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 term ''iatrogenic disease'' means disease caused by therapy prescribed by doctors. Most such diseases are drug induced. Adverse effects of drugs have been more common in seriously ill patients who have received many drugs. Drug interaction has often been the cause. Most have been dose-related from cumulative pharmacologic effects. Reported data have been incomplete. Individual variability due to a genetic basis has been a factor. Environmental influences, such as smoking, atmospheric pollution, and hardness of the water supply may be involved. Sometimes the patient's metabolism has been impaired by concomitant liver or kidney malfunction. In such cases the drug, or its metabolites, may build up to a toxic level. A lowered threshold to the normal action of a drug is frequent among the very old and the very young. Geriatric patients have a considerable reduction in the reserve capacity of many organs. Hypersensitivity to a drug may be present. Skin rashes and eruptions are most common in this type of allergic reaction although jaundice and hemolytic anemia have followed. Polypharmacy increases the risk. Some patients make errors in taking prescribed drugs. Also, additional self-medication is common. Drug-food interactions may occur. Needed vitamins may be absorbed and eliminated by the use of liquid paraffin as a laxative. Intestinal flora-destroying antibiotics permit other organisms to grow. Alcohol is an additional hazard. Oral contraceptive use may be followed by anemia, and may react with other drugs. A list of such known reactions is given. Delayed iatrogenic neoplasia is being considered. Effects on the progeny have been shown with several drugs. Forewarning creates awareness and caution.
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PMID:Iatrogenic disease: a hazard of multiple drug therapy. 79 37

A 91-year-old man had been treated for iron-deficiency anemia for four years before admission to the Geriatric Unit of the Hasharon Hospital because of cardiac insufficiency and epigastric pain. In the Unit, laboratory studies revealed, in addition to hypochromic anemia, a high level of plasma iron and a reduced iron-binding capacity. The low reticulocyte count in the peripheral blood despite hyperplasia in the bone-marrow erythrocyte series, the rapid disappearance of radioactive iron from the plasma, and the impaired erythrocytic uptake of iron were all indicative of the ineffective erythropoiesis. The findings suggested the possibility of sideroblastic anemia, and examination of bone-marrow aspirates stained for iron confirmed this diagnosis.
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PMID:Sideroblastic anemia in an elderly patient. 86 78

An 84-year-old woman was admitted to Tokyo Metropolitan Tama Geriatric Hospital because of knee pain, anemia and hyperglobulinemia. On physical examination, evidence of arthritis was observed in both knees. Nodular temporal arteries were palpable with hypertrophy and weak pulsation. The urine was normal except that the sediment contained 20-30 with blood cells per high power view. Laboratory data showed raised erythrocyte sedimentation rate of 150 mm per hour, elevation of beta and gamma globulin and mild anemia. Although the levels of serum IgG, IgA were markedly increased, there was no monoclonal component on immunoelectrophoresis. Light microscopy examination of an aspirated specimen of bone marrow showed slight hypocellularity and mild plasmacytosis. However, atypical plasma cells were not observed. Radiographs of the knee showed narrowing of the joint space and calcification of articular cartilage and meniscus. Biopsy of the left temporal artery revealed typical findings of giant cell arteritis. The administration of prednisolone resulted in rapid normalization of laboratory findings. But her arthralgia, which had been relieved by analgesics after admission, was worsened if she took prednisolone without analgesic. Therefore, analgesics were given again with prednisolone for the control of the arthralgia.
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PMID:[A case of temporal arteritis associated with marked elevation of serum IgG, IgA levels]. 279 81

A retrospective review of 1,024 charts of Geriatric Screening Clinic patients was carried out to evaluate the prevalence of anemia and degree of correlation of aging with changes in hemoglobin (Hgb) level in a healthy, elderly population (age range, 60 to 96 years; mean age, 70 years). Twelve per cent of participants were anemic overall, although there was a sex difference; more males (17.7%) were anemic than females (8.4%). Mean Hgb levels did not change significantly with age group except in males over 85 years of age. Pearson Correlation Coefficients were small for age versus Hgb in females (-0.10) as well as in males (-0.21). Likewise, linear regression slopes were small for females (-0.01) and males (-0.04). Based on this set of data, one would not expect a change in Hgb with advancing age in healthy elderly patients.
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PMID:Prevalence of anemia and correlation of hemoglobin with age in a geriatric screening clinic population. 358 68

