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 principle of prescribing dialysis therapy is treatment of uremic symptoms and morbidity, and adequate therapy to prevent complication of long term dialysis. For this purpose careful measurement and monitoring of various parameters should be done in chronic dialysis patients. We analyzed the laboratory data of 82 patients treated at our dialysis center. We started correction of renal anemia with erythropoietin from 1987, and the mean hematocrit was improved from 24% to 28%. The blood transfusion volume was decreased markedly. There was a significant correlation between plasma alpha-human atrial natriuretic peptide (HANP) levels and the size of the heart. Plasma HANP seems to be a reliable parameter of the so-called dry weight in patients on maintenance dialysis. We analyzed the parameters of bone for the recent four years. Alkaline phosphatase (ALP) and C-PTH increased throughout the duration of dialysis, while bone mineral density (BMD) decreased. Annual changes of sigma GS/D were negatively correlated with ALP and C-PTH. In relation to duration of dialysis, changes of sigma GS/D were less in the group treated for less than 3 years. Nine patients (60% of patients on dialysis more than 10 years) had carpal tunnel syndrome (CTS) with symptoms and signs. Median nerve distal motor latency was positively correlated with the duration of dialysis. The beta 2-microglobulin (beta 2-MG) level of dialysis patients was very high and even though the beta 2-MG level was lowered by hemodiafiltration CTS was not improved.
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PMID:[Laboratory data in chronic dialysis patients]. 130 6

In a uniform series of 170 untreated myeloma patients (MM) we investigated the distribution of T cell subsets in peripheral blood (PB) and their relationship with the most relevant disease characteristics, including survival. CD4 cells were significantly decreased both in percentage and absolute numbers (P less than 0.0001). On the other hand, the CD8 cells only showed a slight increase in relative numbers. Upon correlating the abnormalities in the distribution of T cells with other clinical and biological disease characteristics the most remarkable correlation was with survival. A low number of CD4 cells (less than 700 x 10(6)/l) was associated with both an advanced clinical stage and a shorter survival (20 v. 43 months, P = 0.01). Moreover, a significant correlation also exists between the decrease in CD4 cells and both high beta 2-microglobulin (beta 2M) levels and anaemia. On the other hand, no relationship was found with the type of M-component nor with the plasma cell phenotype. Finally multivariate analysis showed that the number of CD4 cells add independent prognostic information to other well-established tests for the assessment of disease outcome in patients with multiple myeloma.
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PMID:Lymphoid subsets and prognostic factors in multiple myeloma. Cooperative Group for the Study of Monoclonal Gammopathies. 158 Dec 10

The authors evaluated in a group of 89 patients with monoclonal gammapathy (18 patients with monoclonal gammapathy of undermined significance, 34 patients examined at the time of diagnosis of multiple myeloma (MM) and in a group of 71 patients with MM examined in different stages of the disease) the serum beta 2-microglobulin. It was revealed that the mentioned indicator is of no differential diagnostic value, it is not related to sex nor to the immunochemical type of monoclonal immunoglobulin. A relationship of serum beta 2-microglobulin to age, serum urea and serum creatinine, to the severity of anaemia, serum albumin, sedimentation rate of red cells, degree of infiltration of bone marrow by myeloma plasmocytes and the stage of the disease, evaluated by the systems of Durie-Salmon and Medical Research Council, was found. The authors tested the importance of serum levels of this indicator for the prognosis of the disease.
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PMID:[Serum beta 2-microglobulin in multiple myeloma. I. Relation to selected indicators, clinical stage and disease prognosis]. 205 4

We report herein the case of a 14-year-old female who has acute tubulo-interstitial nephritis (AIN) associated with bilateral diffuse uveitis. She was admitted for the evaluation of "proteinuria", following general fatigue and weight loss about 2 weeks ago. Her laboratory data showed mild anemia, hyper gamma-globulinemia, mild proteinuria, and the reduced glomerular filtration rate with the increased urinary excretion of beta 2-microglobulin. The histological examination obtained by renal biopsy showed mild edema and diffuse infiltration of mononuclear cells in interstitium without any glomerular or vascular abnormalities, which were compatible with AIN. As for the etiology of AIN, clinical investigations could not reveal any specific causes, such as bacterial and viral infections, drugs and systemic diseases. About 4 months after the onset of nephritis, she also became to suffer from bilateral diffuse uveitis. Therefore, the diagnosis of the acute tubulo-interstitial nephritis and uveitis syndrome (TINU syndrome) (Vanhaesebrouck et al., 1985) could be confirmed. In her clinical course, it was noteworthy that uveitis relapsed frequently in spite of systemic administration of prednisolone, and it took two years until uveitis cured, whereas the AIN subsided spontaneously prior to the specific treatment. In this case, characteristic findings of granulomatous uveitis was closely similar to those of sarcoidosis, which has been rarely reported in TINU syndrome. In this respect, the involvement of immune processes, especially cell-mediated, was suggested as the possible pathogenesis in this case.
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PMID:[A case of acute tubulo-interstitial nephritis and uveitis syndrome]. 219 32

