MedWorm: Anemia

Pegloticase for chronic gout.

Cochrane Database of Systematic Reviews — Sat, 20 Mar 2010 06:22:03 +0100

CONCLUSIONS: There are no published double-blind, placebo-controlled RCTs of pegloticase. More evidence is needed to assess risks/benefits of pegloticase in patients with chronic gout. PMID: 20238366 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

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Optimal time for initiation of antiretroviral therapy in asymptomatic, HIV-infected, treatment-naive adults.

Cochrane Database of Systematic Reviews — Sat, 20 Mar 2010 06:22:03 +0100

CONCLUSIONS: There is evidence of moderate quality that initiating ART at CD4 levels higher than 200 or 250 cells/microL reduces mortality rates in asymptomatic, ART-naive, HIV-infected people. Practitioners and policy-makers may consider initiating ART at levels </= 350 cells/microL for patients who present to health services and are diagnosed with HIV early in the infection. PMID: 20238364 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Possible green tea-induced thrombotic thrombocytopenic purpura.

American Journal of Health-System Pharmacy : AJHP — Sat, 20 Mar 2010 01:34:31 +0100

Conclusion A 38-year-old woman developed TTP after consuming a weight-loss product containing green tea extract for two months. PMID: 20237380 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)

Gastrointestinal Stromal Tumor of the Stomach with Narrow Stalk-Like Based, Uneven Protruding Appearance Presenting with Severe Acute Anemia despite Small Size

Karger Publishers — Fri, 19 Mar 2010 23:00:00 +0100

Case Rep Gastroenterol 2010;4:111117 (DOI:10.1159/000292433) (Source: Karger Publishers)

Posttransplant anemia in solid organ recipients

Transplantation Reviews — Fri, 19 Mar 2010 17:30:48 +0100

Abstract: Posttransplantation anemia (PTA) is a prevalent sequela of solid organ transplantation and a potential independent risk factor for cardiovascular morbidity and mortality in kidney transplant recipients. There are multiple causes of PTA, some of which are associated with early phase anemia (6 months). Although impaired kidney function contributes to PTA, it is only one of many factors that result in anemia in transplant recipients. Other causes include iron deficiency, medications, infections, acute rejection, inflammation, and erythropoietin deficiency. Unlike in the predialysis chronic kidney disease population, the impact of anemia after kidney transplantation outcomes is unknown. This is in large part due to the absence of controlled trials that address whether correction of a...

Is There a Role for Autologous/Placental Red Blood Cell Transfusions in the Anemia of Prematurity?

Transfusion Medicine Reviews — Fri, 19 Mar 2010 15:31:43 +0100

Because most extremely preterm infants with birth weight less than 1000 g need red blood cell transfusions, many attempts have been made to collect, process, and store placental blood (ie, umbilical cord blood) for autologous transfusions. Although it is feasible to do this, multiple problems in doing so including insufficient volumes collected, clotting, hemolysis, bacterial contamination, failure to significantly supplant need for allogeneic transfusions, and high costs have led many to question whether, on balance, autologous/placental red blood cell transfusion offers clinically significant benefits. (Source: Transfusion Medicine Reviews)

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Mesothelioma Research Investigates Resistance Mechanisms to Discover Novel Treatment Targets

Asbestos and Mesothelioma News — Thu, 18 Mar 2010 21:48:02 +0100

A study recently published in the medical journal Lung Cancer investigated genetic patterns in malignant mesothelioma that contribute to the cancer’s treatment resistance in hopes of identifying new avenues for treatment. Titled “Malignant pleural mesothelioma: genome-wide expression patterns reflecting general resistance mechanisms and a proposal of novel targets,” the study sought to observe genetic similarities among patients that make malignant mesotheliomas resistant to treatment. Further understanding the genetics behind resistance mechanisms allows scientists to develop improved and more specific mesothelioma treatments that could improve survival rates. Researchers in this study found a close relation between gene profiles and resistance towards cancer-fighting compounds such...

A novel approach to preventing the hemolysis of paroxysmal nocturnal hemoglobinuria: both complement-mediated cytolysis and C3 deposition are blocked by a monoclonal antibody specific for the alternative pathway of complement

Blood — Thu, 18 Mar 2010 16:02:03 +0100

The clinical hallmark of paroxysmal nocturnal hemoglobinuria (PNH) is chronic intravascular hemolysis that is a consequence of unregulated activation of the alternative pathway of complement (APC). Intravascular hemolysis can be inhibited in patients by treatment with eculizumab, a monoclonal antibody that binds complement C5 thereby preventing formation of the cytolytic membrane attack complex of complement. However, in essentially all patients treated with eculizumab, persistent anemia, reticulocytosis, and biochemical evidence of hemolysis are observed; and in a significant proportion, their PNH erythrocytes become opsonized with complement C3. These observations suggest that PNH patients treated with eculizumab are left with clinically significant immune-mediated hemolytic anemia becau...

Cyclophosphamide in aplastic anemia?

Blood — Thu, 18 Mar 2010 16:02:02 +0100

(Source: Blood)

High-dose cyclophosphamide for severe aplastic anemia: long-term follow-up

Blood — Thu, 18 Mar 2010 16:02:02 +0100

Severe aplastic anemia (SAA) is a life-threatening bone marrow failure disorder that can be treated with bone marrow transplantation, immunosuppressive therapy, and high-dose cyclophosphamide. Here, we report long-term follow-up on 67 SAA patients (44 treatment-naive and 23 refractory) treated with high-dose cyclophosphamide. At 10 years, the overall actuarial survival was 88%, the response rate was 71% with the majority being complete, and the actuarial event-free survival was 58% in 44 treatment-naive SAA patients. Patients with refractory SAA fared less well after high-dose cyclophosphamide therapy; at 10 years, overall actuarial survival, response, and actuarial event-free survival rates were 62%, 48%, and 27%, respectively. High-dose cyclophosphamide is highly effective therapy for se...

Thrombotic Thrombocytopenic Purpura and Sickle Cell Crisis

Clinical and Applied Thrombosis/Hemostasis — Thu, 18 Mar 2010 11:48:35 +0100

Described is a case of acute chest syndrome in a sickle-cell patient (hemoglobin SS) who also developed signs and symptoms of thrombotic thrombocytopenic purpura, including thrombocytopenia and hemolysis (anemia, elevated lactate dehydrogenase, presence of schistocytes, dark-colored plasma, and elevations in nucleated red blood cells). The ADAMTS13 activity level was normal. Discussed are the diagnosis and therapeutic management issues and the challenges of differentiating the vasoocclusive and hemolytic complications of sickling red blood cells from the thrombotic microangiopathy of thrombotic thrombocytopenic purpura. (Source: Clinical and Applied Thrombosis/Hemostasis)

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Effect on linear growth and anemia of zinc or multiple micronutrients added to vitamin A: a randomized controlled trial in children aged 6-24 months

BMC Public Health - Latest articles — Thu, 18 Mar 2010 00:00:00 +0100

Conclusions: Daily multiple micronutrient supplementation combined with vitamin A was beneficial in improving growth among children with stunting, compared to vitamin A alone or to vitamin A plus zinc. Effects on anemia require further study.This study is registered with ClinicalTrials.gov, number NCT00156832. (Source: BMC Public Health - Latest articles)

Mitochondrial dysfunction in some oxidative stress-related genetic diseases: Ataxia-Telangiectasia, Down Syndrome, Fanconi Anaemia and Werner Syndrome.

Biogerontology — Thu, 18 Mar 2010 00:00:00 +0100

Authors: Pallardó FV, Lloret A, Lebel M, d'Ischia M, Cogger VC, Le Couteur DG, Gadaleta MN, Castello G, Pagano G Oxidative stress is a phenotypic hallmark in several genetic disorders characterized by cancer predisposition and/or propensity to premature ageing. Here we review the published evidence for the involvement of oxidative stress in the phenotypes of Ataxia-Telangiectasia (A-T), Down Syndrome (DS), Fanconi Anaemia (FA), and Werner Syndrome (WS), from the viewpoint of mitochondrial dysfunction. Mitochondria are recognized as both the cell compartment where energetic metabolism occurs and as the first and most susceptible target of reactive oxygen species (ROS) formation. Thus, a critical evaluation of the basic mechanisms leading to an in vivo pro-oxidant state relies on el...

Comparative mortality risk of anaemia management practices in incident haemodialysis patients

NeLM - News — Wed, 17 Mar 2010 00:00:00 +0100

Source: JAMA Area: News A study comparing the risk of mortality associated with different practices of anaemia management among different dialysis centres in the US has been published in JAMA. The authors note that the appropriate use of erythropoiesis-stimulating agents (ESAs) and intravenous iron can effectively manage the anaemia of chronic kidney disease and end-stage renal disease (ESRD). Several trials have reported an increased risk of mortality and cardiovascular events in patients treated to achieve higher haematocrit levels - as these trials were conducted in selected patient populations however, some controversy around the management of anaemia in ESRD remains. The purpose of this trial was to address this evidence gap - the researchers sought ...

Effectiveness of communication campaign on iron deficiency anemia in Kyzyl-Orda region, Kazakhstan: a pilot study

BMC Blood Disorders — Wed, 17 Mar 2010 00:00:00 +0100

Background: In 2004, wheat flour fortification (WFF) with iron was implemented in Kazakhstan as a public health strategy to increase the iron intake of all women of childbearing age and of children. In 2003, before starting the flour fortification program, a communication campaign on health education took place in a region with a high prevalence of iron deficiency anemia (IDA). The present study aimed to evaluate the prevalence of anemia, iron deficiency and IDA before and after the campaign. In addition, knowledge about IDA and its prevention, as well as awareness about fortified wheat flour, was assessed. Methods: The subjects of the study were women aged 15-49 years and children aged 2-14 years. The study was carried out in urban and rural areas of Kyzyl-Orda region in 2003 before (Marc...

Granulocyte transfusions in severe aplastic anemia: an eleven-year experience

The Aspergillus Website - articles — Wed, 17 Mar 2010 00:00:00 +0100

Quillen K, Wong E, Scheinberg P, Young NS, Walsh TJ, Wu CO, Leitman SF (Source: The Aspergillus Website - articles)

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Mesothelioma Subtypes: Do They Really Affect Prognosis?

Asbestos and Mesothelioma News — Tue, 16 Mar 2010 22:40:46 +0100

In conclusion, the researchers found, “The extremely poor prognosis of sarcomatoid malignant pleural mesothelioma is independent of the extent of surgery unlike other cell types. Patients with sarcomatoid histology should therefore be considered separately in trials evaluating radical procedures and adjuvant treatment. The treatment of biphasic pleural mesothelioma remains debatable.” Additional information on mesothelioma may be found through the Mesothelioma Center. (Source: Asbestos and Mesothelioma News)

Children’s research part of Shang Dynasty lead poisoning documentary

Thrive, Children's Hospital Boston — Tue, 16 Mar 2010 18:30:29 +0100

Alan Woolf, MD, MPH was part of a team that conducted experiments to find out if the vessels the Shang Dynasty drank from contributed to their early demise due to a combination of liquid and the materials the vessels were made from. A documentary airing on the National Geographic channel tonight – Treasure Tomb of the Warrior Queen – explores just that. Woolf took the time to answer this question for Thrive: Did lead poisoning pose a potential health risk to the nobility in the ancient Chinese Shang Dynasty? Lead-contaminated cookware, dishes and pottery have been known sources of human poisoning from antiquity to the present. Lead has been found in the skeletal remains of ancient Romans. Roman dishes, beverage containers, cooking cauldrons and the like were all heavily contam...

Successful treatment with intravenous immunoglobulin of severe thrombocytopenia complicated in primary Sjögren’s syndrome

Rheumatology International — Tue, 16 Mar 2010 14:49:02 +0100

We report here a rare case of patient with primary SS who developed pancytopenia with severe thrombocytopenia as an initial manifestation and successfully treated with IV immunoglobulin (IVIG). The present case suggests that pancytopenia with severe thrombocytopenia can be a difficult-to-treat abnormality, and initial manifestation of primary SS and IVIG might be an effective treatment for severe thrombocytopenia refractory to high-dose steroid in primary SS. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00296-010-1395-4Authors Bum-Su Choung, Chonbuk National University Medical School and Research Institute of Clinical Medicine Division of Rheumatology, Department of Internal Medicine San 2-20 Geumam-dong, Deokjin-gu, Jeonju Jeonbuk 561-756 South KoreaWan-Hee Yoo, ...

Transfusion triggers

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:24 +0100

Summary: Transfusion triggers are increasingly accepted in surgery and in the critically ill. There is very little evidence to suggest a restrictive policy is harmful although higher levels might be sensible in those with cardiovascular disease. A considerable tranche of literature shows that blood is bad for a patient but to date no clear mechanism has emerged and there is an argument that needing blood, a surrogate for illness may be as relevant. The impact of anaemia in the postoperative phase has not been evaluated adequately. The triggers lend themselves to non-acute elective situations but where there is acute blood loss and haemodynamic instability a slightly higher threshold, nearer 10g/dl, allows a margin of safety. (Source: Current Anaesthesia and Critical Care)

Commentary on transfusion triggers

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:24 +0100

In this review article Bunker et al. present their approach to the clinical conundrum regarding the use of red cell transfusion triggers. The impetus to use numerical values of haemoglobin concentration as transfusion triggers has been driven by several factors that have been clearly outlined by the authors. Whilst public perception may differ, blood itself has never been safer and currently the most pressing problem associated with this pharmacological product is the reduction in the donor pool and the exponential rise in cost due to even more sensitive screening tools and pathogen inactivation methods. This has to be tempered with the fact that decisions at the bedside will depend ultimately on the rapidity of blood loss that leads to anaemia and the co morbidities of the patient that m...

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Screening for associated autoimmune disorders in Polish patients with Addison’s disease

Endocrine — Tue, 16 Mar 2010 08:53:10 +0100

This study aimed to investigate the prevalence of concomitant autoimmune disorders in 85 Polish AAD patients (61 females, 24 males). Mean age at AAD onset was 34.6 ± 12.6 years, significantly earlier in males (P < 0.001). Sixty-nine patients presented positive serum antibodies to 21-hydroxylase and shorter AAD duration than those with negative results (P = 0.027). Seventy-three subjects suffered from coexisting autoimmune disorders. Serum autoantibodies against thyreoperoxidase, thyroglobulin, TSH receptor, glutamic acid decarboxylase, insulin, tyrosine phosphatase-like protein IA2, parietal cell H+/K+-ATPase, intrinsic factor and tissue transglutaminase were detectable in 71.8, 41.2, 4.7, 21.0, 4.9, 2.5, 49.4, 12.0 and 3.5% of patients, respecti...

Anti-thymocyte globulin plus etanercept as therapy for myelodysplastic syndromes (MDS): a phase II study

British Journal of Haematology — Tue, 16 Mar 2010 00:00:00 +0100

Immunosuppressive therapies have proven valuable in treating patients with myelodysplastic syndromes (MDS). We evaluated the combination of equine anti-thymocyte globulin (ATGAM®) and the soluble tumour necrosis factor receptor, etanercept (Enbrel®), in a phase II trial. Twenty-five patients with MDS [4-refractory anaemia (RA), 2-RA with ring sideroblasts, 15-refractory cytopenia with multilineage dysplasia (RCMD), 3-RCMD and ring sideroblasts, 1-RA with excess blasts type 1] in International Prognostic Staging System risk groups low (n = 11) or intermediate-1 (n = 14) were enrolled. All patients were platelet or red cell transfusion-dependent. Nineteen patients completed therapy with ATG at 40 mg/kg per day for four consecutive days, followed by etanercept, 25 mg subcutaneous twice a we...

Effect of anakinra on arthropathy in CINCA/NOMID syndrome

Pediatric Rheumatology — Tue, 16 Mar 2010 00:00:00 +0100

CINCA/NOMID is an autoinflammatory disorder characterized by the triad of neonatal onset of cutaneous symptoms, chronic meningitis, and recurrent fever and it presents with distinctive osteoarthropathy, synovitis mainly of the large joints and overgrowth of epimetaphyseal cartilage, particularly of the long bones. The cartilage overgrowth eventually causes osseous overgrowth and deformity that persists beyond skeletal maturity and leads to limb length discrepancy, joint contracture, and early degenerative arthropathy. Autoinflammation in CAPS/NOMID has been proven to derive from excessive release of interleukin-1 (IL-1). It has been well documented that the IL-1 receptor antagonist anakinra (Kineret(R)) helps mitigate systemic inflammation in the disorder. However, a general consensus has ...

The prevalence of anemia and its association with 90-day mortality in hospitalized community-acquired pneumonia

BMC Pulmonary Medicine - Latest articles — Tue, 16 Mar 2010 00:00:00 +0100

Background: The prevalence of anemia in the intensive care unit is well-described. Less is known, however, of the prevalence of anemia in hospitalized patients with lesser illness severity or without organ dysfunction. Community-acquired pneumonia (CAP) is one of the most frequent reasons for hospitalization in the United States (US), affecting both healthy patients and those with comorbid illness, and is typically not associated with acute blood loss. Our objective was to examine the development and progression of anemia and its association with 90d mortality in 1893 subjects with CAP presenting to the emergency departments of 28 US academic and community hospitals. Methods: We utilized hemoglobin values obtained for clinical purposes, classifying subjects into categories consisting of no...

Darbepoetin decreased transfusions and fatigue, but increased adverse effects in patients with chronic kidney disease, diabetes, and anemia.

Annals of Internal Medicine — Tue, 16 Mar 2010 00:00:00 +0100

Authors: PMID: 20231563 [PubMed - in process] (Source: Annals of Internal Medicine)

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Copper deficiency myelopathy

Journal of Neurology — Mon, 15 Mar 2010 17:54:51 +0100

Abstract Acquired copper deficiency has been recognised as a rare cause of anaemia and neutropenia for over half a century. Copper deficiency myelopathy (CDM) was only described within the last decade, and represents a treatable cause of non-compressive myelopathy which closely mimics subacute combined degeneration due to vitamin B12 deficiency. Here, 55 case reports from the literature are reviewed regarding their demographics, aetiology, haematological and biochemical parameters, spinal imaging, treatment and outcome. The pathophysiology of disorders of copper metabolism is discussed. CDM most frequently presented in the fifth and sixth decades and was more common in women (F:M = 3.6:1). Risk factors included previous upper gastrointestinal surgery, zinc overlo...

Incidence and characteristics of newly diagnosed rheumatic heart disease in Urban African adults: insights from the Heart of Soweto Study

European Heart Journal — Mon, 15 Mar 2010 16:45:23 +0100

Conclusion These data reveal a high incidence of newly diagnosed RHD within an adult urban African community. These data argue strongly for the first episode of RHD to be made a notifiable condition in high burden countries in order to ensure control of the disease through register-based secondary prophylaxis programmes. (Source: European Heart Journal)

Isolated gastric metastasis from renal cell carcinoma 19 years after radical nephrectomy

International Journal of Clinical Oncology — Mon, 15 Mar 2010 05:32:48 +0100

We report a case of solitary gastric metastasis from renal cell carcinoma (RCC) 19 years after radical excision of the primary tumor. During evaluation for anemia with melena, a small elevated tumor with ulceration was detected in the gastric fundus of this patient. The tumor was diagnosed as RCC based on endoscopic biopsy findings. There was no evidence of any other metastatic lesion, and a wedge resection of the stomach was performed. No additional metastasis or recurrence has been detected in the patient 12 months after discharge. This case confirms the existence of a very slow growing type of RCC with the potential for late solitary metastases and describes the surgical resectability. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s10147-010-0025-1Autho...

Top-up transfusions in neonates with Rh hemolytic disease in relation to exchange transfusions

Vox Sanguinis — Mon, 15 Mar 2010 00:00:00 +0100

Conclusion In this study, restrictive ET criteria in neonates with Rh hemolytic disease lead to a reduction of the rate of ET but an increase in the number of top-up transfusions for neonatal anemia. (Source: Vox Sanguinis)

Anemia management in chronic kidney disease: Intravenous iron steps forward

American Journal of Hematology — Mon, 15 Mar 2010 00:00:00 +0100

No abstract. (Source: American Journal of Hematology)

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Novel TMPRSS6 mutations associated with iron-refractory iron deficiency anemia (IRIDA)

Human Mutation — Mon, 15 Mar 2010 00:00:00 +0100

Mutations leading to abrogation of matriptase-2 proteolytic activity in humans are associated with an iron-refractory iron deficiency anemia (IRIDA) due to elevated hepcidin levels. In this paper we describe 12 IRIDA patients belonging to 7 unrelated families and identify 10 (9 novel) TMPRSS6 mutations spread along the gene sequence: 5 missense, 1 non sense and 4 frameshift. The frameshift and non sense mutations are predict to result in truncated protein lacking the catalytic domain. The causal role of missense mutations (Y141C, I212T, R271Q, S304L and C510S) is demonstrated by in silico analysis, their absence in 100 control chromosomes and the high conservation of the involved residues. The C510S mutation in the LDLRA domain in silico model causes an intra-molecular structural imbalance...

Idiopathic unilateral adrenal hemorrhage in an elderly patient

Endocrine — Sun, 14 Mar 2010 12:31:31 +0100

We report the case of an 85-year-old woman who has been undergoing treatment for hypertension but has not received anticoagulation therapy. The patient was admitted to our hospital for the evaluation of a right adrenal tumor (size, 10 × 9 cm2). Preoperative contrast-enhanced computed tomography and magnetic resonance imaging findings were indicative of adrenal hemorrhage (AH). Laboratory data revealed mild anemia but no adrenal dysfunction. The final pathological diagnosis was simply idiopathic adrenal hematoma. There is no case report of exactly idiopathic AH over 80 years old. We report an unusual case of idiopathic unilateral adrenal hematoma in an elderly patient. It is important to distinguish this benign lesion from a neoplasm and to consider idiopathic AH i...

Celiac disease in Brazilian patients: associations, complications and causes of death. Forty years of clinical experience

Arquivos de Gastroenterologia — Sat, 13 Mar 2010 14:23:58 +0100

Conclusions - This experience is similar to those described in the world literature. Celiac disease presents the same characteristics independently of the geographic region. We recommend periodic evaluations, from childhood, independent of the duration of the diet. The key is to establish an interval between evaluations.CONTEXTO: A doença celíaca é uma enfermidade multissistêmica e autoimune que pode se manifestar em qualquer idade, em indivíduos geneticamente predispostos. OBJETIVO: Identificação das associações, complicações e causas de morte em pacientes brasileiros após longo período de acompanhamento. MÉTODOS: Foram estudados retrospectivamente 157 pacientes, 23 adolescentes e 134 adultos, 79,6% do sexo feminino e 20,4% do masculino, 75,8% ao diagnóstico e 24,2% em diet...

Middle Cerebral Artery Median Peak Systolic Velocity Validation: Effect of Measurement Technique

American Journal of Perinatology — Fri, 12 Mar 2010 16:23:07 +0100

Amer J PerinatolDOI: 10.1055/s-0030-1249365ABSTRACTWe sought to validate center-specific published medians and estimate the effects of sonologist and Doppler measurement techniques on middle cerebral artery (MCA) peak systolic velocity (PSV) values. We studied 154 gravidas with normal singletons who underwent MCA PSV measurement at 18 to 35 weeks' gestation by one of three experienced sonologists. Pregnancies complicated by a known fetal anomaly (structural or aneuploidy), amniotic fluid volume disturbance, intrauterine growth restriction, multiple gestation, or isoimmunization were excluded. MCA PSV was measured using both manual caliper and auto-trace techniques. Regression models of log-transformed PSV values and gestational age were developed. Although auto-trace medians were significa...

