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2.
Rev. ecuat. pediatr ; 22(1): 1-7, Abril 30, 2021.
Article in English | LILACS | ID: biblio-1222342

ABSTRACT

Introducción: La policitemia afecta del 1 a 5% de los recién nacidos, se asocia a complica-ciones por afectación orgánica y sistémica en el neonato que puede ser prevenible. El ob-jetivo de la presente investigación fue determinar la prevalencia de Policitemia neonatal y sus factores asociados en recién nacidos en un servicio de maternidad Público de la ciudad de Cuenca-Ecuador. Métodos: Se realizó un estudio transversal, el universo estuvo conformado por todos los recién nacidos en el servicio de maternidad del Hospital ¨Vicente Corral Moscoso¨. La muestra fue probabilística de 470 neonatos y sus madres. Para identificar asociación se realizó mediante X2 y para medir intensidad de asociación se utilizó OR (IC 95%) y valor de P < 0.05. Resultados: Ingresaron al estudio en forma aleatoria 470 casos. Se obtuvo una prevalencia del 12.8%. La residencia materna del 93% fue por sobre los 2000 metros sobre el nivel del mar. Los factores asociados fueron: bajo peso al nacer (OR 3.8; IC95%: 1.9 ­ 7.5) P < 0.001), patología materna incluida la diabetes (OR 2.6, IC95%: 1.3 ­ 5.2) P = 0.013), toxemia del em-barazo (OR 2.3; IC95%: 0.7 ­ 7.6) P = 0.134 y asociación negativa con prematuridad (OR 0.3; IC 95%: 0.07 ­ 1.2) P = 0.099. Conclusiones: la prevalencia de policitemia neonatal es alta y se asocia significativamente con bajo peso al nacer, patología materna.


Introduction: Polycythemia affects 1 to 5% of newborns, it is associated with complications due to organic and systemic involvement in the newborn that can be preventable. The objective of this research was to determine the prevalence of neonatal polycythemia and its associated factors in newborns in a public maternity service in the city of Cuenca-Ecuador. Methods: A cross-sectional study was carried out, the universe was made up of all new-borns in the maternity service of the ¨Vicente Corral Moscoso¨ Hospital. The sample was probabilistic of 470 neonates and their mothers. To identify association, it was performed using X2 and to measure association intensity, OR (95% CI) and P value <0.05 were used. Results: 470 cases were randomly entered into the study. A prevalence of 12.8% was ob-tained. The 93% maternal residence was above 2000 meters above sea level. The associat-ed factors were: low birth weight (OR 3.8; 95% CI: 1.9 - 7.5) P <0.001), maternal pathology including diabetes (OR 2.6, 95% CI: 1.3 - 5.2) P = 0.013), pregnancy toxemia (OR 2.3; 95% CI: 0.7 - 7.6) P = 0.134 and negative association with prematurity (OR 0.3; 95% CI: 0.07 - 1.2) P = 0.099. Conclusions: the prevalence of neonatal polycythemia is high and is significantly associated with low birth weight, maternal pathology.


Subject(s)
Polycythemia , Infant, Newborn , Risk Factors , Infant, Extremely Low Birth Weight
3.
Rev. colomb. cardiol ; 28(1): 74-79, ene.-feb. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1341263

ABSTRACT

Resumen El potasio es, sin lugar a duda, uno de los componentes más importantes del balance hidroelectrolítico, además de ser uno de los exámenes de laboratorio más solicitados en el ámbito clínico. La hipercalemia se define por un valor sérico mayor a 5.5 mEq/L y su principal diagnóstico diferencial es la pseudohipercalemia o hipercalemia espuria. Esta se define como elevación del potasio solo en componente sérico y no plasmático con una diferencia mínima de 0.5 mEq/L. Entre las causas de pseudohipercalemia se encuentran factores mecánicos, químicos, contaminantes, temperatura y tiempo de procesamiento de la muestra. Se reporta el caso de un paciente masculino de 22 años de edad, con antecedentes de cardiopatía cianosante, que cursa con elevación espuria de potasio en suero, con aumento aislado severo del hematocrito y trombocitopenia concomitante, que luego mostraría valores normales en plasma.


