1/5. infection and inflammation in dialysis patients: impact on laboratory parameters and anemia. Case study of the anemic patient.infection and inflammation trigger an acute-phase response that can precipitate the development of mild to moderate anemia. In many cases, changes in hematological parameters may be the initial sign of an occult infectious or inflammatory disorder. In dialysis patients, the decrease in erythropoiesis attributed to these conditions is often additive--aggravating the preexisting anemia associated with end-stage renal disease (ESRD). nephrology nurses are in a unique position to conduct regular physical assessments and laboratory evaluations to proactively detect infection or inflammation and limit the short- and long-term impact of these conditions.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/5. Ret-Y a measure of reticulocyte size: a sensitive indicator of iron deficiency anemia.In this study the size of reticulocytes was measured, reticulocyte-Y (Ret-Y), to distinguish iron deficiency anemia from the anemia of chronic disease using a Sysmex XE2100 cell counter. We evaluated this parameter prospectively in 100 patients seen for the evaluation of anemia. A clinical diagnosis of iron deficiency anemia or anemia of chronic disease was made on the basis of a complete blood count, examination of the peripheral smear, and serum ferritin along with a history and physical examination. We analyzed the sensitivity and specificity of the Ret-Y in relationship to the clinical diagnosis. We also measured serum transferrin receptor levels to use as the gold standard laboratory test for iron deficiency against which we compared the Ret-Y. In 40 normal individuals with normal serum ferritin and transferrin receptor levels the mean Ret-Y was 1874 /- 178 (1 SD). The mean Ret-Y in the anemia of chronic disease group (n=62) was 1722 /- 162, not significantly different from normal. The mean Ret-Y value among iron-deficient patients (n=38), was 1407 /- 136 (P <0.01 vs. the anemia of chronic disease group's Ret-Y value). Receiver operator curves showed that Ret-Y correlated closely to the serum transferrin receptor and was superior to the mean corpuscular volume, and ferritin level, in differentiating the type of anemia. The Ret-Y parameter has the highest overall sensitivity and specificity of the panel of tests routinely used in differentiating iron deficiency anemia from anemia of chronic disease.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/5. eating disorders and celiac disease: a case report.OBJECTIVE: Although chronic physical illness may be associated coincidentally with an eating disorder, some clinicians may overlook the possibility that another medical illness may coexist and contribute concurrently to symptoms such as peculiar eating behaviors, restrictive eating, and/or vomiting accompanied by body dissatisfaction. We present a 31-year-old single woman initially diagnosed with an atypical eating disorder. METHOD: After a gastroenterology consultation prompted by the atypical characteristics of her eating disturbance, the diagnosis of celiac disease was established. RESULTS: Cause-and-effect relationships between anorexia nervosa and celiac disease are unclear, and celiac disease may lead to confusion in the differential diagnosis of anorexia nervosa. CONCLUSION: Particularly in atypical cases, and in cases where nausea and bloating are prominent complaints, workup for celiac sprue may reveal the presence of this condition. In such instances, patients may achieve additional relief through the implementation of gluten-free diets.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/5. A case of profound iron deficiency anemia owing to corrosive esophagitis in a 20-year-old developmentally delayed male.The level of severe compensated iron deficiency anemia incompatible with life is not defined in the pediatric or adolescent literature. A hemoglobin of 1.5 gm/dl in an older adolescent with few physical symptoms is distinctly unusual. A case of profound iron deficiency anemia in a 20-year-old developmentally delayed male is the subject of this brief report. There were only subtle physical findings in spite of this severe anemia. The anemia was the result of corrosive esophagitis associated with a hiatal hernia and reflux. physicians dealing with developmentally delayed adolescents should be aware of the fact that a severe anemia may develop, and such individuals should be periodically screened for anemia, melena, hematochezia, and hematemesis.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
5/5. Blue rubber bleb nevus syndrome.A 26-yr-old man was admitted with malaise and melena. During the physical examination, six hemangiomas were spotted on the skin, and laboratory evaluations proved the existence of severe iron deficiency anemia (Hb 2.9 g/dl). Upper endoscopy and small bowel follow-through revealed no pathology. colonoscopy documented the presence of a blue-red cavernous hemangioma, 1 cm in diameter, at the splenic flexura. The skin and colonic lesions were typical; thus, blue-rubber-bleb-nevus syndrome was diagnosed. The patient was given blood transfusions followed by oral iron supplementation. He refused further evaluation or surgery and is still fine after a follow-up period of 6 months. Here, we present a discussion of this case, together with a detailed review of the literature.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |