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)

In 74 chronic glomerulonephritis (CGN) and 13 hemodialysis patients (HD) blood volume and hemodynamic indices were examined. Significant correlation was observed between MPA and PV in CGN. High PV in high S-Cr group is considered to be correlated with anemia. Salt restriction reduced MAP without the change in BV in the impaired kidney function group in CGN. Volume depletion in HD shifted TPRI to lower level in the group with significant MAP reduction. The results indicate that sodium rather than water will play an important role in this type of hypertension.
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PMID:Hypertension in chronic glomerulonephritis. 675 Jan 90

Mortality is the greatest concern in assessing risks of modern reversible contraception. The problems identified with older oral contraceptives (OCs) have decreased with the lower doses in current OCs. These problems include cardiovascular and thrombotic effects, changes in lipid metabolism, breast cancer, liver cancer, increased risk of chlamydia cervicitis, no protection against sexually transmitted diseases (STDs) and HIV, and interferes with breast feeding. On the other hand, OCs protect against anemia, menstrual disorders, ectopic pregnancy, acute pelvic inflammatory disease (PID), and ovarian and endometrial cancer. Since the contraceptive implant, Norplant, has no estrogens, it does not have the cardiovascular risks associated with OCs. Possible risks from Norplant use include changes in carbohydrate, liver, and lipid metabolism but they tend to be clinically insignificant and no protection against STDs/HIV. Menstruation disorders are the major side effect. Apparent benefits of Norplant are protection against anemia and ectopic pregnancy and no effect on lactation. The injectable contraceptive, Depo-Provera, causes menstrual changes, may slightly increase the risk of breast cancer, may decrease bone density, and does not protect against STDs/HIV. It protects against endometrial cancer. It has no effect on metabolism. Risks associated with the IUD include PID, perforation, anemia, increased menstrual bleeding, and pregnancy. IUDs do not affect the quantity of composition of breast milk. They are best suited for women in a mutually monogamous, long-term relationship. Barrier methods provide some degree of protection against STDs/HIV and PID. Condoms provide the most protection. They do not affect lactation. Their major complications are contraceptive failure and risks associated with pregnancy. For all women, especially those in high risk categories, one must balance the risks of modern contraceptive use with the risks of childbearing and with their benefits.
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PMID:The safety of modern contraceptives. 784 6

Women over age 40 have high rates of unwanted pregnancy and abortion and limited choices of contraception. Oral contraceptives (OCs) with 20-35 mcg of estrogen can be recommended for these women as long as they do not smoke. Previously, some association was found between pill users aged over 35 years and an increased risk of myocardial infarction. Thus, OCs were not recommended for them. However, recent findings implicate smoking instead of age in the increased risk of myocardial infarction in OC users. OCs are useful in treating dysfunctional uterine bleeding of the perimenopause, in regulating menstrual cycles, and in preventing anemia. Other benefits include the reduction of endometrial and ovarian cancers, fibroids, endometriosis, benign breast diseases, ovarian cysts, ectopic pregnancy, and pelvic inflammatory disease. Monogamous and parous women with negative cervical cultures for gonorrhea and chlamydia can use IUDs. Sterilization is an option only after the completion of family size; tubal ligation, however, is associated with more morbidity and mortality than vasectomy. Thus, vasectomy should take precedence over tubal ligation. Depo-Provera injections every 3 months are safe, and they also help with dysfunctional bleeding and breakthrough bleeding via the production of amenorrhea. This drug is approved by the Food and Drug Administration and is popular worldwide. Long-term studies have not confirmed the increased risk of breast cancer with Depo-Provera use. Among implants, Norplant is almost as effective as tubal ligation, but it may cause dysfunctional bleeding in women over the age of 40. Mechanical methods also provide protection; however, they result in a pregnancy rate of 10-20% per year.
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PMID:Contraception in women older than 40 years of age. 836 31

Anemia, through a hyperkinetic state, is an important contributor to myocardial function impairment. To determine the cardiovascular effects of recombinant human erythropoietin (rHuEPO) therapy, 10 chronic peritoneal dialysis (CPD)-treated anemic children were studied before and during 18 months of treatment. The following parameters were recorded: hemoglobin (Hb) [percent of target level (TL) = x-2 standard deviations of normal Hb values for age and sex], heart rate (HR, beats/minute), mean arterial pressure (MAP, mmHg), end-diastolic left ventricular diameter (EDLVD, mm/sm BSA), shortening fraction (SF, percent), and interventricular septal thickness (IVS, mm/sm BSA). Student's t-test for paired data showed (vs time before treatment, T0) a progressive increase in Hb, a progressive decrease in HR, and a progressive increase in MAP. EDLVD progressively decreased, while SF and IVS remained unchanged throughout the study. Regression analysis showed a close correlation between anemia correction and decrease of HR (p < 0.01), while no correlation was found between Hb and EDLVD or SF, IVS, or MAP. Our data indicate that anemia correction in these patients is mainly associated with a decrease in hyperkinetic state (HR reduction with SF unvaried), while left ventricular function and dimensions remain normal, despite an increase in MAP.
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PMID:Cardiovascular function in a chronic peritoneal dialysis pediatric population on recombinant human erythropoietin treatment. 839 85

