866 resultados para Anemia falciforme


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We looked for abnormal hemoglobins in blood samples sent for diagnosis of anemia. Identification of the hemoglobins was made using electrophoretic, chromatographic and molecular procedures. The 2020 blood samples were of patients from various regions of Brazil and from some other Latin American countries. Among the abnormal hemoglobins that we found, 3.5% are known to be rare, while 51% had an electrophoretic profile similar to that of Hb S at alkaline pH. Differentiation was possible only by combining electrophoretic and chromatographic methods. Hb Hasharon, an alpha globin chain mutant, was the most frequently found variant hemoglobin; it accounted for 14.3% of the abnormal DNA samples. The other abnormal hemoglobin phenotypes displayed distinct electrophoretic profiles; most of them migrated faster than Hb A. The frequencies of the different abnormal hemoglobin profiles that we found reflect the miscegenation of the Latin American population and indicate the importance of hemoglobin studies using various methods in combination for accurate diagnosis and appropriate counseling of carriers and their families.

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Cameron ulcers are chronic linear lesions willing on the mucosal folds, the level of diaphragmatic impression, in patients with hiatal hernia. Its clinical relevance is due to the potential risk of gastrointestinal complications, such as acute or chronic bleeding and anemia. Usually, the diagnosis is incidental by upper gastrointestinal endoscopy. Proton pump inhibitors are essential for the conduct of cases and the administration of iron when the anemia is associated. Already, the benefit of surgery is in refractory cases. We present a case of this entity of a 50-year-old patient in postmenopausal who developed anemia due to iron deficiency and normal initial endoscopy.

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The aim of this study was to evaluate the hemodynamic and acid-base status of dogs subjected to acute normovolemic anemia. The dogs (n = 10) were evaluated 15 minutes and 24 hours after induction of anemia (hematocrit below 18) with blood withdrawal and simultaneously replacement of same volume of Ringer's lactate solution and hydroxyethyl starch-based solution in a 2:1 ratio. The cardiac output was measured by Doppler echocardiography and blood pressure by oscillometric device, and posteriorly hemodynamic parameters were calculated. The anemic groups had increase in cardiac index (P <.05) (3.82 ± 1.05 to 5.86 ± 1.49 and 5.81 ± 1.63 L/min m) and decreases (P <.05) in the indices of total peripheral resistance (6797.81 ± 3060.22 to 3220.14 ± 1275.02 and 3887.74 ± 1394.89 dinaseg/cm 5× m2) and oxygen delivery (7942.84 ± 3344.00 to 4021.68 ± 1627.00 and 4430.82 ± 1402.61 mL/min× m 2), respectively. There were no significant changes in pH, but PaO2 and SaO2 values were increased, and PaCO2 reduced in anemic dogs (P <.05). Therefore, acute normovolemic anemia can create significant hemodynamic changes and despite some hemogasometric changes, there were no changes in the acid-base status in dogs. Copyright © 2011 Tatiana Champion et al.

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Background Post-transplant anemia is multifactorial and highly prevalent. Some studies have associated anemia with mortality and graft failure. The purpose of this study was to assess whether the presence of anemia at 1 year is an independent risk factor of mortality and graft survival. Methods All patients transplanted at a single center who survived at least 1 year after transplantation and showed no graft loss (n = 214) were included. Demographic and clinical data were collected at baseline and at 1 year. Patients were divided into two groups (anemic and nonanemic) based on the presence of anemia (hemoglobin<130 g/l in men and 120 g/l in women). Results Baseline characteristics such as age, gender, type of donor, CKD etiology, rejection, andmismatches were similar in both groups. Creatinine clearance was similar in both anemic and nonanemic groups (69.32 ± 29.8 × 75.69 ± 30.5 ml/mim; P = 0.17). A Kaplan- Meier plot showed significantly poorer death-censored graft survival in the anemic group, P = 0.003. Multivariate analysis revealed that anemic patients had a hazard ratio for the graft loss of 3.85 (95% CI: 1.49-9.96; P = 0.005). Conclusions In this study, anemia at 1 year was independently associated with death-censored graft survival and anemic patients were 3.8-fold more likely to lose the graft. © 2010 Springer Science+Business Media, B.V.

