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1.
Cureus ; 14(10): e30279, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36407259

RESUMO

BACKGROUND AND AIMS:  Immune thrombocytopenic purpura (ITP) is an acquired bleeding disorder characterized by autoantibodies against platelets. The clinical presentation is variable; the main symptom is bleeding, and many patients are asymptomatic; others have nonspecific symptoms like fatigue. Uncommonly, ITP can present with paradoxical thrombosis. The risk of thrombosis in ITP may be higher than expected, which makes the management of ITP more challenging. This review aims to evaluate patients with ITP who develop thrombosis and identify potential risk factors related to thrombosis in this category of patients. MATERIALS AND METHODS:  English literature was searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for adults above 18 years with primary ITP who had infarctions or thrombotic events. Patients with secondary ITP were excluded. The search included articles published up to 20th October 2021. RESULTS:  A total of 73 articles were included. Seventy-seven patients with ITP had developed infarctions and various thrombotic events. Sixty-three patients had arterial events, and 14 patients developed venous thrombotic events. CONCLUSION:  Patients with ITP have low platelets, which predispose them to bleed; despite that, serious thrombotic complications can happen in these patients and are difficult to predict. Therefore, it is critical for physicians to understand that ITP is paradoxically a prothrombotic condition and to address preventive thromboembolic measures whenever possible.

2.
Hemodial Int ; 2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36397717

RESUMO

INTRODUCTION: Few studies have reported hepatic and cardiac iron overload in patients with end-stage renal disease (ESRD), and the current evidence regarding the prevalence is still scarce. AIM: This review aims to estimate the prevalence of hepatic and/or cardiac iron overload quantified by magnetic resonance imaging (MRI) in patients with ESRD who receive hemodialysis (HD), peritoneal dialysis (PD), or have undergone a kidney transplant. METHODS: A systematic review with meta-analysis was conducted and reported in line with PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. MEDLINE and Embase bibliographic databases were searched using a comprehensive list of controlled vocabulary and keywords to identify relevant studies. All studies reporting the prevalence of hepatic and/or cardiac iron overload quantified by MRI in ESRD patients were considered. The Newcastle-Ottawa scale was used to assess the methodological quality of included studies. To investigate the heterogeneity between studies, random-effect meta-analyses for proportions were used. RESULTS: The review comprised seven studies that included 339 patients. Using meta-analysis, the pooled prevalence of severe and mild to moderate hepatic iron overload quantified by MRI was 0.23 [95% CI: 0.08-0.43] and 0.52 [95% CI: 0.47-0.57], respectively. Only three studies included cardiac iron quantification, and none reported iron overload. CONCLUSIONS: This review has revealed a high prevalence of severe hepatic iron overload in patients with ESRD treated by HD. Further studies with a larger sample size are needed to determine the impact of iron overload on vital organs in patients with ESRD and guide future research in this understudied field. Proper use of iron chelation and continuous monitoring will help in the early detection of unsolicited complications; however, the low renal clearance of most iron chelators limits the options for treating iron excess in patients with ESRD.

3.
Health Sci Rep ; 5(6): e883, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36320657

RESUMO

Background and Aim: The coronavirus-19 is an ongoing global pandemic resulting in millions of deaths worldwide. For a patient population at higher risk of infection, telemedicine is a promising means of providing safe and alternative care routes while minimizing their risk of exposure. This study gives insight into patients' experiences and satisfaction with telemedicine during this pandemic. Methods: We conducted a cross-sectional study on 297 patients (RR: 85%) at the National Center for Cancer Care and Research (NCCCR), Qatar. Data was collected through electronic medical records of the eligibe patient population, and phone calls were made whereby the physician read a standard introductory script followed by a survey questionnaire. We focused on patients' experience with telemedicine services amid the pandemic. This was done using a six-point Likert scoring system of seven questions that were scaled from 1 to 6. Results: More than 80% of patients somewhat to strongly agreed that telemedicine met their healthcare needs, improved their confidence in their healthcare system, and were generally satisfied with the quality of care provided. Nearly all patients (90%) understood their physicians' recommendations over the phone. In addition, more than half of the patients (89%) felt they could freely communicate their concerns. Patients also showed an inclination towards face-to-face consultations at 68%; however, 90% were willing to participate in future teleconsultations. Conclusion: Our study indicates an overall positive experience among patients towards the use of telemedicine. Telemedicine is a safe, futuristic approach toward patient care management and, thus, provides healthcare professionals a platform to implement further patient and physician education. Even though our data also showed that patients liked in-person visits to some degree, this needs to be looked into more in future studies.