We report a case of transfusion-associated graft-versus-host disease (GVHD). A 79-year-old woman with Hodgkin's disease, respiratory failure and severe anemia who had been treated with two courses of chemotherapy was transfused with red cell concentrate (MAP-CRC) and fresh frozen plasma (FFP) in the ICU. On the 7-9th days after transfusion, she developed a diffuse erythematous rash mainly on the chest, high fever, liver dysfunction and thrombocytopenia. Despite treatment with immunoglobulin products and methylprednisolone, her condition deteriorated rapidly, and she died of multiple organ failure on the 7th day after appearance of rash. Skin biopsy demonstrated typical features of acute GVHD, suggesting that MAP-CRC-associated GVHD had occurred.
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PMID:[A case of graft-versus-host disease following red cell concentrate (MAP-CRC) transfusion]. 852 63

In 1993 a group of 367 physicians participated in a survey of family planning service-delivery practices. 76% of them were male with an average tenure of 16 years as doctors. 95% worked in urban areas, and 98% counseled their clients, although 1/4 of them received no training in counseling. Only 25% of them knew of The Family Planning Service Delivery Manual guidelines, and only 27% of those who had heard of the manual ever used it. They stated that women could use Depo-Provera after age 20, but 42% of the doctors would require women to have 2 children before using this method. The guidelines recommended the IUD to women who were at least 27 years old after they had had at least 1 child. 27 years was the average recommended age for female sterilization and 31 years for male sterilization. The average systolic and diastolic blood pressure points noted by the physicians were almost the same for both the oral contraceptive pill and Depo-Provera: an average systolic pressure of 138 and diastolic pressure of 89. They were generally interested in the patient's age, smoking habits, any cardiovascular problems, varicose veins, abnormal vaginal bleeding, and blood pressure. In addition, anemia, pelvic inflammatory disease, and sexually transmitted diseases were important considerations for IUD use but were mentioned by only 12%, 41%, and 82% of the doctors, respectively. 68% of them required tests for male sterilization compared to 97% for IUD use. More than 20% of them required urinalysis before prescribing a contraceptive method. The average number of follow-up visits for combined oral contraceptive users was 2.7 in the 1st year and 1.4 in the 2nd year. 67% of the physicians recommended a rest from at least 1 contraceptive method. More than 1 in 10 of all physicians cited opposition to Depo-Provera (12% mostly for safety reasons) and natural family planning (13% for efficacy reasons).
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PMID:Assessing family planning service-delivery practices: the case of private physicians in Jamaica. 882 73

US teenagers have had access to the injectable contraceptive depot medroxyprogesterone acetate (DMPA; Depo-Provera) since the US Food and Drug Administration approved it in 1992. DMPA suppresses follicle stimulating hormone and luteinizing hormone (LH) levels, which in turn prevents the LH surge and thus inhibits ovulation. It also causes a thick cervical mucus (reducing sperm penetration). Since DMPA also changes tubal mobility and creates shallow and atrophic endometrium, implantation is prevented. DMPA must be administered every 3 months to be effective. Its first-year failure rate is 0.3%, which is lower than that of oral contraceptives (3%). Advantages of DMPA are that it: allows for privacy; improves compliance (since action is required every 3 months rather than every day); has no estrogen-related complications (e.g., thrombophlebitis); is effective; is safe for breast feeding teenagers; reduces seizure frequency in teenagers with epilepsy; has a favorable effect on sickle cell disease or coagulopathy; reduces menstrual flow, thus preventing iron-deficiency anemia; reduces menstrual pain and pre-menstrual symptoms; and decreases risk of pelvic inflammatory disease. The leading disadvantages are menstrual irregularities and spotting. Some other possible disadvantages include weight gain (most common reason for discontinuation), delayed return of fertility, headaches, acne, and nervousness. Health providers must perform a complete history of teenagers requesting DMPA. They should determine the presence or absence of absolute and relative contraindications to DMPA. Absolute contraindications are known or suspected pregnancy, undiagnosed or abnormal vaginal bleeding, known or suspected history of breast cancer, acute liver disease or jaundice, thromboembolism, and sensitivity to DMPA. DMPA is administered intramuscularly at a concentration of 150 mg/ml. Health providers need to use a frank, nonjudgmental, empathic, and unhurried approach to facilitate a trusting relationship and rapport with teenagers. Advanced counseling on the pros and cons of DMPA, how DMPA works, and DMPA's inability to protect against sexually transmitted diseases is essential.
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PMID:Use of depo-provera in teens. 892 Mar 51

