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Your search term(s) "Thrombocytosis or thrombosis" returned 95 results.

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Treatment of the 5q-Syndrome. Washington, DC: American Society of Hematology. 2006. pp. 192-198.

This article reviews treatment of the 5q- syndrome, a specific type of myelodysplastic syndrome (MDS) that presents with particular characteristics, including severe anemia, frequent thrombocytosis, typical dysmegakaryopoiesis, and favorable outcome. The pathogenesis of the 5q- syndrome remains uncertain, in particular the role of inactivation of gene(s) situated in 5q. The authors note that, until the advent of lenalidomide, repeated red blood cell (RBC) transfusions were generally the only treatment of the 5q- syndrome, which was resistant to other therapeutic approaches. Lenalidomide can lead to RBC transfusion independence in at least two-thirds of cases of the 5q- syndrome, with two-thirds of those responses persisting after 2 years of treatment. Not only reversal of anemia but also frequent complete pathological and cytogenetic responses are obtained. The authors caution that Grade 3 or 4 neutropenia and thrombocytopenia, especially during the first 6 to 8 weeks of treatment, are the major side effect of lenalidomide, so patients should have close monitoring of blood counts and regular physician visits. 3 tables. 39 references.

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Vascular Access for the Patient Receiving Parenteral Nutrition. IN: Buchman, A., ed. Clinical Nutrition in Gastrointestinal Disease. Thorofare, NJ: Slack Incorporated. 2006. pp 409-416.

This chapter about vascular access for parenteral nutrition (PN) is from a comprehensive textbook that compiles available data, clinical experience, and research on the role of nutrition in the management of patients with disorders that affect the gastrointestinal (GI) tract. The authors note that the effective administration of PN, whether given to the patient in the hospital or at home, depends on obtaining and maintaining safe, prolonged vascular access. Complications associated with vascular access device insertion and maintenance can be serious or even life threatening. The chapter covers device selection, the use of peripheral catheters, central venous catheters, different devices for hospital and home use, the morbidity of central venous catheters, complications of central line insertion, catheter infections, catheter occlusion, catheter-associated thrombosis, and the role of the interventional radiologist in difficult vascular access situations. The authors conclude that obtaining and maintaining safe vascular access requires the cooperative expertise of interventional radiologists, surgeons, nurses, and experienced physicians; the involvement of these team members can minimize complications associated with vascular access insertion. 2 figures. 2 tables. 56 references.

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Vascular Diseases Involving the Liver. IN: Lichtenstein, G.; Reddy, K.R.; Faust, T., eds. Clinician’s Guide to Liver Disease. Thorofare, NJ: Slack Incorporated. 2006. pp 161-186.

This chapter about vascular diseases involving the liver is from a user-friendly reference book that provides gastroenterologists with an overview of the management of acute and chronic liver disease. The authors outline the physiology and anatomy of the hepatic circulation, noting that clinical characteristics of the vascular diseases of the liver are largely dependent on five factors: the nature of the pathologic process, that is, partial or complete obstruction; the extent of segmental versus diffuse hepatic involvement; the rate of evolution of the pathology; the amount of the accompanying liver parenchymal necrosis; and specific vascular involvement. The chapter discusses specific vascular disease, including Budd-Chiari syndrome (BCS), veno-occlusive disease (VOD), the liver in heart disease, portal vein thrombosis (PVT), and peliosis hepatis. For each condition, the authors discuss pathophysiology, clinical presentation, diagnostic tests, patient care management, and prognosis. The chapter includes tables and two patient care algorithms and concludes with a list of references. 5 figures. 9 tables. 119 references.

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Anticoagulation in Patients on Hemodialysis. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 127-152.

