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)

The relevant parameters of 71 consecutive pediatric admissions for pyogenic meningitis at the University of Ilorin Teaching Hospital, Ilorin, Nigeria, were analyzed to identify possible clinical and nonmicrobiologic investigative clues of disease etiology and mortality. Cerebrospinal fluid (CSF) was Gram-smear positive (GSP) in 41 (57.6%) of the 71 cases. Twenty-three (56.1%) had Gram-positive cocci (GPC), 14 (34.2%) Gram-negative bacilli (GNB) and three (7.3%) Gram-negative diplococci (GND). The respective mean ages of GPC, GNB and GND cases were 4.49 +/- 5.3, 3.06 +/- 4.8 and 4.47 +/-4.9 years. Streptococcus pneumoniae accounted for 22 (78.6%) of the 28 CSF isolates (p=0.00), Haemophilus influenzae for two (7.1%) cases and Neisseria meningitides in one (3.5%). Anemia was significantly more common among GSP cases (p=0.04), as was convulsion among those with GNB-positive smears (p=0.03) and a bulging fontanelle in the Gram-smear-negative category. Otherwise, the prevalence and resolution times of the other clinical parameters were comparable across the etiological categories. There were 30 deaths (42.3%) among which GNB-positive cases had significantly shorter stay (p=0.045). Mortality was significantly higher in those with an abnormal respiratory rhythm at admission (p=0.04), purulent/turbid CSF (p=0.03), CSF protein of >150 mg/dl (p=0.02) and glucose <1 mg/dl (p=0.047). Our findings highlight the inherent limitations of predicting the etiology of pediatric meningitides from the clinical parameters as well as the poor prognostic import of respiratory dysrhythmia and a profoundly deranged CSF protein and glucose. The etiological burden of GPC/S. pneumoniae in childhood meningitides in sub-Saharan Africa, the propensity of GNB/H. influenzae for quick fatality and the need for the relevant preventive vaccines are expounded in the discussion.
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PMID:Childhood pyogenic meningitis: clinical and investigative indicators of etiology and outcome. 1772 74

Antiphospholipid antibodies show a close association to a variety of infections. Recent data implicate that parvovirus B19 may be used as a model-system for studying the interaction of viral infection and the development of these autoantibodies. B19-related diseases commonly associated with the acute infection show flu-like symptoms, transient arthralgias, leukopenia and thrombocytopenia, and, in pregnant women, spontaneous abortion and hydrops fetalis. Hepatitis, myocarditis, meningitis, encephalitis, as well as pure red cell anemia may occur occasionally. In addition, parvovirus B19 infections have been frequently described as the cause or trigger of various forms of autoimmune diseases affecting all blood cell lines, joints, connective tissue, uvea, and large and small vessels. Molecular mimicry may be one major contribution to the appearance of autoimmune antibodies, for example, antiphospholipid and antineutrophil cytoplasmic antibodies as well as antinuclear antigens. These mechanisms implicated in the pathogenesis of parvovirus B19-triggered autoimmune diseases, especially focused on the development of antiphospholipid antibodies, will be discussed in this mini review.
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PMID:Are antiphospholipid antibodies an essential requirement for an effective immune response to infections? 1789 22

