RESUMO
INTRODUCTION: Pica is an eating disorder, defined by long-term ingestion of non-nutritive substances. PURPOSE: To determine the frequency of pica in patients with iron deficiency anemia and to describe the population with both iron deficiency anemia and pica. PATIENTS AND METHODS: This retrospective study examined records from the department of hematology at the Mohammed VI University Hospital Center in Marrakech of all adult patients seen from January 1, 2005, through December 31, 2010 who met both criteria. Results: During the 6-year study period, 320 patients with iron deficiency anemia were seen: 256 women and 64 men (sex-ratio F/M: 4). The prevalence of pica among the patients with iron deficiency anemia was 17.5% (56/320). All the patients with pica were women, for a prevalence of 21.8% (56/256); their average age was 23 years; 40 were white (71.4%) and 16 black (28.6%). The clinical signs were primarily pallor (100%) and asthenia (100%). The mean level of hemoglobin was 7.6 g/dL and of ferritin, 6.4 mg/L. Geophagia was the most common form of pica (75%). Iron supplementation induced regression of pica in 64.3% of patients. CONCLUSION: Our study shows a high prevalence of pica in patients with iron deficiency anemia.
Assuntos
Anemia Ferropriva/complicações , Pica/epidemiologia , Pica/etiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Prevalência , Estudos Retrospectivos , Adulto JovemAssuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Perda Auditiva Súbita/etiologia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bleomicina/efeitos adversos , Bleomicina/uso terapêutico , Dacarbazina/efeitos adversos , Dacarbazina/uso terapêutico , Doxorrubicina/efeitos adversos , Doxorrubicina/uso terapêutico , Perda Auditiva Súbita/diagnóstico , Doença de Hodgkin/complicações , Doença de Hodgkin/tratamento farmacológico , Humanos , Masculino , Vimblastina/efeitos adversos , Vimblastina/uso terapêuticoRESUMO
Use of complementary and alternative medicine (CAM) is very frequent in cancer patients. The aims of this study were to analyze the frequency, the reasons of use of CAM in patients with a cancer treated in a Moroccan oncology department. We included in this study 400 patients. An anonymous questionnaire was proposed to patients during treatment. Over 384 analyzable questionnaires, 71% of patients were using CAM. The most frequent method was religious therapy (60%). The second one was herbal medicine (36%). The main reason for using CAM was reducing psychic pain in 53%, and boosting the immune system in 32%. Adverse effects were reported in 2% of cases. Only 5% of patients discussed CAM with their doctors. The cost of CAM was less than 100 Euros in 88% of cases. To optimize the patient-physician relationship and to avoid a propensity to unproved treatments, accurate and adequate communication is necessary.
Assuntos
Terapias Complementares/estatística & dados numéricos , Neoplasias/terapia , Adulto , Idoso , Terapias Complementares/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Motivação , Neoplasias/epidemiologia , Relações Médico-Paciente , Estudos Prospectivos , Fatores Socioeconômicos , Adulto JovemAssuntos
Neoplasias Encefálicas/patologia , Corpo Caloso/patologia , Linfoma/patologia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/tratamento farmacológico , Corpo Caloso/diagnóstico por imagem , Humanos , Linfoma/diagnóstico por imagem , Linfoma/tratamento farmacológico , Masculino , Tomografia Computadorizada por Raios XRESUMO
Circumcision is a ritual in the Jewish and Muslim religions. It is the most common surgical procedure in the world and one of the oldest. Hemophilia A is an inherited, X-linked, recessive disorder caused by a deficiency of functional plasma clotting factor VIII. Circumcision in patients with hemophilia A is a major challenge, and its consequences can be fatal for this particular type of patient. The aim of this study is to evaluate our experience in circumcision of hemophilia patients and assess the safety of our protocol and the complications associated with it.
Assuntos
Circuncisão Masculina , Hemofilia A , Adolescente , Criança , Pré-Escolar , Circuncisão Masculina/efeitos adversos , Humanos , Masculino , Marrocos , Fatores de Risco , Adulto JovemRESUMO
The aim of this study is to examine retrospectively the clinical, biological and treatment features of anemia by vitamin B12 deficiency in the Hematology department of CHU Mohamed VI Marrakech. We report the results of a retrospective study conducted during six years (2005-2010). It included all patients with anemia (with or without thrombocytopenia or leukopenia) associated with vitamin B12 levels <200 pg / ml. One hundred twenty one cases were analyzed. The average age of patients was 62 years (38-89 years) with a female predominance (sex ratio F/M: 1.3). The clinical symptomatology is dominated by pallor (97.5%), cardiovascular signs (46%) and digestive symptoms (34.7%). Neurological signs were noted in 17.3% of cases. The blood count showed anemia (hemoglobin: mean= 6.9 g/dl), macrocythemia (MCV: mean= 109 fl). Leukopenia was noted in 35 patients (29%), thrombocytopenia in 34 patients (28%) and pancytopenia in 21 patients (17,3%). The average vitamin B12 was 72 pg/ml. The causes of B12 deficiency are pernicious anemia (43%), food-cobalamin malabsorption (43%), and in 14% of cases no etiology was found. Gastritis was found in 82.7% of our patients and Helicobacter pylori (HP) infection in 72.7% of cases. Reticulocyte crisis was observed after parenteral administration of hydroxocobalamine within an average of 8 days and normalization of blood counts, in all patients, within an average of 51 days. In patients with HP infection, eradication therapy of HP was performed. The cure rate of the HP is 90%.
