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1.
Elderly men with clinical and laboratory evidence of androgen deficiency are eligible for testosterone treatment.
With proper monitoring this is acceptably safe.
In the first year of testosterone treatment there should be a digital rectal examination of the prostate and measurement of prostate specific antigen every three months, thereafter yearly.
The rate of increase of prostate specific antigen (PSA) levels is more significant than its absolute values.
Levels of haemoglobin and the haematocrit should be monitored. 相似文献
2.
J. Thiele T. K. Zirbes J. Lorenzen H. M. Kvasnicka S. Scholz A. Erdmann U. Flucke V. Diehl R. Fischer 《Annals of hematology》1997,75(1-2):33-39
In order to determine the dynamics of hematopoietic cell turnover, proliferative activity and incidence of apoptosis (programmed
cell death) were evaluated in bone marrow trephine biopsies. Selection of patients (20 in each group) included in addition
to a control group, idiopathic thrombocytopenia (ITP), reactive thrombocytosis (TH), secondary polycythemia-smokers' polyglobuly
(PG), primary (essential-hemorrhagic) thrombocythemia (PTH), polycythemia vera (PV), and finally acute myeloid leukemia (AML).
Apoptosis was demonstrated by the in situ end-labeling technique (ISEL) and proliferative activity by applying the monoclonal
antibody PC10 raised against proliferating cell nuclear antigen (PCNA). To assess dynamic features of hematopoiesis, an index
was calculated consisting of the ratio between PCNA-positive nuclei and the apoptotic cell fraction. This factor was termed
the hematopoietic turnover index (HTI). Morphometric analysis revealed that the HTI was significantly increased in AML and
PV. According to cell culture studies both disorders are characterized by either a prevalent proliferation of the myeloid
or erythroid cell mass. On the other hand, PG, PTH, and TH showed no relevant enhancement of this index in comparison to the
control specimen. In vitro experiment results are in keeping with the finding that PG and PTH are not associated with a significant
expansion of the erythroid lineage (CFU-E). Similar to ITP and TH, in PTH megakaryocyte proliferation (CFU-MEG) is the predominant
feature of cell turnover. Differences between PTH and TH are in line with the reduced in vitro formation of CFU-MEG in the
latter disorder. In conclusion, our in situ study on turnover rates of the bone marrow in various neoplastic and reactive
lesions extends previous experimental data on hematopoietic cell kinetics.
Received: 10 March 1997 / Accepted: 18 May 1997 相似文献
3.
Seishi Inoue Tadayasu Shono Mieko Shono Masayuki Azuma Toshiaki Hirabayashi Oshi Inagaki Hidetaro Mori Yoshikazu Fujita 《Journal of bone and mineral metabolism》1990,8(3):19-23
A case of polycythemia vera complicated by chronic renal failure under maintenance hemodialysis requiring parathyroidectory
(PTH) for secondary hyperparathyroidism (2° HPT) is reported.
A 62 year old female presented with 75000 white blood cells (WBC)/μl, 703×104 red blood cells (RBC)/μl, 23×104 platelets (PLT)/μl, hyperuricemia and hypertension in 1970 and the diagnosis of polycythemia vera was made. Hemodialysis
was started in October 1974 for chronic renal failure. Blood cells in peripheral blood rapidly decreased in number after the
beginning of dialysis, reaching the level of 10000∼20000 WBC/μl, and 150∼250×104RBC/μl. In August 1988, marked bone resorption in X-ray picture and high serum alkaline phosphatase and parathyroid hormone
(PTH) noted along with 17400 WBC/μl, 370×104RBC/μl and 35.9×104PLT/μl.
After subtotal PTX removing 3.21g parathyroid gland, serum PTH rapidly fell. At 3 months after PTX, WBC rose to 23600/μl,
RBC 372×104/μl and PLT 94.0×104/μl. At 6 months, WBC was to 31000/μl, RBC 429×104/μl and PLT 78.0×104/μl, suggesting an inhibitory action of PTH on not only RBC, but also WBC and PLT. 相似文献
4.
Fenella J. Kirkham Dimitrios Zafeiriou David Howe Philippa Czarpran Ashley Harris Roxanna Gunny Brigitte Vollmer 《European journal of paediatric neurology》2018,22(6):989-1005
Fetal stroke is an important cause of cerebral palsy but is difficult to diagnose unless imaging is undertaken in pregnancies at risk because of known maternal or fetal disorders. Fetal ultrasound or magnetic resonance imaging may show haemorrhage or ischaemic lesions including multicystic encephalomalacia and focal porencephaly. Serial imaging has shown the development of malformations including schizencephaly and polymicrogyra after ischaemic and haemorrhagic stroke. Recognised causes of haemorrhagic fetal stroke include alloimmune and autoimmune thrombocytopaenia, maternal and fetal clotting disorders and trauma but these are relatively rare. It is likely that a significant proportion of periventricular and intraventricular haemorrhages are of venous origin. Recent evidence highlights the importance of arterial endothelial dysfunction, rather than thrombocytopaenia, in the intraparenchymal haemorrhage of alloimmune thrombocytopaenia. In the context of placental anastomoses, monochorionic diamniotic twins are at risk of twin twin transfusion syndrome (TTTS), or partial forms including Twin Oligohydramnios Polyhydramnios Sequence (TOPS), differences in estimated weight (selective Intrauterine growth Retardation; sIUGR), or in fetal haemoglobin (Twin Anaemia Polycythaemia Sequence; TAPS). There is a very wide range of ischaemic and haemorrhagic injury in a focal as well as a global distribution. Acute twin twin transfusion may account for intraventricular haemorrhage in recipients and periventricular leukomalacia in donors but there are additional risk factors for focal embolism and cerebrovascular disease. The recipient has circulatory overload, with effects on systemic and pulmonary circulations which probably lead to systemic and pulmonary hypertension and even right ventricular outflow tract obstruction as well as the polycythaemia which is a risk factor for thrombosis and vasculopathy. The donor is hypovolaemic and has a reticulocytosis in response to the anaemia while maternal hypertension and diabetes may influence stroke risk. Understanding of the mechanisms, including the role of vasculopathy, in well studied conditions such as alloimmune thrombocytopaenia and monochorionic diamniotic twinning may lead to reduction of the burden of antenatally sustained cerebral palsy. 相似文献
5.
6.
Hydroxyurea is a chemotherapeutic agent used for myeloproliferative disorders and sickle cell anemia that is well known to cause painful mucocutaneous ulcers, typically involving the legs or mouth. However, genital ulcerations due to hydroxyurea therapy are a rare, and likely underrecognized, adverse effect with only a few cases reported in the literature to date. Ulcers of the lower legs caused by hydroxyurea are associated with a diagnostic delay, and this is likely exacerbated in cases of genital ulceration due to a lack of awareness. Herein we present two cases of painful genital ulceration in patients on hydroxyurea therapy. In the first Case, an 87 year-old male with polycythemia vera developed an ulcer on the scrotum, which was assessed initially through virtual visits during the COVID-19 pandemic, and was refractory to topical and oral antibiotic treatments. The second case was a 79 year-old male with essential thrombocythemia and a history of persistent leg ulcers who developed erosions of the glans penis. Both patients experienced complete resolution within weeks of discontinuing hydroxyurea therapy. In conclusion, genital ulcers and erosions induced by hydroxyrea may be underrecognized in clinical practice, but if identified, withdrawal of hydroxyurea leads to quick resolution of these lesions and the associated pain. 相似文献
7.
《Hemoglobin》2013,37(2):91-106
This review brings some new insights on erythrocytosis of genetic origin related to problems of oxygen delivery by hemoglobin (Hb). A few molecular mechanisms are individualized among the about 100 Hb variants that cause compensatory erythrocytosis. The most frequently observed structural modifications are localized in the α1β2 interface, or at the C-terminal. They impair formation of a stable T state. Others mutations modify directly or indirectly the surrounding of the heme and the site where oxygen binds. A special interest is brought to the dose effect considering the possibility for formation of hybrid tetramers with altered oxygen binding properties. Homozygous cases, and patients who are compound heterozygotes for a high oxygen affinity Hb and a thalassemia (thal), are discussed. Several examples are provided, specially documented for Hb Olympia [β20(B2)Val→Met] and Hb Saint Nazaire [β103(G5)Phe→Ile]. Other mechanisms leading to erythrocytosis are discussed, and finally, an algorithm is proposed for etiological diagnosis. 相似文献
8.
9.
10.
Colleen Glyde Julian Enrique Vargas Marcelino Gonzales R. Daniela Dávila Anne Ladenburger Lindsay Reardon Caroline Schoo Robert W. Powers Teofilo Lee-Chiong Lorna G. Moore 《Respiratory physiology & neurobiology》2013,186(2):188-196
Chronic mountain sickness (CMS) is considered to be a loss of ventilatory acclimatization to high altitude (>2500 m) resulting in marked arterial hypoxemia and polycythemia. This case–control study explores the possibility that sleep-disordered breathing (SDB) and associated oxidative stress contribute to the etiology of CMS. Nocturnal respiratory and SaO2 patterns were measured using standard polysomnography techniques and compared between male high-altitude residents (aged 18–25) with preclinical CMS (excessive erythrocytosis (EE), n = 20) and controls (n = 19). Measures of oxidative stress and antioxidant status included isoprostanes (8-iso-PGF2alpha), superoxide dismutase and ascorbic acid. EE cases had a greater apnea–hypopnea index, a higher frequency of apneas (central and obstructive) and hypopneas during REM sleep, and lower nocturnal SaO2 compared to controls. 8-iso-PGF2alpha was greater in EE than controls, negatively associated with nocturnal SaO2, and positively associated with hemoglobin concentration. Mild sleep-disordered breathing and oxidative stress are evident in preclinical CMS, suggesting that the resolution of nocturnal hypoxemia or antioxidant treatment may prevent disease progression. 相似文献