Use of complementary and alternative medicine by patients with hematological diseases: experience at a university hospital in northeast Mexico

BACKGROUND: Complementary and alternative medicine includes a diverse group of medical and healthcare systems, practices and products not considered part of conventional medicine. Although there is information on unconventional practices in oncological diseases, specific data regarding the use of complementary and alternative medicine by hematology patients is scarce. OBJECTIVE: The aim of this study is to document the prevalence of this modality of unconventional therapy in patients with malignant and benign hematological diseases, particularly children with acute lymphoblastic leukemia. METHODS: An observational study of adult patients and guardians of children with malignant or benign hematological diseases was carried out by applying a structured questionnaire detailing the use and results of the most prevalent complementary and alternative medicine practices. RESULTS: One hundred and twenty patients were included; 104 had malignant and 16 had benign hematological diseases. The use of complementary and alternative medicine was greater in benign diseases but the difference was not statistically significant (64.7% versus 41.7%; p-value = 0.08). Patients and guardians with high school or college educations used these alternative practices more than patients with less schooling (60.7% versus 54.7%; p-value = 0.032). The use of folk remedies was most prevalent followed by herbal preparations and spiritual healing. Sixty-four percent of patients that used these unconventional practices reported improvement in their symptoms and increased capacity to perform daily activities. CONCLUSION: No significant difference was documented between patients with malignant or benign hematological diseases using these alternative practices. The majority of complementary and alternative medicine users reported improvement of the disease or chemotherapy-related symptoms.

Acute lymphoblastic leukemia of childhood presenting as aplastic anemia: report of two cases

Acute lymphoblastic leukemia is the most common malignancy in pediatric patients; its diagnosis is usually easy to establish as malignant lymphoblasts invade the bone marrow and peripheral blood. Some acute lymphoblastic leukemia patients may initially present with pancytopenia and a hypoplastic bone marrow leading to the initial diagnosis of aplastic anemia. In most of these patients clinical improvement occurs, with normalization of the complete blood count within six months, although recovery can also develop a few weeks after initiating steroid therapy. The etiologic relationship between the aplastic anemia features and the subsequent overt development of acute lymphoblastic leukemia has not been established. We describe the cases of two children who presented with severe infection and signs and symptoms of aplastic anemia confirmed by bone marrow aspirate and bone marrow biopsy that developed acute lymphoblastic leukemia thereafter. No specific therapy for aplastic anemia was administered, nevertheless a full spontaneous recovery was observed in both cases. Acute lymphoblastic leukemia was successfully treated with standard chemotherapy, both children remaining in complete remission 16 and 17 months after their initial aplastic anemia diagnosis.

Variantes de butirilcolinesterasa sérica en población de Santiago oriente / Serum butyrylcholinesterase variants in eastern Santiago

Succinylcholine causes prolonged apneas in a proportion if subjects that have genetical defect of butyrylcholinesterase, due to the presence of unusual alleles in the locus BCHE. To estimate allele frequences of 3 variants of serum butyrylcholinesterase, BCHE*U, BCHE*A and BCHE*F in an urban population of Santiago, Chile, different phenotypes for the locus BCHE were determined in 300 blood samples coming from patients of a private clinical laboratory. The population was formed by an admixture of Amerindian and European (mostly spanich) people. The frequency of BCHE*A was similar to the expected for this population, but BCHE*F frequency was greater than predicted. Eight subjects had a genotype BCHE AK. The higher frequency found for BCHE*F is probably due to the use of more precise detection techniques. Although the used method cannot distinguish BCHE UK from BCHE UU, the findings of individuals with BCHE AK, must lead to the suspicion that the frequency of the allel BCHE K is not negligible in Santiago

Disseminated histoplasmosis

We have presented the microbiology, pathogenesis, clinical presentation, diagnosis and treatment of disseminated histoplasmosis. Emphasis is presented on the manifestations in the HIV infected patient

Septic endophthalmitis associated with bacteremia and liver abscess caused by Klebsiella pneumoniae

El absceso piogénico del hígado es una condición asociada con complicaciones serias en un 10 a 20% de los casos. Endoftalmitis bacteriana por embolización sépticas es una de las complicaciones raras asociadas a abscesos hepáticos. A pesar del tratamiento apropiado, las consecuencias de esta condición son devastadoras en la mayor parte de los casos. En este informe presentamos la etiología de endoftalmitis, su diagnóstico y su tratamiento