4.
Cureus ; 14(8): e28550, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36185893

RESUMO

Polycythemia vera (PV) is a myeloid stem cell disorder characterized by excess red cell mass. The two major complications of PV are thrombosis and bleeding. Atrial fibrillation is a potentially devastating condition that can complicate the course of PV. We describe a case of a 65-year-old woman with PV who presented with new-onset atrial fibrillation. The atrial fibrillation was aborted successfully, and the patient was started on oral anticoagulation with rivaroxaban. PV with atrial fibrillation poses a challenge in management due to the risk of thrombosis and bleeding. Despite the lack of standard recommendations or guidelines, this case highlights that oral anticoagulation therapy can be safe and convenient for such patients.

5.
Front Med (Lausanne) ; 9: 931924, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36186817

RESUMO

Sickle cell disease (SCD) is a heterogeneous group of inherited disorders characterized by the production of sickle hemoglobin which is less soluble than an adult or fetal hemoglobin. Voxelotor is a hemoglobin S polymerization inhibitor that has been approved for sickle cell disease treatment in the adult and adolescent populations. It acts as a hemoglobin modulator by increasing its affinity to oxygen which prevents red blood cells from sickling. Chronic kidney disease is a common but under-reported complication of SCD and it is a leading cause of morbidity and mortality. The data about the safety and efficacy of voxelotor use in chronic kidney disease is limited. Herein we report a 49-year-old man, with sickle cell disease and stage IV chronic kidney disease, who was managed successfully with voxelotor and resulted in decreasing transfusion requirement and vaso-occlusive painful crisis without affecting kidney function.

6.
Case Rep Oncol ; 15(2): 755-761, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36157700

RESUMO

Chronic myeloid leukemia (CML) is a hematologic malignancy that has significant improvement in its prognosis after the introduction of tyrosine kinase inhibitors. Transformation to accelerated phase or blast phase can happen. Myeloid sarcoma or chloroma is an uncommon extramedullary disease. It is very unusual for patients with CML to develop myeloid sarcoma. We report a young man with CML in the chronic phase who developed myeloid sarcoma. There were many difficulties in the diagnosis of myeloid sarcoma due to the simulation of other more common conditions like infections and other malignancies. In addition, there are treatment challenges because of lack of standardized treatment. The case shed light on this rare complication, the challenging diagnosis, and its implication in patients with CML.

7.
Medicine (Baltimore) ; 101(36): e30431, 2022 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-36086749

RESUMO

Neutropenia ranges from a normal variant to life-threatening acquired and congenital disorders. This study aims at providing baseline information regarding the prevalence and spectrum of neutropenia in the Arab blood donors who are living in Qatar. This retrospective cohort study was conducted to review the data of healthy Arab individuals (≥18 years) who donated blood between January 1, 2015 to May 15, 2019. A complete blood count was performed using automated analyzers. The prevalence of neutropenia was 10.7%. The prevalence in females was 32% and in males, it was 6%. Absolute neutrophil count (ANC) below 1 × 109/L was detected in 10% of Arab females and 1.8 % of Arab males. In females, the neutropenic group had significantly lower hemoglobin (Hb) levels and higher red cell distribution width, and lower total white blood cells and lymphocyte counts (P < .001) compared to the group with ANC > 1.5 × 109/L. Significant correlations were found between the ANC and Hb (r = 0.33, P < .05) and ANC and total white blood cells (r = 0.45, P < .01). The prevalence of neutropenia is considerably high in Arab adult females compared to other ethnic groups. Besides the genetic constitution of Arabs, the lower Hb and higher red cell distribution width in females suggest that iron deficiency could contribute to the development of neutropenia.


