The prevalence of hepatitis C virus infection among patients on hemodialysis is about ten times higher than in the normal population. The infection can induce chronic glomerulonephritis, as an extrahepatic manifestation, which can lead to end-stage renal disease. However, in the majority of patients hepatitis C virus is acquired as a nosocomial infection during hemodialysis. Most of the infected patients have usually normal liver enzymes and need regular screening for hepatitis C antibody to detect the infection. Despite the normal liver enzymes, the liver disease may progress to cirrhosis. Some of the patients are on the renal transplantation waiting list. The immunosuppressive treatment after renal transplantation results in a significantly increased viral replication which might induce further progression of the liver disease. Interferon treatment given after transplantation can induce rejection and graft failure. Therefore the antiviral treatment should be administered during or before the hemodialysis period. Only limited data are available about the treatment of patients with impaired renal function. Alfa-interferon was used mostly in these patients. Due to its impaired renal clearance and higher serum concentration interferon seems to be more effective, but less tolerable in patients with end-stage renal disease than in other groups of patients. Ribavirin is also excreted exclusively by the kidney with anemia being even more pronounced in these patients, and as such is contraindicated in patients on hemodialysis. The pharmacokinetics of the pegylated interferon alfa-2a is very advantageous for patients with end-stage renal disease. The safety and efficacy of peginterferon alfa-2a is now being confirmed in many publications.
Authors:Khadiga G. Adham, Manal H. Farhood, Maha H. Daghestani, Nadia A. Aleisa, Ahlam A. Alkhalifa, Maha H. El Amin, Promy Virk, Mai A. Al-Obeid, and Eman M. H. Al-Humaidhi
One of the common causes of iron overload is excessive iron intake in cases of iron-poor anemia, where iron saccharate complex (ISC) is routinely used to optimize erythropoiesis. However, non-standardized ISC administration could entail the risk of iron overload. To induce iron overload, Wistar rats were intraperitoneally injected with subacute (0.2 mg kg−1) and subchronic (0.1 mg kg−1) overdoses of ISC for 2 and 4 weeks, respectively. Iron status was displayed by an increase in transferrin saturation (up to 332%) and serum and liver iron burden (up to 19.3 μmol L−1 and 13.2 μmol g−1 wet tissue, respectively) together with a drop in total and unsaturated iron binding capacities “TIBC, UIBC” as surrogate markers of transferrin activity. Iron-induced leukocytosis (up to 140%), along with the decline in serum transferrin markers (up to 43%), respectively, mark positive and negative acute phase reactions. Chemical stress was demonstrated by a significant rise (p > 0.05) in indices of the hemogram (erythrocytes, hemoglobin, hematocrit, leukocytes) and stress metabolites [corticosterone (CORT) and lactate]. Yet, potential causes of the unexpected decline in serum activities of ALT, AST and LDH (p > 0.05) might include decreased hepatocellular enzyme production and/or inhibition or reduction of the enzyme activities. The current findings highlight the toxic role of elevated serum and liver iron in initiating erythropoiesis and acute phase reactions, modifying iron status and animal organ function, changing energy metabolism and bringing about accelerated glycolysis and impaired lactate clearance supposedly by decreasing anaerobic threshold and causing premature entering to the anaerobic system.