The aim of this study was to retrospectively evaluate the clinical and laboratory characteristics, complications and treatment oucomes of 151 brucellosis cases (age range: 15-79 years; 89 female), who were followed in our clinic between the period of January 2003-July 2005. Of them, 66.2% were diagnosed as acute, 23.8% as subacute and 9.9% as chronic brucellosis. Risk factors were detected as consumption of unpasteurized milk and diary products (80%), stock-breeding (14%) and risky profession such as veterinary, laboratory technician and butcher (3.3%). Most common complaints were arthralgia (87.4%), malaise (86%), fever (79.5%), sweating (78%), and waist pain (71%). In view of laboratory findings, increased erytrocyte sedimentation rate was detected in 61.6%, C-reactive protein positivity in 60%, lymphomonocytosis in 44.4% and anemia in 51.7% of them. Blood cultures were performed from 125 of the patients, and 64 (51.2%) of them yielded Brucella spp. The other specimens in which bacterial growth were detected in one of each, were bone marrow, sternoclavicular joint, psoas abscess, urine and pleural fluid. Standard tube agglutination (STA) test was found negative in 1.3% of patients who were culture positive, while it was positive at 1/160 titer in 20.5%, at 1/320 in 14%, at 1/640 in 14.6% and > or = 1/1280 in 49.7 percent. The most common complication was found as musculo-skeletal system involvement (30 spondylodiscitis, 15 sacroileitis, five peripheric arthritis, one tendinitis) with a rate of 33.7 percent. Other complications were nervous system involvement in 6% (two acute and seven chronic meningitis), genitourinary involvement in 5.3% (five epididymo-orchitis, two prostatitis, one with Brucella positive urine culture), peritonitis in 0.6% and skin involvement in 0.6 percent. Seven different therapy protocols were applied to the patients according to complications and case specialty, however doxycycline+rifampicin combination during six weeks was the most preferred one. Relapse and unresponsiveness to the therapy were detected in 8% and 2% of the cases, respectively. Gastrointestinal intolerance was found as the most common side effect. In conclusion, since brucellosis which is endemic in Turkey, displays diagnostic difficulties due to the various clinical presentations and leads to labor loss due to serious complications, it should be considered in the differential diagnosis of numerous diseases.
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PMID:[Brucellosis: retrospective evaluation of the clinical, laboratory and epidemiological features of 151 cases]. 1817 70

The aim of this study was to describe the epidemiological and clinical features of tuberculous meningitis in the province of Castellon, Spain. Retrospective analysis was done of all cases attended during the last 15 years. The following groups of variables were assessed: sociodemographic data, medical antecedents, clinical presentation, imaging study results, analyses, cerebrospinal fluid microbiology, treatment, and outcome. Twenty-nine cases were included. Median of age of patients was 34 years, and 17 (59%) were males. HIV infection was present in 15 cases (52%), fever, the most common symptom, occurred in 27 (93%), nuchal rigidity was noted in only 16 (55%), and syndrome of inappropriate ADH secretion (SIADH) occurred in 13 cases (45%). Chest radiograph was abnormal in 15 cases (52%). Anaemia was found in 22 subjects (76%), hypoalbuminaemia in 18 (62%) and hyponatraemia in 15 (52%). Macroscopic aspect of cerebrospinal fluid was normal in 17 cases (65%). Acid-fast stain was positive in only one case (4%). Two patients presented resistance to anti-tuberculous medications. Twelve patients (41%) died and eight (28%) presented sequelae. An association was found between death as outcome and presence of SIADH and lower level of serum cholesterol. Tuberculous meningitis is a rare and frequently difficult to recognize disease, which results in significant morbidity and mortality. We found an association of mortality with SIADH and lower level of serum cholesterol.
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PMID:Presentation and outcome of tuberculous meningitis in adults in the province of Castellon, Spain: a retrospective study. 1820 76

A very infrequent report of Listeria monocytogenes meningitis and multiple subtentorial abscesses (cerebellar, bulbar, and pontine in location), occurred in an immunocompetent man, and is described and discussed on the ground of the most recent literature evidences regarding the frequency, presentation, and outcome of this disease. The possibility to resort to combination linezolid therapy in patients who appear to be not responsive to first-line treatment of cerebral abscess of definite origin, and the appearance of anemia as an early untoward event of this novel oxazolidinone antibiotic, are also debated.
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PMID:Linezolid activity against disseminated Listeria monocytogenes meningitis and central nervous system abscesses: focus on early drug myelotoxicity. 1869 Sep 60

