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

At no other time of life is the decision to transfuse potentially as difficult as in the newborn period. Superimposed upon complex "physiologic" changes in the ability to deliver and release oxygen are varying requirements among infants in terms of oxygen need. These are compounded by changes brought about as a direct consequence of frequent phlebotomy in the most ill of preterm infants. Despite the confusion overlying many of the changes occurring at this time of life, certain principles can be applied. Unlike that of the adult, an infant's ability to make oxygen available in response to a specific demand is almost as dependent upon the modifiers of oxygen uptake and release by hemoglobin as upon the hemoglobin concentration itself. These modifiers are constantly changing, sometimes in a predictable fashion, sometimes not. As discussed, some attention to the status of a particular infant's capability in providing oxygen relative to need will assist in the decision when to transfuse. If specific parameters of these assessments can not be determined, it may be necessary to proceed with transfusion based on the clinical presentation of an infant. With regard to the above, any infant sufficiently ill to require frequent blood sampling should have such blood losses replaced, certainly before ten percent of blood volume has been exceeded. This is particularly true in infants who are unable to maintain adequate arterial oxygen tensions with or without the use of supplemental inspired oxygen. At several weeks of age, when the clinical status of a preterm infant may have stabilized, transfusion may or may not be needed during the nadir of the anemia of prematurity. Infants who had been previously transfused or who had earlier received frequent simple transfusions should be able to tolerate lower levels of hemoglobin. Infants without compromised cardiopulmonary function and in whom no unusual metabolic needs exist are unlikely to be aided by transfusions when the hemoglobin concentration is greater than 10 to 11 g/dl. At lower levels of hemoglobin, simple calculations of "available oxygen" may be helpful when it is difficult to determine whether clinical signs and symptoms of anemia exist. Such signs and symptoms may include poor feeding, dyspnea, tachycardia, tachypnea, diminished activity, and pallor. Apnea has not unequivocably been shown to improve following transfusion. Clearly, our current concepts regarding indications for transfusion, even when based upon known principles of physiology, still represent an art form that is less than completely scientific.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Anemia of prematurity. Current concepts in the issue of when to transfuse. 351 96

Two controversial issues of neonatal transfusion practices, erythrocyte 'booster' transfusions and granulocyte transfusions, are critically reviewed, and current recommendations for transfusion practices are made. Infants should receive erythrocyte transfusions to treat congestive heart failure caused primarily by anemia. It is customary to maintain the hematocrit at greater than 40% in neonates with severe respiratory disease, although the efficacy of this practice has not been firmly established. Erythrocyte transfusions seem to be indicated for infants with anemia plus recurrent apnea, poor weight gain or the syndrome of tachycardia, tachypnea, dyspnea and poor feeding for which no other cause can be found. Granulocyte transfusions are likely to benefit seriously ill neonates exhibiting all three of the following: strong evidence of bacterial sepsis, neutropenia (compared to age-related normal values) and a diminished marrow neutrophil storage pool. Granulocyte transfusions for septic infants expressing only one or two of these features should be considered to be experimental therapy.
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PMID:Current issues in neonatal transfusions. 352 25

Over a 7-year period, 15 pregnant women admitted to Parkland Memorial Hospital for acute pyelonephritis developed respiratory insufficiency characterized by dyspnea, tachypnea, hypoxemia, and radiographic evidence of pulmonary infiltrates. Clinical manifestations usually appeared 24 to 48 hours after the patient was admitted and varied from mild respiratory distress to pulmonary failure in three; these three required tracheal intubation and mechanical ventilation. We found no evidence that pulmonary edema was caused by intravenous fluid overload. Oxygen therapy and ventilation were given to maintain the arterial PO2 at 80 mm Hg or greater, and erythrocyte transfusions were given to six women to correct anemia. Women with pulmonary injury were more likely to have multisystem derangement than a control group without respiratory involvement, but there were no clinical risk factors that were predictive at admission. This syndrome was probably caused by permeability pulmonary edema, likely mediated by endotoxin-induced alveolar-capillary membrane injury since other evidence of endotoxemia was common. Thrombocytopenia, hemolysis, intravascular coagulation, renal dysfunction, and transient cardiomegaly concomitant with hyperdynamic ventricular function are all explicable from endotoxin effects.
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PMID:Pulmonary injury complicating antepartum pyelonephritis. 357 94

The clinical signs and lesions of Nubian goats and Desert sheep orally dosed with fresh and dry leaves and stems of Ipomoea carnea at 2.5, 5 and 10 g/kg/day were studied. The signs of Ipomoea poisoning were inappetence, depression, weakness of the hind limbs, dyspnea, staggering, and pallor of the visible mucous membranes. The main lesions were focal necrosis and fatty vacuolation of centrilobular hepatocytes, accumulation of fibroblasts in hepatic portal tracts, degeneration or necrosis of the cells of the renal proximal convoluted tubules, hemorrhage in renal cortices, in renal medullas and in cardiac muscle fibers, focal pulmonary edema, and emphysema and straw-colored fluid in serous cavities. Increased serum aspartate amino transferase and ammonia concentrations, and decreased concentrations of total protein, calcium and magnesium in the serum of Ipomoea-poisoned animals were detected. Hematological changes indicated the development of normocytic normochromic anaemia.
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PMID:The effects of Ipomoea carnea on goats and sheep. 362 12

