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1.
BMC Cancer ; 21(1): 1073, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34598694

RESUMEN

BACKGROUND: This study aimed to evaluate the feasibility, safety, and efficacy of postoperative adjuvant chemotherapy with docetaxel/cisplatin/S-1 (DCS) following S-1 therapy in patients with stage III gastric cancer after curative gastrectomy. METHODS: Patients with stage III gastric cancer who underwent D2 gastrectomy were enrolled. Adjuvant chemotherapy was initiated within 8 weeks of gastrectomy. The first cycle of chemotherapy consisted of S-1 monotherapy (day 1-14), followed by a 7-day rest period. Cycles 2 and 3 consisted of the following: S-1 (day 1-14) administration, followed by a 14-day rest period, and an intravenous infusion of cisplatin and docetaxel on days 1 and 15. After two cycles, S-1 was administered for up to 1 year. RESULTS: Thirty patients were enrolled between 2014 and 2017. Febrile neutropenia of grade 3 or higher was the most common hematological toxicity with 4 patients (13.3%). Other hematological toxicities of grade 3 or higher were as follows: neutropenia in 3 (10.0%), leukopenia in 3 (10.0%), and anemia in 2 (6.7%) patients. Most frequent non-hematological toxicity of grade 3 was anorexia (n = 4, 13.3%) and general fatigue (n = 3, 10.0%); no grade 4 non-hematological toxicities were observed. Twenty-five patients (83.3%) completed two cycles of DCS treatment and 18 (60.0%) completed subsequent S-1 treatment for 1 year. The relative dose intensity of docetaxel and cisplatin was 0.86 and that of S-1 was 0.88. CONCLUSION: The DCS regimen can be acceptable as an adjuvant chemotherapy and offers an effective postoperative treatment option for stage III gastric cancer patients. TRIAL REGISTRATION NUMBER: UMIN000012785 . DATE OF REGISTRY: 08/01/2014.


Asunto(s)
Adenocarcinoma/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Gástricas/tratamiento farmacológico , Adenocarcinoma/patología , Adenocarcinoma/cirugía , Anciano , Anemia/inducido químicamente , Anorexia/inducido químicamente , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Quimioterapia Adyuvante/efectos adversos , Quimioterapia Adyuvante/métodos , Neutropenia Febril Inducida por Quimioterapia/etiología , Cisplatino/administración & dosificación , Cisplatino/efectos adversos , Docetaxel/administración & dosificación , Docetaxel/efectos adversos , Esquema de Medicación , Combinación de Medicamentos , Fatiga/inducido químicamente , Estudios de Factibilidad , Femenino , Humanos , Leucopenia/inducido químicamente , Masculino , Persona de Mediana Edad , Neutropenia/inducido químicamente , Ácido Oxónico/administración & dosificación , Ácido Oxónico/efectos adversos , Cooperación del Paciente , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/patología , Neoplasias Gástricas/cirugía , Tegafur/administración & dosificación , Tegafur/efectos adversos
2.
MMW Fortschr Med ; 163(17): 60-62, 2021 Oct.
Artículo en Alemán | MEDLINE | ID: mdl-34595649
3.
BMJ Case Rep ; 14(10)2021 Oct 13.
Artículo en Inglés | MEDLINE | ID: mdl-34645629

RESUMEN

A 22-year-old pregnant woman was referred to our fetal medicine unit due to severe fetal growth restriction at 26 weeks of gestation. An extensive detailed ultrasound revealed signs of bilateral periventricular hyperechogenicity, suggesting fetal infection potentially due to cytomegalovirus (CMV). Doppler ultrasound showed a high peak systolic velocity in the middle cerebral artery. Percutaneous umbilical cord blood sampling confirmed fetal CMV infection and severe fetal anaemia. We present this case to highlight the importance of fetal anaemia, which can be fatal regardless of whether it is associated with generalised oedema or hydrops fetalis.


