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

The prevalence of abnormal values of initial screening laboratory tests was assessed for 24 children who eventually proved to have Crohn's disease. The screening tests included in this analysis were fecal alpha 1-antitrypsin (FA) concentration, erythrocyte sedimentation rate (ESR), total leukocyte count, serum albumin level, hemoglobin concentration, and qualitative testing of stool for the presence of blood. Of the 24 patients, 21 had abnormal FA values, 17 had anemia, 19 had an increased ESR, 14 had hypoalbuminemia, rectal bleeding was found in 8, and none had leukocytosis. All 24 patients had at least one abnormal screening test value; the most frequently abnormal result was the FA concentration. Pediatric patients without elevated FA values, anemia, a high ESR, bloody stools, or hypoalbuminemia are unlikely to have active Crohn's disease.
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PMID:Screening laboratory tests for Crohn's disease. 274 58

In disposition studies, retinyl methyl ether (RME) was administered to rats in oral doses of 10 or 40 mg/kg. For the high dose, RME was eliminated from plasma with a terminal half-life of 19.5 hr but for the low dose the terminal phase could not be determined. For both doses, the concentrations of RME in the tissues examined (liver, spleen, adrenals, and mammary glands) were greater than those in plasma. In the adrenals of rats given the low dose, concentrations were as much as 10- to 100-fold higher. Concentrations of RME in the mammary gland, a site for chemopreventive activity, were also relatively high (about 1000 ng/g for the low dose and about 4000 ng/g for the high dose), and there was an elimination phase with a half-life of 63-81 hr. After administration of RME, the concentration of retinyl esters in the liver did not increase, and no retinyl esters were detected in the mammary gland. For toxicology studies, rats were administered 20, 40, and 80 mg/kg of RME or retinyl acetate (ROAc) daily for 28 days. The toxic effects of RME were similar to those of ROAc. At equivalent mg/kg doses, weight gain depressions, bone fractures, elevations in serum triglycerides, anemia, elevations in cholesterol in females, and reductions in serum albumin were similar.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The disposition and toxicology of retinyl methyl ether in rats dosed orally. 290 90

Six patients with hypoxic respiratory failure (arterial PO2/alveolar PO2 less than 0.50) resulting from active tuberculosis were evaluated to assess the impact of respiratory failure on the diagnosis of the underlying tuberculosis. All patients demonstrated anemia (hematocrit [mean +/- SEM], 0.29 +/- 0.01 [29.0% +/- 1.0%]) and hypoalbuminemia (serum albumin, 22 +/- 2 g/L [2.2 +/- 0.2 g/dL]) and noted an illness longer than one week. Findings on chest roentgenograms varied from a miliary pattern, misinterpreted as congestive heart failure, to cavitary and noncavitary alveolar infiltrates, misdiagnosed as bacterial pneumonia. Tuberculosis was not considered as a diagnostic possibility on admission in any patient. The mean time from admission until consideration of tuberculosis was 4.7 +/- 1.0 days and the time to diagnosis was 7.2 +/- 1.7 days. In contrast, tuberculosis was considered on admission in 12 patients presenting with undiagnosed active tuberculosis without respiratory failure. We conclude that respiratory failure delays the diagnosis of active tuberculosis by suggesting nontuberculous pneumonia.
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PMID:The impact of respiratory failure on the diagnosis of tuberculosis. 313

Thirty hospitalized patients with newly diagnosed tuberculosis were studied prospectively with a range of in vitro and in vivo tests of immune function. Responses were compared with those of healthy controls matched for age, sex, ethnic group and diet. A series of metabolic and immunologic abnormalities was found, including evidence of undernutrition, anaemia, neutrophil leucocytosis, monocytosis, lymphopenia, hyperglobulinaemia and raised erythrocyte sedimentation rate. Some patients had accelerated, others diminished, cutaneous tuberculin hypersensitivity, and some had diminished mononuclear cell proliferative and lymphokine responses to tuberculin (purified protein derivative, PPD). The patients were not uniform in their responsiveness, but could be arranged within a spectrum which showed a relationship to crude bacillary excretion and response to treatment. 27% of patients were characterized by hypersensitivity, with normal in vitro cellular responses and skin tests to PPD, scanty bacillary excretion and rapid bacteriologic sputum conversion to negative cultures with treatment. In contrast, 30% of patients were relatively anergic with negative skin tests, reduced or absent in vitro cellular reactivity to PPD, moderate or heavy bacillary excretion and later (greater than 4 weeks) bacteriologic sputum conversion. The remainder of the patients fell between these two groups. There were no correlations between cellular immunity on the one hand, and radiological extent of disease, levels of serum immunoglobulins, peripheral white cell counts or ESR on the other. In those patients followed throughout treatment, all the abnormalities with the exceptions of arm muscle circumference and serum albumin, reverted to the normal ranges established in the control group.
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PMID:Immune status in tuberculosis and response to treatment. 318 36