Liposomal-encapsulated superoxide dismutase was clinically applied to patient showing an increase in neutrophil active oxygen generation, and those with diseases such as severe rheumatoid arthritis (RA), Crohn's disease and progressive systemic sclerosis (PSS) in which presence of a plasmatic clastogenic factor has been demonstrated. Liposomal SOD injection (2.5 mg twice a week) resulted in marked remission in 12 out of 16 patients with active Behcet's disease. The drug was impressively effective on patients with intestinal Behcet. Remission rates in the other diseases was 7 out of 8 mucocutaneous lymphnode syndrome (MCLS, Kawasaki disease) 3 out of 5 dermatitis herpetiformis, IgA linear bullous dermatosis or severe cement dermatitis, 4 out of 9 active and severe RA, 3 out of 3 PSS, 4 out of 4 Crohn's disease, 3 out of 4 colitis ulcerosa, and 2 out of 2 unresponsive (hemolytic) anemia. To be emphasized was that three severe active RA patients and two terminal-stage PSS patients with dyspnea due to lung fibrosis showed dramatic improvement after administration of liposomal SOD. In addition, in 13 out of 15 malignant neo plastic patients including cancer, malignant lymphoma and leucemia who were receiving radiotherapy (total dose, more than 4000 rads) and chemotherapy including anthracycline analogs (total over 450 mg/m2) and bleomycin, the drug also prevented the appearance of myocardiac injury and fibrosis, sometimes seen as a consequence of chemotherapy. Liposomal SOD, which shows no toxicity, has various advantages compared to free SOD preparations, and is highly and broadly applicable to various clinical disorders.
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PMID:Effect of liposomal-encapsulated superoxide dismutase on active oxygen-related human disorders. A preliminary study. 388 Feb 79

A case of lupus erythematosis is described, unusual because severe thrombosis occurred before diagnosis of the lupus symptoms and because the patient recovered after stopping oral contraception. The 24-year-old woman had been taking combined pills (2.5 mg lynestrenol and .075 mg mestranol) for 1 year. She experienced chest, foot, and calf pain and stopped working, then sought emergency hospitalization 3 weeks later for intense dyspnea and pain in both legs. She had no femoral pulse, and a clot was removed from the right femoral artery; 2 more clots were found in the pulmonary vessels and the aorta. She was treated with heparin (Calciparine sc) for 6 weeks. A few days after stopping anticoagulants, she was hospitalized again with right chest pain, anemia, swollen glands, but no skin lesions or lupus cells. Endos copy revealed lupus erythematosis lesions on the liver and spleen. She also had elevated IgG, IgM, alpha-glucoproteins, and an antinuclear antibody titer of 1/500. A 3-month pregnancy ended in spontaneous abortion when anticoagulants were supplemented with strong corticoids (60 mg/day prednisone). 1 month later she was fully recovered. The oral contraceptive may have precipitated the lupus, since it regressed after stopping and was aggravated again by pregnancy.
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PMID:[Thrombosing disease in the course of a lupic syndrome revealed by an estroprogestational agent]. 515 Mar 17

The case is reported of an 18-year-old woman hospitalized with severe dyspnea and high temperature. Chest X-ray showed pneumonia with interstitial and air-space consolidation patterns. Serologic tests revealed a cytomegalovirus infection (CMV). The blood findings showed anemia of infectious origin. Liver biopsy was consistent with CMV-hepatitis. CMV-pneumonia in an otherwise healthy patient is extremely rare; a review of the literature revealed only four other cases.
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PMID:[Cytomegalovirus pneumonia in primarily healthy adults]. 626 84

43 patients with advanced breast cancer, resistant to conventional therapies, were treated with mitomycin C at a dose of 20 mg/m2 i.v. every 6 weeks. No response was observed. The most common side effect was myelotoxicity. Leukopenia occurred in 63% of the patients, thrombocytopenia in 67%, and anemia in 14%. Two episodes of acute dyspnea were observed which were thought to be pulmonary hypersensitivity reactions. This study does not suggest that mitomycin C is of value as second- or third-line treatment in metastatic breast cancer. It is likely that the drug could play a more important role in combination with other chemotherapeutic agents.
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PMID:Mitomycin C in patients with metastatic breast cancer refractory to hormone therapy and chemotherapy. 640 47

Some of the problems which we see on the infectious disease consultation service can be quite frustrating. This is one such case. A middle-aged man presented to our medical service with fever and dyspnea. His fulminant downhill course was characterized by anemia, jaundice, hypercalcemia, pulmonary abnormalities, and a lack of responsiveness to conventional antimicrobial therapy. At autopsy, malignant-appearing histiocytes were present in several organs including spleen, lymph nodes, and lung. Histopathological examination of tissues obtained at autopsy confirmed the presence of phagocytized erythrocytes within such histiocytes. This case aptly illustrates the hazy dividing line which sometimes exists between infectious and/or malignant processes which are, at present, still of undetermined etiology.
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PMID:Fever, jaundice, and histiocytic erythrophagocytosis: fulminant infection or malignancy? 652 7

A 4-year-old cow initially examined because of hindlimb lameness had a waxing and waning course of illness for 31 weeks. Signs included lameness, swelling of the affected limb, and intermittent fever, and anorexia. Radiography and bacterial culturing suggested osteomyelitis. Terminally, there was peracute anemia and dyspnea. The final diagnosis was hemangiosarcoma of the metatarsus, with metastasis to the lungs.
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PMID:Hemangiosarcoma in a cow. 654 43


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