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1.
Hematol., Transfus. Cell Ther. (Impr.) ; 44(1): 76-84, Jan.-Mar. 2022. tab, graf, ilus
Article in English | LILACS | ID: biblio-1364883

ABSTRACT

Abstract Preoperative anemia is a common finding. Preoperative allogeneic transfusion, iron therapy, vitamin supplementation and erythropoietin therapy are the current management strategies for preoperative anemia. Previous reviews regarding erythropoietin were limited to specialties, provided little evidence regarding the benefits and risks of erythropoietin in managing preoperative anemia and included non-anemic patients. The purpose of our systematic review was to determine the role of erythropoietin solely in preoperatively anemic patients and to investigate the complications of this treatment modality to produce a guideline for preoperative management of anemic patients for all surgical specialties. The PubMed/Medline, Google Scholar, and Cochrane Library were searched for randomized trials evaluating the efficacy of erythropoietin in preoperative anemia. The risk ratio (RR) and standardized mean difference (SMD) was used to pool the estimates of categorical and continuous outcomes, respectively. Allogeneic transfusion and complications and the 90-day mortality were the primary outcomes, while the postoperative change in hemoglobin, bleeding in milliliters and the number of red blood cell (RBC) packs transfused were the secondary outcomes. Results: Eight studies were included, comprising 734 and 716 patients in the erythropoietin group and non-erythropoietin group, respectively. The pooled estimate by RR for allogeneic transfusion was 0.829 (p = 0.049), while complications and the 90-day mortality were among the 1,318 (p = 0.18) patients. Conclusion: Preoperative erythropoietin provides better outcomes, considering the optimization of preoperative anemia for elective surgical procedures. The benefits of erythropoietin are significantly higher, compared to the control group, while the risks remain equivocal in both groups. We recommend preoperative erythropoietin in anemic patients.


Subject(s)
Humans , Erythropoietin , Anemia , Blood Transfusion , Preoperative Care , Iron Compounds/therapeutic use
3.
Article in Chinese | WPRIM | ID: wpr-921532

ABSTRACT

Objective To compare the efficacy and safety of cyclosporin A(CsA)and CsA combined with recombined human erythropoietin(rhEPO)in the treatment of patients with chronic aplastic anemia(CAA).Methods Data of 79 patients with CAA treated at Department of Hematology,PUMC Hospital between January 2016 and June 2018 were collected for retrospective analysis.Forty-five patients were treated with CsA+rhEPO,and the other 34 patients with CsA alone.All the enrolled patients were treated for at least 1.5-2.0 years and followed for at least 1.0 year.The efficacy,side effects,long-term outcomes were compared between the two groups,and factors that may influence the efficacy were analyzed.Results The patients treated with CsA+rhEPO included 14 males and 31 females,with a median age of 43(19,73)years old.The median treatment duration of CsA and rhEPO was 26(12,38)and 4(3,6)months,respectively,and the median followed-up time was 24(12,42)months.The patients treated with CsA alone included 16 males and 18 females,with a median age of 36(16,85)years old.The median CsA treatment duration was 24(12,40)months and the median follow-up time was 25(12,40)months.There was no statistical difference in baseline characteristics between the two groups(all


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Anemia, Aplastic/drug therapy , Cyclosporine/therapeutic use , Erythropoietin/therapeutic use , Female , Humans , Male , Middle Aged , Recombinant Proteins , Remission Induction , Retrospective Studies , Young Adult
5.
Rev. Hosp. Ital. B. Aires (2004) ; 40(3): 105-116, sept. 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1129064

ABSTRACT

Este trabajo tiene como objetivo revisar las contribuciones de la biotecnología, en relación con el tratamiento, diagnóstico y la monitorización de la enfermedad renal crónica (ERC) y sus comorbilidades más frecuentes, especialmente la anemia. En relación con los tratamientos, enfocamos el desarrollo de productos biofarmacéuticos como los agentes estimulantes de la eritropoyesis (ESA), que fueron los primeros biofármacos utilizados para el tratamiento de la anemia asociada a la ERC; analizamos sus características y utilización actual después de varios años de experiencia clínica, así como también otras alternativas en desarrollo. Revisamos distintos tipos de bioterapias, la utilización de las células estromales mesenquimales de médula ósea (MSC) y tratamientos alternativos con modificaciones dietarias, que se basan en la asociación entre la microbiota intestinal de los pacientes renales crónicos y sus condiciones fisiopatológicas. Finalmente, en relación con el diagnóstico y monitorización, nos referimos al estudio y validación de biomarcadores diagnósticos, predictivos y terapéuticos que han permitido optimizar los resultados clínicos en este tipo de pacientes. (AU)