Diarrhea, intestinal blood loss, anemia, and lethargy were predominant clinical findings in 12 dogs with disseminated histoplasmosis. Young dogs were affected most commonly, with 6 dogs being 1 to 3 years old. A diagnosis of disseminated histoplasmosis was established on the basis of histologic or cytologic detection of Histoplasma organisms in intestinal or rectal mucosa in 7 dogs, in circulating leukocytes in 5 dogs, in bone marrow in 3 dogs, and in multiple tissues at necropsy in 1 dog (4 dogs had Histoplasma organisms detected in greater than 1 site). Anemia was detected in 10 dogs (PCV less than 20% in 3 dogs), and the anemia was inadequately regenerative or nonregenerative in 7. Hypoalbuminemia was detected in 9 dogs, and serum albumin concentrations were low (less than 1.0 g/dl) in 4 of the 9 dogs. Of 5 dogs treated with ketoconazole, 2 were in remission for greater than or equal to 1 year. Corticosteroid therapy may have exacerbated the disease in 4 dogs. Histoplasma infection of multiple organs was detected in 5 necropsied dogs.
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PMID:Disseminated histoplasmosis in dogs: 12 cases (1981-1986). 320 62

Trimellitic anhydride (TMA) can induce immunologic lung disease in exposed workers. We have developed a rat model of TMA lung injury characterized by lung hemorrhage and an immune response to trimellityl (TM) haptenized lung proteins. The model is similar to the pulmonary disease-anemia syndrome (PDA) seen in workers exposed to TMA fumes. Sprague-Dawley rats, 15 per exposure period, inhaled micronized TMA powder, 100 micrograms/m3, 6 h/day, for 2,6, or 10 days and were sacrificed. At each time period, total, IgG, IgA, and IgM antibody to TM-rat serum albumin (TM-RSA) were measured by radiolabeled antigen binding and enzyme-linked immunosorbent assay (ELISA) in serum and bronchoalveolar lavage fluid (BAL). Hemorrhagic lung foci, weight, and displacement volume were determined, and lungs were examined by light and electron microscopy. There was no lung injury or antibody response at 2 days. There was minimal lung injury at 6 days with low levels of antibody in BAL and serum. At 10 days, there was a marked increase in hemorrhagic foci and in BAL and serum antibody levels. BAL antibody levels at 6 and 10 days had higher correlations with measures of lung injury than corresponding serum levels. There was minimal ultrastructural change at 6 days. By Day 10, there was marked intraalveolar hemorrhage, alveolar septal inflammatory nodules, abundant alveolar macrophages, and evidence of endothelial and epithelial cell injury. These results indicate that the immune response to inhaled TMA occurs parallel with the development of lung lesions, and antibody levels in BAL and serum are highly correlated with lung injury.
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PMID:A serial immunologic and histopathologic study of lung injury induced by trimellitic anhydride. 333 62

The risk of homologous blood may cause physicians to withhold red cell treatment after acute blood loss. We believe that in the euvolemic patient with acute anemia, the heart is the principal organ at risk. The cardiac compensation to extreme anemia is unknown and is the purpose of this report. Fourteen adult baboons were anesthetized, paralyzed, and ventilated with room air. Left atrial and coronary sinus catheters were inserted surgically. Experimental animals (n = 7) were hemodiluted at constant left atrial pressure with 5% human serum albumin. Control animals (n = 7) underwent similar volume exchanges with fresh, cross-matched, homologous red blood cells resuspended in human serum albumin, also at constant left atrial pressure. Six of seven experimental animals survived until hematocrit levels were 4%. Adequate cardiac compensation was observed until hematocrit levels were less than 10%. Increased flow, without increases in the O2 extraction ratio, was the mechanism of compensation used by the healthy heart with patent coronary vessels.
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PMID:Limits of cardiac compensation in anemic baboons. 337 93