Metastatic Prostate Cancer in an Asymptomatic Patient with an Initial Prostate-Specific Antigen (PSA) Serum Concentration of 21,380 ng/ml.

Onkologie — Fri, 12 Mar 2010 12:28:05 +0100

Conclusion: This case presents an asymptomatic prostate cancer patient with bone and liver metastasis, enlarged retroperitoneal lymph nodes and the highest PSA level published to date. PMID: 20215802 [PubMed - as supplied by publisher] (Source: Onkologie)

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Affymax(R) Receives $5 Million Milestone Payment On Initiation Of Phase 3 Clinical Trials For Hematide™ In Japan

Health News from Medical News Today — Fri, 12 Mar 2010 08:00:00 +0100

Affymax, Inc. (Nasdaq: AFFY) today announced that it has received a $5 million development milestone payment from Takeda Pharmaceutical Company as part of the companies' exclusive global agreement to develop and commercialize Hematide™, Affymax's investigational drug for the treatment of anemia in chronic renal failure patients. The milestone was achieved with the initiation of Phase 3 clinical testing of Hematide to treat anemia in chronic renal failure patients in Japan... (Source: Health News from Medical News Today)

Affymax(R) Receives $5 Million Milestone Payment On Initiation Of Phase 3 Clinical Trials For Hematide™ In Japan

Urology / Nephrology News From Medical News Today — Fri, 12 Mar 2010 08:00:00 +0100

Affymax, Inc. (Nasdaq: AFFY) today announced that it has received a $5 million development milestone payment from Takeda Pharmaceutical Company as part of the companies' exclusive global agreement to develop and commercialize Hematide™, Affymax's investigational drug for the treatment of anemia in chronic renal failure patients... (Source: Urology / Nephrology News From Medical News Today)

Efficacy and safety of capecitabine in combination with docetaxel and mitomycin C in patients with pre-treated pancreatic, gallbladder, and bile duct carcinoma

Journal of Cancer Research and Clinical Oncology — Fri, 12 Mar 2010 06:48:45 +0100

Conclusion In all, the DocMitoCape regimen exhibited a favorable safety profile and a high rate of tumor stabilizations in patients with pre-treated gallbladder, bile duct and pancreatic carcinoma. It might be considered after failure of standard regimens in these types of cancer. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s00432-010-0843-6Authors Jens Kruth, Universitätsmedizin Mannheim, Ruprecht-Karls-Universität Heidelberg III. Medizinische Klinik, Hämatologie und Onkologie Theodor-Kutzer-Ufer 1-3 68167 Mannheim GermanyJohanna Nissen, Universitätsmedizin Mannheim, Universität Heidelberg Institut für Klinische Radiologie und Nuklearmedizin Theodor-Kutzer-Ufer 1-3 68167 Mannheim GermanyThomas Ernst, Universitätsmedizin Mannheim, Ruprecht-...

Controversies related to red blood cell transfusion in critically ill patients

Journal of Veterinary Emergency and Critical Care — Fri, 12 Mar 2010 00:00:00 +0100

To review the evolution of and controversies associated with allogenic blood transfusion in critically ill patients. Veterinary and human literature review. RBC transfusion practices for ICU patients have come under scrutiny in the last 2 decades. Human trials have demonstrated relative tolerance to severe, euvolemic anemia and a significant outcome advantage following implementation of more restricted transfusion therapy. Investigators question the ability of RBCs stored longer than 2 weeks to improve tissue oxygenation, and theorize that both age and proinflammatory or immunomodulating effects of transfused cells may limit efficacy and contribute to increased patient morbidity and mortality. Also controversial is the ability of pre- and post-storage leukoreduction of RBCs to mitigate adv...

Novel permeability characteristics of red blood cells from sickle cell patients heterozygous for HbS and HbC (HbSC genotype).

Blood Cells, Molecules & Diseases — Fri, 12 Mar 2010 00:00:00 +0100

Authors: Dalibalta S, Ellory JC, Browning JA, Wilkins RJ, Rees DC, Gibson JS Individuals heterozygous for HbS and HbC (HbSC) represent about 1/3(rd) of sickle cell disease (SCD) patients. Whilst HbSC disease is generally milder, there is considerable overlap in symptoms with HbSS disease. HbSC patients, as well as HbSS ones, present with the chronic anaemia and panoply of acute vaso-occlusive complications that characterize SCD. However, there are important clinical and haematological differences. Certain complications occur with greater frequency in HbSC patients (like proliferative retinopathy and osteonecrosis) whilst intravascular haemolysis is reduced. Patients with HbSC disease can be considered as a discrete subset of SCD cases. Although much work has been carried out on underst...

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Iron, the retina and the lens: A focused review.

Experimental Eye Research — Fri, 12 Mar 2010 00:00:00 +0100

Authors: García-Castiñeiras S This review is focused on iron metabolism in the retina and in the lens and its relation to their respective age-related pathologies, macular degeneration (AMD) and cataract (ARC). Several aspects of iron homeostasis are considered first in the retina and second in the lens, paying particular attention to the transport of iron through the blood-retinal barrier and through the lens epithelial cell barrier, to the immunochemistry of iron-related proteins and their expression in both the retina and the lens, and to the nature of the photochemical damage caused by UV light on both tissues. A comparative overview of some iron related parameters (total iron, transferrin (Tf), transferrin saturation and total iron binding capacity), in plasma and ocular...

Blue rubber bleb nevus syndrome: Prominent oral findings

Indian Journal of Dermatology, Venereology and Leprology — Thu, 11 Mar 2010 14:10:55 +0100

We report a unique presentation of this syndrome in a 25-year-old male patient with prominent oral findings. This is a sporadic case, started during early childhood, progressively increasing in number and size. Oral vascular lesions were part of gastrointestinal involvement. Associated cardiac abnormalities were also observed. An early diagnosis of this syndrome is required as it gets complicated with bleeding, anemia and other systemic complications. (Source: Indian Journal of Dermatology, Venereology and Leprology)

Comparison of combination chemotherapy with irinotecan and cisplatin regimen administered every 2 or 4 weeks in pretreated patients with unresectable or recurrent gastric cancer: retrospective analysis

International Journal of Clinical Oncology — Thu, 11 Mar 2010 02:42:07 +0100

Conclusion Irinotecan plus cisplatin chemotherapy administered on a biweekly regimen was comparable in efficacy to a 4-weekly regimen and might be more feasible than the 4-weekly regimen. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10147-010-0054-9Authors Takeshi Sakamoto, Shizuoka Cancer Center Division of Gastrointestinal Oncology 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun Shizuoka 411-8777 JapanHirofumi Yasui, Shizuoka Cancer Center Division of Gastrointestinal Oncology 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun Shizuoka 411-8777 JapanNarikazu Boku, Shizuoka Cancer Center Division of Gastrointestinal Oncology 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun Shizuoka 411-8777 JapanYusuke Onozawa, Shizuoka Cancer Center Division of Gastrointest...

Biweekly vinorelbine and gemcitabine as second-line and beyond treatment in ovarian cancer

Cancer Chemotherapy and Pharmacology — Thu, 11 Mar 2010 02:38:47 +0100

Conclusion The vinorelbine plus gemcitabine combination at the present doses and schedule is a safe but ineffective regimen, and therefore, is not recommended as second-line and beyond treatment in patients with refractory ovarian cancer. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00280-010-1284-2Authors N. Xenidis, University General Hospital of Alexandroupolis Department of Medical Oncology Dragana 68100 Alexandroupolis, Thrace GreeceK. Neanidis, University General Hospital of Alexandroupolis Department of Medical Oncology Dragana 68100 Alexandroupolis, Thrace GreeceK. Amarantidis, University General Hospital of Alexandroupolis Department of Medical Oncology Dragana 68100 Alexandroupolis, Thrace GreeceP. Dimopoulos, University General Hospita...

Boy, 4, with one in 6bn condition needs pint of blood every fortnight to survive

the Mail online | Health — Thu, 11 Mar 2010 01:42:32 +0100

Jamie Andrews, four, has a one of a kind chromosome disorder called Diamond Blackfan Anaemia. (Source: the Mail online | Health)

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Celiac Disease in Siblings With Pearson Syndrome.

The American Journal of the Medical Sciences — Thu, 11 Mar 2010 00:00:00 +0100

Authors: Köklü S, Alioğlu B, Akbal E, Koçak E Pearson syndrome (PS) is a rare mitochondrial disorder characterized by sideroblastic anemia and exocrine pancreas deficiency as a result of mitochondrial DNA deletion or deletion-duplication. A 21-year-old woman and 11-year-old brother who had been diagnosed as PS at the age of 18 and 8, respectively, were admitted to our hospital with the complaints of chronic diarrhea while using exogenous pancreas enzymes. Diarrhea was present in both for a long time and attributed to existing PS. Endoscopic and laboratory examinations revealed celiac disease (CD). After gluten-free diet, their symptoms were resolved. Detailed family investigation revealed that parents and the sister of the siblings were free of both PS and CD. To o...

First-time buyers boost home sales

bizjournals.com Health Care:Health Insurance headlines — Wed, 10 Mar 2010 19:32:44 +0100

First-time homebuyers in California have given a boost to the anemic residential real estate market. (Source: bizjournals.com Health Care:Health Insurance headlines)

Mitigating the Cardiovascular Risk of Anemia in Patients with Type 2 Diabetes and CKD: Does Darbepoetin Help? The TREAT Trial

Current Diabetes Reports — Wed, 10 Mar 2010 16:21:33 +0100

Content Type Journal ArticleCategory Clinical Trial ReportDOI 10.1007/s11892-010-0098-2Authors Christi Hayes, State University of New York-Downstate Medical Center and Kings County Hospital Division of Endocrinology, Department of Medicine 450 Clarkson Avenue Box 50 Brooklyn NY 11203 USAAnis Alam, State University of New York-Downstate Medical Center and Kings County Hospital Division of Endocrinology, Department of Medicine 450 Clarkson Avenue Box 50 Brooklyn NY 11203 USAJulie Black-Peart, State University of New York-Downstate Medical Center and Kings County Hospital Division of Endocrinology, Department of Medicine 450 Clarkson Avenue Box 50 Brooklyn NY 11203 USASamy I. McFarlane, State University of New York-Downstate Medical Center and Kings County Hospital Division of Endocrinolo...

Zoledronic acid and clodronate in the treatment of malignant bone metastases with hypercalcaemia; efficacy and safety comparative study

Medical Oncology — Wed, 10 Mar 2010 16:02:56 +0100

Abstract The aim of this study is to conduct a comparison study between the efficacy and safety of zoledronic acid and clodronate in malignant hypercalcemia secondary to bone metastases in Egyptian adult patients. This is a prospective observational study conducted 80 patients (40 in each group), who were assigned to receive either zoledronic acid (4 mg over a 30 min infusion) every 3–4 weeks or clodronate (a single dose of 1,500 mg over a 4 h infusion) monthly for 3 months. The primary efficacy analysis was the proportion of patients with at least one skeletal-related event. The safety was assessed based on the frequencies of the reported adverse effects as nausea, vomiting, anemia, etc. The calcium level significantly decreased in both grou...

