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[PMID]:29505518
[Au] Autor:Zhang S; Huang Q; Xu B; Ma J; Cao G; Pei F
[Ad] Endereço:Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
[Ti] Título:Effectiveness and safety of an optimized blood management program in total hip and knee arthroplasty: A large, single-center, retrospective study.
[So] Source:Medicine (Baltimore);97(1):e9429, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Little has been published on blood management in total hip and knee arthroplasty (THA and TKA, respectively) patients focusing on both hematopoiesis and hemostasis. Our aim was to explore the effectiveness and safety of an optimized blood management program in THA and TKA patients in a large, single-center, retrospective study.We retrospectively reviewed consecutive primary unilateral THA and TKA patients' data at our institution through the National Health Database. They were divided into 3 groups according to an optimized blood management program: group A-combined use of intravenous and topical tranexamic acid (TXA); group B-use of recombinant human erythropoietin (rHuEPO) and iron supplements in addition to treatments in group A; group C-use of additional multiple boluses of TXA in addition to treatments in group B. The primary outcomes were hemoglobin (Hb) drop and calculated total blood loss (TBL). Other outcome measurements such as transfusion rate, postoperative length of stay (PLOS), venous thromboembolism (VTE), and mortality were also compared.From 2014 to 2016, a total of 1907 unilateral THA (986 in group A, 745 in group B, and 176 in group C) and 1505 unilateral TKA (795 in group A, 556 in group B, and 154 in group C) procedures were conducted at our institution. The Hb drop, calculated TBL, and PLOS in group C were significantly lower than those in groups A and B for THA and TKA patients. The transfusion rate in group C was also significantly less than in groups A and B for THA patients, while it was similar in groups A and B for TKA patients. No patients in group C received a transfusion. A significant difference was not detected in the incidence of deep vein thrombosis. No episode of symptomatic pulmonary embolism or all-cause mortality occurred within 30 days postoperatively.The current retrospective study suggests that for patients receiving primary unilateral THA or TKA, multiple boluses of intravenous TXA combined with topical TXA, rHuEPO, and iron supplements can reduce the calculated TBL, Hb drop, transfusion rate, and PLOS without increasing the incidence of VTE or mortality.
[Mh] Termos MeSH primário: Anemia/tratamento farmacológico
Antifibrinolíticos/administração & dosagem
Perda Sanguínea Cirúrgica/prevenção & controle
Eritropoetina/uso terapêutico
Ferro/uso terapêutico
Oligoelementos/uso terapêutico
Ácido Tranexâmico/administração & dosagem
[Mh] Termos MeSH secundário: Administração Intravenosa
Administração Tópica
Adulto
Idoso
Anemia/etiologia
Artroplastia de Quadril/efeitos adversos
Artroplastia do Joelho/efeitos adversos
Feminino
Seres Humanos
Masculino
Meia-Idade
Proteínas Recombinantes/uso terapêutico
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifibrinolytic Agents); 0 (Recombinant Proteins); 0 (Trace Elements); 11096-26-7 (Erythropoietin); 6T84R30KC1 (Tranexamic Acid); E1UOL152H7 (Iron)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009429


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[PMID]:29268646
[Au] Autor:Kaserer A; Stein P; Spahn GH; Spahn DR
[Ad] Endereço:1 Institut für Anästhesiologie, Universität und Universitätsspital Zürich, Zürich.
[Ti] Título:Patient Blood Management: Der Standard heute..
[So] Source:Ther Umsch;74(7):369-376, 2017.