The hypothesis that misperceptions about the effectiveness of contraceptive methods and the risks and benefits of oral contraceptive (OC) use are widespread in the US, even among the most educated population groups, was investigated in 147 women presenting to the Brown University (Providence, Rhode Island) health service and 189 students solicited by female volunteers on the campus. 90% of respondents correctly estimated the effectiveness of OCs in preventing pregnancy, but 32-34% inflated the pregnancy rates associated with subdermal implants and Depo-Provera. 60% overestimated the failure rate of the IUD. On the other hand, a majority underestimated the failure rates of barrier methods and spermicides. 41% believed OCs increase the risk of breast cancer and 33% thought the pill increases cervical cancer risk. 66% knew that OCs reduce dysmenorrhea and 50% were aware the pill decreases menstrual bleeding. However, the majority were unaware OCs reduce the risk of benign breast disease (95%), ectopic pregnancy (91%), pelvic inflammatory disease (90%), and anemia (89%). 81% were unaware of the protective effects of OCs against uterine cancer and 77% did not know they have a protective effect against ovarian cancer. In general, OC users were more aware of the health benefits of OCs than condom users. Finally, respondents were asked to rate their satisfaction with their current birth control method on a scale of 1-12. Mean satisfaction scores were significantly higher among OC users (10.3) than condom users (7.1). These findings indicate that, even among highly educated US women, misperceptions persist about the reliability of birth control, the risks of pregnancy, and the health effects of OCs.
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PMID:Perceptions of contraceptive effectiveness and health effects of oral contraception. 943 1

Menorrhagia--menstrual periods lasting longer than 7 days and totaling blood losses greater than 80mL--affects 9%-14% of otherwise healthy women, and it can signal cancer, an endocrinologic disorder, or gynecologic disease. Blood loss can be high enough to result in anemia, fatigue, and syncope. Most often, abnormal uterine bleeding such as menorrhagia involves a disruption in the hypothalamic-pituitary axis, the ovary, and/or the uterus. Other identified causes include medications (especially psychotropics) that cross the blood-brain barrier; chronic diseases such as cancer, diabetes, and liver and kidney dysfunction; endocrine disorders, perimenopausal anovulation, polycystic ovary disease, pituitary tumors, and abnormal estrogen cycling caused by morbid obesity; and anatomic abnormalities of the uterus. Routine tests include hematocrit or hemoglobin to detect and evaluate anemia, thyroid stimulating hormone (TSH) level to evaluate thyroid function as a possible cause, and a pregnancy test to rule out an incomplete, spontaneous abortion as a cause. A Pap test is recommended to screen for dysplasia that can suggest a gynecologic cancer cause. Additional screening for endocrine disorders that may be causing menorrhagia include tests of thyroid, liver, and kidney function, and tests of follicle stimulating hormone (FSH), prolactin, and cortisol levels. Treatment can be medical or surgical. Medical treatment includes prostaglandin inhibitors, specifically nonsteroidal antiinflammatory drugs (NSAIDs), and hormonal therapy with estrogen, progesterone, gonadotropin-releasing hormone agonists, or oral contraceptives such as medroxyprogesterone (Depo-Provera). Surgical treatment includes hysteroscopic endometrial ablation by physical agents, laser electrodiathermy, and "roller ball," or surgical, resection. Hysterectomy is the treatment of last resort.
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PMID:Treatment Decisions in the Management of Menorrhagia. 974 72

The case presented in this paper suggests that the levonorgestrel intrauterine system may be an excellent contraceptive method for HIV-positive women. At presentation to a UK family planning clinic, a 32-year-old nulliparous woman was using Depo-Provera for contraception; however, she was bleeding irregularly and complained of acne and lack of vaginal lubrication. The Mirena intrauterine system was considered because it offered lighter menstrual periods or amenorrhea, no need for regular clinic visits, reliable contraception, and fewer systemic side effects than other progestogen-only methods. At follow-up 6 weeks after Mirena insertion, the woman reported one light period, pain on the day of fitting only, and no progestogenic side effects. The reduced blood loss associated with this method is beneficial if mild anemia is present and may reduce exposure of an HIV-negative male partner to infected blood. Moreover, the system's effectiveness is not compromised by the broad-spectrum antibiotics or liver enzyme-inducing drugs taken by women with HIV/AIDS.
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PMID:Successful use of levonorgestrel intrauterine system in a HIV positive woman. 1022 47


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