No description available.

No description available.

Abstract Hereditary hemochromatosis (HH) is a common autosomal recessive disorder estimated to affect one out of every 250–400 Caucasian individuals. It is a disorder of iron metabolism, in which excessive iron accumulation in the body may induce serious clinical manifestations (e.g. liver cirrhosis, hepatocellular carcinoma, diabetes, and cardiomyopathy). HH is caused by mutations in the HFE gene, and HFE genotyping thus enables early diagnosis of the disease and detection of the individuals at risk for HH. HFE mutations have also been proposed to predispose to certain other diseases, such as various hematological malignancies and cardiomyopathy. The present evaluation of the clinical utility and outcome of HFE genotyping in search for HH was based on data obtained from 137 subjects referred for HFE mutation analysis during the years 1999–2001. The C282Y and H63D mutations were determined for each subject. HFE genotyping was also used to examine the association between HFE mutations with various hematological disorders and idiopathic dilated cardiomyopathy (IDCM). The C282Y and H63D mutations were determined from 232 patients with various hematological disorders and the C282Y, H63D, and S65C mutations from 91 patients with IDCM and 102 control subjects. High frequencies of C282Y homozygotes (16.8%) and C282Y/H63D compound heterozygotes (5.1%) were found among the subjects referred for HFE genotyping, and the rate of positive findings for HH increased steadily over the years 1999–2001. The frequencies of HFE mutations did not differ significantly in patients with various hematological disorders and IDCM compared to controls. At the end of the follow-up period, left ventricular end-diastolic diameter (LVEDD) was significantly higher in IDCM patients carrying the C282Y mutation than in those without this mutation (p = 0.037). The present study supports active testing for the HFE gene mutations C282Y and H63D in public health care. Serum transferrin saturation is considered the most useful test for selecting subjects for such analysis. Although increasing numbers of HH cases are recognized by physicians, it may still be an underdiagnosed disease. HFE mutations do not seem to significantly increase the risk for various hematological disorders or IDCM. The C282Y mutation may, nevertheless, mediate the progression of IDCM by modifying LV dilation and remodeling.

No description available.

No / Improved survival in patients with hematological malignancy (HM) admitted to the intensive care unit (ICU) has largely been reported in uncontrolled cohorts from single academic institutions. We compared hospital mortality between 147 patients with HM and 147 general medical admissions to five non-specialist ICUs. The proportion of patients surviving to hospital discharge was significantly worse in patients with HM (27% vs. 56%; p < 0.001). Six-month and 1-year survival in patients with HM was 21% and 18%, respectively. HM, greater age, mechanical ventilation (MV) and acute physiology and chronic health evaluation (APACHE) II score were independent predictors of poor outcome. For patients with HM, culture proven infection, age, MV and inotropes were negative predictors. Disease-specific factors including hematological diagnosis, neutropenia, remission status, prior stem cell transplant, time from diagnosis to admission and degree of prior treatment were not predictive. Overall survival of patients with HM was worse than that recently reported from specialist units.

