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Bussulfano e melfalano como regime de condicionamento para o transplante autogênico de células-tronco hematopoéticas na leucemia mielóide aguda em primeira remissão completa; Busulfan and melphalan as conditioning regimen for autologous hematopoietic stem cell transplantation in acute myeloid leukemia in first complete remission

BUENO, Nadjanara D.; DULLEY, Frederico L.; SABOYA, Rosaura; AMIGO FILHO, José U.; PIRON-RUIZ, Lílian; STURARO, Daniel; CHAMONE, Dalton A. F.
Fonte: Associação Brasileira de Hematologia e Hemoterapia e daSociedade Brasileira de Transplante de Medula Óssea Publicador: Associação Brasileira de Hematologia e Hemoterapia e daSociedade Brasileira de Transplante de Medula Óssea
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
36.17%
Vinte e dois pacientes consecutivos portadores de leucemia mielóide aguda (LMA) em primeira remissão completa (1ªRC) submetidos a transplante de células-tronco hematopoéticas autogênico (TCTH Auto) condicionados com bussulfano e melfalano (Bu/Mel) foram selecionados entre 1993 e 2006. A probabilidade de sobrevida global (SG) pelo método de Kaplan-Meier foi de 57,5% após 36 meses, com "plateau" aos 20 meses após o transplante. Fatores como sexo, classificação Franco-Americana-Britânica (FAB) da LMA, tratamento de indução, consolidação intensiva, remissão após o primeiro ciclo de indução e fonte de células não tiveram impacto na sobrevida. Pela análise citogenética, um paciente de mau prognóstico submetido ao procedimento, foi a óbito um ano após o transplante. Nove pacientes foram a óbito, oito por recidiva e um por hemorragia. Morte antes dos 100 dias ocorreu em dois pacientes, um por recidiva e outro por hemorragia decorrente da plaquetopenia refratária, relacionada ao procedimento. Concluímos que o regime de condicionamento Bu/Mel é opção válida ao uso de outros regimes de condicionamento, apresentando excelente taxa da sobrevida.; Twenty-two consecutive patients with acute myeloid leukemia in first complete remission submitted to autologous hematopoietic stem cells transplantation conditioned with busulfan and melphalan were evaluated between 1993 and 2006. The overall survival...

Oral health as a predictive factor for oral mucositis

Coracin, Fabio Luiz; Santos , Paulo Sergio da Silva; Gallottini , Marina Helena Cury; Saboya, Rosaura; Musqueira, Priscila Tavares; Barban , Alessandra; Chamone , Dalton de Alencar Fischer; Dulley , Frederico Luiz; Nunes , Fabio Daumas
Fonte: Universidade de São Paulo - Faculdade de Medicina; São Paulo Publicador: Universidade de São Paulo - Faculdade de Medicina; São Paulo
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
26.09%
OBJECTIVES: Oral mucositis is a complication frequently associated with hematopoietic stem cell transplantation, decreasing a patient’s quality of life and increasing the occurrence of opportunistic infections. The purpose of this study was to determine the incidence and severity of oral mucositis and to assess the correlation of this disease with the oral health of an individual at the time of hematopoietic stem cell transplantation. METHODS: Before transplantation, patients’ oral health and inflammatory conditions were determined using the gingival index and the plaque index, which are based on gingival bleeding and the presence of dental plaque, respectively. Additionally, the dental health status was determined using the decayed, missing, and filled teeth index. The monitoring of oral mucositis was based on the World Health Organization grading system and was performed for five periods: from Day 0 to D+5, from D+6 to D+10, from D+11 to D+15, from D+16 to D+20, and from D+21 to D+30. RESULTS: A total of 97 patients (56% male and 44% female) who underwent hematopoietic stem cell transplantation at the Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo between January 2008 and July 2009 were prospectively examined. The incidence of ulcerative mucositis was highest from days +6 to +10 and from days +11 to +15 in the patients who underwent autologous and allogeneic hematopoietic stem cell transplantation...

