the postpartum period, iron deficiency is the most common cause of anemia. Longer hospital stays and greater susceptibility to infections are potential consequences of postpartum anemia.

  5. Iron deficiency or anemia of inflammation?

    OpenAIRE

    Nairz, Manfred; Theurl, Igor; Wolf, Dominik; Weiss, Günter

    2016-01-01

    Summary Iron deficiency and immune activation are the two most frequent causes of anemia, both of which are based on disturbances of iron homeostasis. Iron deficiency anemia results from a reduction of the body’s iron content due to blood loss, inadequate dietary iron intake, its malabsorption, or increased iron demand. Immune activation drives a diversion of iron fluxes from the erythropoietic bone marrow, where hemoglobinization takes place, to storage sites, particularly the mononuclear ph...

  6. Is severe visceral leishmaniasis a systemic inflammatory response syndrome? A case control study A leishmaniose visceral grave é uma síndrome da resposta inflamatória sistêmica? Um estudo caso-controle

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Nery Costa

    2010-08-01

    Full Text Available INTRODUCTION: The objective of the study is to identify the main risk factors for death by New World visceral leishmaniasis and establish a coherent pathogenic substrate of severe disease based on clinical findings. METHODS: Seventy-six deceased inpatients and 320 successfully treated inpatients with VL were studied in a case control study. RESULTS: Bacterial infection and bleeding were mutually exclusive events leading to death. Five risk factors were unique for death by bacterial infection (malnutrition, pulmonary rales, severe anemia, severe absolute neutropenia and higher neutrophil count, while another six were unique for death by bleeding (jaundice, severe relative neutropenia, severe thrombocytopenia, liver injury, kidney failure, higher bone marrow parasite load. Bacterial infection, bleeding, severe anemia, diarrhea, dyspnea, edema, jaundice and bone marrow parasite load were the main syndromes of visceral leishmaniasis among successfully treated patients. CONCLUSIONS: The data support the idea that bacterial infections are due to immune paralysis. Broad organ and system involvement is plausibly due to the high production of proinflammatory cytokines, whose actions fit well with visceral leishmaniasis. The syndromes and causative mediators are typical of a slowly developing systemic inflammatory response syndrome.INTRODUÇÃO: O objetivo do estudo foi i dentificar os principais fatores de risco para morte na leishmaniose visceral do Novo Mundo e estabelecer um substrato patogênico baseado nos achados clínicos coerente para doença grave. MÉTODOS: Em um estudo caso-controle, foram estudados 76 pacientes internados que faleceram e 320 pacientes internados tratados com sucesso. RESULTADOS: Infecção bacteriana e sangramento foram eventos que levaram à morte, mutuamente exclusivos. Cinco fatores de risco foram únicos para morte por infecção bacteriana (desnutrição, estertores pulmonares, anemia grave, neutropenia absoluta grave e

  7. Anemia em crianças menores de 3 anos que freqüentam creches públicas em período integral

    Directory of Open Access Journals (Sweden)

    Brunken Gisela S.

    2002-01-01

    Full Text Available Objetivo:estudar a prevalência de anemia em crianças menores de 36 meses de idade, freqüentando creches públicas de Cuiabá, em período integral.Métodos: trata-se de estudo transversal, com o universo de crianças (n=271 menores de 36 meses de idade, presentes nas creches públicas em meados de 1997, avaliadas quanto à concentração de hemoglobina (sangue venoso, analisado no Laboratório Central do Estado e indicadores antropométricos (peso/idade, altura/idade, peso/altura.Resultados: foi encontrada elevada prevalência de anemia (63% e de anemia grave (22,5%. A anemia mostrou-se associada com idade, déficit ponderal e estatural e com tempo de ingresso na creche. A prevalência de desnutrição (< -2 z-score foi de 0,8% de acordo com o índice de peso/altura, 5,0% segundo peso/idade, e 10,3% de inadequação na altura/idade. A proporção de crianças anêmicas foi, portanto, 6 vezes maior do que o déficit de altura e 12 vezes maior que o déficit ponderal. A desnutrição, em geral, não apresentava-se associada com anemia, mas, tomando-se como ponto-de-corte valores extremos de déficits antropométricos (< -2 z-score, seja de altura ou de peso para idade, percebe-se associação com anemia.Conclusões: a elevada prevalência de anemia caracteriza a situação como um grave problema de saúde pública entre os pré-escolares de Cuiabá.

  8. Mouse models of anemia of cancer.

    Directory of Open Access Journals (Sweden)

    Airie Kim

    Full Text Available Anemia of cancer (AC may contribute to cancer-related fatigue and impair quality of life. Improved understanding of the pathogenesis of AC could facilitate better treatment, but animal models to study AC are lacking. We characterized four syngeneic C57BL/6 mouse cancers that cause AC. Mice with two different rapidly-growing metastatic lung cancers developed the characteristic findings of anemia of inflammation (AI, with dramatically different degrees of anemia. Mice with rapidly-growing metastatic melanoma also developed a severe anemia by 14 days, with hematologic and inflammatory parameters similar to AI. Mice with a slow-growing peritoneal ovarian cancer developed an iron-deficiency anemia, likely secondary to chronically impaired nutrition and bleeding into the peritoneal cavity. Of the four models, hepcidin mRNA levels were increased only in the milder lung cancer model. Unlike in our model of systemic inflammation induced by heat-killed Brucella abortus, ablation of hepcidin in the ovarian cancer and the milder lung cancer mouse models did not affect the severity of anemia. Hepcidin-independent mechanisms play an important role in these murine models of AC.

  9. An Approach to Iron-Deficiency Anemia

    Directory of Open Access Journals (Sweden)

    Imran Rasul

    2001-01-01

    Full Text Available Iron-deficiency anemia is a common reason for referral to a gastroenterologist. In adult men and postmenopausal women, gastrointestinal tract pathology is often the cause of iron-deficiency anemia, so patients are frequently referred for endoscopic evaluation. Endoscopy may be costly and at times difficult for the patient. Therefore, physicians need to know what lesions can be identified reliably and, more importantly, the importance of ruling out life-threatening conditions such as occult malignancy. Over the past decade, a number of prospective studies have been completed that examined the yield of endoscopy in the investigation of iron-deficiency anemia. The present article provides a broad overview of iron-deficiency anemia, with particular emphasis on hematological diagnosis, etiology, the use of endoscopy in identifying lesions and iron-repletion therapy. Other clinical scenarios, including assessment of patients on anti-inflammatory or anticoagulation therapy and patients with bleeding of obscure origin, are also addressed. The present article provides a diagnostic algorithm to iron-deficiency anemia, which describes a more systematic manner in which to approach iron-deficiency anemia.

  10. Myocardial disease,anemia and heart failure

    Institute of Scientific and Technical Information of China (English)

    Donald S Silverberg; Dov Wexler; Adrian Iaina; Doron Schwartz

    2005-01-01

    Abstract Many patients with congestive heart failure (CHF) fail to respond to maximal CHF therapy and progress to end stage CHF with many hospitalizations, very poor quality of life, end stage renal failure, or die of cardiovascular complications within a short time. One factor that has generally been ignored in many of these patients is the fact that they are often anemic.The anemia is due mainly to renal failure but also to the inhibitory effects of cytokines on the bone marrow. Anemia itself may further worsen the cardiac function and make the patients resistant to standard CHF therapies. Indeed anemia has been associated with increased severity of CHF, increased hospitalization, worse cardiac function and functional class, higher doses of diuretics,worsening of renal function and reduced quality of life. In both controlled and uncontrolled studies the correction of the anemia with erythropoietin (EPO) and oral or Ⅳ iron is associated with improvement in all these parameters. EPO itself may also play a direct role in improving the heart unrelated to the improvement of the anemia. Anemia may also play a role in the worsening of coronary heart disease even without CHF.

  11. Mitochondrial iron metabolism and sideroblastic anemia.

    Science.gov (United States)

    Sheftel, Alex D; Richardson, Des R; Prchal, Josef; Ponka, Prem

    2009-01-01

    Sideroblastic anemias are a heterogeneous group of disorders, characterized by mitochondrial iron overload in developing red blood cells. The unifying characteristic of all sideroblastic anemias is the ring sideroblast, which is a pathological erythroid precursor containing excessive deposits of non-heme iron in mitochondria with perinuclear distribution creating a ring appearance. Sideroblastic anemias may be hereditary or acquired. Hereditary sideroblastic anemias are caused by defects in genes present on the X chromosome (mutations in the ALAS2, ABCB7, or GRLX5 gene), genes on autosomal chromosomes, or mitochondrial genes. Acquired sideroblastic anemias are either primary (refractory anemia with ring sideroblasts, RARS, representing one subtype of the myelodysplastic syndrome) or secondary due to some drugs, toxins, copper deficiency, or chronic neoplastic disease. The pathogenesis of mitochondrial iron loading in developing erythroblasts is diverse. Ring sideroblasts can develop as a result of a heme synthesis defect in erythroblasts (ALAS2 mutations), a defect in iron-sulfur cluster assembly, iron-sulfur protein precursor release from mitochondria (ABCB7 mutations), or by a defect in intracellular iron metabolism in erythroid cells (e.g. RARS).

  12. Iron deficiency anemia in celiac disease.

    Science.gov (United States)

    Freeman, Hugh James

    2015-08-21

    Iron is an important micronutrient that may be depleted in celiac disease. Iron deficiency and anemia may complicate well-established celiac disease, but may also be the presenting clinical feature in the absence of diarrhea or weight loss. If iron deficiency anemia occurs, it should be thoroughly evaluated, even if celiac disease has been defined since other superimposed causes of iron deficiency anemia may be present. Most often, impaired duodenal mucosal uptake of iron is evident since surface absorptive area in the duodenum is reduced, in large part, because celiac disease is an immune-mediated disorder largely focused in the proximal small intestinal mucosa. Some studies have also suggested that blood loss may occur in celiac disease, sometimes from superimposed small intestinal disorders, including ulceration or neoplastic diseases, particularly lymphoma. In addition, other associated gastric or colonic disorders may be responsible for blood loss. Rarely, an immune-mediated hemolytic disorder with increased urine iron loss may occur that may respond to a gluten-free diet. Reduced expression of different regulatory proteins critical in iron uptake has also been defined in the presence and absence of anemia. Finally, other rare causes of microcytic anemia may occur in celiac disease, including a sideroblastic form of anemia reported to have responded to a gluten-free diet.

  13. Iron deficiency anemia in celiac disease

    Science.gov (United States)

    Freeman, Hugh James

    2015-01-01

    Iron is an important micronutrient that may be depleted in celiac disease. Iron deficiency and anemia may complicate well-established celiac disease, but may also be the presenting clinical feature in the absence of diarrhea or weight loss. If iron deficiency anemia occurs, it should be thoroughly evaluated, even if celiac disease has been defined since other superimposed causes of iron deficiency anemia may be present. Most often, impaired duodenal mucosal uptake of iron is evident since surface absorptive area in the duodenum is reduced, in large part, because celiac disease is an immune-mediated disorder largely focused in the proximal small intestinal mucosa. Some studies have also suggested that blood loss may occur in celiac disease, sometimes from superimposed small intestinal disorders, including ulceration or neoplastic diseases, particularly lymphoma. In addition, other associated gastric or colonic disorders may be responsible for blood loss. Rarely, an immune-mediated hemolytic disorder with increased urine iron loss may occur that may respond to a gluten-free diet. Reduced expression of different regulatory proteins critical in iron uptake has also been defined in the presence and absence of anemia. Finally, other rare causes of microcytic anemia may occur in celiac disease, including a sideroblastic form of anemia reported to have responded to a gluten-free diet. PMID:26309349

  14. Cardio-renal-anemia syndrome: A report of three cases

    Directory of Open Access Journals (Sweden)

    U H Okafor

    2012-01-01

    Full Text Available Patients with chronic kidney diseases (CKDs and cardiovascular diseases (CVDs present with various degree of anemia. Anemia has been associated with poor outcome in patients with CKD and CVD. CVD is the commonest cause of morbidity and mortality in patients with CKD. CKD causes anemia and CVD, and this rapidly deteriorates when anemia is not corrected. This triad of CVD, CKD, and anemia has been termed cardio-renal-anemia syndrome. The objec-tive of this study is to highlight the importance of cardio-renal-anemia syndrome, their relation-ship, and management. Three patients with various stages of CKD who presented with anemia and cardiovascular abnormalities are reported. The patients responded well to various interventional measures, with improvement in their clinical and laboratory parameters. Cardio-renal-anemia syndrome is an entity that should be identified. Early and appropriate intervention leads to better outcome.

  15. ANEMIA IN INFLAMMATORY BOWEL DISEASE MORE THAN AN EXTRAINTESTINAL COMPLICATION.

    Science.gov (United States)

    Nemeş, Roxana Maria; Pop, Corina Silvia; Calagiu, Dorina; Dobrin, Denisa; Chetroiu, Diana; Jantea, Petruta; Postolache, Paraschiva

    2016-01-01

    The most common hematologic complication of inflammatory bowel disease (IBD)--ulcerative colitis and Crohn's Disease is anemia. Anemia in patients with IBD may be a result of iron, vitamin B12 or folate deficiency; anemia of chronic disease and hemolytic anemia are other causes in these patients. Factors contributing to the development of anemia include chronic gastrointestinal blood loss, vitamin B12 malabsorption secondary to terminal ileitis, folate deficiency as a result of sulfasalazine therapy. Approximately 30% of patients with IBD have hemoglobin levels below 12 g/dl. The risk of developing anemia relates to disease activity, given that blood loss and inflammatory anemia are triggered by intestinal inflammation. In the management strategy of IBD patients with anemia it is important to distinguish between the different types of anemia in order to decide an appropriate manner of treatment.

  16. Craniotomia descompressiva bifrontal no tratamento do edema cerebral grave

    Directory of Open Access Journals (Sweden)

    Walter C. Pereira

    1977-06-01

    Full Text Available São apresentados os resultados obtidos com craniotomia descompressiva bifrontal ampla em 12 doentes com edema cerebral grave e irreversível com os métodos convencionais de tratamento, provocado em 10 por traumatismo crânio-encefálico. Todos os pacientes apresentavam quadro neurológico muito grave, com sinais de comprometimento do tronco cerebral superior. Angiografia caro-tídea bilateral foi praticada sistematicamente, tanto no pré como no pós-operatório, constituindo-se no fator decisivo para a indicação cirúrgica. Seis (50% dos doentes sobreviveram, apresentando 5 (41,6% recuperação neurológica e psíquica praticamente totais. Levando em conta estes resultados, consideramos esta técnica cirúrgica o melhor recurso de tratamento em tais casos, máxime se indicada precocemente. São necessários, contudo, cuidados pós-operatórios especiais com estes pacientes, que devem, sempre que possível, ser mantidos em unidade de terapia intensiva, em virtude da grande incidência de complicações, mormente respiratórias.

  17. Clinical update: treatment of hyperthyroidism in Graves' ophthalmopathy.

    Science.gov (United States)

    Azzam, Ibrahim; Tordjman, Karen

    2010-03-01

    The presence of thyroid eye disease (TED) may influence the treatment of hyperthyroidism in patients with Graves' disease. Moreover, treatment of hyperthyroidism may affect the course of Graves' ophthalmopathy (GO). We review the literature and summarise recent knowledge about the impact of treatment modality for hyperthyroidism in GO. Anti-thyroid drugs (ATDs) remain the simplest and safest way to treat hyperthyroidism in patients with GO, but they are associated with a high relapse rate of hyperthyroidism and they have no effect on the course of GO. Radioactive iodine (RAI) treatment may be associated with exacerbation of GO especially in high risk patients, when glucocorticoid prophylaxis may be indicated. Large prospective trials are still lacking to define the exact effect of RAI on the course of GO, particularly in relation to other known risk factors. Likewise, clear guidelines for prophylactic glucocorticoid therapy are needed. RAI should be cautiously used in patients with more severe ophthalmopathy and concomitant I.V glucocorticoids should be considered. Thyroid surgery, whether total or subtotal thyroidectomy, has no effect on the course of ophthalmopathy. However, total thyroid ablation that combines surgery with radioactive iodine, as a means of achieving thyroid antigen disappearance, is increasingly gaining attention for the treatment of patients with GO, especially those undergoing thyroid surgery, but also for those with severe unresponsive ophthalmopathy. Studies supporting this approach are awaited.

  18. Hyperthyroidism in Graves disease. Current trends in management and diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Haibach, H.

    1976-06-01

    The radioimmunoassay for T/sub 3/ is now widely available and is a useful diagnostic tool for hyperthyroidism, especially in T/sub 3/-thyrotoxicosis. It is an essential tool in the management of hyperthyroidism that persists after treatment with normal T/sub 4/ serum levels or, in euthyroid cases, with low T/sub 4/ serum levels. In these conditions, it reflects the metabolic state more accurately than serum levels of T/sub 4/. A promising new test is the response of radioimmunoassayable TSH to protirelin relin (TRH) administration. An absent response indicates pituitary suppression and thyroid autonomy as seen in frank hyperthyroidism or euthyroid Graves disease, treated or untreated. It is safer and quicker than the conventional T/sub 3/ suppression test of thyroid radioactive iodine uptake and may replace it at least partly in the future. The recently recognized sharp decline in the remission rate of patients subjected to thyroid drug therapy in the last decade has made this treatment much less efficacious. By necessity, it will probably lead to greater reliance on treatment with radioactive iodine in the majority of the patients with the hyperthyroidism of Graves disease.

  19. Fanconi Anemia — Case Report of Rare Aplastic Anemia at Child

    Directory of Open Access Journals (Sweden)

    Deaconu Alina

    2014-06-01

    Full Text Available Introduction: Fanconi anemia is an autosomal recessive disease characterized by congenital abnormalities, defective haematopoiesis, and a high risk of developing acute myeloid leukaemia, myelodysplastic syndrome and cancers. FA was first described in 1927 by the Swiss pediatrician Guido Fanconi. The diagnosis is based on morphological abnormalities, hematologic abnormalities (pancytopenia, macrocytic anemia and progressive bone marrow failure and genetic tests (cariograma.

  20. Iron, Anemia, and Iron Deficiency Anemia among Young Children in the United States

    Science.gov (United States)

    Gupta, Priya M.; Perrine, Cria G.; Mei, Zuguo; Scanlon, Kelley S.

    2016-01-01

    Iron deficiency and anemia are associated with impaired neurocognitive development and immune function in young children. Total body iron, calculated from serum ferritin and soluble transferrin receptor concentrations, and hemoglobin allow for monitoring of the iron and anemia status of children in the United States. The purpose of this analysis is to describe the prevalence of iron deficiency (ID), anemia, and iron deficiency anemia (IDA) among children 1–5 years using data from the 2007–2010 National Health and Nutrition Examination Survey (NHANES). Prevalence of ID, anemia, and IDA among children 1–5 years was 7.1% (5.5, 8.7), 3.2% (2.0, 4.3), and 1.1% (0.6, 1.7), respectively. The prevalence of both ID and anemia were higher among children 1–2 years (p < 0.05). In addition, 50% of anemic children 1–2 years were iron deficient. This analysis provides an update on the prevalence of ID, anemia, and IDA for a representative sample of US children. Our results suggest little change in these indicators over the past decade. Monitoring of ID and anemia is critical and prevention of ID in early childhood should remain a public health priority. PMID:27249004

  1. Fanconi's Anemia Effect or Sickle Cell Anemia Effect: That is the Question.

    Science.gov (United States)

    Unal, Sule; Chui, David H K; Gumruk, Fatma

    2015-01-01

    A 16-year-old boy who was diagnosed to have sickle cell anemia was referred to our center. The parental consanguinity, growth retardation and dysmorphic features prompted a search for possible Fanconi's Anemia (FA). The diepoxybutane (DEB) test was positive, confirming FA. The interaction of both diseases might account for his relatively mild phenotype in terms of both sickle cell anemia (or Hb S, HBB: c.20A > T) and FA. The high Hb F level that might be related to concomitant FA, may have caused a milder phenotype of sickle cell anemia, whereas nitric oxide (NO) depletion as a consequence of sickle cell anemia, may have caused a delay in the bone marrow failure of FA.

  2. The 2016 European Thyroid Association/European Group on Graves' Orbitopathy Guidelines for the Management of Graves' Orbitopathy.

    Science.gov (United States)

    Bartalena, Luigi; Baldeschi, Lelio; Boboridis, Kostas; Eckstein, Anja; Kahaly, George J; Marcocci, Claudio; Perros, Petros; Salvi, Mario; Wiersinga, Wilmar M

    2016-03-01

    Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease, though severe forms are rare. Management of GO is often suboptimal, largely because available treatments do not target pathogenic mechanisms of the disease. Treatment should rely on a thorough assessment of the activity and severity of GO and its impact on the patient's quality of life. Local measures (artificial tears, ointments and dark glasses) and control of risk factors for progression (smoking and thyroid dysfunction) are recommended for all patients. In mild GO, a watchful strategy is usually sufficient, but a 6-month course of selenium supplementation is effective in improving mild manifestations and preventing progression to more severe forms. High-dose glucocorticoids (GCs), preferably via the intravenous route, are the first line of treatment for moderate-to-severe and active GO. The optimal cumulative dose appears to be 4.5-5 g of methylprednisolone, but higher doses (up to 8 g) can be used for more severe forms. Shared decision-making is recommended for selecting second-line treatments, including a second course of intravenous GCs, oral GCs combined with orbital radiotherapy or cyclosporine, rituximab or watchful waiting. Rehabilitative treatment (orbital decompression surgery, squint surgery or eyelid surgery) is needed in the majority of patients when GO has been conservatively managed and inactivated by immunosuppressive treatment.

  3. Anemia in patients with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Dimković Nada

    2007-01-01

    Full Text Available Introduction: Anemia is more common and pronounced in patients with diabetic, than in patients with non-diabetic renal disease. While several factors contribute to its pathogenesis, the failure of the kidney to increase erythropoietin in response to falling hemoglobin appears to be the dominant factor. The most frequent complications of anemia in diabetic patients include decreased quality of life and work capacity and increased cardiovascular morbidity and mortality. Material and Methods: This cross-sectional multicenter study included a total of 539 patients with type I (~20% and type II diabetes (~80% classified into five stages according to the glomerular filtration rate. Results Diabetic nephropathy appears in stage I, and progresses in all patients to the stage V (p=0.045. The presence of anemia progressively increased from stage I to stage V (from 60% to 100%, p=0.008. Only 62% of patients with anemia were treated (mainly with iron and only 3.4% received erythropoietin treatment. Hypertension was present in 90% of patients in stage I and in 100% of patients in stage V nephropathy. The presence of heart failure increased from 0% (stage I to 51% (stage IV, p=0.03. Around 62% of patients were referred to a nephrologist, and according to the logistic regression model, renal failure and presence of anemia were significant predictors of patients' referral to nephrologist. Conclusion: In a primary care setting, anemia is a frequent finding, even in the very beginning of diabetic renal disease. Currently available guidelines for management of anemia are not followed; this may explain high percentage of patients with heart failure in pre-dialysis stage. Early referral to a nephrologist and regular follow-up by an endocrinologist and cardiologist are the best way for the prevention of diabetic complications and comorbidity.

  4. Aspectos moleculares da anemia falciforme

    Directory of Open Access Journals (Sweden)

    Galiza Neto Gentil Claudino de

    2003-01-01

    Full Text Available No presente artigo abordaram-se vários aspectos relacionados à natureza molecular da anemia falciforme, desordem hematológica de caráter hereditário que acomete expressivo número de indivíduos em várias regiões do mundo. As pesquisas realizadas em torno desta patologia da hemácia, ao longo de quase um século, a partir de 1910, cooperaram para a criação de um novo e importante segmento da ciência, denominado biologia molecular. A descoberta dos polimorfismos da mutação (GAT->GTG no gene que codifica a cadeia beta da hemoglobina, originando diferentes haplótipos da doença, permitiu um melhor e mais amplo conhecimento em torno da heterogeneidade clínica nos pacientes falcêmicos. Analisando a hemoglobina na sua estrutura normal e mutante, sua produção e evolução, pode-se ter um entendimento mais completo da fisiopatologia desta doença e da sua complexidade clínica.

  5. 75 FR 12377 - Native American Graves Protection and Repatriation Act Regulations-Disposition of Culturally...

    Science.gov (United States)

    2010-03-15

    ... Interior 43 CFR Part 10 Native American Graves Protection and Repatriation Act Regulations-- Disposition of... Part 10 RIN 1024-AD68 Native American Graves Protection and Repatriation Act Regulations--Disposition... rule with request for comments. SUMMARY: This final rule implements the Native American...

  6. 78 FR 27078 - Native American Graves Protection and Repatriation Act Regulations

    Science.gov (United States)

    2013-05-09

    ... Government Relations with Native American Tribal Governments'' (59 FR 22951, April 29, 1994); Executive Order... Office of the Secretary of the Interior 43 CFR Part 10 RIN 1024-AD99 Native American Graves Protection.... SUMMARY: This final rule revises regulations implementing the Native American Graves Protection...

  7. 76 FR 69282 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Science.gov (United States)

    2011-11-08

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native American Graves Protection and... effect the agreed-upon disposition of Native American human remains determined to be...

  8. 75 FR 9429 - Native American Graves Protection and Repatriation Review Committee: Meetings

    Science.gov (United States)

    2010-03-02

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meetings AGENCY... Advisory Committee Act, 5 U.S.C. Appendix (1988), of three meetings of the Native American Graves... agreement, of Native American human remains determined to be culturally unidentifiable; and presentations...

  9. 77 FR 7180 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Science.gov (United States)

    2012-02-10

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Advisory Committee Act, 5 U.S.C. Appendix (1988), of two meetings of the Native American Graves Protection... of Native American human remains determined to be culturally unidentifiable; presentations by...

