ABSTRACT
Bone marrow aspiration (BMA) is much more frequently used than bone marrow biopsy (BMB) in the diagnosis of different haematological disorders. BMB is performed primarily in cases where bone marrow aspiration either fails or gives insufficient information. It is the sole modality of diagnosis in some situations and may give useful information of prognostic importance. The present study was done to find comparative usefulness of each of these procedures in various hematological disorders. Methods: Study subjects included all 45 patients attending the hematology section of pathology department of College of Medicine & Jawaharlal Nehru Memorial Hospital, Kalyani for bone marrow aspiration and who also consented for bone marrow biopsy during the period from 1st July 2011 to 30th June 2012. BMA smears and BMB specimens were obtained from posterior superior iliac spine in the same sitting and stained with Leishman’s stain and Haematoxylin & Eosin stain respectively. Findings of BMA and BMB were compared. Results: BMA was diagnostic in all cases of iron deficiency anemia (IDA), acute myeloid leukemia (AML), chronic myeloid leukemia (CML), chronic lymphocytic leukemia (CLL), idiopathic thrombocytopenic purpura (ITP) and essential thrombocythemia (ET). On the whole, BMA was diagnostic in 82.2% of cases and could accurately reveal hypercellularity in all cases. BMB was the only diagnostic method in myelofibrosis (MF) and provided additional information like fibrosis in cases of AML, CML and MF & pattern of involvement in CLL and multiple myeloma (MM). BMB, however, was poor in assessing iron stores due to leaching of iron during decalcification. Conclusions: BMA alone is sufficient for IDA and ITP. BMB is mandatory for diagnosis of MF and provides additional prognostic information in other cases.
Subject(s)
Biopsy/methods , Biopsy, Needle/methods , Bone Marrow Examination/methods , Hematologic Diseases/classification , Hematologic Diseases/diagnosis , Hematologic Diseases/pathology , Humans , Purpura, Thrombocytopenic, Idiopathic/diagnosis , Purpura, Thrombocytopenic, Idiopathic/pathology , Thrombocythemia, Essential/diagnosis , Thrombocythemia, Essential/pathologyABSTRACT
PURPOSE: The purpose of this study was to identify risk factors for pediatric inpatients falls. METHODS: The study was a matched case-control design. The participants were 279 patients under the age of 6 who were admitted between January 1, 2004 and December 31, 2009. Through chart reviews, 93 pediatric patients who fell and 186 ones who did not fall were paired by gender, age, diagnosis, and length of stay. Five experts evaluated the 38 fall risk factors selected by the researchers. RESULTS: In a general hospital, pediatric patients with secondary diagnosis, tests that need the patient to be moved, intravenous lines, hyperactivity, anxiolytics, sedatives and hypnotics, and general anesthetics showed significance for falls on adjusted-odds ratios. Conditional logistic regression analysis was performed to elucidate the factors that influence pediatric inpatient falls. The probability of falls increased with hyperactivity and general weakness. Patients who didn't have tests that required them to be moved and intravenous line had a higher risk of falls. CONCLUSION: These findings provide information that is relevant in developing fall risk assessment tools and prevention programs for pediatric inpatient falls.
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Accidental Falls/prevention & control , Age Factors , Analgesics , Case-Control Studies , Hematologic Diseases/pathology , Hospitalization , Hospitals, General , Length of Stay , Logistic Models , Neoplasms/pathology , Odds Ratio , Retrospective Studies , Risk Factors , Sex FactorsABSTRACT
Background: The etiology of bicytopenia/pancytopenia varies widely in children, ranging from transient marrow viral suppression to marrow infiltration by fatal malignancy. Depending on the etiology, the clinical presentation can be with fever, pallor or infection. Knowing the exact etiology is important for specific treatment and prognostication. Aims: To evaluate the etiological and clinico-hematological profile in children with bicytopenia and pancytopenia. Materials and Methods: A review of bicytopenic and pancytopenic children referred for bone marrow examination from January 2007 to December 2008 was done. Detailed history, clinical examination and hematological parameters at presentation were recorded. Results and Conclusion: During the study period, a total of 990 children were referred for bone marrow examination for different indications. Of these, 571 (57.7%) had either pancytopenia (17.7%) or bicytopenia (40%). Commonest form of bicytopenia was anemia and thrombocytopenia seen in 77.5% cases, followed by anemia and leukopenia in 17.3% and leukopenia and thrombocytopenia in 5.5% cases. Most common etiology was acute leukemia (66.9%) in bicytopenic children and aplastic anemia (33.8%) in pancytopenic children. Children with bicytopenia had a higher incidence of underlying malignancy (69.5% vs. 26.6%), splenomegaly (60.5% vs. 37.4%), lymphadenopathy (41.8% vs. 15.1%) and circulating blasts (64.6% vs. 20.1%) and a lower incidence of bleeding manifestations (12.1% vs. 26.6%) as compared to children with pancytopenia.