Alterações estomatológicas de pacientes em preparo para transplante de células-tronco hematopoiéticas; Stomatological alterations of patients prior to hematopoietic stem cell transplantation

Araújo, José Endrigo Tinôco de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 25/02/2013 PT
Relevância na Pesquisa
36%
O transplante de células-tronco hematopoiéticas (TCTH) é um procedimento médico com finalidade de substituir um sistema hematopoiético alterado por um sistema normal de um doador após administração de altas doses de terapia mielosupressora. Os cirurgiões-dentistas têm papel importante no diagnóstico precoce e tratamento de alterações estomatológicas, prevenindo complicações durante a internação e na recuperação da medula óssea após o TCTH. Esta pesquisa observacional do tipo levantamento epidemiológico, quantitativo e descritivo, tem como objetivos avaliar a prevalência de alterações estomatológicas de pacientes em preparo para TCTH e avaliar o impacto destas alterações sobre a qualidade de vida. Foram examinados 100 pacientes no setor de Transplante de Medula Óssea do Hospital Amaral Carvalho em Jaú/SP, registrando em uma ficha clínica dados demográficos e médicos, informações sobre alterações estomatológicas, edentulismo, avaliação de cárie dentária (índice CPO) e condição periodontal (índice CPI) conforme preconizado pela Organização Mundial de Saúde. Também foi aplicado questionário Oral Health Impact Profile (OHIP-14), inédito com pacientes onco-hematológicos, para avaliar o impacto da saúde oral sobre a qualidade de vida. Dos 100 pacientes...

Spatial and temporal analysis of stem bleeding disease in coconut palm in the state of sergipe, Brazil

CARVALHO,REJANE R. DA COSTA E; SOUZA,PAULO E. DE; WARWICK,DULCE R.N.; POZZA,EDSON A.; CARVALHO FILHO,JOSE L.S. DE
Fonte: Academia Brasileira de Ciências Publicador: Academia Brasileira de Ciências
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2013 EN
Relevância na Pesquisa
66.48%
ABSTRACT Stem bleeding disease (resinosis) of coconut palm is caused by Thielaviopsis paradoxa and is very important in the state of Sergipe, Brazil. Understanding the epidemiological behavior of the disease is essential for establishing more efficient control strategies. Thus, we characterized the temporal progression and spatial distribution of stem bleeding in a commercial orchard under conditions of natural infection in the area of Neopolis, Sergipe. Three plots with 729 plants each were selected and evaluated every two months for stem bleeding incidence. In the temporal analysis, the monomolecular model gave the best fit to data on disease incidence, as it accurately showed the temporal dynamics of the disease during the experiment period. The spatial pattern of stem bleeding varied over time, with initial infections presenting random pattern and then evolving to aggregate pattern during evaluations. This indicates that the disease may have originated from the pathogen survival structures, followed by auto infections caused by dissemination from plant to plant, either by humans, by contact between roots, or by the vector Rhynchophorus palmarum.

In vitro activity of essential oils of Lippia sidoides and Lippia gracilis and their major chemical components against Thielaviopsis paradoxa, causal agent of stem bleeding in coconut palms

Carvalho,Rejane Rodrigues da Costa e; Laranjeira,Delson; Carvalho Filho,José Luiz Sandes de; Souza,Paulo Estevão de; Blank,Arie Fitzgerald; Alves,Péricles Barreto; Jesus,Hugo Cesar Ramos de; Warwick,Dulce Regina Nunes
Fonte: Sociedade Brasileira de Química Publicador: Sociedade Brasileira de Química
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2013 EN
Relevância na Pesquisa
46.11%
Essential oils of Lippia sidoides, Lippia gracilis and their main chemical components were investigated for in vitro control of Thielaviopsis paradoxa. Mycelial growth and a number of pathogen conidia were inhibited by the essential oil of L. sidoides at all concentrations tested (0.2; 0.5; 1.0; 3.0 µL mL-1). L. sidoides oil contained 42.33% thymol and 4.56% carvacrol, while L. gracilis oil contained 10% thymol and 41.7% carvacrol. Mycelial growth and conidial production of T. paradoxa were completely inhibited by thymol at a 0.3 µL m-1 concentration. The results suggest that thymol could potentially be used for controlling coconut stem bleeding.

