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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hematologic dysfunction occurs commonly in patients with malignancy. Over half are anemic, often because of acute or chronic blood loss, marrow involvement by the malignancy, marrow suppressive effects of chemotherapy or radiation therapy, or because of the anemia of chronic disease. Less frequently, anemia may result from red cell aplasia, folate or B12 deficiency, hemolytic processes, or hypersplenism. Occasional patients may become polycythemic because of erythropoietin-producing tumors such as renal adenocarcinomas or cerebellar hemangiomas. Elevation of the white cell count is commonly seen, especially in patients with lung cancer. Monocytosis and thrombocytosis, which may be early signs of an underlying malignancy, are also very common and occur in up to half of patients. Thrombocytopenia is commonly a result of therapy or marrow replacement; a few patients may have a syndrome resembling immune thrombocytopenic purpura. Abnormalities of coagulation are present in many patients, and may lead to superficial or deep venous thromboses, pulmonary emboli, nonbacterial thrombotic endocarditis with arterial emboli, bleeding, or acute disseminated intravascular coagulation. A sound understanding of the potential hematologic complications that can result from the malignant process is essential to the clinician caring for cancer patients.
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PMID:Hematologic manifestations of malignancy. 268 Mar 58

Intestinal microflora can be considered as a ''dynamic system'' that actively interacts with the intestinal epithelium and the local immune system. It synthesizes antimicrobial substances (bacteriocins), vitamins (PP, B1, B6, B12), it produces a major intestinal nutrient (butyric acid) and interacts in a competitive fashion with the pathogens. Lactobacilli concentration (Gram+, Gram variable, facultative anaerobes) is generally decreased in irritable bowel syndrome (IBS) patients. This syndrome has, until recently been considered to be ''functional'', whereas, in fact, it may result from previous enteritis (in up to 31% of patients), featuring a persistent low-grade intestinal inflammation and a reduction in interleukin-10 (IL-10) concentration. Some Lactobacilli strains (e.g. L. paracasei subsp. paracasei) in vitro lead to normalisation of the hypercontractility of the smooth muscle cells. A growing body of clinical findings indicates that some ''genetically stable'' strains of Lactobacilli may be useful in the treatment, even long term, of IBS, and reduce the postoperative infection rate, especially in critically ill patients (orthotopic liver transplant, severe pancreatitis). However, some Lactobacilli, ''not genetically stable'', used in the treatment of neutropenic patients during chemotherapy and in pediatric patients submitted to gastrojejunostomy, have been reported to lead to bacteremia and endocarditis. These effects may be due to transfer of bacteria and genetic material. Therefore, the confirmed genetic stability and the fact that no antibiotic resistance occurs are fundamental requisites for the use of Lactobacilli in certain disorders of the gastrointestinal tract, such as, for instance, IBS. In conclusion, ''genetically stable'' Lactobacilli (L. paracasei subsp. Paracasei F19) have recently become available, representing an exiting new field in clinical studies and for treatment purposes, offering guarantees of safety also for long-term use. Careful personalized evaluation, as always in medical practice, is necessary in order to gain further insight into, and to validate with additional studies, the role of ''genetically stable'' Lactobacilli in the treatment of IBS.
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PMID:New insights into Lactobacillus and functional intestinal disorders. 1861 77

The array of diagnostic workup for pyrexia of unknown origin (PUO) generally revolves in searching for infections, inflammatory/autoimmune, and endocrine etiologies. A differential diagnosis of fever, hemolytic anemia, and thrombocytopenia can have etiologies varying from infections like malaria, dengue, cytomegalovirus, Ebstein barr virus, Parvovirus, infective endocarditis, to autoimmune disorder (systemic lupus erythromatosis), vasculitis, hemolytic uremic syndrome, thrombotic thrombocytopenic purpura (TTP), autoimmune hemolytic anemia/Evan's syndrome, paroxysmal nocturnal hemoglobinuri (PNH), or drugs. Nutritional deficiencies (especially vitamin B12 deficiency) as a cause of fever, hemolytic anemia, and thrombocytopenia are very rare and therefore rarely thought of. Severe vitamin B12 deficiency may cause fever and if accompanied by concurrent hyper-homocysteinemia and hypophosphatemia can sometimes lead to severe hemolysis mimicking the above-mentioned conditions. We present a case that highlights vitamin B12 and vitamin D deficiency as an easily treatable cause of PUO, hemolytic anemia, and thrombocytopenia, which should be actively looked for and treated before proceeding with more complicated and expensive investigation or starting empiric treatments.
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PMID:Vitamin B12 and vitamin d deficiencies: an unusual cause of Fever, severe hemolytic anemia and thrombocytopenia. 2581 Oct 10