Assuntos
Árabes , Neutropenia , Adulto , Feminino , Humanos , Masculino , Neutropenia/epidemiologia , Prevalência , Catar/epidemiologia , Estudos Retrospectivos
8.
Blood Adv ; 2022 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-36103340

RESUMO

CITE was a prospective, noninterventional study in adult patients with chronic immune thrombocytopenia (cITP) treated with eltrombopag under routine clinical care in Asia-Pacific, Middle East, and Turkey. Data to assess eltrombopag usage, compliance, and outcomes were collected from May 2017 to December 2020. Platelet response was defined as platelet count ≥50×103/µL in the absence of rescue medications and splenectomy. Quality of life was evaluated using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) questionnaire. Noncompliance was defined as the number of missed doses and number of days where the patient did not follow food instructions. A total of 231 patients were enrolled; the median (range) duration of eltrombopag treatment was 484.5 (1-642) days. Compliance to prescribed eltrombopag dose since last routine visit was high at ≥96.0%. Baseline median platelet count was 19.0×103/µL, which increased to ≥50×103/µL at month 2 and mostly fluctuated between 70×103/µL and 100×103/µL thereafter. Median time to first platelet response was 1.05 months (95% confidence interval: 0.92-1.28 months), and the median (interquartile range) maximum duration of platelet response was 193 (57-456) days. FACIT-F scores improved from mean (standard deviation) 34.4 (12.1) at baseline to 38.5 (9.1) at month 18. Adverse events occurred in 50.9% of patients (n=116), the most common being upper respiratory tract infection (8.3%) and headache (6.6%). These findings confirmed effectiveness of eltrombopag treatment in routine practice and reassured that real-world compliance to eltrombopag prescribed doses and dietary instructions in the Asia-Pacific, Middle East, and Turkey were in line with current recommendations.

9.
Cancer Control ; 29: 10732748221106266, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36066031

RESUMO

Coronavirus disease 2019 (COVID-19) infection is caused by severe acute respiratory syndrome coronavirus 2. Adults with cancer are immunocompromised due to several causes including cancer itself and immunosuppressive therapy. Thus, cancer patients are more susceptible to develop COVID-19 infection. As COVID-19 vaccines became available, patients with cancer would benefit from receiving the vaccine. This article aims to review the recent evidences and recommendations about COVID-19 vaccination in cancer patients.Current guidelines recommend that patients with cancer should have the priority to receive the vaccine given their immunocompromised state. The timing of administration varies depending on cancer type and treatment. Generally, the vaccine should be given before starting the chemotherapy if possible or in between chemotherapy cycles and away from nadir phase. For other cancer treatments, it is recommended to give the vaccine when there is evidence of blood count recovery. In general, induction therapy and treatment for newly diagnosed patients should not be delayed for the vaccination purpose. It is noteworthy to mention that cancer patients especially those with hematologic malignancies might have absented or attenuated response to the vaccine due to their pathophysiological status.On the other hand, the current vaccine guidelines have been criticized for lacking evidence on some important topics that need to be addressed. Firstly, some vaccines have been granted an emergency use authorization, prior to the usual comprehensive safety and efficacy evaluation process. Secondly, specific populations including cancer patients were excluded from the approval trials for safety reasons. Finally, some recommendations regarding the COVID-19 vaccines are extrapolated from other vaccines studies. Further studies are required to fill these gaps and observational studies that include cancer patients are warranted to have a better understanding of the safety and efficacy of the vaccines in cancer patients.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Neoplasias , Adulto , Humanos , COVID-19/prevenção & controle , Vacinas contra COVID-19/administração & dosagem , Hospedeiro Imunocomprometido , Neoplasias/complicações , Neoplasias/tratamento farmacológico , Vacinação
10.
Front Med (Lausanne) ; 9: 931925, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35979207

