Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

1. Chloramphenicol has been widely used in the treatment of serious infections including typhoid fever and meningitis. However, the drug is haemotoxic in man inducing firstly, a reversible, dose-dependent anaemia which develops during treatment, secondly, an often fatal aplastic anaemia with pancytopenia and acellular marrow, and thirdly, leukaemia. 2. We investigated the haemotoxicity of chloramphenicol succinate (CAPS) in female CD-1 mice in repeat dose studies, to compare the response with the reversible anaemia reported in man. Studies in male Wistar Hanover rats were also carried out. 3. CAPS was gavaged daily to mice at dose levels from 800 - 2000 mg/kg for seven days. Values were significantly reduced for reticulocytes at 1700 and 2000 mg/kg, and for erythrocytes (RBC), haematocrit (HCT), and haemoglobin (Hb) at 2000 mg/kg. Platelet and white blood cell (WBC) counts were unaffected. 4. Mice were dosed with CAPS at 1400 mg/kg for 10 days and sampled at 1, 4 and 15 days after the last dose. At day 1 post dosing, RBC, HCT and Hb values were significantly reduced, but returned to normal (or above normal) by day 4 or 15. 5. CAPS from 2000 - 4000 mg/kg was gavaged to rats daily for 19 days. Hb values were significantly lower at 3600 and 4000 mg/kg; reticulocytes were not reduced. WBC and platelet counts, in general, were unaffected. 6. Levels of apoptosis in marrow mononuclear cells were increased in CAPS-treated mice, but not in CAPS-treated rats. Serum biochemistry parameters, in general, showed few changes of toxicological significance. 7. We conclude that the administration of CAPS to CD-1 mice induced haematological changes showing close parallels with the chloramphenicol-induced reversible anaemia seen in man.
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PMID:Haemotoxicity of chloramphenicol succinate in the CD-1 mouse and Wistar Hanover rat. 1052 71

We prospectively identified cases of pneumococcal pneumonia and used stringent criteria to stratify them into bacteremic and nonbacteremic cases. Although patients were distributed among racial groups in proportion to all patients seen at this medical center, the proportion of African-Americans with bacteremic disease was significantly increased. All patients had at least 1 underlying condition predisposing to pneumococcal infection, and most had several. Although the mean number of predisposing factors was greater among bacteremic patients than nonbacteremic patients, only alcohol ingestion was significantly more common. Nearly one-third of patients had substantial anemia (hemoglobin < or = 10 g/dL) on admission, which may have predisposed to infection. In the case of other laboratory abnormalities, such as albumin, creatinine, and bilirubin, it was difficult to determine which abnormality might have predisposed to pneumococcal infection and which might have resulted from it. The radiologic appearance was varied. Airspace consolidation and air bronchogram on chest X-ray were highly associated with bacteremic disease, as was the presence of pleural effusion. Although the Pneumonia Patient Outcomes Research Team (PORT) risk score was a predictor of mortality, it did not help to predict the presence of bacteremia in an individual case. Most patients who died in the first week in hospital were bacteremic, and a high PORT risk score with bacteremia reliably predicted a high likelihood of a fatal outcome. Eleven patients had extrapulmonary disease with meningitis, empyema, and septic arthritis predominating; all of these patients were bacteremic. The antibiotic susceptibility of our strains correlated well with those that have been reported in the United States during the years of this study. The use of numerous antibiotics of different classes in many patients, especially those who were the most ill, precluded analysis of outcome based on antibiotic therapy. Only 17 patients had been vaccinated. Since nearly all patients had conditions for which pneumococcal vaccine is recommended and more than one-third had been hospitalized in the preceding 6 months, the low rate of vaccination can be regarded as a missed opportunity to administer a potentially beneficial vaccine.
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PMID:Bacteremic and nonbacteremic pneumococcal pneumonia. A prospective study. 1094 50

