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Gadomska G.,Hematology Clinic | Rosc D.,Nicolaus Copernicus University | Stankowska K.,Nicolaus Copernicus University | Boinska J.,Nicolaus Copernicus University | And 2 more authors.
Blood Coagulation and Fibrinolysis | Year: 2014

Hemostatic disorders are a major clinical problem in patients with myeloproliferative neoplasms (MPNs) and they are the second most common cause of death in MPN patients, after infections. The aim of this study was to assess the fibrinolytic potential of the blood of patients with MPNs. The study involved 112 patients with MPNs diagnosed at the Hematology Clinic Dr J. Biziel University Hospital No. 2 in Bydgoszcz, Poland. The study group included 63 patients with essential thrombocythemia, 29 with polycythemia vera, 11 with chronic myelogenous leukemia (CML) and nine with primary myelofibrosis. The control group consisted of 25 healthy volunteers who were age and sex-matched. The following parameters were determined: concentration of tissue plasminogen activator antigen (t-PA:Ag), plasminogen activator inhibitor type 1 antigen concentration (PAI-1:Ag), D-dimer, thrombin-antithrombin complexes, fibrinogen, activated partial thromboplastin time and international normalized ratio. The study showed significantly increased t-PA:Ag, PAI-1:Ag and D-dimer levels in patients with MPNs. Moreover, we found increased concentrations of thrombin-antithrombin complexes and fibrinogen, as well as elevated platelet counts. Detailed analysis revealed that t-PA:Ag concentration was elevated in patients with essential thrombocythemia, CML and polycythemia vera. Concentration of PAI-1:Ag was increased in patients with essential thrombocythemia and polycythemia vera; D-dimer was significantly higher in essential thrombocythemia, polycythemia vera, CML and primary myelofibrosis patients. Increased concentrations of t-PA:Ag and D-dimer indicate secondary activation of the fibrinolytic system in patients with MPNs. Elevated levels of PAI-1 in MPN patients may result from its increased production by elevated number of activated platelets and vascular endothelial damage. PAI-1 by having an inhibitory effect on fibrinolysis manifests its procoagulant activity. Copyright © 2014 Lippincott Williams & Wilkins. Source


Anca C.,Hematology Clinic | Irina T.,Coltea Clinical Hospital | Oana S.,Coltea Clinical Hospital
Therapeutics, Pharmacology and Clinical Toxicology | Year: 2012

Indolent lymphomas are malignant tumors of the cells of the immune system, located in different tissues. The clinical evolution is unpredictable, some cases going well beyond the average rate of survival of 8-10 years, and others with an increased probability of transforming into lymphomas with high malignancy. Based on the data provided in literature, we shall describe three cases diagnosed with indolent lymphomas focusing on the type of onset, evolution and treatment response. © reserved 2012. Source


Patel A.P.,Gujarat Research and Medical Institute | Patil A.S.,Hematology Clinic
Platelets | Year: 2015

Dapsone is one of the second line treatments of immune thrombocytopenic purpura (ITP). Dapsone is cheap and has response rates comparable to other second line treatment options like azathioprine, danazol, cyclophosphamide, cyclosporine, and vincristine. This retrospective analysis includes 38 patients (out of total 313 patients) of ITP treated with dapsone from 2004 to 2012. All male patients were screened for G6PD deficiency before starting dapsone. Out of 38 patients (12 children and 26 adults), one was newly diagnosed ITP, seven were persistent ITP, and 30 were chronic ITP. Five patients had side effects of dapsone; two required discontinuation due to skin rashes. The average dose of dapsone was 1.57mg/kg/day and time to response was 57 days (19-108 days). The response was irrespective of previous treatments and response to them. The response rate was 48.6% (complete response=40.5%). Only two adult patients had sustained response (> 6 months) after dapsone discontinuation. There were no predictors identified for dapsone response. Dapsone is a safe and cheap second-line therapy for ITP with a response rate of about 50% (majority being CR). A response to dapsone is slow, sustained, and relapses are uncommon on therapy. Dapsone withdrawal leads to relapse in most of the patients. © 2015 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted. Source


Spyropoulou G.A.,Aristotle University of Thessaloniki | Pavlidis L.,Aristotle University of Thessaloniki | Trakatelli M.,Aristotle University of Thessaloniki | Athanasiou E.,Hematology Clinic | And 3 more authors.
Journal of the European Academy of Dermatology and Venereology | Year: 2015

Conclusion: Histological examination of the lesion can be the only definite answer in these cases.Results: The initial search retrieved 337 articles. The papers were reviewed and the articles that referred to benign lesions that appeared at the nipple specifically were identified. Different entities that were described included: neurofibroma, leiomyoma, milium, florid papillomatosis, syringomatous adenoma, nevoid hyperkeratosis, fibroma, pseudolymphoma and haemangioma. Discussion Differential diagnosis of benign tumours of the nipple can be demanding for the physicians. Many of the symptoms and signs like pruritus, serosanguinous discharge, lichenification, erosion and nodular enlargement are produced by either malignant or benign nipple lesions. Radiology can be unclear in the diagnosis of nipple abnormalities.Background: Benign lesions of the breast in total are much more frequent than malignant ones. However, there are no epidemiologic data on the prevalence of benign or malignant tumours of the nipple, and the bibliography on benign nipple tumours in general is limited.Aims: To present some rare cases of benign nipple tumours and review the literature.Materials and methods: Four cases of rare benign nipple tumours: neurofibromas, wart, leiomyoma and milium are presented. The literature search on benign nipple tumours was performed using MEDLINE, Pubmed, and Cochrane databases with limits: English language, human species and available abstract. The keyword used was 'benign nipple tumours'. © 2014 European Academy of Dermatology and Venereology. Source


Demian S.,Hematology Clinic | Macarie I.,Hematology Clinic | Georgescu D.,Victor Babes University of Medicine and Pharmacy Timisoara | Oltean G.,Hematology Clinic | Bataga S.,Victor Babes University of Medicine and Pharmacy Timisoara
Journal of Gastrointestinal and Liver Diseases | Year: 2012

Acquired haemophilia A is a very rare (1-2 cases per million people) but often life-threatening haemorrhagic disorder characterized by antibodies directed against coagulation factor VIII. We report the case of a 55-year old woman under treatment with Pegylated alpha 2a interferon (IFN) and Ribavirin for chronic viral C hepatitis, who developed a progressive severe haemorrhagic syndrome diagnosed as acquired haemophilia based on supplementary laboratory data (prolonged activated partial thromboplastin time, extremely low factor VIII level - 1%, high titre of factor VIII inhibitor - 30 Bethesda U/ml).The onset was insidious, about three months before presenting to our unit. Antiviral therapy had been stopped three weeks before current admission. Emergency intensive treatment included: haemostatic agents - rFVII (Novoseven), FEIBA (Factor VIII Inhibitor Bypassing Activity), vitamin K, adrenostazin, cryoprecipitate, fresh frozen plasma, as well as immunosuppressive therapy (high dose corticotherapy and cyclophoshamide), immunoglobulins (Humaglobin), prophylactic PPI and antibiotics. The evolution was slowly favourable with the remission of the haemorrhagic syndrome and regression of the iliopsoas muscle haematoma. Clinicians should be aware that acquired forms of haemophilia do exist, representing a rare diagnosis and a therapeutic challenge. To our knowledge, this is the first reported case of acquired haemophilia in Romania, in a patient with chronic viral C hepatitis under antiviral treatment. Source

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