Thèse : Médecine : Paris : 1887-88. / N° d'ordre : 100.

Thèse d'exercice : Médecine. Pédiatrie : Université de Nantes : 2003. / Bibliogr. f. 71-78 [60 réf.].

Reproduction de : Mémoire de Sage-femme : Médecine : Nantes : 2009. / Bibliogr.

published_or_final_version / Pathology / Master / Master of Medical Sciences

Thrombotic microangiopathy is featured by microangiopathic haemolytic anaemia, thrombocytopenia and the presence of peripheral fragmented red cells. Thrombotic thrombocytopenic purpura (TTP) is the major disease entity of concern, which is caused by a congenital or acquired deficiency of a von Willebrand factor (vWF) cleaving protease known as ADAMTS13 (A Disintegrin And Metalloprotease with Thrombospondin type 1 motif, member 13). Deficiency of this protease, leads to accumulation of uncleaved ultra-large hyperactive vWF multimers in peripheral circulation causing the extensive microvascular platelet aggregation in a TTP event. However, the differential diagnosis is sometimes difficult because symptoms and signs can be non-specific and the condition may resemble a number of disorders. Early recognition and definite diagnosis of TTP is critical to enable prompt plasma exchange therapy. Specific and sensitive ADAMTS13 assays will be potentially helpful. In this review, archive frozen plasma samples from six patients presented with prominent thrombotic microangiopathy were retrospectively analysed for ADAMTS13 by immunoassays. The relationship between ADAMTS13 antigen, activity and its autoantibodies and TTP was studied. Local reference ranges of these assays were also determined. The assay results were validated by identifying the clinically-confirmed cases of TTP, with also prospective serial measurements of ADAMTS13 in a few cases. Patients presented with acute TTP were characterized by a severely deficient ADAMTS13 antigen and activity level, as well as a positive autoantibody titre detected for its acquired immune aetiology ; while patients with non-TTP conditions only had mildly reduced ADAMTS13 antigen but variably decreased activity level and a negative autoantibody titre . A pooled analysis of patients and normal subjects also demonstrated a positive correlation between ADAMTS13 antigen and activity. / published_or_final_version / Pathology / Master / Master of Medical Sciences

Thesis (MAppSc)--University of South Australia, 1997

A Research Report submitted to the Faculty of Health Sciences, University of Witwatersrand, Johannesburg, in partial fulfilment of the degree of Master of Medicine in the branch of Internal Medicine. / Background. Primary immune thrombocytopenia (ITP) is a rare disease causing significant morbidity. South Africa has a high prevalence of HIV infection which may be associated with immune thrombocytopenia. There is a paucity of clinical, management and outcome data on immune thrombocytopenia in the local South African setting. Objectives. To compare the demographics, clinical presentation, management and treatment outcomes of immune thrombocytopenia in HIV positive and HIV negative patients and to compare the treatment outcomes with established international guidelines. Methods. This was a retrospective comparative study conducted at Charlotte Maxeke Academic Hospital, Johannesburg, from January 2003 to December 2014. Adults (≥ 18 years) with confirmed diagnosis of ITP were included. Hospital charts of eligible patients were reviewed to extract data on their clinical presentation, diagnosis, HIV status, treatment and outcomes. A comparison was made between HIV positive and negative patients. Descriptive analysis was performed on the data and results were presented graphically. The P-value of <0.05 was regarded as significant. Results. A total of 250 patients were screened, of which 154 patients met eligibility criteria for the study. 91% of the patients were female, 58% were HIV negative and 42% were HIV positive. The 25-35 year age-group comprised the highest percentage of HIV positive patients (42%). There was no difference in the presentation of symptoms between HIV positive and HIV negative patients. Response to first line therapy was not significantly different between the HIV positive and HIV negative patients (p=0.1370). The patients who went on second line therapy, showed excellent response with approximately 80% reaching complete response. There was no difference in HIV positive and HIV negative groups. Conclusion. In a large central hospital in a high HIV prevalence setting, there is no significant difference between HIV positive and HIV negative patients in terms of clinical presentation, treatment and outcomes in confirmed patients with immune thrombocytopenia. The management of ITP at the CMJAH is comparable to that of published guidelines. / MT2017

