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

Both aluminum and its salts are commonly used by people. Aluminum salts are components of drugs. Such a widespread use of aluminum was enhanced by the belief that it is not toxic and is quickly excreted from the body with urine. It turned out, however, that this element has a negative impact on human health. Post-dialysis encephalopathy of patients with kidney malfunctioning was ascribed to the presence of aluminum in dialysis fluid. Aluminum cumulating in brain tissue is claimed to play a role in developing neurological disorders. This element affects bones as well as it causes disturbances in phosphorus and calcium levels, which is demonstrated chiefly by osteomalatia. Aluminium accumulation in the liver leads to cholestasis. This element causes numerous changes in peripheral blood and hemogenic system. It also causes normo- or microcytary anemia as it disturbs maturing of erythroblastic series cells and heme biosynthesis; it decreases osmotic resistance of red blood cells. Aluminum inhibits defensive mechanisms connected with white blood cells and macrophages. A number of processes, namely aluminum's hemolytic activity, blood cells' shorter lifetime or disturbed erythropoiesis process, are responsible for hematological changes.
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PMID:Aluminum hemotoxicity mechanisms. 1614 22

Nuchal cord, or cord around the neck of an infant at birth, is a common finding that has implications for labor, management at birth, and subsequent neonatal status. A nuchal cord occurs in 20% to 30% of births. All obstetric providers need to learn management techniques to handle the birth of an infant with a nuchal cord. Management of a nuchal cord can vary from clamping the cord immediately after the birth of the head and before the shoulders to not clamping at all, depending on the provider's learned practices. Evidence for specific management techniques is lacking. Cutting the umbilical cord before birth is an intervention that has been associated with hypovolemia, anemia, shock, hypoxic-ischemic encephalopathy, and cerebral palsy. This article proposes use of the somersault maneuver followed by delayed cord clamping for management of nuchal cord at birth and presents a new rationale based on the available current evidence.
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PMID:Nuchal cord management and nurse-midwifery practice. 1615 63

Establishing consistency between cerebral palsy registries in reporting of new cases enables more effective collaboration in terms of researching predisposing factors. To identify antenatal and intrapartum risk factors for cerebral palsy in the Estonian population, we undertook a matched case-control study of 153 children with cerebral palsy, ascertained from a population-based survey. One hundred two maternal, antenatal, and intrapartum variables were initially retrieved from medical records. Main outcome measures were the odds ratio estimates of relative risk of cerebral palsy. As a result of the study, and considering the whole spectrum of severity, the relevant risk factors during pregnancy were bleeding after 20 weeks, anemia in the second half of pregnancy, pregnancy-induced hypertension in the second half of pregnancy, and preeclampsia. The most important intrapartum factors were premature birth, placental abruption, an acute hypoxic event during delivery, and any fetal presentation other than vertex. Predisposing factors related to neonatal condition were an Apgar score < or = 7 at the first and fifth minutes of life, hypoxic-ischemic encephalopathy, and assisted ventilation. Our findings suggest that intrapartum factors, including those hypothetically realized through hypoxic-ischemic pathways, are not of low importance in the etiology of cerebral palsy.
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PMID:Ante- and perinatal factors for cerebral palsy: case-control study in Estonia. 1622 10

Our aim is to study the effect of improvement in anemia on event-related potentials (ERPs; P300) as markers of cognitive dysfunction in predialysis and dialysis patients of chronic kidney disease (CKD). Thirty anemic patients of CKD (hemoglobin [Hb] < 9 g%), 15 in the predialysis group (Group A), and 15 patients on biweekly hemodialysis (Group B) were recruited for the study. Patients of uremic encephalopathy, dyselectrolytemia, and those with hearing problems were excluded. Both groups were given recombinant human erythropoietin (rhuEPO) 100 IU/kg biweekly for 6 weeks by the subcutaneous route. No intervention was performed in the third control group (Group C), which consisted of 30 normal healthy volunteers. The improvement in Hb was assessed every 2 weeks, and the amplitude and latency of the P300 component of the ERPs were studied before initiating treatment and after 6 weeks of rhuEPO administration. There was a significant increase in Hb in both the study groups without any significant alteration in kidney functions. A significant reduction in P300 latency was noted in both the study groups after intervention. Similarly, the amplitude of P300 also increased in both study groups, but attained statistical significance for the dialysis group only. No significant changes were observed in the control group. Administration of EPO in patients of anemia with CKD resulted in a significant improvement in the electrophysiological markers of cognitive function in the form of increased amplitudes and decreased latencies of P300 in both predialysis and dialysis patients.
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PMID:Effect of improvement in anemia on electroneurophysiological markers (P300) of cognitive dysfunction in chronic kidney disease. 1680 88