Abstract Potassium is, without a doubt, one of the most important components of hydroelectrolitic balance, as well as being one of the most requested laboratory exams in the clinical setting. Hyperkalemia is defined as serum value above 5.5 mEq/L, and its main differential diagnosis is pseudohyperkalemia or spurious hyperkalemia. This conditioned is defined as an elevation of potassium levels exclusively in serum and not in plasma, with a minimal difference of 0.5 mEq/L between these measurements. Some of the causes of pseudohyperkalemia include mechanical factors, chemicals, contaminants, temperature and the time of sample processing. It is reported the case of a 22-year-old male with history of cyanotic heart disease that presented with a spurious elevation of serum potassium, with a severe increment in hematocrit and concomitant thrombocytopenia, that would later show normal levels in plasma.


Subject(s)
Humans , Male , Young Adult , Polycythemia , Thrombocytopenia , Diagnosis, Differential , Heart Defects, Congenital
4.
Arch. cardiol. Méx ; 90(4): 415-419, Oct.-Dec. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1152815

ABSTRACT

Resumen Antecedentes: El corazón pulmonar crónico (CPC) muestra un incremento en habitantes que viven en grandes altitudes. Objetivo: Investigar la frecuencia de arritmias cardíacas y factores de riesgo para su desarrollo. Métodos: Estudio descriptivo y transversal; se revisó el registro de pacientes internados del Departamento de Cardiología del Instituto Nacional de Tórax, La Paz, Bolivia, entre enero de 2017 y junio de 2018; se incorporó a todos los individuos con diagnóstico de CPC, definido por criterios clínicos, electrocardiográficos y ecocardiográficos; se incluyó a 162 pacientes que cumplieron los criterios en el análisis; se utilizaron la t de Student y ANOVA. Resultados: Arritmias: fibrilación auricular (FA), 125 (75%); aleteo auricular (AA), 17 (10.5%); taquicardia auricular (TA), 17 (10.5%); extrasístoles, 3 (1.9%). Según el análisis univariado, los factores relacionados con el desarrollo de arritmias fueron: eritrocitosis: FA, RR: 1.33, otras arritmias (RR: 1.67), p = 0.0001; hipertensión arterial pulmonar: FA, RR: 3.10, otras arritmias (RR: 3.21), p = 0.0001; dilatación de aurícula derecha (AD): FA, RR: 1.92, otras arritmias (RR: 2.13), p = 0.0001; obesidad: FA, RR: 3.47, p = 0.001, otras arritmias (RR: 3.70), p = 0.001; hipertensión arterial sistémica: FA, RR: 3.10, p = 0.001, otras arritmias (RR: 3.21), p = 0.001. Según el análisis multivariado: eritrocitosis (RR: 2.2), dilatación de AD (RR: 1.2), p = 0.0001. Conclusiones: Se encontró FA con mayor frecuencia en los pacientes con CPC; los factores de riesgo con mayor significancia estadística para su presentación fueron la eritrocitosis y la dilatación de la AD.