  10. 77 FR 53228 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Science.gov (United States)

    2012-08-31

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native American Graves..., as required by law, in order to effect the agreed-upon disposition of Native American human...

  11. Premature hair greying may predict reduced bone mineral density in Graves' disease.

    LENUS (Irish Health Repository)

    Leary, A C

    2012-02-03

    BACKGROUND: Premature hair greying has been associated with low bone mineral density (BMD), and it may be more frequent in Graves\\' disease. AIMS: To determine whether premature greying is associated with reduced BMD in women with Graves\\' disease and in control women, and to examine whether premature greying is more common in Graves\\' disease. METHODS: Premature greying (> 50% grey by 40 years) and BMD were determined in 44 women with a history of Graves\\' disease and 133 female controls referred for routine BMD measurement. Exclusion criteria included diseases or drugs known to affect BMD. RESULTS: Mean Z and T scores at the lumbar spine were significantly lower (P < 0.04) in subjects with premature greying than in those not prematurely grey among women with Graves\\' disease, but not among control women. Multiple regression confirmed this difference between Graves\\' and control women (P = 0.041). There were no differences at other measurement sites. Of Graves\\' patients, 36% were prematurely grey compared with 25% of control women (P = 0.14). CONCLUSION: Premature greying may be a weak marker for reduced BMD in women with a history of Graves\\' disease, but it is not a marker in normal women.

  12. STUDY OF RBC HISTOGRAM IN VARIOUS ANEMIAS

    Directory of Open Access Journals (Sweden)

    Sandhya

    2014-12-01

    Full Text Available Over the past few years complete blood count (CBC by the automated hematology analyzers and microscopic examination of peripheral smear have complemented each other to provide a comprehensive report on patients’ blood sample. Numerous classifications for anemia have been established and the important parameters involved in the classifications are Hb, HCT, MCV, RDW, MCH, MCHC, reticulocytes and IRF. Many of these values are obtained only by automated heamatology analyzers. One histogram graph is worth 1000 numbers. A large collection of data, displayed as a visual image, can convey information with far more impact than the numbers alone. In hematology, these data take on several forms, one of which is the RBC histogram. Therefore a study of variation in RBC histograms in various anemias. Many times it is seen that histogram patterns show varying features when a simultaneous peripheral smear is reported. It is also seen that there are many limitations when manual peripheral smears reporting is done for example: peripheral smear reports are subjective, labor intensive and statistically unreliable. However microscopic peripheral smear examination also has their advantages. This study intends to create a guide to laboratory personnel and clinicians with sufficient accuracy to presumptively diagnose morphological classes of anemia directly from the automated hematology cell counter forms and correlate with morphological features of peripheral smear examination. OBJECTIVE: 1. The objective of the study is to know the utility and advantage of red cell histograms. 2. To study the automated histogram patterns along with morphological features noticed on peripheral smear examination. SOURCE OF DATA: All anemic patients from Central Diagnostic Laboratory of A.J.IMS. METHOD OF COLLECTION OF DATA: A total of about 100 patients were included in the study. Complete blood count including HB, TC, DC, Platelet count hematocrit value, RBC indices was obtained

  13. Padrao epidemiologico das oclusopatias muito graves em adolescentes brasileiros

    Directory of Open Access Journals (Sweden)

    Karen Glazer Peres

    2013-12-01

    Full Text Available OBJETIVO: Descrever o padrão de distribuição das oclusopatias em adolescentes brasileiros e identificar fatores associados a esse agravo bucal. MÉTODOS: Foram analisados dados de 7.328 e 5.445 adolescentes de 12 e 15-19 anos, respectivamente, participantes da Pesquisa Nacional de Saúde Bucal (SBBrasil 2010. O desfecho foi oclusopatia muito grave segundo o índice de estética dental. As variáveis de exposição foram sexo, cor da pele, renda familiar mensal, número de bens, aglomeração no domicílio, cárie não tratada, perda dentária, uso, frequência e motivo da consulta odontológica. Foram conduzidas análises de regressão logística considerando a complexidade do desenho amostral, com base em modelo hierarquizado. RESULTADOS: Prevalência de oclusopatia muito grave foi observada em 6,5% e 9,1% nos jovens de 12 e 15-19 anos, respectivamente. Após análise ajustada, a chance do desfecho foi 1,59 (IC95% 1,08;2,34 vez maior nos pardos e pretos em relação aos brancos e 2,66 (IC95% 1,26;5,63 vezes maior dentre aqueles com perda de pelo menos um primeiro molar aos 12 anos. Jovens de 15-19 anos cuja renda familiar mensal foi de até R$ 1.500,00 (OR 2,69 [IC95% 1,62;4,47] e aqueles que consultaram o dentista para tratamento (OR 2,59 [IC95% 2,55;4,34] apresentaram maior chance de oclusopatia muito grave quando comparados aos de maior renda e que procuraram o dentista para prevenção. CONCLUSÕES: A distribuição das oclusopatias em adolescentes brasileiros segue o padrão de iniquidade social de outros agravos à saúde. Essas informações são úteis para a formulação de critérios relacionados tanto com a distribuição e provisão de recursos quanto com as prioridades de tratamento ortodôntico fundamentados no princípio da equidade da atenção à saúde bucal.

  14. HEMOLYTIC ANEMIA IMUNNE-MEDIATED IN DOGS

    Directory of Open Access Journals (Sweden)

    R. C. Castilho

    2016-11-01

    Full Text Available Due to the reduction in the number of red blood cells, caused by the immune system, the immune-mediated hemolytic anemia (IMHA is the most common disease among the hemolytic anemias and occurs more frequently in dogs (Nelson & Couto, 2010, wherein the most affected breeds are Cocker Spaniel, Poodle, Doberman and Collie (ETTINGER; FELDMAN 2004; THRALL et al 2007.. There is no pathognomonic sign for the diagnosis of the immune-mediated hemolytic anemia; however, laboratory findings show regenerative anemia, spherocytosis, positive results in Coombs' test and rarely, monocytes with hemosiderin or erythrocytes phagocytosis, but even with these findings, the primary and secondary IMHA can not be differentiate from each other. Differentiation can only be achieved when there is a deep investigation into the cause of the anemia. The IMHA therapeutics starts with the support treatment and follows with an immunosuppressive therapy. In relation to IMHA Mortality rates, the numbers range from 25% to 50% (Thrall, 2007, or above 70% (CARR; Panciera; Kidd, 2002.

  15. Hereditary sideroblastic anemias: pathophysiology, diagnosis, and treatment.

    Science.gov (United States)

    Camaschella, Clara

    2009-10-01

    Inherited sideroblastic anemia comprises several rare anemias due to heterogeneous genetic lesions, all characterized by the presence of ringed sideroblasts in the bone marrow. This morphological aspect reflects abnormal mitochondrial iron utilization by the erythroid precursors. The most common X-linked sideroblastic anemia (XLSA), due to mutations of the first enzyme of the heme synthetic pathway, delta-aminolevulinic acid synthase 2 (ALAS2), has linked heme deficiency to mitochondrial iron accumulation. The identification of other genes, such as adenosine triphosphate (ATP) binding cassette B7 (ABCB7) and glutaredoxin 5 (GLRX5), has strengthened the role of iron sulfur cluster biogenesis in sideroblast formation and revealed a complex interplay between pathways of mitochondrial iron utilization and cytosolic iron sensing by the iron-regulatory proteins (IRPs). As recently occurred with the discovery of the SLC25A38-related sideroblastic anemia, the identification of the genes responsible for as yet uncharacterized forms will provide further insights into mitochondrial iron metabolism of erythroid cells and the pathophysiology of sideroblastic anemia.

  16. Reticulocyte maturity indices in iron deficiency anemia

    Directory of Open Access Journals (Sweden)

    Muriel Wollmann

    2014-01-01

    Full Text Available Objective: The aim of this study was to analyze the reticulocyte maturity indices (low, medium, and high fluorescence ratios in iron deficient 1- to 6-year-old children, and identify the prevalence of iron deficiency anemia in this population. Methods: The present study included 39 subjects, divided into two groups: control subjects (n = 33, and subjects with iron deficiency anemia (n = 6. The results were analyzed by Student's t-test for comparison of means. Differences were considered significant when two-tailed p-value < 0.05. Results: Subjects with iron deficiency anemia presented increases in the proportion of mean (10.3 ± 4.7% vs. 6.0 ± 3.4%; p-value = 0.003, and high fluorescence reticulocytes (2.3 ± 0.87% vs. 0.9 ± 0.9%; p-value = 0.03 compared to the control group. The prevalence of anemia in this population was 15% (n = 6. Conclusion: The indices related to immaturity of reticulocytes are higher in the presence of iron deficiency, thus demonstrating a deficiency in the raw material to form hemoglobin and are, therefore, possible early markers of iron deficiency and anemia. We emphasize the need to standardize these indices for use in clinical practice and lab test results.

  17. Anemia among school children in eastern Nepal.

    Science.gov (United States)

    Khatiwada, Saroj; Gelal, Basanta; Gautam, Sharad; Tamang, Man Kumar; Shakya, Prem Raj; Lamsal, Madhab; Baral, Nirmal

    2015-06-01

    Anemia is one of the most common public health problems in developing countries like Nepal. This study was done to find the prevalence of anemia among the children aged 4-13 years in eastern Nepal. A cross-sectional study was conducted in 2012 in four districts (Morang, Udayapur, Bhojpur and Ilam) of eastern Nepal to find the prevalence of anemia among the school children of eastern Nepal. Children aged 4-13 years were selected randomly from different schools of above districts and 618 venous blood samples were collected. Hemoglobin level was estimated by using cyanmethemoglobin method. The mean hemoglobin level was 12.2 ± 1.82 gm/dl. About 37.9% (n = 234) children were found anemic. Anemia prevalence was 42.4% (n = 78), 31.6% (n = 60), 45.3% (n = 48) and 34.8% (n = 48) among school children of Morang, Udayapur, Bhojpur and Ilam district, respectively. The study finds anemia as a significant health problem among the school children of eastern Nepal.

  18. Iron-refractory iron deficiency anemia.

    Science.gov (United States)

    Yılmaz Keskin, Ebru; Yenicesu, İdil

    2015-03-05

    Iron is essential for life because it is indispensable for several biological reactions, such as oxygen transport, DNA synthesis, and cell proliferation. Over the past few years, our understanding of iron metabolism and its regulation has changed dramatically. New disorders of iron metabolism have emerged, and the role of iron as a cofactor in other disorders has begun to be recognized. The study of genetic conditions such as hemochromatosis and iron-refractory iron deficiency anemia (IRIDA) has provided crucial insights into the molecular mechanisms controlling iron homeostasis. In the future, these advances may be exploited to improve treatment of both genetic and acquired iron disorders. IRIDA is caused by mutations in TMPRSS6, the gene encoding matriptase-2, which downregulates hepcidin expression under conditions of iron deficiency. The typical features of this disorder are hypochromic, microcytic anemia with a very low mean corpuscular volume of erythrocytes, low transferrin saturation, no (or inadequate) response to oral iron, and only a partial response to parenteral iron. In contrast to classic iron deficiency anemia, serum ferritin levels are usually low-normal, and serum or urinary hepcidin levels are inappropriately high for the degree of anemia. Although the number of cases reported thus far in the literature does not exceed 100, this disorder is considered the most common of the "atypical" microcytic anemias. The aim of this review is to share the current knowledge on IRIDA and increase awareness in this field.

  19. Iron-Refractory Iron Deficiency Anemia

    Science.gov (United States)

    Yılmaz Keskin, Ebru; Yenicesu, İdil

    2015-01-01

    Iron is essential for life because it is indispensable for several biological reactions, such as oxygen transport, DNA synthesis, and cell proliferation. Over the past few years, our understanding of iron metabolism and its regulation has changed dramatically. New disorders of iron metabolism have emerged, and the role of iron as a cofactor in other disorders has begun to be recognized. The study of genetic conditions such as hemochromatosis and iron-refractory iron deficiency anemia (IRIDA) has provided crucial insights into the molecular mechanisms controlling iron homeostasis. In the future, these advances may be exploited to improve treatment of both genetic and acquired iron disorders. IRIDA is caused by mutations in TMPRSS6, the gene encoding matriptase-2, which downregulates hepcidin expression under conditions of iron deficiency. The typical features of this disorder are hypochromic, microcytic anemia with a very low mean corpuscular volume of erythrocytes, low transferrin saturation, no (or inadequate) response to oral iron, and only a partial response to parenteral iron. In contrast to classic iron deficiency anemia, serum ferritin levels are usually low-normal, and serum or urinary hepcidin levels are inappropriately high for the degree of anemia. Although the number of cases reported thus far in the literature does not exceed 100, this disorder is considered the most common of the “atypical” microcytic anemias. The aim of this review is to share the current knowledge on IRIDA and increase awareness in this field. PMID:25805669

  20. Pulmonary functions in pregnancy complicated with anemia

    Directory of Open Access Journals (Sweden)

    Subhalaxmi Dash

    2014-08-01

    Full Text Available Background: The aim of the present study was to find out the variation of pulmonary function parameters in different trimesters of pregnancy as well as variation according to severity of anemia in each trimester. Methods: The present case control study was carried out in the post-graduate department of obstetrics and gynecology, M.K.C.G. medical college and hospital, Berhampur, during the period from October 2012 to October 2013. This study entitled and ldquo;Pulmonary functions in pregnancy complicated with anemia and rdquo;, embodies the pulmonary functions of 60 anemic pregnant females (study group and 100 healthy pregnant females (control in different trimesters of pregnancy. The pulmonary function parameters, which were studied, are FVC, FEV1, FEV1/FVC, FEF25-75%, PEFR and MVV in both the study and control group. Results: Comparing the variation with advancing gestation in study and control, it was seen that FVC, FEV1, FEV1/FVC and FEF25-75% showed no significant alteration. With increasing severity of anemia compared to controls, FVC, FEV1, PEFR and MVV values reduce significantly. As FEF25-75% is not effort dependent, it shows no significant variation. Conclusion: Thus from this study, it can be concluded that moderate to severe anemia in pregnancy can adversely affect pulmonary functions. Hence nutritional anemia in early pregnancy should be provided with iron supplements in order to prevent adverse obstetric outcomes. [Int J Res Med Sci 2014; 2(4.000: 1431-1437

  1. Doenças da tireoide e miastenia grave

    OpenAIRE

    1984-01-01

    Os autores estudam o comportamento da tireóide em um grupo de 304 pacientes com miastenia grave, constatando 15 casos de tireopatias, sendo 9 de hipertireoidismo, um de hipotireoidismo e 5 de bócio sem alterações da função tireoidiana. Nenhum paciente era proveniente de região de bócio endêmico e não havia bócio familiar. A tireotoxicose, que foi a disfunção mais frequente, foi estudada quanto a sua prevalência em pacientes miastênicos, quanto a sua influência sobre os sintomas da miastenia g...

  2. Changes of Regulatory T Cells in Graves' Disease

    Institute of Scientific and Technical Information of China (English)

    WANG Hongxiang; ZHAO Shi; TANG Xiaoqiong; LI Jingyuan

    2006-01-01

    The immune mechanism of Graves' diseases (GD) and the roles of regulator T cells were investigated. In 32 patients with GD (GD group) and 20 healthy volunteers (control group), flow cytometry was used to detect the proportion of CD4+CD25+ cells, MACS to isolate CD4+ CD25+ cells,RT-PCR to assay the expression of FOXP3, and ELISA to test the level of IL-10, respectively. It was found that there was no significant change in the proportion of CD4+CD25+ T cells between GD group and control group (P>0.05), while secretion of IL-10 and expression of FOXP3 in GD group were lower than control group (P<0.01 and P<0.05, respectively). In conclusion, though the proportion of regulatory T cells of peripheral blood lymphocytes in the patients with GD, the functions of them were significantly weakened, which might be a pathogenic factor in GD.

  3. The story of the only (? megalith grave on Gotland Island

    Directory of Open Access Journals (Sweden)

    Helene Martinsson-Wallin

    2010-12-01

    Full Text Available In this paper, we discuss the easternmost material expression of the Funnel Beaker Culture – a megalith grave on the west coast of Gotland Island in the Baltic Sea. The people who built and used the megalith brought the Neolithic lifestyle to Gotland. The biography of this monument includes two excavations, of which we participated in the latest in 1984. Our osteological analysis confirms that some thirty individuals of both sexes and various ages were buried there. The structure of the monument is that of a rectangular dolmen. This paper discusses the discovery of this specific site, and explores the existence of this type of monument in a Gotland context. Furthermore, is this really the only megalith on Gotland, or are more of these structures yet to be recognised? Finally, one may ask if the Neolithic way of life really was successful on Gotland.

  4. Doença Pariodontal: fator associado à asma grave?

    OpenAIRE

    Marques, Kaliane Rocha Soledade

    2012-01-01

    A periodontite constitui-se uma doença crônica de grande prevalência na população, com repercussões imunológicas em todo o organismo. Estima-se que a periodontite pode influenciar na hiper-resposta inflamatória em indivíduos com asma, por meio de alterações imuno-inflamatórias, além de servirem como fontes de microrganismos para o desenvolvimento de infecções pulmonares. Objetivo: Avaliar a possível associação entre a presença periodontite e a asma grave. Método: Estudo caso-co...

  5. Management plan and delivery of care in Graves' ophthalmopathy patients.

    Science.gov (United States)

    Yang, Morgan; Perros, Petros

    2012-06-01

    Most patients with Graves' orbitopathy have mild disease that requires no or minimal intervention. For the minority of patients with moderate or severe disease, multiple medical and surgical treatments may be required at different stages. It is crucial that such patients are monitored closely and treatments applied with care in the right sequence. Medical treatments should be used as early as possible and only during the active phase of the disease. Rehabilitative surgery is indicated in the inactive phase of the disease and should follow the sequence: surgical decompression followed by eye muscle surgery, followed by lid surgery. Delivery of care in a coordinated fashion that makes use of best available expertise is important and best implemented through a Combined Thyroid Eye clinic.

  6. [The necklace from the 660 grave in Megara Iblea].

    Science.gov (United States)

    Verger, Stéphane

    2011-01-01

    The article analyzes the 660 grave in Megara Iblea, a Greek colony in Sicily, in which a woman has been buried. On her breast a magnificent neckless was found, made of amulets recalling the travel of the sun during the summer solstice. Some objects allude to solar cults (a cock; round pendants), others seem to came from Gallia and Macedonia (summer far West and East), others recall archeological contexts such as tombs in Marvinci, in the Vardar Valley, and allude to relations with female practices of medicine and magic and to female roles characterized by extraordinary powers, due to being descendants of the Sun god. These solar symbols, joint with the discovery of many little objects, typical of children burials, allow to hypotize a relation with the cult of Mater Matuta and seem to point out a difficult or anomalous pregnancy or birth.

  7. Clinical patterns and hematological spectrum in autoimmune hemolytic anemia

    Directory of Open Access Journals (Sweden)

    Vanamala Alwar

    2010-01-01

    Conclusion :AIHAs have a female predilection and commonly present with symptoms of anemia. AIHA secondary to other diseases (especially connective tissue disorders is more common. Primary AIHAs presented with severe anemia and laboratory evidence of marked hemolysis.

  8. Gene Therapy: a Breakthrough for Sickle Cell Anemia?

    Science.gov (United States)

    ... fullstory_163849.html Gene Therapy: A Breakthrough for Sickle Cell Anemia? But treatment has only been given to ... gene therapy to treat, or even potentially cure, sickle cell anemia. The findings come from just one patient, ...

  9. Craving and Chewing Ice: A Sign of Anemia?

    Science.gov (United States)

    ... constantly craving and chewing ice a sign of anemia? Answers from Ruben A. Mesa, M.D. Possibly. Doctors use the term "pica" ... ice (pagophagia) is often associated with iron deficiency anemia, although the reason is unclear. At least one ...

  10. What Are the Signs and Symptoms of Fanconi Anemia?

    Science.gov (United States)

    ... What Are the Signs and Symptoms of Fanconi Anemia? Major Signs and Symptoms Your doctor may suspect ... sisters also should be tested for the disorder. Anemia The most common symptom of all types of ...

  11. What Are the Signs and Symptoms of Aplastic Anemia?

    Science.gov (United States)

    ... What Are the Signs and Symptoms of Aplastic Anemia? Lower than normal numbers of red blood cells, ... most of the signs and symptoms of aplastic anemia. Signs and Symptoms of Low Blood Cell Counts ...

  12. Association between polymorphisms in the TSHR gene and Graves' orbitopathy.

    Directory of Open Access Journals (Sweden)

    Beata Jurecka-Lubieniecka

    Full Text Available BACKGROUND: Graves' orbitopathy (GO as well as Graves' disease (GD hyperthyroidism originate from an autoimmune reaction against the common auto-antigen, thyroid-stimulating hormone receptor (TSHR. GO phenotype is associated with environmental risk factors, mainly nicotinism, as well as genetic risk factors which initiate an immunologic reaction. In some patients GO is observed before diagnosis of GD hyperthyroidism, while it can also be observed far after diagnosis. The intensity of GO symptoms varies greatly in these patients. Thus, the pathogenesis of GD and GO may correlate with different genetic backgrounds, which has been confirmed by studies of correlations between GO and polymorphisms in cytokines involved in orbit inflammation. The aim of our analysis was to assess genetic predisposition to GO in young patients (age of diagnosis ≤30 years of age, for whom environmental effects had less time to influence outcomes than in adults. METHODS: 768 GD patients were included in the study. 359 of them had clinically evident orbitopathy (NOSPECS ≥2. Patients were stratified by age at diagnosis. Association analyses were performed for genes with a known influence on development of GD - TSHR, HLA-DRB1, cytotoxic T-lymphocyte antigen 4 (CTLA4 and lymphoid protein tyrosine phosphatase (PTPN22. RESULTS: The rs179247 TSHR polymorphism was associated with GO in young patients only. In young GO-free patients, allele A was statistically more frequent and homozygous carriers had a considerable lower risk of disease incidence than patients with AG or GG genotypes. Those differences were not found in either elderly patients or the group analyzed as a whole. CONCLUSIONS: Allele A of the rs179247 polymorphism in the TSHR gene is associated with lower risk of GO in young GD patients.

  13. Sobre o diagnostico histologico da anemia drepanocytica On the histologic diagnosis of the drepanocytic anemia

    Directory of Open Access Journals (Sweden)

    A. Penna de Azevedo

    1937-01-01

    Full Text Available No presente trabalho são descriptas as alterações anatomo-pathologicas do baço na anemia drepanocytica (anemia falciforme, Sicklecell anemia A observação refere-se a um menino de 12 annos de edade, de côr preta, o qual veio a fallecer em consequencia de processo de trombo-phlebite cerebral e de leptomeningite. A doença não foi reconhecida durante a vida e sómente pelo exame dos córtes histologicos do baço é que foi estabelecido o diagnostico de anemia drepanocytica, apresentando o baço as alterações peculiares á doença.In the present paper, the pathologico-anatomical changes of spleen in drepanocytic anemia are described (Sickle-cell anemia. In the case history, a 12 years old negro boy is concerned, who died in consequence of a cerebral thrombophlebitis process and leptomeningitis. The disease had not been recognized during life, and only on examination of the histological sections of the spleen the diagnosis of drepanocytic anemia was made, as this organ presented changes which are peculiar of the disease.

  14. Immune Hemolytic Anemia in a Patient with Tuberculous Lymphadenitis

    OpenAIRE

    Manjunath Nandennavar; Sanju Cyriac; Krishnakumar,; T G Sagar

    2011-01-01

    Anemia in tuberculosis is usually anemia of chronic disease. Severe hemolytic anemia is exceedingly rare in tuberculosis patients. We report a patient diagnosed with tubercular lymphadenitis complicated by Coomb′s positive hemolytic anemia. Patient responded well to antituberculous treatment. Hematological parameters improved after initiation of antituberculosis treatment. To the best of our knowledge, this is the first case from India of an adult patient with tuberculous lymphadenitis presen...

  15. Anemia among Primary School Children in Eastern Ethiopia

    OpenAIRE

    Firehiwot Mesfin; Yemane Berhane; Alemayehu Worku

    2015-01-01

    Background Anemia during childhood impairs physical growth, cognitive development and school performance. Identifying the causes of anemia in specific contexts can help efforts to prevent negative consequences of anemia among children. The objective of this study was to assess prevalence and identify correlates of anemia among school children in Eastern Ethiopia. Methods A cross sectional study was conducted from January 2012 to February 2012 in Kersa, Eastern Ethiopia. The study included ran...

