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Kuchar E.,Wroclaw Medical University | Nitsch-Osuch A.,Medical University of Warsaw | Stolarczyk C.,Institute of Hematology and Transfusiology | Kurpas D.,Medical University of Warsaw | And 3 more authors.
Advances in Experimental Medicine and Biology | Year: 2013

Splenectomy significantly increases the risk of severe invasive infections caused by capsular bacteria, such as sepsis and meningitis. Immunizations before and after splenectomy reduce the risk and are routinely recommended. Little is known about compliance with actual immunization guidelines in Poland. The aim of this study was to analyze the vaccination rate and the knowledge of splenectomized patients concerning immunizations in Poland. We applied a questionnaire to survey 85 adult patients (F/M 49/36) splenectomized in 2009-2010 and analyzed the patients' medical files and immunization certificates. Patients were also questioned over the phone. We found that the patients were most commonly immunized against Streptococcus pneumoniae (17/85, 20 %), less often against Haemophilus influenzae b (8/85, 9.4 %), and rarely against Niesseria meningitidis C (3/85, 3.5 %). In contrast, hepatitis B immunization coverage rate was as high as 67 % (57/85). The majority of respondents (59/85, 69.4 %) regarded information about the recommended immunizations as insufficient and rated their doctor's reasoning as inconsistent, a smaller number (20/85, 23.5 %) confirmed they received sound information before splenectomy. Both surgeons and primary care physicians did not offer immunizations to the majority of patients (59/85, 69.4 %); as a result, only 30.6 % of patients (26/85) were immunized against any capsular bacteria before splenectomy. In conclusion, the majority of splenectomized patients are not immunized despite current guidelines and do show an inadequate level of knowledge concerning the consequences of splenectomy. It is important that both surgeons and primary care doctors give patients clear instructions about immunizations and antibiotics recommended before and after their splenectomy. © 2013 Springer Science+Business Media Dordrecht.

Babayev M.E.S.,Institute of Hematology and Transfusiology | Babayev M.E.S.,Institute of Child Hematology
Azerbaijan Medical Journal | Year: 2010

In treatment of hereditary spherocytos hemolytic anemia as the radical method of treatment is applied laparoscopy splenectomy. The operation is applied at 11 children at the age from 4 till 16 years. The presence of calculous cholecystit has been revealed in 7 from 11 patients. Regarding to state of condition all patients have been divided into 2 groups: moderately grave and grave conditions. Splenectomy was spent with simultaneous removal of a gallbladder. The improvement of indicators of blood and the general condition of patients was marked within 2 weeks after operation. The obtained data remains stable within the next years. Postoperative complications were not observed. Small hems in a place of operation did not cause discomfort.

Malecka-Massalska T.,Medical University of Lublin | Smolen A.,Medical University of Lublin | Madro E.,Institute of Hematology and Transfusiology | Surtel W.,Lublin University of Technology
The Scientific World Journal | Year: 2012

Background and Objectives. The study was conducted to evaluate soft tissue hydration and mass through pattern analysis of vector plots as height, normalized resistance, and reactance measurements by bioelectric impedance vector analysis in Taiwanese and Polish college students. Methods. Whole-body measurements were made with ImpediMed bioimpedance analysis SFB7 BioImp v1.55 (Pinkenba Qld 4008, Australia) in 16 Taiwanese and Polish men and 16 Taiwanese and Polish women. Results. Mean vectors of Taiwanese men and women groups versus the Polish men and women groups were characterized by almost the same normalized resistance component with reactance component (separate 95 confidence limits, P<0.05) indicating that there were no differences of soft tissue hydration and mass. Interpretation and Conclusion. The evaluation of soft tissue hydration and mass through pattern analysis of vector plots as height, normalized resistance, and reactance measurements by bioelectric impedance vector analysis in Taiwanese and Polish college students did not differ between these two diverse ethnic groups. Further observational research investigating these properties in larger groups would be welcomed to elucidate and/or confirm these findings. Copyright 2012 Teresa Malecka-Massalska et al.

Stone R.M.,Dana-Farber Cancer Institute | Mazzola E.,Dana-Farber Cancer Institute | Neuberg D.,Dana-Farber Cancer Institute | Allen S.L.,Antisoma | And 17 more authors.
Journal of Clinical Oncology | Year: 2015

Purpose: Secondary acute myeloid leukemia (sAML), defined as AML arising after a prior myelodysplastic syndrome or after antineoplastic therapy, responds poorly to current therapies. It is often associated with adverse karyotypic abnormalities and overexpression of proteins that mediate drug resistance. We performed a phase III trial to determine whether induction therapy with cytarabine and amonafide L-malate, a DNA intercalator and non-ATP-dependent topoisomerase II inhibitor that evades drug resistance mechanisms, yielded a superior complete remission rate than standard therapy with cytarabine and daunorubicin in sAML. Patients and Methods Patients with previously untreated sAML were randomly assigned at a one-to-one ratio to cytarabine 200 mg/m2 continuous intravenous (IV) infusion once per day on days 1 to 7 plus either amonafide 600 mg/m2 IV over 4 hours on days 1 to 5 (A + C arm) or daunorubicin 45 mg/m2 IV over 30 minutes once per day on days 1 to 3 (D + C arm). Results The complete remission (CR) rate was 46% (99 of 216 patients) in A + C arm and 45% (97 of 217 patients) in D + C arm (P = .81). The 30- and 60-day mortality rates were 19% and 28% in A +C arm and 13% and 21% in D + C arm, respectively. Conclusion Induction treatment with A + C did not improve the CR rate compared with D + C in patients with sAML. © 2015 by American Society of Clinical Oncology.

Malinowska I.,Medical University of Warsaw | Machaczka M.,Karolinska Institutet | Machaczka M.,University of Rzeszow | Popko K.,Medical University of Warsaw | And 3 more authors.
Archivum Immunologiae et Therapiae Experimentalis | Year: 2014

Hemophagocytic syndrome, also known as hemophagocytic lymphohistiocytosis (HLH), is a heterogenic syndrome, which leads to an acute, life-threatening inflammatory reaction. HLH occurs both in children and adults, and can be triggered by various inherited as well as acquired factors. Depending on the etiology, HLH can be divided into genetic (i.e., primary) and acquired (i.e., secondary) forms. Among genetic HLH forms, one can distinguish between familial HLH and other genetically conditioned forms of HLH. Acquired HLH can be typically triggered by infections, autoimmune diseases, and malignancies. The most common symptoms of HLH are unremitting fever, splenomegaly, and peripheral blood cytopenia. Some severely ill patients present with central nervous system involvement. Laboratory tests reveal hyperferritinemia (often >10,000 μg/L), increased serum concentration of soluble receptor α for interleukin-2 (>2,400 U/L), hypertriglyceridemia, hypofibrinogenemia, coagulopathy, hyponatremia, hypoproteinemia, and elevated liver transaminases and bilirubin. Prognosis in HLH is very serious. Genetic HLH is always lethal if adequate therapy is not administered. Similarly, severe acquired cases often lead to death without appropriate treatment. Since HLH can be encountered by various specialists in the medical field, basic knowledge of this entity such as diagnostic criteria and treatment should be familiar to all physicians. © 2014, The Author(s).

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