Abstract Background: Chronic cor pulmonale (CPC), with increased presentation in high-altitude inhabitants. Objectives: Investigating the frequency of cardiac arrhythmias, and risk factors for its development. Methods: Descriptive, cross-sectional study, the inpatient registry of the Department of Cardiology of the National Institute of Torax, La Paz-Bolivia, from January 2017 to June 2018 was reviewed, all were incorporated with the diagnosis of CPC, defined by clinical criteria, electrocardiographic and echocardiographic, 162 patients who met the criteria were taken, the student's t-test and ANOVA were used for the analysis. Results: Arrhythmias: atrial fibrillation (AF) 125 (75%), atrial flutter (AA) 17 (10.5%), atrial tachycardia (AT) 17 (10.5%), extrasystoles 3 (1.9%). Univariate analysis of factors related to the development of arrhythmias: erythrocytosis: FA, RR: 1.33, other arrhythmias RR: 1.67, p = 0.0001, pulmonary arterial hypertension: FA, RR: 3.10, other arrhythmias RR: 3.21, p = 0.0001, right atrial dilation (AD): FA, RR: 1.92, other arrhythmias RR: 2.13, p = 0.0001, obesity: FA, RR: 3.47, p = 0.001, other arrhythmias RR: 3.70, p = 0.001, systemic arterial hypertension: FA: RR: 3.10, p = 0.001, other arrhythmias RR: 3.21, p = 0.001. Multivariate analysis: erythrocytosis (RR: 2.2), AD dilation (RR: 1.2), p = 0.0001. Conclusions: AF was found more frequently in patients with CPC, the risk factors with the greatest statistical significance for presentation were: erythrocytosis and AD dilation.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Arrhythmias, Cardiac/epidemiology , Pulmonary Heart Disease/epidemiology , Altitude , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/physiopathology , Polycythemia/epidemiology , Bolivia/epidemiology , Registries , Chronic Disease , Cross-Sectional Studies , Risk Factors
5.
Hematol., Transfus. Cell Ther. (Impr.) ; 42(1): 46-53, Jan.-Mar. 2020. tab, graf
Article in English | LILACS | ID: biblio-1090480

ABSTRACT

Abstract Introduction Ruxolitinib has been approved for the treatment of myelofibrosis (MF). In this study, we present safety and efficacy findings from an analysis of 104 patients with intermediate- and high-risk MF in a Brazilian cohort of the JUMP study who received treatment with ruxolitinib. Methods JUMP is a single-arm, open-label, phase IIIb, expanded-access study. The primary endpoint was to evaluate the safety and tolerability (frequency, duration, and severity of adverse events [AEs]) of ruxolitinib. Results All of the 104 patients received the treatment. Median duration of exposure was 35.8 months. The most common hematologic AEs were anemia (57.7), thrombocytopenia (38.5%), neutropenia (11.5%), and leukopenia (9.6%). Second malignancies (all grades) occurred in 19.2% of patients (n = 20). Serious AEs were reported in 62.5% of patients (n = 65). The proportions of patients with ≥50% reduction from baseline in palpable spleen length at weeks 24 and 48 were 62.7% and 69.2%, respectively. The mean change from the baseline in the Functional Assessment of Cancer Therapy (FACT)-Lymphoma total score was 10.8 [15.6%] at week 4, 12.6 [14.1%] at week 24, and 12.2 [14.3%] at week 48. The mean change from the baseline for the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale was 3.9 [42.8%] at week 4, 4.9 [29.9%] at week 24, and 4.7 [28%] at week 48. At week 48, the estimated progression-free survival, leukemia-free survival, and overall survival probabilities were 91%, 91% and 93%, respectively Overall, 21 deaths were observed in the present study. Conclusion Findings from this study suggest that ruxolitinib could be evaluated as a standard-of-care treatment for the MF population in need of a viable treatment option. NCT01493414


Subject(s)
Humans , Male , Adult , Middle Aged , Aged , Aged, 80 and over , Drug Therapy , Primary Myelofibrosis/therapy , Polycythemia , Splenomegaly , Thrombocytosis , Brazil
7.
Rev. méd. (La Paz) ; 26(1): 32-37, 2020. ilus
Article in Spanish | LILACS | ID: biblio-1127074