Impact of the Red River Catastrophic Flood on Women Giving Birth in North Dakota, 1994–2000

Maternal and Child Health Journal — Wed, 10 Mar 2010 15:34:30 +0100

Abstract To document changes in birth rates, birth outcomes, and pregnancy risk factors among women giving birth after the 1997 Red River flood in North Dakota. We analyzed detailed county-level birth files pre-disaster (1994–1996) and post-disaster (1997–2000) in North Dakota. Crude birth rates and adjusted fertility rates were calculated. The demographic and pregnancy risk factors were described among women delivering singleton births. Logistic regression was conducted to examine associations between the disaster and low birth weight (<2,500 g), preterm birth (<37 weeks), and small for gestational age infants adjusting for confounders. The crude birth rate and direct-adjusted fertility rate decreased significantly after the disaster in North Dakota. T...

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Immune-Mediated Severe Hemolytic Crisis with a Hemoglobin Level of 1.6 g/dl Caused by Anti-Piperacillin Antibodies in a Patient with Cystic Fibrosis

Infection — Wed, 10 Mar 2010 15:29:04 +0100

We report a 23-year-old female patient with cystic fibrosis developing severe intravascular hemolysis with a minimal hemoglobin level of 1.6 g/dl after 7 days of treatment with piperacillin, consistent with an immune-mediated hemolytic crisis. Twenty days later, the patient could leave the hospital in good condition without any neurological deficit. To our knowledge, this is the lowest reported hemoglobin value caused by hemolytic anemia with intact survival. As piperacillin is commonly used in patients with cystic fibrosis, it is important to monitor the full-blood counts of patients during treatment with piperacillin and to be aware of the potential for hemolytic anemia to develop. Anti-piperacillin antibodies should be considered whenever these patients develop hemolytic...

Diagnostic accuracy of serum hepcidin for iron deficiency in critically ill patients with anemia

Intensive Care Medicine — Wed, 10 Mar 2010 12:54:32 +0100

Conclusions Hepcidin levels may be suppressed by ID even in case of inflammation. Serum hepcidin of 129.5 µg/l was the most accurate threshold for ID diagnosis in critically ill patients with anemia. Content Type Journal ArticleCategory Brief ReportDOI 10.1007/s00134-010-1794-8Authors Sigismond Lasocki, AP-HP, CHU Bichat-Claude Bernard, Université Paris 7 Diderot Service de Réanimation Chirugicale, Département d’Anesthésie-Réanimation chirurgicale 46, rue Henri Huchard 75877 Paris Cedex 18 FranceGabriel Baron, AP-HP, CHU Bichat-Claude Bernard, Université Paris 7 Diderot Département d’Epidémiologie, Biostatistique et Recherche Clinique Paris FranceFathi Driss, INSERM U773, CRB3 équipe 4, Université Paris 7 Diderot site Bichat Paris FranceMark Weste...

Inhalant Abuse and Hemoptysis: Is there really cause and effect?

The Poison Review — Wed, 10 Mar 2010 01:19:16 +0100

2 out of 5 stars Inhalant Abuse: A Case of Hemoptysis Associated with Halogenated Hydrocarbon Abuse. Schloneger M et al. Pediatr Emerg Care 2009;25:754-757. Abstract This case report describes an 18-year-old male with respiratory difficulty — initially treated as pneumonia — that eventually was diagnosed as massive pulmonary hemorrhage. Many rare causes of this condition — Goodpasture syndrome, bacterial and viral pneumonia, Wegener granulomatosis, etc — were ruled-out. Despite intensive treatment, the patient’s respiratory condition continued to deteriorate and he died on the 11th hospital day. Because the patient’s mother revealed that he had been huffing keyboard cleaner (tetrafluoroethane), the authors report this association but are careful ...

Influence of carotene-rich vegetable meals on the prevalence of anaemia and iron deficiency in Filipino schoolchildren

European Journal of Clinical Nutrition — Wed, 10 Mar 2010 00:00:00 +0100

Authors: C C Maramag, J D Ribaya-Mercado, P Rayco-Solon, J A A Solon, L W Tengco, J B Blumberg & F S Solon (Source: European Journal of Clinical Nutrition)

Vulvar squamous cell carcinoma associated with Fanconi's anemia.

International Journal of Hematology — Wed, 10 Mar 2010 00:00:00 +0100

We report a 23-year-old virgin female with Fanconi's anemia and diabetes mellitus who presented with a history of 6-month ulcerative lesions of the vulva. Gynecologic examination disclosed a 1 x 2 cm ulcerated tumor lesion at the right labia minor near to the urethra. The biopsy showed a high-grade vulvar intraepithelial neoplasia (VIN III). She underwent wide local excision for this lesion. Pathologic examination of the surgically removed specimen revealed SCC of the vulva. Therefore, radical vulvectomy and bilateral inguino-femoral lymphadenectomy were performed. Due to the involvement of right inguinal lymph node, radiotherapy with a total dose of 45 Gy was delivered to mid-pelvis through antero-posterior/postero-anterior fields with 18 mV photon energies. Until her last follow-up about...

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Extracranial internal carotid arterial disease in children with sickle cell anemia.

Haematologica — Wed, 10 Mar 2010 00:00:00 +0100

Conclusions Extracranial ICA stenosis is strongly associated with stroke in children with SCA, and may explain some cases of stroke without overt intracranial vasculopathy. Doppler ultrasound scanning of extracranial ICAs is non-invasive and fairly quick to perform and may identify children at increased risk of stroke who would otherwise be missed. The value of extracranial ICA scanning should be studied prospectively. PMID: 20220066 [PubMed - as supplied by publisher] (Source: Haematologica)

Regulated oxygen sensing by protein hydroxylation in renal erythropoietin-producing cells.

American Journal of Physiology. Renal Physiology — Wed, 10 Mar 2010 00:00:00 +0100

Authors: Wenger RH, Hoogewijs D The kidney is a major site of systemic oxygen sensing, regulating blood erythrocyte and hence oxygen content by hypoxia-inducible erythropoietin (Epo) expression. A constant ratio between blood perfusion and oxygen consumption, a stable cortico-medullary oxygen gradient, and a relatively low tissue pO2 are the prerequisites for the function of renal Epo-producing and oxygen sensing (REPOS) cells which are located in the juxtamedullary cortex. In kidney disease, renal oxygen consumption is decreased, leading to an increase in pO2, dysfunction of REPOS cells and anemia. The molecular principles of cellular oxygen sensing have been elucidated in the last few years and genetically altered mouse models as well as hereditary diseases causing erythrocytosis hav...

Left ventricular diastolic abnormalities and the impact of hepatitis C virus infection in multitransfused Egyptian children

Articles of Archives of Medical Science - TERMEDIA publishing house — Tue, 09 Mar 2010 16:12:51 +0100

Conclusions: Multitransfused children are more liable to left ventricular diastolic dysfunction suggested by impaired relaxation probably due to iron overload and anaemia. Hepatitis C virus infection is an additional factor which might share in impairing left ventricular systolic function. Left ventricular performance is better preserved when chelation treatment is adjusted to maintain serum ferritin at (Source: Articles of Archives of Medical Science - TERMEDIA publishing house)

Relationship between anaemia and cognitive functions in elderly people.

European Journal of Internal Medicine — Tue, 09 Mar 2010 15:36:49 +0100

CONCLUSION: In the elderly anaemic group, the dependency for daily activities that require physical effort was higher compared to the nonanaemic group. The MMSE score in the elderly anaemic group was lower than subjects who had normal haemoglobin levels. We conclude that anaemia may impair cognitive functions and some daily living activities in the elderly. PMID: 20206877 [PubMed - as supplied by publisher] (Source: European Journal of Internal Medicine)

Anemia in diabetic patients at an internal medicine ward: Clinical correlates and prognostic significance.

European Journal of Internal Medicine — Tue, 09 Mar 2010 15:36:46 +0100

CONCLUSION: Frequency of anemia was increased in diabetic patients admitted to the Internal Medicine Departments, compared to the studies performed on ambulatory patient populations. Anemia was multifactorial and associated with higher mortality, predominantly from infections. Males with albuminuria and heart failure were at higher risk of death. PMID: 20206878 [PubMed - as supplied by publisher] (Source: European Journal of Internal Medicine)

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Functional vitamin B12 deficiency in alcoholics: An intriguing finding in a retrospective study of megaloblastic anemic patients.

European Journal of Internal Medicine — Tue, 09 Mar 2010 15:36:36 +0100

CONCLUSION: Some alcohol-dependent patients with megaloblastic anemia may respond to vitamin B12 treatment despite normal cobalamin serum levels; therefore in alcoholics caution is urged in the interpretation of these vitamin assays, because of possible functional vitamin B12 deficiency. PMID: 20206879 [PubMed - as supplied by publisher] (Source: European Journal of Internal Medicine)

Baseline characteristics and outcome in Romanian patients with Gaucher disease type 1.

European Journal of Internal Medicine — Tue, 09 Mar 2010 15:36:25 +0100

CONCLUSIONS: The genotype N370S/L444P is frequent in our patients, in line with the severe phenotypes. ERT improved haematological parameters and visceromegaly, without a clear benefit for bone mineral density. To attain therapeutic goals, an early treatment start with optimal dosage is mandatory. PMID: 20206881 [PubMed - as supplied by publisher] (Source: European Journal of Internal Medicine)

Children’s launches new stem cell Web site

Thrive, Children's Hospital Boston — Tue, 09 Mar 2010 15:21:24 +0100

By Jonathan Kraft, president of The Kraft Group and New England Patriots As a long-time supporter of stem cell research, I’m proud to announce the launch of a new Children’s Hospital Boston Web site that we hope will demystify the science of stem cells and answer some of the public’s questions about them. For the past three and a half years, my wife, Patti, and I have served as co-chairs of Children’s Hospital Boston’s Stem Cell Task Force because we believe that stem cells hold incredible promise for the future of health care. During this time I’ve gotten to know Len Zon and George Daley, the two physician-scientists who head up the hospital’s Stem Cell Research Program, and I believe that the work they are doing will revolutionize health care.They’ve expl...

Phase II Trial of Weekly Bortezomib in Combination With Rituximab in Relapsed or Relapsed and Refractory Waldenstrom Macroglobulinemia [Hematologic Malignancies]

Journal of Clinical Oncology — Mon, 08 Mar 2010 23:01:30 +0100

Conclusion The combination of weekly bortezomib and rituximab showed significant activity and minimal neurologic toxicity in patients with relapsed WM. (Source: Journal of Clinical Oncology)

History and Current Status of Newborn Screening for Hemoglobinopathies

Seminars in Perinatology — Mon, 08 Mar 2010 17:41:29 +0100

The impact of hemoglobinopathies on healthcare in the United States, particularly sickle cell disease (SCD), has been significant. Enactment of the Sickle Cell Anemia Control Act in 1972 significantly increased the federal interest in the SCDs and other hemoglobinopathies. Only since May 1, 2006, have all states required and provided universal newborn screening for SCD despite a national recommendation to this effect in 1987. In this article, we review the history of screening for SCD and other hemoglobinopathies, along with federal and state activities that have contributed to improved health outcomes for patients with SCD, as well as current newborn screening practices. We also chronicle the federal activities that have helped to shape and to refine laboratory screening and diagnostic pr...

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Lipid levels in sickle-cell disease associated with haemolytic severity, vascular dysfunction and pulmonary hypertension

British Journal of Haematology — Mon, 08 Mar 2010 00:00:00 +0100

Pulmonary hypertension (PH) in sickle cell disease (SCD) is an emerging and important clinical problem. In a single-institution adult cohort of 365 patients, we investigated lipid and lipoprotein levels and their relationship to markers of intravascular haemolysis, vascular dysfunction and PH. In agreement with prior studies, we confirm significantly decreased plasma levels of total cholesterol, high-density lipoprotein-cholesterol (HDL-C) and low-density lipoprotein-cholesterol (LDL-C) in SCD versus ethnically-matched healthy controls. Several cholesterol parameters correlated significantly with markers of anaemia, but not endothelial activation or PH. More importantly, serum triglyceride levels were significantly elevated in SCD compared to controls. Elevated triglyceride levels correlat...

