Effects of pesticides on rural workers: haematological parameters and symptomalogical reports / Efeitos dos pesticidas sobre trabalhadores rurais: parâmetros hematológicos e relatos sintomatológicos

Abstract Exposure to pesticides by the rural population is increasing worldwide. Pesticides can induce the development of different diseases such as cancer and diseases of the central nervous system. This study analysed the clinical symptoms and haematological changes of a rural population in Conceição do Castelo, Espirito Santo, Brazil. For evaluation of symptomatology exposure to pesticides, 142 rural workers were interviewed. Of these, 22 workers were selected for haematological tests randomly as to evaluate haematological changes during the period of exposure to pesticides. Haematological analyses showed that erythrocytes, haemoglobin, haematocrit, mean corpuscular (VCM) volume, mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC) are in accordance with the reference intervals in haematology. Variations in the concentrations of rods and neutrophils indicates that exposure to pesticides increases the amount of those cells. Haematological disorders in rural workers exposed to pesticides can be correlated with reported symptoms. The results described in this study are relevant to the health public and reinforce the concern about the indiscriminate use of pesticides.

Resumo A exposição a pesticidas pela população rural está crescendo em todo o mundo. Os pesticidas podem induzir o desenvolvimento de diferentes doenças, como o cancer e as do sistema nervoso central. Este estudo analisou os sintomas clínicos e alterações hematológicas de uma população rural em Conceição do Castelo, Espírito Santo, Brasil. Para a avaliação da exposição a pesticidas e sintomatologias, 142 trabalhadores rurais foram entrevistados. Destes, 22 trabalhadores foram selecionados de randomicamente para testes hematológicos e avaliação de alterações hematológicas durante o período de exposição a pesticidas. Análises hematológicas mostraram que eritrócitos, hemoglobina, hematócrito, volume corpuscular médio (VCM), hemoglobina corpuscular média (HCM), concentração de hemoglobina corpuscular média (CHCM) estão em conformidade com os intervalos de referência. As variações nas concentrações de bastonetes e neutrófilos indicam que a exposição a pesticidas aumenta a quantidade dessas células. Alterações hematológicas em trabalhadores rurais expostos a pesticidas podem ser correlacionados com alguns sintomas relatados. Os resultados descritos neste estudo são relevantes para a saúde pública e para reforçar a preocupação com o uso indiscriminado de pesticidas.

Les hémopathies lymphoïdes chroniques à Brazzaville

L'épidémiologie des hémopathies lymphoïdes chroniques au Congo n'est pas connue. L'objectif de cette étude est de rapporter la distribution des hémopathies lymphoïdes chronique à Brazzaville.Patients et méthodes : Il s'agi d'une étude transversale descriptive réalisée dans le Service d'Hématologie Clinique du CHU de Brazzaville au Congo. La période étudiée est de 10 ans (du 1er janvier 2006 au 31 décembre 2015). Etaient inclus dans l'étude tous les dossiers de consultation et d'hospitalisation portant le diagnostic d'hémopathie lymphoïdes chroniques.Résultats : 150 cas d'hémopathies lymphoïdes chroniques ont été diagnostiquées durant la période d'étude. Parmi elles, le myélome multiple représentait 52% de la population étudiée (n=78), le lymphome malin non Hodgkinien 22,67% (n=34), le lymphome de Hodgkin et la leucémie lymphoïde chronique respectivement 9,33% (n=14) et la leucémie à tricholeucocyte 6,67% (n=10). La distribution était essentiellement féminine (sex-ratio=0,70). Les pathologies lymphoprolifératives chroniques étaient plus observées dans la tranche d'âge de 45 à 49 ans (66,7%).Conclusion : Les hémopathies lymphoïdes chroniques constituent par leur fréquence un problème sanitaire. Elles plaident pour des études épidémiologiques analytiques afin de mettre en place une politique préventive de celles-ci