ABSTRACT

Introducción. Los valores de hemoglobina (Hb) en una población dependen de diversas variables entre ellas la altura y tiempo de radicatoria. Poblaciones que consiguieron adaptarse a grandes alturas albergan peculiares concentraciones de hemoglobina, los tibetanos tienen concentraciones similares a las del nivel del mar; mientras que, en los aymaras están incrementadas. Chorolque es una localidad minera situada a 5000 msnm que fue poblada desde hace 100 años aproximadamente y sus datos hematológicos requieren dilucidación. Objetivo. Describir concentraciones de hemoglobina y prevalencia de eritrocitosis patológica en habitantes de Chorolque. Material y métodos. Estudio descriptivo transversal realizado mediante revisión retrolectiva de 1328 (varones=1176, mujeres=142) resultados de hemograma y datos epidemiológicos. Se estableció parámetros normales preliminares de hemoglobina (varones 17 - 20 g/dl, mujeres 16 - 19 g/dl) considerando la altura y hemoglobina de otras poblaciones residentes de altura. Se consideró eritrocitosis cuando la Hb fue >18 g/dl en mujeres y >19 g/dl en varones. Resultados. La edad promedio fue de 39 años en varones y 45 años en mujeres. Se evidenció Hb media de 18.5 g/dl en mujeres y 20.8 g/dl en varones. Referente a los parámetros normales preliminares, la Hb media fue 17.5 g/dl en mujeres (n=83) y 18.0 g/dl en varones (n=282). Adicionalmente, 8 % de mujeres reflejaron Hb <16 g/dl y 2 % de varones Hb <17 g/dl. Se consideró eritrocitosis en 34 % de mujeres y 74 % de varones, Hb media de 20,7 g/dl y 21,8 g/dl respectivamente. Conclusión. Las concentraciones promedio de hemoglobina en los habitantes de Chorolque reflejan valores hematológicos no reportados en el territorio boliviano. Estudios biomoleculares permitirán caracterizar valores normales de hemoglobina y eritrocitosis patológicas en esta población.


Introduction. Hemoglobin values in a population depend on several variables, including altitude and time of residence. Populations living at high altitudes have peculiar hemoglobin levels, Tibetan hemoglobin levels are similar to those of sea level; while in Aymaras those are increased. Chorolque is a mining district located at 5000 masl and inhabited for 100 years approximately, in this sense, its hematological values require to be elucidated. Objective. To describe hemoglobin levels and prevalence of pathological erythrocytosis in Chorolque high altitude dwellers. Material and methods. Cross-sectional descriptive study carried out through a retrolective review of 1328 (men=1176, women=142) blood cell counts and epidemiological data. Preliminary normal hemoglobin parameters (males 17-20 g/ dl, females 16-19 g/dl) were established considering the altitude and hemoglobin levels in other high altitude populations. Erythrocytosis was considered when Hb was >18 g/dl in women and >19 g/dl in men. Results. The average age was 39 years for men and 45 years for women. A mean Hb of 18.5 g/dl in women and 20.8 g/dl in men were observed. Regarding the preliminary normal parameters, the mean Hb was 17.5 g/dl in women (n=83) and 18.0 g/dl in men (n=282). Additionally, 8 % of women reflected Hb <16 g/dl and 2 % of men Hb <17 g/dl. Erythrocytosis was considered in 34% of women and 74% ofmen, mean Hb of 20.7 g/dl and 21.8 g/dl respectively. Conclusion. The average hemoglobin levels in Chorolque highlanders evidences unreported hematological values in Bolivia. Biomolecular studies will allow to characterize normal hemoglobin values and pathological erythrocytoses in this population


Subject(s)
Polycythemia
8.
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. 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
10.
Article in Korean | WPRIM | ID: wpr-761395

ABSTRACT

OBJECTIVE: Myeloproliferative neoplasm (MPN) is considered as one of the risk factors of ischemic stroke. Some MPN patients manifest stroke as their first symptom. Our purpose was to assess diagnostic rate of MPN in newly diagnosed acute ischemic stroke patients. METHODS: This study was performed using National Health Insurance Service Ilsan Hospital dataset. Data retrieving was performed by defining by defining the patient with coding of acute ischemic stroke from January 2013 to June 2017. We selected only the patients who had checked brain magnetic resonance imaging and complete blood cell count (CBC) in emergency room or on admission. Among the results of CBC finding, hemoglobin and platelet count were analyzed. Erythrocytosis was defined >16.5 g/dL (male), >16 g/dL (female) according to revised World Health Organization (WHO) classification of polycythemia vera (PV) criteria. Thrombocytosis was >450,000/µL according to revised WHO classification of essential thrombocythemia (ET). RESULTS: Total number of newly diagnosed acute ischemic stroke was 1,613 patients. Seven patients (0.43%) were diagnosed MPN (ET=2, PV=5) after ischemic stroke. Patients who had thrombocytosis and erythrocytosis were 18 and 105, respectively. Three patients who had thrombocytosis were diagnosed MPN (ET=2, PV=1). Two patients with erythrocytosis were diagnosed MPN (PV=2). Two patients had both thrombocytosis and erythrocytosis, and two of them were diagnosed PV. Seventy-one patients who had erythrocytosis were normalized in follow-up period. Six patients who had thrombocytosis and 30 patients who had erythrocytosis did not further evaluate. CONCLUSION: CBC has to be carefully read and MPN can be suspected. Diagnosis must be confirmed by hematologist to initiate appropriate treatment. It is important to recognized suspected MPN patients to prevent stroke.