Effect of eculizumab on haemolysis-associated nitric oxide depletion, dyspnoea, and measures of pulmonary hypertension in patients with paroxysmal nocturnal haemoglobinuria

British Journal of Haematology — Mon, 08 Mar 2010 00:00:00 +0100

Pulmonary hypertension (PH) is a common complication of haemolytic anaemia. Intravascular haemolysis leads to nitric oxide (NO) depletion, endothelial and smooth muscle dysregulation, and vasculopathy, characterized by progressive hypertension. PH has been reported in patients with paroxysmal nocturnal haemoglobinuria (PNH), a life-threatening haemolytic disease. We explored the relationship between haemolysis, systemic NO, arginine catabolism and measures of PH in 73 PNH patients enrolled in the placebo-controlled TRIUMPH (Transfusion Reduction Efficacy and Safety Clinical Investigation Using Eculizumab in Paroxysmal Nocturnal Haemoglobinuria) study. At baseline, intravascular haemolysis was associated with elevated NO consumption (P < 0·0001) and arginase-1 release (P < 0·0001). Almost...

Evaluation of histopathology, real-time PCR and virus isolation for diagnosis of infectious salmon anaemia in Norwegian salmon using latent class analysis

Journal of Fish Diseases — Mon, 08 Mar 2010 00:00:00 +0100

(Source: Journal of Fish Diseases)

Weekly paclitaxel plus carboplatin is an effective nonanthracycline-containing regimen as neoadjuvant chemotherapy for breast cancer.

Ann Oncol — Mon, 08 Mar 2010 00:00:00 +0100

CONCLUSIONS: Weekly PCb regimen was very active and tolerable as neoadjuvant treatment of breast cancer. This weekly PCb regimen should consider as a reasonable nonanthracycline-containing option in the neoadjuvant treatment of breast cancer. PMID: 20211870 [PubMed - as supplied by publisher] (Source: Ann Oncol)

Erythropoiesis stimulating agents, thrombosis and cancer.

Mon, 08 Mar 2010 00:00:00 +0100

Authors: Barbera L, Thomas G Venous thromboembolism (VTE) is common in cancer and is associated with both morbidity and mortality. Erythropoiesis stimulating agents (ESAs) were originally developed to correct anemia. Recent trials in cancer patients however, raise concerns over both increased VTE rates and the possibility of worse tumour outcomes and increased mortality with ESA use. The most common reason offered for explaining the possible negative impact of ESAs on cancer outcomes has been the stimulation of erythropoietin receptors on tumour cells. Despite an extensive literature, it is unlikely that most practicing appreciate the intricate relationship and interaction between the coagulation pathways, angiogenesis and tumour progression and ESA effects. This paper will review thes...

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A multiprotein complex involved in the DNA damage response network of Fanconi anemia, breast cancer, and Bloom syndrome

Videocast - All Events — Fri, 05 Mar 2010 14:30:00 +0100

The DNA Repair Interest Group is concerned with all forms of DNA damage and repair. As a major defense against environmental damage to cells DNA repair is present in all organisms examined including bacteria, yeast, drosophila, fish, amphibians, rodents and humans. The members of the DNA Repair Interest Group perform research in areas including DNA repair enzymology and fine structure, mutagenesis, gene and cell cycle regulation, protein structure, and human disease. For more information, visit the DNA Repair Interest GroupAir date: 3/16/2010 12:30:00 PM (Source: Videocast - All Events)

Vulnerability to anemia may underlie beta-blocker peri-operative risk

MedWire News - Anesthesiology — Fri, 05 Mar 2010 00:00:00 +0100

The putative excess risk for certain peri-operative complications in patients given beta blockers may be caused by the drugs increasing patients’ vulnerability to the effects of anemia, research suggests. (Source: MedWire News - Anesthesiology)

[Case Report] Altered pain perception in schizophrenia

LANCET — Fri, 05 Mar 2010 00:00:00 +0100

In June, 2009, a 51-year-old woman presented with a 4-day history of abdominal swelling and fever, and a 2-week history of loss of appetite. There was no history of abdominal pain or nausea. She was febrile (38·4°C) and her abdomen was swollen but soft without spontaneous pain or tenderness. She had a history of schizophrenia since the age of 40 years which was well controlled with perospirone 12 mg/day and quetiapine 150 mg/day. At the age of 45 years, she was diagnosed with diabetes mellitus and had achieved good glycaemic control (HbA1c 6·5%) with biphasic insulin aspart 30 (6 U/day). There was no sign of obvious peripheral neuropathy. Laboratory test results showed normocytic anaemia (haemoglobin 95 g/L), leucocytosis (13·3×109/L) with neutrophilia (91·5%), high concentration of ...

Mutagenic repair of DNA interstrand crosslinks

Environmental and Molecular Mutagenesis — Fri, 05 Mar 2010 00:00:00 +0100

Formation of DNA interstrand crosslinks (ICLs) in chromosomal DNA imposes acute obstruction of all essential DNA functions. For over 70 years bifunctional alkylators, also known as DNA crosslinkers, have been an important class of cancer chemotherapeutic regimens. The mechanisms of ICL repair remains largely elusive. Here, we review a eukaryotic mutagenic ICL repair pathway discovered by work from several laboratories. This repair pathway, alternatively termed recombination-independent ICL repair, involves the incision activities of the nucleotide excision repair (NER) mechanism and lesion bypass polymerase(s). Repair of the ICL is initiated by dual incisions flanking the ICL on one strand of the double helix; the resulting gap is filled in by lesion bypass polymerases. The remaining lesio...

The IL-12p70/IL-10 interplay is differentially regulated by free heme and hemozoin in murine bone-marrow-derived macrophages.

International Journal for Parasitology — Fri, 05 Mar 2010 00:00:00 +0100

Authors: Cambos M, Bazinet S, Abed E, Sanchez-Dardon J, Bernard C, Moreau R, M MO, Scorza T The outcome of malarial anaemia is determined by a complex interplay between pro-inflammatory and anti-inflammatory cytokines, its severity associated with accumulation of hemozoin (Hz) in macrophages, elevated IL-10 responses and impaired IL-12 production. Although free heme contributes to malarial anaemia by inducing oxidative damage of red blood cells (RBCs) and enhancing their clearance by phagocytes, its impact on IL-12/IL-10 interactions has not been fully characterized. Herein, the effect of hemin (HE) on IL-12 and IL-10 responses was studied in murine bone marrow-derived macrophages (BMDM) and compared with synthetic Hz. Our data reveal that HE induces modest inhibition of IL-12p70 respo...

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Iron chelation therapy associated with improvement of hematopoiesis in transfusion-dependent patients.

Transfusion — Fri, 05 Mar 2010 00:00:00 +0100

CONCLUSION: Although there are few reports on erythroid responses in patients undergoing iron chelation therapy, they may give new insights in the pathogenesis of MDS and other myeloproliferative neoplasms. AA may benefit in terms of erythroid response. The findings in these cases underline the clinical importance of treating patients with iron overload. A survival benefit of chelation in patients with myeloproliferative neoplasms is still to be confirmed. PMID: 20230535 [PubMed - as supplied by publisher] (Source: Transfusion)

Fixed-dose-rate gemcitabine: a viable first-line treatment option for advanced pancreatic and biliary tract cancer.

The Oncologist — Thu, 04 Mar 2010 23:04:03 +0100

Conclusions. Currently available evidence, including this updated analysis, supports the use of FDR-Gem as a first-line option in advanced PDAC, and possibly in BTC, patients and prompts the continued evaluation of this approach in combination regimens. PMID: 20189980 [PubMed - in process] (Source: The Oncologist)

International Women’s Day: A girl called 'Good News'

MSF News — Thu, 04 Mar 2010 20:12:00 +0100

In Burundi becoming pregnant is a matter of life and death. According to the World Health Organisation, the maternal mortality rate is 11 for every 1,000 live births, while the neonatal mortality rate is 41 per 1,000 live births. Since 2008, Médecins Sans Frontières (MSF) has been running a centre for obstetric emergencies in the town of Kabezi, south of the capital Bujumbura. The centre provides free specialised medical care during pregnancy and delivery, and treats an average of 250 women a month. Mary Nicizanye, 30, is one of those women. She is sitting in the ward at the MSF centre. It has been four days since she gave birth to a little girl. Beads of sweat run down her neck, but her eyes are bright. Before she gave birth, Mary was brought to a local health centre suffering f...

Red blood cells transfusion in intensive care unit

Revista Brasileira de Terapia Intensiva — Thu, 04 Mar 2010 17:26:01 +0100

CONCLUSIONS: Politrauma and sepsis/sepsis chock were the pre diagnosis criteria. A low hemoglobin level is the main clinical criteria with average hemoglobin pre - transfusion was 8,11 g/dL. (Source: Revista Brasileira de Terapia Intensiva)

Analysis of novel sph (spherocytosis) alleles in mice reveals allele-specific loss of band 3 and adducin in {alpha}-spectrin-deficient red cells

Blood — Thu, 04 Mar 2010 17:00:46 +0100

Five spontaneous, allelic mutations in the -spectrin gene, Spna1, have been identified in mice (spherocytosis [sph], sph1J, sph2J, sph2BC, sphDem). All cause severe hemolytic anemia. Here, analysis of 3 new alleles reveals previously unknown consequences of red blood cell (RBC) spectrin deficiency. In sph3J, a missense mutation (H2012Y) in repeat 19 introduces a cryptic splice site resulting in premature termination of translation. In sphIhj, a premature stop codon occurs (Q1853Stop) in repeat 18. Both mutations result in markedly reduced RBC membrane spectrin content, decreased band 3, and absent β-adducin. Reevaluation of available, previously described sph alleles reveals band 3 and adducin deficiency as well. In sph4J, a missense mutation occurs in the C-terminal EF hand domain (C...

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Fetal hemoglobin in sickle cell anemia: genome-wide association studies suggest a regulatory region in the 5' olfactory receptor gene cluster

Blood — Thu, 04 Mar 2010 17:00:46 +0100

In a genome-wide association study of 848 blacks with sickle cell anemia, we identified single nucleotide polymorphisms (SNPs) associated with fetal hemoglobin concentration. The most significant SNPs in a discovery sample were tested in a replication set of 305 blacks with sickle cell anemia and in subjects with hemoglobin E or β thalassemia trait from Thailand and Hong Kong. A novel region on chromosome 11 containing olfactory receptor genes OR51B5 and OR51B6 was identified by 6 SNPs (lowest P = 4.7E–08) and validated in the replication set. An additional olfactory receptor gene, OR51B2, was identified by a novel SNP set enrichment analysis. Genome-wide association studies also validated a previously identified SNP (rs766432) in BCL11A, a gene known to affect fetal hemoglobin ...

Anemia Management in ESRD Patients May Be Risky (CME/CE)

MedPage Today Nephrology — Thu, 04 Mar 2010 15:43:07 +0100

Among patients with end-stage renal disease who are anemic, more intensive use of iron or erythropoiesis-stimulating agents lowered or increased the risk of death, depending on hematocrit levels, researchers said. (Source: MedPage Today Nephrology)

Study Examines Outcomes Associated With Anemia Management For Patients With End-Stage Renal Disease

Health News from Medical News Today — Thu, 04 Mar 2010 09:00:00 +0100

Greater use of erythropoiesis-stimulating agents (ESAs) and more frequent use of iron at lower hematocrit levels (the proportion of the blood that consists of red blood cells) was associated with a decreased risk of death for hemodialysis patients, according to a study in the March 3 issue of JAMA... (Source: Health News from Medical News Today)

Study Examines Outcomes Associated With Anemia Management For Patients With End-Stage Renal Disease

Urology / Nephrology News From Medical News Today — Thu, 04 Mar 2010 09:00:00 +0100

The FDA's Perspective on the Risk for Rapid Rise in Hemoglobin in Treating CKD Anemia: Quo Vadis.