RESUMO

Background: L-glutamine has been shown to play an important role in the regulation of oxidative stress which is one of the key contributors to the pathophysiology of sickle cell disease (SCD). In a Phase 3 clinical trial, L-glutamine demonstrated a significant reduction in SCD-related complications including vaso-occlusive crises (VOCs), hospitalizations, and acute chest syndrome (ACS) compared to placebo in patients with SCD. Objective: The primary objective was to confirm the efficacy of L-glutamine (Endari®) therapy in pediatric and adult patients with SCD at follow-up time points of 24, 48 and 72 weeks. Methods: In the observational study, nineteen patients with SCD were treated orally with L-glutamine twice daily for 72 weeks. Clinical and laboratory parameters were measured at baseline and follow-up time points. Patients with severe VOC and ACS were hospitalized. Blood transfusion was given in case of ACS and uncontrolled pain associated with VOC despite administration of the highest dose of intravenous (IV) narcotic. Results: Compared to baseline, patients had significantly fewer pain crises (median change from 3.0 to 0.0; P < 0.00001), hospitalizations (median change from 3.0 to 0.0; P < 0.00001), days of hospitalization (median change from 15.0 to 0.0; P < 0.00001), and blood transfusions (median change from 3.0 to 0.0; P < 0.00001) at 24, 48, and 72 weeks following L-glutamine therapy. Moreover, there was a drastic decrease in the number of ACS events during this time. A significant increase was observed in mean hemoglobin levels and hematocrit proportions from baseline to 72 weeks (P < 0.001). Conversely, compared to baseline, mean reticulocyte counts and lactate dehydrogenase (LDH) levels were considerably lower at follow-up time points (P = 0.003 and P < 0.001, respectively). No patient reported treatment-related adverse events. Conclusion: Although the sample size was small, our data clearly demonstrated that L-glutamine therapy was safe and significantly improved clinical outcomes and hemolysis parameters in patients with SCD.

11.
Medicine (Baltimore) ; 101(28): e29131, 2022 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-35839057

RESUMO

INTRODUCTION: Cerebrovascular accidents in sickle cell disease (SCD) patients carry a high socioeconomic impact and represent the most important cause of morbidity, neurological deficits, and impaired quality of life in SCD young population.Patent foramen ovale (PFO) is prevalent in 25% of the general population and it is associated with ischemic stroke in the young population via paradoxical embolism, yet there are no specific guidelines to address how to manage SCD patients with PFO who suffer a stroke. PATIENT CONCERNS AND DIAGNOSIS: Here we present a young SCD patient, aged 24 years, who suffered a stroke in childhood and later was discovered to have a PFO on subsequent echocardiography. The patient has been receiving blood transfusion therapy since 3 years of age. INTERVENTIONS AND OUTCOMES: No treatment was administered to the patient.The intervention that was done was echocardiography with a bubble study to detect PFO. CONCLUSION: Recommendations need to be put in place regarding screening for PFO in patients with SCD, in addition to highlighting issues of whether screening needs to be done in patients who have not developed stroke, and if PFO were to be found, what would be the best management approach and how will prognosis be affected.


Assuntos
Anemia Falciforme , Forame Oval Patente , Acidente Vascular Cerebral , Anemia Falciforme/complicações , Pré-Escolar , Forame Oval Patente/complicações , Forame Oval Patente/diagnóstico por imagem , Humanos , Qualidade de Vida , Fatores de Risco , Acidente Vascular Cerebral/complicações
12.
Cureus ; 14(6): e25953, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35855233