Sickle-cell disease (SCD) is associated with frequent and often severe infections as a result of immune function impairment and functional asplenia. Also, infection can trigger a vasoocclusive crisis. Pneumonococcal bacteremia and meningitis due to S. pneumoniae are often lethal and justify the penicillin prophylaxis, which has provided a dramatic decrease in early mortality bacterial pneumonia is common in patients younger than four years, with most cases being due to S. pneumoniae, H. influenzae, Mycoplasma pneumoniae, Chlamydia pneumoniae. Acute chest syndrome is both a difficult differential diagnosis and a common concomitant of bacterial pneumonia, because they are often intricated. Osteomyelitis is generally due to Salmonella, most often S. enteritidis. Multiple foci are common and treatment is difficult, with some patients developing chronic osteomyelitis with sequestration. Osteomyelitis is less frequent in developed countries and must been differentiated with bone infarction by use of bone scintigraphy. Parvovirus B19 infection causes acute erythroblastopenias. Malaria does not result in cerebral malaria, but can lead to severe anaemia or vasoocclusive crisis, and should therefore be effectively prevented. Antimicrobials are generally selected for efficacy against pneumococci (septicemia, meningitis), Salmonella (osteomyelitis, meningitis), and M. pneumoniae (pneumonia). Prophylactic therapy is of paramount importance and relies on long-term or lifelong penicillin therapy started at three months of age and no closely-spaced immunizations, most notably against peumococci, hepatitis B virus, S. typhi and H. influenzae. Resistant pneumococcal strains have not been reported to cause prophylactic treatment failures. New conjugated pneumococcal vaccines are effective in protecting very young infants and should therefore be used in sickle cell patients.
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PMID:[Severe infections in children with sickle cell disease: clinical aspects and prevention]. 1158 20

West Nile (WN) virus is endemic in Israel. The last reported outbreak had occurred in 1981. From August to October 2000, a large-scale epidemic of WN fever occurred in Israel; 417 cases were confirmed, with 326 hospitalizations. The main clinical presentations were encephalitis (57.9%), febrile disease (24.4%), and meningitis (15.9%). Within the study group, 33 (14.1%) hospitalized patients died. Mortality was higher among patients >70 years (29.3%). On multivariate regressional analysis, independent predictors of death were age >70 years (odds ratio [OR] 7.7), change in level of consciousness (OR 9.0), and anemia (OR 2.7). In contrast to prior reports, WN fever appears to be a severe illness with high rate of central nervous system involvement and a particularly grim outcome in the elderly.
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PMID:Clinical characteristics of the West Nile fever outbreak, Israel, 2000. 1158 31

A study of 165 maternal deaths at the University of Benin Teaching Hospital, Benin City over a 13-year period (from April 1, 1973 to December 31, 1985) is presented. All patients' case files were recovered from the central records library and each case file was carefully analyzed. With a total delivery of 29,324, the maternal mortality rate, inclusive of death from abortion, was 563/100,000 deliveries. There was a general increase in maternal mortality rate with age and this became alarming from 35 years. There was an equally high mortality rate among teenagers, mainly accounted for by illegally induced abortion. Indeed, abortion accounted for 72% of teenage mortality. A statistically significant association between maternal deaths and parity (p, 0.001) was observed. The most important causes of death were hemorrhage with a total of 26 out of 42 deaths, sepsis, and abortion. Other important causes were hypertensive disorders such as eclampsia, liver and respiratory disease, anemia, trophoblastic diseases, caesarean sections, and acute renal failure. Additional causes of maternal deaths include tetanus, sickle-cell disease, anesthetic death, drug reactions, pulmonary embolism, acute pyogenic meningitis, typhoid disease, urinary bladder tumor, acute lymphoblastic leukemia, and carcinoma of the breast thyroid. Factors identified with these deaths included such health services factors as deficient medical treatment of obstetric complications, lack of adequate personnel at primary and secondary health care levels, lack of access to maternal health services, and consequently, lack of prenatal care. Extreme reproductive age, grandmultiparity, and unwanted pregnancies, especially among teenagers, also contributed to maternal deaths. Overhaul of the maternal health care services at national level to include organization of such programs as provision of adequate blood transfusion facilities, prompt treatment of infections, early referrals of patients at risk to secondary and tertiary health centers, intensified family planning programs, and liberalization of abortion laws are recommended in order to reduce the unacceptably high maternal mortality.
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PMID:Maternal mortality at the University of Benin Teaching Hospital Benin City, Nigeria. 1217 71