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Background: The aim of this study was to evaluate the frequency of Candida species and presence of lesions in the oral cavity of patients with sickle cell anemia (SS). Methods: The study included 30 patients diagnosed with sickle cell anemia and taking hydroxyurea for at least 90 days (SS/HU+); and 39 patients with sickle cell anemia and without hydroxyurea therapy (SS/HU-). Two control groups were constituted by healthy individuals matched to the test groups in age, gender, and oral conditions (C/HU+ for SS/HU+ and C/HU- for SS/HU-). Oral clinical examination and anamnesis were performed. Yeasts were collected by oral rinses and identified by API system. Antifungal susceptibility evaluation was performed according to the CLSI methodology. Data obtained for microorganisms counts were compared by Student's t test (SS/HU+ vs. C/HU+ and SS/HU- vs. C/HU-) using MINITAB for Windows 1.4. Significance level was set at 5%. Results: No oral candidosis lesions were detected. Significant differences in yeasts counts were observed between SS/HU- group and the respective control, but there were no differences between SS/HU+ and C/HU+. Candida albicans was the most prevalent species in all groups. Candida famata was observed both in SS and control groups. Candida dubliniensis, Candida glabrata, Candida krusei, Candida tropicalis, Candida pelliculosa, and Candida parapsilosis were observed only in SS groups. Most strains were susceptible to all antifungal agents. Conclusion: Hydroxyurea therapy seems to decrease candidal counts and resistance rate in sickle cell anemia patients. However, further studies should be conducted in the future to confirm this finding. Hydroxyurea therapy in sickle cell anemia patients maintains fungal species balance in oral cavity. © 2013 John Wiley & Sons A/S.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Pós-graduação em Saúde Coletiva - FMB

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Pós-graduação em Fisiopatologia em Clínica Médica - FMB

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As partes aéreas de Indigofera suffruticosa Mill. (família Leg. Papilionoideae), planta incriminada pelos criadores de diversas áreas do Nordeste por doença caracterizada por hemoglobinúria em bovinos, foram administradas por via oral a seis bovinos, em doses diárias repetidas de 10 a 40 g/kg, Todos os animais experimentais apresentaram hemoglobinúria, porém passageira, apesar continuidade da administração da planta. Dois desses bovinos não apresentaram manifestações adicionais, um terceiro animal evidenciou manifestações leves, e os três outros, sintomas adicionais de intensidade moderada: apatia, mucosas visíveis de coloração esbranquiçada, pêlos arrepiados, anorexia, diminuição da freqüência e intensidade dos movimentos ruminais, taquicardia, pulso venoso positivo e dispnéia. Antes da crise hemolítica a urina apresentava coloração verde azulada. Nenhum animal experimental morreu, porém um foi sacrificado durante a fase hemoglobinúrica. À necropsia observaram-se anemia, bexiga contendo urina cor de vinho tinto, rins aumentados de volume com coloração marrom-escura, fígado, na superfície e ao corte, de coloração azulada com lobulação perceptível. As principais alterações histológicas foram verificadas no fígado, sob forma de necrose coagulativa e tumefação e/ou microvacuolização citoplasmática dos hepatócitos, e no rim representadas por acentuada nefrose, associada a grande quantidade de filtrado e/ou hemoglobina nos espaços de Bowman dentro de túbulos e do citoplasma das células epiteliais.

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A incidência de anemia, parasitismo intestinal e prevalência da exposição mercurial foi avaliada em duas comunidades amazônicas ribeirinhas, São Luiz do Tapajós (Rio Tapajós) e Igarapé-Mirim (Rio Tocantins) cujos padrões sócio-econômicos são semelhantes. Foram analisadas amostras de cabelo, sangue e fezes dos residentes nestas comunidades, empregando metodologia analítica oficialmente reconhecida. Oitenta amostras de cabelo, sangue e fezes foram analisadas. Os resultados demonstraram incidência média de 42,5 % de parasitose intestinal em São Luiz do Tapajós e 75,15 % em Igarapé-Mirim. Os índices hematimétricos indicaram incidência de anemia de 40 % em São Luiz do Tapajós e 25 % em Igarapé-Mirim. Os teores médios de mercúrio total nas amostras de cabelo dos residentes em São Luiz do Tapajós foram de 14,9 ± 6,6 µg/g nos indivíduos do sexo masculino e 13,4 ± 3,4 µg/g no sexo feminino, enquanto que em Igarapé-Mirim foi de 2,5 ± 1,4 µg/g na população masculina e 3,5 ± 1,6 µg/g na feminina. Observou-se que em São Luiz do Tapajós, 82 % das concentrações de mercúrio total encontram-se acima de 10µg/g, valor considerado de referência para população não exposta, enquanto que em Igarapé-Mirim, não foram encontrados valores acima destes. Pode-se concluir que a qualidade de vida dos ribeirinhos analisados é comprometida pelos fatores avaliados, tornando-se necessária à adoção de medidas preventivas e ações educadoras nestas comunidades pelas autoridades governamentais responsáveis.

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Anemia is a prevalent comorbidity and marker of a poorer prognosis in patients with heart failure (HF). Its clinical relevance, as well as its pathophysiology and the clinical management of these patients are important subjects in the specialized literature. In the present review, we describe the current concepts on the pathophysiology of anemia in HF, its diagnostic criteria, and the recommendations for iron supplementation. Also, we make a critical analysis of the major studies showing evidences on the benefits of this supplementation. The four main components of anemia are addressed: chronic disease, dilutional, renal and malabsorption. In patients with HF, the diagnostic criteria are the same as those used in the general population: serum ferritin levels lower than 30 mcg/L in patients without kidney diseases and lower than 100 mcg/L or serum ferritin levels between 100-299 mcg/L with transferring saturation lower than 20% in patients with chronic kidney diseases. Finally, the therapeutic possibilities for anemia in this specific patient population are discussed.