Hematology
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To report the observations on various bleeding manifestations in children with immune thrombocytopenic purpura (ITP) having severe thrombocytopenia (platelet count (PC) < 20,000/microl) and to compare the differences in bleeding manifestations at levels of PC at < 10,000/microl compared with between 10,000 and 20,000/microl. ⋯ During episodes of severe thrombocytopenia, most children have clinically mild disease. When the PC is < 10,000/microl clinically mild disease is observed less often compared to episodes with PC 10,000-20,000/microl. Based on these observations, it can be recommended that during severe thrombocytopenia, particularly when the PC is between 10,000-20,22,000/microl, patients can be safely managed with watchful waiting without any specific therapeutic intervention.
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Antiphospholipid syndrome is an autoimmune disorder characterized by the association between antiphospholipid antibodies and venous or arterial thrombosis or obstetric complications. In spite of the recent progresses, many aspects of this disease remain unclear. In this review, we briefly focus on the most important advances in the pathophysiology, diagnosis and treatment of this condition.
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These studies were designed as two experiments. Experiment 1 was performed to validate the hypothesis that oxygen saturation of the venous blood may be a marker for vaso-occlusive crisis (VOC) in sickle cell patients undergoing hydroxyurea (HU) treatments. Experiment 2 was performed to test the hypothesis that an acute increase in the blood nitric oxide (NO) concentration by administering HU modulates the perception of pain in sickle cell subjects in VOC. ⋯ HU and O
2
treatment did not play important role on venous blood %O2
Hb and pain scores in SCD during VOC. A single oral dose of HU was associated with a significant increase in the venous concentration of nitric oxide metabolites (NOx), p<0.05. These findings suggest that the ratio %O2
Hb/RHb in venous blood and pain scores differentiate HU-untreated and HU-treated at steady state subjects from HU-treated subjects in VOC; however, the acute increase in venous NOx produced by administering HU to HU-treated subjects in VOC does not explain this difference. -
Extracellular proteolytic enzymes of the urokinase-type plasminogen activator (uPA) and metalloproteinase (MMP) family play a crucial role in the matrix degradation and tissue remodeling process characteristic of malignant disorders. The receptor for urokinase plasminogen activator (uPAR) serves to localize and intensify the action of UPA and is expressed on the surface of malignant cells. Although the biological significance of MMP-9 and soluble urokinase receptor in growth and progression of lymphoid neoplasm is understood, its clinical significance in acute myeloid leukemia (AML) has not been fully elucidated. ⋯ In AML survivors, MMP-9, cellular uPAR and suPAR were significantly lower as compared to non-survivors (P= 0.001 for all). In conclusion, MMP-9 and su PAR levels might be used as a marker for disease activity and may contribute to blast cell dissemination. MMP-9 and suPAR may be target molecules in the strategy of treatment of AML.