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Register a new userAutomated Red Cell Exchange in Sickle Cell Disease
تبديل الكريات الحمر الآلي في فقر الدم المنجلي
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تهاني علي( باحث )
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يتلقى غالبية مرضى فقر الدم المنجلي نقل دم في بعض مراحل حياتهم، نقل الدم يمكن أن يكون بشكل بسيط أو بشكل نقل دم تبديلي، و هو يقدم سيطرة أفضل على حجم الدم و لزوجته، و سيكون إنجازه أسهل بتبديل آلي للكريات الحمر. هدف البحث إلى تقييم نتائج تجربة تطبيق تقنية الفصل الانتقائي بالجريان الخلوي المستمر Apheresise لإجراء تبديل كريات حمر آلي لمرضى فقر الدم المنجلي لإنقاص مستوى الخضاب المنجلي HbS في حالات معينة، و خاصة التحضير لعمل جراحي.
The majority of patients with SCD receive transfusions at some point in their life. Transfusion can be simple transfusion or exchange transfusions which offer better control of blood volume and viscosity. Such transfusions are most readily accomplished via automated red cell exchange. Evaluate the results of our experience in applying the technique of selective cell separation by continuous flow (Cytapheresis) for automated red cell exchange for patients with sickle cell anemia to reduce the level of hemoglobin S (HbS) in certain cases, especially in preparation for major surgery.
Artificial intelligence review:
Research summary
تتناول هذه الدراسة تطبيق تقنية الفصل الخلوي الانتقائي بالتنبيذ بالجريان المستمر (Cytapheresis) لإجراء تبديل كريات حمر آلي لمرضى فقر الدم المنجلي. تم إجراء الدراسة بين عامي 2005 و2007 باستخدام جهاز فصل الخلايا من شركة Fresenius AG، وشملت 15 مريضًا بمتوسط عمر 31.2 سنة. كانت الاستطبابات الرئيسية تشمل الجراحة العظمية (53.3%) واستئصال الحويصل الصفراوي (26.6%) ونوب الألم المعندة (6.6%) وغيرها. أظهرت النتائج أن متوسط نسبة تخفيض الخضاب المنجلي كانت 52%، ومتوسط حجم الكريات الحمر المستخدمة كان 1412.4 مل، ومتوسط زمن الجلسة كان 76.5 دقيقة. خلصت الدراسة إلى أن تبديل الكريات الحمر الآلي هو إجراء آمن وفعال في خفض مستوى الخضاب المنجلي إلى مستويات آمنة للجراحات الكبرى وعلاج نوب الانسداد الوعائي.
Critical review
دراسة نقدية: على الرغم من أن الدراسة تقدم نتائج مشجعة حول فعالية وأمان تقنية تبديل الكريات الحمر الآلي، إلا أن هناك بعض النقاط التي يمكن مناقشتها. أولاً، حجم العينة صغير نسبياً (15 مريضاً فقط)، مما قد يؤثر على تعميم النتائج. ثانياً، لم يتم مقارنة النتائج مع مجموعة ضابطة تتلقى العلاج التقليدي، مما يجعل من الصعب تقييم الفعالية النسبية للتقنية الجديدة. ثالثاً، لم يتم التطرق بشكل كافٍ إلى التكلفة والموارد المطلوبة لتنفيذ هذه التقنية، والتي قد تكون عائقاً في بعض البيئات الطبية. وأخيراً، كان من المفيد تقديم متابعة طويلة الأمد للمرضى لتقييم الآثار الجانبية المحتملة والمضاعفات التي قد تظهر بعد فترة من العلاج.
Questions related to the research
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ما هي التقنية المستخدمة في الدراسة لتبديل الكريات الحمر؟
تم استخدام تقنية الفصل الخلوي الانتقائي بالتنبيذ بالجريان المستمر (Cytapheresis) لتبديل الكريات الحمر الآلي.
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ما هي الاستطبابات الرئيسية لتبديل الكريات الحمر الآلي في الدراسة؟
الاستطبابات الرئيسية تشمل الجراحة العظمية (53.3%)، استئصال الحويصل الصفراوي (26.6%)، نوب الألم المعندة (6.6%)، النعوظ المؤلم المعند (6.6%)، وقرحة الساق المعندة (6.6%).
-
ما هو متوسط نسبة تخفيض الخضاب المنجلي بعد جلسة التبديل؟
متوسط نسبة تخفيض الخضاب المنجلي كانت 52%.
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ما هي مدة الجلسة الواحدة لتبديل الكريات الحمر الآلي؟
متوسط زمن الجلسة الواحدة كان 76.5 دقيقة.