The mortality and morbidity in abdominal surgery were investigated in two groups of patients, one with empty (N = 228) and the other with normal (N = 220) iron stores before operation. The estimation of body iron stores by measurements of serum ferritin concentration assumes that the only reason for a low ferritin value is an empty iron store. The results showed that the period of hospital treatment was shorter and the number of complications, especially infections, fewer, in patients with normal as compared to empty iron stores before the operation (p less than 0.001). These differences were especially striking in patients subjected to gastric or large bowel surgery. The results were not explained by differences in sex, age, serum albumin, or clinical anemia. The complications were not predictable from preoperative serum albumin, alkaline phosphatase, or alanine amino transferase levels. Among patients with postoperative complications those with preoperative empty iron stores also had a lower preoperative blood hemoglobin concentration (127 +/- 10 g/liter) than those with normal preoperative iron stores (136 +/- 9 g/liter). Thus it is speculated that the mechanisms behind postoperative complications due to preoperative empty iron stores might be a decrease in tissue oxygenation, resulting in an increased fatigue while working, decreased contractile capacity of the respiratory muscles, and a decrease in immune function. Thus a measurement of serum ferritin concentration and correction of empty iron stores is recommended before abdominal surgery.
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PMID:Empty iron stores as a significant risk factor in abdominal surgery. 339 23

We have shown that primates adequately compensate for acute normovolemic anemia to hematocrits (HCT) of 10%. We have described a whole-body extraction ratio (O2 consumption/O2 delivery; ER) of 50% as a reliable physiologic indicator of transfusion need. There is concern that whole-body ER may not accurately reflect impaired myocardial metabolism. The onset of significant lactate production by the left ventricle is an indicator of anaerobic metabolism. Our purpose is to compare left ventricular lactate metabolism (arterial-coronary sinus lactate; delta [L]) to ER in acute normovolemic anemia. Fourteen adult baboons were anesthetized, paralyzed, and ventilated on room air. Left atrial, coronary sinus, aortic, and Swan-Ganz catheters were inserted. Experimental animals (N = 7) were hemodiluted, at constant left atrial pressure (LAP), with 5% human serum albumin (HSA) to a HCT below 4%. Control animals (N = 7) underwent similar volume exchanges, also at constant LAP, with homologous RBCs resuspended in HSA. Whole-body extraction ratio and left ventricular lactate production were measured at baseline and at hematocrits of 20, 10, 6, and 4% in the experimental group. Data were obtained at similar volume exchange points in the control group. Significant lactate production occurred only in the experimental animals (P less than 0.05) when extraction ratio exceeded 50%. Significant lactate production does not occur before the whole-body ER exceeds 50%. ER appears to be a valid indicator of myocardial metabolism in anemia, in this setting.
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PMID:Oxygen extraction ratio: a valid indicator of myocardial metabolism in anemia. 358 30

The effect of end-stage renal failure and the dialytic process on erythrocyte sedimentation rate (ESR) is largely unknown. We prospectively studied 60 stable patients with end-stage renal disease to determine the prevalence of elevated ESR in this population. ESRs were also measured immediately pre- and postdialysis in 48 hemodialysis patients. ESR was found to be elevated (greater than or equal to 25 mm/h, Westergren method) in 93% of patients with end-stage renal failure. Fifty-seven percent of patients had marked elevation of ESR (greater than 60 mm/h), while 20% had extreme increases in ESR (greater than or equal to 100 mm/h). In a linear models analysis, aging (P less than .02), anemia (P less than .01), and hypocalcemia (P less than .0001) correlated significantly with ESR elevation. Midweek BUN and creatinine, type and duration of dialysis, cause of renal failure, and serum albumin and total protein measurements did not correlate with ESR. In 48 stable in-center hemodialysis patients, mean predialysis ESR of 70 +/- 4 mm/h was not significantly different from mean postdialysis ESR of 72 +/- 5 mm/h. Retrospective chart review of available ESRs prior to initiation of any dialysis treatment also revealed significant elevation of ESR, mean 82 +/- 9 mm/h, in patients with renal disease not yet on dialysis. An upward trend in ESR during acute illness (74 +/- 9 to 95 +/- 8, N = 10) was observed. In a subpopulation of patients, fibrinogen correlated significantly with ESR while gamma-globulins did not. We conclude that measurement of ESR in end-stage renal failure has little clinical utility. Possible explanations for acceleration of ESR in this population are discussed.
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PMID:The erythrocyte sedimentation rate in end-stage renal failure. 360 82


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