Toxicidad cerebelosa por citarabina: serie de 4 casos / Cerebellar toxicity due to cytarabine: A series of 4 cases

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Pseudonaneurisma de arteria poplítea post-traumático. Presentación de un caso / Pseudoaneurysm of poplíteal artery post traumatic: A Case report

Los pseudoaneurismas son más frecuentes hallarlos en los traumatismos arteriales en miembros inferiores. Se describe por la literatura internacional que hay una incidencia elevada en ortopedia con el uso de los fijadores en las fracturas de tibia yperoné. Se reporta un caso que sufrió una herida por arma blanca en cara externa de la pierna que estuvo sin diagnósticopor espacio de 18 meses, en todo este tiempo presentó aumento de volumen progresivo de la pierna y no padeció ningún síntomahasta su tratamiento. Se realizó la evacuación del gran hematoma con restauración de la arteria poplítea previa ligadura del pseudoaneurismas. La herida se cerró por segunda intención con el uso de azúcar de caña granulado. A los 29 días del postoperatorio el paciente estaba recuperado por completo (AU)

Pseudoaneurysms are more frequently found in arterial traumatisms in inferior members. According to international literaturethere is a risen incidence in orthopedics due to the use of fixers or nails in the tibia and fibula fractures. A case is reportedthat suffered a settle wound in the external face of the leg. It went without any diagnosis for 18 months. During this periodof time the leg presented and increase of progressive volume and the patient did not experience any symptom until his treatment.He underwent the evacuation of great haematoma and the restoration of the of the popliteal artery previous bond of the pseudoaneurysm. The wound closed up on second intention with the use of granulated sugar cane. After 29 days the patient was completely recovered (AU)

Autoimmune hemolytic anemia following allogeneic hematopoietic stem cell transplantation in adult patients.

Autoimmune hemolytic anemia (AIHA) after allogeneic hematopoietic stem cell transplantation (HSCT) is still not well characterized. The aim of this study was to analyze the incidence and risk factors for the development of AIHA, as well as its prognosis and response to treatment in a series of patients undergoing allogeneic HSCT at a single institution. Between 1996 and 2004, 272 adult patients with a variety of malignant hematopoietic disorders underwent allogeneic HSCT. Direct antiglobulin testing was performed in routine pretransfusion compatibility testing or after clinical suspicion of AIHA. Twelve patients developed AIHA after HSCT at a median time of 147 days (range, 41-170). The 3-year cumulative incidence of AIHA was 4.44%. Eight cold antibodies and four warm antibodies were detected. Multivariate analysis shows that HSCT from unrelated donors (P=0.02) and the development of chronic extensive graft-versus-host disease (GVHD) (P=0.0004) were the only independent factors associated with AIHA. Two patients are still alive. AIHA was never the primary cause of death but added morbidity in patients with other concomitant complications. Patients undergoing HSCT from unrelated donors and those who develop chronic extensive GVHD are especially predisposed for this complication.

Transplantation of CD34+ selected peripheral blood to HLA-identical sibling patients with aplastic anaemia: results from a single institution.

We evaluated the use of CD34+ selected allogeneic peripheral blood as a source of hematopoietic progenitors for allogeneic transplantation in 11 patients with aplastic anemia (AA). The median age was 17 years (range, 6--9), and the median time between diagnosis and transplant 1 month (range, 1--4). Conditioning consisted of cyclophosphamide (50 mg/kg per day) on days--7 to--4 and antithymocyte globulin (30 mg/kg per day) on days--4 to--2 in nine patients. Total lymphoid irradiation was added to the preparative regimen for two. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine A and prednisone. Median doses of CD34+ and CD3+ cells infused were 3.91 x 10(6) and 0.3 x 10(6)/kg, respectively. The median time taken to achieve a neutrophil count >0.5 x 10(9)/l was 12 days and to recover a platelet count >20 x 10(9)/l, 13 days. Two patients developed acute GVHD grade I--II and one developed limited chronic GVHD. There were two treatment-related deaths. At a median follow-up of 44 months (range, 4--3), nine patients were alive with sustained and complete engraftment. This is a promising procedure in patients with AA, resulting in a rapid hematopoietic recovery, a low transplant-related mortality, and a low incidence of GVHD.