scholarly journals Prevalence and Risk Factors of Complications in Patients with Thalassemia Intermedia

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1360-1360
Author(s):  
Adisak Tantiworawit ◽  
Poramed Winichakoon ◽  
Sasinee Hantrakool ◽  
Chatree Chai-adisaksopha ◽  
Ekarat Rattarittamrong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Function ◽  
Iron Overload ◽  
Ferritin Level ◽  
Significant Risk ◽  
Extramedullary Hematopoiesis ◽  
Abnormal Liver Function ◽  
Thalassemia Intermedia ◽  
Factors Affecting ◽  
Alpha Thalassemia

Abstract BACKGROUND Thalassemia intermedia (TI) or Non-transfusion dependent thalassemia (NTDT) is a mild form of thalassemia and does not require regular transfusion. Many complications can be found in this disease and different from thalassemia major(TM). Most studies mainly focus on beta thalassemia and lack of study in alpha group. This study aims to elucidate the prevalence of complications and identify predictive factors affecting complication of both alpha and beta NTDT patients. METHODS We retrospectively reviewed NTDT patients who attended our clinic from 1 January 2012 to 31 December 2013. Medical record was reviewed for complication and clinical data. RESULTS One hundred NTDT patients were included in this study, female (60%), median age 38 years (19-78). Alpha thalassemia was the majority population (54%). Interestingly, overall complications were found in 83%. The three most common were extramedullary hematopoiesis (47%), cholelithiasis (35%) and abnormal liver function (29%). The others were endocrinopathy (29%), osteoporosis (17%), pulmonary hypertension (14%), cardiomyopathy (11%), thrombosis (4%), and leg ulcer (2%), respectively. The mean ferritin level was 1,563.46 ng/ml. Forty four and seventy six percent of patients had ferritin level more than 2,500 and 800 ng/ ml, respectively. The significant risk factors affecting complications in extramedullary hematopoiesis were female with odd ratio 2.76 (95% CI 1.046-7.294, p= 0.040) and hemoglobin level below 8 g/dL with odd ratio 3.08 (95% CI 1.113-8.521, p= 0.03) and the significant risk factors affecting complications in osteoporosis were female with odd ratio 7.64 (95% CI 1.514-38.604, p= 0.014) and age more than 40 years with odd ratio 4.66 (95% CI 1.313-16.506, p= 0.017). Iron overload (ferritin > 800 ng/ml) was the only risk factor for abnormal liver function from this study with odd ratio 3.79 (95% CI 1.033-13.919, p= 0.035), but trend to be statistical significant in other complications. Three patients were death and all of them died from sepsis. CONCLUSION Alpha thalassemia is the common type of NTDT in our study which is different from previous study. The complication in NTDT is also different from TM. The most common complications were extramedullary hematopoiesis, cholelithiasis and abnormal liver function. The prevalence of iron overload was high in these patients. Thus, regular iron monitoring and early investigation for complication detecting were necessary in this group of patients. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals Prevalence and Risk Factors for Complications in Patients with Nontransfusion Dependent Alpha- and Beta-Thalassemia

Anemia ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Poramed Winichakoon ◽  
Adisak Tantiworawit ◽  
Thanawat Rattanathammethee ◽  
Sasinee Hantrakool ◽  
Chatree Chai-Adisaksopha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Function ◽  
Medical Records ◽  
Female Gender ◽  
Extramedullary Hematopoiesis ◽  
Abnormal Liver Function ◽  
Beta Thalassemia ◽  
Alpha Thalassemia ◽  
Gender And Age ◽  
Available Information