Asunto(s)
Anemia , Infecciones por Citomegalovirus , Adulto , Anemia/etiología , Infecciones por Citomegalovirus/complicaciones , Femenino , Retardo del Crecimiento Fetal/diagnóstico por imagen , Retardo del Crecimiento Fetal/etiología , Feto , Humanos , Hidropesía Fetal/diagnóstico por imagen , Hidropesía Fetal/etiología , Embarazo , Ultrasonografía Prenatal , Adulto Joven
4.
BMJ Case Rep ; 14(10)2021 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-34607817

RESUMEN

Pericardial effusion secondary to isolated severe iron-deficiency anaemia is an extremely rare condition. We present a case with severe anaemia presented with moderate pericardial effusion. Pericardial effusion completely resolved with correction of anaemia.


Asunto(s)
Anemia Ferropénica , Anemia , Derrame Pericárdico , Anemia Ferropénica/complicaciones , Humanos , Derrame Pericárdico/complicaciones , Derrame Pericárdico/diagnóstico por imagen
5.
Medicine (Baltimore) ; 100(40): e27371, 2021 Oct 08.
Artículo en Inglés | MEDLINE | ID: mdl-34622838

RESUMEN

BACKGROUND: Anemia in patients with chronic kidney disease (CKD) presents significant impacts on patients, the health-care system, and financial resources. Therefore, this study aimed to identify the risk factors of anemia among CKD patients. METHODS: This meta-analysis was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols statement guidelines. Studies were identified through systematic searches in September 2021 with no restrictions on date and time, and publication status using the following bibliographic databases: Embase, Medline, PubMed, Web of Science, Science Direct, and the Cochrane Library. The search was conducted using the following terms and phrases: "anemia", "risk factors", "associated factors", "chronic kidney injury", "chronic kidney disease", and "chronic renal insufficiency". The quality of each included study was assessed according to the Newcastle-Ottawa scale. Meta-analysis was performed using STATATM version 14 statistical software for WindowsTM. RESULTS: The results of this systematic review and meta-analysis will be published in a peer-reviewed journal. CONCLUSION: This meta-analysis may help policymakers and program managers design evidence-based interventions on preventing the occurrence of anemia with CKD patient populations.


Asunto(s)
Anemia/etiología , Insuficiencia Renal Crónica/complicaciones , Humanos , Metaanálisis como Asunto , Factores de Riesgo , Revisiones Sistemáticas como Asunto
6.
Trials ; 22(1): 712, 2021 Oct 18.
Artículo en Inglés | MEDLINE | ID: mdl-34663434

RESUMEN

BACKGROUND: Erythropoiesis and iron homeostasis are closely related; anemia due to lower-risk myelodysplastic syndromes (MDS) remains difficult to treat. In the last decade, we have been committed to improving the regulation of iron metabolism using traditional Chinese medicine (TCM). Previous studies have found that the TCM Yi Gong San (YGS) can reduce the expression of transferrin by inhibiting hepcidin overexpression caused by inflammation, promote the outward transfer of intracellular iron, and improve the symptoms of anemia. Here, our study aimed to compare the efficacy of a conventional drug with YGS with that of conventional medicine with placebo to provide a scientific basis for making clinical decisions. METHODS: A prospective, multicenter, double-blinded, randomized controlled clinical trial will be conducted to evaluate the therapeutic efficacy of conventional medicine combined with YGS with that of conventional medicine alone in the treatment of MDS. A total of 60 patients would be enrolled in this study, with each treatment group (conventional medicine + YGS and conventional medicine + placebo) comprising 30 patients. Oral medication would be administered twice daily for 3 months. All patients would be followed up throughout the 3-month period. The primary outcome was measured by assessing blood hemoglobin level. The secondary outcome was measured by assessing TCM symptom score, iron metabolism, hepcidin levels, and inflammatory factors. DISCUSSION: This trial would aim to demonstrate the effectiveness and feasibility of YGS in the treatment of lower-risk MDS anemia, as well as its impact on inflammatory factors and iron metabolism in patients with lower-risk MDS. TRIAL REGISTRATION: Chinese Clinical Trials Registry ( http://www.chictr.org.cn/ ) ChiCTR1900026774 .  Registered on October 21, 2019.