[Is] ISSN:0040-5930
[Cp] País de publicação:Switzerland
[La] Idioma:ger
[Mh] Termos MeSH primário: Anemia Ferropriva/terapia
Anemia/terapia
Transfusão de Sangue/normas
Cuidados Intraoperatórios/normas
Monitorização Intraoperatória/métodos
[Mh] Termos MeSH secundário: Anemia/diagnóstico
Anemia Ferropriva/diagnóstico
Medicina Baseada em Evidências
Seres Humanos
Ferro
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
E1UOL152H7 (Iron)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.1024/0040-5930/a000928


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[PMID]:28459899
[Au] Autor:Makam AN; Nguyen OK; Clark C; Halm EA
[Ad] Endereço:Division of General Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX; Division of Outcomes and Health Services Research, University of Texas Southwestern Medical Center, Dallas, TX.
[Ti] Título:Incidence, Predictors, and Outcomes of Hospital-Acquired Anemia.
[So] Source:J Hosp Med;12(5):317-322, 2017 May.
[Is] ISSN:1553-5606
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although hypothesized to be a hazard of hospitalization, it is unclear whether hospital-acquired anemia (HAA) is associated with increased adverse outcomes following discharge. OBJECTIVE: To examine the incidence, predictors, and postdischarge outcomes associated with HAA. DESIGN: Observational cohort study using electronic health record data. SUBJECTS: Consecutive medicine discharges between November 1, 2009 and October 30, 2010 from 6 Texas hospitals, including safety-net, teaching, and nonteaching sites. Patients with anemia on admission or missing hematocrit values at admission or discharge were excluded. MEASURES: HAA was defined using the last hematocrit value prior to discharge and categorized by severity. The primary outcome was a composite of 30-day mortality and nonelective readmission. RESULTS: Among 11,309 patients, one-third developed HAA (21.6% with mild HAA; 10.1% with moderate HAA; and 1.4% with severe HAA). The 2 strongest potentially modifiable predictors of developing moderate or severe HAA were length of stay (adjusted odds ratio [OR], 1.26 per day; 95% confidence interval [CI], 1.23-1.29) and receipt of a major procedure (adjusted OR, 5.09; 95% CI, 3.79-6.82). Patients without HAA had a 9.7% incidence for the composite outcome versus 16.4% for those with severe HAA. Severe HAA was independently associated with a 39% increase in the odds for 30-day readmission or death (95% CI, 1.09-1.78). Most patients with severe HAA (85%) underwent a major procedure, had a discharge diagnosis of hemorrhage, and/or a discharge diagnosis of hemorrhagic disorder. CONCLUSIONS: Severe HAA is associated with increased odds for 30-day mortality and readmission after discharge; however, it is uncertain whether severe HAA is preventable. Journal of Hospital Medicine 2017;12:317-322.
[Mh] Termos MeSH primário: Anemia/diagnóstico
Anemia/epidemiologia
Registros Eletrônicos de Saúde/tendências
Readmissão do Paciente/tendências
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Estudos de Coortes
Feminino
Hospitalização/tendências
Seres Humanos
Incidência
Masculino
Meia-Idade
Valor Preditivo dos Testes
Estudos Retrospectivos
Fatores de Risco
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.12788/jhm.2723


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[PMID]:29466149
[Au] Autor:Knuesel SJ; Guseh JS; Karp Leaf R; Ciaranello AL; Eng GM
[Ad] Endereço:From the Departments of Medicine (S.J.K., J.S.G., R.K.L., A.L.C.) and Pathology (G.M.E.), Massachusetts General Hospital, and the Departments of Medicine (S.J.K., J.S.G., R.K.L., A.L.C.) and Pathology (G.M.E.), Harvard Medical School - both in Boston.
[Ti] Título:Case 6-2018: A 35-Year-Old Woman with Headache, Subjective Fever, and Anemia.