Subject(s)
Anemia/epidemiology , Anemia/etiology , Bone Marrow/pathology , Child , Child, Preschool , Female , Hematologic Diseases/etiology , Hematologic Diseases/pathology , Humans , Infant , Infant, Newborn , Leukopenia/epidemiology , Leukopenia/etiology , Male , Pancytopenia/epidemiology , Pancytopenia/etiology , Prevalence , Tertiary Care Centers , Thrombocytopenia/epidemiology , Thrombocytopenia/etiologyABSTRACT
El sindrome de inmunodeficiencia adquirida es causado por la infección con el virus de inmunodeficiencia humana (VIH). Este retrovirus produce un deterioro usualmente progresivo en el sistema inmunitario del huesped en que los estadios más avanzados se complica con infecciones oportunistas, trastornos neurológicos y neoplasmas. Las alteraciones hematológicas que ocurren en la mayoría de los individuos durante el curso de esta infección son ocasionadas por las alteraciones inmunitarias del huésped, complicaciones de las infecciones secundarias, de los neoplasmas, del tratamiento y también por efectos directos del virus en las celulas hematopoyéticas. En ausencia de tratamiento la infección de VIH conduce a una disminución progresiva en el numero de linfocitos CD4. Los individuos con infección de VIH se califican como enfermos de SIDA cuando el numero de linfocitos T CD4+ disminuye al 200/µL o menos (normal 800-100) o el porcentaje de estas células disminuye a 14 por ciento o menos (normal 50-60 por ciento). Los individuos también son clasificados como pacienetes con SIDA cuando el curso de la enfermedad con infecciones oportunistas, neoplasias o desórdenes neurológicos
Subject(s)
Male , Humans , Female , Hematologic Diseases/complications , Hematologic Diseases/pathology , Acquired Immunodeficiency Syndrome/complicationsABSTRACT
Se presentan los resultados del estudio de 165 biopsias de medula osea realizadas a pacientes ingresados en el Hospital Pediatrico Docente "Juan Manuel Marques". Las distintas afecciones que motivaron las biopsias fueron: enfermedades hematologicas no malignas, 56 casos; leucemia linfoblastica aguda, 9 casos; leucemia mieloide cronica juvenil, 2 casos; histiocitosis maligna, 1 caso; linfoma no Hoggkin, 25 casos; enfermedad de Hodgkin, 31 casos; neuroblastoma, 13 casos; sarcoma de partes blandas, 11 casos; neuroblastoma, 13 casos; evaluacion del organo posquimioterapia, 17 casos. Se describen las caracteristicas morfologicas de la medula osea en diferentes hemopatias y los patrones de infiltracion de las leucemias y los tumores solidos mas frecuentes en el nino
Subject(s)
Humans , Biopsy, Needle , Bone Marrow Examination , Hematologic Diseases/pathology , Histiocytic Sarcoma/pathology , Hodgkin Disease/pathology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology , Lymphoma, Non-Hodgkin/pathology , Bone Marrow/pathology , Neuroblastoma/pathology , Sarcoma/pathology , Soft Tissue Neoplasms/pathologyABSTRACT
Con la finalidad de precisar la prevalencia de las infecciones por hongos en el curso de las Hemopatías Malignas (HM), para así instaurar un tratamiento menos empírico, con base comprobada, en el medio en el cual trabajamos, se seleccionaron 15 pacientes con diagnóstico de Leucemia Linfoma o Mieloma Múltiple (MM), sin signos de infección, que no sufrieran neutropenia severa y que no hubieran recibido quimioterapia, por lo menos en los últimos 3 meses. Se le tomaron muestras de orina, sangre, líquido cefalorraquídeo (LCR), médula ósea, e hisopados de faringe, conducto auditivo esterno(CAE), nariz, canal y vagina, que se cultivaron en medios especiales para hongos. El único hongo patógeno aislado fue el género Cándida. En 10 de los 15 pacientes (66,6 por ciento) en sus especies albicans, tropicalis, guilliermondii y stellatoidea. Siendoeste trabajo, un preliminar, se recomienda estudios posteriores para llegar a resultados más concluyentes
Subject(s)
Adolescent , Adult , Middle Aged , Humans , Male , Female , Culture Media/analysis , Hematologic Diseases/pathology , Hematologic Diseases/therapy , Mycoses/diagnosis , PrevalenceABSTRACT
Partiendo de la hipótesis de que las personas que acuden en demanda de servicios quirúrgicos a la Facultad de Odontología, no son solamente pacientes estomatológicos y que, es consecuencia, los exámenes de laboratorio clínico que se practican rutinariamente, deben poner de manifiesto patologías de órden sistémico, se hizo un estudio a 225 pacientes de un total de 336 atendidos en la Cátedra de Cirugía Estomatológica entre marzo de 1982 y julio de 1983. Los resultados obtenidos por sexo y edades, se muestran en cuadros estadísticos, gráficos de barras, tablas y polígonos de frecuencia que recogen las características de las distintas variables estudiadas. Se incluye, también, un análisis de la posible correlación entre triglicéridos y glicemia. El estudio realizado no permitió comparar nuestro resultados con los obtenidos en el Proyecto Venezuela en los Estados Carabobo y Zulia y con los valores de la literatura médica norteamericana de empleo frecuente en nuestro medio. Las comparaciones efectuadas ponen de manifiesto que no todas las personas que acuden en demanda de servicios quirúrgicos son enfermenos estomatológicos solamente, y que un número importante de ellos, reactualizan el concepto de que el odontólogo no puede limitarse unicamente a "atender la condición bucal de su paciente" sino que está obligado a brindarle atención integral, directa o referida, a que lo compromete la naturaleza de la Facultad de Odontología cuya misión esencial es impartir salud