  16. Osteopetrosis: A rare cause of anemia - Review of literature

    Directory of Open Access Journals (Sweden)

    Saluja S

    2009-07-01

    Full Text Available Normocytic anaemia is caused either by hypoproliferation of haemopoietic tissue or increased destruction of red cell. Osteopetrosis is a rare cause of anaemia. The leading clinical features are pallor, growth failure, hepatosplenomegaly.On hematological examination, anemia, thrombocytopenia, leucocytosis and myelophthisic anemia are commonly observed in this disease. We are highlighting osteopetrosis as a rare cause of anemia presenting to us for evaluation of anemia

  17. Fanconi anemia: in all its glory

    Directory of Open Access Journals (Sweden)

    Rajesh Rai

    2015-04-01

    Full Text Available Fanconi Anemia (FA is a rare autosomal recessive disorder affecting multiple body systems. The diagnosis is based on morphological abnormalities, hematological abnormalities (pancytopenia, macrocytic anemia and progressive bone marrow failure and genetic testing. However, genetic testing is complicated for FA because there are often many genes that are associated with its development, and large duplications, deletions or sequence variations are frequently observed in some of these genes. We report a patient with cytogenetically confirmed Fanconi anemia. Although morphological abnormalities were present from birth, diagnosis was suspected and made at 8 years of age when he presented to us. We report this case to create awareness among clinicians to use modern modalities of diagnosis for such cases in addition to the clinical assessment. This would further help these children reach their adulthood with good quality of life. [Int J Res Med Sci 2015; 3(4.000: 998-1001

  18. Severe Combined Immunodeficiency (SCID) Presenting with Neonatal Aplastic Anemia

    Science.gov (United States)

    Scott, Angela; Glover, Jason; Skoda-Smith, Suzanne; Torgerson, Troy; Xu, Min; Burroughs, Lauri; Woolfrey, Ann; Fleming, Mark; Shimamura, Akiko

    2015-01-01

    Aplastic anemia in the neonate is rare. We report a case of severe combined immunodeficiency (SCID) presenting with neonatal aplastic anemia. This report highlights the importance of considering SCID early in the evaluation of neonatal aplastic anemia prior to the development of infectious complications. PMID:26011426

  19. Severe combined immunodeficiency (SCID) presenting with neonatal aplastic anemia.

    Science.gov (United States)

    Scott, Angela; Glover, Jason; Skoda-Smith, Suzanne; Torgerson, Troy R; Xu, Min; Burroughs, Lauri M; Woolfrey, Ann E; Fleming, Mark D; Shimamura, Akiko

    2015-11-01

    Aplastic anemia in the neonate is rare. We report a case of severe combined immunodeficiency (SCID) presenting with neonatal aplastic anemia. This report highlights the importance of considering SCID early in the evaluation of neonatal aplastic anemia prior to the development of infectious complications.

  20. Enhanced thyroid iodine metabolism in patients with triiodothyronine-predominant Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Takamatsu, J.; Hosoya, T.; Naito, N.; Yoshimura, H.; Kohno, Y.; Tarutani, O.; Kuma, K.; Sakane, S.; Takeda, K.; Mozai, T.

    1988-01-01

    Some patients with hyperthyroid Graves' disease have increased serum T3 and normal or even low serum T4 levels during treatment with antithyroid drugs. These patients with elevated serum T3 to T4 ratios rarely have a remission of their hyperthyroidism. The aim of this study was to investigate thyroid iodine metabolism in such patients, whom we termed T3-predominant Graves' disease. Mean thyroid radioactive iodine uptake was 51.0 +/- 18.1% ( +/- SD) at 3 h, and it decreased to 38.9 +/- 20.1% at 24 h in 31 patients with T3-predominant Graves' disease during treatment. It was 20.0 +/- 11.4% at 3 h and increased to 31.9 +/- 16.0% at 24 h in 17 other patients with hyperthyroid Graves' disease who had normal serum T3 and T4 levels and a normal serum T3 to T4 ratio during treatment (control Graves' disease). The activity of serum TSH receptor antibodies was significantly higher in the patients with T3-predominant Graves' disease than in control Graves' disease patients. From in vitro studies of thyroid tissue obtained at surgery, both thyroglobulin content and iodine content in thyroglobulin were significantly lower in patients with T3-predominant Graves' disease than in the control Graves' disease patients. Thyroid peroxidase (TPO) activity determined by a guaiacol assay was 0.411 +/- 0.212 g.u./mg protein in the T3-predominant Graves' disease patients, significantly higher than that in the control Graves' disease patients. Serum TPO autoantibody levels determined by immunoprecipitation also were greater in T3-predominant Graves' disease patients than in control Graves' disease patients. Binding of this antibody to TPO slightly inhibited the enzyme activity of TPO, but this effect of the antibody was similar in the two groups of patients.

  1. Anemia intrahospitalaria y descenso de hemoglobina en pacientes internados Hospital-acquired anemia and decrease of hemoglobin levels in hospitalized patients

    Directory of Open Access Journals (Sweden)

    Carina V. Gianserra

    2011-06-01

    Full Text Available Es frecuente observar el desarrollo de anemia durante la internación, especialmente en pacientes graves. Esto se ha relacionado a extracciones de laboratorio. Pocos estudios evaluaron su prevalencia y factores asociados en pacientes internados en sala general. El objetivo fue determinar la prevalencia, características y factores clínicos asociados a anemia intrahospitalaria y descenso de hemoglobina en pacientes internados. Se efectuó un estudio transversal, prospectivo, descriptivo. Se analizaron 192 internaciones consecutivas en sala general. Se determinó aquellas que presentaron un descenso del valor de hemoglobina = 2 g/dl y se analizaron factores de riesgo asociados. Presentaron anemia 139 pacientes (72.4%, 89 (46.4% al ingreso y 50 (26% durante la internación. Se presentaron 47 casos de descenso de hemoglobina = 2 g/dl (24.47%, en los que se observaron los valores más bajos de hematocrito y hemoglobina al alta (p = 0.01, hidratación parenteral con mayor volumen (p = 0.01 y estadías hospitalarias más prolongadas (p = 0.0001. En el análisis univariado las variables leucocitosis = 11 000mm³ (OR; IC95%: 2.02; 1.03-4; p = 0.01, días de internación = 7 (OR; IC95%: 3.39; 1.62-7.09; p = 0.0006, hidratación parenteral = 1500 ml/día (OR; IC95%: 2.47; 1.06-6.4; p = 0.01, vía central (OR; IC95%: 10.29; 1.75-108.07, p = 0.003 y anemia intrahospitalaria (OR; IC95%: 7.06; 3.41-15.83; p = 0.00000004 fueron estadísticamente significativos como factores de riesgo para descenso de hemoglobina = 2 g/dl. En el análisis multivariado las variables leucocitosis = 11 000 mm³ (OR; IC95%:2.45; 1.14-5.27; p = 0.02; días de internación = 7 (OR; IC95%: 5.15; 2.19-12.07; p = 0.0002; hidratación parenteral = 1500 ml/día (OR; IC95%: 2.95; 1.13-7.72; p = 0.02 y vía central (OR; IC95%:8.82; 1.37-56.82; p = 0.02 fueron factores predictivos independientes de descenso de hemoglobina = 2 g/dl. La anemia intrahospitalaria tuvo una elevada prevalencia. La

  2. 76 FR 39007 - Native American Graves Protection and Repatriation Act Regulations- Definition of “Indian Tribe”

    Science.gov (United States)

    2011-07-05

    ... Office of the Secretary of the Interior 43 CFR Part 10 RIN 1024-AD98 Native American Graves Protection... regulations implementing the Native American Graves Protection and Repatriation Act (NAGPRA) removes the... implementation of the Native American Graves Protection and Repatriation Act, including the issuance...

  3. Assessment of anemia during CT pulmonary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Caroline, E-mail: cjung@uke.de [Department of Diagnostic and Interventional Radiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg (Germany); Groth, Michael; Bley, Thorsten A.; Henes, Frank O. [Department of Diagnostic and Interventional Radiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg (Germany); Treszl, András [Department of Medical Biometry and Epidemiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg (Germany); Adam, Gerhard; Bannas, Peter [Department of Diagnostic and Interventional Radiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg (Germany)

    2012-12-15

    Objectives: Anemia is associated with increased mortality in patients with acute symptomatic pulmonary embolism (PE). The purpose of this study was to evaluate the feasibility of Hounsfield unit (HU) measurements on the single unenhanced trigger slice of pulmonary CT angiography scans for diagnosis of anemia. Material and Methods: 150 consecutive patients (median age 64 ± 16 years) with suspected PE underwent pulmonary CT angiography. Two radiologists, blinded to laboratory results, performed HU measurements in the single unenhanced trigger scan independently by region-based analysis (ROI). HU values from ascending and descending aorta and the calculated mean of both were correlated with serum hemoglobin levels. Inter- and intraobserver variability was determined for HU measurements, and ROC analysis was performed for diagnosis of anemia. Calculated linear models were used to assess formulas for estimation of hemoglobin levels from HU measurements. Results: HU measurements revealed high intra- and interrater reliability (ICC > 0.981 and ICC > 0.965, respectively). Calculated mean HU values showed a strong correlation with serum hemoglobin levels (r = 0.734), which allowed generation of different formulas for calculation of hemoglobin levels from HU measurements. ROC analyses confirmed a high sensitivity (80.4 for men; 91.3 for women) and specificity (84.0 for men; 84.9 for women) for diagnosing anemia. Conclusion: Diagnosis of anemia and quantification of hemoglobin levels upon a single unenhanced trigger scan of pulmonary CT angiography is feasible. We suggest disclosing the anemic state in the radiological report, independent of the presence of PE, since anemia carries increased risks of morbidity and mortality.

  4. Multiple mechanisms for hereditary sideroblastic anemia.

    Science.gov (United States)

    Furuyama, Kazumichi; Sassa, Shigeru

    2002-02-01

    Hereditary sideroblastic anemia (HSA) is a heterogeneous group of inherited anemic disorders which is characterized by the presence of ringed sideroblasts in the bone marrow, microcytic hypochromic anemia and typically its X-linked inheritance in patients. It has been shown that a deficiency of the erythroid-specific delta-aminolevulinate synthase (ALAS-E) activity is responsible for pyridoxine-responsive HSA in many patients, however, the pathogenesis of other types of HSA remains still unknown. In this article, recent evidence suggesting multiple causes for HSA is summarized and discussed.

  5. Iron deficiency anemia in heart failure.

    Science.gov (United States)

    Arora, Natasha P; Ghali, Jalal K

    2013-07-01

    Anemia and iron deficiency are quite prevalent in patients with heart failure (HF) and may overlap. Both anemia and iron deficiency are associated with worse symptoms and adverse clinical outcomes. In the past few years, there has been an enormous interest in the subject of iron deficiency and its management in patients with HF. In this review, the etiology and relevance of iron deficiency, iron metabolism in the setting of HF, studies on iron supplementation in patients with HF and potential cardiovascular effects of subclinical iron overload are discussed.

  6. Idiopathic aplastic anemia: diagnosis and classification.

    Science.gov (United States)

    Dolberg, Osnat Jarchowsky; Levy, Yair

    2014-01-01

    Aplastic anemia (AA) is a disease characterized by pancytopenia and hypoplastic bone marrow caused by the decrease of hematopoietic stem cells. The pathogenesis of AA is complex and involves an abnormal hematopoietic microenvironment, hematopoietic stem cell/progenitor cell deficiencies and immunity disorders. Survival in severe aplastic anemia (SAA) has markedly improved in the past 4 decades because of advances in hematopoietic stem cell transplantation, immunosuppressive and biologic drugs, and supportive care. Herein, we will update the main issues concern AA according to our literature review.

  7. An Unusual Cause of Anemia: Cameron Ulcer

    Directory of Open Access Journals (Sweden)

    Cenk Aypak

    2013-04-01

    Full Text Available Cameron ulcer is a linear gatric ulser on the mucosal folds in patients with a large hiatal hernia. Cameron ulcer could be seen in 5% of patients with hiatal hernia who undergo upper gastrointestinal system (GIS endoscopy examination. The clinical relevance of Cameron ulcer is due to its potential complications such as GIS bleeding and anemia. In this report a case who was applied to Family Medicine outpatient clinics with the diagnosis of iron deficiency anemia and determined Cameron ulser at upper gastroentestinal endoscopy was presented. [Cukurova Med J 2013; 38(2.000: 315-318

  8. Frequency of anemia in chronic psychiatry patients

    Directory of Open Access Journals (Sweden)

    Korkmaz S

    2015-10-01

    Full Text Available Sevda Korkmaz,1 Sevler Yildiz,1 Tuba Korucu,1 Burcu Gundogan,1 Zehra Emine Sunbul,1 Hasan Korkmaz,2 Murad Atmaca1 1Department of Psychiatry, 2Department of Cardiology, Faculty of Medicine, Firat University, Elazig, Turkey Purpose: Anemia could cause psychiatric symptoms such as cognitive function disorders and depression or could deteriorate an existing psychiatric condition when it is untreated. The objective of this study is to scrutinize the frequency of anemia in chronic psychiatric patients and the clinical and sociodemographic factors that could affect this frequency.Methods: All inpatients in our clinic who satisfied the study criteria and received treatment between April 2014 and April 2015 were included in this cross-sectional study. Sociodemographic data for 378 patients included in the study and hemoglobin (Hb and hematocrit values observed during their admission to the hospital were recorded in the forms. Male patients with an Hb level of <13 g/dL and nonpregnant female patients with an Hb level of <12 g/dL were considered as anemic.Findings: Axis 1 diagnoses demonstrated that 172 patients had depressive disorder, 51 patients had bipolar disorder, 54 patients had psychotic disorder, 33 patients had conversion disorder, 19 patients had obsessive-compulsive disorder, 25 patients had generalized anxiety disorder, and 24 patients had other psychiatric conditions. It was also determined that 25.4% of the patients suffered from anemia. Thirty-five percent of females and 10% of males were considered as anemic. The frequency of anemia was the highest among psychotic disorder patients (35%, followed by generalized anxiety disorder patients (32%, and obsessive-compulsive disorder patients (26%. Anemia was diagnosed in 22% of depressive disorder patients, 25% of bipolar disorder patients, and 24% of conversion disorder patients.Results: The prevalence of anemia among chronic psychiatry patients is more frequent than the general population

  9. Autoimmune hemolytic anemia in HCV/HIV coinfected patients during treatment with pegylated alpha-2a interferon plus ribavirin Anemia hemolítica auto-imune durante o tratamento da hepatite crônica com interferon peguilado alfa 2a e ribavirina, em pacientes com co-infecção HCV/HIV

    Directory of Open Access Journals (Sweden)

    Fernando Crivelenti Vilar

    2007-12-01

    Full Text Available Two cases of autoimmune hemolytic anemia that occurred during the treatment of chronic hepatitis C with pegylated alpha-2a interferon and ribavirin, in HIV coinfected patients, are presented and described. The late occurrence (after six months of therapy of this severe hemolytic anemia leads to the recommendation that hemoglobin levels should be monitored throughout the treatment period, even among patients who presented stable hemoglobin levels in the preceding months.São apresentados e discutidos dois casos de anemia hemolítica auto-imune que ocorreram durante o tratamento da hepatite crônica pelo vírus C, com interferon peguilado alfa 2a e ribavirina, em pacientes co-infectados pelo HIV. A ocorrência de anemia hemolítica grave em etapa tardia, após o sexto mês da terapêutica, recomenda que o controle dos níveis de hemoglobina deva ser feito durante todo o período do tratamento , mesmo nos pacientes que apresentam níveis estáveis de hemoglobina nos meses precedentes.

  10. Prevalence and Risk Factors for Iron Deficiency Anemia and Iron Depletion During Pregnancy: A Prospective Study.

    Science.gov (United States)

    Gomes da Costa, Ana; Vargas, Sara; Clode, Nuno; M Graça, Luís

    2016-09-01

    Introdução: A anemia e a carência de ferro são problemas de saúde globais e são mais frequentes em grávidas, mulheres em idade reprodutiva e crianças. O objetivo deste trabalho consistiu na avaliação da prevalência de anemia ferropénica e dos fatores de risco associados à ferropénia, na primeira metade da gravidez, numa amostra da população portuguesa. Material e Métodos: Estudo prospetivo, conduzido num hospital terciário, que incluiu grávidas até à 20ª semana de gestação. Foram coletados dados demográficos, relativos à gravidez e foram determinados os níveis séricos de hemoglobina e de ferritina no sangue materno. Recorreu-se à análise de regressão logística de variáveis múltiplas para identificar potenciais fatores de risco para ferropénia. Resultados: Foram incluídas 201 grávidas, das quais cinco (2,49%) tinham anemia. Para além disso, 77 grávidas (38,3%) tinham carência de ferro e 22 (10,9%) apresentaram ferropénia grave. A idade materna foi o único fator de risco identificado. O odds ratio foi de 12,99 (95% IC 2,41 - 70,0) para grávidas com idade inferior a 20 anos e de 2,09 (95% IC 1,05 - 4,14), para grávidas com idade superior a 30 anos. Discussão e Conclusão: Na nossa amostra, a prevalência de anemia na primeira metade da gravidez foi inferior à reportada noutros estudos. No entanto, mais de 30% das grávidas apresentaram carência de ferro. A idade materna foi o único fator de risco identificado.

  11. Soluble transferrin receptor and transferrin receptor-ferritin index in iron deficiency anemia and anemia in rheumatoid arthritis.

    Science.gov (United States)

    Margetic, Sandra; Topic, Elizabeta; Ruzic, Dragica Ferenec; Kvaternik, Marina

    2005-01-01

    The aim of the study was to evaluate the clinical efficiency of soluble transferrin receptor and transferrin receptor-ferritin index (sTfR/logF) in the diagnosis of iron deficiency anemia, as well as the differential diagnosis of iron deficiency anemia and anemia in rheumatoid arthritis. The study included 96 patients with anemia and 61 healthy volunteers as a control group. In healthy subjects there were no significant sex and age differences in the parameters tested. The study results showed these parameters to be reliable in the diagnosis of iron deficiency anemia, as well as in the differential diagnosis of iron deficiency anemia and anemia of chronic disease. The results indicate that sTfR/logF could be used to help differentiate coexisting iron deficiency in patients with anemia of chronic disease. Receiver operating characteristic analysis showed a higher discriminating power of transferrin receptor-ferritin index vs. soluble transferrin receptor in the diagnosis of iron deficiency anemia, as well as in the differential diagnosis between iron deficiency anemia and anemia of chronic disease. In patients with anemia in rheumatoid arthritis, the parameters tested showed no significant differences with respect to C-reactive protein concentration. These results suggested that the parameters tested are not affected by acute or chronic inflammatory disease.

  12. The Role of Oxidative Stress on the Pathogenesis of Graves' Disease

    Directory of Open Access Journals (Sweden)

    Miloš Žarković

    2012-01-01

    Full Text Available Graves' disease is a most common cause of hyperthyroidism. It is an autoimmune disease, and autoimmune process induces an inflammatory reaction, and reactive oxygen species (ROSs are among its products. When balance between oxidants and antioxidants is disturbed, in favour of the oxidants it is termed “oxidative stress” (OS. Increased OS characterizes Graves' disease. It seems that the level of OS is increased in subjects with Graves' ophthalmopathy compared to the other subjects with Graves' disease. Among the other factors, OS is involved in proliferation of orbital fibroblasts. Polymorphism of the 8-oxoG DNA N-glycosylase 1 (hOGG1 involved in repair of the oxidative damaged DNA increases in the risk for developing Grave's disease. Treatment with glucocorticoids reduces levels of OS markers. A recent large clinical trial evaluated effect of selenium on mild Graves' ophthalmopathy. Selenium treatment was associated with an improved quality of life and less eye involvement and slowed the progression of Graves' orbitopathy, compared to placebo.

  13. A Japanese family with X-linked sideroblastic anemia affecting females and manifesting as macrocytic anemia.

    Science.gov (United States)

    Katsurada, Tatsuya; Kawabata, Hiroshi; Kawabata, Daiki; Kawahara, Masahiro; Nakabo, Yukiharu; Takaori-Kondo, Akifumi; Yoshida, Yataro

    2016-06-01

    X-linked sideroblastic anemia (XLSA) is a rare hereditary disorder that typically manifests in males as microcytic anemia. Here, we report a family with XLSA that affects females and manifests as macrocytic anemia. The proband was a Japanese woman harboring a heterozygous mutation c.679C>T in the ALAS2 gene. This mutation causes the amino acid substitution R227C, which disrupts the enzymatic activity of erythroid-specific δ-aminolevulinic acid synthase. The mutation was not detected in the ALAS2 complementary DNA from peripheral blood red blood cells of the proband, indicating that the cells were mostly derived from erythroblasts expressing wild-type ALAS2. The proband's mother, who had been diagnosed with myelodysplastic syndrome, also had XLSA with the same mutation. Clinicians should be aware that XLSA can occur not only in males but also in females, in whom it manifests as macrocytic anemia.

  14. Iron-deficiency anemia caused by a proton pump inhibitor.

    Science.gov (United States)

    Hashimoto, Rintaro; Matsuda, Tomoki; Chonan, Akimichi

    2014-01-01

    A 59-year-old man was orally administered rabeprazole, a proton pump inhibitor (PPI), for gastroesophageal reflux disease, after which he gradually developed iron-deficiency anemia. The anemia did not improve following the administration of ferrous fumarate, and endoscopic screening of the entire gastrointestinal tract, including the small intestine, did not reveal any findings indicating the cause of the anemia. The patient was then switched from rabeprazole to famotidine and the anemia was cured within three months. There is much debate as to whether the long-term use of PPIs causes iron-deficiency. However, this case strongly suggests that PPIs can induce iron-deficiency anemia.

  15. Iron deficiency and hemolytic anemia reversed by ventricular septal myectomy

    Science.gov (United States)

    Costa, Steven M.; Cable, Christian

    2015-01-01

    Hemolytic anemia has been reported to occur in the setting of aortic stenosis and prosthetic heart valves, but much more rarely in association with obstructive hypertrophic cardiomyopathy (HC). Of the few descriptions of hemolytic anemia secondary to HC, all but one case involved bacterial endocarditis contributing to left ventricular outflow tract obstruction. We present the case of a 67-year-old man with recurrent hemolytic anemia and HC, without infective endocarditis. Attempts at iron repletion and augmentation of beta-blocker therapy proved his anemia to be refractory to medical management. Ventricular septal myectomy led to the resolution of hemolysis, anemia, and its coexisting symptoms. PMID:26424952

  16. The Evidence-Based Evaluation of Iron Deficiency Anemia.

    Science.gov (United States)

    Hempel, Eliana V; Bollard, Edward R

    2016-09-01

    Anemia is a prevalent disease with multiple possible etiologies and resultant complications. Iron deficiency anemia is a common cause of anemia and is typically due to insufficient intake, poor absorption, or overt or occult blood loss. Distinguishing iron deficiency from other causes of anemia is integral to initiating the appropriate treatment. In addition, identifying the underlying cause of iron deficiency is also necessary to help guide management of these patients. We review the key components to an evidence-based, cost-conscious evaluation of suspected iron deficiency anemia.

  17. Radioiodine treatment of recurrent hyperthyroidism in patients previously treated for Graves' disease by subtotal thyroidectomy

    DEFF Research Database (Denmark)

    Vestergaard, H; Laurberg, P

    1992-01-01

    Radioiodine therapy is often employed for treatment of patients with relapse of hyperthyroidism due to Graves' disease, after previous thyroid surgery. Little is known about the outcome of this treatment compared to patients with no previous surgery. A total of 20 patients who had received surgical...... treatment for Graves' hyperthyroidism 1-46 years previously and with relapse of the hyperthyroidism, and 25 patients with hyperthyroidism due to Graves' disease and no previous thyroid surgery were treated with radioiodine, following the same protocol. Early after treatment the previously operated patients...

  18. Strategies of radioiodine therapy for Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Lind, P. [Department of Nuclear Medicine and Endocrinology, PET Center Klagenfurt, LKH Klagenfurt (Austria)

    2002-08-01

    Several therapeutic options are available for the treatment of Graves' disease (GD), including long-term antithyroid drug medication (ATD), near-total resection (NTR) and radioiodine therapy (RIT). These treatments are used with different frequencies depending on geographical location, size of the goitre, age of the patient and experience of the physician. It should be noted that RIT is still being applied more frequently in the United States than in Europe. Despite the fact that RIT was introduced as long ago as 1941, several questions are still the subject of debate: Should a fixed dose or a calculated dose be used. If the dose is calculated, how many Grays (Gy) should be delivered to the thyroid? What is the goal of RIT in GD? Which factors, including ATD, influence the outcome of RIT? Is RIT appropriate in GD with Graves' ophthalmopathy (GO)? Although not all these questions have been answered yet, conclusions can be derived regarding a general strategy for use of RIT in GD. As with surgery, the goal of RIT in GD is euthyroidism with or without L-thyroxine medication. There is a clear advantage of dose calculation over use of a fixed dose because the only factor influencing the outcome is the dose delivered to a certain thyroid volume. To minimise recurrent hyperthyroidism, an ablative approach using a delivered dose of 250 Gy is widely accepted. Beside pretherapeutic T{sub 3} levels, thyroid volume and 24-h thyroid uptake, ATD may influence the outcome of RIT. Today it is accepted by most thyroidologists that, if ATD medication is necessary in overt hyperthyroidism, it should be withdrawn at least 2 days before RIT. In patients with GD and GO, RIT may worsen GO. If RIT is performed in GO it should be done under a 3-month steroid medication regimen. In conclusion, RIT can be considered an appropriate and cost-effective therapy in GD, although the decision regarding treatment should be taken on an individual basis, paying due respect to the course and

  19. [Autoimmune hemolytic anemia: diagnosis and management].

    Science.gov (United States)

    Philippe, Pierre

    2007-12-01

    Autoimmune hemolytic anemia (AIHA) is diagnosed in the presence of anemia, usually macrocytic and of variable intensity, reticulocytosis, and a positive direct and/or indirect antiglobulin test, after ruling out other types of hemolytic anemia. A positive direct antiglobulin test alone is not sufficient to diagnose AIHA and may be positive in many patients without anemia or negative in some patients with AIHA. AIHA may be classified into two major categories according to the optimal temperature of antibody activity: warm-reacting autoantibodies (usually IgG) optimal around 37 degrees C and cold-reacting autoantibodies, optimal at 4 degrees C (usually IgM). This classification guides the selection of tests and treatment. AIHA is widely reported to be associated with a variety of other diseases, although these associations are often fortuitous. A minimal set of useful investigations is appropriate since AIHA may be secondary to viral infections, lymphoid malignancies, or autoimmune disorders such as lupus. Transfusion should remain rare in AHAI, but close contact with the transfusion service is necessary if it is to succeed. As for many autoimmune and/or systemic diseases, numerous types of treatment have been proposed but have not been validated in controlled multicenter studies. These are necessary to improve the management of these rare disorders.