We have studied the course of early neonatal period in the newborns with delayed intrauterine development syndrome (DIUDS). Clinical neurological and electroencephalographic (EEG) studies of 208 neonates with DIUDS have been performed. Control group consisted of 234 newborns with normal height-weight values. Newborns with DIUDS exhibited hypoxy-ischemic encephalopathy with prevailing general cerebral symptoms in 64%; respiratory distress syndrome in 33.1%, partial pulmonary atelectasis--12.9%, and intrauterine infection--8.1%. Most frequently hypoxy-ischemic encephalopathy was registered in premature babies with DIUDS--78.2% (18% in control group), in cases with history of mother's extragenital pathology--in 72.4% (9% in control group), in 66% in cases with pre-eclampsia (4% in control group), and in 50% in both cases of perinatal infection and anemia of pregnancy (23% and 10% in control group, respectfully). Clinical-neurological and electro-encephalographic data of the newborns is in correlation with severity of DIUDS. Results of the electro-encephalographic study can be useful in assessment of degree of the central neural system disorder and evaluation of its functional condition.
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PMID:[Perinatal results of delayed intrauterine development of fetus]. 1705 90

Cerebral malaria is the most common cause of non-traumatic encephalopathy in the world. The mainstay of therapy is either quinine or artemisinin, both of which are effective antimalarials. The clinical picture of cerebral malaria may persist or even become worse in spite of the clearance of parasites from blood. The death rate is unacceptably high even with effective antimalarials in tertiary care hospitals. The mortality increases in presence of multi organ failure (renal failure, jaundice, respiratory distress, severe anaemia, lactic acidosis, etc.). The pathogenesis of cerebral malaria is multifactorial and includes clogging, sequestration, rosette formation, release of cytokines, cerebral oedema, increased intracranial hypertension, etc. Attempts are made to use adjuvant therapy which will act through alternate mechanisms and address one or more of the pathogenetic processes. In this review, we have discussed the role of corticosteroids, pentoxifylline, desferrioxamine, mannitol and newer agents in the treatment of cerebral malaria. Though the literature on adjuvant therapy in cerebral malaria is large enough, there are a number of shortcomings in the clinical trials, many being open and non randomized or of very small sample size. Further research is of utmost importance through large multicentric, double-blind controlled trials to show the efficacy of any of these drugs.
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PMID:Adjuvant therapy in cerebral malaria. 1733 64

To study the pre- and intraoperative causes of hemodynamic disorders at the basic stages of liver transplantation in adult recipients, case histories and anesthesia protocols were analyzed in detail in 15 recipients of the cadaveric liver (Group 1) and 60 recipients of a liver portion taken from a living relative donor (Group 2). The patients' preoperative status, the etiology of the disease, the pattern and scope of preoperative preparation and examination, the cause of anesthesia, the volume, pattern, and rate of infusion were studied. Particular emphasis was placed on the presence of pathophysiological prerequisites and various intraoperative factors, which are causes of hemodynamic disorders. Orthotopic transplantation of the liver was performed under generalized balanced anesthesia whose major components were the inhalational anesthetics isoflurane and sevoflurane (89.3%) or total intravenous anesthesia based on neuroleptic anesthetics (10.7%). The main causes of hemodynamic disorders were the patients' severe baseline condition, anemia, ascitis, intoxication, encephalopathy, and the specific features of a surgical intervention, blood loss, heavy plasma and perspiration losses, water-electrolyte balance impairments, vein-vein shunt and reperfusion syndrome. Operations of extraordinary duration (longer than 15-20 hours) required higher plasma compensation volumes (36-52 ml/kg). Severest hemodynamic disorders were observed in patients admitted to hospital for emergency transplantation of the cadaveric liver. These patients who are to undergo transplantation are outside hospital in most cases, which is why any operation should be regarded in them as an emergency one made in patients who are in a very severe state (ASA IV-VE).
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PMID:[Hemodynamic disorders in liver transplantation and their correction]. 1718 68

