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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with spinal cord injury (SCI) have a high incidence of anemia. Intact erythropoietin (EPO) production is essential to the maintenance of erythrocyte mass and prevention and correction of anemia. However, the effect of chronic SCI on EPO production remains unclear. We measured plasma EPO concentration in 83 men with longstanding SCI and a group of normal able-bodied individuals. The SCI patients showed a significant reduction in hematocrit, a high prevalence of anemia, and an increased plasma EPO concentration. Active smokers showed a significantly higher hematocrit and lower EPO concentration than nonsmokers. No significant difference was found in hematocrit or EPO between individuals with paraplegia and those with quadriplegia. A negative correlation was found between EPO and hematocrit in SCI patients lacking significant lung disease. Thus, in the absence of renal insufficiency, EPO response to anemia is qualitatively preserved in SCI patients and is largely independent of the level of injury.
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PMID:Erythropoietin profile in spinal cord injured patients. 842 May 23

Patients with chronic renal failure (CRF) and haemodialysis treatment usually have a reduced CO transfer factor. The aim of this study was to evaluate the effects of alveolar wall fibrosis and of anaemia on gas diffusion in the lungs. The NO and CO transfer factors of the lung (TLNO and TLCO) were measured, simultaneously, in 15 patients haemodialysed three times a week for 1-10 yrs. Assuming that NO is highly reactive with blood, Tlno is thus directly proportional to the membrane diffusion factor (DmCO). The lung capillary blood volume (Vc) was derived from the set of the two transfer equations. Transfer factors were measured between haemodialysis sessions. All patients but one were anaemic, with haemoglobin concentrations ranging 61-151 g.l-1. All had decreased Vc, and a decreased DmCO was observed in 14 patients. However, after correction for the anaemia, Vc values were normal with the exception of three patients. The percentage decrease in DmCO with respect to normal was correlated with the time elapsed since the first haemodialysis. These results support the idea of a progressive development of haemodialysis-induced chronic lung disease, that may be related to a mechanism of complement activation by a bio-incompatible membrane (Cuprophane). Accordingly, patients with compromised cardiopulmonary functions should be dialysed with a bio-compatible membrane.
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PMID:Membrane diffusion of the lungs in patients with chronic renal failure. 844 94

Acute normovolemic hemodilution (ANH) is a common blood conservation strategy in elective surgical procedures. Moderate ANH is safe in patients > 60 years of age; ANH is not recommended for patients who have coronary artery disease, significant anemia, renal disease, severe hepatic disease, pulmonary emphysema, or obstructive lung disease. Preservation of oxygen delivery during ANH depends on the maintenance of normovolemia to avoid decompensation and falling cardiac output. Preoperative autologous donation (PAD) as a blood conservation strategy has the advantage of protecting the patient from risks associated with allogenic transfusion, but it is expensive and time consuming. No protocols have established a preference for either ANH or PAD; an early study suggested that ANH is less expensive and more effectively preserves blood components, but other researchers warn that the methodology for ANH remains unresolved.
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PMID:Alternatives to allogeneic blood use in surgery: acute normovolemic hemodilution and preoperative autologous donation. 854 48

Sickle cell disease is the most common inherited disease in the African American population. Multiorgan pathologic features with a predilection for thoracic organs predominate. Acute cardiopulmonary diseases include acute chest syndrome, pneumonia, and left ventricular failure. Cardiomegaly, pleural effusions, pulmonary consolidation, pulmonary edema on chest radiographs, and ground-glass opacities on computed tomographs are characteristic. Chronic changes include sickle cell lung disease with lung fibrosis, pulmonary arterial hypertension, hyperkinetic circulation related to severe anemia, and thoracic skeletal abnormalities; the latter are H-shaped vertebrae, rib infarction, and extramedullary hematopoesis.
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PMID:Thoracic manifestations of sickle cell disease. 955 90