Subject(s)
Blood Cell Count , Brain , Classification , Clinical Coding , Dataset , Diagnosis , Emergency Service, Hospital , Follow-Up Studies , Humans , Magnetic Resonance Imaging , National Health Programs , Platelet Count , Polycythemia , Polycythemia Vera , Risk Factors , Stroke , Thrombocythemia, Essential , Thrombocytosis , World Health Organization
11.
JEMDSA (Online) ; 24(2): 37-40, 2019.
Article in English | AIM, AIM | ID: biblio-1263764

ABSTRACT

Background: According to the literature, parenteral testosterone replacement therapy (TRT)-induced polycythaemia is associated with cardiovascular events. No or minimal data exist for the prevalence of TRT-induced polycythaemia in late- onset hypogonadism (LOH) patients from South Africa. Polycythaemia is the side effect most frequently associated with parental TRT formulations. Design: This was a quantitative, observational, descriptive, retrospective study. Setting: The study setting was a private practice male clinic in Emalahleni. Subject: An all-inclusive sampling method was used. Outcome measures:The main outcome measure for polycythaemia was haematocrit (Hct). An Hct percentage of > 50% at month 3 (post-treatment initiation) constituted a positive diagnosis for polycythaemia. For the rise in total testosterone (TT) and Hct, the variance was used as documented between pre- and post-treatment initiation. Results:The prevalence of polycythaemia was 34%. A statistically significant increase in both TT and Hct was observed. The Cohen'sdeffect size was 0.68 and 0.73, respectively, for TT and Hct. Conclusion: Depot-testosterone undecanoate parenteral formulation induces polycythaemia in LOH patients, where the rise in TT demonstrates the effectiveness of therapy


Subject(s)
Polycythemia , South Africa , Spinocerebellar Degenerations
13.
Rev. am. med. respir ; 18(4): 258-263, dic. 2018. tab
Article in Spanish | LILACS | ID: biblio-977186