  20. Iron deficiency anemia in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Sindhu; Kaitha; Muhammad; Bashir; Tauseef; Ali

    2015-01-01

    Anemia is a common extraintestinal manifestation of inflammatory bowel disease(IBD) and is frequently overlooked as a complication. Patients with IBD are commonly found to have iron deficiency anemia(IDA) secondary to chronic blood loss, and impaired iron absorption due to tissue inflammation. Patients with iron deficiency may not always manifest with signs and symptoms; so, hemoglobin levels in patients with IBD must be regularly monitored for earlier detection of anemia. IDA in IBD is associated with poor quality of life, necessitating prompt diagnosis and appropriate treatment. IDA is often associated with inflammation in patients with IBD. Thus, commonly used labora-tory parameters are inadequate to diagnose IDA, and newer iron indices, such as reticulocyte hemoglobin content or percentage of hypochromic red cells or zinc protoporphyrin, are required to differentiate IDA from anemia of chronic disease. Oral iron preparations are available and are used in patients with mild disease activity. These preparations are inexpensive and con-venient, but can produce gastrointestinal side effects, such as abdominal pain and diarrhea, that limit their use and patient compliance. These preparations are partly absorbed due to inflammation. Non-absorbed iron can be toxic and worsen IBD disease activity. Although cost-effective intravenous iron formulations are widely available and have improved safety profiles, physicians are reluctant to use them. We present a review of the pathophysiologic mechanisms of IDA in IBD, improved diagnostic and therapeutic strategies, efficacy, and safety of iron replacement in IBD.

  1. Stroke Prevention Trials in Sickle Cell Anemia

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2006-06-01

    Full Text Available As part of an International Pediatric Stroke Study launched in 2002, the Stroke Prevention Trial in Sickle Cell Anemia (STOP reports a reduction in the number of overt clinical strokes in children with critically high transcranial Doppler velocities (>200 cm/sec who were regularly transfused.

  2. [Hereditary sideroblastic anemia: a rare diagnosis].

    Science.gov (United States)

    Brahem-Jmili, N; Salem, N; Abdelkefi, S; Champ, B Grand; Bekri, S; Sboui, H; Mahjoub, T; Yacoub, S; Kortas, M

    2004-01-01

    Hereditary sideroblastic anemia is a very rare disease recessive and X-linked that affect heme biosynthesis by deficit or decreased of delta aminolevulinic acid synthase (ALAS) activity. We report a case of a six-month-old boy, admitted in the hospital for anemic syndrome. The hemogram showed anemia (hemoglobin: 4.5 g/dL), frankly hypochronic microcytic and a regenerated (mean corpuscular hemoglobin concentration: 26 g/dL, mean cell volume: 53 fl, reticulocytes: 10 x 10(9)/L) with red cells morphologic disorders in smears (anisopoikylocytosis) without attack of the other lineages; white blood cells: 11 x 10(9)/L (neutrophils: 64% and lymphocytes: 35%); platelets: 350 x 10(9)/L. Examination of bone marrow showed an important erythroid hyperplasia (about 69%) with dyserythropoiesis. Perls stain revealed intense siderosis with 90% of ringed sideroblasts and a large number of siderocytes. Exploration of ALAS2 and ABC7 genes on the DNA of the infant was not found abnormalities. Treatment with pyridoxine corrects moderately the anemia. By the way, we proposed to remind that iron deficiency, inflammatory syndrome and thalassemia are the common microcytic anemia. However, it's mandatory to explore other causes if diagnosis is not solved.

  3. Iron-Deficiency Anemia and Stroke

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2007-11-01

    Full Text Available The prevalence of iron-deficiency anemia (IDA in young children at the time of stroke and in age-matched healthy controls was compared in a case-control study conducted at the Hospital for Sick Children, Toronto, Canada.

  4. Iron deficiency anemia in inflammatory bowel disease

    Science.gov (United States)

    Kaitha, Sindhu; Bashir, Muhammad; Ali, Tauseef

    2015-01-01

    Anemia is a common extraintestinal manifestation of inflammatory bowel disease (IBD) and is frequently overlooked as a complication. Patients with IBD are commonly found to have iron deficiency anemia (IDA) secondary to chronic blood loss, and impaired iron absorption due to tissue inflammation. Patients with iron deficiency may not always manifest with signs and symptoms; so, hemoglobin levels in patients with IBD must be regularly monitored for earlier detection of anemia. IDA in IBD is associated with poor quality of life, necessitating prompt diagnosis and appropriate treatment. IDA is often associated with inflammation in patients with IBD. Thus, commonly used laboratory parameters are inadequate to diagnose IDA, and newer iron indices, such as reticulocyte hemoglobin content or percentage of hypochromic red cells or zinc protoporphyrin, are required to differentiate IDA from anemia of chronic disease. Oral iron preparations are available and are used in patients with mild disease activity. These preparations are inexpensive and convenient, but can produce gastrointestinal side effects, such as abdominal pain and diarrhea, that limit their use and patient compliance. These preparations are partly absorbed due to inflammation. Non-absorbed iron can be toxic and worsen IBD disease activity. Although cost-effective intravenous iron formulations are widely available and have improved safety profiles, physicians are reluctant to use them. We present a review of the pathophysiologic mechanisms of IDA in IBD, improved diagnostic and therapeutic strategies, efficacy, and safety of iron replacement in IBD. PMID:26301120

  5. [Biermer's disease and autoimmune hemolytic anemia].

    Science.gov (United States)

    Nafil, Hatim; Tazi, Illias; Mahmal, Lahoucine

    2012-01-01

    Biermer's disease is an autoimmune atrophic gastritis of the fundus predominantly responsible for a malabsorption of vitamin B12. Despite its association with several autoimmune disorders, few observations have reported an association with autoimmune hemolytic anemia (AIHA). We report a case of Biermer's disease associated with AIHA in a patient of 66 years old.

  6. Autoimmune hemolytic anemia secondary to chicken pox

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    Abraham M Ittyachen

    2013-01-01

    Full Text Available Autoimmune hemolytic anemia (AIHA is a rare complication of chicken pox. It is described mainly in children. Even in children it is a rare complication and the long-term prognosis remains to be elucidated. Herein we report an adult, a 23-year-old male who developed AIHA secondary to chicken pox.

  7. Curso clínico da anemia hemolítica auto-imune: um estudo descritivo Clinical course of autoimmune hemolytic anemia: an observational study

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    Maria Christina L. A. Oliveira

    2006-02-01

    Full Text Available OBJETIVO: A anemia hemolítica auto-imune é caracterizada pela produção de auto-anticorpos contra antígenos de superfície das hemácias. O objetivo do estudo foi identificar as características clínicas, imunológicas e evolutivas dos pacientes com anemia hemolítica auto-imune acompanhados no serviço de hematologia pediátrica do HC-UFMG e no Hemocentro de Belo Horizonte. MÉTODOS: Foram avaliadas 17 crianças menores de 15 anos, diagnosticadas entre 1988 e 2003. O diagnóstico de anemia hemolítica auto-imune foi baseado no quadro de hemólise adquirida e confirmado por meio do teste de Coombs direto poliespecífico. Os dados clínicos, demográficos, laboratoriais e referentes à evolução dos pacientes foram obtidos retrospectivamente nos prontuários médicos. RESULTADOS: A mediana de idade ao diagnóstico foi de 10,5 meses. O teste de Coombs direto poliespecífico foi positivo em 13 pacientes e negativo em quatro. Em 14 pacientes, foi realizado o teste de Coombs direto monoespecífico. Nestes, a classe de anticorpo mais freqüente foi IgG (cinco pacientes, seguida pela IgM em dois. Em 13 (76% pacientes, a anemia foi considerada grave, o que tornou necessária a hemotransfusão. Em quatro pacientes, foi identificada uma doença de base: lúpus eritematoso sistêmico, linfoma de Hodgkin, hepatite auto-imune e histiocitose de células de Langerhans. Os demais casos foram considerados como primários. A mediana de seguimento foi de 11 meses (5 a 23 meses. Ocorreram três óbitos, sendo dois após esplenectomia e um pela doença de base. CONCLUSÃO: A anemia hemolítica auto-imune é rara em crianças e adolescentes. Apesar de apresentar resposta ao corticóide e imunoglobulina, casos fatais têm sido relatados. O prognóstico é pior na presença de uma doença crônica de base.OBJECTIVE: Autoimmune hemolytic anemia is characterized by the production of autoantibodies against erythrocyte membrane antigens. This study was carried out to

  8. Managing anemia and blood loss in elective gynecologic surgery patients.

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    Rock, W A; Meeks, G R

    2001-05-01

    Hysterectomy is the second-most-common surgical procedure among premenopausal women. The conditions that lead to the need for a hysterectomy often are accompanied by chronic blood loss that can lead to anemia. Moreover, hysterectomy and myomectomy may result in significant blood loss, which exacerbates the anemia. The presence of fatigue associated with anemia has a substantially negative impact on quality of life and the ability to perform activities of daily living. Options for alleviating perioperative anemia include minimizing surgical blood loss, blood transfusion, supplementation with hematinics, such as iron and folic acid, and treatment with recombinant human erythropoietin. Treating preoperative anemia is expected to help correct anemia prior to surgery and may have a positive impact on anemia-related symptoms and surgical outcomes.

  9. Prevalence of Anemia in Renal Transplant Patients in Turkey

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    Alparslan MERDİN

    2014-05-01

    Full Text Available OBJECTIVE: Post-transplant anemia is a common complication in renal allograft recipients. The most common causes are impaired graft function, immunosuppressive drugs, and infections. The aim of our study was to further investigate the prevalence of anemia before and after renal transplantation in renal allograft recipients in Turkey. MATERIAL and METHODS: We assessed 464 patients who received a kidney transplant between the years 2010 and 2012. The prevalence of anemia was evaluated before transplantation and at the 3 rd and at 6th months after transplantation. Our study is a retrospective study. RESULTS: The prevalence of anemia at the 6th month after the transplant surgery was 28.8%. The percentage of the patients who did not have anemia prior to the transplant surgery, and who developed anemia after the transplantation was 24.4%. CONCLUSION: Our findings are similar to those found in the literature, and show that anemia is a very common entity after renal transplantation.

  10. Risk Factors of Neonatal Anemia in Placenta Previa

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    Dong Gyu Jang, Yun Sung Jo, Sung Jong Lee, Gui Se Ra Lee

    2011-01-01

    Full Text Available Objectives: Placenta previa is a major cause of neonatal anemia. The purpose of this study was to elucidate the risk factors of neonatal anemia in placenta previa.Methods: The study was conducted on 158 placenta previa patients at 3 hospitals in affiliation with the Catholic Medical Center, Seoul, Korea from May 1999 through December 2009. The subjects were divided in to 2 groups: 47 placenta previa patients with neonatal anemia, and 113 placenta previa patients without neonatal anemia. The subjects' characteristics were compared. Logistic regression was used to control for confounding factors.Results: Anterior placental location (OR 2.48; 95% CI: 1.20-5.11 was an independent risk factor of neonatal anemia after controlling for potential confounders.Conclusion: To manage neonatal anemia in placenta previa patients, obstetricians should do their best to detect placental location. Pediatricians should consider the high possibility of neonatal anemia in cases involving anterior placental location.

  11. Development of Graves' ophthalmopathy and uveitis after radioiodine therapy for Graves' disease in a patient with HTLA-I associated myelopathy (HAM)

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    Ozawa, Yasunori; Migita, Masayoshi; Watanabe, Tomoji; Okuda, Itsuko; Takeshita, Akira; Takagi, Akio; Shishiba, Yoshimasa (Toranomon Hospital, Tokyo (Japan))

    1994-09-01

    HTLV-I carriers or patients with HTLV-I associated myelopathy (HAM) are prone to immune-mediated inflammatory disorders. We present a 44-year-old female with HAM who developed Graves' disease. She developed severe Graves' ophthalmopathy shortly after [sup 131]I therapy, concurrently with a remarkable increase in TSH-receptor antibody titer. Ophthalmopathy was aggravated in spite of prednisolone therapy and euthyroidism being maintained by thyroxine replacement. Uveitis also developed after [sup 131]I therapy and iridocyclitis finally required trabeculotomy. This case suggests that HAM patients may have a higher risk of immune-mediated Graves' ophthalmopathy after [sup 131]I therapy.(author).

  12. Hereditary sideroblastic anemia with associated platelet abnormalities.

    Science.gov (United States)

    Soslau, G; Brodsky, I

    1989-12-01

    A 62 year old male (R.H.) presented with a mild anemia (Hb 11-12 gm%) and a history of multiple hemorrhagic episodes. The marrow had 40-50% sideroblasts. Marrow chromosomes were normal. His wife was hematologically normal, while one daughter, age 30 years, had a sideroblastic anemia (Hb 11-12 gm%) with 40-50% sideroblasts in the marrow. Her anemia was first noted at age 15 years. Administration of vitamin B6 did not correct the anemia in either the father or daughter. Platelet abnormalities inherited jointly with this disorder are described for the first time. Both R.H. and his daughter had prolonged bleeding times, with normal PTT, PT times, fVIII:C, fVIII:Ag levels, and vWF multimers, which may rule out a von Willebrand's disease. They have normal platelet numbers but abnormally low platelet adhesiveness and greatly depressed ADP, collagen, and epinephrine responsiveness. Response to ristocetin was in the low normal range, and aggregation with thrombin was normal. While desmopressin completely normalized R.H.'s bleeding time, none of these platelet parameters were improved. No differences in the SDS PAGE protein patterns of RH platelets could be detected in comparison to normal samples. His platelets took up and released serotonin (5HT) normally, and electron micrographs defined no morphological abnormalities. However, no ATP was released from platelets activated with collagen, and when followed by thrombin about fourfold greater ATP was released by control platelets as compared to RH platelets. The dense granule fraction derived from RH platelets contained about 20% the level of ATP, 40% the level of ADP, and 50% the level of 5HT detected in a normal sample. The results indicate that the bleeding disorder is related to a non-classical heritable storage pool defect. The connection between the inherited sideroblastic anemia and platelet defects is obscure.

  13. Cradle-to-Grave Logistic Technologies for Exploration Missions

    Science.gov (United States)

    Broyan, James L.; Ewert, Michael K.; Shull, Sarah

    2013-01-01

    Human exploration missions under study are very limited by the launch mass capacity of exiting and planned vehicles. The logistical mass of crew items is typically considered separate from the vehicle structure, habitat outfitting, and life support systems. Consequently, crew item logistical mass is typically competing with vehicle systems for mass allocation. NASA is Advanced Exploration Systems (AES) Logistics Reduction and Repurposing (LRR) Project is developing four logistics technologies guided by a systems engineering cradle-to-grave approach to enable used crew items to augment vehicle systems. Specifically, AES LRR is investigating the direct reduction of clothing mass, the repurposing of logistical packaging, the processing of spent crew items to benefit radiation shielding and water recovery, and the conversion of trash to propulsion supply gases. The systematic implementation of these types of technologies will increase launch mass efficiency by enabling items to be used for secondary purposes and improve the habitability of the vehicle as the mission duration increases. This paper provides a description, benefits, and challenges of the four technologies under development and a status of progress at the mid ]point of the three year AES project.

  14. Sheehan's syndrome co-existing with Graves' disease.

    Science.gov (United States)

    Arpaci, D; Cuhaci, N; Saglam, F; Ersoy, R; Cakir, B

    2014-01-01

    Sheehan's syndrome (SS), which is an important cause of hypopituitarism, is common in developing countries. The most common presentation is the absence of lactation and amenorrhea. Hypothyroidism rather than hyperthyroidism is the usual expected phenomenon in SS. Postpartum hyperthyroidism is also common and Graves' disease (GD) is an important cause of postpartum hyperthyroidism. Here we report a case of a 22-year-old female patient in our clinic presented symptoms of amenorrhea, lack of lactation, palpitations and sweating. Her physical examination revealed goiter, moist skin and proptosis. Her laboratory evaluation showed suppressed thyroid stimulating hormone, elevated levels of free thyroxine and free triiodothyronine. Thyroid antibodies were positive. Tec 99m thyroid scintigraphy results were gland hyperplasia and increased uptake consistent with GD. She gave birth 7 months ago; after delivery she had a history of prolonged bleeding, amenorrhea and inability to lactate. She had hypogonadotropic hypogonadism, hyperprolactinemia and growth hormone deficiency. Serum cortisol and adrenocorticotropic hormone levels were normal. Her magnetic resonance imaging was empty sella. Our diagnosis was GD co-existing with SS. GD with concomitant hypopituitarism is rare but has been described previously, but there are no reports of GD occurring with SS. In this case study, we report a patient with GD associated with SS.

  15. Special features of Graves' disease in early childhood.

    Science.gov (United States)

    Segni, M; Leonardi, E; Mazzoncini, B; Pucarelli, I; Pasquino, A M

    1999-09-01

    Graves' disease (GD) is extremely rare in children younger than 4 years of age, but if not recognized and treated it can seriously interfere with growth and development. We report three unrelated children, all females, in whom GD occurred before the age of 3. These children presented with goiter, exophthalmos, tachycardia, and hyperactivity. Moreover, one showed a severe psychomotor delay, and had previously undergone surgery due to craniosynostosis; the other two manifested a language delay. All had high thyroid hormones and thyrotropin receptor antibody (TRAb) serum levels that clearly indicated autoimmune hyperthyroidism. In all of them, the disease presumably had developed during the first or second year of life. No maternal history of GD was present in two. The third child was born to a mother affected with GD during pregnancy, but it is likely that her GD began to develop after 6 months of life. These children are being treated with methimazole, and treatment is still necessary after 32 months. TRAb levels were persistently high at follow-up. Psychological evaluation including language development at follow-up was appropriate for age in two children; the third child improved, but severe mental retardation is still evident. GD assessment in early childhood also needs to focus on psychological evaluation. Pediatricians should be aware of the possibility of permanent brain damage and craniosynostosis due to hyperthyroidism in infancy.

  16. [Graves' disease: ultrasonographic, color Doppler and histological aspects].

    Science.gov (United States)

    Messina, G; Viceconti, N; Trinti, B

    1997-11-01

    The aim of the present work was to study the relationship between thyroid low echogenicity, the thyroid blood flow by color-Doppler (CD) and histological features in patients with Graves' disease (GD). Thyroid ultrasonography and CD was performed on 28 patients with GD. In 5 patients has been compared CD with histology. The thyroid volume was higher in 100% of patients with GD at the onset rather than in euthyroidism. Diffuse hypoechogenicity of the thyroid was discovered in 100% of patients with GD at the onset and it persisted in 57.1% of patients that became euthyroid after therapy. Qualitative CD resulted in different patterns that were classified as follow: pattern A ("thyroid inferno") in 17 patients (60.7%); pattern B (mildly increased of parenchymal blood flow) in 11 patients (39.3%). In the 5 histological proven cases, in the pattern A (3 cases) there was a diffuse microfollicular hyperplasia with functional activation notes. There was lymphocytic infiltration. While in the pattern B (two cases) there were a non-follicular hypercellular nodule with pseudocapsule and rare colloid. We conclude that there are two different histological types with different CD patterns in GD.

  17. Radioiodine therapy for Graves' disease: case selection and restrictions recommended to patients in North America.

    Science.gov (United States)

    Wartofsky, L

    1997-04-01

    Each of the three major therapies for Graves' disease has its own advantages, disadvantages, indications, and contraindications. Today, radioactive iodine (RAI) therapy is the most commonly employed means of therapy for Graves' disease in the United States, with approximately 70% of patients so treated after initial presentation and an additional fraction of arguably 10-15% treated with RAI after failure of antithyroid drugs or surgery. RAI therapy is acknowledged to have the clear-cut advantage of being safe, with low morbidity and cost. The indications for RAI therapy are clear and noncontroversial for most patients with Graves' disease. Moreover, RAI treatment is employed by some thyroidologists for subclinical thyrotoxicosis (normal T4 or T3 but immeasurable TSH), particularly in patients > age 45 due to risks of atrial fibrillation. RAI therapy is not considered indicated or is contraindicated during breast feeding and in pregnancy, subacute thyroiditis, postpartum thyroiditis, struma ovarii, pituitary (TSH-driven) hyperthyroidism, euthyroid, hyperthyroxinemia, and thyroid hormone resistance. Opinions vary on the use of RAI therapy in children with Graves' disease; generally, a lower age cutoff of 17 years is acceptable in most clinics. Even more controversial is whether RAI therapy in the presence of Graves' ophthalmology constitutes a risk for worsening ophthalmopathy. Resolution of this latter issue awaits more definitive studies, but RAI therapy is likely to remain the first choice for most patients with Graves' disease.

  18. Prognostic factors of the outcomes of subtotal thyroid resection in graves disease

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    A J Tsurkan

    2011-03-01

    Full Text Available The long-term results of subtotal resection of thyroid gland on 82 patients with Graves' disease were studied. There was analysed the influence of three factors on outcome at Graves' disease: volume of a thyroid gland before operation, morphological structure of thyroid tissue and volume of thyroid remnant. Outcomes of subtotal resection of thyroid gland were studied on the basis of thyrotropic hormone level of blood in 3, 6, 12 months, 2 and 3 years after operation. Based on research it has been established that the volume of thyroid gland before operation does not influence to outcome of subtotal resection of thyroid gland with Graves' disease. Morphological changes of removed thyroid tissue in the form of colloidal nodules at patients with Graves' disease statistically significantly raise risk of development of postoperative complications after subtotal resection of thyroid gland. The surgeon defining the volume of thyroid rem-nant durng the operation could be mistaken as towards it's increase so towards it's reduction, with an average deviation about 35%. Various outcomes of subtotal resection of thyroid gland at the same volume of thyroid remnant let us conclude that this out-come depends more on intensity of autoimmune process rather than on the volume of thyroid remnant. According modern views to aetiology and patogenesis of Graves' disease, the optimum volume of operation at Graves' disease is thyroidectomy.

  19. Refractory Graves' Disease Successfully Cured by Adjunctive Cholestyramine and Subsequent Total Thyroidectomy

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    Yeoree Yang

    2015-12-01

    Full Text Available The three major forms of treatment for Graves thyrotoxicosis are antithyroid drugs, radioactive iodine therapy and thyroidectomy. Surgery is the definitive treatment for Graves thyrotoxicosis that is generally recommended when other treatments have failed or are contraindicated. Generally, thyrotoxic patients should be euthyroid before surgery to minimize potential complications which usually requires preoperative management with thionamides or inorganic iodine. But several cases of refractory Graves' disease have shown resistance to conventional treatment. Here we report a 40-year-old female patient with Graves' disease who complained of thyrotoxic symptoms for 7 months. Her thyroid function test and thyroid autoantibody profiles were consistent with Graves' disease. One kind of thionamides and β-blocker were started to control her disease. However, she was resistant to nearly all conventional medical therapies, including β-blockers, inorganic iodine, and two thionamides. She experienced hepatotoxicity from the thionamides. What was worse is her past history of serious allergic reaction to corticosteroids, which are often used to help control symptoms. A 2-week regimen of high-dose cholestyramine improved her uncontrolled thyrotoxicosis and subsequent thyroidectomy was successfully performed. In conclusion, cholestyramine could be administered as an effective and safe adjunctive agent for preoperative preparation in patients with severe hyperthyroid Graves's disease that is resistant to conventional therapies.

  20. Characteristics of anemia in subclinical and overt hypothyroid patients.

    Science.gov (United States)

    Erdogan, Mehmet; Mehmet, Erdogan; Kösenli, Aybike; Aybike, Kosenli; Ganidagli, Sencer; Kulaksizoglu, Mustafa; Mustafa, Kulaksizoglu

    2012-01-01

    Thyroid hormones stimulate directly or indirectly growth of erythroid colonies through erythropoietin. Anemia is often the first sign of hypothyroidism. Hypothyroidism can cause a wide variety of anemic disorders. Numerous mechanisms are involved in the pathogenesis of these anemias that can be microcytic, macrocytic and normocytic. We designed this study to investigate the anemia frequency and if present, etiology of anemia in hypothyroid patients. 100 patients with overt hypothyroid, 100 patients with subclinical hypothyroid, and 200 healthy controls were enrolled in this study. Overt hypothyroidism diagnosis is done when elevated TSH and low levels of free T4 and/or free T3 have been observed. Subclinical hypothyroidism is defined as elevated serum TSH with normal free T(4) and free T(3) levels. Peripheral smears of the anemic patients were examined. Anemia prevalence was 43% in the overt hypothyroid group, 39% in the subclinical hypothyroid group, and 26% in the control group (p=0.0003 and p=0.021 respectively related to controls). Thus, the frequency of anemia in subclinical hypothyroidism is as high as that in overt hypothyroidism. There was no difference between the hypothyroid groups in terms of anemia. Vitamin B12, Fe, and folic acid were similar between these groups. According to our findings, anemia of chronic disease is the most common type of anemia in hypothyroid patients. Suspicion of hypothyroidism should be considered in anemias with uncertain etiology.

  1. Erythropoietin Levels in Elderly Patients with Anemia of Unknown Etiology.

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    Zachary Gowanlock

    Full Text Available In many elderly patients with anemia, a specific cause cannot be identified. This study investigates whether erythropoietin levels are inappropriately low in these cases of "anemia of unknown etiology" and whether this trend persists after accounting for confounders.This study includes all anemic patients over 60 years old who had erythropoietin measured between 2005 and 2013 at a single center. Three independent reviewers used defined criteria to assign each patient's anemia to one of ten etiologies: chronic kidney disease, iron deficiency, chronic disease, confirmed myelodysplastic syndrome (MDS, suspected MDS, vitamin B12 deficiency, folate deficiency, anemia of unknown etiology, other etiology, or multifactorial etiology. Iron deficiency anemia served as the comparison group in all analyses. We used linear regression to model the relationship between erythropoietin and the presence of each etiology, sequentially adding terms to the model to account for the hemoglobin concentration, estimated glomerular filtration rate (eGFR and Charlson Comorbidity Index.A total of 570 patients met the inclusion criteria. Linear regression analysis showed that erythropoietin levels in chronic kidney disease, anemia of chronic disease and anemia of unknown etiology were lower by 48%, 46% and 27%, respectively, compared to iron deficiency anemia even after adjusting for hemoglobin, eGFR and comorbidities.We have shown that erythropoietin levels are inappropriately low in anemia of unknown etiology, even after adjusting for confounders. This suggests that decreased erythropoietin production may play a key role in the pathogenesis of anemia of unknown etiology.