Transmission of lupus anticoagulant by allogeneic stem cell transplantation

Massoud,Mira Romany; William,Basem M.; Harrill,Katrina; Cooper,Brenda Wimpfheimer; Lima,Marcos de; Schmaier,Alvin H.
Fonte: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular Publicador: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2014 EN
Relevância na Pesquisa
36.22%
Passive transmission of autoimmune diseases by allogeneic stem cell transplantation is rare and is ascribed to passive transfer of memory B-cells from donor to recipient. We hereby report a case of transmission of an asymptomatic lupus anticoagulant from a sibling donor to a recipient of transplantation for secondary acute myeloid leukemia. On pre-harvest evaluation, the sibling donor with no history of bleeding or thrombosis was found to have a lupus anticoagulant. After engraftment, the recipient was found to have a new prolonged activated partial thromboplastin time and was subsequently shown to have a lupus anticoagulant on Day +73 after stem cell transplantation. The recipient remained well with no evidence of bleeding, thrombosis, or graft-versus-host disease and was on a stable dose of tacrolimus at the time the lupus anticoagulant was detected. There was no other identifiable trigger for the appearance of a lupus anticoagulant.

Results of radiosurgery for brain stem arteriovenous malformations

Kurita, H.; Kawamoto, S.; Sasaki, T.; Shin, M.; Tago, M.; Terahara, A.; Ueki, K.; Kirino, T.
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /05/2000 EN
Relevância na Pesquisa
26.09%
OBJECTIVE—To assess the treatment results of radiosurgery for brain stem arteriovenous malformations (AVMs) and to seek optimal dose and treatment volume prescription for these lesions.
METHODS—The clinical and radiological data of 30 consecutive patients with brain stem AVM treated with gamma knife radiosurgery were retrospectively reviewed with a mean follow up period of 52.2months. There were 26 patients with previous haemorrhages and 21 with neurological deficit. Seventeen AVMs were located in the midbrain, 11 in the pons, and two in the medulla oblongata. All of the lesions were small with the intra-axial component occupying less than one third of the area of brain stem parenchyma on axial section of multiplaner MRI or CT. The mean diameter of the nidus was 1.26 cm, and the nidus volume within the brain stem parenchyma ranged from 0.1 to 2.0 cm3. The mean radiation dose to the AVM margin was 18.4Gy.
RESULTS—The actuarial 3 year obliteration rate was 52.2%; 69.4% in cases treated with standard doses (minimum target dose, 18-20Gy), and 14.3% in cases treated with low doses (<18 Gy) (p<0.05). Two patients sustained symptomatic radiation injury, but there was no permanent neurological deficit caused by radiosurgery. Five patients had haemorrhage from the AVM after irradiation...

Loss of proliferative capacity in immunohemopoietic stem cells caused by serial transplantation rather than aging

Fonte: The Rockefeller University Press Publicador: The Rockefeller University Press
Tipo: Artigo de Revista Científica
Publicado em 01/05/1978 EN
Relevância na Pesquisa
26.24%
Marrow stem cell lines from old donors and those from young controls gave equally rapid rates of colony growth on spleens of irradiated mice. Old and young stem cell lines competed equally well with chromosomally marked marrow stem cells from a young donor in producing cell types that are stimulated by bleeding; old cells competed 70% as well as young in producing cell types stimulated by phytohemagglutinin (PHA) in vitro. After a single serial transplantation, the rates of colony growth declined 1.5- to 2.5-fold, and the ability to compete declined 2- to 4-fold for bleeding-stimulated and 4- to 10-fold for PHA- stimulated cells. Thus, immediate stem cell proliferative capacities decline much more after one serial transplantation than after a lifetime of normal function.

