Prediction of Poor Outcomes for Septic Children According to Ferritin Levels in a Middle-Income Setting*
Objectives: To evaluate serum ferritin measured within 48 hours of admission as a prognostic marker and examine the association with unfavorable outcomes in a population of pediatric patients with sepsis and high prevalence of iron deficiency anemia in which this biomarker is routinely measured. Design: Retrospective cohort study. Setting: PICU of a tertiary care teaching hospital in a middle-income country in South America. Patients: All patients 6 months to 18 years old (n = 350) admitted with a diagnosis of sepsis, suspected or proven, were eligible for inclusion. Exclusion criteria were length of PICU stay less than 8 hours and inherited or acquired disorder of iron metabolism that could interfere with serum ferritin levels. Interventions: None. Measurements and Main Results: Three-hundred twelve patients had their ferritin levels measured within 48 hours, and only 38 did not. The prevalence of iron deficiency anemia (hemoglobin
Condition: Severe Aplastic Anemia (SAA) Intervention: Drug: REGN7257 Sponsor: Regeneron Pharmaceuticals Not yet recruiting
Condition: Anemia Associated With End Stage Renal Disease (ESRD) Intervention: Drug: Roxadustat Sponsors: FibroGen; AstraZeneca Not yet recruiting
Objective: To describe the management of anemia at PICU discharge by pediatric intensivists. Design: Self-administered, online, scenario-based survey. Setting: PICUs in Australia/New Zealand, Europe, and North America. Subjects: Pediatric intensivists. Interventions: None. Measurements and Main Results: Respondents were asked to report their decisions regarding RBC transfusions, iron, and erythropoietin prescription to children ready to be discharged from PICU, who had been admitted for hemorrhagic shock, cardiac surgery, craniofacial surgery, and polytrauma. Clinical and biological variables were altered ...
No abstract available
Abstract MR angiography is a flexible imaging technique enabling morphologic assessment of mesenteric arterial and venous vasculature. Conventional gadolinium-based contrast media and ferumoxytol are used as contrast agents. Ferumoxytol, an intravenous iron replacement therapy approved by the US Food and Drug Administration for iron deficiency anemia, is an effective and well tolerated blood pool contrast agent. The addition of 4D flow MR imaging enables a functional assessment of the arterial and venous vasculature; when coupled with a meal challenge, the severity of mesenteric arterial stenosis is well appreciat...
Investigational use of intravenous vitamin C has been on the rise, but its side effects may be underreported. A 75-year-old woman presented with acute onset of jaundice, dark urine and shortness of breath after receiving 30 g of vitamin C infusion as an unconventional therapy for her hemifacial spasm. Diagnosis of methemoglobinemia and hemolytic anemia was made clinically and confirmed on laboratory tests. She recovered with supportive treatment and packed cell transfusion. Her previously unrecognised underlying con dition of glucose-6-phosphate dehydrogenase (G6PD) deficiency was confirmed months after the initial presentation.
A 27-year-old woman with a history of autoimmune polyendocrinopathy syndrome with adrenal insufficiency and autoimmune thyroiditis, recurrent central line –associated bloodstream infections, gastroparesis while receiving home total parenteral nutrition via a peripherally inserted central catheter (PICC), deep venous thrombosis and pulmonary embolism, hypogammaglobulinemia, and chronic anemia attributed to iron and vitamin B12 deficiency requiring nu merous packed red blood cell transfusions presented to the emergency department (ED) with fevers, headache, and worsening anemia.
DNA interstrand cross-links (ICLs) are a form of DNA damage that requires the interplay of a number of repair proteins including those of the Fanconi anemia (FA) and the homologous recombination (HR) pathways. Pathogenic variants in the essential gene BRCA2/FANCD1, when monoallelic, predispose to breast and ovarian cancer, and when biallelic, result in a severe subtype of Fanconi anemia. BRCA2 function in the FA pathway is attributed to its role as a mediator of the RAD51 recombinase in HR repair of programmed DNA double-strand breaks (DSB). BRCA2 and RAD51 functions are also required to protect stalled replication forks f...