Incidence hospitalière des hémopathies malignes de l'enfant à Brazzaville

Objectif. L'épidémiologie des hémopathies malignes chez l'enfant au Congo n'est pas connue. L'objectif de cette étude est de rapporter le type et la distribution des hémopathies malignes chez l'enfant à Brazzaville. Matériels et méthodes. Il s'agit d'une étude transversale descriptive réalisée dans le Service d'hématologie Clinique du CHU de Brazzaville au Congo sur une période de 10 ans (du 1er janvier 2006 au 31 décembre 2015). Nous avons analysé tous les dossiers des enfants hospitalisés, âgés de 0 à 14 ans portant le diagnostic d'hémopathie maligne. Les hémopathies malignes étaient définies comme des proliférations monoclonales de cellules hématopoïétiques selon la classification de l'OMS. Résultats. Trente cas d'hémopathies malignes ont été diagnostiquées durant la période d'étude. Il s'agissait de leucémies aigues n=23 (76,67%), de lymphomes n=6 (20%) et de leucémie myéloïde chronique n=1 (3,33%). Les leucémies aigues étaient de type lymphoblastique dans 17 cas et myéloblastique dans 6 cas. Une prédominance masculine était observée dans toutes les hémopathies malignes sauf pour la leucémie myéloïde chronique. Les hémopathies malignes étaient plus fréquentes dans la tranche d'âge de 7 à 14 ans (63,33%). Conclusion. Les hémopathies malignes à Brazzaville atteignent surtout l'enfant d'âge scolaire de sexe masculin. Il s'agit avant tout de leucémie aigue lymphoblastique ou plus rarement myéloblastique.

Adverse drug reactions associated with the use of disease-modifying anti-rheumatic drugs in patients with rheumatoid arthritis / Reacciones adversas a medicamentos asociadas con el uso de fármacos antirreumáticos modificadores de la enfermedad en pacientes con artritis reumatoide

This study describes the adverse drug reactions (ADRs) and their incidence in patients with rheumatoid arthritis who were treated in the Colombian health system. A retrospective cohort study was conducted using information from all patients who were diagnosed with rheumatoid arthritis and attended specialized health care centers in the cities of Bogotá, Cali, Manizales, Medellin, and Pereira between 1 December 2009 and 30 August 2013. The ADRs were obtained from medical records and the pharmacovigilance system registry and sorted by frequency and affected tissue according to World Health Organization Adverse Reaction Terminology (WHO-ART). A total of 949 reports of ADRs were obtained from 419 patients (32.8 ADRs per 100 patient-years); these patients were from a cohort of 1 364 patients being treated for rheumatoid arthritis and followed up for an average of 23.8 months (± 12.9). The cohort was mostly female (366, 87.4%) and had a mean age of 52.7 years (± 13.1). The highest numbers of ADRs were reported following the use of tocilizumab, rituximab, and infliximab (28.8, 23.1, and 13.3 reports per 100 patient-years respectively). The most frequently reported ADRs were elevated transaminase levels and dyspepsia. Overall, 87.7% of ADRs were classified as type A, 36.6% as mild, 40.7% as moderate, and 22.7% as severe. As a result, 73.2% of patients who experienced an ADR stopped taking their drugs. The occurrence of ADRs in patients treated for rheumatoid arthritis is common, especially in those associated with the use of biotechnologically produced anti-rheumatic drugs. This outcome should be studied in future research and monitoring is needed to reduce the risks in these patients.

Este estudio describe las reacciones adversas a medicamentos (RAM) y su incidencia en pacientes con artritis reumatoide y tratados en el sistema de salud colombiano. Se llevó a cabo un estudio retrospectivo de cohortes utilizando la información correspondiente a todos los pacientes con diagnóstico de artritis reumatoide que acudieron a centros especializados de atención de salud de las ciudades de Bogotá, Cali, Manizales, Medellín y Pereira entre el 1 de diciembre del 2009 y el 30 de agosto del 2013. Los casos de RAM se obtuvieron de las historias clínicas y del registro del sistema de farmacovigilancia, y se clasificaron por su frecuencia y el tejido afectado, según la Terminología de Reacciones Adversas de la Organización Mundial de la Salud ­ (WHO-ART). Se obtuvo un total de 949 informes de RAM en 419 pacientes (32,8 RAM por 100 pacientes-año); estos pacientes correspondían a una cohorte de 1 364 pacientes tratados por artritis reumatoide y seguidos durante un promedio de 23,8 meses (± 12,9). La cohorte estaba compuesta principalmente por mujeres (366, 87,4%) y la media de edad era de 52,7 años (± 13,1). El mayor número de casos de RAM se notificó tras el uso de tocilizumab, rituximab e infliximab (28,8, 23,1 y 13,3 notificaciones por 100 pacientes-año, respectivamente). Las RAM notificadas con mayor frecuencia fueron la elevación de los niveles de transaminasas y la dispepsia. En términos generales, 87,7% de las RAM se clasificaron como de tipo A, 36,6% como leves, 40,7% como moderadas y 22,7% como graves. Como consecuencia, 73,2% de los pacientes que presentaron una RAM dejaron de tomar sus medicamentos. La aparición de RAM en pacientes tratados por artritis reumatoide es frecuente, especialmente cuando se utilizan fármacos antirreumáticos de producción biotecnológica. Estos resultados deben ser objeto de estudio en futuras investigaciones y señalan la necesidad de actividades de vigilancia para reducir los riesgos en estos pacientes.