Community acquired pneumonia (CAP) is the sixth leading cause of death. Atypical pneumonia caused by Mycoplasma pneumoniae, Chlamydophila pneumoniae and Legionella pneumophila accounts for up to 40% of all cases of CAP. Atypical pneumonia due to Mycoplasma and Chlamydophila usually cause milder forms of pneumonia and are characterized by a more drawn out course of symptoms unlike other forms of pneumonia which can come on more quickly with more severe early symptoms. Mycoplasma pneumonia often affects younger people and may be associated with symptoms outside of the lungs (such as anemia and rashes), and neurological syndromes (such as meningitis, myelitis, and encephalitis). Severe forms of Mycoplasma pneumonia have been described in all age groups. Chlamydophila pneumonia occurs year round and accounts for 5-15% of all pneumonias. It is usually mild with a low mortality rate. In contrast, atypical pneumonia due to Legionella accounts for 2-6% of pneumonias and has a higher mortality rate. Elderly individuals, smokers, and people with chronic illnesses and weakened immune systems are at higher risk for this type of pneumonia. Contact with contaminated aerosol systems (like infected air conditioning systems) has also been associated with pneumonia due to Legionella. All of known macrolides, including azythromycin and clarythromycin, have excellent activity against the atypical respiratory pathogens. The are primarily bacteriostatic, by binding to the 50S subunit of the ribosome, they inhibit bacterial protein. The potential indications for treatment lower respiratory tract infections with macrolides were presented in this study.
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PMID:[Lower tract infections as potential indication for therapy with macrolides]. 1917 81

The conventional 8-day Integrated Management of Neonatal and Childhood Illness (IMNCI) training package poses several operational constraints, particularly due to its long duration. A 5-day training package was developed and administered in an interrupted mode of 3 days and 2 days duration with a break of 4 days in-between, in a district of Haryana state in northern India. Improvement in the knowledge and skills of 50 primary health care workers following the interrupted 5-day training was compared with that of 35 primary health care workers after the conventional 8-day IMNCI training package. The average score increased significantly (P < 0.05) from 46.3 to 74.6 in 8-day training and from 40.0 to 73.2 in 5-day training. Knowledge score improved for all health conditions, like anaemia, diarrhoea, immunization, malnutrition, malaria, meningitis and possible severe bacterial infection, and for breastfeeding in 8-day as well as in 5-day training. Average skills score for respiratory problems increased from 38 to 57 in 8-day training and from 41 to 91 in 5-day training. Corresponding increases in skill scores for diarrhoea assessment were from 28 to 67 and 48 to 75, and for breastfeeding assessment from 33 to 84 and 42 to 86 in 8-day and 5-day training, respectively. Average counselling skill score also rose from 42 to 89 in 8-day and from 37 to 70 in 5-day training. A direct cost saving of US$813 for a batch of 25 trainees and an indirect cost saving of 3 days per trainee and resource person makes the interrupted 5-day IMNCI training more cost-effective.
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PMID:The effect of interrupted 5-day training on Integrated Management of Neonatal and Childhood Illness on the knowledge and skills of primary health care workers. 1918 73

Various techniques have been described in the reconstruction of mastoidectomy cavity in an attempt to minimize or control the problems of persistent postoperative otorrhoea. We report the efficacy of deep temporalis fascia and its pedicled flap in 34 cases. Retrospective study method was used. There were 34 cases, 19 males and 13 females, the age ranged between 5 and 64 years, mean of 28 years. The clinical pathology included mastoiditis which was common to all the patients, others are middle ear polyp in 7, mastoid abscess 6, meningitis 4, lateral sinus thrombosis 3 and cholesteatoma 2. Comorbidity factors included diabetes mellitus in 2, moderate anaemia in 3 and septicaemia in 7. The procedures comprised of 18 modified radical mastoidectomy (MRM) and 8 atticoantrostomy (AA) with lining of the resulting cavity and tympanoplasty using a pedicled temporalis fascia flap; and 8 cortical mastoidectomy (CM) and tympanoplasty using a graft. The success rate in terms of control of otorrhoea was 55% and there was no case of postoperative wound infection, an improvement compared to an earlier report. In addition there was a reduction in terms of postoperative hospital stay to an average of 9 days. We found the technique simple to learn and needing minimal equipment, hence relevant to otolaryngologic practice in a resource--poor environment. In addition the deep temporalis fascia is an autologous tissue with no risk of immune rejection. We recommend that mastoid reconstruction with the temporalis fascia becomes a routine in mastoidectomy so as to achieve control of chronic discharging ear, particularly in the sub-Saharan Africa where this is still predominant.
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PMID:Deep temporalis fascia in tympanomastoid reconstruction. 1920 83