In spite of a decrease of the prevalence of hepato-splenic schistosomiasis thanks to mass-treatment with Praziquentel from December 1994 till now (CNM - MSF - WHO - Health Provincial Director) of target-populations in Kratie Province, severe cases of portal hypertension are not exceptional (digestive bleedings, after rupture of oesophageal varices). Out of 106 cases of portal hypertension: alI patients have had clinical survey biological tests (liver function, haematology and serology). Most of them had ultrasonography (Aloka 55,500 Sound 3.5 MHz). Nearly half of the group of 153 patients has never had bleedings. More than 45 were not eligible for surgery for different reasons: severe anaemia (few possibilities for massive transfusion in Cambodia), serology (S. mekongi) + but also hepatitis B or C +, hepatic biological exams (hepatic insufficiency). So we decided for eleven of them to use a surgical decompression procedure in order to decrease portal hypertension and the porto-systemic gradient. After defining portal hypertension, specific clinical features of portal hypertension (secondary to Schistosomiasis) the authors report eleven cases who were operated on (2000-2002): 4 mesenterico-cave shunt with interposition of a graft (Drapanas' procedure), 1 operation of HASSAB (after splenectomy), 6 proximal spleno-renal diversion (after splenectomy). After studying the results of the eleven patients, discussion with other surgical procedures, particularly endoscopic procedures is developed. The follow-up of these patients during at least five years is mandatory to give guidelines for post-systemic shunts to prevent rebleeding (near other methods). Treated too late, schistosomiasis has no benefit from drugs (Praziquentel). After a mean period of forty two months, the following results are: mortality: one case (10 days after operation): hepatic insufficiency (group Child B/C). morbidity: one occlusion of the small intestine, after 4 months (debridment), operated at the Provincial hospital of Kratie (case no1). Ten patients resume work, family and social life between Kratie and Sambor in 2002. No rebleeding. No encephalopathy.
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PMID:[Place of surgery in the prevention of recurrences of digestive haemorrhages at the patients presenting a portal hypertension due to Schistosoma mekongi]. 1725 55

Over a four-year period (1987-1990), 28 cases of fat embolism syndome (FES) were prospectively evaluated for clinical, hematological and biochemical manifestations and prognostication. In a total of 2,112 patients admitted to the Intensive Care Unit (ICU), 1.3% were diagnosed as having FES which was also seen in 2.6% of the patients with polytrauma. FES followed multiple fractures in 60.7% of cases; 17.9% of patients had an isolated fracture of the femur. Other predisposing fractures included closed head injury (7.1%), lipectomy (7.1%), and soft tissue injury (3.6%). The mean free interval was 48 +/- 13.1 hours and 64.3% of the patients had the full clinical syndrome. Respiratory insufficiency was the most common abnormality noted. Petechiae were seen in 82% of patients but were observed mostly in the infraclavicular and axillary areas. Other principal manifestations noted included fever (67.8%), anemia (64.3%), jaundice (57.1%), thrombocytopenia (46.4%), and encephalopathy (42.8%). A total of 60.7% of the patients had radiological evidence of ARDS. Cranial computed tomographic (CT) scans in 17.9% cases showed minimal global edema. All patients had supportive management including mechanical ventilition in 78.6% and none of the patients received steroids. During the four-year period, only one patient died (3.6%). We recommend that early and aggressive critical care management can minimize mortality in patients with FES.
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PMID:Fat embolism syndrome: A clinical appraisal. 1758 18

Long-term backyard smelting of lead in a district known as Mona Commons, Kingston, Jamaica, has produced lead burdens as high as 30 000 mg/kg in soils near to the smelter, and indoor dust loadings of 373 microg/f2 in the residents' home. The blood lead levels (BPb) of 107 children from the district were in the range 2.2-202 microg/dL. Fifty-nine per cent of these had BPb levels above 10 microg/dL and the population mean was an unacceptably high 25.1 microg/dL. The highest levels were observed for five siblings, two of whom presented with lead encephalopathy. This severe chronic exposure to lead was exacerbated by a significant history of pica, and chronic nutritional anaemia. Chelation therapy significantly reduced the BPb levels but due to lead storage in other organs, the values after several months were still higher than desirable. This study emphasizes the importance of reducing the exposure of children to lead.
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PMID:Acute lead poisoning associated with backyard lead smelting in Jamaica. 1769 Dec 33


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