Fertility recovery and pregnancy after allogeneic hematopoietic stem cell transplantation in Fanconi anemia patients

Nabhan, Samir K.; Bitencourt, Marco A.; Duval, Michel; Abecasis, Manuel; Dufour, Carlo; Boudjedir, Karim; Rocha, Vanderson; Socié, Gérard; Passweg, Jakob; Goi, Kumiko; Sanders, Jean; Snowden, John; Yabe, Hiromasa; Pasquini, Ricardo; Gluckman, Eliane
Fonte: Ferrata Storti Foundation Publicador: Ferrata Storti Foundation
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
26.07%
Reduced fertility is one clinical manifestation among other well known Fanconi anemia features. Most recipients of allogeneic hematopoietic stem cell transplantation suffer from secondary infertility owing to gonadal damage from myeloablative conditioning. In order to evaluate the rate of pregnancy in Fanconi anemia transplanted patients, we performed a retrospective analysis of female patients transplanted in 15 centers from 1976 to 2008. Among 578 transplanted Fanconi anemia patients, we identified 285 transplanted females of whom 101 patients were aged 16 years or over. Ten became pregnant (4 twice). Before hematopoietic stem cell transplantation all had confirmed Fanconi anemia diagnosis. Median age at transplantation was 12 years (range 5–17 years). Conditioning regimen consisted of cyclophosphamide with or without irradiation. During follow up, 5 of 10 patients presented signs of ovarian failure. Among those, 2 patients spontaneously recovered regular menses, and 3 received hormonal replacement therapy. Pregnancy occurred from four to 17 years after hematopoietic stem cell transplantation. Three patients had preterm deliveries, one patient had a hysterectomy for bleeding. All 14 newborns had normal growth and development without congenital diseases. In conclusion...

Medicinal Plants Used in Wound Care: A Study of Prosopis africana (Fabaceae) Stem Bark

Ezike, A. C.; Akah, P. A.; Okoli, C. O.; Udegbunam, S.; Okwume, N.; Okeke, C.; Iloani, O.
Fonte: Medknow Publications Publicador: Medknow Publications
Tipo: Artigo de Revista Científica
Publicado em //2010 EN
Relevância na Pesquisa
26.17%
The effects of the methanol extract of the stem bark of Prosopis africana (Guill., Perrott. and Rich.) Taubert (Fabaceae) on bleeding/clotting and coagulation time, excision and dead space wounds were studied in rats. Also, the extract was subjected to antibacterial, and acute toxicity and lethality (LD50) tests. The extract significantly (P<0.05) reduced bleeding/clotting and coagulation time in rats. It also reduced epithelialization period of excision wounds in rats and inhibited the growth of laboratory strains of Staphylococcus aureus, Bacillus subtilis, Salmonella typhi, Pseudomonas aeruginosa and Klebsiella pneumoniae to varying extents. Acute toxicity and lethality (LD50) test on the extract established an LD50 of 774 mg/kg (i.p) in mice while phytochemical analysis gave positive reactions for alkaloids, saponins, tannins, flavonoids, steroids, terpenoids and carbohydrates. The results of this study demonstrate the beneficial effects of the stem bark of P. africana in wound care.