Cytologie des hemopathies malignes de type myeloide a Kinshasa

Objectifs : Determiner la part de differentes entites d'hemopathies malignes myeloides et identifir leurs caracteres cytologiques et epidemiologiques. Methodes: L'etude s'est deroulee de 2004 a 2010 au sein de deux laboratoires de biologie medicale de Kinshasa. Apres la ponction medullaire a l'aiguille intramusculaire ou spinale; les frottis des patients sont colores au May Grunwald Giemsa. Les hemopathies myeloides malignes sont retenues; les variables cytologiques et epidemiologiques des patients sont etudiees. Resultats : Soixante dix neuf hemopathies malignes du tissu myeloide sont diagnostiquees sur un total de 483 malades ponctionnes. Elles sont reparties chez 52 hommes et 27 femmes. Ces hemopathies atteignent tous les ages. Leur distribution selon les tranches d'age montrait une courbe ascendante avec trois paliers : la vingtaine; la quarantaine et la soixantaine. Les entites les plus rencontrees etaient: 39;2 de leucemie myeloide chronique (LMC) et 24;1 des syndromes myelodysplasiques (SMD). La LMC predominait entre 20-39 ans ; les SMD et quelques LAM; entre 50-59 ans. Au-dela de 60 ans; on avait le grand pic des LAM et le second pic de la LMC. Conclusion : Les hemopathies malignes myeloides presentaient une tendance a l'augmentation progressive sur la duree de l'etude. Les differentes entites apparaissaient plus tot qu'a l'age decrit dans la litterature avec un taux de SMD plus important

Epidemiología de los síndromes mielodisplásicos / Epidemiology of myelodysplastic syndromes

Revisión acerca de los aspectos epidemiológicos locales e internacionales en relación con este grupo heterogéneo de neoplasias hematológicas.

Outcomes and organ dysfunctions of critically ill patients with systemic lupus erythematosus and other systemic rheumatic diseases

Our objective was to compare the pattern of organ dysfunctions and outcomes of critically ill patients with systemic lupus erythematosus (SLE) with patients with other systemic rheumatic diseases (SRD). We studied 116 critically ill SRD patients, 59 SLE and 57 other-SRD patients. The SLE group was younger and included more women. Respiratory failure (61 percent) and shock (39 percent) were the most common causes of ICU admission for other-SRD and SLE groups, respectively. ICU length-of-stay was similar for the two groups. The 60-day survival adjusted for the groups’ baseline imbalances was not different (P = 0.792). Total SOFA scores were equal for the two groups at admission and during ICU stay, although respiratory function was worse in the other-SRD group at admission and renal and hematological functions were worse in the SLE group at admission. The incidence of severe respiratory dysfunction (respiratory SOFA >2) at admission was higher in the other-SRD group, whereas severe hematological dysfunction (hematological SOFA >2) during ICU stay was higher in the SLE group. SLE patients were younger and displayed a decreased incidence of respiratory failure compared to patients with other-SRDs. However, the incidences of renal and hematological failure and the presence of shock at admission were higher in the SLE group. The 60-day survival rates were similar.

Sobrevida de pacientes submetidos a transplante alogênico de medula óssea / Survival of patients submittes to allogeneic boné marrow transplantation

Introdução: O transplante de células-tronco hematopoiéticas (TCTH) alogênico é um procedimento que oferece um potencial de cura para doenças hematológicas malignas e benignas. O benefício da técnica está especialmente relacionado ao aumento da sobrevida em pacientes com doadores HLA-compatíveis em cujos casos o tratamento quimioterápico mostrou-se insuficiente ou ineficaz. Objetivos: Analisar a sobrevida de pacientes que receberam TCTH alogênico aparentado no Serviço de Hematologia Clínica e Transplante de Medula Óssea (SHCTMO) do Hospital de Clínicas de Porto Alegre (HCPA). Métodos: Estudo de coorte prospectiva com análise de sobrevida de pacientes transplantados entre 1994 e 2003. Resultados: Foram analisados 133 pacientes com idade média de 30,8±14,8 anos com um tempo médio de 26,8 meses entre o diagnóstico e o TCTH. Cinco anos após o transplante, 71 pacientes (53,4%) estavam vivos, 22 pacientes tinham leucemia mieloide aguda (LMA), 54, leucemia mieloide crônica (LMC), e seis padeciam de síndrome mielodisplásica (SMD), sendo que, em 5 anos, a sobrevida foi de 52, 50 e 33%, respectivamente. Dos 26 pacientes transplantados por anemia aplásica (AA), 66,7% tinham idade inferior a 20 anos, e 61,5% dos que tinham mais de 20 anos estavam vivos. Conclusão: Embora, no nosso estudo, o tempo médio entre o diagnóstico e o transplante tenha sido superior a 2 anos, e embora nossa análise tenha sido apenas estratificada pelo tipo da doença, independentemente do regime de condicionamento ou da fase da doença no momento do TCTH, nossos resultados são superponíveis aos descritos na literatura mundial.

Background: Hematopoietic stem cell transplantation (HSCT) represents a curative alternative for malignant and benign hematological diseases. The benefits of the technique are especially related to an increase in the survival of patients with HLA-compatible hematopoietic stem cell donors when chemotherapy or clinical therapy has resulted ineffective. Objectives: To analyze the survival of patients submitted to allogeneic HSCT at the Hematology and Bone Marrow Transplant Service of Hospital de Clínicas de Porto Alegre. Methods: A prospective cohort of all patients submitted to transplantation between 1994 and 2003 was analyzed for overall survival. Results: A total of 133 patients were submitted to transplantation in the study period, with a mean age of 30.8±14.8 years; mean time elapsed between diagnosis and transplant was 26.8 months. Five years after the procedure, 71 patients (53.4%) were alive, 22 patients had acute and 54 had chronic myeloid leukemia, and six patients presented myelodysplastic syndrome; the 5 year overall survival was 52, 50, and 33%, respectively. Of the 26 patients transplanted for aplastic anemia, 66.7% had 20 or less years of age, and 61.5% of the patients older than 20 years were alive. Conclusion: Although the mean time elapsed between diagnosis and transplantation was over 2 years and although our results were stratified by type of disease only, the findings herein reported are similar to those found in the literature, independently of conditioning regimen or disease stage at the time of transplant.

Esplenectomía laparoscópica: experiencia de 12 años en dos instituciones privadas / Laparoscopic splenectomy: twelve-year experience in two private institutions

Introducción: en 1991, Delaitre y colaboradores reportaron la primera esplenectomía laparoscópica exitosa. Ésta se ha convertido en el procedimiento de elección en pacientes con enfermedades hematológicas que requieren tratamiento quirúrgico. Las ventajas potenciales del abordaje laparoscópico sobre el convencional son menor estancia intrahospitalaria, retorno más rápido a la vía oral y disminución en las tasas de morbilidad y mortalidad. Material y métodos: de junio de 1993 a diciembre de 2004, 42 pacientes fueron sometidos a esplenectomía laparoscópica tanto en el Texas Endosurgery Institute como en el Hospital “San José” del Tecnológico de Monterrey. Las variables utilizadas para valorar eficacia y seguridad fueron tiempo quirúrgico, estancia intrahospitalaria, inicio de la vía oral, conversión a procedimiento abierto, morbilidad y mortalidad. Resultados: las enfermedades hematológicas representaron el diagnóstico más común. El procedimiento fue técnicamente exitoso en 95 % de los casos. Solamente hubo dos conversiones a cirugía convencional. El tiempo quirúrgico promedio fue de 120 minutos. La tasa de mortalidad fue de 2.3 % y la estancia intrahospitalaria y el inicio de la vía oral promedios, de cuatro y dos días, respectivamente. Conclusiones: nuestra serie contribuye a reafirmar que actualmente la esplenectomía laparoscópica representa un método seguro y efectivo, conservando además algunas de las ventajas de los procedimientos mínimamente invasivos.