Newborn infants were studied longitudinally to assess their serum copper (Cu) and ceruloplasmin (CLP) status. All infants were born between July 1, 1991, and June 30, 1992, at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. Preterm infants (PI) of a maximum gestational age 36 weeks were divided into sick (A) and stable (B) cohorts, beginning with 30 in each of the 2 groups. The groups were matched with respect to gender, gestational age, birth weight, Apgar scores, and socioeconomic class. Cu levels were also determined in 30 stable, full-term infants. Sick PIs had significantly lower mean Cu and CLP levels at birth, while Cu level was significantly increased by 4 weeks in cohort A and approached levels of the stable PIs. With regard to CLP, catch-up of levels was delayed until 8 weeks, and a triphasic pattern of linear rise in Cu and CLP was discernible by 24 weeks. Sick PIs had mean serum CLP levels of 0.5 mcmol/dl, 5.9, 15.2, 17.3, 21.2, 25.1, and 23.7 mcmol/dl at birth, 4, 8, 12, 20, and 24 weeks, respectively, and were similar from 8 weeks in cohort B. Generally, CLP paralled serum Cu levels. Cu levels in the full-term infant (FI) were higher at birth and became similar to PIs from 12 weeks, but were overtaken by levels in PI at 24 weeks. FIs' Cu was significantly elevated by 8 weeks. Decreased growth rate, nonpitting pedal edema, exaggerated physiological anemia, and chronic lung disease were morbidities noted in association with very low Cu and CLP levels. Newborns with serum Cu and CLP higher than 0.2 mcmol/ml and 2.3 mcmol/dl, respectively, did not have a poor outcome.
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PMID:Serial copper and ceruloplasmin levels in African newborns with emphasis on the sick and stable preterm infant, and their antioxidant capacities. 980 71

A case of 68 years old women suffering from chronic anemia, myelodysplastic syndrome and treated with progestogen due to endometrial hypertrophy is presented. Initially she was admitted to a regional hospital because of progressive weakness and exertional dyspnea. Three months earlier she reported an episode of acute dyspnea and chest pain. On the basis of clinical symptoms and perfusion lung scintigraphy pulmonary embolism (PE) was diagnosed. Patient received i.v. heparin which was changed to s.c. nadroparine subcutaneously. Platelet count dropped to 55,000'/ml on fifth day of treatment from initial level of about 200,000'/ml. Heparin induced thrombocytopenia was diagnosed, heparin was stopped and ticlopidine was recommended. After 3 weeks symptoms suggesting recurrent PE were observed. The patient was transferred to National Tuberculosis and Lung Diseases Research Institute. Recombinant hirudine (Refludan) was administrated (bolus 0.4 mg/kg and initial dose of infusion 0.1 mg/kg/h) overlapping with acenocoumarol from second day. Dose of r-hirudine was adjusted to achieve APTT prolongation 1.5 to 2.5 times of mid-normal range. During treatment with r-hirudine no bleeding and new thromboembolic complications occurred. Platelets count remained within normal range. After 14 days clinical improvement was observed, though symptoms of right ventricular overload and hypoxemia were still present after 6 months of treatment with oral anticoagulants suggesting chronic thromboembolic pulmonary hypertension.
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PMID:[Recombinant hirudine in suspected heparin induced thrombocytopenia--case report of pulmonary embolism]. 1143 91

To establish a practical weight management program for mariners in the Japan Maritime Self-Defense Force (JMSDF) Fleet Escort Force, the relationship between morbidity and body mass index (BMI) was studied. To estimate morbidity, 10 medical problems were used as indices (hyperlipidemia, hyperuricemia, diabetes mellitus, lung disease, heart disease, upper gastrointestinal tract disease, hypertension, renal disease, liver disease, and anemia). A curvilinear relationship was found between morbidity and BMI, in which a BMI of 17.5 was associated with the lowest morbidity. This curvilinear pattern was more complex than a curve reported previously for Japanese civilians. Using the present curve and aiming for a BMI of 17.5 will help in the design and implementation of a practical management program for health promotion in the JMSDF.
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PMID:Relationship between morbidity and body mass index of mariners in the Japan Maritime Self-Defense Force Fleet Escort Force. 1151 16

Pulmonary involvement due to disseminated non Hodgkin lymphoma (LNH), is an unusual cause of lung disease in AIDS patients. We report a 38 years old male patient, with advanced AIDS, who, in the course of three weeks, developed cough, dyspnea and fever. The chest X ray film showed diffuse thickening of the peribronchovascular connective tissue with possible mediastinal lymph node enlargement. The evolution was unfavorable with hypoxemia, severe anemia, liver damage and elevated levels of lactic dehydrogenase. The presumptive initial diagnoses were Pneumocystis carinii pneumonia, pulmonary tuberculosis with hematogenous dissemination and Kaposi sarcoma. Definitive diagnosis was made through a transbronchial biopsy performed the day before his death. The pathological and inmunohistochemical report demonstrated a highly aggressive lymphoma (lymphoblastic, B precursor). This finding was confirmed by autopsy that revealed multiple organ involvement.
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PMID:[Pulmonary involvement due to disseminated non Hodgkin lymphoma in one patient with AIDS]. 1183 85