The aim of this work is to review the contributions of biotechnology, in relation to the treatment, diagnosis and monitoring of chronic kidney disease (CKD) and its most frequent comorbidities, especially anemia. Regarding the treatment, we focus on the development of biopharmaceutical products such as erythropoiesis stimulating agents (ESA), which were the first biopharmaceuticals used to treat anemia associated with chronic kidney disease (CKD). We analyzed their characteristics and their current use after several years of clinical experience, as well as other alternatives in development. We also review different types of biotherapies, the use of bone marrow mesenchymal stromal cells (MSC) and alternative treatments with dietary modifications, which are based on the association between the intestinal microbiota of chronic kidney patients and their pathophysiological conditions. Finally, in relation to diagnosis and monitoring, we refer to the study and validation of diagnostic, predictive and therapeutic biomarkers that have made clinical results possible to be optimized in this type of patient. (AU)


Subject(s)
Humans , Biological Therapy/trends , Renal Insufficiency, Chronic/therapy , Quality of Life , Biotechnology , Biomarkers , Erythropoietin/deficiency , Probiotics/therapeutic use , Mesenchymal Stem Cell Transplantation/trends , Erythropoiesis/drug effects , Renal Insufficiency, Chronic/diagnosis , Renal Insufficiency, Chronic/diet therapy , Renal Insufficiency, Chronic/rehabilitation , Prebiotics/classification , Glycoside Hydrolase Inhibitors/therapeutic use , Gastrointestinal Microbiome , Hematinics/administration & dosage , Hematinics/pharmacology , Hematinics/pharmacokinetics , Anemia/diagnosis , Anemia/etiology , Anemia/drug therapy
6.
Gac. méd. espirit ; 22(1): 60-70, ene.-abr. 2020.
Article in Spanish | LILACS | ID: biblio-1124825

ABSTRACT

RESUMEN Fundamento: La quemadura grave representa el tipo de agresión biológica más severo que puede sufrir el organismo y ponen en peligro la vida del paciente por el permanente riesgo de sepsis y falla multisistémica progresiva. La anemia incide en la morbilidad y mortalidad del quemado en estado grave; su tratamiento ha pasado por diversos momentos en la historia y su corrección depende de las transfusiones sanguíneas que aumentan el riesgo de complicaciones y reacciones adversas. Objetivo: Actualizar los conocimientos sobre la utilidad de la eritropoyetina en el tratamiento de la anemia en el quemado grave. Desarrollo: La gravedad de la quemadura está determinada por la intensidad de la temperatura y la duración de la exposición. La anemia es una de las complicaciones más frecuentes en los quemados graves y su tratamiento en ocasiones se limita al uso de transfusiones de sangre, sin embrago la eritropoyetina es una alternativa terapéutica; pertenece a la familia de las citoquinas, alcanza la médula ósea, donde estimula células progenitoras cuyo objetivo es lograr su transformación en eritrocitos. La administración de eritropoyetina humana recombinante en el paciente quemado grave con anemia se considera eficaz, ya que al estimular los mecanismos de la eritropoyesis, produce una elevación paulatina pero mantenida del hematocrito acompañándose de otros efectos beneficiosos. Conclusiones: La eritropoyetina humana por sus características farmacológicas, se muestra como una opción de tratamiento para el paciente quemado grave con anemia al permitir la recuperación de manera sostenida de los valores de hemoglobina con un mínimo de complicaciones, disminuye el uso de transfusiones de sangre que pueden aumentar la morbilidad de estos enfermos.