Asunto(s)
Anemia , Medicamentos Herbarios Chinos , Síndromes Mielodisplásicos , Anemia/diagnóstico , Anemia/tratamiento farmacológico , Anemia/etiología , China , Método Doble Ciego , Medicamentos Herbarios Chinos/efectos adversos , Humanos , Estudios Multicéntricos como Asunto , Síndromes Mielodisplásicos/diagnóstico , Síndromes Mielodisplásicos/tratamiento farmacológico , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto
7.
Rev Bras Enferm ; 75(1): e20210064, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-34614085

RESUMEN

OBJECTIVE: To evaluate the presence of anemia in patients with chronic lower limb ulcers based on profile and hematometric indices. METHOD: This is a cross-sectional study carried out in a university hospital in Rio de Janeiro. The sample was composed of 64 participants with lower limb ulcers and evolution time greater than 12 weeks. Data was collected between May/2016 and December/2017 from hematological analyses, records from medical records, and wound assessment form. RESULTS: 36 (56.2%) were male; 38 (59.4%) between 60 and 80 years old; 56 (87.5%) with chronic diseases and 52 (81.2%) with venous ulcers. 6 years mean of active ulceration. Anemia was detected in 36 (56.2%), 27 (75%) of which were normochromic and normocytic; 14 (38.8%) had deficiency anemia recorded in their medical chart. CONCLUSION: The low hemoglobin concentration is recurrent among the participants characterizing an anemia condition, whose profile reveals congruence to the anemia of chronic disease.


Asunto(s)
Anemia , Úlcera de la Pierna , Anciano , Anciano de 80 o más Años , Anemia/complicaciones , Anemia/epidemiología , Brasil/epidemiología , Estudios Transversales , Humanos , Laboratorios , Úlcera de la Pierna/complicaciones , Úlcera de la Pierna/epidemiología , Masculino , Persona de Mediana Edad
10.
Gan To Kagaku Ryoho ; 48(10): 1255-1257, 2021 Oct.
Artículo en Japonés | MEDLINE | ID: mdl-34657058

RESUMEN

The patient was a 61-year-old woman who presented to the hospital with the chief complaints of anemia and thrombocytopenia. There was a mass in her left breast, and a needle biopsy with pathology revealed invasive ductal carcinoma, which was HR-positive and HER2-negative. A PET scan revealed multiple bone metastases, which were confirmed on bone marrow biopsy, leading to the diagnosis of bone marrow carcinomatosis. As the patient was in good general condition, an aromatase inhibitor(AI)therapy was selected. Rapid improvements in her hemoglobin level and platelet count were observed. At 19 months after the start of treatment, we were able to perform a left mastectomy with left axillary lymph node dissection. The histological evaluation of her response to treatment was Grade 2a, and severe lymph node metastasis was observed. The patient continued to receive the AI postoperatively. Thirty-two months after the start of treatment, there was no evidence of cancer on clinical imaging. Although it is rare for bone marrow carcinomatosis to occur, as in the present case, it is also notable that the patient had been in long-term remission with consistent AI therapy.


Asunto(s)
Anemia , Neoplasias de la Mama , Neoplasias Peritoneales , Trombocitopenia , Anemia/tratamiento farmacológico , Anemia/etiología , Inhibidores de la Aromatasa , Médula Ósea , Neoplasias de la Mama/complicaciones , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/cirugía , Femenino , Humanos , Mastectomía , Persona de Mediana Edad , Trombocitopenia/tratamiento farmacológico , Trombocitopenia/etiología
11.
BMC Infect Dis ; 21(1): 1016, 2021 Sep 28.
Artículo en Inglés | MEDLINE | ID: mdl-34583644