Between January 1987 and October 1989, 561 consecutive untreated patients with monoclonal gammopathy of undetermined clinical importance (MGUS) (n = 295) or with multiple myeloma (n = 266) were evaluated in a multicentre trial. Both bone marrow biopsy and aspiration (performed at different anatomical sites) were required at presentation. Bone marrow biopsy data indicated that changes in bone marrow composition from MGUS to early multiple myeloma and to advanced multiple myeloma followed a precise pattern, including an increased percentage of bone marrow plasma cells (BMPC%), a shift from plasmocytic to plasmoblastic cytology, an increase in bone marrow cellularity and fibrosis, a change in bone marrow infiltration (becoming diffuse rather than interstitial), a decrease in residual haemopoiesis and an increase in osteoclasts. In multiple myeloma the BMPC% of biopsy specimens and aspirate were closely related, although in 5% of cases the difference between the two values was greater than 20%. Some histological features were remarkably associated with each other. For example, BMPC% was higher in cases with plasmoblastic cytology, heavy fibrosis, or reduced residual haemopoiesis. Anaemia was the clinical characteristic most influenced by bone marrow histology. The BMPC% was the only histological variable which affected the greatest number of clinical and laboratory characteristics, including, besides haemoglobin concentration, erythrocyte sedimentation rate, radiographic skeletal bone disease, and serum concentrations of monoclonal component, calcium, beta 2-microglobulin and thymidine kinase activity. These data indicate that comparative bone marrow histology in monoclonal gammopathies has clinical importance.
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PMID:Bone marrow biopsy in monoclonal gammopathies: correlations between pathological findings and clinical data. The Cooperative Group for Study and Treatment of Multiple Myeloma. 219 32

Although there are only 10 years of clinical experience with CAPD, compared to about 30 years of clinical practice with haemodialysis, it is time to compare the results obtained from the two methods. In this review, after briefly summarising the state of the art for some worrisome aspects of CAPD (peritonitis, loss of ultrafiltration and peritoneal clearance, malnutritional status), the ability of CAPD and haemodialysis to control the uraemic abnormalities are compared. Anaemia, blood pressure, cardiac function, renal bone disease, beta 2-microglobulin, and uraemic neuropathy are examined in the light of our personal experience and the literature; data so far published seem to indicate that the two methods are roughly similar for controlling these conditions. A survey of the studies comparing patient and method survival is also included. Patient survival on CAPD or on haemodialysis does not differ by more than 6 years. Method survival is better for haemodialysis; this is primarily due to the high drop-out rate from CAPD because of peritonitis, and the difference is very much reduced in CAPD centres with a low incidence of peritonitis. On the whole, CAPD seems to be able to compete, sometimes favourably, with haemodialysis. However, in our opinion the two methods are not in competition; each has its preferential indications, limits and complications, and both should be offered to uraemic patients in accordance with their medical or social needs. One should be ready to shift the patient from one method to the other when necessary, either for short periods of time or indefinitely.
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PMID:Is CAPD competitive with haemodialysis for long-term treatment of uraemic patients? 250 31

Data concerning the presentation and response to treatment of 73 patients with multiple myeloma who survived for 5 years or more were reviewed. At the time of diagnosis, the proportion of patients with hypercalcaemia (4%), severe anaemia (9%), renal failure (10%) or high beta 2-microglobulin levels (25%) was low. Less than one-third of our patients belonged to a "high risk" group, as defined by the three classification systems adopted: the lowest percentage of such patients (18%) was observed with the Medical Research Council classification. In all patients, but even more in those with an initially aggressive disease (P less than 0.05), obtaining a plateau (70% of the cases) or even an optimal tumoral regression with complete disappearance of monoclonal immunoglobulin (26% of the cases) seems to be a highly favourable factor. The same applies, though to a lesser degree, to slow response to chemotherapy (18 months on average). In all responders whether the remission was maintained or not by chemotherapy seemed to have no influence on the frequency (70%) and delay of relapses (4 1/2 years on average from the time of diagnosis). The risk of secondary blood disease (2 AML 1, 1 AML4, 1 RAEB, 1 ASIA, four of which were directly responsible for death) after 4 years on average of chemotherapy must be taken into consideration.
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PMID:[Prolonged survival in multiple myeloma. Characteristics of presentation and response to treatment of 73 patients who survived 5 years or longer]. 294