Clinical Journal of the American Society of Nephrology : CJASN — Thu, 04 Mar 2010 00:00:00 +0100

Authors: Singh AK PMID: 20203166 [PubMed - as supplied by publisher] (Source: Clinical Journal of the American Society of Nephrology : CJASN)

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[Follow-up of pregnancies with red-cell allo-immunisation: State-of-the art.]

Gynecologie, Obstetrique & Fertilite — Thu, 04 Mar 2010 00:00:00 +0100

Authors: Carbonne B, Castaigne V, Cynober E, Levy R, Cortey A, Mailloux A, Larsen M, Brossard Y Anti-RhD allo-immunisation has become rare since anti-D prophylaxis was introduced in the seventies; however, it remains the first cause of fetal anemia. It may cause severe fetal complications such as fetal hydrops, cerebral anoxic lesions and fetal death. In the neonatal period, severe jaundices and anemias requiring transfusion or exsanguino-transfusion are still common in case of severe allo-immunisation. Neonatal death and sequellae due to bilirubin encephalopathy have not fully disappeared. Follow-up of pregnancies with maternal allo-immunisation requires identification of the antibody (anti-RhD, anti-Kell and anti-c are the most frequently responsible for fetal complications), dosage ...

Anemia Drugs Help End-Stage Anemic Kidney Patients

Medscape Medical News Headlines — Wed, 03 Mar 2010 17:26:04 +0100

Aggressive treatment with blockbuster anemia drugs may offer the best approach for kidney dialysis patients with severe anemia, U.S. researchers said on Tuesday. Reuters Health Information (Source: Medscape Medical News Headlines)

More aggressive ESA, iron use associated with decreased mortality in anemia patients on hemodialysis

HemOncToday.com — Wed, 03 Mar 2010 16:45:00 +0100

(Source: HemOncToday.com)

Anemia Therapies in Dialysis Patients with Higher Hematocrit May Be 'Problematic'

Physician's First Watch current issue — Wed, 03 Mar 2010 13:47:28 +0100

(Source: Physician's First Watch current issue)

Study Identifies Risks, Benefits Of Anemia Drugs

Health News from Medical News Today — Wed, 03 Mar 2010 11:00:00 +0100

Aggressive treatment of anemia with intravenous iron and drugs known as erythropoiesis-stimulating agents (ESAs) may lower the risk of death for dialysis patients with severe anemia but also may increase the risk of death among patients with milder anemia, a new study led by a University of North Carolina at Chapel Hill epidemiologist suggests. Anemia is a common and often debilitating complication of kidney disease that has been linked to poor quality of life and increased risk of hospitalization and death... (Source: Health News from Medical News Today)

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Study Identifies Risks, Benefits Of Anemia Drugs

Urology / Nephrology News From Medical News Today — Wed, 03 Mar 2010 11:00:00 +0100

Aggressive treatment of anemia with intravenous iron and drugs known as erythropoiesis-stimulating agents (ESAs) may lower the risk of death for dialysis patients with severe anemia but also may increase the risk of death among patients with milder anemia, a new study led by a University of North Carolina at Chapel Hill epidemiologist suggests... (Source: Urology / Nephrology News From Medical News Today)

Hemoperitoneum in pregnancy from a ruptured varix of broad ligament

Archives of Gynecology and Obstetrics — Wed, 03 Mar 2010 08:50:39 +0100

We present a case of a 31-year-old woman, gravida 4 para 1, pregnant at 33 + 2 weeks of gestational age with acute abdomen due to hemoperitoneum. Hemoperitoneum was suspected for non-specific symptoms such as acute abdominal pain, vomit, cardiotocography alterations and maternal acute anaemia. An emergency caesarean section was performed; 3 L of blood was present in abdomen. Careful exploration of the uterus, placenta, abdominal organs and vessels was negative; only a bleeding from a rupture in a varix of the left broad ligament was observed. Hemoperitoneum due to a ruptured uterine varix in pregnancy is a rare condition. The solution to prevent the development of maternal hypovolemic shock is an immediate surgical intervention. A good foetal prognosis principally depe...

For Some on Dialysis, Anemia Drugs Pose Risks

MedicineNet Cancer General — Wed, 03 Mar 2010 07:00:00 +0100

Title: For Some on Dialysis, Anemia Drugs Pose RisksCategory: Health NewsCreated: 3/2/2010 4:10:00 PMLast Editorial Review: 3/3/2010 (Source: MedicineNet Cancer General)

For Some on Dialysis, Anemia Drugs Pose Risks

MedicineNet Cholesterol General — Wed, 03 Mar 2010 07:00:00 +0100

Title: For Some on Dialysis, Anemia Drugs Pose RisksCategory: Health NewsCreated: 3/2/2010 4:10:00 PMLast Editorial Review: 3/3/2010 (Source: MedicineNet Cholesterol General)

For Some on Dialysis, Anemia Drugs Pose Risks

MedicineNet Heart General — Wed, 03 Mar 2010 07:00:00 +0100

Title: For Some on Dialysis, Anemia Drugs Pose RisksCategory: Health NewsCreated: 3/2/2010 4:10:00 PMLast Editorial Review: 3/3/2010 (Source: MedicineNet Heart General)

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For Some on Dialysis, Anemia Drugs Pose Risks

MedicineNet Crohn's Disease General — Wed, 03 Mar 2010 07:00:00 +0100

Title: For Some on Dialysis, Anemia Drugs Pose RisksCategory: Health NewsCreated: 3/2/2010 4:10:00 PMLast Editorial Review: 3/3/2010 (Source: MedicineNet Crohn's Disease General)

For Some on Dialysis, Anemia Drugs Pose Risks

MedicineNet HIV General — Wed, 03 Mar 2010 07:00:00 +0100

Title: For Some on Dialysis, Anemia Drugs Pose RisksCategory: Health NewsCreated: 3/2/2010 4:10:00 PMLast Editorial Review: 3/3/2010 (Source: MedicineNet HIV General)

Hematocrit Tied to Anemia Treatment Outcomes in Dialysis

Modern Medicine — Wed, 03 Mar 2010 00:00:00 +0100

In patients with end-stage renal disease utilizing hemodialysis, greater use of erythropoiesis-stimulating agents and iron was associated with higher and lower mortality risk, depending on patients' hematocrit levels, according to research published in the March 3 issue of the Journal of the American Medical Association. (Source: Modern Medicine)

Disappearing Myelodysplastic Syndrome-Associated Hemolytic Anemia in Leukemic Transformation

International Archives of Allergy and Immunology — Tue, 02 Mar 2010 23:00:00 +0100

Int Arch Allergy Immunol 2010;152:407412 (DOI:10.1159/000288294) (Source: International Archives of Allergy and Immunology)

Anemia drugs help end-stage anemic kidney patients

Reuters: Health — Tue, 02 Mar 2010 21:43:08 +0100

CHICAGO (Reuters) - Aggressive treatment with blockbuster anemia drugs may offer the best approach for kidney dialysis patients with severe anemia, U.S. researchers said on Tuesday. (Source: Reuters: Health)

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For Some on Dialysis, Anemia Drugs Pose Risks

MedlinePlus Health News — Tue, 02 Mar 2010 21:00:00 +0100

But experts say not using them would lower people's quality of life Source: HealthDay Related MedlinePlus Pages: Anemia, Dialysis, Drug Safety (Source: MedlinePlus Health News)

Comparative Mortality Risk of Anemia Management Practices in Incident Hemodialysis Patients [Original Contribution]

JAMA — Tue, 02 Mar 2010 20:50:35 +0100

Conclusions Greater ESA and iron use were associated with decreased mortality risk at lower hematocrit levels, in which mortality rates are the highest. Although the overall mortality rate was lower at higher hematocrit levels, elevated mortality risk was associated with greater use of ESAs and iron in these patients. (Source: JAMA)

Thrombocytopenia and increased clotting time in rats acutely infected by Trypanosoma evansi

Comparative Clinical Pathology — Tue, 02 Mar 2010 10:01:53 +0100

Abstract The aims of this study were to evaluate clotting disturbances in the acute infection by Trypanosoma evansi in rats and to investigate two possible causes. To address this issue, 21 2-month-old male rats were separated into three groups with seven animals each. The control group (group I) was composed of non-infected animals and group II was composed of 14 T. evansi-infected animals. This group was subdivided into two homogeneous groups. Animals from group II-a and from group II-b were euthanized at days 3 and 5 post-inoculation (PI), respectively. Hematological parameters were evaluated for monitoring of the disease. Infected animals showed anemia and leukocytosis 3 days PI and a significant decrease was observed in platelet count at days 3 and 5 PI. The p...

Study examines outcomes associated with anemia management for patients with end-stage renal disease

EurekAlert! - Infectious and Emerging Diseases — Tue, 02 Mar 2010 05:00:00 +0100

(JAMA and Archives Journals) Greater use of erythropoiesis-stimulating agents and more frequent use of iron at lower hematocrit levels (the proportion of the blood that consists of red blood cells) was associated with a decreased risk of death for hemodialysis patients, according to a study in the March 3 issue of JAMA. (Source: EurekAlert! - Infectious and Emerging Diseases)

Hydroxyurea-induced Expression of Glutathione Peroxidase 1 in Red Blood Cells of Individuals with Sickle Cell Anemia

Antioxidants and Redox Signaling — Tue, 02 Mar 2010 03:51:20 +0100

Antioxidants & Redox Signaling , Vol. 0, No. 0. (Source: Antioxidants and Redox Signaling)

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Targeting and processing of site-specific DNA interstrand crosslinks

Environmental and Molecular Mutagenesis — Tue, 02 Mar 2010 00:00:00 +0100

DNA interstrand crosslinks (ICLs) are among the most cytotoxic types of DNA damage, and thus ICL-inducing agents such as cyclophosphamide, melphalan, cisplatin, psoralen, and mitomycin C have been used clinically as anticancer drugs for decades. ICLs can also be formed endogenously as a consequence of cellular metabolic processes. ICL-inducing agents continue to be among the most effective chemotherapeutic treatments for many cancers; however, treatment with these agents can lead to secondary malignancies, in part due to mutagenic processing of the DNA lesions. The mechanisms of ICL repair have been characterized more thoroughly in bacteria and yeast than in mammalian cells. Thus, a better understanding of the molecular mechanisms of ICL processing offers the potential to improve the effic...

Aerobic capacity in patients with chronic liver disease: Very modest effect of liver transplantation.

Presse Medicale — Tue, 02 Mar 2010 00:00:00 +0100

DISCUSSION: Our study provides evidence of a very modest and inconsistent increase in aerobic capacity in liver transplant candidates after liver transplantation alone. This persistent impairment of exercise tolerance was principally of peripheral origin but anemia and beta-blocker treatment should be considered as major aggravating factors. Rehabilitation programs before and after transplantation may increase its benefits to these deconditioned liver transplant recipients in their daily lives. PMID: 20202784 [PubMed - as supplied by publisher] (Source: Presse Medicale)

25-Year-Old Woman With Anemia

Mayo Clinic Proceedings — Mon, 01 Mar 2010 18:02:04 +0100

(Source: Mayo Clinic Proceedings)

Pro-Inflammatory Cytokine-Mediated Anemia: Regarding Molecular Mechanisms of Erythropoiesis

Mediators of Inflammation — Mon, 01 Mar 2010 17:07:11 +0100

Anemia of cancer and chronic inflammatory diseases is a frequent complication affecting quality of life. For cancer patients it represents a particularly bad prognostic. Low level of erythropoietin is considered as one of the causes of anemia in these pathologies. The deficiency in erythropoietin production results from pro-inflammatory cytokines effect. However, few data is available concerning molecular mechanisms involved in cytokine-mediated anemia. Some recent publications have demonstrated the direct effect of pro-inflammatory cytokines on cell differentiation towards erythroid pathway, without erythropoietin defect. This suggested that pro-inflammatory cytokine-mediated signaling pathways affect erythropoietin activity. They could interfere with erythropoietin-mediated signaling pat...