Claritromicina e clofazimina têm sido utilizadas no tratamento da hanseníase e tuberculose e também em infecções pelo complexo Mycobacterium avium, complicação comum em pacientes que se encontram em estágios avançados da síndrome da imunodeficiência adquirida (SIDA). Como os dados sobre a toxicidade de esquemas terapêuticos que incluem estes fármacos são escassos, o presente estudo teve como objetivo determinar os efeitos adversos destas terapias, por meio da avaliação dos parâmetros hematológicos, hemostáticos e bioquímicos e a correlação destes parâmetros com as doses testadas e destas com a concentração plasmática dos medicamentos administrados, intraperitonealmente, em ratos machos Wistar, em monoterapia, em regime de doses única (50, 100 e 200mg/kg de peso) e múltipla (100mg/kg). Clofazimina, em regime de dose única, provocou aumento no número de eritrócitos e redução dos índices eritrocitométricos VCM e CHCM. Em regime de dose múltipla, claritromicina provocou aumento de leucócitos e de células mono e polimorfonucleares. Ambos os fármacos, em dose única, parecem inverter a proporção entre células mono e polimorfonucleares. Foi observado aumento do número de células polimorfonucleares e células em degeneração, ocasionados tanto por clofazimina como pela claritromicina. Em regime de dose única, clofazimina e claritromicina prolongaram o TP. Claritromicina, quando administrada em dose múltipla, causou este mesmo efeito e também o prolongamento do TTPA. Os resultados da avaliação da função hepática mostraram resultados inconclusivos com relação às dosagens de AST, ALT e fosfatase alcalina, porém, foi observado aumento dos níveis plasmáticos de ?-GT provocado pela clofazimina, em regime de dose única. Claritromicina induziu aumento dos níveis de ?-GT, em regime de doses única e múltipla, e provocou elevação de bilirrubinas total e direta, em dose única. Houve aumento das concentrações plasmáticas dos fármacos à medida que as doses administradas aumentaram, apesar da claritromicina exibir um comportamento farmacocinético não-linear. Portanto, clofazimina e claritromicina provocam alterações hematológicas, hemostáticas e bioquímicas e os resultados de concentração plasmática são valiosos para avaliação de efeitos adversos em estudos comparativos de monoterapia e associação entre os medicamentos. / Clarithromycin and clofazimine have been used to treat leprosy and tuberculosis as well as infections of Mycobacterium avium complex, an ordinary complication in patients who are in advanced stage of Acquired Immunodeficiency Syndrome (AIDS). As the data about the toxicity of therapeutic schemes including those drugs are scarce, this research had the aim to determine the adverse effects of those therapies, through the evaluation of hematological, hemostatic and biochemical parameters and the relationship between these parameters and doses tested and between doses and plasma concentrations of drugs administered intraperitoneally, in male Wistar rats, in monotherapy, in single (50, 100 and 200mg/kg body wt), and multiple (100mg/kg body wt) doses regime. Clofazimine, in single dose regime, increased the number of erythrocytes, and it decreased the red cells indices MCV and MCHC. In multiple dose regime, clarithromycin increased the number of leukocytes and mononuclear and polymorphonuclear cells. Both the drugs, in single dose, seem to invert the proportion between mononuclear and polymorphonuclear cells. It was observed an increase in the number of polymorphonuclear cells and cells under degeneration caused by clofazimine and clarithromycin. In single dose regime, clofazimine and clarithromycin prolonged PT. When clarithromycin was administered in multiple dose, it brought about this same effect and also it prolonged aPTT. The results of hepatic function evaluation showed inconclusive results about AST, ALT and alkaline phosphatase levels, but it was observed an increase of U-GGT plasma levels provoked by clofazimine, in single dose regime. Clarithromycin brought about an increase of U-GGT plasma levels, in single and multiple dose regime, and caused an increase of total and direct bilirrubin, in single dose. An increase of plasma concentration of drugs was observed as administered doses were increased, though clarithromycin has nonlinear pharmacokinetics behavior. Therefore, clofazimine and clarithromycin induce hematological, hemostatic and biochemical alterations and the results of plasmatic concentration are valuable to evaluate adverse effects in comparative research of monotherapy and association between drugs.

Tidigare studier har fokuserat på barn och deras familjers upplevelser i samband med en hematologisk malignitet, framförallt leukemi. Hematologiska maligniteter är ett samlingsnamn för leukemi och några andra blodsjukdomar. Prevalensen för sjukdomarna ökar och främst vuxna drabbas. Syftet med studien var att beskriva patienters upplevelser av att leva med en hematologisk malignitet. Metoden för denna litteraturöversikt var kvalitativ. Fem artiklar och två avhandlingar analyserades. Studiens resultat utvecklades till fyra huvudteman: att få en sjukdom, att genomgå behandling, upplevelse av vårdmöten och att skakas om i sin livsvärld. Resultatet visar att sjukdomen upplevs som ett osynligt hot och att det ibland förekommer ett vårdlidande som beror på bristfälligt engagemang för människan bakom den sjuka kroppen. Att genomgå en svår tid med lidandets olika aspekter, förändrade oftast människors syn på sig själva och sina medmänniskor. Relationer fördjupades. Förbättringar i omvårdnadsarbetet kan göras genom ökad fokus på patienters känslomässiga lidande då studien visar att denna aspekt ibland förbises och detta resulterar i en objektifiering av patienter. / Previous studies have focused on children and their families' experiences in connection with a haematological malignancy, especially leukemia. Hematolocical malignancies is a collective name for leukemia and other blood diseases. The prevalence of diseases is increasing and affects mainly adults. The purpose of this study is to describe patients' experiences of living with a haematological malignancy. The methodology for this literature review was qualitative. Five articles and two dissertations were analyzed. Results of the study, developed into four main themes: to get a disease, to undergo treatment, experience of care meetings and to shake in their life-world. The result shows that the disease is perceived as an invisible threat, and that sometimes there is a health suffering due to inadequate involvement of the person behind the disease body. To undergo a difficult time with various aspects of suffering often alters people's views of themselves and their fellow human beings and relationships deepen. Improvements in care work can be done by increasing the focus on patients' emotional distress when the study shows that this aspect is sometimes overlooked and it results in an objectification of patients.

<p>Tidigare studier har fokuserat på barn och deras familjers upplevelser i samband med en hematologisk malignitet, framförallt leukemi. Hematologiska maligniteter är ett samlingsnamn för leukemi och några andra blodsjukdomar. Prevalensen för sjukdomarna ökar och främst vuxna drabbas. Syftet med studien var att beskriva patienters upplevelser av att leva med en hematologisk malignitet. Metoden för denna litteraturöversikt var kvalitativ. Fem artiklar och två avhandlingar analyserades. Studiens resultat utvecklades till fyra huvudteman:</p><p>att få en sjukdom, att genomgå behandling, upplevelse av vårdmöten och att skakas om i sin livsvärld. Resultatet visar att sjukdomen upplevs som ett osynligt hot och att det ibland förekommer ett vårdlidande som beror på bristfälligt engagemang för människan bakom den sjuka kroppen. Att genomgå en svår tid med lidandets olika aspekter, förändrade oftast människors syn på sig själva och sina medmänniskor. Relationer fördjupades. Förbättringar i omvårdnadsarbetet kan göras genom ökad fokus på patienters känslomässiga lidande då studien visar att denna aspekt ibland förbises och detta resulterar i en objektifiering av patienter.</p> / <p>Previous studies have focused on children and their families' experiences in connection with a haematological malignancy, especially leukemia. Hematolocical malignancies is a collective name for leukemia and other blood diseases. The prevalence of diseases is increasing and affects mainly adults. The purpose of this study is to describe patients' experiences of living with a haematological malignancy. The methodology for this literature review was qualitative. Five articles and two dissertations were analyzed. Results of the study, developed into four main themes:</p><p>to get a disease, to undergo treatment, experience of care meetings and to shake in their life-world. The result shows that the disease is perceived as an invisible threat, and that sometimes there is a health suffering due to inadequate involvement of the person behind the disease body. To undergo a difficult time with various aspects of suffering often alters people's views of themselves and their fellow human beings and relationships deepen. Improvements in care work can be done by increasing the focus on patients' emotional distress when the study shows that this aspect is sometimes overlooked and it results in an objectification of patients.</p>

alpha-TEA (alpha-tocopherol ether linked acetic acid) has been shown to induce apoptosis in human prostate, ovarian and breast cancer cells in culture and in xenograft models by promoting pro-apoptotic pathways and inhibiting anti-apoptotic pathways. Studies investigated the ability of alpha-TEA to induce apoptosis in human hematological malignant cell lines Jurkat, Raji and U266, representing T cell leukemia, B cell lymphoma and multiple myeloma, respectively. The three cell lines were cultured in the presence of different concentrations of alpha-TEA for different time periods, and examined for apoptosis by annexin V – FITC analyses, DAPI staining, and western blotting for poly (ADP-ribose) polymerase cleavage. alpha-TEA induced apoptosis in all three cell lines in a dose and time dependent manner. Levels of pro-apoptotic molecules DR5, c-Jun N-terminal protein kinase (JNK), C/EBP homologous protein (CHOP), caspase 9, and caspase 3 were upregulated in alpha-TEA treated cells in comparison to vehicle controls. Caspase 8 was activated in Jurkat and U266 cells but not in Raji cells. Apoptosis and pro-death signaling mediators were blocked by ceramide inhibitor, desipramine. The anti-apoptotic nuclear factor kappa B (NF-[kappa]B) signaling pathway was down-regulated in alpha-TEA treated Raji and U266 cells. Combinations of omega-3 fatty acid docosahexaenoic (DHA) and alpha-TEA significantly enhanced apoptosis in Jurkat cells in comparison to single treatments and vehicle control. In summary, alpha-TEA induced apoptosis in the malignant hematological cell lines is via shared and distinct pathways. ASMase/ceramide-mediated JNK activation and endoplasmic reticulum (ER) stress mitochondrial dependent apoptosis are involved in alpha-TEA induced apoptosis in the three cell lines; however, the cell lines exhibit cell type-specific responses to alpha-TEA: activation of death receptor/caspase 8 pathway is involved in Jurkat cells, suppression of NF-[kappa]B signaling is involved in Raji cells, and the U266 cells share both of these pathways for the induction of apoptosis. / text