RESUMO

Background Fertility is a highly complex subject; it involves more than one individual and has profound psychological and economic implications. Moreover, it is affected by several factors, including age, significant systemic illness in either partner, exposure to environmental toxins, medications, or radiation. In patients with malignancy, fertility is more complicated. Patients with a malignancy might have reduced fertility due to the disease, medication, and radiation. Besides the reduced fertility, there are more concerns regarding the subsequent effect of cancer treatment on their offspring and the possibility of having healthy children. There were many studies regarding fertility in patients with cancer; however, in male patients with Philadelphia-negative myeloproliferative neoplasms (MPNs), there are very limited data. Objectives In this study, we aim to see the outcome of fatherhood in male patients with Philadelphia-negative myeloproliferative neoplasms (MPNs), polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF) whether on treatment or not. Methods A retrospective mixed-design study of male patients with Philadelphia-negative MPN was followed up in our institute (National Center for Cancer Care and Research (NCCCR)), Doha, Qatar, between January 1, 2008, and January 1, 2020. Patients were interviewed regarding fertility-related information. All included patients had a confirmed diagnosis of Philadelphia-negative MPN according to World Health Organization (WHO) 2008 or WHO 2016 criteria for MPN, aged more than 18 years old. Results A total of 124 male patients were interviewed, and only 20 patients met the inclusion criteria. The majority of the patients were lost to follow-up or could not be contacted, and 28.8% of the excluded patients had their families completed by the time of diagnosis. The treatment received included hydroxycarbamide (n=8), pegylated interferon 2 alpha (n=10), ruxolitinib (n=1), and phlebotomy (n=1). The mean duration of exposure to treatment before pregnancy was 4.7 years. The mode of delivery was normal vaginal delivery in 71.4% of the pregnancies. The total number of offspring was 30, and the total number of conceptions was 30. Conclusion Our data showed that most Philadelphia-negative MPN male patients on treatment had their offspring born normally with no serious complications, congenital anomalies, or reports of MPN-related cancers. Patients' concerns regarding fertility should be addressed well to ensure a better quality of life.

13.
Acta Biomed ; 93(3): e2022242, 2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-35775758

RESUMO

BACKGROUND: Advances in ß- thalassemia major (ß-TM) care have transformed a disease which had previously led to an early childhood death into a chronic condition. With increased lifespan, comorbidities associated with the disease have become more common, among them glucose dysregulation (GD) which develops insidiously, aggravating prognosis and patients' quality of life. OBJECTIVES: The objectives of this study were to retrospectively review the extent to which ß-TM patients, having combined impaired fasting glucose (IFG) and impaired glucose tolerance test (IGT) on oral glucose tolerance test (OGTT), progressed to diabetes and to analyze the potential determinants inducing this progression, or regression to normal glucose tolerance test (NGT). RESEARCH DESIGN AND METHOD: Data of 58 ß-TM patients, followed for a mean duration of 7.7 years (range: 1-20 years) with annual or biennial OGTT, were retrieved. Insulin release and insulin sensitivity (IS) were also analyzed. RESULTS: During the follow-up, FPG and 2-h PG levels after OGTT reverted to NGT in 13 patients (22.4%), deteriorated in 13 patients (22.4%) who developed diabetes mellitus, and did not change in the remaining 32 patients (55.2%). A significant correlation was observed between FPG and ALT level (r: 0.3158; P:0.01) and an inverse correlation was found between chronological age and serum ferritin (SF) level (r: -0.321; P:0.014). Finally, SF and ALT, both at the baseline and at the time of last observation, were independent predictors of evolution to diabetes mellitus. CONCLUSION: The combination IFG/IGT in ß-TM patients with severe iron overload constitutes a high-risk state for developing diabetes.


Assuntos
Intolerância à Glucose , Estado Pré-Diabético , Talassemia beta , Glicemia , Pré-Escolar , Jejum , Seguimentos , Humanos , Qualidade de Vida , Estudos Retrospectivos , Talassemia beta/complicações
14.
Qatar Med J ; 2022(3): 22, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35864918

RESUMO

BACKGROUND: Rituximab is used as second-line therapy in patients with immune thrombocytopenic purpura (ITP) who do not respond to first-line management. The response rate for Rituximab is variable in different populations ranging from 30% to 90%. The adverse effects of rituximab in patients with ITP range from infusion site reactions to the reactivation of hepatitis B virus and progressive multifocal leukoencephalopathy and interpopulation variation. METHODS: We conducted a single-center, retrospective study in Qatar's National Center for Cancer Care & Research. The study included patients with chronic refractory ITP who received rituximab as second-line therapy. Descriptive and summary statistics were used to describe the sociodemographic parameters of the study cohort. RESULTS: Of the 41 patients with chronic ITP, 26 were Arabs, 12 were Asians, and 3 were of other ethnicities. Rituximab was associated with an overall response rate of 80.4%. Arabic patients had the highest clinical response (84.6%) among the ethnicities with the lowest adverse effects (11.5%). Asians had a response rate of 66.6%, and adverse effects were seen in 16.7% of the patients. CONCLUSIONS: In chronic refractory ITP, rituximab appears to have a better clinical response in the Arabic population with minimal toxicity than in other ethnicities.