ABSTRACT

Introducción: La enfermedad crónica de montaña (ECM) o Enfermedad de Monge es un síndrome clínico observado en personas que vivieron largo tiempo en grandes altitudes. Se caracteriza por eritrocitosis excesiva, hipoxemia, presencia o no de hipertensión pulmonar o insuficiencia cardíaca o ambas, con o sin patología pulmonar. Este síndrome incluye cefalea, alteraciones neurológicas, trastornos del sueño y del aparato digestivo, astenia y disnea. Hasta nuestro conocimiento, no hay referencias bibliográficas que describan esta enfermedad en habitantes de la provincia de Jujuy en la República Argentina. Objetivo: Describir una serie de casos de presentación típica de enfermedad crónica de montaña en habitantes en localidades de altura, de la provincia de Jujuy. Material y método: Diseño de estudio: Estudio descriptivo, de serie de casos, transversal. Población de estudio: Se evaluaron 8 pacientes durante el período comprendido entre los años 2010 y 2011, con diagnóstico de enfermedad crónica de montaña; todos residentes de localidades de altura de la referida provincia. La edad promedio fue de 46 ± 15 años, representando el sexo masculino el 87.5% de esta serie. No se aplicaron criterios de inclusión y exclusión, los pacientes no firmaron consentimiento informado. Lugar: Todos los pacientes fueron evaluados en la región de Humahuaca (2900 metros sobre el nivel del mar). Para esta altitud la oximetría de pulso esperada es de 92%; esta población de estudio mostró, en promedio, un valor de SpaO2 inferior. Se calculó el score de Qinghai, diseñado para clasificar la severidad de la enfermedad crónica de montaña el cual, además, permite comparar casos de enfermedad crónica de montaña entre diferentes regiones. Este score considera una variedad de síntomas y la concentración de hemoglobina. Resultados: El 87.5% de los participantes tenía un índice de masa corporal ≥ 25 kg/m², de los cuales el 71.4% eran obesos (≥ 30 kg/m²). Se constataron un caso de várices de vena safena externa con úlceras en ambos miembros inferiores y un evento de varicorragia grave; un caso de enfermedad pulmonar obstructiva crónica con enfisema en la tomografía computada de tórax; un caso de síndrome metabólico y síndrome de apnea hipopnea obstructiva del sueño. Un paciente presentaba elevación de la presión sistólica del ventrículo derecho (44 mmHg) evaluado por ecocardiograma Doppler con SpaO2 promedio en reposo de 89%. En un paciente se encontró hiperuricemia (10.81 mg/dl); y en otro se completó la evaluación hematológica mediante medulograma observándose aumento de la serie eritroblástica con maduración preservada. La espirometría fue normal en todos los participantes, excepto en el paciente con diagnóstico de EPOC. Se realizó en todos una prueba de marcha de los 6 minutos en aire ambiente. Conclusiones: Esta serie permite describir las características de pacientes con diagnóstico de enfermedad crónica de montaña con criterios clínicos y score específico, en habitantes de altura de la provincia de Jujuy. En este sentido son necesarias políticas de salud acordes a la región montañosa donde se habitan estos individuos y disponer de tecnología adecuada para lograr un diagnóstico precoz y tratamiento adecuado.


Subject(s)
Polycythemia , Hypertension, Pulmonary , Altitude Sickness
14.
Article in English | WPRIM | ID: wpr-718356

ABSTRACT

OBJECTIVE: There is concern regarding the safety of delayed cord clamping (DCC) in babies born at less than 34 weeks' gestation. Therefore, the primary objective of this study was to compare the rates of hyperbilirubinemia and polycythemia during initial 7 days in infants born at less than 34 weeks' gestation and randomized to receive DCC by 120 seconds or early cord clamping (ECC) within less than 30 seconds. METHODS: One hundred pregnant women were randomly subjected to DCC or ECC at the time of birth in a tertiary referral hospital setting. Blood samples were obtained from each newborn at 48 hours and 7 days for hematocrit measurement. Serum bilirubin levels were estimated once the infant had clinically significant jaundice or at 72 hours. For the statistical analysis, the χ2 test, student's t-test, or Wilcoxon rank sum test was used. RESULTS: The hematocrit was significantly higher in the DCC group than in the ECC group (P < 0.001). None of the babies had polycythemia. Mean total serum bilirubin level was 6.6 mg/dL in the DCC group and 8.7 mg/dL in the ECC group (P < 0.001). There was no increased risk of hyperbilirubinemia in the DCC group. CONCLUSION: DCC benefits preterm neonates with no significant adverse effects.


Subject(s)
Bilirubin , Constriction , Female , Hematocrit , Humans , Hyperbilirubinemia , Infant , Infant, Newborn , Jaundice , Parturition , Polycythemia , Pregnancy , Pregnant Women , Tertiary Care Centers , Umbilical Cord
15.
Article in English | WPRIM | ID: wpr-713611

ABSTRACT

High oxygen-affinity hemoglobin (Hb) variants and a 2,3-diphosphoglycerate (2,3-DPG) deficiency could cause congenital (familial) erythrocytosis. High oxygen-affinity Hb variants and a 2,3-DPG deficiency might result in low tissue oxygen tension left-shifted oxygen dissociation curves and reduction in the standard P₅₀ value (P(50,std), oxygen tension at which haemoglobin is 50% saturated). Hence, the P(50,std) value is considered while formulating diagnostic strategies for erythrocytosis. In this study, we established a reference range for P(50,std) using an International Federation of Clinical Chemistry and Laboratory Medicine-approved equation (Hill's equation) for individual single venous/arterial blood samples. Blood gas analysis results of 243 samples with oxygen saturation ranging from 40%–90% (Hb < 16 mg/dL) were selected. The reference range of P(50,std) was in the 2.5th–97.5th percentile, and was 25.9–27.3 mm Hg. Hill's equation is a simple approved method for evaluating the P(50,std) values. Only a single sample of venous or arterial blood and a blood gas analyser are required to obtain the P(50,std). Our study provides a useful tool for the diagnostic work-up of patients with erythrocytosis.