Analysis of incidence, risk factors and clinical outcome of thromboembolic and bleeding events in 431 allogeneic hematopoietic stem cell transplantation recipients

Labrador, Jorge; Lopez-Anglada, Lucia; Perez-Lopez, Estefania; Lozano, Francisco S.; Lopez-Corral, Lucia; Sanchez-Guijo, Fermin M.; Vazquez, Lourdes; Perez Rivera, Jose Angel; Martin-Herrero, Francisco; Sanchez-Barba, Mercedes; Guerrero, Carmen; del Cañi
Fonte: Ferrata Storti Foundation Publicador: Ferrata Storti Foundation
Tipo: Artigo de Revista Científica
Publicado em /03/2013 EN
Relevância na Pesquisa
26.41%
Allogeneic hematopoietic stem cell transplantation recipients have an increasing risk of both hemorrhagic and thrombotic complications. However, the competing risks of two of these life-threatening complications in these complex patients have still not been well defined. We retrospectively analyzed data from 431 allogeneic transplantation recipients to identify the incidence, risk factors and mortality due to thrombosis and bleeding. Significant clinical bleeding was more frequent than symptomatic thrombosis. The cumulative incidence of a bleeding episode was 30.2% at 14 years. The cumulative incidence of a venous or arterial thrombosis at 14 years was 11.8% and 4.1%, respectively. The analysis of competing factors for venous thrombosis revealed extensive chronic graft-versus-host disease to be the only independent prognostic risk factor. By contrast, six factors were associated with an increased risk of bleeding; advanced disease, ablative conditioning regimen, umbilical cord blood transplantation, anticoagulation, acute III-IV graft-versus-host disease, and transplant-associated microangiopathy. The development of thrombosis did not significantly affect overall survival (P=0.856). However, significant clinical bleeding was associated with inferior survival (P<0.001). In allogeneic hematopoietic stem cell transplantation...

Transmission of lupus anticoagulant by allogeneic stem cell transplantation

Massoud, Mira Romany; William, Basem M.; Harrill, Katrina; Cooper, Brenda Wimpfheimer; de Lima, Marcos; Schmaier, Alvin H.
Fonte: Sociedade Brasileira de Hematologia e Hemoterapia Publicador: Sociedade Brasileira de Hematologia e Hemoterapia
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
26.17%
Passive transmission of autoimmune diseases by allogeneic stem cell transplantation is rare and is ascribed to passive transfer of memory B-cells from donor to recipient. We hereby report a case of transmission of an asymptomatic lupus anticoagulant from a sibling donor to a recipient of transplantation for secondary acute myeloid leukemia. On pre-harvest evaluation, the sibling donor with no history of bleeding or thrombosis was found to have a lupus anticoagulant. After engraftment, the recipient was found to have a new prolonged activated partial thromboplastin time and was subsequently shown to have a lupus anticoagulant on Day +73 after stem cell transplantation. The recipient remained well with no evidence of bleeding, thrombosis, or graft-versus-host disease and was on a stable dose of tacrolimus at the time the lupus anticoagulant was detected. There was no other identifiable trigger for the appearance of a lupus anticoagulant.

Concurrent treatment with a tumor necrosis factor-alpha inhibitor and veno-venous extracorporeal membrane oxygenation in a post-hematopoietic stem cell transplant patient with idiopathic pneumonia syndrome: a case report

Koinuma, Toshitaka; Nunomiya, Shin; Wada, Masahiko; Koyama, Kansuke; Suzuki, Takahiro
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 22/08/2014 EN
Relevância na Pesquisa
26.11%
Idiopathic pneumonia syndrome (IPS) is a fatal non-infectious respiratory complication that develops after hematopoietic stem cell transplantation (HSCT). Because of the poor prognosis of post-HSCT patients with IPS requiring mechanical ventilatory support, performing extracorporeal membrane oxygenation (ECMO) has been regarded as relatively contraindicated in these patients. A tumor necrosis factor-alpha inhibitor, etanercept, has been reported to be a promising treatment option for post-HSCT patients with IPS; however, the phase III clinical trial of etanercept has recently been terminated without definitive conclusion. If post-HSCT patients with IPS really benefit from etanercept, mechanical ventilation (MV)-dependent IPS patients might be worth receiving ECMO treatment in line with the protective lung strategy. We therefore performed veno-venous ECMO (VV-ECMO), which substantially acted as an extracorporeal carbon dioxide removal, on a 56-year-old post-HSCT male with severe MV-dependent IPS due to graft-versus-host disease. Although a serious bleeding complication due to post-HSCT thrombocytopenia occurred, the VV-ECMO was continued for 11 days. The patient successfully entered remission of the IPS and was finally extubated on the 12th MV day. However...