Background.Nontransfusion dependent thalassemia (NTDT) is a milder form of thalassemia that does not require regular transfusion. It is associated with many complications, which differ from that found in transfusion-dependent thalassemia (TDT). Currently available information is mostly derived from beta-NTDT; consequently, more data is needed to describe complications found in the alpha-NTDT form of this disease.Methods. We retrospectively reviewed the medical records of NTDT patients from January 2012 to December 2013. Complications related to thalassemia were reviewed and compared.Results. One hundred patients included 60 females with a median age of 38 years. The majority (54 patients) had alpha-thalassemia. Overall, 83 patients had one or more complications. The three most common complications were cholelithiasis (35%), abnormal liver function (29%), and extramedullary hematopoiesis (EMH) (25%). EMH, cardiomyopathy, cholelithiasis, and pulmonary hypertension were more commonly seen in beta-thalassemia. Osteoporosis was the only complication that was more common in alpha-thalassemia. The risk factors significantly related to EMH were beta-thalassemia type and hemoglobin < 8 g/dL. The risk factors related to osteoporosis were female gender and age > 40 years. Iron overload (ferritin > 800 ng/mL) was the only risk factor for abnormal liver function.Conclusion. The prevalence of alpha-NTDT complications was lower and different from beta-thalassemia.

scholarly journals LONGITUDINAL STUDY ON LIVER FUNCTIONS IN PATIENTS WITH THALASSEMIA MAJOR BEFORE AND AFTER DEFERASIROX (DFX) THERAPY

2014 ◽  
Vol 6 (1) ◽  
pp. e2014025 ◽  
Author(s):  
Ashraf Tawfik Soliman ◽  
Mohamed Yassin ◽  
Fawzia AlYafei ◽  
Lolwa Al-Naimi ◽  
Noora Almarri ◽  
...  
Keyword(s):  
Liver Function ◽  
Iron Overload ◽  
Serum Ferritin ◽  
Negative Correlation ◽  
Ferritin Level ◽  
Iron Chelation ◽  
Thalassemia Major ◽  
Growth Potential ◽  
Igf I ◽  
Liver Functions

With regular blood transfusion and iron chelation therapy, most patients with thalassemia major (BTM) now survive beyond the third decade of life . Liver disease is becoming an important cause of morbidity and mortality in these patients. Chronic hepatitis and/or severe iron overload are important causes of liver pathology. Iron chelation with desferrioxamine (Desferal)  reduces excessive body iron, but its efficacy is limited by poor compliance and dose related toxicity. The recent use of Deferasirox (Exjade- DFX ), an  oral single dose therapy has improved the compliance to chelation therapy.Aims: To study the long-term liver functions in BMT patients, seronegative for liver infections before versus after DFX therapy in relation to ferritin level and IGF-I level.Methods: Liver function tests including: serum bilirubin, alanine transferase (ALT), aspartate transferase (AST) , albumin, insulin-like growth factor – I (IGF-I) and serum ferritin concentrations were followed every 6 months in 40 patients with BTM, with hepatitis negative screening (checked every year), for at  least   five years of DFO therapy and 4-5 years of DFX therapy .Results: DFX  therapy (20 mg/kg/day)  significantly decreased serum ferritin level in patients with BTM, this was associated with significant decrease in serum ALT, AST, ALP and increase in IGF-I concentrations. Albumin concentrations did not change after DFX treatment. ALT and AST levels were correlated significantly with serum  ferritin concentrations ( r = 0.45 and 0.33 respectively , p < 0.05) . IGF-I concentrations were correlated significantly with serum ALT (r= 0.26, p = 0.05) but not with AST, ALP, bilirubin or albumin levels.The negative correlation between serum ferritin concentrations and ALT suggests that impairment of hepatic function negatively affects IGF-I synthesis in these patients due to iron toxicity, even in the absence of hepatitis.Conclusions: Some impairment of liver function can occur in hepatitis negative BMT patients with iron overload. The use of DFX was associated with mild but significant reduction of ALT, AST and ALP and increase in IGF-I levels. The negative correlation between IGF-I and ALT concentrations suggest that preventing hepatic dysfunction may improve the growth potential in these patients.