Subject(s)
2,3-Diphosphoglycerate , Blood Gas Analysis , Chemistry, Clinical , Humans , Methods , Oxygen , Polycythemia , Reference Values
16.
Article in English | WPRIM | ID: wpr-713404

ABSTRACT

BACKGROUND: Although chronic obstructive pulmonary disease is a known cause of secondary polycythemia with elevated erythropoietic demands in response to hypoxemia, anemia is relatively common in patients with chronic obstructive pulmonary disease and is related to increased mortality. However, little is currently known about the relationship between various iron parameters and disease severity in chronic obstructive pulmonary disease patients. METHODS: Data from the fifth Korean National Health and Nutrition Examination Survey, a population-based epidemiologic survey conducted in 2010–2012, were used. A total of 1,129 patients with chronic obstructive pulmonary disease were examined to reveal the associations between the forced expiratory volume in 1 second (FEV1) and hemoglobin and iron parameters, including serum iron, ferritin, total iron binding capacity, and transferrin saturation, using Spearman correlations and multiple linear regression analyses. RESULTS: The FEV1 was positively correlated with serum hemoglobin (γ=0.37, P < 0.001), iron (γ=0.20, P < 0.001), transferrin saturation (γ=0.19, P < 0.001), and ferritin (γ=0.22, P < 0.001), and negatively correlated with age (γ=−0.40, P < 0.001) and lower in female patients (γ=−0.56, P < 0.001) in the Spearman correlation. The FEV1 was independently associated with serum iron (β=0.049, P=0.035) and transferrin saturation (β=0.049, P=0.035) after adjusting for age, sex, and body mass index in the multiple linear regression analyses. CONCLUSION: The serum iron and transferrin saturation levels were independently associated with FEV1 as a marker of chronic obstructive pulmonary disease severity.


Subject(s)
Anemia , Hypoxia , Body Mass Index , Female , Ferritins , Forced Expiratory Volume , Humans , Iron , Linear Models , Mortality , Nutrition Surveys , Polycythemia , Pulmonary Disease, Chronic Obstructive , Transferrin
17.
Arq. bras. med. vet. zootec. (Online) ; 70(5): 1378-1382, set.-out. 2018. graf
Article in Portuguese | LILACS, VETINDEX | ID: biblio-946853

ABSTRACT

A eritrocitose absoluta primária, também denominada de policitemia vera, é um distúrbio mieloproliferativo crônico de causa desconhecida, caracterizado pela proliferação clonal de células-tronco eritróides neoplásicas. Acomete cães de meia-idade entre seis e sete anos. As manifestações clínicas mais comuns são letargia, fraqueza, poliúria, polidipsia, sangramentos como epistaxe, hematúria, hematoemese, hematoquezia, até mesmo convulsões e ataxia. O diagnóstico é baseado em valores altos de hematócrito, geralmente acima de 70%, excluindo-se as causas de eritrocitose secundária. As concentrações séricas de eritropoietina estão normais ou diminuídas. O tratamento consiste em flebotomia e administração de hidroxiuréia. Relata-se o caso de uma cadela, raça Bichon Frise, 11 anos, que, no início do quadro, apresentou hematócrito de 84%, letargia, ataxia, mucosas congestas, cianose de língua, poliúria e polidipsia. Realizou-se o tratamento com hidroxiuréia durante oito anos, na dose de 15 a 30 mg/kg, a cada 24 horas, sem ocorrência de efeitos colaterais ou recidiva das manifestações clínicas.(AU)