RESUMEN

BACKGROUND: Anemia is the most common hematologic abnormalities in AIDS patients usually associated with disease progression and poor clinical outcomes. Zidovudine (AZT), which is one of the nucleoside reverse transcriptase inhibitor drug families of the first line antiretroviral therapy regimen for HIV/AIDS patients, causes anemia due to early long-term of higher-dose therapy. This study was aimed to assess the magnitude and associated factors of anemia among AZT containing HAART experienced adult HIV/ADIS patients at University of Gondar Comprehensive Specialized Referral Hospital, northwest, Ethiopia, 2019. METHODS: A retrospective cohort study was conducted among a total of 320 adult AZT based HAART experienced HIV/AIDS patients from January 2016 to December 2018. Systematic random sampling technique was used to select the patients' charts. All required data for this study were extracted from patients' medical charts. Data were coded, cleared and entered into Epi Info version 3.5.3, and transformed to SPSS version 20 for analysis. Descriptive statistics, bivariable and multivariable logistic regression models were fitted to identify associated factors of anemia and P-value < 0.05 was considered as statistically significance. RESULTS: A total of 320 adult AZT based HAART experienced HIV/AIDS patients' charts were assessed. Of the total patients, 198 (61.9%) were females and 133 (41.6%) were within the age range of 35-45 years. More than half, 237(76.9%) of the patients were from the urban area and 186 (58.1%) were on WHO clinical stage III at the baseline. The prevalence of anemia was 50% (95% CI 44.7-55.0%), 44.1% (95% CI 38.4-50.0%), 35.6% (95% CI 30.3-40.6%), 40% (95% CI 34.4-45.6%), 40.6% (95% CI 35.0-46.3) and 39.1% (95% CI 33.4-44.1%) at baseline, 6 months, 12 months, 18 months, 24 months and 30 months of follow-up period, respectively. The overall prevalence of anemia was 41.6%. Anemia had significant association with WHO clinical stage and base line Hgb values. CONCLUSIONS: A significant number of participants were anemic in this study. WHO clinical stage and baseline Hgb value were the contributing factors for anemia among these patients. Therefore, anemia needs an immediate intervention on associated factor to improve the anemic status and living condition of HIV patient.


Asunto(s)
Anemia , Infecciones por VIH , Adulto , Anemia/inducido químicamente , Anemia/epidemiología , Terapia Antirretroviral Altamente Activa/efectos adversos , Etiopía/epidemiología , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Hospitales Especializados , Humanos , Persona de Mediana Edad , Derivación y Consulta , Estudios Retrospectivos , Zidovudina/efectos adversos
12.
J Assoc Physicians India ; 69(9): 11-12, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34585895

RESUMEN

Four patients who presented with autoimmune cytopenias as the sole manifestation of undiagnosed tuberculosis are described here. These were refractory to conventional immunosuppressive therapy and responded dramatically to treatment of the infection. The potential association between tuberculosis and immune hematological conditions is highlighted. Literature is reviewed with respect to possible pathogenetic mechanisms. Clinicians need to be aware of this type of unusual presentation of tuberculosis and must consider this chronic bacterial infection as a potential cause for refractory cytopenias.


Asunto(s)
Anemia , Leucopenia , Trombocitopenia , Tuberculosis , Humanos , Inmunosupresores/uso terapéutico , Tuberculosis/complicaciones , Tuberculosis/diagnóstico , Tuberculosis/tratamiento farmacológico
13.
14.
BMC Oral Health ; 21(1): 445, 2021 09 14.
Artículo en Inglés | MEDLINE | ID: mdl-34521396