Dapsone: Haemolytic anaemia and methaemoglobinaemia in an elderly patient: case report

Reactions — Mon, 01 Mar 2010 14:50:10 +0100

(Source: Reactions)

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Learning From the Past. What is Chlorosis?

PediatricEducation.org — Mon, 01 Mar 2010 00:01:20 +0100

Discussion In practicing medicine, clinicians try to provide the best care for the patients and families they serve. They usually try to use the most current information available and apply it to the specific patient situation, yet medicine is an ever-changing science and art. Disease theories change. For example, mental illness was once thought to be caused by the lunar cycles thus the name “lunacy” or “lunatic.” Overtime it became known that neurochemical and genetic factors play a role. Scientific information is re-analyzed or classified. For example, the organism that causes cat-scratch disease has had 3 names since 1991 - Afipis felis, Rochlimacae henselae, and currently Bartonella henselae. Disease treatments are often changing as new information becomes avail...

Efficacy and tolerability of artesunate-amodiaquine (Camoquin plus®) versus artemether-lumefantrine (Coartem®) against uncomplicated Plasmodium falciparum malaria: multisite trial in Senegal and Ivory Coast

Tropical Medicine and International Health — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion This study demonstrates the efficacy and tolerability of AS + AQ for uncomplicated Plasmodium falciparum malaria treatment in African patients over the age of 7 years. (Source: Tropical Medicine and International Health)

Low Oxygen-Affinity Hemoglobin Solution Increases Oxygenation of Partially Ischemic Tissue During Acute Anemia

Journal of the American College of Surgeons — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Results suggest the existence of an optimal concentration of low O2-affinity acellular Hb to increase oxygenation of partially ischemic tissue during anemic conditions. (Source: Journal of the American College of Surgeons)

Management of ESRD in Patients With Autosomal Dominant Polycystic Kidney Disease

Advances in Chronic Kidney Disease — Mon, 01 Mar 2010 00:00:00 +0100

Autosomal dominant polycystic kidney disease (ADPKD) is the leading hereditary cause of ESRD in the United States. Because of the renal and extrarenal manifestations of ADPKD, specific challenges exist caring for these patients once they reach ESRD. In this article, we report the overall outcomes of individuals with ADPKD after ESRD as compared with non-ADPKD patients. We also review the available literature concerning issues specific to dialysis or kidney transplantation. For the ADPKD patient on dialysis, we address the use of peritoneal dialysis, the management of renal cystic, and extrarenal complications, and we discuss the significance of the relative polycythemia often observed in this population. For the ADPKD patient undergoing kidney transplantation, we highlight issues of anemia...

National Kidney Foundation 2010 Spring Clinical Meetings Abstracts April 13 - 17, 2010

Advances in Chronic Kidney Disease — Mon, 01 Mar 2010 00:00:00 +0100

Efficacy and Tolerability of Oral Iron as Initial Treatment for Iron Deficiency in Pre-Dialysis Anemia of CKD (Source: Advances in Chronic Kidney Disease)

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Efficacy and Tolerability of Oral Iron as Initial Treatment for Iron Deficiency in Pre-Dialysis Anemia of CKD

Advances in Chronic Kidney Disease — Mon, 01 Mar 2010 00:00:00 +0100

Oral (OFe) or intravenous (IvFe) iron is required for most CKD patients receiving Erythropoesis Stimulating Agents (ESA). We retrospectively examined the efficacy and tolerability of OFe plus oral ascorbic acid (VitC) in iron naïve CKD patients as initial treatment for iron deficiency anemia. (Source: Advances in Chronic Kidney Disease)

Serum Pro-hepcidin Could Reflect Disease Activity in Patients with Rheumatoid Arthritis.

J Korean Med Sci — Mon, 01 Mar 2010 00:00:00 +0100

In conclusion, serum concentration of pro-hepcidin reflects the disease activity, regardless of the anemia states in RA patients, thus it may be another potential marker for disease activity of RA. PMID: 20191031 [PubMed - in process] (Source: J Korean Med Sci)

Urolithiasis in patients suffering from malignant hematologic diseases.

Yonsei Medical Journal — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSION: The incidence of urolithiasis for malignant hematologic patients was significantly higher than that for the control group. PMID: 20191017 [PubMed - in process] (Source: Yonsei Medical Journal)

Accuracy of pedicle screw placement in the lumbosacral spine using conventional technique: computed tomography postoperative assessment in 102 consecutive patients.

Journal of Neurosurgery.Spine — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions Our rates of screw misplacement and complications compare favorably with the lowest rates of the series in which conventional technique was used and are close to the rates reported for image-guided methods. The risk of malpositioning may be reduced with careful preoperative surgical planning, accurate knowledge of the spinal anatomy, surgical experience, and correct indication for conventional surgery. The conventional technique still remains a practical, safe, and effective surgical method for lumbosacral fixation. PMID: 20192632 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

Results of hematopoietic stem cell transplant in shiraz: 15 years experience in southern iran.

Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: These data reflect the important role of hematopoietic stem cell transplant in improving survival for a variety of hematopoietic system disorders at our center in Southern Iran. In patients with B-thalassemia major hematopoietic stem cell transplant seems to be the treatment of choice, because it leads to a cure in all classes (Lucarelli risk group, I-III). Based on high success rates in patients with class II and III thalassemia with the addition of the antithymocyte globulin to conditioning regimen of stem cell transplant, we also recommend using this new method of conditioning in transplant of thalassemia patients. PMID: 20199373 [PubMed - in process] (Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantati...

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Haemolysis after a single dose of primaquine co-administered with an artemisinin is not restricted to glucose-6-phosphate dehydrogenase (G6PD A- variant) deficient individuals in Tanzania.

Antimicrobial Agents and Chemotherapy — Mon, 01 Mar 2010 00:00:00 +0100

Authors: Shekalaghe SA, Ter Braak R, Daou M, Kavishe R, van den Bijllaardt W, van den Bosch S, Koenderink JB, Luty AJ, Whitty CJ, Drakeley C, Sauerwein RW, Bousema T The current interest in malaria elimination has led to a renewed interest in drugs that could be used in mass administration to minimise malaria transmission. Primaquine (PQ) is the only generally available drug with a strong activity against mature P. falciparum gametocytes, the parasite stage responsible for transmission. Despite concerns about PQ-induced haemolysis in glucose-6-phosphate dehydrogenase (G6PD) deficient individuals, a single dose of PQ may be safe and efficacious in clearing gametocytes that persist after conventional treatment. As part of a mass drug intervention, we determined the haematolytic effect of...

Reply

Urology — Mon, 01 Mar 2010 00:00:00 +0100

Suprapubic prostatectomy is the tested and most widely accepted option of surgery for men with large-volume benign prostate hyperplasia (BPH) and against which newer alternatives need to be compared. The morbidity and mortality associated with open suprapubic prostatectomy has generally decreased over the years, yet morbid events are still commonly reportedly. Significant and often excessive hemorrhage is the most immediate and serious problem of suprapubic prostatectomy. With regard to surgical technique, our study suggests that tapering the bladder neck to index finger size and oversewing of the mucosal edge may be important for hemostasis. Ensuring adequate hemostatic control lowers morbidity and reduces the need for blood transfusion. Blood transfusion in general is highly undesirable ...

Montana Court Rules in Favor of Aid in Dying

Internal Medicine News — Mon, 01 Mar 2010 00:00:00 +0100

Physicians in Montana may legally assist terminally ill patients in hastening death, according to a ruling by the Montana Supreme Court. The decision in the case of Baxter v. State of Montana concerned Robert Baxter, a retired truck driver from Billings, Mont., who was terminally ill with lymphocytic leukemia with diffuse lymphadenopathy. As a result of the disease and its treatment, Mr. Baxter suffered from symptoms including “infections, chronic fatigue and weakness, anemia, night sweats, nausea, massively swollen glands, significant ongoing digestive problems, and generalized pain and discomfort,” according to the decision. (Source: Internal Medicine News)

Factors contributing to left atrial enlargement in adults with normal left ventricular systolic function.

Journal of Cardiology — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSION: Increased LV wall thickness and decreased hemoglobin concentration might contribute to LA enlargement in patients with normal LV systolic function irrespective of gender. PMID: 20206072 [PubMed - as supplied by publisher] (Source: Journal of Cardiology)

Long-term follow-up of patients with moderate aplastic anemia and pure red cell aplasia treated with daclizumab.

Haematologica — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions Red cell transfusion-independence prior to treatment in mAA patients predicted response. The only significant adverse treatment-related events were transient rashes and arthralgias. Daclizumab is safe and effective, and produces lengthy remissions in patients with PRCA and mAA. PMID: 20207845 [PubMed - in process] (Source: Haematologica)

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The complete blood count.

Neonatal Network — Mon, 01 Mar 2010 00:00:00 +0100

Authors: Milcic TL THE COMPLETE BLOOD COUNT (CBC) is one of the more common laboratory tests ordered during the neonatal period. The CBC may be obtained to evaluate for anemia, infection, and thrombocytopenia.1 The test offers a wealth of clinical information about the hematopoietic system, including erythrocyte, leukocyte, and thrombocyte values. Establishing normal neonatal ranges has been difficult because blood has not been drawn on healthy neonates of similar ages.2 Reference ranges that consist of the 5th to 95th percentile compiled from various studies have been used to approximate normal neonatal values.3 A variety of factors such as sample site, timing of the sample, gestational age, and the neonate's degree of health can affect the CBC.1 Therefore, the astute practitioner mus...

Significance of travel to rural areas as a risk factor for malarial anemia in an urban setting.

The American Journal of Tropical Medicine and Hygiene — Mon, 01 Mar 2010 00:00:00 +0100

Authors: Siri JG, Wilson ML, Murray S, Rosen DH, Vulule JM, S.sker L, Lindblade KA The epidemiology of malaria in urban environments is poorly characterized, yet increasingly problematic. We conducted an unmatched case-control study of risk factors for malarial anemia with high parasitemia in urban Kisumu, Kenya, from June 2002 through February 2003. Cases (n = 80) were hospital patients with a hemoglobin level </= 8 g/dL and a Plasmodium parasite density >/= 10,000/muL. Controls (n = 826) were healthy respondents to a concurrent citywide knowledge, attitude, and practice survey. Children who reported spending at least one night per month in a rural area were especially at risk (35% of cases; odds ratio = 9.3, 95% confidence interval [CI] = 4.4-19.7, P < 0.0001), and use of mo...

"Endoscopy in a Stone Quarry" - Multiple Pigment Stones 6 Weeks after Delivery.

Zeitschrift fur Gastroenterologie — Mon, 01 Mar 2010 00:00:00 +0100

Authors: Sandmann M, Fähndrich M, Heike M A 29-year-old African woman without any history of diseases was referred to our clinic because of recurrent abdominal pain. 6 weeks earlier she had delivered a healthy baby. Laboratory data revealed hypochromic microcytic anemia, elevated cholestatic liver enzymes, and an elevated bilirubin level of 2.2 mg/dl. Abdominal sonography showed choledocholithiasis. The endoscopic retrograde cholangiography showed the presence of more than 100 small stones in the intra- and extrahepatic bile ducts. An endoscopic papillotomy was performed and multiple small black stones were removed from the bile duct by basket into the duodenum. Because of the hypochromic microcytic anemia, the detection of pigment stones and the ethnic background of the patient w...