Comparison of incidence and pattern of interstitial lung disease (ILD) during erlotinib and gefitinib treatment in Japanese pts with NSCLC

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e19056-e19056
Author(s):  
K. Hotta ◽  
K. Kiura ◽  
N. Takigawa ◽  
H. Yoshioka ◽  
S. Harita ◽  
...  
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Toxicity Data ◽  
Factors Affecting ◽  
History Of ◽  
Gefitinib Treatment ◽  
Clinical Records ◽  
Erlotinib Therapy ◽  
Significant Factors

e19056 Background: Erlotinib was approved in Dec 2007 in Japan, and incidence and pattern of ILD during its therapy for Japanese pts with NSCLC has not still been determined, although we had previously reported the frequency of ILD through the gefitinib treatment [PASCO2004, #7063]. In this study, we intended to elucidate this issue in pts receiving erlotinib therapy. Methods: We reviewed the clinical records of 159 pts who had initiated erlotinib therapy last year (cohort A), and of 330 pts receiving gefitinib between 2000 and 2003 (cohort B) for comparing the incidence and pattern of ILD during the both TKI treatments. Toxicity data during the first months after the initiation of TKIs were obtained. Results: The demographics of 489 pts were as follows; M:63%, Ad:75%, and PS 0–1:69%. None of pts in the cohort B received erlotinib therapy before the gefitinib treatment, whereas 66 of the 159 cohort A pts (42%) were given gefitinib before the erlotinib therapy. In 23% and 28% of the pts in the cohorts A and B, erlotinib and gefitinb treatments were discontinued within 1 month after the initiation of TKI therapy, respectively. Two pts (1.3%) developed ILD in the cohort A during the first month of erlotinib treatment, while 8 ILD-events (2.4%) were observed in the gefitinib therapy (cohort B) during the same treatment period. Both 2 pts who developed ILD during the erlotinib therapy had not had a history of prior gefitinib treatment. The toxicity grades of ILD were as follows: grades 1 and 2 in 1 each (cohort A) and grades 3, 4 and 5 in 1, 1 and 6 pts, respectively (cohort B). Statistically significant factors affecting the occurrence of ILD by multivariate analysis were presence of prior pulmonary fibrosis (OR=37.3, p<0.01) and poor PS (OR=6.4, p=0.02), but type of TKIs was not a significant risk factor for ILD. Conclusions: In this setting, the type of TKIs did not affect the incidence of ILD although its incidence after the initiation of erlotinib was somewhat low as compared with that during gefitinib therapy. In addition, the grade of ILD was less severe in the cohort A. These might be partly due to a patient selection based on the recent awareness of Japanese physicians regarding the risk factors for ILD events who learned it through the gefitinib treatment. No significant financial relationships to disclose.

Differences in limb, age and sex of Chinese deep vein thrombosis patients

2014 ◽  
Vol 30 (4) ◽  
pp. 242-248 ◽  
Author(s):  
Feng Chen ◽  
Ji Xin Xiong ◽  
Wei Min Zhou
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Age Groups ◽  
Significant Risk ◽  
Factors Affecting ◽  
Vein Thrombosis ◽  
Left Limb ◽  
Deep Vein ◽  
Age And Sex ◽  
Compression Ultrasonography

Objective Recently, the differences in age or sex of deep vein thrombosis (DVT) patients have been widely debated. However, close analyses of the differences in limb, age and sex of Chinese DVT patients have been scarcely reported. The purpose of this research is to study the differences in limb, age and sex of DVT patients. Methods A total of 783 consecutive DVT patients were retrospectively reviewed. Patients with an acute presentation of DVT were diagnosed by means of compression ultrasonography or venography. Clinical characteristics and provoked risk factors were analyzed. Results There were three frequency peaks including two smaller peaks at age 20–24 and 70–74 years, and the largest peak at age 45–59 years. The most significant risk factors affecting different age groups were as follows: pregnancy/puerperium for age ≤39; fracture and hysterectomy for age 40–64; fracture and malignancy for age ≥65. DVT frequency rate provoked by malignancy was higher in right DVT than left DVT (15.8% vs. 4.6%; p < 0.001). Left DVT was more common than right DVT (582 vs. 158). Left DVT tended to occur in females (male:female, 40.5%:59.5%), and right DVT in males (male:female, 74.7%:25.3%). DVT provoked by pregnancy/puerperium (56/63, 88.9%) or hysterectomy (27/30, 90.0%) was mostly located in left limb. Conclusion It is necessary to pay more attention to thromboprophylaxis for patients with the risk factors of pregnancy/puerperium, hysterectomy, fracture and malignancy, especially those over the age of 65. And further research into the cause of limb, age and sex differences in DVT occurrence is needed.