ABSTRACT Background: The serious burn represents the most severe type of biological aggression the body can suffer and endangers the patient's life due to the permanent risk of sepsis and progressive multisystem failure. Anemia affects the morbidity and mortality of seriously burned patient in serious condition; its treatment has gone through different moments in history and its correction depends on blood transfusions that increase the risk of complications and adverse reactions. Objective: To update knowledge about the usefulness of erythropoietin in the treatment of anemia in seriously burned patient. Development: The severity of the burn is determined by the intensity of the temperature and the duration of the exposure. Anemia is one of the most frequent complications in seriously burned patient and its treatment is sometimes limited to the use of blood transfusions. However, erythropoietin is a therapeutic alternative; it belongs to the family of cytokines, reaches the spinal cord, where it stimulates progenitor cells with the objective of achieving their transformation into erythrocytes. The administration of recombinant human erythropoietin in seriously burned patient with anemia is considered effective, since by stimulating the mechanisms of erythropoiesis, it produces a gradual but sustained elevation of the hematocrit accompanied by other beneficial effects. Conclusions: Human erythropoietin, due to its pharmacological characteristics, is shown as a treatment option for seriously burned patient with anemia by allowing the sustained recovery of hemoglobin values with a minimum of complications, reducing the use of blood transfusions that can increase the morbidity of these patients.


Subject(s)
Burns , Erythropoietin/therapeutic use , Anemia/drug therapy
7.
Med. lab ; 24(4): 344-347, 2020. tab
Article in Spanish | LILACS | ID: biblio-1283924

ABSTRACT

La eritropoyetina (EPO) es una hormona glucoproteica producida principalmente en las células peritubulares de los riñones, que regula la producción y diferenciación eritrocitaria. La síntesis de eritropoyetina está regulada por cambios en la disponibilidad del oxígeno, es decir, a mayor cantidad de oxígeno, menor producción de EPO, y a la inversa. La EPO se une a los receptores en las células madre hematopoyéticas CD34+, promoviendo la activación de los genes para estimular su proliferación y diferenciación hasta eritrocitos maduros [1]. La medición de eritropoyetina en suero es de gran utilidad para el diagnóstico de eritrocitosis y el establecimiento de su etiología. Su determinación en suero permite identificar si la producción eritrocitaria es autónoma (primaria), como en el caso de la producida en la policitemia vera, o secundaria, mediada por la eritropoyetina. En pacientes con eritrocitosis secundaria, los niveles de eritropoyetina están aumentados como un mecanismo compensatorio cuando es por hipoxia [2], o pueden ser el resultado de una patología que estimula su producción, como ocurre con ciertos tumores, entre otros factores. De acuerdo con la clasificación vigente de neoplasias hematolinfoides de la Organización Mundial de la Salud, los niveles disminuidos de eritropoyetina son un criterio menor para el diagnóstico de policitemia vera [2], y los niveles normales o elevados de eritropoyetina descartan que se trate de esta entidad e indican al médico tratante que debe explorar otras causas de eritrocitosis [2].


Subject(s)
Polycythemia , Glycoprotein Hormones, alpha Subunit , Erythropoietin , Diagnosis , Kidney
9.
Rev. colomb. reumatol ; 26(3): 151-159, jul.-set. 2019. tab, graf
Article in English | LILACS | ID: biblio-1126330

ABSTRACT

Abstract Background & aim: Systemic lupus erythematosus is an autoimmune disease, its pathogenesis encompasses numerous organs. About 50% of cases of SLE are anemic; multiple pathways are attributed to the occurrence of anemia. Anemia of chronic disease is generally due to reduced erythropoietin function, reduced production and low response to erythropoietin action on red blood cells, which play a role in the development of anemia of chronic disease seen in several conditions with autoimmune etiology. There were three main contributions in our research: First: To evaluate the types of anemia associated with SLE. Second: To evaluate the role of erythropoietin in pathogenesis of SLE associated anemia. Third: To evaluate the correlation between level of anemia and erythropoietin level. Subjects & methodology: 150 patients with SLE were registered in our study. SLE activity was measured by SLE disease activity index. Results: Our study encompassed (150) SLE patients, 20 men and 130 women and (50) controls, 9 men and 41 women. Among them, anemia of chronic disease was the most prevalent (41.3%), then anemia due to iron deficiency (33.3%), and lastly anemia of autoimmune etiology (25.3%). Our study also showed that there was statistically significant dissimilarity (P value = 0.023) between all groups of anemia in erythropoietin value but there was no significant correlation between erythropoietin and hemoglobin levels in any of the three groups. Conclusion: Erythropoietin level variation was detected among the dissimilar groups of anemia but no correlation between hemoglobin level and erythropoietin was found (blunted erythropoietin response).