The structure and function of a newly created interdisciplinary Geriatric Consultation Team (GCT) are described. The GCT was introduced on a single medical unit, where consultations were given to 46 consecutive patients aged 75 years and over. The GCT patients had, on the average, 5.5 illnesses and were receiving 3.7 medications. Anemia (50 per cent), were hypoalbuminemia (65 per cent), and elevated blood urea nitrogen (BUN) (58 per cent) were frequent. Functional assessment showed frequent dependence on others for assistance with ambulation (59 per cent), transfers (54 per cent), and dressing (52 per cent); cognitive impairment was found in 52 per cent and clinical depression in 11 per cent of the patients. In comparison with control units, the GCT increased use of physical therapy by 357 per cent, occupational therapy by 390 per cent, and speech therapy by 300 per cent without increasing length of stay. In comparison with control subjects, GCT patients had no decrease in hospital readmission rates (43 per cent) over 10.5 months of follow up. It was concluded that a GCT in an acute-care hospital promotes geriatrics, teaches interdisciplinary teamwork, improves awareness of functional problems of patients, and increases use of rehabilitative services, but does not decrease the high rate of readmission of hospitalized geriatric patients.
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PMID:An interdisciplinary geriatric consultation service: a controlled trial. 636 Nov 4

Geriatric failure to thrive (GFTT) is a syndrome associated with functional decline, depression and malnutrition. Adverse drug reactions are cited as one of the most common causes of GFTT. Two distinct drug-related issues should be considered. Firstly, failure to provide appropriate treatment for conditions such as anaemia, depression, nutritional deficiencies and pain may precipitate GFTT. Secondly, drug-induced functional decline and decreased nutrient intake may cause or contribute to the syndrome. Pharmacological intervention may include discontinuing potentially offending agents for a trial period, or drug treatment of anorexia and depression.
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PMID:The role of medications in geriatric failure to thrive. 889 21

During 1996, 585 patients, aged 55 to 96, were admitted into hospital at the Geriatric Department of Ospedale Maggiore (Turin). Acute confusion was seen in 22.2% of these patients who tended to have more serious clinical condition, were more likely to have chronic cognitive impairment, were treated with a greater number of drugs and suffered more from immobility with pressure ulcer. The confusional state, manifested at admission to Geriatric department, was mostly related with the patient's clinical severity, while the one which developed during hospital stay was linked to situations of physical frailty, as pressure ulcer and low albumin values. The most frequent causes of acute confusional state were acute infectious diseases, heart failure, gastro-intestinal bleeding with secondary anaemia, stroke and dehydration. In many cases the very cause of the acute confusional state could not be identified. Falls, more than 31 days length of stay in hospital and death were more frequent in patients suffering from confusional state. Chronic cognitive impairment, functional dependence, clinical severity and treatment involving a great number of drugs, are the main contributing factors in this syndrome. Thus, a multi-dimensional evaluation which takes into account both clinical-functional and socio-economical aspects, is useful for a correct preventive and diagnostic approach of acute confusional state.
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PMID:[Acute confusion in the geriatric patient]. 967 28