[So] Source:N Engl J Med;378(8):753-760, 2018 Feb 22.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Anemia Hemolítica Autoimune/diagnóstico
Anemia/etiologia
Eritema Infeccioso/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Anemia Hemolítica Autoimune/etiologia
Doença de Crohn/complicações
Doença de Crohn/tratamento farmacológico
Diagnóstico Diferencial
Eritema Infeccioso/complicações
Feminino
Morte Fetal/etiologia
Febre/etiologia
Cefaleia/etiologia
Seres Humanos
Hospedeiro Imunocomprometido
Parvovirus B19 Humano/isolamento & purificação
Gravidez
Complicações Infecciosas na Gravidez
Viremia
[Pt] Tipo de publicação:CASE REPORTS; CLINICAL CONFERENCE; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMcpc1712223


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[PMID]:29390387
[Au] Autor:Zhang X; He Y; Xie X; Ji M; Ma X; Yu Z
[Ad] Endereço:Public Health College of Zhengzhou University, Zhengzhou.
[Ti] Título:Distribution of hemoglobin and prevalence of anemia in 10 ethnic minorities in China: A population-based, cross-sectional study.
[So] Source:Medicine (Baltimore);96(50):e9286, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Racial differences have been reported in hemoglobin (Hb). However, distributions of Hb and anemia rate in ethnic minorities were rarely reported.We aimed to observe whether there are ethnic differences in Hb distributions and prevalence of anemia.The data included 480,699 women 20 to 49 years' old from 10 ethnic minorities in China in 2014. Analyses of variance were used to examine the differences of Hb distribution among the 10 ethnic groups, as well as the differences in Hb level between different ages, education levels, occupations, and non- or ethnic enclaves in each ethnic group. χ2-test was adopted to analyze the differences in anemia rate among the 10 ethnic groups and between different ages and nonethnic or ethnic enclaves in each ethnic group.The ethnic differences of the Hb distribution and anemia prevalence were observed in the 10 ethnic groups. The lowest mean Hb concentration was shown in Chuang (126.8 g/L), and the highest mean Hb concentration was in Tibetan (138.5 g/L). According to the World Health Organization criteria to define anemia, the highest prevalence was in Tibetan (46.9%) after the adjustment of Hb concentration for altitude, and the lowest prevalence was in Yi (10.6%). Furthermore, there were differences on mean Hb concentration or anemia rate in participants between ethnic enclaves and non-ethnic enclaves in most ethnic groups.The ethnic differences of the Hb distribution and anemia prevalence were observed in the 10 ethnic groups, which might be associated with geographic conditions, genetic background, and eating habits.
[Mh] Termos MeSH primário: Anemia/etnologia
Anemia/epidemiologia
Hemoglobinas/análise
[Mh] Termos MeSH secundário: Adulto
China/epidemiologia
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Prevalência
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hemoglobins)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009286


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[PMID]:29390381
[Au] Autor:Ek S; Rosenborg S
[Ad] Endereço:Department of Obstetrics and Gynecology, Center of Fetal Medicine, Karolinska University Hospital.
[Ti] Título:Mesalazine as a cause of fetal anemia and hydrops fetalis: A case report.
[So] Source:Medicine (Baltimore);96(50):e9277, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Mesalazine and its prodrug sulfasalazine are both used for inflammatory bowel disease. Sulfasalazine has been associated with hematological side-effects such as aplastic and hemolytic anemia in patients, but also in fetuses after intrauterine exposure. To our knowledge, we describe the first case of a fetus with severe anemia, and subsequent hydrops, where this drug was found at concentrations in the fetus corresponding to those in the mother and most likely responsible for the fetal condition. PATIENT CONCERNS: A uniparous woman was referred at 31 weeks of gestation due to a hydropic fetus with massive ascites and cardiomegaly. DIAGNOSES: The patient had Crohn's disease and was thus treated with 4 g mesalazine daily. The fetus had severe anemia with an initial hemoglobin level of 51 g/L. INTERVENTIONS: The maternal medication was discontinued and four intrauterine erythrocyte transfusions were given during three weeks. Plasma samples were drawn from mother and fetus during cordocentesis for later analysis of mesalazine. OUTCOMES: A healthy baby was born after 37 full weeks of gestation. Plasma levels of mesalazine were non-conspicuous in neither mother nor fetus. The mesalazine half-life in the fetus (37 h) was half that of the mother (80 h), both considerably longer than previously reported (about 19 h). LESSONS: A causal relationship must be suspected between the fetal anemia and the maternal use of mesalazine. This fetal side-effect should be considered in pregnant women on mesalazine (and its prodrug sulfasalazine).