Treatment of Acquired von Willebrand Syndrome and Prevention of Bleeding Postautologous Stem Cell Transplant during Severe Pancytopenia with IVIG

Zoghi, Behyar; Shaughnessy, Paul; Lyons, Roger M.; Helmer, Richard; Bachier, Carlos; LeMaistre, C. Frederick
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
26.22%
The use of high dose chemotherapy followed by autologous hematopoietic stem cell transplantation for remission consolidation after initial induction represents standard of care for patients with multiple myeloma. Patients with myeloma and Acquired von Willebrand Syndrome (AVWS) undergoing autologous stem cell transplant (ASCT) are at significant risk of bleeding due to the profound thrombocytopenia, low Factor VIII levels, fever, and toxicities associated with the preparative regimen. We report a patient with AVWS associated with multiple myeloma who underwent autologous stem cell transplants as consolidation after initial induction and again at relapse. He was successfully treated with high dose intravenous immunoglobulin (IVIG) prior to each transplant with rapid resolution of AVWS.

Risk of bleeding and use of platelet transfusions in patients with hematologic malignancies: recurrent event analysis

Stanworth, Simon J.; Hudson, Cara L.; Estcourt, Lise J.; Johnson, Rachel J.; Wood, Erica M.
Fonte: Ferrata Storti Foundation Publicador: Ferrata Storti Foundation
Tipo: Artigo de Revista Científica
Publicado em /06/2015 EN
Relevância na Pesquisa
26.42%
A recent randomized trial (TOPPS) compared prophylactic platelet transfusions (for counts <10×109/L) with a strategy of no-prophylaxis in adults with hematologic malignancies. Seventy percent of enrolled patients received an autologous hematopoietic stem cell transplant. Statistical models were developed to explore which patient factors or clinical characteristics are important prognostic factors for bleeding. These models were presented for baseline characteristics and for recurrent analysis of bleeding to assess the risks of World Health Organization grade 2–4 bleeding on any given day. Additional analyses explored the importance of fever. Treatment plan (chemotherapy/allogeneic hematopoietic stem cell transplant), female sex, and treatment arm (no-prophylaxis) were significantly associated with an increased number of days of bleeding. The number of days with a platelet count <10×109/L was significantly associated with a grade 2–4 bleed (P<0.0001). Patients with a temperature of at least 38°C had the highest hazard of a grade 2–4 bleed (hazard ratio: 1.7, 95% confidence interval: 1.3 to 2.4, compared with the risk in patients with a temperature <37.5°C). There was no evidence that minor bleeding predicted a grade 2–4 bleed. The results highlighted the limited role of correction of thrombocytopenia by platelet transfusion in reducing the risk of bleeding. Clinically stable patients undergoing autologous hematopoietic stem cell transplantation had the lowest risk of bleeding and benefited least from prophylactic platelet transfusions. Prospective studies are required to address the usefulness of risk factors to support better targeted platelet transfusions. TOPPS Controlled-Trials.com number ISRCTN08758735.