This chapter on anticoagulation in patients on hemodialysis is from a textbook on the clinical management of dialysis patients. The author notes that, despite continuing advances, the goal of finding a satisfactory method for preventing clotting in hemodialysis circuits remains elusive. The relative risks of bleeding and thrombosis tend to be different for acute and chronic dialysis situations but have to be assessed for each individual patient. The choice of an anticoagulation prescription for hemodialysis must be based also on several other considerations, including knowledge of hemostatic mechanisms and their status in uremic patients, the pharmacology and practical aspects of each of the available methods, and the empiric results that have been achieved with respect to effectiveness and complications. The author discusses the coagulation status of patients with renal failure, the mechanisms of thrombosis in hemodialysis circuits, approaches to maintaining the patency of hemodialysis circuits, the pharmacology of heparin, the use of heparin for intermittent hemodialysis, nonheparin methods of anticoagulation and their use for intermittent hemodialysis, and anticoagulation for continuous renal replacement therapy (CRRT). 1 figure. 4 tables. 312 references.

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Diagnostic Imaging in Kidney Transplantation. IN: Danovitch, G.M. Handbook of Kidney Transplantation. Philadelphia, PA: Lippincott Williams and Wilkins. 2005. pp. 347-368.

The clinician evaluating a patient with renal transplant dysfunction has the choice of a variety of imaging procedures, including ultrasound (US), nuclear medicine (NM) or molecular imaging, computed tomography (CT), magnetic resonance imaging (MRI), and excretory urography. This chapter on diagnostic imaging in kidney transplantation is from a handbook that offers a practical guide for health care providers who manage kidney transplant patients. In this chapter, the authors focus on the use of US and NM techniques in kidney transplantation. They also note that CT, MRI, and urography may, on occasion, be the optimal imaging modalities for certain clinical problems encountered in renal transplant recipients. Specific topics include the radiologic evaluation of the living donor; radiologic techniques in the early posttransplant period (up to 3 months), including that for hematomas, urinomas, lymphoceles, abscesses, and acute rejection; nuclear medicine imaging of graft function and dysfunction; posttransplantation vascular complications, including arterial thrombosis, infarction, renal vein thrombosis, chronic rejection, renal artery stenosis, arteriovenous fistulas, and pseudoaneurysms; and measurement of glomerular filtration rate. 13 figures. 1 table. 13 references.

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Hematologic Complications of Transplantation. In: Medical Management of Kidney Transplantation. Philadelphia, PA: Lippincott Williams and Wilkins. 2005. pp. 305-323.

The current success of kidney transplantation is largely due to advances in the manipulation of the immune component of the hematologic system and surgical techniques. This chapter on the hematologic complications of transplantation is from a textbook that provides a compendium of the latest advances and understandings regarding the complex medical problems seen in kidney transplant patients. The authors of this chapter summarize the hematologic changes after transplantation but focus on disorders of erythropoiesis and thrombosis due to increasing evidence of their importance on determining outcomes in transplant patients. Other topics include the diagnosis and treatment of posttransplant anemia; disorders of white blood cells in transplantation, including leukocytosis and leukopenia; hypercoagulable disorders in transplantation; and thrombotic microangiopathies following transplantation. 3 figures. 6 tables. 201 references.

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How to Interpret and Pursue an Abnormal Complete Blood Cell Count in Adults. Mayo Clinic Proceedings. 80(7): 923-936. July 2005.

A complete blood cell count (CBC) is one of the most common laboratory tests in medicine. This article provides practical diagnostic algorithms that address frequently encountered conditions associated with CBC abnormalities. These conditions include anemia (decreased hemoglobin, the oxygen-carrying compound of the blood), thrombocytopenia (decreased platelets in the blood), leukopenia (decreased white blood cells), polycythemia (increased erythrocytes, which are the red blood cells), thrombocytosis (increased platelets in the blood), and leukocytosis (increased white blood cells). The objective is to help the nonhematologist recognize when a subspecialty consultation is reasonable and when it may be foregone, thus allowing a cost-effective and intellectually rewarding practice. The authors conclude that, in general, it is prudent to perform a PBS (peripheral blood smear) in most instances of abnormal CBC, along with basic tests that are dictated by the type of CBC abnormalities encountered. The latter may include, for example, serum ferritin in patients with microcytic anemia or lymphocyte immunophenotyping by flow cytometry in patients with lymphocytosis. However, a prompt hematology consultation is encouraged in patients with severe cytopenia, pancytopenia, or extreme cytosis of any type or when a PBS report suggests thrombotic thrombocytopenic purpura (TTP) or acute leukemia. 6 figures. 4 tables. 114 references.