BACKGROUND: In 1991, Delaitre et al. reported the first successful laparoscopic splenectomy. This procedure has become the best option in patients with hematological diseases and who require surgical treatment. The potential advantages of the laparoscopic approach over the conventional surgery are shorter length of hospital stay, shorter time to resume normal diet and decreased rates of morbidity and mortality. METHODS: From June 1993 to December 2004, 42 patients underwent laparoscopic splenectomy in our two surgical care centers: Texas Endosurgery Institute and Hospital San José-TEC de Monterrey. The measured variables to evaluate efficacy and safety were operating time, length of hospital stay, time to resume normal diet, conversion to open procedure, morbidity and mortality. RESULTS: Hematological diseases were the most common diagnosis. The procedure was technically successful in 95% of the patients. There were two conversions to open surgery. The mean operating time was 120 min. Mortality rate was 2.3%. The mean length of hospital stay and time to resume normal diet were 4 and 2 days, respectively. CONCLUSIONS: We regard that our series contributes to supporting laparoscopic splenectomy as a safe and effective method, retaining some advantages of minimally invasive techniques.

Hemoglobinopatias em população infantil de um município maranhense / Haemoglobinopathies among infants in a municipality of the state of Maranhão

Este estudo teve como objetivo determinar a frequência de hemoglobinopatias em crianças de 6 a 60 meses de idade, residentes na Vila São Pedro, Paço do Lumiar- MA e cadastradas no Programa Saúde da Família. A pesquisa foi realizada em 2003. O método utilizado para a determinação das variantes da hemoglobina foi a eletroforese da hemoglobina em amostra de 3 ml de sangue venoso. Foram analisadas 371 crianças, entre estas foram identificadas 17 portadores de hemoglobina S, duas de hemoglobina C e nenhum caso de doença da célula falciforme. Esses valores correspondem a uma frequência de 5,1 de crianças portadoras do traço falciforme. Esses achados impõem a continuidade do acompanhamento dos casos positivos e do aconselhamento genélico às famílias acometidas.

Doenças hematológicas e ambiente: estudo do registro de condições de risco em serviço especializado / Hematologic diseases and environment: study of the risk conditions record in specialized service

(...) Este estudo verificou o registro de condições de risco ambientais/ocupacionais em um serviço especializado em hematologia. Trata-se de um estudo descritivo, que analisou prontuários de assistência médica relativo à um período de dez anos. As patologias selecionadas foram aquelas que apresentam na literatura especializada maiores evidências de associação com riscos ambientais e ou ocupacionais e que tiveram maior freqüência de atendimento no serviço estudado. Dentre os principais resultados observou-se que, apesar dos relatos científicos apontarem para um grande número de agravos hematológicos relacionados com situações de risco ambiental/ocupacional e considerando ser o serviço uma referência estadual no atendimento de patologias hematológicas, para o grupo de agravos selecionados neste estudo, houve alto sub-registro acerca das situações de novicidade (atividades/condições de trabalho e local de residência próxima a unidades produtoras de risco) e de outros condicionantes de vulnerabilidade (antecedentes pessoais: uso de medicamentos, doenças infecto-parasitárias, hábitos e características individuais – raça e escolaridade). Conclui-se, que de um modo geral, não houve por parte das equipes de saúde a preocupação com o registro de dados que possibilitem fazer inferências causais e orientar medidas preventivas de caráter coletivo para doenças hematológicas possivelmente relacionadas com riscos ambientais e ou ocupacionais. As patologias incluídas no estudo mostraram-se de alta letalidade, o que pode ser devido a aspectos fisiopatológicos próprios, como também, pode ser decorrente de diagnósticos tardios e/ou problemas de acesso aos serviços de saúde nos diversos níveis de complexidade. Esta consideração reforça a importância da organização do Sistema de Vigilância à Saúde frente a situações de riscos ambientais/ocupacionais para doenças hematológicas. No momento em que o Ministério da Saúde reconhece a relevância dessa problemática mediante a portaria nº777/2004 que objetiva a estruturação de um sistema de vigilância à saúde dos trabalhadores e a instituição da Norma Técnica de Vigilância para Expostos ao Benzeno de 2003, é fundamental a conscientização dos profissionais de saúde da importância do registro de dados sobre situações de risco e de agravos a eles relacionados para que estes objetivos se efetivem.