A no-prophylaxis platelet-transfusion strategy for hematologic cancers

Stanworth, S.J.; Estcourt, L.J.; Powter, G.; Kahan, B.C.; Dyer, C.; Choo, L.; Bakrania, L.; Llewelyn, C.; Littlewood, T.; Soutar, R.; Norfolk, D.; Copplestone, A.; Smith, N.; Kerr, P.; Jones, G.; Raj, K.; Westerman, D.A.; Szer, J.; Jackson, N.; Bardy, P.G
Fonte: Massachusetts Medical Society Publicador: Massachusetts Medical Society
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
26.42%
BACKGROUND: The effectiveness of platelet transfusions to prevent bleeding in patients with hematologic cancers remains unclear. This trial assessed whether a policy of not giving prophylactic platelet transfusions was as effective and safe as a policy of providing prophylaxis. METHODS: We conducted this randomized, open-label, noninferiority trial at 14 centers in the United Kingdom and Australia. Patients were randomly assigned to receive, or not to receive, prophylactic platelet transfusions when morning platelet counts were less than 10×10(9) per liter. Eligible patients were persons 16 years of age or older who were receiving chemotherapy or undergoing stem-cell transplantation and who had or were expected to have thrombocytopenia. The primary end point was bleeding of World Health Organization (WHO) grade 2, 3, or 4 up to 30 days after randomization. RESULTS: A total of 600 patients (301 in the no-prophylaxis group and 299 in the prophylaxis group) underwent randomization between 2006 and 2011. Bleeding of WHO grade 2, 3, or 4 occurred in 151 of 300 patients (50%) in the no-prophylaxis group, as compared with 128 of 298 (43%) in the prophylaxis group (adjusted difference in proportions, 8.4 percentage points; 90% confidence interval...

Histologic Features of Intestinal Thrombotic Microangiopathy in Pediatric and Young Adult Patients after Hematopoietic Stem Cell Transplantation

El-Bietar, Javier; Warren, Mikako; Dandoy, Christopher; Myers, Kasiani C.; Lane, Adam; Wallace, Gregory; Davies, Stella M.; Jodele, Sonata
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
26.11%
High-risk transplantation-associated thrombotic microangiopathy (TMA) can present with multisystem involvement and is associated with a poor outcome after hematopoietic stem cell transplantation (HSCT), with < 20% 1-year survival. TMA may involve the intestinal vasculature and can present with bleeding and ischemic colitis. There are no established pathologic criteria for the diagnosis of intestinal TMA (iTMA). The goal of our study was to identify histologic features of iTMA and describe associated clinical features. We evaluated endoscopic samples from 50 consecutive HSCT patients for 8 histopathologic signs of iTMA and compared findings in 3 clinical groups based on the presence or absence of systemic high-risk TMA (hrTMA) and the presence or absence of clinically staged intestinal graft-versus-host disease (iGVHD): TMA/iGVHD, no TMA/iGVHD, and no TMA/no iGVHD. Thirty percent of the study subjects had a clinical diagnosis of systemic hrTMA. On histology, loss of glands, intraluminal schistocytes, intraluminal fibrin, intraluminal microthrombi, endothelial cell separation, and total denudation of mucosa were significantly more common in the hrTMA group (P < .05). Intravascular thrombi were seen exclusively in patients with hrTMA. Mucosal hemorrhages and endothelial cell swelling were more common in hrTMA patients but this difference did not reach statistical significance. Patients with hrTMA were more likely to experience significant abdominal pain and gastrointestinal bleeding requiring multiple blood transfusions (P < .05). Our study shows that HSCT patients with systemic hrTMA can have significant bowel vascular injury that can be identified using defined histologic criteria. Recognition of these histologic signs in post-transplantation patients with significant gastrointestinal symptoms may guide clinical decisions.