15.
Molecules ; 27(13)2022 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-35807465

RESUMO

Unconsolidated earthen surface materials can retain heavy metals originating from different sources. These metals are dangerous to humans as well as the immediate environment. This danger leads to the need to assess various geochemical conditions of the materials. In this study, the assessment of topsoil materials' contamination with heavy metals (HMs) was conducted. The material's representative spatial samples were taken from various sources: agricultural, industrial, and residential areas. The materials include topsoil, eolian deposits, and other unconsolidated earthen materials. The samples were analyzed using the ICP-OES. The obtained results based on the experimental procedure indicated that the average levels of the heavy metals were: As (1.21 ± 0.69 mg/kg), Ba (110.62 ± 262 mg/kg), Hg (0.08 ± 0.18 mg/kg), Pb (6.34 ± 14.55 mg/kg), Ni (8.95 ± 5.66 mg/kg), V (9.98 ± 6.08 mg/kg), Cd (1.18 ± 4.33 mg/kg), Cr (31.79 ± 37.9 mg/kg), Cu (6.76 ± 12.54 mg/kg), and Zn (23.44 ± 84.43 mg/kg). Subsequently, chemometrics modeling and a prediction of Cr concentration (mg/kg) were performed using three different modeling techniques, including two artificial intelligence (AI) techniques, namely, generalized neural network (GRNN) and Elman neural network (Elm NN) models, as well as a classical multivariate statistical technique (MST). The results indicated that the AI-based models have a superior ability in estimating the Cr concentration (mg/kg) than MST, whereby GRNN can enhance the performance of MST up to 94.6% in the validation step. The concentration levels of most metals were found to be within the acceptable range. The findings indicate that AI-based models are cost-effective and efficient tools for trace metal estimations from soil.


Assuntos
Metais Pesados , Poluentes do Solo , Solo , Inteligência Artificial , Quimiometria , Cromo/análise , Monitoramento Ambiental/métodos , Metais Pesados/análise , Modelos Químicos , Análise Multivariada , Redes Neurais de Computação , Arábia Saudita , Solo/química , Poluentes do Solo/análise
16.
Surv Ophthalmol ; 67(6): 1731-1732, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35872011

RESUMO

This editorial discusses that the diabetic proliferative retinopathy progresses as a result of ischemia angiogenic stimuli, which may be exacerbated by concomitant CML retinopathy generating increased blood viscosity and vascular endothelial growth factor levels.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Leucemia Mielogênica Crônica BCR-ABL Positiva , Retinopatia Diabética/complicações , Retinopatia Diabética/epidemiologia , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/complicações , Fator A de Crescimento do Endotélio Vascular/metabolismo , Fatores de Crescimento do Endotélio Vascular
17.
Cureus ; 14(6): e25701, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35812564

RESUMO

BACKGROUND: Eltrombopag olamine (ELT) is a synthetic nonpeptide with a low molecular weight that has been investigated in various phase-3 studies and shown to be efficacious at a typical dose of 50 mg. Varied ethnic groups have reported different responses to ELT. AIM: The aim is to examine the efficacy of ELT in Asian and Arab patients with immune thrombocytopenia (ITP) from the Indian subcontinent by starting with (12.5 mg, as a minimum dose) and gradually increasing to a maximum dose of 50 mg. METHODS: Between January 2015 and January 2019, we reviewed the electronic health records of non-Arab Asian (n = 17) versus Arab (n = 41) patients who were ≥18 years old, residing in Qatar, and with confirmed diagnoses with chronic ITP and under active treatment with a platelet count of 30,000/L, and bleeding symptoms. Following receiving ELT for three months or longer at various dosages, patients' response was examined. RESULTS: After three months of ELT therapy, the response rate (platelet count of 50,000/L) was equivalent in non-Arab (88.2%) versus Arab (87.5%) patients. However, to achieve an adequate response, 26% of Arab patients required a lower dose of 12.5 or 25 mg, and 41.5% required a higher dose of 50 mg. CONCLUSION:  In adult chronic ITP patients, ELT is typically well-tolerated and delivers the desired outcomes. In 67.5% of Arab patients, smaller dosages of ELT (12.5-50 mg) were helpful in sustaining acceptable PLT levels. This helps patients get the most benefit at the lowest feasible dose, reducing toxicity and expense.