  2. Prevalência de anemia e insuficiência renal em portadores de insuficiência cardíaca não-hospitalizados Prevalencia de anemia e insuficiencia renal en portadores de insuficiencia cardiaca no hospitalizados Prevalence of anemia and renal insufficiency in non-hospitalized patients with heart failure

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    Francisco José Farias Borges dos Reis

    2009-09-01

    Full Text Available FUNDAMENTOS: Insuficiência cardíaca (IC é uma doença comum com alta taxa de mortalidade. Anemia e insuficiência renal (IR são frequentemente encontradas em portadores de IC associadas com maior gravidade da doença cardíaca e pior prognóstico. OBJETIVO: Avaliar a prevalência de anemia e insuficiência renal, bem como a associação entre esses dois quadros, em portadores de IC não hospitalizados. MÉTODOS: Foram observados pacientes acompanhandos na clínica de IC de um hospital universitário de julho de 2003 a novembro de 2006. Anemia foi definida como níveis de hemoglobina abaixo de 13 mg/dl para homens e de 12 mg/dl para mulheres. A função renal foi avaliada por meio da taxa de filtração glomerular (TFG, calculada pela fórmula simplificada do estudo MDRD (Modification of Diet in Renal Disease. RESULTADOS: Dos trezentos e quarenta e cinco pacientes incluídos neste estudo, 26,4% (n = 91 tinham anemia e 29,6% tinham insuficiência renal moderada a grave (TFG FUNDAMENTO: La insuficiencia cardiaca (IC es una enfermedad común con alta tasa de mortalidad. La anemia y la insuficiencia renal (IR, encontradas frecuentemente en portadores de IC, son asociadas a mayor severidad de la enfermedad cardiaca y peor pronóstico. OBJETIVO: Evaluar la prevalencia de anemia e insuficiencia renal, así como la asociación entre esos dos cuadros, en portadores de IC no hospitalizados. MÉTODOS: Se observaron a pacientes seguidos en la clínica de IC de un hospital universitario de julio de 2003 a noviembre de 2006. Se definió la anemia como niveles de hemoglobina abajo de 13 mg/dl para varones y de 12 mg/dl para mujeres. La función renal se evaluó por medio de la tasa de filtración glomerular (TFG, calculada por la fórmula simplificada del estudio MDRD (Modification of Diet in Renal Disease. RESULTADOS: Teniendo en cuenta los trescientos y cuarenta y cinco pacientes incluidos en este estudio, el 26,4% (n = 91 tenía anemia y el 29

  3. Current trends in the management of Graves' disease

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    Solomon, B.; Glinoer, D.; Lagasse, R.; Wartofsky, L. (Walter Reed Army Medical Center, Washington, DC (USA))

    1990-06-01

    Members of the American Thyroid Association were invited to participate in a survey of the management of Graves' disease. One primary case and several variations were provided, which differed in respect to age, sex, goiter size, severity, etc. The questionnaire was based on the format used in a similar survey of members of the European Thyroid Association. The aim of the survey was to determine (1) how expert thyroidologist employ diagnostic procedures for this disorder, and (2) the choice of therapy of the three treatment options and its manner of implementation. Questionnaires were sent only to clinically active members. The overall response rate was 62%. Data analysis was possible on 52% of members surveyed and was performed using SPSS and a specific Fortran program. In the laboratory evaluation of the primary case a radioiodine uptake, scan, serum total T4, and basal TSH were requested by 92%, 47%, 83%, and 66%, respectively, with 84% of respondents using an ultrasensitive TSH assay. For management of the primary case, radioiodine treatment was the first choice of 69% of the respondents. Antithyroid drugs were used briefly (3-7 days) before 131I by 28%, whereas 41% said they would employ thioureas after 131I. Of those using 131I, 66% tailored the dose to achieve euthyroidism as the goal of therapy, while 34% aimed for hypothyroidism requiring T4 replacement. Only 30% of respondents chose thioureas as a first line of treatment (72% propylthiouracil; 28% tapazole). The duration of drug therapy was a predetermined fixed interval for 80% of the respondents, with 90% treating for 1-2 yr. Other specific trends in diagnostic approach and therapeutic preferences were identified for the eight variations on the primary case problem.

  4. Lithium as an Alternative Option in Graves Thyrotoxicosis

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    Ishita Prakash

    2015-01-01

    Full Text Available A 67-year-old woman was admitted with signs and symptoms of Graves thyrotoxicosis. Biochemistry results were as follows: TSH was undetectable; FT4 was >6.99 ng/dL (0.7–1.8; FT3 was 18 pg/mL (3–5; TSI was 658% (0–139. Thyroid uptake and scan showed diffusely increased tracer uptake in the thyroid gland. The patient was started on methimazole 40 mg BID, but her LFTs elevated precipitously with features of fulminant hepatitis. Methimazole was determined to be the cause and was stopped. After weighing pros and cons, lithium was initiated to treat her persistent thyrotoxicosis. Lithium 300 mg was given daily with a goal to maintain between 0.4 and 0.6. High dose Hydrocortisone and propranolol were also administered concomitantly. Free thyroid hormone levels decreased and the patient reached a biochemical and clinical euthyroid state in about 8 days. Though definitive RAI was planned, the patient has been maintained on lithium for more than a month to control her hyperthyroidism. Trial removal of lithium results in reemergence of thyrotoxicosis within 24 hours. Patient was maintained on low dose lithium treatment with lithium level just below therapeutic range which was sufficient to maintain euthyroid state for more than a month. There were no signs of lithium toxicity within this time period. Conclusion. Lithium has a unique physiologic profile and can be used to treat thyrotoxicosis when thionamides cannot be used while awaiting elective radioablation. Lithium levels need to be monitored; however, levels even at subtherapeutic range may be sufficient to treat thyrotoxicosis.

  5. Iron Deficiency Anemia Coexists with Cancer Related Anemia and Adversely Impacts Quality of Life

    Science.gov (United States)

    Kanuri, Giridhar; Sawhney, Ritica; Varghese, Jeeva; Britto, Madonna; Shet, Arun

    2016-01-01

    Cancer related anemia (CRA) adversely affects patient Quality of Life (QoL) and overall survival. We prospectively studied the prevalence, etiology and the impact of anemia on QoL in 218 Indian cancer patients attending a tertiary referral hospital. The study used the sTfR/log Ferritin index to detect iron deficiency anemia and assessed patient QoL using the Functional Assessment of Cancer Therapy-Anemia (FACT-An) tool, standardized for language. Mean patient age was 51±13 years and 60% were female. The prevalence of cancer related anemia in this setting was 64% (n = 139). As expected, plasma ferritin did not differ significantly between anemic (n = 121) and non-anemic cancer patients (n = 73). In contrast, plasma sTfR levels were significantly higher in anemic cancer patients compared to non-anemic cancer patients (31 nmol/L vs. 24 nmol/L, p = 0.002). Among anemic cancer patients, using the sTfR/log Ferritin index, we found that 60% (n = 83) had iron deficiency anemia (IDA). Interestingly, plasma sTfR levels were significantly higher in cancer patients with CRA+IDA (n = 83) compared with patients having CRA (n = 38) alone (39 nmol/L vs. 20 nmol/L, p<0.001). There was a significant linear correlation between Hb and QoL (Spearman ρ = 0.21; p = 0.001) and multivariate regression analysis revealed that every gram rise in Hb was accompanied by a 3.1 unit increase in the QoL score (95% CI = 0.19–5.33; p = 0.003). The high prevalence of anemia in cancer patients, a major portion of which is due to iron deficiency anemia, the availability of sensitive and specific biomarkers of iron status to detect IDA superimposed on anemia of inflammation, suggests an urgent need to diagnose and treat such patients. Despite the potential negative consequences of increasing metabolically available plasma iron in cancer, our clinical data suggest that detecting and treating IDA in anemic cancer patients will have important consequences to their QoL and overall survival. Clinical

  6. Transfusiones en pacientes con pruebas de compatibilidad positivas y en aquellos con anemia hemolítica autoinmune Approach to transfusion support in patients with positive compatibility tests and in those with autoimmune hemolytic anemia

    Directory of Open Access Journals (Sweden)

    2007-12-01

    Full Text Available Es frecuente la presencia de pruebas de compatibilidad positivas en pacientes que requieren soporte transfusional. Los pacientes con anemia hemolítica autoinmune presentan autoanticuerpos calientes o fríos que reaccionan contra antígenos de los eritrocitos y producen reacciones hemolíticas, que pueden ir desde leves hasta graves. Los pacientes multitransfundidos o con insuficiencia renal crónica o con anemia de células falciformes, presentan aloanticuerpos que dificultan el tratamiento con derivados de la sangre. La frecuencia de los mismos es hasta de 32% en algunas series. Dado el perfeccionamiento de las técnicas de laboratorio, en la actualidad son posibles la detección y determinación de la especificidad de los autoanticuerpos y aloanticuerpos; el enfoque integral del paciente y el conocimiento de dichas técnicas son los mejores fundamentos para un soporte transfusional seguro. Positive compatibility tests in patients who need blood transfusions are common. Patients with autoimmune hemolytic anemia may have warm or cool autoantibodies that react with red blood cell antigens and produce hemolytic transfusion reactions. Multitransfused patients, and those with either chronic renal disease or sickle cell disease, have alloantibodies that make blood transfusion difficult. In some series the frequency of such antibodies is as high as 32%. Detection and determination of specificity of autoantibodies and alloantibodies are now possible because of technical developments in laboratory. An integral approach to patients and the knowledge of these procedures are the best bases to offer secure blood transfusions.

  7. CLINICO PATHOLOGICAL STUDY OF PATTERNS OF ANEMIA DURING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Chamakuri

    2015-10-01

    Full Text Available INTRODUCTION: Anemia is defined as haemoglobin level in the blood below the lower extreme of the normal range for the age and sex of the individual. According to WHO, in developing countries the prevalence of anemia among pregnant women averages 60%, ranging between 35 to 100% among different regions of the world. A hemoglobin concentration below 11.0g/dl or packed cell volume (PCV of less than 33.0% is regarded as anemia during pregnancy by the WHO. It occurs in 40 - 80% of the pregnant women. Iron and folic acid defici encies, malaria, intestinal parasitic infections and hemoglobinopathies are the principal causes of anemia in pregnancy. Predisposing factors include young age, grand multiparity, low socioeconomic status, illiteracy, ignorance and short intervals of pregn ancy. AIM AND OBJECTIVES: 1. To study various patterns of anemia in pregnant women having haemoglobin level < 11 gm%. 2. To determine the most common pattern of anemia in pregnancy based on red cell morphology. MATERIALS AND METHODS: This study is a prospe ctive study over a period of one year from September 2014 to August 2015 in the department of pathology, Andhra medical college, Visakhapatnam . The study was conducted on 120 pregnant women whose haemoglobin level is < 11 gm/dl. All the haemotological parameters & peripheral blood smear stained by Leishman’s stain were evaluated. Complete clinical & obstetric history was recorded. Socioeconomic status was also noted. RESULTS: Out of 120 cases of anemia, we found 47 patie nts (39.1% having dimorphic anemia, 36(30% – microcytic hypochromic anemia, 23(19.1% - normocytic hypochromic anemia, 11(9.16% - sickle cell anemia and 1(0.83% case of pancytopenia. Maximum cases were seen in the age group of 21 - 30 years. 52 cases (43. 3% were primigravida and remaining 68 cases (56.6% were gravida two to four. 20 cases (16.6% were diagnosed in the first trimester, 38 cases (31.6% in the second trimester & 62 cases (51.6s% in the

  8. Canine autoimmune hemolytic anemia: management challenges

    Directory of Open Access Journals (Sweden)

    Swann JW

    2016-07-01

    Full Text Available James W Swann,1 Barbara J Skelly2 1Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, Hertfordshire, 2Department of Veterinary Medicine, University of Cambridge, Cambridge, UK Abstract: Immune-mediated hemolytic anemia is one of the most common manifestations of canine immune-mediated disease, yet treatment regimens remain nonstandardized and, in some cases, controversial. The main reason for this, as for most diseases in veterinary medicine, is the lack of large-scale placebo-controlled trials so that the efficacy of one treatment over another can be established. Most of the evidence used for treatment comes from retrospective studies and from personal preference and experience, and because of this, treatment regimens tend to vary among institutions and individual clinicians. Management of immune-mediated hemolytic anemia includes immunosuppression, thromboprophylaxis, and supportive care measures to help prevent and treat concurrent conditions. Keywords: IMHA, canine immune-mediated disease, management regimens

  9. LABORATORY DIAGNOSIS OF INFECTIOUS SALMON ANEMIA (ISA)

    DEFF Research Database (Denmark)

    Schyth, Brian Dall; Olesen, Niels Jørgen; Østergaard, Peter

    The first outbreak of ISA on the Faroe Islands was diagnosed in March 2000. Despite intensive surveillance, control and eradication of ISA, the disease has since spread to most of the Faroe Islands affecting about half of the 23 aquaculture farms. Sampling and laboratory diagnosis of ISA is perfo...... characterisation of the virus causing infectious salmon anemia in Atlantic salmon (Salmo salar L): an orthomyxo-like virus in a teleost....

  10. Iron deficiency anemia in infants and toddlers

    Science.gov (United States)

    Joo, Eun Young; Kim, Keun Young; Kim, Dong Hyun; Lee, Ji-Eun

    2016-01-01

    Background In Korea, the prevalence of anemia and iron deficiency anemia (IDA) among older infants and young children remains high. To detect IDA early and to reduce its adverse impact, we assessed the characteristics of infants and young children who had IDA or were at risk of developing IDA, or who exhibited characteristics associated with severe anemia. Methods Among the 1,782 IDA-affected children aged 6 months to 18 years who visited the hospital, we retrospectively analyzed the medical records and laboratory data of 1,330 IDA-affected children aged 6–23 months who were diagnosed between 1996 and 2013. We excluded patients with a C-reactive protein level ≥5 mg/dL. Results IDA was predominant in boys (2.14:1) during infancy and early childhood. The peak IDA incidence was noted among infants aged 9–12 months. Only 7% patients exhibited symptoms of IDA, while 23.6% patients with severe IDA demonstrated classic symptoms/signs of IDA. Low birth weight (LBW) infants with IDA demonstrated low adherence to iron supplementation. In a multivariate analysis, prolonged breastfeeding without iron fortification (odds ratio [OR] 5.70), and a LBW (OR 6.49) were identified as risk factors of severe anemia. Conclusion LBW infants need more attention in order to increase their adherence to iron supplementation. For the early detection of IDA, nutritional status of all infants, and iron batteries of high-risk infants (LBW infants, infants with prolonged breastfeeding, picky eaters, and/or infants with the presence of IDA symptoms) should be evaluated at their health screening visits. PMID:28090490

  11. Pulmonary functions in pregnancy complicated with anemia

    OpenAIRE

    Subhalaxmi Dash; Sudhanshu Sekhara Nanda; Ashok Kumar Behera

    2014-01-01

    Background: The aim of the present study was to find out the variation of pulmonary function parameters in different trimesters of pregnancy as well as variation according to severity of anemia in each trimester. Methods: The present case control study was carried out in the post-graduate department of obstetrics and gynecology, M.K.C.G. medical college and hospital, Berhampur, during the period from October 2012 to October 2013. This study entitled and ldquo;Pulmonary functions in pre...

  12. Anemia - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... العربية) Bosnian (Bosanski) Chinese - Simplified (简体中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Russian (Русский) ... Anémie - français (French) Bilingual PDF Health Information Translations Hindi (हिन्दी) Anemia हिन्दी (Hindi) Bilingual PDF ...

  13. Imaging Diagnosis of Neonatal Anemia: Report of Two Unusual Etiologies

    OpenAIRE

    2013-01-01

    Anemia in neonatal period is rare, with the common causes being Rh and ABO blood group incompatibility, hemorrhagic disease of newborn, congenital hemolytic anemia, hemoglobinopathies, and TORCH (toxoplasmosis, rubella, cytomegalovirus, herpes virus) infections. Congenital leukemia and infantile osteopetrosis (OP) are among the rare causes of neonatal anemia. A review of the literature shows approximately 200 reported cases of congenital leukemia. Articles describing the imaging features of c...

  14. Anemia associated with chronic heart failure: current concepts

    OpenAIRE

    Shah R; Agarwal AK

    2013-01-01

    Ravish Shah, Anil K AgarwalDivision of Nephrology, The Ohio State University, Columbus, Ohio, USAAbstract: Anemia is a frequent comorbidity of heart failure and is associated with poor outcomes. Anemia in heart failure is considered to develop due to a complex interaction of iron deficiency, kidney disease, and cytokine production, although micronutrient insufficiency and blood loss may contribute. Currently, treatment of anemia of heart failure lacks clear targets and specific therapy is not...

  15. Cisplatin-associated anemia: an erythropoietin deficiency syndrome.

    OpenAIRE

    Wood, P A; Hrushesky, W J

    1995-01-01

    Cisplatin-based therapy results in a cumulative anemia that is disproportionate to the effects on other blood cells. The severity of this treatment-induced anemia and the resultant transfusion requirement in cancer patients correlate with cisplatin-induced renal tubular dysfunction. Observed/expected serum erythropoietin (EPO) ratios decline with progressive cisplatin therapy and are proportionate to the degree of renal dysfunction. Recovery from anemia and of observed/expected serum EPO rati...

  16. Gambaran Radiografi Rongga Mulut Pada Penderita Sickle Cell Anemia

    OpenAIRE

    Amri

    2008-01-01

    Eritrosit yang tidak normal ( hemoglobin S ) tidak larut pada tegangan oksigen rendah yang akan mengakibatkan eritrosit berbentuk bulan sabit. Eritrosit berbentuk bulan sabit ini mengalami hemolisis sehingga menyebabkan anemia berat yang dikenal sebagia anemia sel sabit atau sickle cell anemia. Gen sel sabit adalah salah satu contoh dari suatu gen yang bertahan dan menyebar di dalam populasi yang berasal dari penduduk kulit hitam Afrika. Keuntungan dari gen ini adalah dapat memberikan res...

  17. Microcytic anemia factor no estudo das anemias microcíticas

    OpenAIRE

    Teixeira, Joana; Barros, Clara

    2010-01-01

    A anemia ferropénica e a β-Talassemia menor são as anemias microcíticas mais frequentes na prática laboratorial, sendo o seu diagnóstico de extrema importância clínica. O objectivo deste estudo consistiu na análise do poder discriminatório do MAF na caracterização destas anamias. Foi desenvolvido um estudo caso-controlo, tendo sido analisados os hemogramas de um grupo de 47 indivíduos com anemia ferropénica e 37 com β-talassemia, e de um grupo controlo constituído por 58 indivíduos saudáve...

  18. Pyrexia due to megaloblastic anemia: An Unusual Case

    Directory of Open Access Journals (Sweden)

    Singh PS, Vijay Verma, Vidyasagar, Granth Kumar

    2014-07-01

    Full Text Available Postmenopausal vegetarian female presented with short febrile illness associated with generalized weakness Clinical and investigative findings evidenced megaloblastic anemia Since none of investigations could pinpoint the cause for pyrexia and patient did not respond to empirical antibiotic and conservative antimalarial therapy, megaloblastic anemia itself was suspected to be cause for febrile episode Patient was treated with parenteral B12 and oral folic acid for megaloblastic anemia and she responded to it and became afebrile within 72 hours. Subsequently megaloblastic anemia was correlated to be cause of febrile illness.

  19. Anemia Among Children Exposed to Polyparasitism in Coastal Kenya.

    Science.gov (United States)

    Chang Cojulun, Alicia; Bustinduy, Amaya L; Sutherland, Laura J; Mungai, Peter L; Mutuku, Francis; Muchiri, Eric; Kitron, Uriel; King, Charles H

    2015-11-01

    Anemia represents a substantial problem for children living in areas with limited resources and significant parasite burden. We performed a cross-sectional study of 254 Kenyan preschool- and early school-age children in a setting endemic for multiple chronic parasitic infections to explore mechanisms of their anemia. Complete venous blood cell counts revealed a high prevalence of local childhood anemia (79%). Evaluating the potential links between low hemoglobin and socioeconomic factors, nutritional status, hemoglobinopathy, and/or parasite infection, we identified age anemia. A total of 130/155 (84%) of anemic children with iron studies had evidence of iron-deficiency anemia (IDA), 16% had non-IDA; 50/52 of additionally tested anemic children met soluble transferrin-receptor (sTfR) criteria for combined anemia of inflammation (AI) with IDA. Children in the youngest age group had the greatest odds of iron deficiency (OR: 10.0, 95% CI: 3.9, 26). Although older children aged 9-11 years had less anemia, they had more detectable malaria, Schistosoma infection, hookworm, and proportionately more non-IDA. Anemia in this setting appears multifactorial such that chronic inflammation and iron deficiency need to be addressed together as part of integrated management of childhood anemia.

  20. Genetics Home Reference: thiamine-responsive megaloblastic anemia syndrome

    Science.gov (United States)

    ... Encyclopedia: Optic nerve atrophy Encyclopedia: Thiamine Health Topic: Anemia Health Topic: Diabetes Health Topic: Hearing Problems in Children Genetic and Rare Diseases Information Center (1 link) ...

  1. ACOG Practice Bulletin No. 95: anemia in pregnancy.

    Science.gov (United States)

    2008-07-01

    Anemia, the most common hematologic abnormality, is a reduction in the concentration of erythrocytes or hemoglobin in blood. The two most common causes of anemia in pregnancy and the puerperium are iron deficiency and acute blood loss. Iron requirements increase during pregnancy, and a failure to maintain sufficient levels of iron may result in adverse maternal-fetal consequences. The purpose of this document is to provide a brief overview of the causes of anemia in pregnancy, review iron requirements, and provide recommendations for screening and clinical management of anemia during pregnancy.

  2. [Anemia in workers exposed to lead: update on differential diagnosis].

    Science.gov (United States)

    Di Lorenzo, L; Soleo, L; Cassano, F; Elia, G; Schiavulli, N; Martino, M G; Corfiati, M; Bulfaro, D; Apostoli, P

    2005-01-01

    Occupational lead exposure can cause anemia at blood lead levels >50 microg/dl, as high as rarely occurs in industrialized countries nowadays. Whereas other forms of anemia are fairly probable to be found in lead exposed workers, especially in areas highly endemicfor extraoccupational anemias, such as beta thalassemia and iron deficiency anemia. The etiology of anemias has to be correctly defined in order to assess suitable therapeutical approaches and medicolegal consequences. The objective of this study is to verify in male lead exposed workers whether an accurate evaluation of hemocromocytometric parameters and of usual biological indices of lead exposure and effect on heme can differentiate the most common forms of anemia in Southern Italy. 68 workers occupationally exposed to low to moderate lead doses were studied and 59 workers of an alimentary plant have been taken as control group. On venous blood samples collected from these workers a complete hemocromocytometric test was performed and blood lead and erythrocytic zincoprotoporphyrin were determined. Anemia (Hb lead exposed workers and in a nonexposed worker. The reasoned evaluation of laboratory parameters led to identify among lead exposed workers four subjects with high probability of beta-thalassemic trait and two with lead poisoning anemia. Moreover a diagnostic algorithm was developed based on literature that seems to be able to discriminate lead poisoning from other causes of anemia in lead exposed workers in this study.

  3. Relation between blood lead levels and childhood anemia in India.

    Science.gov (United States)

    Jain, Nitin B; Laden, Francine; Guller, Ulrich; Shankar, Anoop; Kazani, Shamsah; Garshick, Eric

    2005-05-15

    Lead pollution is a substantial problem in developing countries such as India. The US Centers for Disease Control and Prevention has defined an elevated blood lead level in children as > or = 10 microg/dl, on the basis of neurologic toxicity. The US Environmental Protection Agency suggests a threshold lead level of 20-40 microg/dl for risk of childhood anemia, but there is little information relating lead levels anemia. Therefore, the authors examined the association between lead levels as low as 10 mug/dl and anemia in Indian children under 3 years of age. Anemia was divided into categories of mild (hemoglobin level 10-10.9 g/dl), moderate (hemoglobin level 8-9.9 g/dl), and severe (hemoglobin level Lead levels lead levels > or = 10-19.9 microg/dl and 97 (9%) had levels > or = 20 microg/dl. After adjustment for child's age, duration of breastfeeding, standard of living, parent's education, father's occupation, maternal anemia, and number of children in the immediate family, children with lead levels > or = 10 microg/dl were 1.3 (95% confidence interval: 1.0, 1.7) times as likely to have moderate anemia as children with lead levels anemia was 1.7 (95% confidence interval: 1.1, 2.6). Health agencies in India should note the association of elevated blood lead levels with anemia and make further efforts to curb lead pollution and childhood anemia.