[Mh] Termos MeSH primário: Anemia/induzido quimicamente
Anti-Inflamatórios não Esteroides/efeitos adversos
Doenças Fetais/induzido quimicamente
Hidropisia Fetal/induzido quimicamente
Mesalamina/efeitos adversos
[Mh] Termos MeSH secundário: Anemia/terapia
Transfusão de Eritrócitos
Feminino
Doenças Fetais/terapia
Seres Humanos
Hidropisia Fetal/terapia
Gravidez
Resultado da Gravidez
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal); 4Q81I59GXC (Mesalamine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009277


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[PMID]:28452910
[Au] Autor:Sacdalan C; Crowell T; Colby D; Kroon E; Chan P; Pinyakorn S; Chomchey N; Prueksakaew P; Puttamaswin S; Chintanaphol M; Cheng T; Phanuphak N; Ananworanich J
[Ad] Endereço:*SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand; †Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA; ‡US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; §Yale University, New Haven, CT, USA; ‖Mayo Medical School, Rochester, MN, USA; and ¶University of Amsterdam, Amsterdam, The Netherlands.
[Ti] Título:Brief Report: Safety of Frequent Blood Sampling in Research Participants in an Acute HIV Infection Cohort in Thailand.
[So] Source:J Acquir Immune Defic Syndr;76(1):98-101, 2017 09 01.
[Is] ISSN:1944-7884
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Anemia is a potential adverse effect of phlebotomy during participation in research. Clinical studies of acute HIV infection (AHI) require frequent phlebotomy to maximize scientific yield, but this participant population may also be at increased risk for anemia and other adverse events. OBJECTIVE: The objective of this study was to describe baseline and longitudinal hemoglobin changes among participants with AHI. METHODS: Participants with AHI (n = 202) were enrolled in a prospective cohort study in Thailand. AHI was diagnosed using pooled nucleic acid testing and sequential HIV antibody immunoassays. Antiretroviral therapy was initiated on enrollment. During 48 weeks of study participation, a total of 629 mL of blood was drawn over 14 visits. Hemoglobin levels were measured serially, and abnormalities were graded using the Division of AIDS (National Institute of Allergy and Infectious Diseases) adverse event table. RESULTS: AHI was diagnosed at a median of 18 days after infection. Mean hemoglobin at enrollment of male participants was 14.8 g/dL, and for females, it was 13.0 g/dL. Over 48 weeks, there was a mean increase of 0.2 g/dL among men (P = 0.01) and a decrease of 0.7 g/dL among women (P = 0.03). The overall prevalence of anemia was low, with 7 (3.5%) of 202 fulfilling grade 1 or 2 anemia criteria. CONCLUSIONS: Anemia was rare after frequent phlebotomy in research participants with AHI, before and after antiretroviral therapy. Given that the blood volume drawn from this study did not pose substantial clinical risk, increasing the volume of blood drawn for research purposes in acute HIV-infected research participants could be considered for future studies.
[Mh] Termos MeSH primário: Coleta de Amostras Sanguíneas/efeitos adversos
Infecções por HIV/sangue
Segurança do Paciente/normas
Sujeitos da Pesquisa
[Mh] Termos MeSH secundário: Adolescente
Adulto
Anemia/etiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Flebotomia/efeitos adversos
Prevalência
Estudos Prospectivos
Tailândia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000001436


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[PMID]:29254377
[Au] Autor:Del Vecchio L; Locatelli F
[Ad] Endereço:a Department of Nephrology and Dialysis , A. Manzoni Hospital , Lecco , Italy.