Claritromicina e clofazimina têm sido utilizadas no tratamento da hanseníase e tuberculose e também em infecções pelo complexo Mycobacterium avium, complicação comum em pacientes que se encontram em estágios avançados da síndrome da imunodeficiência adquirida (SIDA). Como os dados sobre a toxicidade de esquemas terapêuticos que incluem estes fármacos são escassos, o presente estudo teve como objetivo determinar os efeitos adversos destas terapias, por meio da avaliação dos parâmetros hematológicos, hemostáticos e bioquímicos e a correlação destes parâmetros com as doses testadas e destas com a concentração plasmática dos medicamentos administrados, intraperitonealmente, em ratos machos Wistar, em monoterapia, em regime de doses única (50, 100 e 200mg/kg de peso) e múltipla (100mg/kg). Clofazimina, em regime de dose única, provocou aumento no número de eritrócitos e redução dos índices eritrocitométricos VCM e CHCM. Em regime de dose múltipla, claritromicina provocou aumento de leucócitos e de células mono e polimorfonucleares. Ambos os fármacos, em dose única, parecem inverter a proporção entre células mono e polimorfonucleares. Foi observado aumento do número de células polimorfonucleares e células em degeneração, ocasionados tanto por clofazimina como pela claritromicina. Em regime de dose única, clofazimina e claritromicina prolongaram o TP. Claritromicina, quando administrada em dose múltipla, causou este mesmo efeito e também o prolongamento do TTPA. Os resultados da avaliação da função hepática mostraram resultados inconclusivos com relação às dosagens de AST, ALT e fosfatase alcalina, porém, foi observado aumento dos níveis plasmáticos de ?-GT provocado pela clofazimina, em regime de dose única. Claritromicina induziu aumento dos níveis de ?-GT, em regime de doses única e múltipla, e provocou elevação de bilirrubinas total e direta, em dose única. Houve aumento das concentrações plasmáticas dos fármacos à medida que as doses administradas aumentaram, apesar da claritromicina exibir um comportamento farmacocinético não-linear. Portanto, clofazimina e claritromicina provocam alterações hematológicas, hemostáticas e bioquímicas e os resultados de concentração plasmática são valiosos para avaliação de efeitos adversos em estudos comparativos de monoterapia e associação entre os medicamentos. / Clarithromycin and clofazimine have been used to treat leprosy and tuberculosis as well as infections of Mycobacterium avium complex, an ordinary complication in patients who are in advanced stage of Acquired Immunodeficiency Syndrome (AIDS). As the data about the toxicity of therapeutic schemes including those drugs are scarce, this research had the aim to determine the adverse effects of those therapies, through the evaluation of hematological, hemostatic and biochemical parameters and the relationship between these parameters and doses tested and between doses and plasma concentrations of drugs administered intraperitoneally, in male Wistar rats, in monotherapy, in single (50, 100 and 200mg/kg body wt), and multiple (100mg/kg body wt) doses regime. Clofazimine, in single dose regime, increased the number of erythrocytes, and it decreased the red cells indices MCV and MCHC. In multiple dose regime, clarithromycin increased the number of leukocytes and mononuclear and polymorphonuclear cells. Both the drugs, in single dose, seem to invert the proportion between mononuclear and polymorphonuclear cells. It was observed an increase in the number of polymorphonuclear cells and cells under degeneration caused by clofazimine and clarithromycin. In single dose regime, clofazimine and clarithromycin prolonged PT. When clarithromycin was administered in multiple dose, it brought about this same effect and also it prolonged aPTT. The results of hepatic function evaluation showed inconclusive results about AST, ALT and alkaline phosphatase levels, but it was observed an increase of U-GGT plasma levels provoked by clofazimine, in single dose regime. Clarithromycin brought about an increase of U-GGT plasma levels, in single and multiple dose regime, and caused an increase of total and direct bilirrubin, in single dose. An increase of plasma concentration of drugs was observed as administered doses were increased, though clarithromycin has nonlinear pharmacokinetics behavior. Therefore, clofazimine and clarithromycin induce hematological, hemostatic and biochemical alterations and the results of plasmatic concentration are valuable to evaluate adverse effects in comparative research of monotherapy and association between drugs.