Primary absolute erythrocytosis, also termed polycythemia vera, is a chronic myeloproliferative disorder of unknown cause. It is characterized by clonal proliferation of neoplastic erythroid stem cells. It affects middle-aged dogs between 6-7 years. The most common clinical manifestations are lethargy, weakness, polyuria, polydipsia, and bleeding such as epistaxis, hematuria, hematoemese, and hematochezia. Seizures and ataxia are also common. Diagnosis is based on high hematocrit values, generally above 70% excluding the causes of secondary erythrocytosis. Serum concentrations of erythropoietin are at a normal level or decreased level. Treatments consists of hydroxyurea and phlebotomy management. It is reported that case of female Bichon Frise, 11 years old who onset of the disease had a hematocrit of 84%, lethargy, ataxia, congested mucous membranes, tongue cyanosis, polyuria and polydipsia. The treatment with hydroxyurea was performed for 8 years, at a dose of 15 to 20mg/kg, every 24 hours, without occurrence of side effects or recurrence of clinical manifestations.(AU)


Subject(s)
Animals , Dogs , Dogs/blood , Hydroxyurea/analysis , Polycythemia/veterinary
18.
Article in English | WPRIM | ID: wpr-761252

ABSTRACT

Polycythemia vera (PV) is well known chronic myeloproliferative neoplasm, caused by clonal expansion of an abnormal hematopoietic stem cell. Patients with PV may present diverse neurologic symptoms including headache, dizziness or vertigo, tinnitus. However, the attention has not been directed to the neurootological findings in patients with PV. Here, we present a 71-year-old male patient with PV suffered from vertigo and headache. He demonstrated gaze-evoked nystagmus and perverted head shaking nystagmus. Transcranial Doppler showed decrement of blood flow velocity in posterior circulation. The patient's neuro-otologic findings were normalized as polychethemia and blood flow improved with repetitive phlebotomy and medications such as hydroxyurea and aspirin. Considering the neurological and hemodynamic findings in our patient, the mechanism of vertigo in PV could be explained by central vestibulopathy because of vascular insufficiency rather than peripheral vestibulopathy because of inner ear blood hyperviscosity.


Subject(s)
Aged , Aspirin , Blood Flow Velocity , Dizziness , Ear, Inner , Head , Headache , Hematopoietic Stem Cells , Hemodynamics , Humans , Hydroxyurea , Male , Neurologic Manifestations , Phlebotomy , Polycythemia Vera , Polycythemia , Tinnitus , Vertigo
19.
Yonsei Medical Journal ; : 665-667, 2017.
Article in English | WPRIM | ID: wpr-28762

ABSTRACT

Congenital erythrocytosis (CE) is a rare and heterogeneous disease. The high oxygen affinity hemoglobin (Hb) variants are the most common cause of CE. Herein, we report a Korean patient with isolated erythrocytosis. A 25-year-old man was referred to our hospital for evaluation of high Hb level (Hb 20.4 g/dL, hematocrit 58%, reticulocyte count 2.90%, white blood cell count 6.83×10⁹/L, and platelet count 195×10⁹/L). Bone marrow biopsy revealed normocellular marrow without myeloproliferative features. JAK2 (V617F, exon 12), CALR (exon 9), and MPL W515K/L mutations were not detected. P₅₀ (partial pressure at which Hb is half saturated with oxygen), which is an indicator of left-shift of oxygen dissociation curve (high oxygen affinity state), was 14.3 mm Hg (reference value 22.6–29.4 mm Hg). He was suspected to have CE. Mutation analysis of the HBB gene revealed the known Hb variant, Hb Heathrow [β103(G5)Phe→Leu]. This is the first report of Hb Heathrow in Asian.


Subject(s)
Adult , Asian Continental Ancestry Group , Biopsy , Bone Marrow , Exons , Hematocrit , Humans , Leukocyte Count , Oxygen , Platelet Count , Polycythemia , Reticulocyte Count
20.
In. Díaz, Lilian. Consultas frecuentes en hematología ambulatoria. Montevideo, Universidad de la República (Uruguay). Facultad de Medicina. Cátedra de Hematología, 2017. p.11-20, tab.
Monography in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1362243
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