Caracteristiques epidemiologiques des hemopathies malignes dans les services d'hematologie oncologie medicale et de medecine interne du CHU du Point G

Notre etude consacree aux aspects epidemiologiques des hemopathies malignes; est une retrospective sur dossiers des malades. Elle a couvert la periode de 1996 a 2003 et inclus les dossiers des malades usagers de deux services de prise en charge des affections hematologiques et cancereuses du CHU du Point G a Bamako; Mali. Durant la periode consideree; le diagnostic d'hemopathie maligne a ete retenu chez 264 malades; ce qui correspond a un recrutement moyen de 33 cas par an. Les hemopathies malignes observees etaient plus souvent des hemopathies lymphoides (76;51) ; parmi elles; les LMNH etaient predominants. Parmi les hemopathies malignes non lymphoides; la LMC etait de loin la plus frequente (70;96). De 1996 a 2003; la prevalence des hemopathies malignes etait multipliee par 2;32 pour les lymphomes; 2;24 pour les leucemies et 2;04 pour le myelome multiple ; elle etait restee stable pour les autres hemopathies malignes. Nous avons note une predominance masculine pour toutes les hemopathies malignes sauf pour la LMC qui etait apparue significativement plus frequente chez la femme que chez l'homme. La distribution des cas selon l'age permettait de noter une distribution bimodale avec un premier pic de survenue entre 10 et 19 ans et autre entre 40 et 49 ans. Parmi 44 sujets testes pour l'infection par le VIH; 5 (11;4) avaient une serologie positive. La place des autres facteurs de risque classiquement rapportes n'a pu etre evaluee. L'etude de la provenance des patients et des delais de consultation laissait apparaitre quelques particularites qui pourraient s'expliquer par des facteurs de risque differents. La mortalite hospitaliere etait estimee a 10;4 pour 1000. Des etudes prospectives prenant en compte les facteurs favorisant la survenue des hemopathies malignes au Mali pourraient aider a la comprehension des particularites epidemiologiques observees au cours de ce travail et a l'elaboration de strategies de traitement et de prevention au Mali

Pulmonary and hematological alterations in idiopathic ulcerative colitis.

BACKGROUND: Patients with idiopathic ulcerative colitis (IUC) may suffer from one or more extraintestinal manifestations. We decided to prospectively study the prevalence of extraintestinal manifestations among patients with IUC, with special reference to pulmonary and hematological alterations. METHODS: Fifty-one consecutive patients with IUC attending the gastroenterology services of our tertiary-care referral center were evaluated prospectively. A detailed clinical evaluation of the musculoskeletal system, eye and skin, X-ray examination of the sacroiliac joints and chest, liver function tests, coagulation profile, hemogram, pulmonary function tests (PFT) and diffusion capacity for carbon monoxide (DLCO) were done in all patients. ERCP, liver biopsy and high-resolution computerized tomography (HRCT) of the chest were performed whenever indicated. RESULTS: Nearly half (24/51; 47%) the patients had one or more extraintestinal manifestations; these included pulmonary function abnormalities (14 patients; 27%), sacroiliitis (8; 16%), arthritis (5; 10%), ocular complications (4; 8%), and pyoderma gangrenosum and Budd-Chiari syndrome (one patient each). Of the 14 (27%) patients who had abnormal pulmonary function, isolated PFT abnormalities were seen in 8 (restrictive pattern in 7, obstructive pattern in 1), decreased DLCO in four, and both of the above in two. All patients with decreased DLCO (n=6) were asymptomatic and had normal chest X-ray and HRCT chest. Thirteen (25%) patients had thrombocytosis, 19 (37%) had increased fibrinogen level, and one patient had decreased antithrombin level. Disease activity had significant association with decreased DLCO (p=0.008), increased platelet count (p<0.0001), increased fibrinogen level (p=0.016), low antithrombin levels (p=0.046) and arthritis (p=0.002). CONCLUSION: Extraintestinal manifestations of IUC were seen in 47% of patients. Asymptomatic pulmonary interstitial involvement was seen in 12%, more often among patients with active disease.