RESUMEN

BACKGROUND: Human beta defensin-3 (HßD-3) is an antimicrobial peptide present in saliva that protects tooth surfaces from microbial attack. These peptides are part of innate immunity so levels may be affected by different systemic diseases like anemia. Therefore, anemia may predispose an affected child to an increased risk of dental caries. The objectives of this study were to determine the association of early childhood caries (ECC) with HßD-3 levels and observe the association of HßD-3 levels with childhood anemia. METHODS: A total of 80 children admitted in a pediatric medical ward, age 48-71 months, of either sex were included in the study. The included children were categorized as cases (children with ECC n = 40) and controls (children without ECC n = 40). Children were further segregated into the anemic and non-anemic sub-groups based on the hospital record of hemoglobin level. The salivary concentration of HßD-3 was measured by Enzyme-Linked Immuno-sorbent assay (ELISA). IBM SPSS version 20 software was used for statistical analysis. Two sample t-test and one-way ANOVA were used to compare mean values while spearman was used for correlations at p < 0.05. RESULTS: The mean Salivary HßD-3 level in cases (8.87 ± 4.30) was significantly higher (p = 0.042) as compared to controls (7.23 ± 2.57). Salivary HßD-3 level in patients with caries and without anemia was highest (10.80 ± 4.50) whereas salivary HßD-3 level in the presence of caries and anemia was lowest (6.94 ± 3.13) amongst all groups. This difference was statistically significant (p = 0.001). Salivary HßD-3 level was found to be moderately correlated with cases (p = 0.002). An inverse correlation was found between salivary HßD-3 level and anemia (r = -0.479, p = 0.002). CONCLUSION: Anemia may affect the innate immunity of children, and may result in a decreased level of salivary HßD3, thus increasing vulnerability to decay.


Asunto(s)
Anemia , Caries Dental , beta-Defensinas , Estudios de Casos y Controles , Niño , Preescolar , Susceptibilidad a Caries Dentarias , Humanos , Saliva
15.
Trials ; 22(1): 649, 2021 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-34556166

RESUMEN

BACKGROUND: Anaemia is a worldwide problem and iron deficiency is the most common cause. In pregnancy, anaemia increases the risk of adverse maternal, foetal and neonatal outcomes. India's anaemia rate is among the highest in the world with India's National Family Health Survey indicating over 50% of pregnant women were affected by anaemia. India's Anaemia Mukt Bharat-Intensified National Iron Plus Initiative aims to reduce the prevalence of anaemia among reproductive-age women, adolescents and children by 3% per year and facilitate the achievement of a Global World Health Assembly 2025 objective to achieve a 50% reduction of anaemia among women of reproductive age. However, preliminary results of the NFHS-5 survey completed in 2020 indicate that anaemia rates are increasing in some states and these targets are unlikely to be achieved. With oral iron being the first-line treatment for iron deficiency anaemia (IDA) in pregnancy, these results are likely to be impacted by the side effects, poor adherence to tablet ingestion and low therapeutic impact of oral iron. These reports suggest a new approach to treating IDA, specifically the importance of single-dose intravenous iron infusions, may be the key to India effectively reaching its targets for anaemia reduction. METHODS: This 3-arm, randomized controlled trial is powered to report two primary outcomes. The first is to assess whether a single dose of two different intravenous formulations administered early in the second trimester of pregnancy to women with moderate IDA will result in a higher percentage of participants achieving a normal for pregnancy Hb concentration at 30-34 weeks' gestation or just prior to delivery when compared to participants taking standard doses of oral iron. The second is a clinical outcome of low birth weight (LBW) (< 2500 g), with a hypothesis that the risk of LBW delivery will be lower in the intravenous iron arms when compared to the oral iron arm. DISCUSSION: The RAPIDIRON trial will provide evidence to determine if a single-dose intravenous iron infusion is more effective and economically feasible in reducing IDA in pregnancy than the current standard of care. TRIAL REGISTRATION: Clinical Trials Registry - India CTRI/2020/09/027730. Registered on 10 September 2020, http://ctri.nic.in/Clinicaltrials/showallp.php?mid1=46801&EncHid=&userName=anemia%20in%20pregnancy.