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Kidney and Pancreas Transplantation in Diabetic Patients. IN: Danovitch, G.M. Handbook of Kidney Transplantation. Philadelphia, PA: Lippincott Williams and Wilkins. 2005. pp. 390-413.

Diabetes mellitus is the leading cause of end-stage renal disease (ESRD) and one of the primary diseases that most commonly leads to kidney transplantation. This chapter on kidney and pancreas transplantation in patients with diabetes is from a handbook that offers a practical guide for health care providers who manage kidney transplant patients. The authors focus on the management issues associated with kidney and pancreas transplantation in patients with diabetes and the pros and cons of the different forms of pancreas transplantation. The first section discusses kidney transplantation, including the preoperative assessment, patients with coronary artery disease, predialysis transplantation, insulin requirements, preoperative preparation, postoperative complications, graft dysfunction, and long-term complications, such as peripheral vascular disease, retinopathy, neuropathy, diabetic gastropathy, neurogenic bladder, blood pressure considerations, bone disease, recurrent diabetic nephropathy, and pregnancy. The second section describes kidney-pancreas dual transplantation, including surgical options, surgical techniques, complications (enzyme and urine leaks, graft pancreatitis, vascular thrombosis, intra-abdominal abscess, and complications specific to bladder-drained pancreas transplants), immunosuppressive therapy, the diagnosis of rejection, the effect of pancreas transplantation on secondary diabetes complications, and choice of procedure. An additional section covers the transplantation of pancreas islets, including the process of islet isolation and recipient selection. 5 figures. 3 tables. 15 references.

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Platelets and Thrombosis in Myeloproliferative Diseases. IN: Hematology 2005. Washington, DC: American Society of Hematology. 2005. pp. 409-415.

This article reviews the role of platelets and thrombosis in myeloproliferative diseases (MPD), which include chronic myeloid leukemia, polycythemia vera (PV), idiopathic myelofibrosis (IMF), and essential thrombocythemia (ET). The author covers thrombosis and hemorrhage, the pathogenesis of thrombosis, platelets and their contribution to thrombotic risk, platelet number, platelet receptors, platelet activation, platelet interaction with leukocytes and the endothelium, hematocrit, risk factors for thrombosis, and the prevention of thrombosis through the use of phlebotomy, aspirin, hydroxyurea, anagrelide, or interferon. The author cautions that the clinical course of the predominant MPDs is characterized by thrombotic and hemorrhagic events that significantly impact prognosis and quality of life. 1 figure. 2 tables. 40 references.

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POEMS Syndrome. IN: Hematology 2005. Washington, DC: American Society of Hematology. 2005. pp. 360-367.

This article describes POEMS syndrome, a condition defined by the presence of a peripheral neuropathy (P), a monoclonal plasma cell disorder (M), and other paraneoplastic features, the most common of which include organomegaly (O), endocrinopathy (E), skin changes (S), papilledema, edema, effusions, ascites, and thrombocytosis. Virtually all patients will have either sclerotic bone lesion(s) or co-existent Castleman’s disease. The author stresses that not all features of the disease are required to make the diagnosis, and early recognition is important to reduce morbidity. Clues to an early diagnosis include thrombocytosis and sclerotic bone lesions on plain skeletal radiographs. Treatments that may be effective in patients with CIDP and MGUS associated peripheral neuropathy, such as intravenous gammaglobulin and plasmapheresis, are not effective in patients with POEMS. Instead, the mainstays of therapy for patients with POEMS include irradiation, corticosteroids, and alkylator-based therapy, including high-dose chemotherapy with peripheral blood stem cell transplantation. Radiation therapy produces substantial improvement of the neuropathy in more than half of the patients who have a single lesion or who have multiple lesions in limited areas. 3 figures. 5 tables. 40 references.

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