18.
Cureus ; 14(5): e25196, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35747002

RESUMO

Coronavirus disease 2019 (COVID-19) is a respiratory viral illness caused by coronavirus 2 (SARS-CoV-2). The disease often presents with non-specific symptoms, including fever, and fatigue, usually associated with respiratory symptoms (eg., cough) and other systemic involvement. The primary strategy to prevent transmission and reduce the disease severity of the SARS-CoV-2 infection is through vaccination. However, the virus had shown significant changes and mutations that resulted in the emergence of different strains. Each strain varies in its virulence, disease severity, and the body's immune system response. Previous reports showed that the Omicron variant causes mild disease. Little is known about the effect of Omicron in patients with acute leukemia. We present three patients with acute leukemia who had an infection with the Omicron variant of the SARS-CoV-2 virus.

19.
Health Sci Rep ; 5(4): e692, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35702513

RESUMO

Introduction: Few studies have reported cardiac and hepatic iron overload in patients with kidney failure or end-stage renal disease and the current evidence regarding the prevalence is still scarce. To the best of the authors' knowledge and following an exhaustive search; no systematic review/meta-analysis has estimated the aggregated prevalence of cardiac and hepatic iron overload in this patient population. Aim: This review aims to estimate the prevalence of hepatic and/or cardiac iron overload in patients with kidney failure who are receiving hemodialysis, peritoneal dialysis, or underwent kidney transplants. Methods: A systematic review with meta-analysis will be conducted and reported in line with PRISMA guidelines. MEDLINE and Embase bibliographic databases will be searched using a comprehensive list of controlled vocabularies and keywords to identify relevant studies. All studies reporting the prevalence of hepatic and/or cardiac iron overload prevalence in patients with kidney failure will be considered. Risk of bias assessment for included studies will be conducted based on the study design. StataBE v17 and MetaXL v5.3 will be utilized to perform the meta-analysis. Discussion: The findings of this systematic review and analysis are expected to give information on the prevalence of iron overload among patients with kidney failure, which will optimize interventions and guide future research in this understudied field.

20.
Medicine (Baltimore) ; 101(23): e29236, 2022 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-35687772

RESUMO

INTRODUCTION: Although it usually involves extranodal sites such as the gastrointestinal tract in more than 80% of cases, mantle cell lymphoma is considered a rare cause of gastrointestinal bleeding, especially severe and life-threatening bleeding. PATIENT CONCERN: A 60-year-old man with peptic ulcer disease, who presented with severe upper gastrointestinal (GI) bleeding and large gastric ulcer. DIAGNOSIS: Primary gastric mantle cell lymphoma. INTERVENTIONS: He was treated conservatively with blood transfusion and started on Traneximic acid for 3 days. Then, the patient underwent urgent hemostatic radiotherapy. OUTCOMES: The patient became stable and kept in the hospital for monitoring with a definite diagnosis of stage IV Mantle cell lymphoma is made. CONCLUSION: Mantle cell lymphoma should be kept in mind when assessing massive upper GI bleeding, as an unusual cause of bleeding gastric ulcer, given that bleeding is an uncommon presenting feature of GI lymphoma.


Assuntos
Linfoma de Célula do Manto , Úlcera Péptica , Úlcera Gástrica , Adulto , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Humanos , Linfoma de Célula do Manto/complicações , Linfoma de Célula do Manto/diagnóstico , Linfoma de Célula do Manto/terapia , Masculino , Pessoa de Meia-Idade , Úlcera Péptica/complicações , Úlcera Péptica Hemorrágica/complicações , Úlcera Gástrica/complicações , Úlcera Gástrica/diagnóstico
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