Gallstones in a Newborn-Cohort with Sickle Cell Anemia (SCA): Cumulative Risk and Predictive Factors

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 513-513 ◽  
Author(s):  
Annie Kamdem ◽  
Cécile Arnaud ◽  
Nadia Médejel ◽  
Clément Tassel ◽  
Isabelle Hau ◽  
...  
Keyword(s):  
Risk Factors ◽  
Predictive Factors ◽  
Cox Regression ◽  
Reticulocyte Count ◽  
Cumulative Risk ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Abdominal Sonography ◽  
Alpha Thalassemia ◽  
Febrile Episodes

Abstract Abstract 513 Background: The accelerated hemolysis in SCA increases bilirubin excretion and the susceptibility to pigment gallstone formation. Uridine diphosphate-glucuronosyltransferase (UGT1A1) gene polymorphism and alpha-thalassemia are factors known to modify this risk. However, their relative influence and other factors such as SCA disease severity and the use of ceftriaxone for acute febrile episodes remain to be explored in a newborn cohort. The goal of this study was to define the cumulative incidence and risk factors for the occurrence of gallstones in a SCA-newborn-cohort. Patients and Methods: Alpha-genes, beta-globin haplotypes, UGT1AI genotype, G6PD-enzymatic activity were recorded; baseline biological parameters were determined during the second year of life, away from crises and transfusions as previously described (Blood 2011,117, 4). Annual check-ups including abdominal sonography were performed as soon as the age of 1 year. Cholecystectomy was systematically performed in the 6 months following the discovery and confirmation of presence of gallstones. All hospitalizations and their causes were prospectively recorded. Patients were censored on the date of gallstone occurrence or last abdominal sonography; event rates/year (pain crises, ACS, febrile episodes) were calculated, and KM-estimated cumulative risk for gallstones and Cox regression were used to assess the predictive factors for gallstones. Results: SCA-patients (364: 353 SS, 8 Sb0, 3 SDPunjab; 182 F,182 M) born before February 2010 and followed until the age of 18–20 years were included in this study. Alpha-thalassemia was present in 46% patients (available in 323; 2 genes: n=33; 3 genes: n=116; 4 genes: n=172; 5 genes: n=2); beta-haplotypes (available in 291) were Car/Car in 42.6%, Ben/Ben in 19.9%, Sen/Sen in 9.6%, and others in 27.8%. G6PD activity (available in 309) was deficient in 11.6%. UGTA1 polymorphism (available in 175) showed Gilbert genotype in 19.8%, i.e., 7/7 in 13.4% and 7/8 in 6.4%. The frequency of the other genotypes was: 5/6: 6.4%; 5/7:7%; 5/8:0.6%; 6/6:23.3%, 6/7:34.3%; and 6/8:8.1%. Unconjugated bilirubin values at baseline were significantly correlated with the total number of UGTA1A1 repeats (r=0.415, p<0.001). Mean rates (SD) of pain crises, ACS and acute febrile episodes were 0.56 (0.68), 0.12 (0.18), 0.34 (0.54), respectively. Gallstones were observed in 98/364 patients at the median age of 9.2 (range: 2.5 to 17.9 years). The cumulative risk of gallstones was 5% by age 5, 20.7% by age 10 and 35.6 % by age 15 and was not significantly different in patients with Gilbert polymorphism (Log Rank p=0.4) but was significantly related to the number of alpha-genes (Log-Rank p=0.039). However, the risk was significantly increased in patients homozygous or heterozygous for (TA8) (Log Rank p=0.016). Univariate Cox regression analysis showed that the number of alpha-genes was a significant risk factor (p=0.014) whereas G6PD deficiency, beta-haplotypes and Gilbert genotype were not significant risk factors; however, the presence of at least one allele (TA8) was a significant risk factor (p=0.025). Among the baseline biological parameters, hemoglobin, WBC, neutrophils, platelets, MCV, and bilirubin were not significant factors whereas HbF level (p=0.028), reticulocyte count (p<0.001) and LDH (p=0.020) significantly increased the risk for gallstones. Among clinical events, pain crises, ACS and febrile episodes significantly increased the risk (p<0.001). Multivariate Cox analysis including all the significant risk factors in the univariate analysis retained the deletion of 2 alpha genes (HR=4.66; 95% CI:1.11-19.52,p=0.035) which decreases the risk, the presence of at least one allele (TA8) (HR=2.26:95% CI:1.07-4.78, p=0.032), which increases the risk and the baseline reticulocytes count per 1×109/L increase(HR:1.001;1.000-1.002;p=0.005), as independent and significant predictive factors for gallstones. Conclusion: This prospective SCA newborn-cohort study shows that gallstones may begin as soon as 2.5 years of age and that the cumulative risk reaches a high 35.6% by age 15. The deletion of 2 alpha genes, the presence of at least one UGT1A1 (TA8) allele and high baseline reticulocyte count are independent and significant predictive factors showing that the risks are multifacturial and highly and primarily dependent on hemolysis Disclosures: No relevant conflicts of interest to declare.