Assuntos
Anemia Macrocítica/epidemiologia , Anemia Perniciosa/epidemiologia , Deficiência de Vitamina B 12/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia Macrocítica/sangue , Anemia Macrocítica/tratamento farmacológico , Anemia Macrocítica/etiologia , Anemia Perniciosa/sangue , Anemia Perniciosa/tratamento farmacológico , Anemia Perniciosa/etiologia , Comorbidade , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Gastrite/epidemiologia , Gastrite/microbiologia , Infecções por Helicobacter/epidemiologia , Hematologia/estatística & dados numéricos , Departamentos Hospitalares/estatística & dados numéricos , Humanos , Hidroxocobalamina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Síndromes Pós-Gastrectomia/epidemiologia , Estudos Retrospectivos , Avaliação de Sintomas , Deficiência de Vitamina B 12/tratamento farmacológico , Deficiência de Vitamina B 12/epidemiologia , Vitiligo/epidemiologiaAssuntos
Anemia Perniciosa/epidemiologia , Anemia Perniciosa/etiologia , Deficiência de Vitamina B 12/complicações , Deficiência de Vitamina B 12/epidemiologia , Vitamina B 12/administração & dosagem , Complexo Vitamínico B/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia Ferropriva/epidemiologia , Anemia Perniciosa/diagnóstico , Anemia Perniciosa/tratamento farmacológico , Feminino , Hospitais Universitários , Humanos , Injeções Intramusculares , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Deficiência de Vitamina B 12/tratamento farmacológicoRESUMO
This retrospective study evaluated the frequency of different causes of pancytopenia in all adult patients with pancytopenia presenting to the Department of Haematology of Mohamed VI Hospital, Marrakesh from 1 January 2008 to 31 December 2010. A total of 118 cases of pancytopenia were found (average of 39 cases per year). The mean age of patients was 52 years (range 18-82 years) and 52.5% were male. The main clinical signs were pallor (100%), asthenia (100%) and fever (30.5%). Mean haemoglobin was 6.5 g/dL (range 2.9-9.2 g/dL), mean white blood cell count was 2360/mm3 (range 840-3360/mm3) and platelet count 66 000/mm3 (range 3000-123 000/mm3). Bone marrow aspiration was performed in 112 patients; megaloblastosis was found in 32.2% and marrow blasts in 23.7%. Anaemia due to vitamin B12 deficiency (32.2%), acute leukaemia (23.7%) and aplastic anaemia (15.2%) were the main causes of pancytopenia. Given the incidence of acute leukemia among our cases, patients presenting with pancytopenia require urgent diagnosis and treatment.
Assuntos
Pancitopenia/epidemiologia , Pancitopenia/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia Aplástica/diagnóstico , Anemia Aplástica/epidemiologia , Feminino , Humanos , Leucemia/diagnóstico , Leucemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Marrocos , Estudos Retrospectivos , Deficiência de Vitamina B 12/diagnóstico , Deficiência de Vitamina B 12/epidemiologiaAssuntos
Meningoencefalite/diagnóstico , Púrpura Trombocitopênica Trombótica/diagnóstico , Adulto , Antirretrovirais/uso terapêutico , Diagnóstico Diferencial , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , HIV-1/fisiologia , Humanos , Masculino , Otite Média Supurativa/diagnóstico , Otite Média Supurativa/etiologia , Púrpura Trombocitopênica Trombótica/tratamento farmacológico , Púrpura Trombocitopênica Trombótica/etiologiaAssuntos
Vincristina/efeitos adversos , Paralisia das Pregas Vocais/induzido quimicamente , Antineoplásicos Fitogênicos/administração & dosagem , Antineoplásicos Fitogênicos/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ciclofosfamida/efeitos adversos , Ciclofosfamida/uso terapêutico , Doxorrubicina/efeitos adversos , Doxorrubicina/uso terapêutico , Humanos , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Prednisona/efeitos adversos , Prednisona/uso terapêutico , Neoplasias Gástricas/tratamento farmacológico , Vincristina/administração & dosagem , Vincristina/uso terapêuticoRESUMO