Authors:Fumina Sasaoka, Jin Suzuki, Toh-Ichi Hirata, Toshihiro Ichijo, Kazuhisa Furuhama, Ryô Harasawa, and Hiroshi Satoh
. , Griot , C. , Stark , K. D. C. , Willi , B. , Schmidt , J. , Kocan , K. M. and Lutz , H. ( 2004 ): Concurrent infections with vector-borne pathogens associated with fetal hemolytic anemia in a cattle herd in Switzerland . J. Clin. Microbiol
Sulkowski, M. S., Poordad, F., Manns, M. P., et al.: Anemia during treatment with peginterferon alfa-2b/ribavirin with or without boceprevir is associated with higher SVR rates: analysis of previously untreated and previous treatment – failure patients. J
Authors:B. Panwar, I. Kádár, B. Bíró, K. Rajkai-Végh, P. Ragályi, M. Rékási, and L. Márton
Phytoremediation is an approach designed to extract excessive heavy metals from contaminated soils through plant uptake. Cadmium (Cd) is among the elements most toxic to living organisms. Health hazards associated with the lethal intake of Cd include renal (kidney) damage, anaemia, hypertension and liver damage. A greenhouse experiment was carried out with Indian mustard (Brassica juncea) grown on artificially spiked soil (100 μg Cd g−1) with EDTA (2 mmol kg−1 in 5 split doses), FYM, vermicompost (VC) and microbial inoculants (MI) such as Azotobacter sp. and Pseudomonas sp. The growth of Brassica juncea L. was better in soil amended with FYM or VC as compared to unamended Cd-polluted soil. Growth was slightly suppressed in EDTA-treated soil, whereas it was better after treatment with MI. The application of FYM and VC increased the dry matter yield of Indian mustard either alone or in combination with microbial inoculants, while that of EDTA caused a significant decrease in the biomass of Indian mustard. The application of microbial inoculants increased the dry matter yield of both the roots and shoots, but not significantly, because MI shows greater sensitivity towards cadmium. The maximum cadmium concentration was observed in the EDTA +MI treatment, but Cd uptake was maximum in the VC + MI treatment. The Cd concentration in the shoots increased by 120% in CdEDTA over the Cd100 treatment, followed by CdVC (65%) and CdFYM (42%) in the absence of microbial inoculants. The corresponding values in the presence of MI were 107, 51 and 37%, respectively. A similar trend was also observed in the roots in the order CdEDTA+M > CdVC+M > CdFYM+M>Cd100+M.MI caused an increase in Cd content of 5.5% in the roots and 4.1% in the shoots in the CdEDTA+M treatment compared with the CdEDTA treatment. FYM, VC and EDTA also increased Cd uptake significantly both in the shoots and roots with and without microbial inoculants.The results indicated that Vermicompost in combination with microbial inoculants is the best treatment for the phytoremediation of Cd-contaminated soil by Indian mustard, as revealed by the Cd uptake values in the shoots: CdVC+M (2265.7 μg/pot) followed by CdEDTA+M (2251.2 μg/pot), CdFYM+M (1485.7 μg/pot) and Cd100+M (993.1 μg/pot).
Authors:Géza Bozóky, Éva Ruby, Ilona Góhér, Andrea Mohos, Csilla Bálint, and István Bozóky
An increased disposition to thrombosis demonstrated by laboratory methods in patients with solid malignancies develops due to the activating effect of tumour cells on the haemostatic system. The development of this activating effect results from interactions between tumour cells and various components of the coagulation system (coagulation factors, platelets, endothelial cells, and fibrinolytic system) which leads from a prothrombotic state to the clinically overt disorders of the haemostatic system.
In a retrospective analysis, the authors sought for an answer to the following question: What is the type and frequency of haemostatic disorders that occurred in a large population of patients with solid malignancies?
Between 1996 and 2004, solid malignancies have been diagnosed in 1381 patients by histological and/or cytological examinations. Most of the patients had primary bronchopulmonary carcinoma (
= 1140). In the other patients the malignancies were of mammary, colorectal, renal, vesical, thyroidal, and pancreatic localisation; mesothelioma was diagnosed in six patients. Based on the staging examinations, the majority of patients were in an advanced clinical stage. Type and frequency of haemostatic disorders occurring in patients with solid malignancies were studied, with special regard to the occurrence of venous thromboembolism. Particular attention was given to the role of non-malignant co-morbidity in the development of haemostatic disorders.
Clinically overt haemostatic disorders were observed in 397 (28.7%) of the 1381 patients with malignancies. Deep vein thrombosis and acute pulmonary embolism were the most frequent ones (
= 305; 22%). Migrating superficial thrombophlebitis, septic thrombosis, acute diffuse intravascular coagulation, and microangiopathic haemolytic anaemia occurred in 71 patients (6.7%). In 40% of patients with malignant diseases and associated haemostatic disorders, non-malignant co-morbidity has been observed with the dominance of various cardiac diseases as well as chronic obstructive pulmonary disease. In addition to the systemic causes leading to an increased disposition to thrombosis, the significantly increased local-regional tumour mass also contributed to the development of venous circulation disorder.
Active cancer is often associated with a hypercoagulable state, which perturbs the haemostatic balance between anticoagulant and procoagulant forces, creating a prothrombotic state. The interaction between tumour cells and host cells involves a direct cell-to-cell interaction or an indirect mechanism by cytokine release. The hypercoagulable state in patients with a malignant disease may result in the occurrence of various clinically identifiable haemostatic system disorders: the most frequent one is venous thromboembolism (so-called secondary thrombosis). In cases of idiopathic venous thromboembolism, targeted examinations are warranted in order to prove or to preclude asymptomatic malignant diseases.