  4. Iron deficiency anemia--bridging the knowledge and practice gap.

    Science.gov (United States)

    Shander, Aryeh; Goodnough, Lawrence T; Javidroozi, Mazyar; Auerbach, Michael; Carson, Jeffrey; Ershler, William B; Ghiglione, Mary; Glaspy, John; Lew, Indu

    2014-07-01

    Despite its high prevalence, anemia often does not receive proper clinical attention, and detection, evaluation, and management of iron deficiency anemia and iron-restricted erythropoiesis can possibly be an unmet medical need. A multidisciplinary panel of clinicians with expertise in anemia management convened and reviewed recent published data on prevalence, etiology, and health implications of anemia as well as current therapeutic options and available guidelines on management of anemia across various patient populations and made recommendations on the detection, diagnostic approach, and management of anemia. The available evidence confirms that the prevalence of anemia is high across all populations, especially in hospitalized patients. Anemia is associated with worse clinical outcomes including longer length of hospital stay, diminished quality of life, and increased risk of morbidity and mortality, and it is a modifiable risk factor of allogeneic blood transfusion with its own inherent risks. Iron deficiency is usually present in anemic patients. An algorithm for detection and management of anemia was discussed, which incorporated iron study (with primary emphasis on transferrin saturation), serum creatinine and glomerular filtration rate, and vitamin B12 and folic acid measurements. Management strategies included iron therapy (oral or intravenous), erythropoiesis-stimulating agents, and referral as needed.

  5. Unexpected Anemia and Reticulocytopenia in an Adolescent With Sickle Cell Anemia Receiving Chronic Transfusion Therapy.

    Science.gov (United States)

    Blauel, Emily R; Grossmann, Lily T; Vissa, Madhav; Miller, Scott T

    2015-10-01

    In a patient with sickle cell disease receiving chronic transfusion, exacerbation of anemia with reticulocytopenia must prompt consideration of a delayed hemolytic transfusion reaction with hyperhemolysis, as further transfusion may worsen this condition; definitive diagnosis is sometimes difficult. Anemia evolving during parvovirus B19-induced erythroid hypoplasia (transient aplastic crisis) should be attenuated in chronic transfusion patients due to superior survival of transfused over endogenous red blood cells. A 16-year-old with sickle cell disease receiving chronic transfusion of modified intensity (goal to maintain hemoglobin Sanemia with reticulocytopenia was later shown to have had transient aplastic crisis.

  6. APLASTIC ANEMIA ET CAUSA OF SUSPECT VIRAL HEPATITIS INFECTION: A CASE REPORT

    OpenAIRE

    I Wayan Wawan Lismana

    2014-01-01

    Aplastic anemia is anemia that occurs because of a failure of hematopoiesis is relatively rarebut can be life threatening. The cause of aplastic anemia itself is still largely unknown oridiopathic. Minority of cases mainly due to a virus infection, one of which is viral hepatitishas long been known to cause symptoms of aplastic anemia. This report discusses thesuspected aplastic anemia caused by hepatitis virus infection. Course of the disease or theprognosis of aplastic anemia varies, but a ...

  7. Long-term sequential monitoring of controlled graves representing common burial scenarios with ground penetrating radar: Years 2 and 3

    Science.gov (United States)

    Schultz, John J.; Walter, Brittany S.; Healy, Carrie

    2016-09-01

    Geophysical techniques such as ground-penetrating radar (GPR) have been successfully used for forensic searches to locate clandestine graves and physical evidence. However, additional controlled research is needed to fully understand the applicability of this technology when searching for clandestine graves in various environments, soil types, and for longer periods of time post-burial. The purpose of this study was to determine the applicability of GPR for detecting controlled graves in a Spodosol representing multiple burial scenarios for Years 2 and 3 of a three-year monitoring period. Objectives included determining how different burial scenarios are factors in producing a distinctive anomalous response; determining how different GPR imagery options (2D reflection profiles and horizontal time slices) can provide increased visibility of the burials; and comparing GPR imagery between 500 MHz and 250 MHz dominant frequency antennae. The research site contained a grid with eight graves representing common forensic burial scenarios in a Spodosol, a common soil type of Florida, with six graves containing a pig carcass (Sus scrofa). Burial scenarios with grave items (a deep grave with a layer of rocks over the carcass and a carcass wrapped in a tarpaulin) produced a more distinctive response with clearer target reflections over the duration of the monitoring period compared to naked carcasses. Months with increased precipitation were also found to produce clearer target reflections than drier months, particularly during Year 3 when many grave scenarios that were not previously visible became visible after increased seasonal rainfall. Overall, the 250 MHz dominant frequency antenna imagery was more favorable than the 500 MHz. While detection of a simulated grave may be difficult to detect over time, long term detection of a grave in a Spodosol may be possible if the disturbed spodic horizon is detected. Furthermore, while grave visibility increased with the 2D

  8. Morbidade Materna Grave e Near Misses em Hospital de Referência Regional

    Directory of Open Access Journals (Sweden)

    Márcia Lait Morse

    Full Text Available OBJETIVO: Analisar perfil epidemiológico da morbidade materna grave/near miss em uma maternidade pública de referência regional, utilizando diferentes critérios identificadores. MÉTODOS: Trata-se de um estudo descritivo de corte transversal dos casos de morbidade materna grave/near miss realizado em Hospital de referência regional entre junho e outubro de 2009, identificados a partir dos livros de registro de internação da maternidade e análise dos prontuários clínicos. Foram estudadas mulheres que, durante a gestação, parto ou puerpério, apresentaram qualquer quadro clínico compatível com os critérios definidores de morbidade materna grave/near miss de Waterstone et al., Mantel et al. e Organização Mundial de Saúde. RESULTADOS: Entre as 1.544 internações foram identificadas 89 mulheres com morbidade materna grave, considerando os critérios adotados. As razões de morbidade materna grave/near miss variaram entre 81,4 a 9,4 por 1.000 NV, dependendo do critério utilizado. O índice de Mortalidade foi de 3,2%, chegando a 23% no critério da OMS. Das 89 mulheres, apenas 40% fizeram mais de seis consultas de pré-natal e 10% não realizaram qualquer consulta. Os marcadores mais encontrados foram a pré-eclâmpsia grave seguida de hemorragia grave, internação em UTI, Síndrome HELLP e eclâmpsia. Ocorreram três mortes maternas por causas obstétricas com RMM de 280/100.000 NV e uma morte tardia. O critério da OMS se mostrou mais específico, identificando os casos mais graves, enquanto o de Waterstone foi mais sensível. CONCLUSÃO: O estudo da morbidade materna grave/near miss em um hospital de referência regional pode contribuir para o conhecimento da magnitude deste evento, como também identificar suas características e condições clínicas mais frequentes, sendo extremamente importante para o enfrentamento da morbi-mortalidade materna.

  9. Prevalence and pattern of anemia in the second and third trimester pregnancy in Western Rajasthan

    Directory of Open Access Journals (Sweden)

    Kiran Rawat

    2016-11-01

    Results: 17,552 second and third trimester pregnant females were evaluated and prevalence of anemia was found 48.4%. The percentages of mild, moderate and severe anemia were 35.1%, 51.3% and 13.4% respectively. Most common morphological type was microcytic hypochromic anemia (51% followed by normocytic normochromic anemia (32%, dimorphic anemia (13% and macrocytic anemia (4%. Conclusions: There is high prevalence of anemia in pregnant females. This warrants the need of proper prophylaxis and early diagnosis of anemia in pregnancy to minimize the maternal-fetal morbidity and mortality. [Int J Res Med Sci 2016; 4(11.000: 4797-4799

  10. Induction of animal model of Graves' disease in BALB/c mice

    Institute of Scientific and Technical Information of China (English)

    Zhu-fang Tian; Bing-yin Shi; Xiao-yan Wu; Li Xu

    2009-01-01

    Objective To construct an animal model of Graves' disease (GD) by immunizing BALB/c mice with hM12 cells co-expressing major histocompatibility complex (MHC) class Ⅱ molecules and human thyrotropin receptor (TSHR) molecules. Methods BALB/c mice in experimental group (H-2d) were immunized with hM12 cells Intraper-itoncally every 2 weeks for six times, while mice in control group were immunized with M12 cells. Five weeks later, the thyroids were histologically examined, and serum samples were tested for thyroid-stimulating antibodies (TSAb) and thyroid hormone levels. Results One BALB/c mouse in experimental group developed Graves'-like disease. Total T4 and T3 levels in this mouse were above the upper limit of normal, TSAb activity was displayed in its serum. The thyroid histologically showed the features of thyroid hyperactivity including thyrocyte hypercellularity and colloid absorption.None of control mice developed Graves'-like disease. Conclusion An animal model with some characteristics of human Graves' disease was successfully induced and the model will facilitate studies aimed directly at understanding the patho-genesis of autoimmunity in Graves' disease.

  11. Pollen studies of textile from an Iron Age grave at Hammerum, Denmark

    DEFF Research Database (Denmark)

    Enevold, Renée

    2013-01-01

    was rewarded with a set of results which permitted detailed interpretation. Large amounts of pollen of crops and associated anthropogenic plants in the textile sample suggest that agricultural work was the primary source of the pollen embedded in the clothing. In contrast, the pollen assemblages from......This article presents the methods employed and the results obtained in pollen studies of a prehistoric grave, identifying a fascinating and productive context for pollen analyses: prehistoric textiles. The methods involved direct sampling from the grave during excavation and various measures aimed...... at minimizing the risk of contamination, thereby maximising the information gained about various aspects of contemporary prehistoric life. The example used was an Iron Age grave from Hammerum, Denmark which was found to contain very well preserved clothing. The clothing and surrounding sediment were block...

  12. Image and Role of the Queen Mother of the West in Han Grave Art

    Directory of Open Access Journals (Sweden)

    Nataša VAMPELJ SUHADOLNIK

    2015-12-01

    Full Text Available The present article is a detailed study of the image of an ancient Chinese goddess, The Queen Mother of the West, called Xiwangmu 西王母 in Chinese. In the mythological tradition, Xiwangmu is a goddess who possesses the elixir of immortality and dwells in the western paradise, on the magic mountain Kunlun 崑崙. While her image can be found in mural paintings, and on lacquered objects and bronze mirrors, it appears primarily in the form of relief images on the stones and bricks of grave chambers and temples in the Han (206 BCE–220 CE grave complexes. The literary tradition reveals a multifunctional role of the mother, with her many attributes developing in accordance with the changing values of social and mythological concepts. The article concludes with a detailed discussion of her image and role within the wider cosmological context of Han grave art.

  13. Heterotopic relation between media and materiality in children's online memorials and on children's graves

    DEFF Research Database (Denmark)

    Sandvik, Kjetil; Christensen, Dorthe Refslund

    place across media. We show how the death of an infant can lead to mediation, remediation and mediatization strategies which involves both the uses and arrangement of objects on memorial pages and on children’s graves as well as uses of new social technologies, that produce, negotiate and develop social......In this paper we analyze how bereaved parents make use of various media-strategies on online memorial sites and on children’s graves when performing processes of grief and commemoration for their stillborns and infants, and how these processes are not just linked to one particular media but take...... relations with the dead child and the (re)negotiating of parenthood. We understand media as a function of an object reflected in human practices and embedded and structured by the different materialities they are intertwined with. We argue that the use of media and materiality online and on the graves are...

  14. Urinary iron excretion test in iron deficiency anemia.

    Directory of Open Access Journals (Sweden)

    Kimura,Ikuro

    1980-02-01

    Full Text Available A urinary iron excretion test was carried out in 22 patients with iron deficiency anemia. The iron excretion index was significantly higher in patients with intractable iron deficiency anemia compared with normal subjects and anemic patients who were responsive to iron therapy. The findings suggest that iron excretion may be a factor that modulates the response of patients to iron therapy.

  15. Management of Anemia of Inflammation in the Elderly

    Directory of Open Access Journals (Sweden)

    Antonio Macciò

    2012-01-01

    Full Text Available Anemia of any degree is recognized as a significant independent contributor to morbidity, mortality, and frailty in elderly patients. Among the broad types of anemia in the elderly a peculiar role seems to be played by the anemia associated with chronic inflammation, which remains the most complex form of anemia to treat. The origin of this nonspecific inflammation in the elderly has not yet been clarified. It seems more plausible that the oxidative stress that accompanies ageing is the real cause of chronic inflammation of the elderly and that the same oxidative stress is actually a major cause of this anemia. The erythropoietic agents have the potential to play a therapeutic role in this patient population. Despite some promising results, rHuEPO does not have a specific indication for the treatment of anemia in the elderly. Moreover, concerns about their side effects have spurred the search for alternatives. Considering the etiopathogenetic mechanisms of anemia of inflammation in the elderly population, an integrated nutritional/dietetic approach with nutraceuticals that can manipulate oxidative stress and related inflammation may prevent the onset of this anemia and its negative impact on patients’ performance and quality of life.

  16. Anemia caused by low iron -- infants and toddlers

    Science.gov (United States)

    ... tongue Have headaches or dizziness With more severe anemia, your child may have: Blue-tinged or pale whites of ... and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). Pediatrics. 2010;126( ...

  17. Etiology of Strokes in Children with Sickle Cell Anemia

    Science.gov (United States)

    DeBaun, Michael R.; Derdeyn, Colin P.; McKinstry, Robert C., III

    2006-01-01

    The most devastating complication of sickle cell anemia is cerebral infarction, affecting [approximately]30% of all individuals with sickle cell anemia. Despite being one of the most common causes of stroke in infants and children, the mechanism of cerebral infarction in this population has not been extensively studied and is poorly understood.…

  18. Anemia in chronic heart failure : etiology and treatment options

    NARCIS (Netherlands)

    Westenbrink, B. Daan; de Boer, Rudolf A.; Voors, Adriaan A.; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    2008-01-01

    Purpose of review Anemia is common in patients with chronic heart failure, and is related to increased morbidity and mortality. The etiology of anemia in heart failure is complex and still not fully resolved. The review will describe current advances in the understanding of the pathophysiology of an

  19. Multivariable Discriminant Analysis for the Differential Diagnosis of Microcytic Anemia

    Directory of Open Access Journals (Sweden)

    Eloísa Urrechaga

    2013-01-01

    Full Text Available Introduction. Iron deficiency anemia and thalassemia are the most common causes of microcytic anemia. Powerful statistical computer programming enables sensitive discriminant analyses to aid in the diagnosis. We aimed at investigating the performance of the multiple discriminant analysis (MDA to the differential diagnosis of microcytic anemia. Methods. The training group was composed of 200 β-thalassemia carriers, 65 α-thalassemia carriers, 170 iron deficiency anemia (IDA, and 45 mixed cases of thalassemia and acute phase response or iron deficiency. A set of potential predictor parameters that could detect differences among groups were selected: Red Blood Cells (RBC, hemoglobin (Hb, mean cell volume (MCV, mean cell hemoglobin (MCH, and RBC distribution width (RDW. The functions obtained with MDA analysis were applied to a set of 628 consecutive patients with microcytic anemia. Results. For classifying patients into two groups (genetic anemia and acquired anemia, only one function was needed; 87.9% β-thalassemia carriers, and 83.3% α-thalassemia carriers, and 72.1% in the mixed group were correctly classified. Conclusion. Linear discriminant functions based on hemogram data can aid in differentiating between IDA and thalassemia, so samples can be efficiently selected for further analysis to confirm the presence of genetic anemia.

  20. An Etiologic Profile of Anemia in 405 Geriatric Patients

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    Tabea Geisel

    2014-01-01

    Full Text Available Background. Anemia is a common condition in the elderly and a significant risk factor for increased morbidity and mortality, reducing not only functional capacity and mobility but also quality of life. Currently, few data are available regarding anemia in hospitalized geriatric patients. Our retrospective study investigated epidemiology and causes of anemia in 405 hospitalized geriatric patients. Methods. Data analysis was performed using laboratory parameters determined during routine hospital admission procedures (hemoglobin, ferritin, transferrin saturation, C-reactive protein, vitamin B12, folic acid, and creatinine in addition to medical history and demographics. Results. Anemia affected approximately two-thirds of subjects. Of 386 patients with recorded hemoglobin values, 66.3% were anemic according to WHO criteria, mostly (85.1% in a mild form. Anemia was primarily due to iron deficiency (65%, frequently due to underlying chronic infection (62.1%, or of mixed etiology involving a combination of chronic disease and iron deficiency, with absolute iron deficiency playing a comparatively minor role. Conclusion. Greater awareness of anemia in the elderly is warranted due to its high prevalence and negative effect on outcomes, hospitalization duration, and mortality. Geriatric patients should be routinely screened for anemia and etiological causes of anemia individually assessed to allow timely initiation of appropriate therapy.

  1. Iron deficiency anemia in adolescents: a literature review

    Directory of Open Access Journals (Sweden)

    Romilda Castro de Andrade Cairo

    2014-06-01

    Full Text Available Introduction: Anemia is one of the most important nutritional deficiencies affecting various social and socioeconomic strata. It is more common in developing countries, with children and adolescents being at a significantly higher risk for the condition. Objective: To perform a literature review on iron deficiency anemia in adolescence as a public health issue and on the risk factors that may contribute towards nutritional deficiencies, stunted growth and development in this age group, emphasizing the physiopathology and causes of anemia, the different diagnostic approaches, and its clinical characteristics, prevention and treatment. Methodology: The LILACS-BIREME, SCIELO and PUBMED databases were consulted for the study. Scientific papers published in Spanish, Portuguese or English between 2000 and 2013 on the subject of iron deficiency anemia in adolescents were selected for inclusion. A total of 102 studies published between January 1st, 2000 and June 30th, 2013 were identified and evaluated. Forty-two articles meeting the inclusion criterion (adolescents with anemia were selected for this review. Finally, an analysis was conducted and the papers were evaluated in accordance with the study objectives. Results and Discussion: The studies reviewed revealed a prevalence of iron deficiency anemia of around 20% in adolescents and described the harmful effects of anemia in this age group. Conclusion: Preventive action is required with respect to iron deficiency anemia. Healthcare professionals should be aware of the need for early diagnosis, prophylaxis and treatment.

  2. Factors Associated with Anemia in the Institutionalized Elderly

    Science.gov (United States)

    da Silva, Emanuelle Cruz; Roriz, Anna Karla Carneiro; Eickemberg, Michaela; Mello, Adriana Lima; Côrtes, Elvira Barbosa Quadros; Feitosa, Caroline Alves; Medeiros, Jairza Maria Barreto; Ramos, Lílian Barbosa

    2016-01-01

    As a common problem in long-term care facilities (LTCFs), anemia affects 25–63% of the elderly. The aim of the present study was to describe the prevalence and characteristics of anemia and its associated factors in the institutionalized elderly. The cross-sectional study was carried out with three hundred thirteen individuals aged ≥ 60 years, of both genders, living in long-term care facilities for the elderly in Salvador, Bahia, Brazil. Poisson regression (PR) with robust variance estimates was used to assess the factors related to anemia. The prevalence of anemia was 38%. Mild anemia was predominant in both genders (male: 26.8%; female: 21.1%), as normocytic and normochromic anemia, with no anisocytosis (69.75%). Anemia was associated with thinness (PR: 1.68; 95% CI: 1.04–2.72) and with moderate (PR: 1.98; 95% CI: 1.07–3.63) and total (PR: 2.61; 95% CI: 1.34–5.07) dependence in the final model. Severe dependence exhibited borderline significance (PR: 1.94; 95% CI: 1.00–3.77). The prevalence of anemia was high in the institutionalized elderly in both genders, with characteristics suggesting chronic diseases as the causal factor, and the frequency of occurrence was higher in thinness elderly with moderate to total dependence. PMID:27607057

  3. Iron deficiency anemia due to excessive green tea drinking

    OpenAIRE

    Fan, Frank S.

    2016-01-01

    Key Clinical Message Tea interferes with iron absorption and can lead to iron deficiency anemia when consumed in large quantities. The rechallenge effect of green tea on anemia in a middle‐aged man emphasizes the potential causal role of this beverage. Lifestyle and dietary habits are important diagnostic considerations in diseases of this type.

  4. Treatment of iron deficiency anemia with Ferro-Folgamma.

    Science.gov (United States)

    Ghinea, Mihaela Maria

    2004-01-01

    Iron deficiency anemia is a hypochromic anemia in which hemoglobin poor synthesis is due to a decrease in the amount of iron in the body. The decrease of iron quantity has many causes: insufficient intake of aliments rich in iron (meat, viscera, green vegetables), increased necessities during growth period, pregnancy, erythrocytes hyperregeneration, high-performance sportsmen, increased loss by digestive way, genito-urinary way, respiratory, hemorrhagic syndromes. Clinically, symptoms and signs specific to all types of anemia and those specific to lack of iron occur besides the symptoms and signs of the underlying disease: atrophic glositis, angular stomatitis, sideropenic dysphagia, pica, skin and nails changes. Laboratory investigations useful for diagnosis are: microcytic, hypochromic anemia, decreased serum iron level, total capacity of iron binding increased, medullar iron store absent, good response to iron therapy. Ferro-Folgamma is one of the most indicated medicines in iron deficiency anemia. Due to its components this medicine has many indications: insufficient alimentary intake concerning iron, folic acid, B12 vitamin, vegetarian alimentation, increased needs during growth period, iron deficiency anaemia secondary to chronic hemorrhages, malnutrition, anemias associated with chronic alcohol intake, preventive treatment of iron deficiency anemia and megaloblastic anemia during pregnancy and lactation.

  5. Accuracy of anemia diagnosis by physical examination

    Directory of Open Access Journals (Sweden)

    Isabela Martins Benseñor

    Full Text Available CONTEXT AND OBJECTIVES: Quantification of clinical signs such as the presence or absence of pallor at clinical examination is a key step for making diagnoses. The aim was, firstly, to evaluate two methods for anemia diagnosis by physical examination: four-level evaluation (crosses method: +/++/+++/++++ and estimated hemoglobin values, both performed by medical students and staff physicians; and secondly, to investigate whether there was any improvement in assessment accuracy according to the number of years in clinical practice. DESIGN AND SETTING: Forty-four randomly selected physicians and medical students in a tertiary care teaching hospital completed a physical examination on five patients with mild to severe anemia. METHODS: The observers used four-level evaluation and also predicted the hemoglobin level. Both methods were compared with the real hemoglobin value as the gold standard. RESULTS: The mean estimated hemoglobin value correlated better with the real hemoglobin values than did the four-level evaluation method, for attending physicians, residents and students (Spearman's correlation coefficients, respectively: 1.0, 1.0 and 0.9 for guessed hemoglobin and -0.8, -0.8 and -0.7 for the four-level evaluation method. There were no differences in the mean "guessed" hemoglobin values from attending physicians, residents and students. However, the correlation between guessed hemoglobin value and the four-level method was positive for attending physicians, thus suggesting some kind of improvement with time (p = 0.04. CONCLUSIONS: This study showed that estimated hemoglobin was more accurate than evaluation by the four-level method. The number of years in clinical practice did not improve the accuracy of clinical examination for anemia.

  6. Iron, anemia and hepcidin in malaria

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    Natasha eSpottiswoode

    2014-05-01

    Full Text Available Malaria and iron have a complex but important relationship. Plasmodium proliferation requires iron, both during the clinically silent liver stage of growth and in the disease-associated phase of erythrocyte infection. Precisely how the protozoan acquires its iron from its mammalian host remains unclear, but iron chelators can inhibit pathogen growth in vitro and in animal models. In humans, iron deficiency appears to protect against severe malaria, while iron supplementation increases risks of infection and disease. Malaria itself causes profound disturbances in physiological iron distribution and utilization, through mechanisms that include hemolysis, release of heme, dyserythropoiesis, anemia, deposition of iron in macrophages, and inhibition of dietary iron absorption. These effects have significant consequences. Malarial anemia is a major global health problem, especially in children, that remains incompletely understood and is not straightforward to treat. Furthermore, the changes in iron metabolism during a malaria infection may modulate susceptibility to coinfections. The release of heme and accumulation of iron in granulocytes may explain increased vulnerability to non-typhoidal Salmonella during malaria. The redistribution of iron away from hepatocytes and into macrophages may confer host resistance to superinfection, whereby blood-stage parasitemia prevents the development of a second liver-stage Plasmodium infection in the same organism. Key to understanding the pathophysiology of iron metabolism in malaria is the activity of the iron regulatory hormone hepcidin. Hepcidin is upregulated during blood-stage parasitemia and likely mediates much of the iron redistribution that accompanies disease. Understanding the regulation and role of hepcidin may offer new opportunities to combat malaria and formulate better approaches to treat anemia in the developing world.

  7. The Roma: People without a Home or Grave

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    Vera Klopčič

    2010-12-01

    Full Text Available Although the Roma have been living in Europe for centuries, they still face rejection by majority populations, being treated as undesirable strangers in almost all European countries. Written evidence of their arrival can be traced back to the fourteenth and fifteenth centuries. There are many legends and myths about their origins and reasons for emigrating from their country of origin. Until recently, the Roma transmitted their own history only as oral tradition. One of the best-known contemporary Roma intellectuals, journalist and writer Rajko Djurić, picturesquely explains the importance of the Romany language for further exploration of Roma culture and their origin: “Romany is the only book they brought from India; it constitutes their collective memory and reflects the views of this people, to themselves, to the world, and to other peoples. Their language is an inventory of the material and spiritual culture to which they once belonged, and contains elements of culture of other peoples that they came into contact with during their long and yet insufficiently studied journey.” When the Roma arrived in Europe, their lifestyle differed significantly from that of other European peoples. As a result, majorities and other groups in Europe intervened in their lives for centuries. They were forced to abandon their nomadic way of life. In the past, authorities often expelled them from their territory and they did not enjoy legal protection when violence or crimes were committed against them. Living in isolated settlements, excluded from social life, segregated, and discriminated against by others, they lived on the margins as a people without a home or a grave. At the same time, they established their parallel world as a system of social norms valid within their community, and within it all non-Roma were perceived as gadje ‘outsiders’. Roma legends explain the reasons for their nomadic way of life: they contain stories of persecution and

  8. Mediastinal neoplasms in patients with Graves disease: a possible link between sustained hyperthyroidism and thymic neoplasia?