A retrospective chart review of the case notes of all children aged 6 months to 8 years presenting with fever and seizures to the University Hospital of the West Indies (UHWI) between January 2000 and December 2004 was conducted. Descriptive analyses were performed. Fifty-nine children (median age 1.58 years, range 0.58 to 6.83 years) were entered into the study. The main laboratory abnormalities were metabolic acidosis (23%), anaemia (10%), leukocytosis (35%) and hypomagnesaemia (3%). These were not significantly associated with meningitis or an underlying bacterial infection. There were no significant episodes of hyponatraemia, hypocalcaemia or hypoglycaemia. Meningitis was uncommon and occurred in only two (3.4%) children both younger than 16 months of age and who had other abnormal clinical signs. This study demonstrated that routine performance of haematological and biochemical investigations in children presenting with seizures and fever were of limited value. Lumbar punctures in children older than age 18 months with no other abnormal clinical signs were also found to be of low yield Current American Academy of Paediatrics (AAP) recommendations that serum electrolytes, calcium, phosphate, magnesium, complete blood count and blood glucose should not be performed routinely in a child with a first simple febrile seizure can be safely applied to this study population.
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PMID:Routine laboratory investigations in infants and children presenting with fever and seizures at the University Hospital of the West Indies. 1956 18

CINCA/NOMID is an autoinflammatory disorder characterized by the triad of neonatal onset of cutaneous symptoms, chronic meningitis, and recurrent fever and it presents with distinctive osteoarthropathy, synovitis mainly of the large joints and overgrowth of epimetaphyseal cartilage, particularly of the long bones. The cartilage overgrowth eventually causes osseous overgrowth and deformity that persists beyond skeletal maturity and leads to limb length discrepancy, joint contracture, and early degenerative arthropathy. Autoinflammation in CAPS/NOMID has been proven to derive from excessive release of interleukin-1 (IL-1). It has been well documented that the IL-1 receptor antagonist anakinra (Kineret(R)) helps mitigate systemic inflammation in the disorder. However, a general consensus has not been reached on its beneficial effect on osteoarthropathy. The case of a girl with CINCA/NOMID syndrome who showed dramatic improvement of osteoarthropathy after anakinra treatment is reported. A 4-year-old girl suffered at the age of 10 months from a generalized urticarial skin lesion with recurrent episodes of fever and growth disorder. Blood examination revealed persistent massive neutrophilia, anemia and intense acute phase response. She manifested knee joint swelling with limited ROM when she was 20 months old and was diagnosed as being CINCA/NOMID based on characteristic findings of radiograph despite negative CIAS1 mutation. Radiological examination demonstrated metaphyseal fraying and cupping and widening of the growth plate in the distal femur. MR imaging showed mottled gadolinium enhancement at the chondrosseous junction. Neither significant joint effusion nor synovitis was identified. At 2 years and 7 months of age, anakinra, 2 mg/kg/day given by regular daily subcutaneous injections, was started. A few days after the initiation of the treatment, her clinical symptoms and laboratory findings of active inflammation were promptly alleviated. She was not able to walk unaided prior to the treatment, but she walked independently 1 month after the treatment. Follow-up radiographs and MR imaging showed that growth plate widening and gadolinium enhancement at the chondrosseous junction were less conspicuous. Furthermore, longitudinal growth of the femur and tibia was identified during 20 months of observation.
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PMID:Effect of anakinra on arthropathy in CINCA/NOMID syndrome. 2023 Jun 45


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