Resumen Antecedentes y objetivo: El lupus eritematoso sistémico (LES) es una enfermedad autoinmune, su patogénesis abarca numerosos órganos. Alrededor del 50% del lupus sistêmico es anémico; las múltiples vías se atribuyen a la aparición de anemia. La anemia por enfermedad crónica generalmente se debe a la función reducida de la eritropoyetina, la producción reducida y la baja respuesta a la acción de la eritropoyetina en los glóbulos rojos que desempeñan un papel en el desarrollo de la anemia de la enfermedad crónica observada en varias enfermedades con etiología autoinmune. Hubo 3 contribuciones principales en nuestra investigación: Primero: evaluar los tipos de anemia asociados con el lupus sistémico. Segundo: evaluar el papel de la eritropoyetina en la patogénesis de la anemia asociada al lupus sistêmico. Tercero: evaluar la correlación entre el nivel de anemia y el nivel de eritropoyetina. Sujetos y metodología: Ciento cincuenta pacientes con lupus sistémico se registraron en nuestro estudio. La actividad sistémica del lupus se calculó mediante el índice de actividad de la enfermedad del LES. Resultados: Nuestro estudio abarcó 150 pacientes con lupus sistêmico, 20 varones y 130 mujeres y 50 controles, 9 varones y 41 mujeres. Entre ellos, la anemia de la enfermedad crónica fue la más prevalente (41,3%), seguida de la anemia por deficiencia de hierro (33,3%) y, finalmente, la anemia con etiología autoinmune (25,3%). Nuestro estudio también mostró que hubo diferencias estadísticamente significativas (valor de p = 0,023) entre todos los grupos de anemia en el valor de eritropoyetina, pero no hubo una correlación significativa entre los niveles de eritropoyetina y hemoglobina en ninguno de los 3 grupos. Conclusión: Se detectó una variación en el nivel de eritropoyetina entre los diferentes grupos de anemia, pero no se encontró correlación entre el nivel de hemoglobina y la eritropoyetina (respuesta de eritropoyetina atenuada).


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Erythropoietin , Noxae , Prevalence , Anemia , Lupus Erythematosus, Systemic
10.
Oncol. (Guayaquil) ; 29(1): 54-66, 30 de abril 2019.
Article in Spanish | LILACS | ID: biblio-1005053

ABSTRACT

Introducción: Los riesgos asociados con las Transfusiones de Sangre Alogénicas (TSA) son ampliamente conocidos y han contribuido a nuevos paradigmas de tratamiento para la medicina y cirugía sin sangre. Por tanto, es importante contar con estrategias terapéuticas efectivas y prácticas que sirvan como alternativas al uso de TSA. Este informe describirá las estrategias aplicadas a los pacientes de este reporte. Métodos: Estudio retrospectivo descriptivo de alternativas a la TSA utilizadas en SOLCA Guayaquil con pacientes que no aceptaron TSA bajo ninguna circunstancia, entre los años 2011 y 2017. La estrategia terapéutica se basó en un diagnóstico temprano y un tratamiento agresivo de la anemia y cualquier tipo de sangrado activo. Se utilizó eritropoyetina, hierro y folato, según requerimientos del paciente. Todos los pacientes quirúrgicos recibieron ácido tranexámico y otros hemostáticos tópicos según necesidad. Resultados: De 73 pacientes oncológicos, el 68.5 % eran no quirúrgicos, de este grupo el 62 % recibió quimioterapia. La hemoglobina aumentó hasta 12.6 g/dL. Por tratamiento global por paciente se administraron hasta 3000 mg de hierro, 140.000 unds de eritropoyetina y megadosis de vitamina C fue aplicada con una media de 24 gramos. Todos los pacientes aumentaron sus niveles de hemoglobina en un promedio de 25 días. Conclusión: Es esencial iniciar un tratamiento temprano, preventivo y coordinado con un equipo multidisciplinario comprometido a estos esquemas. Los pacientes respondieron bien a los medicamentos y las dosis recibidas y no se informaron efectos secundarios. También podemos ver que estas estrategias son efectivas y factibles de aplicar.


