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

There is an increased incidence of chronic disease in old age, and blood disorder is not uncommon. Some diseases are more frequent in the latter half of life, while others -- such as the hereditary disorders -- are rare and occur only in a mild degree. Diagnosis of blood disease is more difficult in the elderly because symptoms of anaemia such as weakness, shortness of breath and mental disorder are often attributed to old age.
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PMID:Blood diseases in old age. 85 40

Iron deficiency, the most common cause of anemia, is prevalent in 10 percent to 30 percent of the world's population. Inadequate intake of iron may be an important causative factor, particularly when the body requires more iron than usual (e.g., during infancy, early childhood, adolescence, pregnancy and periods of blood loss). The popular increase of fiber in diets may increase the incidence of iron-deficiency anemia because too much fiber in the diet renders available iron unabsorbable. Symptoms in children include skin or conjunctival pallor, excessive sleepiness, learning disabilities, diminished attention span, tiredness, irritability or inappropriate behavior, and pica. Adults may have shortness of breath, decrease in exercise tolerance, palpitations, tachycardia, angina, congestive heart failure, orthopnea and edema. Iron deficiency occurs in sequential states and is measured by many laboratory tests. The levels of hemoglobin and hematocrit are both decreased, while the red blood cell count may be normal initially, but will decrease as the iron-deficiency state continues. The steps of treatment include correction of the underlying disorder, administration of the amount of iron needed and observation of the response to treatment.
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PMID:A guide to primary care of iron-deficiency anemia. 143 77

The purpose of this study was to develop a strategy to reduce transfusion-related HIV transmission which went beyond the limits of routine HIV screening of blood donors. Current blood transfusion practices were assessed in 1044 patients for whom staff physicians had requested a transfusion between 5 September and 19 October, 1988. Children under 5 years of age with malaria, and pregnant women with acute anaemia requiring blood transfusion were the two highest risk groups. Many of the transfusions were given without an obvious medical indication; 22.7% (214 out of 955) of the recipients were transfused without prior laboratory tests [haemoglobin (Hb) or haematocrit (Hct)], 7.2% with Hb greater than 6g/100ml or Hct greater than 25% and 16.6% without clinical signs of severe anaemia (pulse less than 100/min without shortness of breath). The data of this study were used to organize a workshop for all the physicians responsible for blood transfusions in Kinshasa and two nearby health zones. A consensus statement on the indications for blood transfusion was developed. Subsequently, transfusion centres adopted this consensus statement instead of previous guidelines.
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PMID:Prevention of transfusion-associated HIV transmission in Kinshasa, Zaire: HIV screening is not enough. 238 19

A case of primary myelofibrosis complicated with pericardial effusion and proteinuria is described. A 66-year-old female was admitted to our hospital because of abdominal fullness and shortness of breath. On admission, hepatosplenomegaly and pericardial effusion were observed. Blood examination revealed leukoerythroblastic anemia and thrombocytosis with tear drop cells and giant platelets. Bone marrow aspiration was dry tap and its biopsy showed remarkable myelofibrosis. Urinalysis indicated severe proteinuria. Although neutrophilic alkaline phosphatase score was low, no signs of acute blastic crisis of chronic myelogenous leukemia was found. The diagnosis of an atypical type of primary myelofibrosis was obtained. Administration of MCNU was started in August 1987. Hepatosplenomegaly, pericardial effusion and proteinuria were gradually improved after the administration. The etiology of the pericardial effusion and proteinuria were not obvious, however, these facts suggest that these abnormal findings might be related to PMF itself and MCNU was effective to PNF.
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PMID:[The use of MCNU to a patient of primary myelofibrosis complicated with pericardial effusion and proteinuria]. 276 70

Intraarterial digital subtraction arteriography (DSA) was performed in a 39-year-old man with multiple myeloma, high-output congestive heart failure unresponsive to correction of anemia, and a pelvic bruit suspicious for an arteriovenous malformation. DSA revealed extensive neovascularity of all the visualized skeletal structures with rapid arteriovenous shunting in the pelvis. Temporary embolization of both hypogastric arteries with Gelfoam and autologous clot produced immediate and dramatic clinical relief of the shortness of breath, orthopnea, and hyperdynamic circulation. Following return of symptoms, repeat permanent occlusion with Ivalon and Gianturco coils produced minimal clinical response, but a decrease in cardiac output from approximately 23 L/min to 19 L/min. The etiology of congestive heart failure in myeloma, the implications of the use of intraarterial DSA, and the arteriographic findings in myeloma are discussed.
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PMID:Transcatheter treatment of myelomatous AV shunting causing high-output failure. 309 55

A 64-year-old man had slowly progressive thickening of the bulbar and palpebral conjunctiva of the right eye, followed by signs and symptoms of an upper respiratory infection. A biopsy specimen of the conjunctival lesions demonstrated granulomatous inflammation with eosinophils compatible with a diagnosis of Churg-Strauss syndrome (asthma, eosinophilia, vasculitis, and granulomatous inflammation with eosinophils). Subsequently, fever, shortness of breath, moderate renal failure, and anemia developed. Therapy with systemic corticosteroids and cyclophosphamide was instituted, with resolution of the systemic and ocular manifestations.
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PMID:Conjunctival involvement in Churg-Strauss syndrome. 377 79