Characteristics of Female Youth Offenders in New Zealand

2018 ◽  
Vol 63 (2) ◽  
pp. 198-217 ◽  
Author(s):  
Stacey Lim ◽  
Ian Lambie ◽  
Annik van Toledo
Keyword(s):  
Risk Factors ◽  
New Zealand ◽  
Ecological Model ◽  
Significant Risk ◽  
School Behavior ◽  
Youth Offenders ◽  
Factors Affecting ◽  
Female Youth ◽  
Nonviolent Offenders ◽  
Mental Health Difficulties

Female youth offending is poorly understood, despite increased rates of such offending. Research indicates there are a range of factors that have a causal impact on the development of offending in young people. This study investigated risk factors using a retrospective file audit of 184 female youth offenders in New Zealand. The findings were classified using Bronfenbrenner’s ecological model, which highlights the different contextual levels that influence behavior, including individual, family, peer, school, community, and cultural factors. The results indicate that there are significant risk factors for female youth offenders. There were high rates of mental health difficulties, drug use, histories of maltreatment, family stressors, peer issues, and school behavior problems in the cohort. There was very little difference between violent and nonviolent offenders. All the young women had risk factors affecting them at many levels. Targeted, multisystemic intervention and prevention programs are therefore needed to address female youth offending.

scholarly journals Association between Abnormal Liver Function and Risk Factors for Metabolic Syndrome among Freshmen

2007 ◽  
Vol 41 (2) ◽  
pp. 132-137 ◽  
Author(s):  
Ping-Yun Tsai ◽  
Chung-Jen Yen ◽  
Yi-Chin Li ◽  
Tai-Yuan Chiu ◽  
Ching-Yu Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Liver Function ◽  
Abnormal Liver Function

scholarly journals Epidemiology and risk factors of needlestick injuries among healthcare workers in Iran: a systematic reviews and meta-analysis