Introduction: Risks associated with the Allogeneic Blood Transfusions (ABT) are widely known and have contributed to new treatment paradigms for bloodless medicine and surgery. Therefore, it is essential to have effective therapeutic strategies that serve as alternatives to ABTs. This report describes the strategies applied to patients in this paper. Methods: A Retrospective descriptive study of ABT alternatives used in SOLCA Guayaquil with patients who did not accept ABTs under any circumstances, between 2011 and 2017. The therapeutic strategy was an early diagnosis and an aggressive treatment of anemia and any active bleeding. Erythropoietin, iron, and folate were applied, according to the patient's requirements. All surgical patients received tranexamic acid and other hemostatics as needed. Results: Of 73 cancer patients, 68.5% were non-surgical, 62% of the group received chemotherapy. For global treatment per patient, up to 3000 mg of iron was administered, 140,000 units of erythropoietin and megadoses of vitamin C were applied with an average of 24 grams. All patients increased their hemoglobin levels by an average of 25 days. All patients increased their hemoglobin levels by an average of 25 days. Conclusion: It is essential to start early treatment, prevent and coordinate with a multidisciplinary team committed to these schemes. The patients responded well to the medications, and the doses received, and no side effects were reported. We can also see that these strategies are practical and feasible to apply.


Subject(s)
Humans , Blood Transfusion , Erythropoietin , Bloodless Medical and Surgical Procedures , Blood Transfusion, Autologous , Blood Component Transfusion , Transfusion Medicine
11.
Rev. Hosp. Ital. B. Aires (2004) ; 39(1): 19-21, mar. 2019. ilus., graf.
Article in Spanish | LILACS | ID: biblio-1022121

ABSTRACT

La policitemia primaria es producida por una mutación adquirida o heredada en las células progenitoras de los glóbulos rojos, mientras que la poliglobulia secundaria está relacionada con un aumento de la eritropoyetina sérica como respuesta a la hipoxia tisular o a la producción autónoma tumoral. Hace más de medio siglo que se conoce que la hidronefrosis puede actuar como una rara causa de eritrocitosis debido al aumento de producción de eritropoyetina por un riñón que censa una disminución de oxígeno, mecanismo también observado en la estenosis de la arteria renal y en los quistes renales. Se describe a continuación el caso de un paciente de 38 años con poliglobulia atendido en el Hospital Italiano de San Justo (Argentina), que presenta como hallazgo una hidronefrosis unilateral severa y cuya resolución quirúrgica a través de una nefrectomía revierte el cuadro hematológico de base. (AU)


Primary polycythemia is produced by an acquired or inherited mutation in progenitor cells of red blood cells, while secondary polyglobulia is related to an increase in serum erythropoietin in response to tissue hypoxia or autonomous tumor production. Since the middle of the twentieth century, the hydronephrosis is known to be a rare etiology of secondary polycythemia, with increased erythropoietin production caused by diminished oxygen sensing by the kidney, also seen in renal artery stenosis and kidney cysts. We describe a case of a 38 year old patient with polycythemia studied in the "Hospital Italiano de San Justo" (Argentina) that presented an incidental severe unilateral hydronephrosis, and nephrectomy was carried out as a final resolution of the hematological disorder. (AU)


Subject(s)
Humans , Animals , Male , Adult , Middle Aged , Polycythemia/diagnosis , Pyelonephritis/diagnosis , Urinary Tract Infections/complications , Erythropoietin/blood , Hydronephrosis/diagnosis , Nephrectomy/trends , Polycythemia/complications , Polycythemia/etiology , Pyelonephritis/blood , Renal Artery Obstruction/pathology , Low Back Pain , Hypoxia-Ischemia, Brain/pathology , Erythrocytes/physiology , Kidney Diseases, Cystic/pathology , Dysuria , Fever , Hydronephrosis/surgery , Hydronephrosis/complications , Anemia , Nephrectomy/methods
12.
J. bras. nefrol ; 41(1): 145-151, Jan.-Mar. 2019. tab, graf
Article in English | LILACS | ID: biblio-1002413

ABSTRACT

ABSTRACT Introduction: Anemia is a frequent multifactorial complication of CKD seen in patients on dialysis derived mainly from impaired erythropoietin (EPO) production. A less common cause of anemia in individuals with CKD is pure red cell aplasia (PRCA) secondary to the production of anti-EPO antibodies. Objective: This paper aimed two describe two cases of PRCA secondary to the production of anti-EPO antibodies including choice of treatment, patient progression, and a literature review. Materials: This study included the cases of two patients with CKD on hemodialysis with severe anemia in need of specific investigation and management. Results: Patient 1 with CKD secondary to hypertension treated with EPO for 7 months showed persistent decreases in hemoglobin (Hb) levels despite the subcutaneous administration of increasing doses of EPO; the patient required recurring blood transfusions. Workup and imaging tests were negative for the main causes of anemia in individuals with CKD on dialysis. Patient 2 with CKD secondary to adult polycystic kidney disease had been taking EPO for 2 years. The patient developed severe abrupt anemia the month he was started on HD, and required recurring transfusions to treat the symptoms of anemia. Workup and imaging findings were inconclusive. Specific laboratory tests confirmed the patients had anti-EPO antibodies. After six months of immunosuppressant therapy (corticosteroids + cyclosporine) the patients were stable with Hb > 9.0 g/dl. Conclusion: PRCA is a rare condition among patients on dialysis treated with rhEPO and should be considered as a possible cause of refractory anemia. Treating patients with PRCA may be challenging, since the specific management and diagnostic procedures needed in this condition are not always readily available.