    Directory of Open Access Journals (Sweden)

    Boyd Jonathan D

    2012-07-01

    Full Text Available Abstract Background Anterior mediastinal masses are a rare but well documented finding in Graves disease. The vast majority of these lesions represents benign thymic hypertrophy and regress after treatment of the hyperthyroidism. A small percentage of these cases however represent neoplastic/malignant diseases which require further treatment. Cases 12 year old boy with one year history of refractory Graves disease was found to have an anterior mediastinal mass and underwent curative thyroidectomy for sustained hyperthyroidism. Cervical lymphadenopathy was detected during the procedure and biopsy was obtained. A 23 year old woman who presented with a one month history of hyperthyroid symptoms, was diagnosed with Graves disease and also was found to have an anterior mediastinal mass on imaging. Biopsy of the anterior mediastinal mass was obtained and subsequently the patient underwent robotic thymectomy. Histologic examination and immunophenotyping of the cervical lymph node in a 12 year old boy revealed neoplastic proliferation of T lymphoblasts diagnostic of T lymphoblastic leukemia/lymphoma. Examination of the anterior mediastinal mass biopsy in the 23 year old woman revealed type B1 thymoma which was confirmed after examination of the subsequent robotic thymectomy specimen. Conclusion This is the first reported case of T cell lymphoblastic lymphoma and the third reported case of thymoma associated with sustained hyperthyroidism due to Graves disease. These cases indicate that an anterior mediastinal mass in a patient with active Graves disease may be due to a neoplastic cause, which may require definitive treatment. Caution should be exercised when dismissing a mediastinal mass as benign thymic hyperplasia in patients with active Graves disease.

  9. Doença de Graves associada à artrite idiopática juvenil Graves' disease associated with juvenile idiopathic arthritis

    Directory of Open Access Journals (Sweden)

    Vanessa de Matos Santos Mendonça Marques

    2011-04-01

    Full Text Available Os autores relatam o caso de uma menina de 10 anos de idade com diagnóstico de doença de Graves (DG, em tratamento com propiltiouracil, que desenvolveu uveíte e artrite poliarticular e cuja mãe também tem DG e lúpus discoide. São discutidos os diagnósticos diferenciais de artrite inflamatória que surge em uma criança com doença tireoidiana autoimune medicada com drogas antitireóideas.The authors report the case of a 10-year-old girl with Graves' disease (GD, treated with propylthiouracil, who developed uveitis and polyarticular arthritis, and whose mother also had GD and discoid lupus. The differential diagnosis of inflammatory arthritis that appears in a child with autoimmune thyroid disease managed with antithyroid drugs is discussed.

  10. SEVERE IMMUNE HEMOLYTIC ANEMIA AFTER LIVER TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    A. I. Sushkov

    2013-01-01

    Full Text Available Clinical case of successful treatment of severe immune hemolytic anemia after liver transplantation is represen- ted in this article. The cause of complication was so-called passenger lymphocyte syndrome (a type of graft- versus-host disease. Two plasmapheresis sessions and Ig (0.5 g/kg in combination with increased maintenance immunosuppression with a short course of oral methylprednisolone in a total dose of 150 mg during 12 days were effective. The patient was discharged from hospital 34 days after transplantation in a satisfactory condition with a stable hemoglobin level. 

  11. Anemia falciforme e infecções

    OpenAIRE

    Di Nuzzo, Dayana V. P.; Silvana F. Fonseca

    2004-01-01

    p.347-354 Objetivo: A alta prevalência de anemia falciforme em nosso meio e a elevada morbimortalidade por infecções associada a esta condição estimularam a realização deste artigo de revisão. Fonte de dados: Realizamos uma revisão bibliográfica no banco de dados MEDLINE no período de 1986 até 2003. Foram encontradas cerca de 600 referências sobre o tema, sendo selecionados 35 artigos, os quais, aliados a capítulos de dois livros-textos, compuseram esta revisão. Sín...

  12. Diagnosis and classification of autoimmune hemolytic anemia.

    Science.gov (United States)

    Bass, Garrett F; Tuscano, Emily T; Tuscano, Joseph M

    2014-01-01

    Uncompensated autoantibody-mediated red blood cell (RBC) consumption is the hallmark of autoimmune hemolytic anemia (AIHA). Classification of AIHA is pathophysiologically based and divides AIHA into warm, mixed or cold-reactive subtypes. This thermal-based classification is based on the optimal autoantibody-RBC reactivity temperatures. AIHA is further subcategorized into idiopathic and secondary with the later being associated with a number of underlying infectious, neoplastic and autoimmune disorders. In most cases AIHA is confirmed by a positive direct antiglobulin test (DAT). The standard therapeutic approaches to treatment of AIHA include corticosteroids, splenectomy, immunosuppressive agents and monoclonal antibodies.

  13. Postpartum thyrotoxicosis in a patient with Graves' disease. Association with low radioactive iodine uptake

    Energy Technology Data Exchange (ETDEWEB)

    Eckel, R.H.; Green, W.L.

    1980-04-11

    A patient with previously diagnosed Graves' hyperthyroidism had a transient episode of thyrotoxicosis three months postpartum. This was associated with a diffusely enlarged thyroid gland, a rise in antithyroid microsomal antibody titer, a 24-hour radioactive iodine uptake (RAIU) of 1%, and an aspiration biopsy specimen suggestive of chronic lymphocytic thyroiditis. An alternative cause for the depressed RAIU was not discovered. This case would suggest that patients with previously diagnosed Graves' disease can have thyrotoxicosis without an enhanced RAIU and that the postpartum thyrotoxin syndrome may involve an immunologic injury causing a release of performed thyroid hormone.

  14. Epidemiología del traumatismo torácico grave

    OpenAIRE

    Cordero Lorenzana, María Lourdes

    2016-01-01

    [Resumen] Objetivo: Características del traumatismo torácico grave en UCI. Mortalidad. Material y método: Análisis descriptivo retrospectivo, univariado y regresión de 100 variables en 1174 pacientes con traumatismo torácico grave (1993-2010). Resultados: Más varones (4:1) de 43,5±18,9 años. 96,5% de traumatismos torácicos cerrados y 89% asociado. Lesiones óseas frecuentes: fracturas costales (71,2%) y claviculares (17,9%). Otras: contusión pulmonar (44%), hemotórax (41,7...

  15. [Treatment of hyperthyroidism due to Graves' disease: what is the recommended antithyroid drug during pregnancy?].

    Science.gov (United States)

    Caron, P

    2013-05-01

    Clinical hyperthyroidism during the first trimester of pregnancy due to Graves' disease can be associated with maternal, obstetrical and fetal complications, indicating an active treatment to restore normal thyroid function. Antithyroid drugs are the first line treatment in pregnant women with hyperthyroidism. Due to the increased congenital malformations reported in neonates after first-trimester carbimazole/methimazole treatment and propylthiouracil associated hepatotoxicity, the recommended treatment for pregnant women with hyperthyroid Graves' disease is propylthiouracil during the first trimester of pregnancy and following the first trimester, consideration should be given switching to carbimazole/methimazole during the second part of gestation.

  16. ¿Hay diferencias entre la violencia grave y la violencia menos grave contra la pareja?: un análisis comparativo

    Directory of Open Access Journals (Sweden)

    Enrique Echeburúa

    2008-01-01

    Full Text Available En este estudio ex post facto se lleva a cabo una descripción de las características presentadas por 1.081 casos denunciados por violencia contra la mujer en las comisarías de la Ertzaintza del País Vasco. En primer lugar, se presentan las variables psicológicas y sociodemográficas del agresor y de la víctima, así como de la relación de pareja. Y en segundo lugar, se determinan las diferencias más significativas entre la violencia grave y la violencia menos grave en relación con esas mismas variables. Los resultados ponen de manifiesto que tanto los agresores como las víctimas tienden a ser jóvenes, con una sobrerrepresentación de agresores y víctimas extranjeros inmigrantes. En el caso de los maltratadores graves, tienden a ser celosos o posesivos, a sentirse humillados por la ruptura de la pareja, lo que redunda directamente en un descenso de su autoestima y a consumir abusivamente alcohol o drogas. Por lo que se refiere a las víctimas de la violencia grave, se suelen sentir con frecuencia en peligro de muerte y están más fácilmente en circunstancias de vulnerabilidad, como una edad muy joven, una personalidad muy dependiente, una situación de enfermedad crónica o de dependencia económica, un consumo de drogas o un entorno de soledad. Se comentan las implicaciones de este estudio para la investigación y para la práctica clínica.

  17. Management of Iron-Deficiency Anemia in Inflammatory Bowel Disease

    DEFF Research Database (Denmark)

    Nielsen, Ole Haagen; Ainsworth, Mark; Coskun, Mehmet;

    2015-01-01

    , and the websites of WHO, FDA, and EMA covered prospective trials investigating the management of iron-deficiency anemia in IBD published since 2004. A total of 632 articles were reviewed, and 13 articles (2906 patients) with unique content were included. In general, oral supplementation in iron-deficiency anemia......Anemia is the most frequent complication of inflammatory bowel disease (IBD), but anemia, mostly due to iron deficiency, has long been neglected in these patients. The aim was to briefly present the pathophysiology, followed by a balanced overview of the different forms of iron replacement...... available, and subsequently, to perform a systematic review of studies performed in the last decade on the treatment of iron-deficiency anemia in IBD. Given that intravenous therapies have been introduced in the last decade, a systematic review performed in PubMed, EMBASE, the Cochrane Library...

  18. Management of Iron-Deficiency Anemia in Inflammatory Bowel Disease

    DEFF Research Database (Denmark)

    Nielsen, Ole Haagen; Ainsworth, Mark; Coskun, Mehmet

    2015-01-01

    Anemia is the most frequent complication of inflammatory bowel disease (IBD), but anemia, mostly due to iron deficiency, has long been neglected in these patients. The aim was to briefly present the pathophysiology, followed by a balanced overview of the different forms of iron replacement...... available, and subsequently, to perform a systematic review of studies performed in the last decade on the treatment of iron-deficiency anemia in IBD. Given that intravenous therapies have been introduced in the last decade, a systematic review performed in PubMed, EMBASE, the Cochrane Library......, and the websites of WHO, FDA, and EMA covered prospective trials investigating the management of iron-deficiency anemia in IBD published since 2004. A total of 632 articles were reviewed, and 13 articles (2906 patients) with unique content were included. In general, oral supplementation in iron-deficiency anemia...

  19. THIAMINE RESPONSIVE MEGALOBLASTIC ANEMIA IN TWO FEMALE SIBLINGS

    Directory of Open Access Journals (Sweden)

    Shilpa Reddy

    2014-08-01

    Full Text Available Thiamine responsive megaloblastic anemia (TRMA is an autosomal recessive disorder, which is caused by loss of function mutations in the SLC19A2 gene. TRMA is characterized by anemia, deafness, and diabetes mellitus. We now report two sisters, the eldest of which presented to a different hospital during childhood with sensorineural deafness, which was treated with a hearing prosthesis, insulin requiring diabetes, megaloblastic anemia. The younger sister is also affected with sensorineural deafness along with diabetes and megaloblastic anemia. Because a diagnosis of TRMA was suspected, therapy with insulin and thiamine was started to which the child is responding. Diabetes associated with deafness and megaloblastic anemia, suggests a diagnosis of TRMA.

  20. Anemia associated with chronic heart failure: current concepts

    Directory of Open Access Journals (Sweden)

    Shah R

    2013-02-01

    Full Text Available Ravish Shah, Anil K AgarwalDivision of Nephrology, The Ohio State University, Columbus, Ohio, USAAbstract: Anemia is a frequent comorbidity of heart failure and is associated with poor outcomes. Anemia in heart failure is considered to develop due to a complex interaction of iron deficiency, kidney disease, and cytokine production, although micronutrient insufficiency and blood loss may contribute. Currently, treatment of anemia of heart failure lacks clear targets and specific therapy is not defined. Intravenous iron use has been shown to benefit anemic as well as nonanemic patients with heart failure. Treatment with erythropoietin-stimulating agents has been considered alone or in combination with iron, but robust evidence to dictate clear guidelines is not currently available. Available and emerging new agents in the treatment of anemia of heart failure will need to be tested in randomized, controlled studies.Keywords: anemia, heart failure, chronic kidney disease, elderly population

  1. [Case report: hookworm infection in a patient with severe anemia].

    Science.gov (United States)

    Yilmaz, Hasan; Taş Cengiz, Zeynep; Ciçek, Mutalip; Dülger, Ahmet Cumhur

    2009-01-01

    In this study, a patient who was hospitalized with a severe anemia in the Internal Medicine Clinic of the Health Research and Application Hospital of Yüzüncü Yil University for one week is presented. The patient had fatigue, paleness and dizziness for one month and approximately 12 kg weight lost for four mounts previous to admission.. Severe iron deficiency anemia was diagnosed in the patient by laboratory analyses. Because there were no hematologic factors associated with severe anemia, the stool examination was also performed. In the Parasitology Laboratory, stool microscopy of the patient revealed numerous ova of hookworm. General condition of the patient well improved with anti-parasitic and anti-anemia treatment. It was concluded that patients with iron deficiency anemia diagnosed in health centers should be also examined for the intestinal parasitic diseases encountered rarely, and physicians should consider non-endemic parasitic diseases in their provinces.

  2. Anemia and functional capacity in elderly Brazilian hospitalized patients.

    Science.gov (United States)

    Bosco, Raquel de Macedo; Assis, Elisa Priscila Souza; Pinheiro, Renata Rosseti; Queiroz, Luiza Cristina Viana de; Pereira, Leani S M; Antunes, Carlos Maurício Figueiredo

    2013-07-01

    This study evaluated the association between anemia and physical functional capacity in a cross-sectional population-based sample of 709 hospitalized elderly patients aged 60 years and over admitted to the Madre Teresa Hospital, Belo Horizonte, State of Minas Gerais, Brazil. The Mann-Whitney or "t" test, and chi-square or Fisher exact test were used for quantitative and categorical variables, respectively, and hierarchical binary logistic regression was used to identify significant predictors. The presence of anemia was found in 30% of participants and was significantly associated with decreased functionality according to the two measures which were used - ADL (activities of daily living) and IADL (instrumental activities of daily living). Anemia was also independently associated with older age. The results of this study demonstrate a strong association between the presence of anemia and lower levels of functional capacity. Further investigations are needed to assess the impact of anemia treatment on the functionality and independence of older people.

  3. Pathogenesis of anemia in Trypanosoma brucei-infected mice.

    Science.gov (United States)

    Amole, B O; Clarkson, A B; Shear, H L

    1982-01-01

    The pathogenesis of anemia was studied in trypanosome-infected mice. A strain of Trypanosoma brucei, TREU 667, was used which first produces an acute phase marked by waves of parasitemia. Erythrocytes from infected animals were coated with immunoglobulin M during or just before the waves of anemia and parasitological crises. Erythrocytes from normal animals could be sensitized with "precrisis" sera presumably containing antigen and antibody. These data suggest that anemia during the acute phase is due to sensitization of erythrocytes with immunoglobulin M-antigen complexes. The anemia is partially compensated by a strong erythropoietic response. The acute phase is followed by a chronic phase marked by a constant high parasitemia and immunosuppression. The less marked anemia occurring during this latter phase is due to hemodilution and perhaps a low but significant immune response to the parasites, which causes continuing erythrocyte sensitization by immunoglobulin M-antigen complexes. PMID:7201455

  4. Management of Iron-Deficiency Anemia in Inflammatory Bowel Disease

    DEFF Research Database (Denmark)

    Nielsen, Ole Haagen; Ainsworth, Mark; Coskun, Mehmet;

    2015-01-01

    Anemia is the most frequent complication of inflammatory bowel disease (IBD), but anemia, mostly due to iron deficiency, has long been neglected in these patients.The aim was to briefly present the pathophysiology, followed by a balanced overview of the different forms of iron replacement available......, and subsequently, to perform a systematic review of studies performed in the last decade on the treatment of iron-deficiency anemia in IBD.Given that intravenous therapies have been introduced in the last decade, a systematic review performed in PubMed, EMBASE, the Cochrane Library, and the websites of WHO, FDA......, and EMA covered prospective trials investigating the management of iron-deficiency anemia in IBD published since 2004.A total of 632 articles were reviewed, and 13 articles (2906 patients) with unique content were included. In general, oral supplementation in iron-deficiency anemia should be administered...

  5. Vitamin B6 deficiency and anemia in pregnancy.

    Science.gov (United States)

    Hisano, M; Suzuki, R; Sago, H; Murashima, A; Yamaguchi, K

    2010-02-01

    Iron deficiency is the most common cause of anemia in pregnancy. Pregnant women with anemia are, in general, exclusively treated with iron supplementation. We observed that several pregnant women with anemia who were nonresponsive to iron supplementation also had vitamin B6 deficiency, and that anemia in these cases improved with the administration of vitamin B6. Our prospective study in healthy pregnant women showed that blood levels of iron, ferritin and vitamin B6, in particular, fell to the lower limit of the nonpregnant reference range by the third trimester. We conclude that it is important to take into account the deficiency of vitamin B6 besides iron in the evaluation of anemia during pregnancy.

  6. Eficácia e toxicidade da hidroxiuréia em crianças com anemia falciforme Effectiveness and toxicity of hydroxyurea in children with sickle cell anemia

    Directory of Open Access Journals (Sweden)

    Michelle C. Silva

    2006-06-01

    Full Text Available A anemia falciforme é uma doença genética caracterizada pelo alto índice de morbimortalidade, considerada como a mais grave entre as doenças falciformes. As opções terapêuticas mais eficazes atualmente disponíveis para tratamento desta hemoglobinopatia são transplante de medula óssea (TMO e hidroxiuréia (HU. O TMO apesar de ser a medida curativa é considerado de alto risco por apresentar diversos graus de complicações e significativo nível de mortalidade. O uso de HU em crianças portadoras de anemia falciforme tem proporcionado redução de complicações clínicas e aumento significativo na expectativa de vida, por promover elevação dos níveis de hemoglobina fetal, da concentração de hemoglobina e do VCM, bem como redução da hemólise e de eventos vaso-oclusivos. Desse modo, a HU é considerada como melhor opção terapêutica atualmente disponível. Porém, por ser apontada como droga potencialmente carcinogênica, há questionamentos quanto aos benefícios e toxicidades quando utilizada por longo período. Este trabalho teve como proposta, avaliar por meio da revisão literária, os riscos, benefícios e efeitos adversos da hidroxiuréia em crianças.Sickle cell anemia is a genetic disease characterized by a high morbimortality rate, it is considered as the most serious among all sickle cell diseases. The most effective therapeutic options available nowadays for the treatment of this hemoglobinopathy are bone morrow transplantation (BMT and hydroxyurea (HU. BMT is considered a high risk procedure due to the different complications and significant mortality rates. The use of HU for children with sickle cell anemia has reduced the clinical complications and given a significant increase in life expectancy by augmenting the fetal hemoglobin levels and hemoglobin concentrations and reducing cytomegalovirus, as well as reducing hemolysis and vaso-occlusive events. Thus, HU is considered the best therapeutic option currently

  7. Reticulocyte parameters in hemoglobinopathies and iron deficiency anemia

    Directory of Open Access Journals (Sweden)

    Cortellazzi Laura C.

    2003-01-01

    Full Text Available Flow cytometric reticulocyte analysis allows the evaluation of reticulocyte maturity. New reticulocyte parameters have been used in the diagnosis and management of anemias, in the bone marrow transplant setting and in the monitoring of iron replacement or erythropoiet in therapy. Reticulocyte numbers and maturation levels have been studied in different hemoglobinopathies and the results have been correlated with the degree of ineffective erythropoiesis. In order to verify differences in reticulocyte parameters in various types of anemias and to test the absolute number of immature reticulocytes as a possible discriminating factor among various types of anemias, reticulocyte counts were performed on 219 samples from patients with sickle cell anemia (SS (n= 62, hemoglobin S trait (n=9, Sbeta thalassemia (n=7, hemoglobin SC disease (n=11, beta thalassemia trait (n=33 and iron deficiency anemia (n= 47, and non-anemic individuals (n= 50. Mean fluorescence index (MFI was defined as representative of the degree of reticulocyte immaturity and it was evaluated as a percentage and in absolute values. Reticulocyte counts and MFI values were significantly higher in SS, Sbeta thalassemic and SC groups when compared to controls, but not different among the three anemia groups. Patients with hemoglobin S trait, iron deficiency anemia and beta thalassemia trait showed reticulocyte parameters similar to the non-anemic group. There was no difference between the b thalassemic trait and iron deficiency anemia in relation to any parameters. MFI in absolute numbers were significantly higher in anemias that develop with the hemolytic process, although this was not evident in MFI percentage values. Our results showed that the erythoid expansion in sickle cell diseases (SS, SC and Sb thalassemia leads to an enhanced immature reticulocyte release from bone marrow and that the phenomena is more evident by the MFI counting in absolute figures than in percentages. We

  8. Socio-economic and demographic determinants of childhood anemia

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    Sankar Goswmai

    2015-10-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate socio-economic and demographic determinants of anemia among Indian children aged 6-59 months. METHODS: Statistical analysis was performed on the cross-sectional weighted sample of 40,885 children from 2005 to 2006 National Family Health Survey by using multinomial logistic regression to assess the significance of some risk factors in different degrees of child anemia. Anemia was diagnosed by World Health Organization (WHO cut-off points on hemoglobin level. Pearson's chi-squared test was applied to justify the associations of anemia with different categories of the study population. RESULTS: The prevalence of anemia was 69.5%; 26.2% mild, 40.4% moderate, and 2.9% severe anemia. Overall prevalence rate, along with mild and moderate cases, showed an increasing trend up to 2 years of age and then decreased. Rural children had a higher prevalence rate. Of 28 Indian states in the study, 10 states showed very high prevalence, the highest being Bihar (77.9%. Higher birth order, high index of poverty, low level of maternal education, mother's anemia, non-intake of iron supplements during pregnancy, and vegetarian mother increased the risks of all types of anemia among children (p < 0.05. Christian population was at lower risk; and Scheduled Caste, Scheduled Tribe, and Other Backward Class categories were at higher risk of anemia. CONCLUSION: The results suggest a need for proper planning and implementation of preventive measures to combat child anemia. Economically under-privileged groups, maternal nutrition and education, and birth control measures should be priorities in the programs.

  9. Symmetric increased skeletal muscular uptake of F-18 fluoro-deoxyglucose: A clue for the diagnosis of Graves' disease.

    Science.gov (United States)

    Santhosh, Sampath; Mittal, Bhagwant Rai; Kashyap, Raghava; Bhattacharya, Anish; Singh, Baljinder

    2011-07-01

    F-18 fluoro-deoxyglucose (FDG) uptake in the thyroid and thymus is well reported in patients with Graves' disease. Incidental skeletal muscle uptake has also been reported in other non-musculoskeletal (benign and malignant) pathologies. We report a patient of Graves' disease showing symmetrical skeletal muscle uptake but no thyroidal or thymus uptake of FDG.

  10. 78 FR 31570 - Prospective Grant of a Start-Up Exclusive Patent License Agreement: Treatment of Graves' Disease...

    Science.gov (United States)

    2013-05-24

    ... a Start-Up Exclusive Patent License Agreement: Treatment of Graves' Disease, Hyperthyroidism and...' Disease, hyperthyroidism and thyroid cancer. DATES: Only written comments or applications for a license... useful in treating hyperthyroidism and Graves' disease, an autoimmune disease that is commonly...

  11. Initial diagnosis of anemia from sore mouth and improved classification of anemias by MCV and RDW in 30 patients.

    Science.gov (United States)

    Lu, Shin-Yu; Wu, Hong-Cheng

    2004-12-01

    Thirty patients with a wide range of sore mouth that led to the diagnosis of iron deficiency in 12 patients, pernicious anemia in 8 patients, combined deficiency of iron and vitamin B12 in 2 patients, and anemia of chronic disease in 8 patients were investigated. The oral signs and symptoms included glossitis, glossodynia, angular cheilitis, recurrent oral ulcer, oral candidosis, diffuse erythematous mucositis, and pale oral mucosa. The values of hemoglobin in 30 patients varied from normal to severe life-threatening levels, but none had developed generalized symptoms sufficiently advanced to arouse suspicions of anemia before they visited the Oral Medicine Clinic. The aim of this paper is to describe a retrospective study of 30 patients with oral changes as the initial manifestation of nutritional deficiency or anemia of chronic diseases. Improved diagnosis and classification of anemia based on the mean and heterogeneity of red cell size will be discussed.

  12. Microfluidic approach of Sickled Cell Anemia

    Science.gov (United States)

    Abkarian, Manouk; Loiseau, Etienne; Massiera, Gladys

    2012-11-01

    Sickle Cell Anemia is a disorder of the microcirculation caused by a genetic point mutation that produces an altered hemoglobin protein called HbS. HbS self-assembles reversibly into long rope like fibers inside the red blood cells. The resulting distorded sickled red blood cells are believed to block the smallest capillaries of the tissues producing anemia. Despite the large amount of work that provided a thorough understanding of HbS polymerization in bulk as well as in intact red blood cells at rest, no consequent cellular scale approaches of the study of polymerization and its link to the capillary obstruction have been proposed in microflow, although the problem of obstruction is in essence a circulatory problem. Here, we use microfluidic channels, designed to mimic physiological conditions (flow velocity, oxygen concentration, hematocrit...) of the microcirculation to carry out a biomimetic study at the cellular scale of sickled cell vaso-occlusion. We show that flow geometry, oxygen concentration, white blood cells and free hemoglobin S are essential in the formation of original cell aggregates which could play a role in the vaso-occlusion events.