The seminar on maternal morbidity and mortality in the Philippines held in 1991 is described. The objective of the meeting was to define the status of women's health in the country and to prepare for a more comprehensive and developed implementation of local reproductive health services. The seminar honored the International Day of Action for Women's Health. Maternal mortality statistics show a rate of 1.1.1000 live births since 1988 vs. 2.1/1000 live births in 1980. Maternal mortality is greater among young 1st time mothers, among those with 5 children, and among those 40 years regardless of the number of children. Obstetric deaths account for 85% of all maternal deaths. The common causes in 1985-89 were hemorrhage, infection, and hypertensive disorders. Pulmonary disease and acute hepatitis account for indirect obstetric mortality. The prior period from 1984 to 1985 in Manila showed the leading causes to be puerpural sepsis, septic induced abortion, postpartum hemorrhage, and eclampsia. In Manila 33% deliver at home. 65% of hospital emergency cases involve women without prenatal care, and 1 out of 4 are dying upon admission and 1 out of 5 die within 5-6 hours. 58% died within 2 days after admission. 80% of these deaths were preventable. Lack of health education and inadequate diet due to poverty account for a major predisposing role. Confounding factors are anemia, tuberculosis, and parasitism. Broad risk factors are the inadequacy of health services and socioeconomic conditions. Proposals to reduce maternal mortality by 50% include focusing health programs on both mother and child, improving knowledge about prenatal care, improving the quality of prenatal care, and improving the quality of family planning (FP) services. Medical institutions need to maintain adequate supplies of equipment and supplies. Statistics and research are needed. Contraception for the health of the child was proposed as the appropriate tool for acceptance of FP. Competition for funds was a problem. Problems were also identified as the power imbalance between the sexes. High risk screening was recommended at the local level by the health worker. Workshops were formed and issues were identified, recommendations made, activities described, and the government and nongovernmental responses given.
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PMID:The perils of motherhood. 1228 38

Chronic arsenic toxicity due to drinking arsenic-contaminated water has been one of the worst environmental health hazards affecting eight districts of West Bengal since the early eighties. Detailed clinical examination and investigation of 248 such patients revealed protean clinical manifestations of such toxicity. Over and above hyperpigmentation and keratosis, weakness, anaemia, burning sensation of eyes, solid swelling of legs, liver fibrosis, chronic lung disease, gangrene of toes, neuropathy, and skin cancer are some of the other manifestations. A cross-sectional survey involving 7683 participants of all ages was conducted in an arsenic-affected region between April 1995 and March 1996. Out of a population of 7683 surveyed, 3467 and 4216 people consumed water containing As below and above 0.05 mg/L, respectively. Except pain abdomen the prevalence of all other clinical manifestations tested (e.g., pigmentation, keratosis, hepatomegaly, weakness, nausea, lung disease and neuropathy) were found to be significantly higher in As exposed people (water As > 0.05 mg/L) compared to control population (water As level < 0.05 mg/L). The prevalence of pigmentation and keratosis, hepatomegaly, chronic respiratory disease and weakness rose significantly with increasing arsenic concentrations in drinking water. The respiratory effects were most pronounced in individuals with high arsenic water concentrations who also had skin lesion. Therapy with chelating agent DMSA was not found to be superior to placebo effect. However, therapy with DMPS caused significant improvement of clinical condition of chronic arsenicosis patients as evidenced by significant reduction of total clinical scores from 8.90 +/- 2.84 to 3.27 +/- 1.73; p < 0.0001. Efficacy of specific chelation therapy for patients suffering from chronic As toxicity has further need to be fully substantiated. However, supportive treatment could help in reducing many symptoms of the patients. Treatment in hospital with good nutritious diet has been found to reduce symptom score in a subset of placebo treated patients in West Bengal during the course of DMSA and DMPS trial. People should be advised to stop drinking As contaminated water or exposure to As from any other source. The various clinical manifestations should be treated symptomatically.
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PMID:Chronic arsenic toxicity: clinical features, epidemiology, and treatment: experience in West Bengal. 1263 24


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