RESUMO Introdução: Anemia é complicação frequente da Doença Renal Crônica (DRC) em pacientes dialíticos. Apresenta caráter multifatorial principalmente pela insuficiente produção de eritropoietina (EPO). Situação rara causadora de anemia na DRC é Aplasia Pura de Células Vermelhas (APCV), em decorrência da produção de anticorpos anti-EPO. Objetivo: Descrever 2 casos de APCV com formação de anticorpos anti-EPO, sua abordagem clínica, evolução e revisão de literatura. Métodos: Dois pacientes em hemodiálise que desenvolveram anemia grave, necessitando investigação e manejo específico. Resultados: Paciente nº 1: feminina, 75 anos, DRC secundária à hipertensão arterial. Após 7 meses com EPO desenvolveu queda persistente em valores de hemoglobina (Hb) mesmo com incremento em doses EPO SC, necessitando transfusões de sangue recorrentes. Extensa investigação laboratorial e de imagem resultou negativa para principais causas de anemia. Paciente nº 2: masculino, 66 anos, DRC secundária à DRPA, há 2 anos em uso de EPO. No mês de entrada em HD desenvolveu anemia severa, também exigindo transfusões recorrentes para tratamento da anemia sintomática. Extensa investigação laboratorial e por imagem, sem chegar a uma conclusão definitiva. Em ambos os casos a presença de anticorpos anti-EPO foi confirmada por exames laboratoriais específicos. Terapia imunossupressora resultou em estabilização do quadro e Hb > 9,0 g/dl em ambos os pacientes, 6 meses após início do tratamento. Conclusão: APCV é condição rara entre pacientes dialíticos que recebem EPOHuR e deve ser lembrada como causa de anemia refratária. Seu manejo específico e diagnóstico laboratorial nem sempre acessível, tornando desafiadora a condução dos casos para o nefrologista.


Subject(s)
Humans , Male , Female , Aged , Recombinant Proteins/therapeutic use , Erythropoietin/immunology , Erythropoietin/therapeutic use , Renal Dialysis/adverse effects , Red-Cell Aplasia, Pure/etiology , Antibodies, Neutralizing/blood , Kidney Failure, Chronic/drug therapy , Recombinant Proteins/adverse effects , Prednisone/administration & dosage , Prednisone/therapeutic use , Erythropoietin/biosynthesis , Erythropoietin/adverse effects , Kidney Transplantation , Treatment Outcome , Cyclosporine/administration & dosage , Cyclosporine/therapeutic use , Red-Cell Aplasia, Pure/drug therapy , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/therapeutic use , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/therapeutic use
13.
In. CASMU. Investigación clínica: desarrollo e innovación, 2019. Montevideo, Ideas Uruguay, 2019. p.141-142.
Monography in English | LILACS, BNUY, UY-BNMED | ID: biblio-1359509
14.
In. CASMU. Investigación clínica: desarrollo e innovación, 2019. Montevideo, Ideas Uruguay, 2019. p.139-140, tab.
Monography in English | LILACS, BNUY, UY-BNMED | ID: biblio-1359507
15.
Cuad. Hosp. Clín ; 60(n. esp.): 56-60, 2019. ilus
Article in Spanish | LILACS, LIBOCS | ID: biblio-1118798

ABSTRACT

La aplasia pura de serie roja (APSR) adquirida es un trastorno hematopoyético poco frecuente caracterizado por anemia normocítica y normocrómica, reticulocitopenia y ausencia de precursores eritroides en la médula ósea, frecuencia que ha ido incrementando en pacientes con enfermedad renal crónica. Presentamos el caso de un varón de 38 años de edad, con hipertensión arterial sistémica, en terapia hemodialítica. En su evolución cursa con anemia aguda, tras protocolo de estudio se objetivó una aplasia pura de células eritroides por anticuerpos anti eritropoyetina, el paciente recibió bolos de ciclofosfamida, quimioprofilaxis, terapia dialítica, se suspendió la eritropoyetina, presentando buena evolución, efectuándose posteriormente el trasplante renal.