Oral health as a predictive factor for oral mucositis

Coracin,Fabio Luiz; Santos,Paulo Sergio da Silva; Gallottini,Marina H.C.; Saboya,Rosaura; Musqueira,Priscila Tavares; Barban,Alessandra; Chamone,Dalton de Alencar Fischer; Dulley,Frederico Luiz; Nunes,Fabio Daumas
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2013 EN
Relevância na Pesquisa
26.09%
OBJECTIVES: Oral mucositis is a complication frequently associated with hematopoietic stem cell transplantation, decreasing a patient's quality of life and increasing the occurrence of opportunistic infections. The purpose of this study was to determine the incidence and severity of oral mucositis and to assess the correlation of this disease with the oral health of an individual at the time of hematopoietic stem cell transplantation. METHODS: Before transplantation, patients' oral health and inflammatory conditions were determined using the gingival index and the plaque index, which are based on gingival bleeding and the presence of dental plaque, respectively. Additionally, the dental health status was determined using the decayed, missing, and filled teeth index. The monitoring of oral mucositis was based on the World Health Organization grading system and was performed for five periods: from Day 0 to D+5, from D+6 to D+10, from D+11 to D+15, from D+16 to D+20, and from D+21 to D+30. RESULTS: A total of 97 patients (56% male and 44% female) who underwent hematopoietic stem cell transplantation at the Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo between January 2008 and July 2009 were prospectively examined. The incidence of ulcerative mucositis was highest from days +6 to +10 and from days +11 to +15 in the patients who underwent autologous and allogeneic hematopoietic stem cell transplantation...

Avaliação da supressividade do solo a Thielaviopsis sp.; Evaluation to soil suppressiveness to Thielaviopsis sp.

Pereira, Priscilla de Fátima
Fonte: Universidade Federal de Lavras; Programa de Pós-Graduação em Agronomia/Fitopatologia; UFLA; brasil; Departamento de Fitopatologia Publicador: Universidade Federal de Lavras; Programa de Pós-Graduação em Agronomia/Fitopatologia; UFLA; brasil; Departamento de Fitopatologia
Tipo: Dissertação
Publicado em 16/12/2015 POR
Relevância na Pesquisa
46.11%
The stem-bleeding caused by Thielaviopsis sp. has became cause of extreme concern for farmers, research institutions, technical assistance agencies, and health protection and monitoring agencies. This disease has been spreading and, thus, increasing the quantity of coconut trees and farms affected each year. The search for a sustainable control of this pathogen has become constant over time. In this study, we aimed to evaluate the suppressiveness and / or conduciveness of coconut planting soils of two Brazilian regions, as well as the possible variables responsible for such suppression and / or conduciveness. The influence of soils on Thielaviopsis sp. population was assessed by estimating the percentage of baits of ripe banana colonized by this pathogen on soils. This colonization percentage ranged from 4.61 to 83,08%. Then, based on the Scott Knott means test, samples of five most suppressive soils, and five most conducive soils were collected to estimate their nature, as well as determining factors for suppressiveness and / or conduciveness. Physical, chemical and biological characters were assessed for each sample. The total bacteria parameter was found to be higher in suppressive soils. Fluorescent Pseudomonas was only found in one type of soil. The pH...

Diffuse cavernous hemangioma of the rectum: an atypical cause of rectal bleeding

Hervías,D.; Turrión,J. P.; Herrera,M.; Navajas León,J.; Pajares Villarroya,R.; Manceñido,N.; Castillo,P.; Segura,J.M.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/05/2004 ENG
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Objective: cavernous hemangioma of the rectosigmoid colon is a rare disease, with no more than 200 cases reported in the literature. The rectosigmoid is the most common site of this disease in the gastrointestinal tract. Case report: we report the case of a 31-year-old male with recurrent episodes of rectal bleeding, who was finally diagnosed of diffuse cavernous hemangioma of the rectum. The tumor, of 12 x 10 x 9 cm in size, occupied the rectum to the margin of the anal sphincter. A surgical procedure was ruled out because of the inability to carry out a safe anastomosis while preserving anal sphincters. Discussion: rectal hemangiomas are less frequent vascular malformations. The clinical presentation of a cavernous hemangioma of the rectum is usually acute, recurrent or chronic rectal bleeding. Other symptoms stem from the possible compression or invasion of adjacent structures, such as lumbar or perianal pain, metrorrhage, hematuria, etc. This diagnosis is commonly made in younger patients. Colonoscopy is without doubt the diagnostic technique of choice, and it allows to establish the localization, morphology, and total extension of the lesion; its characteristic image is a red-purplish nodule with great vascular congestion. According to the opinion of most authors...