Geriatric and cancer-afflicted patients often experience decreased quality of life with cachexia, anemia, anorexia, and decreased activity level. We have studied the possibility that a myogenic plasmid that expresses growth hormone releasing hormone (GHRH) can prevent and/or treat these conditions. We administered plasmid to 17 geriatric and five cancer-afflicted companion dogs with an average age of 10.5+/-1.0 and 11.3+/-0.6 years at enrollment, respectively. Effects of the treatment were documented for at least 180 days post-treatment, with 10 animals followed for more than 1 year post-treatment, on average 444+/-40 days. Treated dogs showed increased IGF-I levels, and increases in scores for weight, activity level, exercise tolerance, and appetite. No adverse effects associated with the GHRH plasmid treatment were found. Most importantly, the overall assessment of the quality of life of the treated animals increased. Hematological parameters such as red blood cell count, hematocrit, and hemoglobin concentrations were improved and maintained within their normal ranges. We conclude that intramuscular injection of a GHRH-expressing plasmid is both safe and capable of improving the quality of life in animals for an extended period of time in the context of aging and disease. The observed anabolic and hematological responses to a single dose of this plasmid treatment may also be beneficial in geriatric patients or patients with cancer-associated anemia and/or cachexia.
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PMID:Long-term effects of plasmid-mediated growth hormone releasing hormone in dogs. 1507 11

Patients who are > or =65 years of age are the fastest growing segment of the U.S. population. These patients with already existing physiologic decline and comorbidities, when diagnosed with cancer, provide considerable challenges in management issues. Along with therapy for the tumor the practicing oncologist must also keep in mind the various symptoms, like fatigue, pain, and depression, that may occur due to the tumor itself or due to therapy. The prevalence of fatigue is greater than 50-70% in advanced cancer. The tools to measure fatigue are all subjective in nature and no one tool has been tested in the elderly cancer patient. Treatment of fatigue in the elderly may involve education, antidepressants, treatment of anemia, exercise, and use of psychostimulants. Pain is present is 80% of elderly patients with advanced cancer. Pain should be assessed in a systematic way and it has been shown that the Visual Descriptor Scale is the tool most preferred by the elderly. Several guidelines for management of pain exist and options include acetaminophen, nonsteroidal anti-inflammatory drugs, opioids, adjuvant analgesics, and education of patients and caregivers. Depression is also a prevalent symptom arising from a variety of causes. There are many validated tools to measure depression in the elderly like the Geriatric Depression Scale. Treatment includes use of education, selective serotonin reuptake inhibitors, psychotherapy, and electroconvulsive therapy. There exists an interplay of many of these symptoms and quite often they can occur simultaneously in the elderly cancer patient. Future research is needed to expand our base of knowledge on the occurrence and management of each of these symptoms and to better understand how aging systems interact with these phenomena to produce unique situations in older adults.
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PMID:Symptom management in the elderly cancer patient: fatigue, pain, and depression. 1526 59

Strategies for treating cancer are evolving to address the growing number of elderly patients with cancer. Older patients have highly variable physiologic ages, and their treatment should be individualized for optimal outcomes. Treatment paradigms should also take into account the diversity of patients' life expectancy, functional reserve, social support, and personal preference. A Comprehensive Geriatric Assessment (CGA) is a useful tool for estimating life expectancy and tolerance of treatment and for identifying reversible factors that may interfere with cancer treatment, including depression, malnutrition, anemia, neutropenia, and lack of caregiver support. Adopting a common language to describe older patients may facilitate the design and analysis of studies to determine effective drugs and care strategies for them. Information from a CGA can guide the prescription of potentially curative therapy, determine the best use of supportive care agents, and help identify frail patients for whom palliative care is the best option. There is evidence in a number of settings that the routine use of a CGA has a positive effect on health outcomes by reducing hospitalizations, preserving functional independence, and preventing geriatric syndromes. Guidelines for supportive care are also important in treating elderly patients with cancer. Pain, caused by cancer or its treatment, is prevalent, and guidelines for its assessment and treatment should be implemented to improve quality of life. Toxicities such as neutropenia and mucositis should be managed aggressively. Growth factors reduce the incidence and severity of neutropenia and its complications in older patients, particularly when they are administered in the early cycles of chemotherapy. The development of effective strategies for the management of toxicity caused by anticancer drugs may help the elderly, as much as younger patients, expect and look forward to a positive outcome with their treatment.
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PMID:New paradigms for treating elderly patients with cancer: the comprehensive geriatric assessment and guidelines for supportive care. 1534 98


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