  13. Erythremia with special reference to sideroblastic anemia.

    Science.gov (United States)

    Taki, T; Wakabayashi, T; Kishimoto, H

    1980-07-01

    An autopsy case of erythremia with sideroblastic tumor cell proliferation is described. A 60-year-old man was admitted to the hospital due to general fatigue and anorexia. Bone marrow aspiration revealed abnormalities in erythropoiesis (megaloblasts, 4%; sideroblasts, 84%; ring-formed, 39%, and PAS-positive, 5%). Therapy was directed to pulmonary tuberculosis. Anemia was not improved despite repeated whole blood and platelet transfusions. Serum iron and percentage saturation of the total iron-binding capacity rose during the course. Administration of vitamin B12, B6 or folic acid was inefffective. INAH was replaced by its derivative, IHMS, during the course, but the population of sideroblasts especially of ring-sideroblasts was invariably large (78%-100% and 39%-65% for total sideroblasts and ring-sideroblasts, respectively). He died with increasing abdominal pain and jaundice after three months' hospitalization. Main autopsy findings were: diffuse proliferation of atypical erythroblasts in the bone marrow, systemic lymph nodes, liver, spleen and kidneys. Most of the cells positively stained with iron. Tuberculosis of lungs with cavity formation. Discussion is focussed on the relationship between erythremia and sideroblastic anemia.

  14. Cameron lesion: An unusual cause of anemia

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    Jovanović Ivan

    2010-01-01

    Full Text Available Introduction. Cameron lesions are linear gastric ulcers or erosions positioned on the crests of mucosal folds at the diaphragmatic impression, in patients with large hiatal hernia, and can cause iron deficiency anaemia. Case report. We present a case of a 56-year-old woman who was referred to our institution for further investigation after she was examined in gastroenterology emergency room (GER for signs and symptoms of severe hypochromic microcytic anemia without signs of acute gastrointestinal bleeding and with no obvious cause of chronic blood loss. Endoscopy showed linear ulceration at the level of diaphragm-Cameron lesions with large hiated hernia. She was treated with proton pump inhibitors and iron supplements. The laparoscopic fundoplication was done. Six months later she was asymptomatic. Conclusion. Large hiatus hernia may cause iron deficiency anemia due to occult bleeding from Cameron erosions. The current therapy concept includes the surgical reconstruction of the hiatus together with gastric fundoplication in combination with the proton pump inhibitor therapy.

  15. Supplementary iron dose in pregnancy anemia prophylaxis.

    Science.gov (United States)

    Reddaiah, V P; Raj, P P; Ramachandran, K; Nath, L M; Sood, S K; Madan, N; Rusia, U

    1989-01-01

    This study was conducted to determine the optimum dose of supplemental iron for prophylaxis against pregnancy anemia. One hundred and ten pregnant women were randomly allocated to three groups: Group A receiving equivalent of 60 mg, group B 120 mg and Group C 240 mg, elemental iron as ferrous sulphate daily; the content of folic acid was constant in all the three groups (0.5 mg). These women had at least consumed 90 tablets in 100 +/- 10 days. Blood was drawn at the beginning and at the end of the treatment. Fifty percent were anemic (less than 11 g/100 ml). The hemoglobin levels rose similarly in all groups and the differences were statistically not significant. Fifty-six percent had depleted iron stores (serum ferritin value less than 12 micrograms/l) at the beginning of the study. Following therapy a statistically significant increase in iron stores was observed in group B and C as compared to group A. The difference between group B and C was not significant. The side effects increased with increasing doses of iron; 32.4%, 40.3% and 72% in group A, B and C respectively. Based on these findings, the authors advocate that optimum dose of iron should be 120 mg instead of 60 mg as is currently being used in the National Nutritional Anemia Prophylaxis Programme.

  16. A Patient with Microcytic Anemia and Fever

    Directory of Open Access Journals (Sweden)

    Sacha Bhatia

    2006-01-01

    Full Text Available A 62-year-old man with a history of mechanical aortic valve insertion and ascending aorta replacement in 1997 presented to his family doctor in August 2004 with a two-week history of melena after recently returning from a six-month vacation in Mexico. The patient had no other abdominal complaints. He took warfarin but did not take nonsteroidal anti-inflammatory agents, acetylsalicylic acid or alcohol. The patient had no history of liver or peptic ulcer disease. He had lost 7 kg over the past month, but did not complain of fever or night sweats. On physical examination, vital signs were normal, the second heart sound was mechanical, and there were no abnormal findings. Laboratory investigations showed a borderline microcytic anemia (hemoglobin 76 g/L; mean corpuscular volume 79 fL; mean corpuscular hemoglobin concentration 323 g/L, a therapeutic international normalized ratio (2.6 and an elevated creatinine level (112 µmol/L. His stool was positive for occult blood, although the ferritin level was high (623 µg/L. Other routine blood work was normal. The patient was admitted to hospital for investigation of the anemia.

  17. Immunotherapy Treatments of Warm Autoimmune Hemolytic Anemia

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    Bainan Liu

    2013-01-01

    Full Text Available Warm autoimmune hemolytic anemia (WAIHA is one of four clinical types of autoimmune hemolytic anemia (AIHA, with the characteristics of autoantibodies maximally active at body temperature. It produces a variable anemia—sometimes mild and sometimes severe. With respect to the absence or presence of an underlying condition, WAIHA is either idiopathic (primary or secondary, which determines the treatment strategies in practice. Conventional treatments include immune suppression with corticosteroids and, in some cases, splenectomy. In recent years, the number of clinical studies with monoclonal antibodies and immunosuppressants in the treatment of WAIHA increased as the knowledge of autoimmunity mechanisms extended. This thread of developing new tools of treating WAIHA is well exemplified with the success in using anti-CD20 monoclonal antibody, Rituximab. Following this success, other treatment methods based on the immune mechanisms of WAIHA have emerged. We reviewed these newly developed immunotherapy treatments here in order to provide the clinicians with more options in selecting the best therapy for patients with WAIHA, hoping to stimulate researchers to find more novel immunotherapy strategies.

  18. Autoimmune hemolytic anemia: transfusion challenges and solutions

    Directory of Open Access Journals (Sweden)

    Barros MM

    2017-03-01

    Full Text Available Melca M O Barros, Dante M Langhi Jr, José O Bordin Department of Clinical and Experimental Oncology, Universidade Federal de São Paulo, São Paulo, Brazil Abstract: Autoimmune hemolytic anemia (AIHA is defined as the increased destruction of red blood cells (RBCs in the presence of anti-RBC autoantibodies and/or complement. Classification of AIHA is based on the optimal auto-RBC antibody reactivity temperatures and includes warm, cold-reactive, mixed AIHA, and drug-induced AIHA subtypes. AIHA is a rare disease, and recommendations for transfusion are based mainly on results from retrospective data and relatively small cohort studies, including heterogeneous patient samples or single case reports. In this article, we will review the challenges and solutions to safely transfuse AIHA patients. We will reflect on the indication for transfusion in AIHA and the difficulty in the accomplishment of immunohematological procedures for the selection of the safest and most compatible RBC units. Keywords: hemolytic anemia, RBC autoantibodies, autoimmunity, hemolysis, direct ­antiglobulin test

  19. Anxiety and depression are more prevalent in patients with graves' disease than in patients with nodular goitre

    DEFF Research Database (Denmark)

    Bové, Kira Bang; Watt, Torquil; Vogel, Asmus

    2014-01-01

    ' disease compared to patients with another chronic thyroid disease, nodular goitre, and to investigate determinants of anxiety and depression in Graves' disease.METHODS: 157 cross-sectionally sampled patients with Graves' disease, 17 newly diagnosed, 140 treated, and 251 controls with nodular goitre......' disease versus 4% in nodular goitre (p = 0.038), anxiety was 18 versus 13% (p = 0.131). Symptoms of anxiety (p = 0.04) and depression (p = 0.01) increased with comorbidity. Anxiety symptoms increased with duration of Graves' disease (p = 0.04). Neither thyroid function nor autoantibody levels were...... associated with anxiety and depression symptoms.CONCLUSIONS: Anxiety and depression symptoms were more severe in Graves' disease than in nodular goitre. Symptoms were positively correlated to comorbidity and duration of Graves' disease but neither to thyroid function nor thyroid autoimmunity....

  20. Anemia do lactente: etiologia e prevalência Anemia in infancy: etiology and prevalence

    Directory of Open Access Journals (Sweden)

    Maria Claret C.M. Hadler

    2002-01-01

    Full Text Available Objetivo: verificar a prevalência de anemia, anemia ferropriva e deficiência de ferro em lactentes, de unidade pública de saúde, no município de Goiânia, Brasil, analisar e correlacionar as variáveis bioquímicas e hematológicas. Métodos: realizou-se estudo transversal. De 120 mães entrevistadas, foram incluídos 110 lactentes de 6 a 12 meses de idade, a termo e não gemelares. Dados socioeconômicos e hematológicos foram obtidos. Colheu-se sangue venoso dos lactentes em jejum para realização do hemograma completo por contagem eletrônica, ferro sérico, ferritina sérica e proteína C-reativa, os quais foram utilizados na avaliação da etiologia ferropriva nos anêmicos. Crianças com hemoglobina Objective: To verify the prevalence of anemia, iron deficiency anemia and iron deficiency in infants, at a Public Health Unit in the city of Goiânia - Brazil; to analyze and to correlate the hematologic and biochemical variables. Methods: A cross-sectional study was carried out. One hundred and ten full-term infants of the 120 mothers interviewed were included. The infants aged between six and twelve months and there were not twins. Socioeconomic and hematologic data was obtained. Venous blood was taken from fasting infants in order to carry out a complete hemogram through electronic cell counting, serum iron, serum ferritin and C-reactive protein, which were used in the evaluation of the etiology of iron deficiency in the anemic infants. Children with hemoglobin < 11g/dL were considered anemic. Results: The prevalence of anemia was 60.9%. In the diagnosis of the iron deficiency etiology in infants without an inflammation process, when considering the alteration of hemoglobin plus two more indices among mean corpuscular volume (MCV or mean corpuscular hemoglobin (MCH or serum ferritin or serum iron, the prevalence of the iron deficiency was 87%. Nevertheless, when red cell distribution width (RDW was included in the indices, the

  1. Anemia de Doença Crônica Anemia of chronic disease

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    Rodolfo D. Cançado

    2002-04-01

    Full Text Available Anemia de Doença Crônica (ADC é usualmente definida como a anemia que ocorre em distúrbios infecciosos crônicos, inflamatórios ou doenças neoplásicas, e é uma das síndromes clínicas mais comuns na prática clínica. Caracteristicamente, ADC corresponde à anemia normocrômica/normocítica, leve a moderada, e caracteriza-se por hipoferremia na presença de estoques adequados de ferro. Os três principais mecanismos patológicos envolvidos na ADC são: diminuição da sobrevida da hemácia, falha da medula óssea em aumentar a produção de glóbulos vermelhos para compensar o aumento da sua demanda, e distúrbio da mobilização do ferro de depósito do sistema mononuclear fagocitário. O papel central dos monócitos e dos macrófagos e o aumento da produção de citocinas mediadoras da resposta imune ou inflamatória, tais como: TNF alfa, INF gama e IL-1 estão implicados nos três processos envolvidos no desenvolvimento da ADC. O propósito desse artigo é revisar os recentes avanços no entendimento dos aspectos patofisiológico, diagnóstico e terapêutico desta síndrome.The anemia of chronic disease (ACD is usually defined as the anemia occurring in chronic infectious, inflammatory disorders, or neoplastic diseases, and is one of the most common syndromes in the clinical practice. Characteristically, ACD is a mild-to-moderate, normochromic/normocytic anemia, and is characterized by hypoferremia in the presence of adequate iron stores. The three principal pathologic mechanisms involved in ACD are: reduced erythrocyte survival, bone marrow failure to increase red blood cell production to compensate for the increase in its demand, and abnormal mobilization of reticuloendothelial iron stores. The central role of monocytes and macrophages, and the increased production of the cytokines that mediate the immune or inflammatory response, such as tumor necrosis factor, interleukin-1 and the interferons, are implicated in all three

  2. Too early to dismiss Yersinia enterocolitica infection in the aetiology of Graves' disease

    DEFF Research Database (Denmark)

    Brix, Thomas H; Hansen, Pia S; Hegedüs, Laszlo

    2008-01-01

    BACKGROUND: Yersinia enterocolitica (YE) infection has long been implicated in the pathogenesis of Graves' disease (GD). The association between YE and GD could, however, also be due to common genetic or environmental factors affecting the development of both YE infection and GD. This potential...

  3. Treatment of Graves' disease with rituximab specifically reduces the production of thyroid stimulating autoantibodies

    DEFF Research Database (Denmark)

    El Fassi, Daniel; Banga, J Paul; Gilbert, Jacqueline A;

    2008-01-01

    Treatment of Graves' disease (GD) with the B-lymphocyte depleting agent rituximab in addition to standard methimazole-therapy prolongs remission. Paradoxically, it does not mediate a reduction in thyrotropin receptor antibody (TRAb) levels over that of methimazole monotherapy. Using a bioassay in...

  4. Affective symptoms and cognitive functions in the acute phase of Graves' thyrotoxicosis

    DEFF Research Database (Denmark)

    Vogel, Asmus; Elberling, Tina V; Hørding, Merete;

    2007-01-01

    patients with Graves' thyrotoxicosis. A control group of 34 individuals matched for age, education and premorbid intelligence was also included. At baseline all patients and control subjects were examined with psychiatric rating scales and a comprehensive neuropsychological battery. The effect of treatment...

  5. B lymphocyte depletion with the monoclonal antibody rituximab in Graves' disease: a controlled pilot study

    DEFF Research Database (Denmark)

    El Fassi, Daniel; Nielsen, Claus H; Bonnema, Steen J

    2007-01-01

    Graves' disease (GD) is a common TSH receptor autoantibody (TRAb)-mediated disorder. Because B lymphocytes are important self-antigen presenting cells and precursors for antibody-secreting plasma cells, temporary B-lymphocyte depletion with the monoclonal antibody rituximab (RTX) might...

  6. Miastenia grave induzida por D-penicilamina em paciente com esclerose sistêmica progressiva

    Directory of Open Access Journals (Sweden)

    Paulo E. Marchiori

    1984-12-01

    Full Text Available Relato de caso de miastenia grave induzida por D-penicilamina. São descutidos os possíveis mecanismos etiopatogênicos envolvidos no desencadeamento da doença e é salientada a presença de anticorpo anti-receptor de acetilcolina e hiperplasia tímica na DPA-MG.

  7. Graves' disease in two pregnancies complicated by fetal goitrous hypothyroidism: successful in utero treatment with levothyroxine

    DEFF Research Database (Denmark)

    Bliddal, Sofie; Rasmussen, Åse Krogh; Sundberg, Karin Milner;

    2011-01-01

    Treatment of Graves' disease during pregnancy with antithyroid drugs (ATDs) poses a risk of inducing hypothyroidism and, thus, development of a goiter to the fetus. PATIENT FINDINGS: We report two patients referred to our department after discovery of a fetal goiter by ultrasound examination...

  8. B lymphocyte depletion with the monoclonal antibody rituximab in Graves' disease: a controlled pilot study

    DEFF Research Database (Denmark)

    El Fassi, Daniel; Nielsen, Claus H; Bonnema, Steen Joop

    2007-01-01

    CONTEXT: Graves' disease (GD) is a common TSH receptor autoantibody (TRAb)-mediated disorder. Because B lymphocytes are important self-antigen presenting cells and precursors for antibody-secreting plasma cells, temporary B-lymphocyte depletion with the monoclonal antibody rituximab (RTX) might...

  9. /sup 131/I-therapy of Graves' disease and non-immunogenic thyrotoxicosis

    Energy Technology Data Exchange (ETDEWEB)

    Hoeschel, M.; Heinze, H.G.

    1984-06-01

    From 1977 to 1982, 315 patients suffering from thyrotoxicosis with diffuse and/or nodular goitre or Graves' disease were treated with /sup 131/I. In 246 patients, the results of treatment after 7 months to 5 1/2 years could be evaluated. After a single treatment with /sup 131/I, 72% of the patients with hyperthyroid nodular goitre and 61% of those with diffuse goitre, but only 36% of the patients with Graves' disease showed normal thyroid function. By repeated /sup 131/I treatments - as many as 5 for those with Graves' disease - normal thyroid function could be achieved in nearly all patients examined. Patients with immune thyrotoxicosis, type Graves' disease, showed a high resistance to therapy. A dependence was found between the results of these treatments and previous antithyroidal drug therapy or surgery. The rate of hypothyroidism varied between 4 and 15%. The highest rate of hypothyroidism was observed in operated patients with persistent or recurring thyrotoxicosis.

  10. Graves, Ancestors and Cement in Land disputes in Acholi and Ikland, Uganda

    DEFF Research Database (Denmark)

    Meinert, Lotte; Willerslev, Rane; Seebach, Sophie Hooge

    2017-01-01

    The paper explores the roles of graves, ancestors and concrete pillars in disputes over land across different land-systems, -conflicts, and territory making in northern Uganda by comparing extended cases between Acholi in Gulu district and Ik in Kaabong district . In the post-conflict Acholi region...

  11. Incidence of vitiligo in children with Graves' disease and Hashimoto's thyroiditis

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    Prindaville Brea

    2011-11-01

    Full Text Available Abstract Background Limited data are available on the association between vitiligo and autoimmune thyroid disease in pediatric patients. In addition, reported studies of pediatric patients have been based on a population known to have vitiligo and subsequently evaluated for the presence of thyroid function abnormalities. Methods A retrospective chart review was performed on 333 children who had been followed for thyroid disorders by endocrinologists at the Yale Pediatric Thyroid Center over the last 5 years for autoimmune thyroid disease. Demographical and clinical features of patients found to have thyroid disease and vitiligo were recorded. These studies were approved by the Yale Human Investigation Committee. Results Of the total 333 children and adolescents, 9 (2.7% were noted to have vitiligo. Four patients (44% had Graves' disease and 5 patients (66% had Hashimoto's thyroiditis. For patients with Graves' disease and vitiligo, the average age of onset of thyroid disease was young at 4 ± 0.7 years, and the diagnosis of vitiligo usually preceded that of thyroid disease. For children with Hashimoto's thyroiditis and vitiligo, thyroid disease was diagnosed at an average age of 13.25 ± 2.8 years. Conclusion In our population, 4.6% of children with Graves' disease and 2.0% of children with Hashimoto's thyroiditis had vitiligo. Interestingly, when vitiligo presents with Graves' disease, it occurs in younger rather than older children.

  12. A Danish Early Germanic Iron Age Grave with Tablet Woven Cuffs

    DEFF Research Database (Denmark)

    Mannering, Ulla; Knudsen, Lise Ræder

    2007-01-01

    This article presents exciting new textile information from a Danish Early Germanic Iron Age grave at Broedbaek, North West Jutland, where tiny little fragments of textiles were found on metal clasps and brooches. Some of the textiles appeared to be made in a so far unknown tablet weaving technique....

  13. 78 FR 16295 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Science.gov (United States)

    2013-03-14

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... the Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native American... the Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native...

  14. 77 FR 74874 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Science.gov (United States)

    2012-12-18

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a telephonic meeting of the Native American... Advisory Committee Act, 5 U.S.C. Appendix (1988), of a telephonic meeting of the Native American...

  15. Educational Interventions Targeted at Minors in Situations of Grave Social Vulnerability and Their Families

    Science.gov (United States)

    de la Caba Collado, Mariangeles; Rojas, Isabel Bartau

    2010-01-01

    The aim of this article is to outline and assess an educational intervention programme targeted at improving the skills of families and the personal and social development of children living in situations of grave social vulnerability. The sample comprised 10 families during the first phase of the intervention and six during the second. The…

  16. Subclinical Hypothyroidism after 131I-Treatment of Graves' Disease: A Risk Factor for Depression?

    Directory of Open Access Journals (Sweden)

    Jing Yu

    Full Text Available Although it is well accepted that there is a close relationship between hypothyroidism and depression, previous studies provided inconsistent or even opposite results in whether subclinical hypothyroidism (SCH increased the risk of depression. One possible reason is that the etiology of SCH in these studies was not clearly distinguished. We therefore investigated the relationship between SCH resulting from 131I treatment of Graves' disease and depression.The incidence of depression among 95 patients with SCH and 121 euthyroid patients following 131I treatment of Graves' disease was studied. The risk factors of depression were determined with multivariate logistic regression analysis. Thyroid hormone replacement therapy was performed in patients with thyroid-stimulating hormone (TSH levels exceeding 10 mIU/L.Patients with SCH had significantly higher Hamilton Depression Scale scores, serum TSH and thyroid peroxidase antibody (TPOAb levels compared with euthyroid patients. Multivariate logistic regression analysis revealed SCH, Graves' eye syndrome and high serum TPO antibody level as risk factors for depression. L-thyroxine treatment is beneficial for SCH patients with serum TSH levels exceeding 10 mIU/L.The results of the present study demonstrated that SCH is prevalent among 131I treated Graves' patients. SCH might increase the risk of developing depression. L-thyroxine replacement therapy helps to resolve depressive disorders in SCH patients with TSH > 10mIU/L. These data provide insight into the relationship between SCH and depression.

  17. A randomized controlled trial of orbital radiotherapy versus sham irradiation in patients with mild Graves' ophthalmopathy

    NARCIS (Netherlands)

    Prummel, MF; Terwee, CB; Gerding, MN; Baldeschi, L; Mourits, MP; Blank, L; Dekker, FW; Wiersinga, WM

    2004-01-01

    Radiotherapy is often used in Graves' ophthalmopathy, but its efficacy has been doubted. We compared its efficacy with sham irradiation in mild ophthalmopathy. In a double-blind randomized trial, 44 patients received orbital irradiation, and 44 were sham-irradiated. The primary outcome was assessed

  18. The Analysis of Anemia in Chronic Heart Failure

    Institute of Scientific and Technical Information of China (English)

    Yuan Guiyi; Wu Wei; Luo Yilong; Li Yiqing; Zhou Shuxian; Fang Chang

    2006-01-01

    objectives To demonstrate the phenomena and explore the causes of anemia in patients with chronic heart failure (CHF). Methods To observe the phenomena of anemia in patients with CHF, a total of 276 patients with CHF were included in this retrospective study. The clinical characteristics of the patients are: mean age 69.2±11.0 years; male 151,female 125; NYHA Ⅲ and Ⅳ 115 (41.7%). Results ①Among the 276 patients with CHF, 81 (29.4%)had anemia (Mean hemoglobulin concentration 101.5±13.0g/L). ② Patients with Anemia were more likely to be female and to have greater NYHA (Ⅲ or Ⅳ) (P<0.05), higher serum creatinine, as well as lower serum albumin and low-density lipoprotein levels (P<0.01).③ A weak negative correlation was also noted between the level of NYHA and hemoglobulin. ④ There was no significant difference in age, the primary cardiac etiology of the CHF, the history of diabetes, left ventricular end diastolic diameter, and left ventricular ejection fraction between CHF patient with and without anemia. Conclusions The prevalence of anemia is high among patients with CHF. The anemia patients with CHF tend to be female, have greater cardiac and renal functional impairment, but with lower serum albumin and LDL that suggests some degree of malnutrition.

  19. Stimulating erythropoiesis in inflammatory bowel disease associated anemia

    Institute of Scientific and Technical Information of China (English)

    Georgia Tsiolakidou; Ioannis E Koutroubakis

    2007-01-01

    Anemia is a frequent complication in patients with inflammatory bowel disease (IBD), and is associated with decreased quality of life and increased rate of hospitalization. The primary therapeutic targets of IBDassociated anemia are iron deficiency and anemia of chronic disease. An important prognostic parameter of the success or failure of therapy is the outcome of the underlying disease. Iron deficiency should be appropriately managed with iron supplementation.However, the use of oral iron therapy is limited by several problems, the most important being gastrointestinal side effects leading occasionally to disease relapse and poor iron absorption. Intravenous iron preparations are more reliable, with iron sucrose demonstrating the best efficacy and tolerability. Treatment with erythropoietin or darbepoetin has been proven to be effective in patients with anemia, who fail to respond to intravenous iron. Patients with ongoing inflammation have anemia of chronic disease and may require combination therapy comprising of intravenous iron sucrose and erythropoietin. After initiating treatment, careful monitoring of hemoglobin levels and iron parameters is needed in order to avoid recurrence of anemia. In conclusion, anemia in the setting of IBD should be aggressively diagnosed, investigated, and treated. Future studies should define the optimal dose and schedule of intravenous iron supplementation and appropriate erythropoietin therapy in these patients.

  20. Anemia as a risk factor for childhood asthma

    Directory of Open Access Journals (Sweden)

    Ramakrishnan K

    2010-01-01

    Full Text Available Objective: This prospective-(cohort study was conducted to evaluate whether anemia is a risk factor for childhood asthma. Materials and Methods: Two hundred children in the age group of 2-18 years who attended the Outpatient Department with upper respiratory / lower respiratory tract infections were included in this study. One hundred children with anemia were taken as the study group and another 100, age - and sex-matched children without anemia were taken as the control.They were subjected to complete blood count (CBC C-reactive protein (CRP estimation, Mantoux test and chest X-ray. Pulmonary function tests (PFTs were performed on those above six years showing evidence of asthma. Peripheral smear, serum ferritin and serum iron-binding capacity were estimated for all anemic children. Results: Asthma was present in 74 (74% children in the study group and in 33 (33% children in the control group. Iron-deficiency anemia was present in 85 (85% anemia of chronic infection in 20 (20% and the other five (5% had hemolytic anemia. Anemia was found to be a risk factor for childhood asthma. Conclusion: Anemic children were 5.75 times more susceptible to asthmatic attacks when compared with nonanemic children.