Acquired pure red cells aplasia (PRCA) is a rare hematopoietic disorder characterized by normocytic and normochromic anemia, reticulocytopenia and absence of erythroid precursors in bone marrow, frequency that has been increasing in patients with chronic kidney disease. We present the case of a 38-year-old man with systemic hypertension in hemodialysis therapy. During the course of the disease, acute anemia was observed. After a study protocol, pure erythroid cell aplasia was detected by antierythropoietin antibodies, the patient received boluses of cyclophosphamide, chemoprophylaxis, dialysis therapy, erythropoietin was suspended, with favorable evolution. Subsequently, the kidney transplant.


Subject(s)
Humans , Male , Patients , Acute Disease , Erythropoietin , Renal Insufficiency, Chronic , Hypertension , Anemia
16.
Clinics ; 74: e674, 2019. tab, graf
Article in English | LILACS | ID: biblio-1019700

ABSTRACT

OBJECTIVE: To evaluate the effects of interleukin-6 (IL-6) and erythropoietin (EPO) in experimental acute spinal cord injury (SCI) in rats. METHODS: Using standardized equipment, namely, a New York University (NYU) Impactor, a SCI was produced in 50 Wistar rats using a 10-g weight drop from a 12.5-mm height. The rats were divided into the following 5 groups of 10 animals each: "Group EPO", treated with erythropoietin only; "Group EPO + IL-6", treated with both substances; "Group IL-6", receiving IL-6 administration only; "Group Placebo", receiving a placebo solution; and "Group Sham", submitted to an incomplete procedure (only laminectomy, without SCI). All drugs and the placebo solution were administered intraperitoneally for three weeks. The animals were followed up for 42 days. Functional motor recovery was monitored by the Basso, Beattie, and Bresnahan (BBB) scale on days 2, 7, 14, 21, 28, 35 and 42. Motor-evoked potential tests were performed on the 42nd day. Histological analysis was performed after euthanasia. RESULTS: The group receiving EPO exhibited superior functional motor results on the BBB scale. IL-6 administration alone was not superior to the placebo treatment, and the IL-6 combination with EPO yielded worse results than did EPO alone. CONCLUSIONS: Using EPO after acute SCI in rats yielded benefits in functional recovery. The combination of EPO and IL-6 showed benefits, but with inferior results compared to those of isolated EPO; moreover, isolated use of IL-6 resulted in no benefit.


Subject(s)
Animals , Male , Rats , Spinal Cord Injuries/drug therapy , Erythropoietin/therapeutic use , Interleukin-6/therapeutic use , Evoked Potentials, Motor/drug effects , Spinal Cord Injuries/pathology , Erythropoietin/pharmacology , Interleukin-6/pharmacology , Rats, Wistar , Neuroprotective Agents/pharmacology , Recovery of Function/drug effects , Disease Models, Animal
17.
Biol. Res ; 52: 28, 2019. tab, graf
Article in English | LILACS | ID: biblio-1011430

ABSTRACT

BACKGROUND: Hypoxic-ischemic encephalopathy (HIE) is a common disease that occurs during the perinatal period. The primary cause of neonatal HIE is related to fetal intrauterine anoxia. Carbamylated erythropoietin (CEPO), a derivative of erythropoietin (EPO), does not exert any erythropoietic effect; however, the neuroprotective effects resemble those of EPO. Previous studies have shown the potential benefits of CEPO on the central nervous system. The present study aimed to investigate the role of CEPO in neuronal apoptosis during intrauterine HIE and the underlying mechanisms. RESULTS: To validate our hypothesis, we established an intrauterine HIE model by occluding the bilateral uteroovarian arteries of pregnant Sprague-Dawley rats. Compared to the I/R group, neuronal apoptosis in the CEPO group was significantly lower at 4, 12, 24, and 48 h (P < 0.05). CEPO significantly inhibited CC3 expression (P < 0.05) during the early-stages after ischemia-reperfusion (0.5, 4, 8, 12 and 24 h), upregulated Bcl-2 expression, and downregulated Bax expression at 4, 8, 12, and 24 h (P < 0.05). CONCLUSIONS: Carbamylated erythropoietin pretreatment inhibited the expression of proapoptotic protein CC3 in brain and regulated the Bcl-2/Bax ratio, resulting in reduced neuronal apoptosis and thus resulting in a protective effect on intrauterine HIE.


