- Non-Hodgkin lymphoma, diagnostic, and prognostic particularities in children - a series of case reports and a review of the literature (CARE compliant). [Journal Article]
- MMedicine (Baltimore) 2018; 97(8):e9802
- CONCLUSIONS: Despite the advances in the management, NHL remains a fatal condition in pediatrics.
- Sirolimus alternative to blood transfusion as a life saver in blue rubber bleb nevus syndrome: A case report. [Journal Article]
- MMedicine (Baltimore) 2018; 97(8):e9453
- CONCLUSIONS: we report a case of a mutation in exon 15 of the TEK gene leading to BRBN. It was successfully treated with a small dose of sirolimus as an alternative to blood transfusion in order to save the of BRBN patient's life.
- Managing iron deficiency and iron deficiency anemia in inflammatory bowel disease. The results of the "Gestiona hierro-EII" survey. [Journal Article]
- RERev Esp Enferm Dig 2018 Feb 21; 110:172-178
- CONCLUSIONS: the "Gestiona Hierro EII" survey on the management of anemia in IBD demonstrated a high quality of care, even though some aspects need to be improved. These included the prescription of intravenous iron for patients with disease activity, the use of high-dose intravenous iron and the implementation of algorithms into clinical practice.
- Erythropoietic Response to Anaemia of Dialysis Naïve Patients with Chronic Kidney Disease in Zaria, North-West Nigeria. [Journal Article]
- NJNiger J Clin Pract 2018; 21(2):189-194
- CONCLUSIONS: In contrast to some existing literature, this study has demonstrated that EPO resistance and iron deficiency contributes to anemia in CKD and serum ferritin can be used to assess the iron level of dialysis naïve CKD patients at every stage of the disease.
- Quel pourrait être le futur de la prise en charge de l’anémie dans l’insuffisance rénale chronique ? [Journal Article]
- NTNephrol Ther 2017; 13(6S):S7-S10
- Erythropoietin (EPO) plays an essential role in the regulation of erythropoiesis. Its production is under the control of the Hypoxia Inducible Factor (HIF) protein whose stability varies according to...
Erythropoietin (EPO) plays an essential role in the regulation of erythropoiesis. Its production is under the control of the Hypoxia Inducible Factor (HIF) protein whose stability varies according to the oxygen level. During chronic renal failure, EPO deficiency is the main cause of anemia, but other factors such as iron deficiency and inflammatory syndrome are also involved. More recently, it is hypothesized that other factors such an excess of GDF-11 production may be also involved. Thus, beside Epo treatment HIF and GDF-11 are potentially new therapeutic targets in anemia of chronic kidney disease.
- Approaches for Reducing the Risk of Early-Life Iron Deficiency-Induced Brain Dysfunction in Children. [Review]
- NNutrients 2018 Feb 17; 10(2)
- Iron deficiency is the most common micronutrient deficiency in the world. Women of reproductive age and young children are particularly vulnerable. Iron deficiency in late prenatal and early postnata...
Iron deficiency is the most common micronutrient deficiency in the world. Women of reproductive age and young children are particularly vulnerable. Iron deficiency in late prenatal and early postnatal periods can lead to long-term neurobehavioral deficits, despite iron treatment. This may occur because screening and treatment of iron deficiency in children is currently focused on detection of anemia and not neurodevelopment. Anemia is the end-stage state of iron deficiency. The brain becomes iron deficient before the onset of anemia due to prioritization of the available iron to the red blood cells (RBCs) over other organs. Brain iron deficiency, independent of anemia, is responsible for the adverse neurological effects. Early diagnosis and treatment of impending brain dysfunction in the pre-anemic stage is necessary to prevent neurological deficits. The currently available hematological indices are not sensitive biomarkers of brain iron deficiency and dysfunction. Studies in non-human primate models suggest that serum proteomic and metabolomic analyses may be superior for this purpose. Maternal iron supplementation, delayed clamping or milking of the umbilical cord, and early iron supplementation improve the iron status of at-risk infants. Whether these strategies prevent iron deficiency-induced brain dysfunction has yet to be determined. The potential for oxidant stress, altered gastrointestinal microbiome and other adverse effects associated with iron supplementation cautions against indiscriminate iron supplementation of children in malaria-endemic regions and iron-sufficient populations.
- Rapidly Dissolving Microneedle Patches for Transdermal Iron Replenishment Therapy. [Journal Article]
- JPJ Pharm Sci 2018 Feb 17
- The prevalence of Iron Deficiency Anemia (IDA) is predominant in women and children especially in developing countries. The disorder affects cognitive functions and physical activity. While oral iron...