Haematological abnormalities in patients of sarcoidosis.

OBJECTIVE: To study the presence and pattern of haematological abnormalities in patients with sarcoidosis in India. METHODS: Haematological investigations including complete blood cell counts, ESR and peripheral smear examination were carried out in 30 consecutive freshly diagnosed cases of sarcoidosis and compared with equal number of age and sex matched healthy controls. Coagulation parameters such as prothrombin time (PT), prothrombin index (PTI), partial thromboplastin time (PTTK) and fibrinogen levels were also studied. RESULTS: There were 15 men (mean age 40.4 +/- 10.15 years) and equal number of women (mean age 38.6 +/- 12.14 years) in the study group. Haematological abnormalities were present in 11 (36.66%) of the patients. Four cases (13.33%, all females) were found to have anaemia and in three of them no other cause for this was evident. Lymphopenia (lymphocyte count <1500/cu mm) was present in eight (26.66%) patients and three (10%) controls (P<0.05). Only one patient (3.3%) had leucopenia. Number of subjects with raised ESR and the mean ESR was higher in the study group as compared to the controls. No coagulation abnormalities were encountered. CONCLUSIONS: Different haematological manifestations in total are common in Indian patients, leucopenia is relatively rare while anaemia, lymphopenia and raised ESR are common

TTV: prevalência e caracterizaçäo do novo vírus de DNA transmissível pelo sangue em diferentes populaçöes de São Paulo / TTV: prevalence and phylogenetic characterization of a novel blood-borne DNA virus in different groups from São Paulo, Brazil

A recente descoberta do novo vírus de DNA denominado TT virus (TTV), que foi inicialmente associado à hepatite pós-transfusional não A-G, levou os autores a realizar uma investigação abrangente desta infecção em diferentes populações de São Paulo, envolvendo tanto aspectos clínico-epidemiológicos quanto a caracterização viral. Para tanto, estudou-se indivíduos aparentemente sadios [crianças/adolescentes (n=138) e doadores de sangue (n=401)] e pacientes com coagulopatias (n=130). O TTV foi detectado por reação em cadeia da polimerase (PCR) da região genômica não codificadora de proteína (UTR), sendo sua prevalência extremamente elevada tanto nas crianças e doadores de sangue (81-85 por cento) como nos coagulopatas (98 por cento)...

Prevalence of Hepatitis C Virus among Hematological Diseases Children in Pediatric Hospital in Damascus

Blood transfusion is considered one of the main risk factors, which causes infection of blood-born viruses, mainly HCV and HBV. The study included 75 children [ages between 1-14 years], admitted to Pediatric Hospital in Damascus. Those patients had different hematological diseases like Thalassemia and Sickle Cell Anemia. Serum ALT, AST, and total bilirubin were tested, and the results were compared to the normal range values of those parameters, which were determined during the study. Viral markers [anti-HCV, HRsAg, anti HBc] were tested using enzyme linked immuno sorbent assays. The results showed that mean values of biochemical parameters in those patients were higher than mean values of normal range of those parameters. Ten out of seventy-five patients [13.3%] were positive for anti-HCV, 4 / 75 [5.3%] were positive for HBs Ag, and 2/75 [2.6%] were positive for anti-HBc, only one case [1.3%] was positive for both anti-I and HBsAg. There was a significant correlation between anti-HCV positivity, and number of blood transfusions [P<0.05] Whereas, there was no such correlation between age, sex of patients and anti-HCV positivity. Results showed that hepatitis viruses infection is common among hematological diseases patients due to repeated blood transfusion. Diagnostic assays adopted by Syrian blood banks will decrease the prevalence of these viruses among those patients

Concurrent chemotherapy and radiotherapy in invasive cervical cancer patients with high risk factors