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

Orientador: Sandra Cecilia Botelho Costa / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-10T23:14:22Z (GMT). No. of bitstreams: 1 Oliveira_TelmaBarbosade_M.pdf: 1175004 bytes, checksum: 5912fb5d3dc25609414bb097190091e2 (MD5) Previous issue date: 2008 / Resumo: O He/icobacter pylori é uma bactéria gram-negativa que está relacionada ao desenvolvimento de doenças gástricas e extragástricas. Dentre as doenças gástricas incluem-se o câncer gástrico, a gastrite crônica, a úlcera péptica e linfoma tipo MALT. Com relação às doenças extragástricas essa bactéria recentemente foi relacionada com a anemia por deficiência de ferro e com algumas doenças autoimunes, como a artrite reumatóide e a púrpura trombocitopênica idiopática. A PCR tem sido uma importante ferramenta para a análise de pequenos fragmentos de DNA, os quais podem, inclusive, ser armazenados por um tempo maior em amostras emblocadas em parafina ou obtidas a fresco à temperatura de -80°C. Dessa maneira, foram estudados 33 pacientes com púrpura trombocitopênica idiopática (PTI) e H.pylori positivo. No que diz respeito à detecção da bactéria pela nested PCR, foi obtido um resultado de 100% de concordância em comparação aos resultados de histologia e teste da urease, usados rotineiramente. Além dos primers para detecção do He/icobacter pylori foram utilizados primers para as regiões do gene urease C e do gene cagA, sendo os fragmentos obtidos analisados em gel de 2% agarose observados sob luz ultravioleta. Foi obtida também uma concordância de 100% para a região do gene urease C. Em relação ao gene cagA, 30,3% desses pacientes apresentaram esse. Dos 33 pacientes positivos para H pylori, após tratamento específico, 27,7% tiveram remissão completa do quadro clínico, 33% remissão parcial e 40% não tiveram remissão. Para o gene cagA positivo, 9,0% dos pacientes com PTI tiveram remissão completa e em 21,2% não houve remissão. Em relação ao gene cagA negativo, 21,2% tiveram remissão completa e em 48,4% não houve remissão. Foram aplicados testes estatísticos para observar a relação do gene cagA com a PTI, (teste exato de Fisher, Box-plot média e desvio padrão da contagem das plaquetas e Mann-Withney). Os resultadoS' obtidos não foram estatisticamente significantes neste grupo estudado. Portanto o gene cagA não está relacionado com o desenvolvimento da PTI / Abstract: Helicobacter pylori is a gram-negative bacterium that is related to the development of gastric and extragastric diseases. Gastric diseases include gastric cancer, chronic gastritis, peptic ulcer and MALT lymphoma. Extragastric diseases include iron deficiency anemia and some auto-immune conditions such as reumathoid arthritis and idiopathic thrombocytopenic purpura. PCR has been an important tool for the analysis of small fragments of DNA that may be stored for a longer time inserted in paraffin blocks or fresh tissue at -80ºC. Here we studied 45 patients with ITP and 33 of these ones had positive tests, with agreement of 100% of histological and rapid urease test. Besides the primers for H. pylori detection, primers for urease C region and cagA gene were used and the fragments obtained were analysed in agarose gel by ultraviolet radiation. We obtained 100% of agreement for urease C region and for detection of H. pylori and 30% of agreement for cagA gene. In these 33 patients which were H. pylori positive, 27,7% had complete remission, 33,0% partial remission and 40,0% had no remission. In positive patients for cagA gene, 9,0% had complete remission and 21,2% had no remission. In negative patients for cagA gene, 21,2% had complete remission and 48,4% had no remission. We used statistical analysis (Exact Fishers test, Box-plot and Mann-Withney) to relation cagA gene and thrombocytopenic idiopathic purpura Our results don't suggest or correlate the presence of cagA gene with idiopathic thrombocytopenic purpura development / Mestrado / Mestre em Farmacologia

Orientador : Fawzi Dawood / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-07-17T07:36:53Z (GMT). No. of bitstreams: 1 Garcia_Concilia_M.pdf: 3172328 bytes, checksum: 62127e66e3cd92626d2fe7e49ed9f3a5 (MD5) Previous issue date: 1989 / Resumo: Os níveis de imunoglobulinas séricas (IgG, IgM e IgA), anticorpos anti-plaqueta, imunocomplexos e o terceiro componente do complemento (C3) foram estudados numa população de 28 pacientes com Púrpura Trombocitopênica Idiopática (PTI), utilizando-se uma população de 30 indivíduos normais, como controle. Após essas determinações concluiu-se que: 1. Os dados obtidos demonstraram claramente alterações nos níveis das imunoglobulinas séricas dos pacientes, quando comparados com os controles. Os níveis de IgG e IgM se encontram 473,3 mg% e 67,2 mg% respectivamente maiores nos pacientes do que nos controles, enquanto IgA se acha diminuída em torno de 36,4 mg%. A análise estatística dos valores de imunoglobulinas IgG, IgM e IgA dos pacientes, comparados com indivíduos normais, realizadas pelo teste t de Student demonstrou que esses valores são altamente significativos. 2. A maioria dos pacientes estudados (89,3%) possui anticorpos contra componentes normais da membrana paquetária, evidenciados pela reação de imunofluorescência. 3. A pesquisa de imuno-complexos precipitados do soro de pacientes evidenciou decréscimo na concentração de IgG, IgM, IgA e C3, quando / Mestrado / Mestre em Ciências Biológicas