An 84-year-old woman was admitted because of anemia and marked leukocytosis. The white cell count was 237,660/microliter, with 93% abnormal lymphoid cells. The cells had abundant cytoplasm and prominent nucleoli. They were positive for CD 5, 19, 20, 22, 23, HLA-DR, IgM, IgD and kappa chain. Thus, a diagnosis of B-cell PLL was made. Chromosome analysis disclosed a complex karyotypic abnormality. Massive splenomegaly was detected by abdominal computed tomography. No external or internal lymphadenopathy was found. The patient was intermittently treated with etoposide. Although the white cell counts had been suppressed, she refused to take the drug because of side effects. When the white cell count exceeded more than 200,000/microliter again, she developed severe headache, diplopia, nausea, and vomiting. A lumber puncture disclosed infiltration of the prolymphocytes in the cerebrospinal fluid. Though intrathecal chemotherapy alleviated the symptoms and the leukemic cells disappeared, the effects were transient. When the therapy was withheld because of bone marrow suppression, the meningitis recurred and the symptoms progressed. The patient died six months after the initial presentation.
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PMID:[Leukemic meningitis in B-cell prolymphocytic leukemia]. 1222 29

Railway, postal, and telecommunications companies in Uganda are experiencing a manpower crisis due to AIDS. Uganda's Railway Corporation reports for 1991 a loss of 10% of staff due to AIDS. AIDS has also contributed to a high turnover of staff (15%/year). AIDS has affected all levels of employment in the industry and there is concern about the shortage of skilled staff. Already there are staff shortages in the marine division where 132 out of 252 posts are unfilled. High absenteeism rates are also associated with AIDS. Hospital bills have risen. In the Uganda Post and Telecommunications Corporation, it is reported that 8% of the 3000 work force carry the HIV infection and 94 staff have died of AIDS between May 1991 and March 31, 1992. 238 have tested positive for HIV. The company has begun an AIDS awareness and sensitization campaign through unions and its clinic. Major mortality groups in Uganda are maria (14%), AIDS (9%), diarrhea (8.7%), pneumonia (7.9%), anemia (7.3%), and meningitis (6%) as reported in a survey of 20 hospitals and 5439 cases. Condoms are not readily accepted. Complaints arose when a firm imported condoms in Kabarole district in western Uganda when AIDS was more prevalent elsewhere. The public and public officials are against introducing condoms. Education and information should be emphasized. Objections are based on sexual practices which are abrasive and may rupture the condom. Women object due to fears of condoms falling off and exposure to the viruses in condoms. People are reckless even when family members have died of AIDS. Sexual behavior does not appear to have changed. It is suggested that condom distribution methods should change. IEC may be effective if properly implemented. Research by the International Population Services has shown that 100% acceptance is possible if the price is cheap and the product fits. A Malaysian manufactured condom seems to be appropriate for fit and is packed in quantities of 5 because 5 is the average "times per night."
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PMID:AIDS and the company: 3. Uganda's parastatals quantify the manpower losses, while condom sales run into criticism. 1228 4