The aim of this study was to evaluate the survival of 395 previously untreated cervical cancer patients with at least one high risk factor following concurrent chemoradiation and to assess the toxicities. Two different chemotherapy regimens were used for concurrent chemoradiation. In the patients with squamous cell carcinoma, 100 mg/m2 of cisplatin was infused intravenously, followed immediately by five consecutive daily administrations of 5-fluorouracil, 1,000 mg/m2/day, each infused intravenously over 24 hr. As for the patients with adenocarcinoma, 70 mg/m2 of cisplatin, 250 mg/m2 of cytoxan and 45 mg/m2 of adriamycin were administered intravenously on days 1, 2, and 3, respectively. The 5-year survival rate was 54.4+ACU- with stage III and IV, 62.6+ACU- with lymph node metastasis on computed tomogram or MRI, 77.9+ACU- with stage I-II disease with lesion size +AD4- or +AD0-4 cm, and 50.3+ACU- with small cell carcinoma or adenocarcinoma. Side effects from concurrent chemoradiation such as nausea, vomiting, and alopecia were present in all 395 cases. Anemia, leukopenia, thrombocytopenia, hepatotoxicity, and nephrotoxicity were observed to varying degrees, but there was no toxic death. This study suggests that cisplatin-based concurrent chemoradiation in treating cervical cancer patients with high risk factors is effective and relatively well tolerated, with acceptable toxicity.

Concurrent chemotherapy and radiotherapy in invasive cervical cancer patients with high risk factors

The aim of this study was to evaluate the survival of 395 previously untreated cervical cancer patients with at least one high risk factor following concurrent chemoradiation and to assess the toxicities. Two different chemotherapy regimens were used for concurrent chemoradiation. In the patients with squamous cell carcinoma, 100 mg/m2 of cisplatin was infused intravenously, followed immediately by five consecutive daily administrations of 5-fluorouracil, 1,000 mg/m2/day, each infused intravenously over 24 hr. As for the patients with adenocarcinoma, 70 mg/m2 of cisplatin, 250 mg/m2 of cytoxan and 45 mg/m2 of adriamycin were administered intravenously on days 1, 2, and 3, respectively. The 5-year survival rate was 54.4+ACU- with stage III and IV, 62.6+ACU- with lymph node metastasis on computed tomogram or MRI, 77.9+ACU- with stage I-II disease with lesion size +AD4- or +AD0-4 cm, and 50.3+ACU- with small cell carcinoma or adenocarcinoma. Side effects from concurrent chemoradiation such as nausea, vomiting, and alopecia were present in all 395 cases. Anemia, leukopenia, thrombocytopenia, hepatotoxicity, and nephrotoxicity were observed to varying degrees, but there was no toxic death. This study suggests that cisplatin-based concurrent chemoradiation in treating cervical cancer patients with high risk factors is effective and relatively well tolerated, with acceptable toxicity.

Incidencia de parasitosis intestinales en pacientes pediátricos hematoncológicos de 1 a 15 años de edad / Frequent intestinal parasites in the hematologic patients

Introducción. Se hace referencia a los parásitos intestinales más frecuentes en los pacientes hematoncológicos y la asociación con desnutrición. Material y método. En la Unidad de Pediatría del Hospital General de México SSA, se estudió en forma prospectiva, observacional y descriptiva a un grupo de 85 pacientes hematoncológicos, provenientes de la consulta externa, con o sin síntomas parasitarios. Los pacientes se atendieron entre junio y diciembre de 1994. A todos se les realizaron estudios coproparasitoscópicos en serie de tres, por el método de Faust. Resultados. Se estudió un total de 85 niños de 1 a 15 años de edad; 59 se encontraron parasitados (69.5 por ciento) y 26 (30.5 por ciento) libres de parásitos. Conclusiones. Las afecciones más frecuente fueron: leucemia, tumores del sistema nervioso central y linfomas. Los parásitos más frecuentes fueron: Giardia lamblia, 28.7 por ciento, Entamoeba histolytica 26 por ciento, Ascaris lumbricoides 12.3 por ciento. De los 59 pacientes con algún parásito, 54 (91.4 por ciento) cursaron con algún grado de desnutrición