References used
Montalembert. M, Galacteros.F, Girot.R, Geffrier.A.Ch. Prise en charge de la drépanocytose chez l`enfant et l`adolescent. Recommandations pour la pratique clinique .HAS / Service des recommandations professionnelles.France 2005 :1-31. http://www.has-sante.fr/portail/jcms/c-269713/drepanocytose-argumentairepdf
Aliyu.Z.Y, Tumblin.A.R, Kato.J.G. Current therapy of sickle cell disease. haematologica/ the hematology journal 2006; 91(1):7-10
Kim.H.C. .RBC Exchange Transfusion to Prevent Iron Overload in Patients with Sickle Cell Disease.5ht Brazilian symposium for sickle cell disease and other hemoglobinopathies, USA 2009. http://www.cehmob.org.br/simposio/imagens/download/palestras/KIM_Haewon.pdf
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This study aims to show the effectiveness of hydroxyl urea in the treatment of
severe forms of sickle-cell anemia.
The study included 30 patients from patients with sickle cell anemia and who
reviewed the Blood clinics in AL- Assad University Hosp
ital .
We had studied patients treated with hydroxy urea for at least 6 months, where it was
compared to blood and clinical variables before and after hydroxy urea treatment.
The results showed an improvement in blood and clinical manifestations , and it was
noted a significant increase in the level of fetal hemoglobin, and a decrease in the level of
hemoglobin and sickle cell after hydroxy urea treatment.
hydroxy urea treatment also led to a clear increase in the level of total hemoglobin,
and a decrease in the value of total bilirubin.
Decrease in the number of the pain episodes that needed hospitalization, and the
number of times of blood transfusion after treatment, too.
Objective:
Evaluate sensitivity and specificity of nitrite test to urine culture(gold standard) for
diagnosing urinary tract infection in patients with sickle cell anemia with urinary
symptoms and signs.
Methods:
The study sample included 79 chi
ldren aged 2 to 14 years with SCA presenting with
fever (temperature >38°C),abdominal pain, urgency, dysuria or increased urinary
frequency who referral to the general pediatric clinic and the children's ambulance
department in Tishreen University Hospital in Lattakia during( 2016-2017).
Midstream urine specimen was collected from children. Samples were subjected to nitrite
test, culture and sensitivity.
Results :
There was significant bacteriuria in 17 (21.5%) children with SCA. A positive test
for nitrite was obtained in 12 of the 17(70.5%) children. The nitrite test has a specificity of
95.2% in detecting bacteriuria, a sensitivity of 70.6%, a positive predictive value of 80%
and a negative predictive value of 92%. A positive nitrite test was significantly associated
with bacteriuria, while a negative test was also significantly associated with an absence of
bacteriuria.
The purpose of the present study was to investigate whether a relationship exists between bilirubin, RDW, and prognostic factors for gastric cancer (tumor stage - tumor markers). Methods: The study included 112 individuals admitted to Tishreen Univer
sity Hospital and the Oncology Center in Latakia during the period between July 2018 and December 2019. They were distributed into two groups as follow: the group of gastric cancer patients included 56 patients (33 males and 23 females) between the ages of 37 and 83 years, and the control group included 56 individuals (34 males and 22 females) between the ages of 37 and 80 years. The stage of gastric cancer was evaluated based on the AJCC (American Joint Committee on Cancer) cancer staging system. Patients were interrogated, and social and behavioral information were obtained, then venous blood samples were obtained for biomedical evaluation. Statistical analysis was done using SPSS version 25 software. Results: Bilirubin and RDW were significantly associated with the prognostic factors of gastric cancer. RDW was positively associated with the tumor stage and tumor markers (CEA and CA19-9). Total bilirubin (TBIL) and indirect bilirubin (IBIL) were negatively associated with these factors, while direct bilirubin (DBIL) showed no significant association. Patients with gastric cancer had higher RDW than healthy controls, while total bilirubin (TBIL) and indirect bilirubin (IBIL) were significantly decreased. The results of our study indicate that both RDW and bilirubin could be potential prognostic factor for gastric cancer.
This study included 502 children between 0,5-15 years old. They were all subjected to duodenal biobsy for several reasons, and underwent investigations; Hb, MCV, MCH, MCHC and RDW.
The prevalence of celiac disease among anemic children was higher
than nonanemic patients (36,04% vs 12,14%). The mean duration of compliance was higher in both anemic children and celiac patients than in comparing groups .The mean levels of Hb,MCV,MCH and MCHC were lower in celiac group, while RDW was higher. Anemia was the most common presentation of celiac disease and it was seen in 77% among celiac children, while failure to thrive was detected in 43% of celiac group. Clinicians should consider celiac disease as a possible cause of anemia in all subjects with unexplained or refractory anemia
It was used in this study (15) of the female mice . They were divided into three
groups : control , and two experimental groups (five mice in each group) .The control
group was given distilled water, while the first experimental group was received
only
Paraben daily ( 250 mg / kg of body weight). As the second experimental group was
received daily together of Paraben and aqueous ginger extract ( 250 mg / kg of paraben and
250 mg / aqueous ginger extract ) for (18 ) day .
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