Asunto(s)
Anemia Ferropénica , Anemia , Complicaciones Hematológicas del Embarazo , Adolescente , Anemia Ferropénica/diagnóstico , Anemia Ferropénica/tratamiento farmacológico , Anemia Ferropénica/prevención & control , Niño , Femenino , Humanos , Recién Nacido de Bajo Peso , Recién Nacido , Hierro , Embarazo , Complicaciones Hematológicas del Embarazo/diagnóstico , Complicaciones Hematológicas del Embarazo/tratamiento farmacológico , Mujeres Embarazadas
16.
J Med Case Rep ; 15(1): 472, 2021 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-34517883

RESUMEN

BACKGROUND: Anemia is a serious global health problem that affects individuals of all ages but particularly women of reproductive age. Iron deficiency anemia is one of the most common causes of anemia seen in women, with menstruation being one of the leading causes. Excessive, prolonged, and irregular uterine bleeding, also known as menometrorrhagia, can lead to severe anemia. In this case report, we present a case of a premenopausal woman with menometrorrhagia leading to severe iron deficiency anemia with record low hemoglobin. CASE PRESENTATION: A 42-year-old Hispanic woman with no known past medical history presented with a chief complaint of increasing fatigue and dizziness for 2 weeks. Initial vitals revealed temperature of 36.1 °C, blood pressure 107/47 mmHg, heart rate 87 beats/minute, respiratory rate 17 breaths/minute, and oxygen saturation 100% on room air. She was fully alert and oriented without any neurological deficits. Physical examination was otherwise notable for findings typical of anemia, including: marked pallor with pale mucous membranes and conjunctiva, a systolic flow murmur, and koilonychia of her fingernails. Her initial laboratory results showed a critically low hemoglobin of 1.4 g/dL and severe iron deficiency. After further diagnostic workup, her profound anemia was likely attributed to a long history of menometrorrhagia, and her remarkably stable presentation was due to impressive, years-long compensation. Over the course of her hospital stay, she received blood transfusions and intravenous iron repletion. Her symptoms of fatigue and dizziness resolved by the end of her hospital course, and she returned to her baseline ambulatory and activity level upon discharge. CONCLUSIONS: Critically low hemoglobin levels are typically associated with significant symptoms, physical examination findings, and hemodynamic instability. To our knowledge, this is the lowest recorded hemoglobin in a hemodynamically stable patient not requiring cardiac or supplemental oxygen support.


Asunto(s)
Anemia Ferropénica , Anemia , Menorragia , Adulto , Anemia Ferropénica/complicaciones , Anemia Ferropénica/diagnóstico , Anemia Ferropénica/tratamiento farmacológico , Femenino , Hemoglobinas , Humanos , Hierro
18.
Am Fam Physician ; 104(3): 271-276, 2021 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-34523897

RESUMEN

Splenomegaly can be due to several mechanisms but is almost always a sign of a systemic condition. Patient habits, travel, and medical conditions can increase risk of splenomegaly and suggest etiology. Symptoms can suggest infectious, malignant, hepatic, or hematologic causes. Physical examination will typically reveal splenomegaly, but abdominal ultrasonography is recommended for confirmation. Physical examination should also assess for signs of systemic illness, liver disease, and anemia or other hematologic issues. The most common causes of splenomegaly in the United States are liver disease, malignancy, and infection. Except for apparent causes such as infectious mononucleosis, basic laboratory analysis and ultrasonography are the first-line steps in determining etiology. Malaria and schistosomiasis are common in tropical regions, where as many as 80% of people may have splenomegaly. Management of splenomegaly involves treating the underlying disease process. Splenectomies and spleen reduction therapies are sometimes performed. Any patient with limited splenic function requires increased vaccination and prophylactic antibiotics for procedures involving the respiratory tract. Acute infections, anemia, and splenic rupture are the most common complications of splenomegaly, and people with splenomegaly should refrain from participating in contact sports to decrease risk of rupture.


Asunto(s)
Esplenomegalia/diagnóstico , Esplenomegalia/terapia , Anemia/etiología , Anemia/fisiopatología , Manejo de la Enfermedad , Humanos , Rotura del Bazo/complicaciones , Rotura del Bazo/cirugía , Esplenomegalia/fisiopatología , Ultrasonografía/métodos
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