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Soheil Hassanipour ◽  
Mojtaba Sepandi ◽  
Reza Tavakkol ◽  
Mousa Jabbari ◽  
Hadiseh Rabiei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Reviews ◽  
Work Experience ◽  
Healthcare Workers ◽  
Meta Analysis ◽  
Significant Risk ◽  
Female Gender ◽  
Healthcare Personnel ◽  
Needlestick Injuries ◽  
Factors Affecting

Abstract Background Occupational contact with blood and body fluids poses a significant risk to healthcare workers. The aim of this systematic review is to investigate the epidemiology and risk factors affecting needlestick injuries (NSI) in healthcare personnel in Iran. Methods In March 2020, researchers studied six international databases such as Medline/PubMed, ProQuest, ISI/WOS, Scopus, Embase, and Google Scholar for English papers and two Iranian databases (MagIran and SID) for Persian papers. Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess quality of studies. The method of reporting was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Results A total of 43 articles were included in the analysis. Results showed that females (OR = 1.30, 95 % CI 1.06–1.58, P value = 0.009), younger age (OR = 2.75, 95 % CI 2.27–3.33, P value < 0.001, rotated shift workers (OR = 2.16, 95 % CI 1.47–3.15, P value < 0.001), not attending training courses (OR = 1.30, 95 % CI 1.07–1.56, P value = 0.006), working in the surgery ward (OR = 1.83, 95 % CI 1.33–2.50, P value < 0.001), less work experience (OR = 1.43, 95 % CI 1.04–1.95, P value = 0.025) apposed a greater risk factors for NSI among healthcare workers. Conclusion Based on the results of this review, factors such as young age, less work experience, work shift, and female gender are considered as strong risk factors for NSI injury in Iran. Preventive measures including education programs can reduce the burden of NSI among healthcare personnel.

scholarly journals Vaccination programs, parity, and calving season as factors affecting the risk of fetal losses and mummified fetuses in Holstein cows

2021 ◽  
Vol 19 (3) ◽  
pp. e0402-e0402
Author(s):  
Miguel Mellado ◽  
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Holstein Cows ◽  
Vaccination Programs ◽  
Factors Affecting ◽  
Logistic Regression Models ◽  
Viral Vaccine ◽  
Single Vaccination ◽  
Calving Season ◽  
The Relationship

Aim of the study: To investigate vaccination programs, parity, and calving season as factors affecting the risk of abortion and mummified fetuses in Holstein cows. Area of study: Hot zone of Northeast Mexico. Material and methods: Multiple logistic regression models were used to examine the relationship between peripartum disorders, parity, previous occurrence of abortion, season of calving, vaccination program, incidence of abortion, and mummified fetuses in Holstein cows. Main results: For 7014 pregnancies (2886 cows), the percentage of cows aborting and having mummified fetuses was 17.7 and 1.1, respectively. As the number of brucellosis vaccinations increased, the incidence of abortion increased (10.4% for a single vaccination and 38.0% for 6 accumulated vaccinations). Abortion for cows having 1-2 previous abortions (56%) and >2 abortions (77%) was fivefold and sevenfold greater (p<0.01), respectively, than that for cows without previous abortion. Other important risk factors for abortion were number of calvings (19.8% for nulliparous and primiparous vs. 13.8% for >3 parturitions; OR=1.7, p<0.01), leptospirosis vaccine application <55 days postpartum (dpp; OR=1.3, p<0.05), viral vaccine application >37 dpp (OR=1.3, p<0.01), brucellosis vaccine application >20 dpp (OR=1.6, p<0.01), and no application of clostridial vaccine (OR=3.7, p<0.01). Significant risk factors for mummified fetuses were application of ≥3 brucellosis vaccinations (OR=3.3, p<0.01), no application of 10-way clostridial vaccine (OR=2.3, p<0.01), >2 previous abortions (OR=18.4, p<0.01), and calving in autumn (OR=0.4, compared to winter, p<0.05). Research highlights: Risk of abortion and mummified fetuses in Holstein cows has been found to be related to vaccination programs.

Sign in / Sign up

Export Citation Format

Share Document