In Hokkaido, there were 305 chronic dialysis patients surviving more than ten years as of July 31, 1985. All patients except for one (CAPD) have been placed under hemodialysis. About 73% of them were introduced into a dialysis therapy in their thirties and chronic glomerulonephritis was extremely predominant as for the underlying disease. 93.2% of the cases possessed internal AV-fistulae using own vessels and other types of blood access remained only 6.8%. Hematocrit (Hct) was 27.5% on average of 305 cases. The value was fairly satisfactory but it must be noted that Hct of 33 patients (10.8% of all) was less than 20%. Severe anemia is still one of major complication in chronic dialysis patients. Characteristic complications, which have been increasing in frequency in parallel with prolonged dialysis length, became clarified: renal osteodystrophy, secondary hyperparathyroidism, carpal tunnel syndrome, persistent hypotension and so on. The former two are strongly related to Ca & P metabolism and some of the long-term survivals require parathyroidectomy. It is now estimated that carpal tunnel syndrome is induced by accumulation and deposition of beta 2-microglobulin, which increases in blood progressively if used Cuprophane membrane dialyser. Patients with CTS must be placed under surgical intervention, which relieves the symptoms effectively and the prophylaxis might require protein-permeating dialyser.
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PMID:[Statistical analyses on over ten years survivals in Hokkaido under chronic dialysis therapy]. 355 75

Workers, who had been exposed to cadmium oxide fume, i.e., engaged in welding work with cadmium containing silver solder in an automobile parts manufacturing factory, were examined in 1975. Twenty two male welders were 22 to 55 years old and exposed to cadmium for periods ranging from 7 months to 23 years. Excreted urinary cadmium levels varied from 5.7 micrograms to 184.9 micrograms per day, and these values were useful indices of most recent exposures in workshop environments. The examinees were divided into three groups according to excreted urinary cadmium levels: five of them in high, eleven in middle, and six in low group, respectively. Workers in high-excretion group complained of considerable subjective symptoms and their urinary protein showed a remarkable increase, compared to middle- and low-excretion groups, and the electrophoretic pattern of urinary proteins showed preponderance of globulins. Urinary calcium and beta 2-microglobulin in the high-excretion group showed a remarkable increase. In all examinees, urinary phosphate, calcium, and beta 2-microglobulin were significantly correlated with urinary excreted cadmium. Furthermore, in the high-excretion group showed a considerable increase of serum creatinine values and reduction of creatinine clearance, and percent tubular reabsorption of phosphate, calcium and beta 2-microglobulin decreased. In all examinees, creatinine clearance and percent tubular reabsorption of both phosphate and calcium were significantly negatively correlated with urinary cadmium excretion. Therefore, five high-excretion workers showed evidence of chronic renal tubular dysfunction and one of these was particularly recognized as having remarkable renal damage. The possibility to affirm the effects of exposure to cadmium was suggested on hematological findings related to anemia. Liver function abnormalities were not recognized. A slight reduction of the respiratory function was found in one worker of the high-excretion group, but radiological examination of chest showed no abnormalities in all examinees.
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PMID:[Chronic renal dysfunction in workers exposed to cadmium oxide fume. Medical examinations of welders using cadmium containing silver solder]. 639 51

cis-Diammine-1,1-cyclobutane dicarboxylate platinum II (CBDCA, JM8), an analogue of cisplatin showing reduced toxicity in preclinical studies, was evaluated in 60 patients. Doses were given initially every 3 weeks and escalated from 20 to 520 mg/m2. Following this, doses were given every 4 weeks and escalated from 300 to 500 mg/m2. The dose-limiting toxicity, thrombocytopoenia, occurred in four-fifths of patients treated at 520 mg/m2, with the nadir occurring 3 weeks after treatment. Leucopoenia and anaemia also occurred but were less severe. Vomiting occurred in all patients receiving over 120 mg/m2 but seldom persisted beyond 24 h. Serial measurements of 51Cr-EDTA clearances, urinary N-acetylglucosaminidase, urinary leucine aminopeptidase, and beta 2-microglobulin did not reveal significant evidence of nephrotoxicity. Detriment to the audiogram has not been seen in the first 13 patients studied. Pharmacological studies showed that most of the dose of platinum was excreted in the urine, and that impairment of renal function may be associated with drug retention and an increased risk of myelosuppression. The previous therapy and age of the patient also affected the tolerance of the drug. Clinical responses were seen in patients with ovarian carcinoma receiving greater than 120 mg/m2. A further dose escalation was performed on a 4-week schedule in patients under 65 with good renal function. The maximum dose it was possible to administer repeatedly without incurring myelosuppression was in the range 400-500 mg/m2. JM8 is not significantly nephrotoxic and is less emetic than cisplatin. It has antitumour activity in man and deserves wider evaluation, along with the other analogues under study in various centres, as an alternative to cisplatin.
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PMID:Early clinical studies with cis-diammine-1,1-cyclobutane dicarboxylate platinum II. 676 Oct 10


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