The prevalence of Iron Deficiency Anemia (IDA) is predominant in women and children especially in developing countries. The disorder affects cognitive functions and physical activity. While oral iron supplementation and parenteral therapy remains the preferred choice of treatment, gastric side effects and risk of iron overload decreases adherence to therapy. Transdermal route is an established approach which circumvents the side-effects associated with conventional therapy. In this project, an attempt was made to investigate the use of rapidly dissolving microneedles loaded with Ferric pyrophosphate (FPP) as a potential therapeutic approach for management of IDA. Microneedle array patches were made using the micromolding technique and tested in vitro using rat skin to check the duration required for dissolution/disappearance of needles. The ability of FPP loaded microneedles to replenish iron was investigated in anemic rats. Rats were fed iron deficient diet for 5 weeks to induce IDA following which microneedle treatment was initiated. Recovery of rats from anemic state was monitored by measuring hematological and biochemical parameters. Results from in vivo study displayed significant improvements in hemoglobin and serum iron levels after two-week treatment with FPP loaded microneedles. The study effectively demonstrated the potential of microneedle mediate iron replenishment for treatment of IDA.
- Renal anemia syndromes in iraqi hemodialysis patients according to iron status. [Journal Article]
- SJSaudi J Kidney Dis Transpl 2018 Jan-Feb; 29(1):127-135
- Anemia is common in patients on hemodialysis (HD). Adequate iron stores are essential for achieving the best hemoglobin level through maximum benefit from erythropoiesis-stimulating agents (ESA). Dec...
Anemia is common in patients on hemodialysis (HD). Adequate iron stores are essential for achieving the best hemoglobin level through maximum benefit from erythropoiesis-stimulating agents (ESA). Decreased iron stores or decreased availability of iron are the most common reasons for resistance to the effect of these agents. Our objective was to categorize a group of Iraqi HD patients according to absolute or functional iron deficiency anemia (IDA); this study was conducted in the HD unit of the Baghdad Teaching Hospital from October 2012 to January 2013. Seventy prevalent adult HD Iraqi patients were enrolled. All patients were tested for full blood counts and iron parameters. They were categorized as nonanemic and those with absolute or functional iron deficiency. The patients were also tested for serum albumin, C-reactive protein (CRP), parathyroid hormone, and serum hepcidin levels. Data were expressed as mean ± standard deviation, and frequencies (number) and proportions (%). The mean age of the study group was 49.8 ± 12.3 years. Diabetes was the primary cause of end-stage renal disease, seen in 30 patients (42.8%). Majority of the HD patients were anemic, [51 (82.9%)] and among them, 39 (76.4%), had functional IDA. The mean serum iron, serum ferritin, and transferrin saturation were significantly higher in patients with functional IDA than those with absolute IDA (P <0.05). The mean highly sensitive CRP, parathormone and hepcidin values were also significantly higher in functional IDA patients than in those with absolute IDA and the nonanemic group (P <0.05). More than half of the study patients had functional IDA, and this can explain ESA hyporesponsiveness. This is besides the interplay of other factors including inflammation, inadequate dialysis, and secondary hyperparathyroidism. It is essential to diagnose functional IDA early, before the initiation of unnecessary iron therapy.
- Pazopanib effective for bevacizumab-unresponsive epistaxis in hereditary hemorrhagic telangiectasia. [Case Reports]
- LLaryngoscope 2018 Feb 16
- Hereditary hemorrhagic telangiectasia (HHT) most commonly manifests with nasal mucosal telangiectasias, and vascular endothelial growth factor (VEGF) plays a significant role in this angiodysplasia. ...
Hereditary hemorrhagic telangiectasia (HHT) most commonly manifests with nasal mucosal telangiectasias, and vascular endothelial growth factor (VEGF) plays a significant role in this angiodysplasia. We describe a patient with HHT with epistaxis recalcitrant to several endonasal procedures and six cycles of intravenous bevacizumab, for which he was dependent on iron infusions and packed red blood cells transfusions. He then started pazopanib at 100 mg with dramatic improvements in epistaxis and normalization of hemoglobin and iron levels, without replenishment needs for 12 months. This is the first report on the efficacy of pazopanib with high selectivity for abrogating VEGF receptor-2 signaling in HHT, and needs to be explored further. Laryngoscope, 2018.
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- Hepcidin and proinflammatory markers in children with chronic kidney disease: A case-control study . [Journal Article]
- CNClin Nephrol 2018 Feb 16
- CONCLUSIONS: A positive correlation between hepcidin and other inflammatory biomarkers in non-dialyzed, iron- and EPO-naïve pediatric CKD patients suggests a role of these markers in higher hepcidin production and its contribution to iron-restricted erythropoiesis across the spectrum of CKD. Median hepcidin levels were highest in those with impaired iron trafficking, followed by those with no iron deficiency, followed by those with absolute iron deficiency, suggesting that in an iron-replete state, high hepcidin levels inhibit iron absorption from the gut and release from iron storing cells, thus restricting erythropoiesis leading to anemia. .