[Ti] Título:Roxadustat in the treatment of anaemia in chronic kidney disease.
[So] Source:Expert Opin Investig Drugs;27(1):125-133, 2018 Jan.
[Is] ISSN:1744-7658
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Anaemia is one of the hallmarks of advanced chronic kidney disease (CKD); it correlates with a lower quality of life and increased cardiovascular risk. Currently its management is based on iron and erythropoiesis-stimulating agents (ESAs) therapy. Given safety issues on ESA therapy and excessive iron use, anaemia management is still suboptimal. Areas covered: The inhibitors of the prolyl-hydroxylases domain (PHD) are oral drugs which activate the hypoxia-inducible factors (HIF) and stimulate the production of endogenous erythropoietin. Roxadustat (FG-4592) is a second-generation PHD inhibitor; it is undergoing now phase-III clinical development. Expert opinion: Phase-II clinical trials have shown that roxadustat is effective and save in the short term in either non-dialysis or dialysis CKD patients. Roxadustat is a chemical drug and thus has the potential of being cheaper than traditional ESAs. Given that the peaks of endogenous EPO are much lower than those observed with traditional ESA, it is possible to speculate the roxadustat (and more in general PHD inhibitors) will be safer than ESA on cardiovascular safety end-points. Considering that HIFs are involved in different pathways, with possible promotion of relevant side effects, their safety must be proven in long-term studies.
[Mh] Termos MeSH primário: Anemia/tratamento farmacológico
Glicina/análogos & derivados
Isoquinolinas/uso terapêutico
Insuficiência Renal Crônica/complicações
[Mh] Termos MeSH secundário: Anemia/etiologia
Animais
Doenças Cardiovasculares/etiologia
Doenças Cardiovasculares/prevenção & controle
Eritropoetina/metabolismo
Glicina/efeitos adversos
Glicina/farmacologia
Glicina/uso terapêutico
Hematínicos/efeitos adversos
Hematínicos/uso terapêutico
Seres Humanos
Isoquinolinas/efeitos adversos
Isoquinolinas/farmacologia
Inibidores de Prolil-Hidrolase/efeitos adversos
Inibidores de Prolil-Hidrolase/farmacologia
Inibidores de Prolil-Hidrolase/uso terapêutico
Qualidade de Vida
Diálise Renal
Insuficiência Renal Crônica/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (FG-4592); 0 (Hematinics); 0 (Isoquinolines); 0 (Prolyl-Hydroxylase Inhibitors); 11096-26-7 (Erythropoietin); TE7660XO1C (Glycine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE
[do] DOI:10.1080/13543784.2018.1417386


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[PMID]:29342203
[Au] Autor:Zurauskaite G; Meier M; Voegeli A; Koch D; Haubitz S; Kutz A; Bernasconi L; Huber A; Bargetzi M; Mueller B; Schuetz P
[Ad] Endereço:Medical University Department, Kantonsspital Aarau, Aarau, Switzerland.
[Ti] Título:Biological pathways underlying the association of red cell distribution width and adverse clinical outcome: Results of a prospective cohort study.