Subject(s)
Animals , Female , Pregnancy , Rats , Erythropoietin/analogs & derivatives , Apoptosis/drug effects , Neuroprotective Agents/therapeutic use , Hypoxia-Ischemia, Brain/prevention & control , Time Factors , Erythropoietin/therapeutic use , Rats, Sprague-Dawley , Hypoxia-Ischemia, Brain/pathology , Disease Models, Animal
18.
Article in Korean | WPRIM | ID: wpr-759584

ABSTRACT

We developed a new blood management protocol that allows patients to not undergo transfusion during major orthopaedic surgery. Here, we report the safety of or our protocol. The preoperative pharmacological protocol consisted of the administration of 40 µg of recombinant erythropoietin subcutaneously and 100 mg of iron supplements intravenously. During the operation, reinfusion of drainage blood using a cell saver and plasma expander was used. The cell saver device passed the collected blood through a filter, which washed the blood, removing the hemolyzed cells and other impurities. Intravenous tranexamic acid 1 g is given just before the operation, except high-risk patients for venous thromboembolism. Postoperatively, recombinant erythropoietin and iron supplements were administered in the same manner with the preoperative protocol and continued until a hemoglobin level reached 10 g/dL.


Subject(s)
Drainage , Erythropoietin , Humans , Iron , Orthopedics , Plasma , Tranexamic Acid , Venous Thromboembolism
19.
Article in English | WPRIM | ID: wpr-766354

ABSTRACT

Trigeminal nerve injury as a consequence of lower third molar surgery is a notorious complication and may affect the patient in long term. Inferior alveolar nerve (IAN) and lingual nerve (LN) injury result in different degree of neurosensory deficit and also other neurological symptoms. The long term effects may include persistent sensory loss, chronic pain and depression. It is crucial to understand the pathophysiology of the nerve injury from lower third molar surgery. Surgery remains the most promising treatment in moderate-to-severe nerve injuries. There are limitations in the current treatment methods and full recovery is not commonly achievable. It is better to prevent nerve injury than to treat with unpredictable results. Coronectomy has been proved to be effective in reducing IAN injury and carries minimal long-term morbidity. New technologies, like the roles of erythropoietin and stem cell therapy, are being investigated for neuroprotection and neural regeneration. Breakthroughs in basic and translational research are required to improve the clinical outcomes of the current treatment modalities of third molar surgery-related nerve injury.


Subject(s)
Chronic Pain , Depression , Erythropoietin , Humans , Lingual Nerve , Mandibular Nerve , Molar, Third , Neuroprotection , Postoperative Complications , Regeneration , Stem Cells , Translational Medical Research , Trigeminal Nerve Injuries , Trigeminal Nerve
20.
Journal of Experimental Hematology ; (6): 1013-1019, 2019.
Article in Chinese | WPRIM | ID: wpr-771846

ABSTRACT

OBJECTIVE@#To investigate the effect of silencing LNK gene on the expression of EPO and EPOR in acute myeloid leukemia cells (THP-1).@*METHODS@#THP-1 cells were cultured. The lentivirus was used as a vector to silence the LNK gene stably. After 72 hours of infection, GFP expression level was detected by the fluorescent inverted microscopy. The lentiviral Infection efficiencies were monitored by flow cytometry. The LNK silencing effect was confirmed. The mRNA expressions of EPO and EPOR were detected by RT-PCR. The protein levels of LNK, EPO and EPOR were detected by Western blot.@*RESULTS@#At the time-point of 72 hours after lentivirus infection, the expression level of GFP was above 85% detected by fluorescent inverted microscopy. The infection efficiency was above 99% by flow cytometry. mRNA expressions of LNK, EPO and EPOR in LNK silencing group were signifycantly lower than those in control group (P<0.05). The protein levels of LNK, EPO and EPOR in LNK silencing group were significantly lower than those in the control group (P<0.05).@*CONCLUSION@#THP-1 cell line of LNK gene silencing has been successfully established,the LNK gene has been silenced, the expression of EPO and EPOR decrease, indicating that LNK may participate in the regulation of EPO and EPOR.


Subject(s)
Blotting, Western , Erythropoietin , Gene Silencing , Humans , Proteins , Genetics , Receptors, Erythropoietin , THP-1 Cells
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