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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.

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Magyar Sebészet
Authors: Hicham El-Meouch, Imre Nagy, Laura Simsay, Gábor Váradi, Magdolna Lőrincz, Nikoletta Hajszán, György Demján, and Károly Szentléleki

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A szerzők egy 78 éves nőbeteg esetét ismertetik, aki kórházuk kardiológiai osztályára került felvételre pacemaker-beültetés elbírálásának céljából. Kivizsgálása során észlelt anaemia, illetve melena miatt végzett gastrocopos vizsgálat (felső panendoscopia) nagy duodenalis diverticulumot igazolt. A vizsgálat után acut has képe alakult ki, az elvégzett vizsgálatok a diverticulum perforatióját mutatták. Sürgős műtétet végeztek, a diverticulumot resecálták, ezt követően a beteg gyógyultan távozott. A szerzők tárgyalják a diverticulum ritka lokalizációját, a preoperatív diagnózis nehézségeit, a sikeres felismerést és kezelést, valamint az irodalmi adatokat.

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Orvosi Hetilap
Authors: Béla Telek, Péter Batár, László Váróczy, Lajos Gergely, László Rejtő, Róbert Szász, Zsófia Miltényi, Zsófia Simon, Miklós Udvardy, and Árpád Illés

A Waldenström-macroglobulinaemia ritka, indolens lefolyású B-sejt-eredetű lymphoproliferativ kórkép. A tumorsejtek monoklonális IgM proteint termelnek, a diagnózis a monoklonális IgM és a csontvelőt infiltráló lymphoid és lymphoplasmacytoid sejtek kimutatásán alapul. A klinikai tünetek (hyperviscositas, neuropathia, anaemia stb.) a monoklonális IgM és a csontvelői (ritkábban extramedulláris) érintettség következményei. A korábbi alkilálószereken alapuló terápiát a purinanalógok, a rituximab, a bortezomib alkalmazása, illetve ezek kombinációi váltották fel. Bővülnek a tapasztalatok az autológ és az allogén őssejt-transzplantációval is. A szerzők saját tapasztalataik mellett áttekintik a betegséggel kapcsolatos ismereteket és a jelenlegi terápiás lehetőségeket. Orv. Hetil., 2013, 154(50), 1970–1974.

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. Balkan Med J. 2016; 33: 112–114. 12 McAdams RM, Chabra S. Umbilical cord haematoma and adrenal haemorrhage in a macrosomic neonate with anaemia. BMJ Case Rep. 2016; 2016: bcr

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Acta Veterinaria Hungarica
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

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Orvosi Hetilap
Authors: Dániel Horányi, Andrea Várkonyi, Gyula Richárd Nagy, Imre Bodó, and Tamás Masszi

Tichelli, A., Socié, G., Marsh, J., et al.: Outcome of pregnancy and disease course among women with aplastic anemia treated with immunosuppression. Ann. Intern. Med., 2002, 137 (3), 164

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Introduction: 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. Objectives: 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? Methods: 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 ( n = 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. Results: 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 ( n = 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. Conclusions: 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.

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iron homeostasis [ 6, 7 ]. The expression of the key iron regulatory hormone hepcidin is regulated by iron availability, inflammation, hormones, hypoxia, and anaemia. Hepcidin shows antimicrobial activity in human hepatic cells in case of iron overload

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Orvosi Hetilap
Authors: Péter Attila Király, Krisztián Kállay, Dóra Marosvári, Gábor Benyó, Anita Szőke, Judit Csomor, and Csaba Bödör

mutations. Br. J. Haematol., 2013, 161 (5), 701–705. 33 Kee, Y., D’Andrea, A. D.: Molecular pathogenesis and clinical management of Fanconi anemia. J. Clin. Invest

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Park, C. Y., Kim, H. J., Kim, Y. J., Park, Y. H., Lee, J. W., Min, W. S., Kim, C. C.: Very severe aplastic anemia appearing after thymectomy. Korean J Intern Med 18 , 61-63 (2003). Very

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