[So] Source:PLoS One;13(1):e0191280, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Red cell distribution width (RDW) predicts disease outcome in several patient populations, but its prognostic value in addition to other disease parameters in unselected medical inpatients remains unclear. Our aim was to investigate the association of admission RDW levels and mortality adjusted for several disease pathways in unselected medical patients from a previous multicenter study. METHODS: We included consecutive adult, medical patients at the time point of hospital admission through the emergency department into this observational, cohort study. The primary endpoint was mortality at 30-day. To study association of admission RDW and outcomes, we calculated regression analysis with step-wise inclusion of clinical and laboratory parameters from different biological pathways. RESULTS: The 30-day mortality of the 4273 included patients was 5.6% and increased from 1.4% to 14.3% from the lowest to the highest RDW quartile. There was a strong association of RDW and mortality in unadjusted analysis (OR 1.32; 95%CI 1.27-1.39, p<0.001). RDW was strongly correlated with different pathways including inflammation (coefficient of determination (R2) 0.30; p<0.001), nutrition (R2 0.20; p<0.001) and blood diseases (R2 0.30; p<0.001 The association was eliminated after including different biological pathways into the models with the fully adjusted regression model showing an OR of 1.02 (95%CI 0.93-1.12; p = 0.664) for the association of RDW and mortality. Similar effects were found for other outcomes including intensive care unit admission and hospital readmission. CONCLUSION: Our data suggests that RDW is a strong surrogate marker of mortality in unselected medical inpatients with most of the prognostic information being explained by other disease factors. The strong correlation of RDW and different biological pathways such as chronic inflammation, malnutrition and blood disease suggest that RDW may be viewed as an unspecific and general "chronic disease prognostic marker".
[Mh] Termos MeSH primário: Índices de Eritrócitos
[Mh] Termos MeSH secundário: Adulto
Idoso
Anemia/sangue
Estudos de Coortes
Serviço Hospitalar de Emergência
Feminino
Mortalidade Hospitalar
Seres Humanos
Pacientes Internados
Masculino
Meia-Idade
Admissão do Paciente
Prognóstico
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191280


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[PMID]:29390506
[Au] Autor:Anzai M; Morikawa M; Okuno T; Umeda Y; Demura Y; Sonoda T; Yamaguchi M; Kanno K; Shiozaki K; Ameshima S; Akai M; Ishizuka T
[Ad] Endereço:Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui.
[Ti] Título:Efficacy and safety of nanoparticle albumin-bound paclitaxel monotherapy as second-line therapy of cytotoxic anticancer drugs in patients with advanced non-small cell lung cancer.
[So] Source:Medicine (Baltimore);96(51):e9320, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Nanoparticle albumin-bound paclitaxel (nab-PTX), which avoids toxicities associated with a vehicle used in solvent-based PTX, has already shown safety and efficacy in patients with non-small cell lung cancer (NSCLC). METHODS: A phase II study was performed to assess the safety and efficacy of nab-PTX monotherapy as second-line chemotherapy after cytotoxic anticancer drugs for previously treated advanced NSCLC. Thirty-two patients with advanced NSCLC who had previously undergone 1 regimen of cytotoxic anticancer drugs were enrolled. Nab-PTX was administered intravenously at a dose of 100 mg/m on days 1, 8, and 15 of a 28-day cycle. The objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and toxicity profile were evaluated. RESULTS: The ORR was 28.1%, the DCR was 71.9%, median PFS was 3.9 months (95% confidence interval [CI] 2.7-5.1 months), and median OS was 10.9 months (95% CI 9.5-12.3 months). The mean relative dose intensity of nab-PTX was 77%. Grade 3 or 4 neutropenia, and grade 3 febrile neutropenia were observed in 11 and 1 of 32 patients, respectively. As nonhematologic toxicities, grade 3 peripheral sensory neuropathy and pneumonitis were each observed in 2 of 32 patients. CONCLUSION: Nab-PTX is an active and well-tolerated regimen in patients with previously treated NSCLC.
[Mh] Termos MeSH primário: Paclitaxel Ligado a Albumina/uso terapêutico
Antineoplásicos/uso terapêutico
Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico
Neoplasias Pulmonares/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Anemia/induzido quimicamente
Carcinoma Pulmonar de Células não Pequenas/mortalidade
Feminino
Seres Humanos
Japão/epidemiologia
Neoplasias Pulmonares/mortalidade
Masculino
Meia-Idade
Neutropenia/induzido quimicamente
Doenças do Sistema Nervoso Periférico/induzido quimicamente
Pneumonia/induzido quimicamente
Terapia de Salvação
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Albumin-Bound Paclitaxel); 0 (Antineoplastic Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009320



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