Dietary cells and the vitamins B12 and folate are necessary for the production of the red blood cells (erythrocytes), which carry oxygen from the lungs to the tissues and carbon dioxide from tissues to lungs. Deficiency of either one results in anaemia, which is characterised by low haemoglobin concentration. Symptoms result from reduced tissue oxygenation and include weakness, lethargy, palpitation, headache and shortness of breath. The first-time laboratory test of all patients suspected of being anaemic is the full blood count. Results of a full blood count may suggest the anaemia is caused by a nutritional deficiency of B12 folate or iron. Laboratory measurement of the concentration in blood of iron and vitamin B12 and folate, along with several other tests described here, are useful in the differential diagnosis of the anaemic patients.
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PMID:Deficiency testing for iron, vitamin B12 and folate. 760 52

A reduction in the capacity of blood to carry oxygen leads to increased extraction of oxygen from the blood by peripheral tissues, and consequently to a decrease in the venous partial pressure of oxygen (pO2). At reduced venous pO2 pre-existing venous-arterial shunts gain in influence on arterial pO2 and arterial pO2 also decreases. In addition, physical exercise leads to lactate acidosis earlier and at lower levels of exercise than in healthy subjects. The low arterial pO2 and the low pH of acidosis are sensed by chemoreceptors of the carotid bodies and neural signals are transmitted to centers of the brain stem, where they are integrated and result in the sensation of shortness of breath (dyspnea). The capacity of the blood to carry oxygen is determined not only by the concentration of hemoglobin but also by the binding characteristics of hemoglobin for oxygen, which can be deduced from its molecular structure. In contrast to cases with acute anemia, dyspnea is often absent in patients in whom anemia develops gradually (down to hemoglobin levels of 7 g/dl). This tolerance is not mediated by pulmonary or cardiac compensatory mechanisms also at work in acute anemia, but is due to increases in the concentration of diphosphoglycerate. This allosteric effector molecule induces, by binding to hemoglobin, a decrease in the affinity of hemoglobin for oxygen, thereby leading to improved release of oxygen from hemoglobin in peripheral tissues.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Reduced oxygen transport capacity as a cause of dyspnea]. 804 64

Patients with sickle cell disease have been reported to have an increased risk of thromboembolism and pulmonary hypertension. Some of these patients may benefit from pulmonary thromboendarterectomy (PTE), a procedure that requires profound hypothermia, cardiopulmonary bypass, and periods of circulatory arrest, factors that may potentially increase the risk of sickling. Two patients with sickle cell disease (sickle-thalassemia [Hb S/beta+] and Hb SS) presented to the Pulmonary Vascular Center of UCSD Medical Center with significant shortness of breath and limitation of daily activities. Both of these patients were found to have surgically accessible chronic thromboembolic disease with pulmonary hypertension. PTE was performed in both patients using exchange transfusion, with avoidance of anemia, hypoxia, and acidosis. A successful outcome with resolution of pulmonary hypertension was achieved in both cases. To our knowledge this is the first report of patients with sickle cell disease who successfully underwent PTE for chronic thromboembolic pulmonary hypertension.
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PMID:Successful pulmonary thromboendarterectomy in two patients with sickle cell disease. 960 56

Optimal management of dyspnea in terminal cancer patients requires an understanding of the responsible pathophysiological mechanisms. This prospective study assessed visual analogue scales (VAS) of shortness of breath (SOB) and anxiety, bedside spirometry, maximum inspiratory pressure (MIP), chest radiography, arterial blood gases, hemoglobin, and electrocardiogram, if indicated, in 100 terminally ill cancer patients. Forty-nine percent of the patients had lung cancer. The median VAS scores for SOB and anxiety were 53 mm and 29 mm, respectively. Spirometry was abnormal in 93% of patients, with 5% having obstructive, 41% restrictive, and 47% mixed patterns. The median MIP was 16 cm H2O. Sixty-five percent of the patients had parenchymal or pleural involvement on chest radiograph. Twenty-nine percent had evidence of cardiac ischemia, recent or current myocardial infarction or atrial fibrillation. Patients had a median of five different abnormalities that could have contributed to their shortness of breath. Only anxiety (p = 0.001), a history of smoking (p = 0.02), and pCO2 levels were statistically significantly correlated with SOB VAS scores. The potentially correctable causes of dyspnea included hypoxia (40%), anemia (20%), and bronchospasm (52%). The finding of very low MIPs suggests severe respiratory muscle weakness may contribute significantly to dyspnea in this patient population. Further studies are needed to confirm this finding and characterize the underlying pathophysiology.
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PMID:Dyspnea in the advanced cancer patient. 1058 52


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