Fever is often an indication of a serious illness in children. In areas endemic to malaria, hospital workers should check a febrile child for malaria parasites. Children with a fever associated with meningitis or malaria need immediate attention. To diagnose meningitis: microscopic examination of cerebrospinal fluid obtained by lumbar puncture is the only reliable method. If a febrile child also has a stiff neck, health workers should immediately administer antibiotic treatment without waiting for the results of the lumbar puncture. If available and in epidemic situations, oily chloramphenicol may be administered, since it is effective in a single dose. Treatment with other antibiotics should last for 10 days in children and 14-21 days for young infants. To diagnose malaria in endemic areas: laboratory technicians should examine thick and thin blood films of sick children with fever. Health workers must consider as medical emergencies children who have a slide positive for malaria parasites plus severe anemia, hypoglycemia, deep rapid breathing, any indication of kidney malfunction or failure, or altered consciousness. They should begin antimalarial treatment with quinine, the drug of choice for severe and complicated malaria. In cases of convulsions lasting longer than 5 minutes, health workers should administer anticonvulsants and take actions to prevent aspiration pneumonia. If the fever persists for 14 days or if the child does not emerge from unconsciousness and someone in the family has active tuberculosis, health workers should consider tuberculous meningitis. If a child with malaria has low hemoglobin levels (5 g/dl) and many malaria parasites in the blood and is in heart failure, a blood transfusion (15-20 ml/kg whole blood over 4 hours) and infusion of 1 mg/kg fursemide (to prevent cardiac failure) are needed. If the preceding case has pulmonary edema, a single dose of fursemide at the same dosage is needed to prevent overloading of the circulation. Health workers should closely monitor that intravenous fluids not exacerbate brain swelling.
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PMID:Managing meningitis and severe malaria. 1229 72

The archives of the blood bank of the hospital of Dr. Louis Manual Morillo King, in the city of La Vega, Dominican Republic, were reviewed to identify all children who had been given blood transfusion during the period of July 1983 to July 1987 in order to identify HIV and the surface antigen of hepatitis B (HBsAg). Those who were released were visited in their homes for administration of HIV and hepatitis tests. Positive tests were confirmed by another test (AUSYME MONOCLONAL and Western Blot). Mothers were also tested to detect vertical transmission. 256 patients had been transfused, of whom 61 died. 80 of the 195 remaining patients could not be located. Of the 115 patients located, 52 had died in their homes after release from the hospital. Thus, the sample comprised 63 patients: 36 were 0-3 years old, 21 were 4-7 years old, and 6 were 8-11 years old. 50 lived in rural and 13 in urban areas. 56 patients had one transfusion and 4 had two transfusions. 28 patients had transfusion for anemia, 19 for malnutrition, 7 for sepsis, 6 for various reasons (meningitis, pleuritis, pneumonia), and 3 for sickle cell disease. 47 patients had been transfused at the hospital using the blood bank, 13 used blood from relatives, and 3 received blood from friends. Out of the 63 samples processed, 2 patients presented seropositivity for hepatitis B, while none were seropositive for HIV. Among the 2 patients who were seropositive for hepatitis B, the mother of one of them was also seropositive.
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PMID:[Human immunodeficiency virus and hepatitis B virus in children transfused in the Dr. Luis Manuel Morillo King Hospital]. 1234 60

Tick-borne encephalitis (TBE) is the major European arbovirosis. Man is often infected by the tick bite; laboratory infections as well as infections after consumption of nonpasteurized milk have occasionally been reported. TBE typically takes a biphasic course. After an incubation period (7-14 days usually), the prodromal symptoms occur. The first stage of the disease lasts 1-8 days. After an afebrile asymptomatic interval of approximately 1-week the second stage develops, in which TBE may manifest as isolated meningitis, meningoencephalitis, meningoencephalomyelitis and/or radiculitis. The mortality rate is 0-3.3%. There is high frequency of sequelae. Patients who have suffered from a TBE infection are immune for the rest of their lives. At present there is no effective antiviral therapy and management is strictly supportive. Active immunization against TBE is recommended for all subjects living in and travelling to areas of risk. Passive immunization is recommended only within 48 hours after a tick bite. The authors present the case report of 75-years old female subject, who suffered from the uncommon severe clinical course of TBE--with the development of consciousness impairment, tetraplegia, and dyspnoea (demanding ventilatory support). Her state was complicated by the transient left side faciobrachial motor Jackson's convulsions, blood pressure instability, heart arrhythmia, respiratory infection, anemia, and by the development of critical illness neuropathy. Although she made slow progress during treatment, she died on the 114th day because of suspected aspiration.
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PMID:An uncommon severe clinical course of European tick-borne encephalitis. 1257 99


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