This retrospective study evaluated the frequency of different causes of pancytopenia in all adult patients with pancytopenia presenting to the Department of Haematology of Mohamed VI Hospital, Marrakesh from 1 January 2008 to 31 December 2010. A total of 118 cases of pancytopenia were found [average of 39 cases per year]. The mean age of patients was 52 years [range 18-82 years] and 52.5% were male. The main clinical signs were pallor [100%], asthenia [100%] and fever [30.5%]. Mean haemoglobin was 6.5 g/dL [range 2.9-9.2 g/dL], mean white blood cell count was 2360/mm[3] [range 840-3360/mm[3]] and platelet count 66 000/mm[3] [range 3000-123 000/mm[3]]. Bone marrow aspiration was performed in 112 patients; megaloblastosis was found in 32.2% and marrow blasts in 23.7%. Anaemia due to vitamin B[12] deficiency [32.2%], acute leukaemia [23.7%] and aplastic anaemia [15.2%] were the main causes of pancytopenia. Given the incidence of acute leukemia among our cases, patients presenting with pancytopenia require urgent diagnosis and treatment
Assuntos
Pancitopenia , Exame de Medula Óssea , Anemia Megaloblástica , LeucemiaRESUMO
INTRODUCTION: Acute lymphoblastic leukemia (ALL) is the most common hematologic malignancy in children. The clinical presentation at diagnosis is due to bone marrow infiltration or extra-medullary involvement. Maxillofacial localization is very rare in ALL. We report a case of T-ALL revealed by right cheek swelling in a 14-year-old boy. CASE PRESENTATION: A 14-year-old boy had presented with a 6 cm right cheek swelling for two months, complicated by pyrexia, cervical adenopathy, and splenomegaly. CT scan revealed a 3×7×8 cm swelling surrounded by voluminous sub chin, subclavicular, mediastinal, and paratracheal bilateral adenopathies. The biological analyses revealed normocytic anemia, hyperleukocytosis with 83.6% blast cells, neutropenia, and thrombopenia. The biopsy histology and the immuno-histochemical analysis suggested a diffuse small-cell Non-Hodgkin lymphoma (NHL). The myelogram identified a type 1 ALL and immunophenotyping on bone marrow cells suggested phenotype T ALL. The patient was treated according to the MARALL-06 protocol and died on the 17th day of induction, in septic shock. DISCUSSION: Despite their rare occurrence, ALL should be included in the differential diagnosis of jugal swelling. The evident hematological context should suggest the diagnosis and a myelogram should be performed as soon as possible because the outcome is rapidly fatal.
Assuntos
Edema/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Zigoma/patologia , Adolescente , Diagnóstico Diferencial , Edema/etiologia , Febre/diagnóstico , Febre/etiologia , Humanos , Infiltração Leucêmica/complicações , Infiltração Leucêmica/diagnóstico , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/etiologiaAssuntos
Dor Abdominal/etiologia , Linfoma de Burkitt/diagnóstico , Complicações Neoplásicas na Gravidez/diagnóstico , Neoplasias Gástricas/diagnóstico , Adulto , Antineoplásicos/uso terapêutico , Biópsia , Linfoma de Burkitt/complicações , Linfoma de Burkitt/tratamento farmacológico , Diagnóstico Diferencial , Endoscopia , Evolução Fatal , Feminino , Humanos , Imuno-Histoquímica , Gravidez , Complicações Neoplásicas na Gravidez/tratamento farmacológico , Neoplasias Gástricas/complicações , Neoplasias Gástricas/tratamento farmacológico , Tomografia Computadorizada por Raios XAssuntos
Neoplasias da Mama/genética , Neoplasias da Mama/terapia , Cromossomos Humanos Par 22 , Cromossomos Humanos Par 9 , Segunda Neoplasia Primária/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Translocação Genética , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cromossomos Humanos Par 22/genética , Cromossomos Humanos Par 9/genética , Feminino , Humanos , Segunda Neoplasia Primária/etiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/etiologia , Radioterapia Adjuvante/efeitos adversos , Translocação Genética/fisiologiaRESUMO
Much progress has been made during the last few decades in the treatment of hematological malignancies. Monoclonal antibodies (MoAbs) represent a major advance toward a targeted therapy that can dramatically improve the antitumor effect with a substantial reduction of toxicity derived from therapy. Unlike many small molecules, MoAbs offer unique target specificity. Several MoAbs are now in clinical use for hematologic malignancies therapy, and many others are currently undergoing clinical evaluation. This review summarizes the state-of-the-art MoAbs treatment, beginning with an overview of the scientific background to their synthesis, mechanism of action and choice of target antigen, mainly focusing on those antibodies that are currently in use in clinical practice. Despite these advances, significant challenges remain in the identification of optimal cellular targets, antibody forms and treatment schedules for therapeutic applications.