Cold agglutinin induced hemolysis in a newly diagnosed systemic lupus erythematosus.

The American Journal of the Medical Sciences — Mon, 01 Mar 2010 00:00:00 +0100

Authors: Srinivasan N, Oswal A, Garg S, Nahar J, Gosmonova A, Nahar R Systemic lupus erythematosus (SLE) is a well-known autoimmune chronic inflammatory disease, which can virtually affect any organ system in the body. Although hemolytic anemia has been known to occur in <10% of SLE patients, they are usually mediated through warm antibodies. It is extremely rare to see cold antibody-mediated hemolytic anemia in SLE, and only few cases have been reported in literature to our knowledge. This is a unique case report of SLE associated with cold agglutinin hemolytic anemia in a patient presented with generalized tender lymphadenopathy and typical B-symptoms including fever, night sweats, and significant weight loss. PMID: 20220336 [PubMed - in process] (Source: The American Journal ...

FDA Requires Risk-Management Plan for ESA Prescription

Rheumatology News — Mon, 01 Mar 2010 00:00:00 +0100

The Food and Drug Administration is requiring a risk management plan for erythropoietin-stimulating agents that addresses the potential hazards and benefits associated with these anemia drugs, the agency has announced. (Source: Rheumatology News)

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Risk Management Plan for ESAs Begins This Month

Hospitalist News — Mon, 01 Mar 2010 00:00:00 +0100

Extensive Work-Up for IBS Rarely Needed

Clinical Psychiatry News — Mon, 01 Mar 2010 00:00:00 +0100

LAKE BUENA VISTA, FLA. — An extensive work-up that includes tests such as colonoscopy should generally be avoided for patients suspected of having irritable bowel syndrome. Only when there are atypical or alarming symptoms such as fever, anemia, hematochezia, or a family history of colon cancer should an extensive diagnostic work-up including colonoscopy or barium enema be undertaken, according to Dr. Georgine M. Lamvu. (Source: Clinical Psychiatry News)

Hematological profile of chronic kidney disease (CKD) patients in Iran, in pre-dialysis stages and after initiation of hemodialysis.

Saudi Journal of Kidney Diseases and Transplantation — Mon, 01 Mar 2010 00:00:00 +0100

In conclusion, data shows that anemia in our patients with CKD is a predominant manifestation, with high frequency but of moderate degree. The most likely cause is inadequate erythropoietin production. PMID: 20228535 [PubMed - in process] (Source: Saudi Journal of Kidney Diseases and Transplantation)

Sleep disorders in hemodialysis patients.

Saudi Journal of Kidney Diseases and Transplantation — Mon, 01 Mar 2010 00:00:00 +0100

Authors: Sabry AA, Abo-Zenah H, Wafa E, Mahmoud K, El-Dahshan K, Hassan A, Abbas TM, Saleh Ael-B, Okasha K The prevalence of sleep disorders is higher in patients with kidney failure than the general population. We studied the prevalence of sleep disorders in 88 (mean age; 41.59 +/- 16.3 years) chronic hemodialysis (HD) patients at the Urology and Nephrology Center, Mansoura Uni-versity, Egypt over 4-month period. The investigated sleep disorders included insomnia, restless leg syndrome (RLS), obstructive sleep apnea syndrome (OSAS), excessive daytime sleepiness (EDS), narcolepsy and sleep walking, and we used a questionnaire in accordance with those of the International Restless Legs Syndrome Study Group, the Berlin questionnaire, Italian version of Epworth Sleepiness Scale, Internati...

Brown recluse spider is sometimes to blame when anemia strikes

ScienceDaily Headlines — Sun, 28 Feb 2010 15:54:00 +0100

As spring approaches and people return to outdoor activities, caution should be taken in areas of the country that are home to Loxosceles reclusa, also called the brown recluse spider. A new study found that when patients present with sudden anemia, but the cause is elusive, the brown recluse spider should be part of the differential diagnosis, at least in parts of the nation where the spider is regularly found. (Source: ScienceDaily Headlines)

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Brown Recluse Spider Is Sometimes To Blame When Anemia Strikes

Health News from Medical News Today — Sun, 28 Feb 2010 09:00:00 +0100

As spring approaches and people return to outdoor activities, caution should be taken in areas of the country that are home to Loxosceles reclusa, also called the brown recluse spider. A new study from St. Jude Children's Research Hospital found that when patients present with sudden anemia, but the cause is elusive, the brown recluse spider should be part of the differential diagnosis, at least in parts of the nation where the spider is regularly found. In a recent issue of The Journal of Pediatrics, St... (Source: Health News from Medical News Today)

Brown Recluse Spider Is Sometimes To Blame When Anemia Strikes

Pediatrics News From Medical News Today — Sun, 28 Feb 2010 09:00:00 +0100

Unknown: A firm plaque on the back of a newborn.

Dermatol Online J — Sat, 27 Feb 2010 11:58:02 +0100

We report a case of subcutaneous fat necrosis of the newborn (SCFN), a rare disorder in term or post-term neonates. Although it is often associated with hematological abnormalities such as anemia and hypercalcemia, SCFN in this patient presented with hyperbilirubinemia. The course of SCFN is generally benign and self-limiting, though may be associated with complications secondary to hypercalcemia. PMID: 20178707 [PubMed - in process] (Source: Dermatol Online J)

Brown Recluse Spider Is Sometimes To Blame When Anemia Strikes

Health News from Medical News Today — Sat, 27 Feb 2010 09:00:00 +0100

As spring approaches and people return to outdoor activities, caution should be taken in areas of the country that are home to Loxosceles reclusa, also called the brown recluse spider. A new study from St. Jude Children's Research Hospital found that when patients present with sudden anemia, but the cause is elusive, the brown recluse spider should be part of the differential diagnosis, at least in parts of the nation where the spider is regularly found. In a recent issue of The Journal of Pediatrics, St... (Source: Health News from Medical News Today)

Brown Recluse Spider Is Sometimes To Blame When Anemia Strikes

Pediatrics News From Medical News Today — Sat, 27 Feb 2010 09:00:00 +0100

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Akebia Announces Initiation Of Phase 1b Clinical Study Of AKB-6548

Health News from Medical News Today — Sat, 27 Feb 2010 02:00:00 +0100

Akebia Therapeutics, Inc., a small molecule discovery and development company focused on anemia and vascular disorders, announced that it has initiated dosing for a phase 1b multi-dose clinical trial of AKB-6548, an orally bioavailable hypoxia-inducible factor-prolyl hydroxylase (HIF-PH) in development for anemia. The phase 1a study of AKB-6548 demonstrated a dose-related increase in erythropoietin with no significant adverse events. "We are pleased to be rapidly moving AKB-6548 into phase 1b studies following the successful completion of the phase 1a trial," said Joseph Gardner, Ph.D... (Source: Health News from Medical News Today)

Med Sci Monit 2010; 16(3):CR124-131 "Palliative first-line treatment with weekly high-dose 5-fluorouracil as 24h-infusion and gemcitabine in metastatic pancreatic cancer (UICC IV)"

Medical Science Monitor — Fri, 26 Feb 2010 19:37:00 +0100

Conclusions: The administration of gemcitabine and 5-FU as a 24h-infusion is feasible and offers good tumour control rate accompanied by tolerable toxicity. The subgroup of patients with a good performance status (ECOG 0) and tumour markers within the normal range benefit from the gemcitabine combination therapy. (Source: Medical Science Monitor)

Separate mechanisms cause anemia in ischemic vs. nonischemic murine heart failure

AJP: Regulatory, Integrative and Comparative Physiology — Fri, 26 Feb 2010 17:04:26 +0100

In conclusion, the mechanism of anemia in CHF depends on the etiology of cardiac disease; whereas TNF- impairs hematopoiesis in CHF following MI, NO inhibits blood cell formation in nonischemic murine CHF. (Source: AJP: Regulatory, Integrative and Comparative Physiology)

Phase I/II Study of S-1 plus Cisplatin Combination Chemotherapy in Patients with Advanced/Recurrent Head and Neck Cancer

Japanese Journal of Clinical Oncology — Fri, 26 Feb 2010 16:57:31 +0100

Conclusions This is considered to be an effective regimen with acceptable toxicities for HNC. (Source: Japanese Journal of Clinical Oncology)

Multiple transfused thalassemia major: Ocular manifestations in a hospital-based population

Indian Journal of Ophthalmology — Fri, 26 Feb 2010 15:05:53 +0100

Conclusion:</b> Regular ocular examinations can aid in preventing, delaying or ameliorating the ocular complications of thalassemia. (Source: Indian Journal of Ophthalmology)

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Anemia in pregnant women from two cities in the South and Mid-West Regions of Brazil

Revista da Escola de Enfermagem da USP — Fri, 26 Feb 2010 14:57:14 +0100

Objetivou-se analisar a distribuição da anemia em gestantes da rede básica de saúde de dois municípios, na região Sul e Centro-Oeste do Brasil. Estudo transversal retrospectivo e descritivo desenvolvido a partir de dados de prontuários de 954 e 781 gestantes em Cuiabá-MT e Maringá-PR, respectivamente. Coletaram-se dados de caracterização sociodemográfica, de pré-natal e indicadores sociais. Foram consideradas anêmicas, as mulheres com hemoglobina inferior a 11g/dL. A desigualdade social existente entre os municípios foi evidente. Gestantes atendidas em Cuiabá-MT apresentavam características sociodemográficas significativamente mais precárias. A prevalência de anemia era significativamente maior e valores médios de hemoglobina menores em Cuiabá-MT, independentemente da...

Effect of Anemia in High-Risk Groups of Patients With Acute Myocardial Infarction Treated With Percutaneous Coronary Intervention

The American Journal of Cardiology — Fri, 26 Feb 2010 13:53:26 +0100

The significance of anemia in patients with acute myocardial infarction (AMI) treated with percutaneous coronary intervention (PCI) remains controversial. The aim of the present study was to evaluate the effect of anemia on the short- and long-term prognosis of patients with AMI treated with PCI, including high-risk subgroups. The study group consisted of 1,497 consecutive patients with AMI treated in the acute phase with PCI. Anemia was defined using World Health Organization criteria (hemoglobin level (Source: The American Journal of Cardiology)

Oxidative stress, inflammation and nutritional status during darbepoetin alpha treatment in peritoneal dialysis patients.

Clinical Nephrology — Fri, 26 Feb 2010 08:00:30 +0100

Conclusion: Darbepoetin alpha given subcutaneously once every 2 weeks is effective for the treatment of anemia in PD patients. Less frequent administration of darbepoetin has a biological response similar to weekly administration of rHuEPO. PMID: 20178720 [PubMed - in process] (Source: Clinical Nephrology)

Acute pancreatitis preceding an acute episode of thrombotic microangiopathy.

Clinical Nephrology — Fri, 26 Feb 2010 08:00:12 +0100

We present the case of a 74-year-old man who visited our emergency department due to acute abdominal pain. He had no history of alcohol abuse or pancreatitis. Blood tests indicated elevated lipase and amylase. An abdominal computerized tomography (CT) indicated mild pancreatitis. After admission, the patient suffered a seizure and developed anemia, thrombocytopenia, elevated lactic dehydrogenase (LDH) and elevated unconjugated bilirubin. A peripheral blood smear indicated fragmented red blood cells. We diagnosed the patient as having TMA. After plasma exchange and plasma infusion therapy, the LDH and platelet levels gradually improved. A differential diagnosis of disseminated intravascular coagulation (DIC) and TMA following pancreatitis is necessary because of the different treatment stra...