Anemia

ABSTRACT: Only a small number of patients with celiac disease exhibit the textbook symptoms of malabsorptive diarrhea with steatorrhea, weight loss, and nutritional deficiencies. Others may present with a subclinical enteropathy, GI complaints without constitutional symptoms, persistent travelers' diarrhea, or extraintestinal manifestations alone. Be alert for suggestive signs, such as weight loss, skin lesions, oral aphthae, muscle atrophy, de-enamelization of the teeth, and vague GI symptoms, such as bloating. Helpful serologic tests include IgG and IgA antigliadin antibodies, enzyme tissue transglutaminase antibodies, antiendomysial antibodies, and total IgA. Typical endoscopic findings are mucosal atrophy, fissuring, and scalloping. In addition to a gluten-free diet, management encompasses repletion of vitamins and minerals, including iron, folate, calcium, and vitamin D; screening for thyroid disease and diabetes mellitus; bone densitometry and age-appropriate cancer screening; and pneumococcal vaccination.

ROCKVILLE, Md. -- The FDA has approved Zolinza (vorinostat) capsules as second-line therapy for cutaneous T-cell lymphoma that is refractory or recurrent.

FLINT, Mich. -- Moderate aerobic exercise three to five times a week may make adjuvant radiation for breast cancer more tolerable, found researchers here.

TAMPA, Fla. -- Patients with severe refractory anemia caused by myelodysplastic syndrome (MDS) with a 5q31 deletion could reduce or halt transfusion dependency after treatment with Revlimid (lenalidomide), reported investigators here.

OKLAHOMA CITY -- A strategy for transfusion-free liver transplantation, developed for Jehovah's Witness patients, reduced overall blood use when applied to all patients, researchers here reported.

BALTIMORE -- Mild anemia, long associated with fatigue and weakness, may be an independent risk factor for loss of so-called executive function in older patients, researchers reported.

BALTIMORE -- Mild anemia, long associated with fatigue and weakness, may be an independent risk factor for loss of so-called executive function in older patients, researchers reported.

A 44-year-old African American woman presented to the emergency department with constipation of 4 days' duration. She also complained of a sticking sensation in her throat over the past year and dysphagia to solids but not liquids. Over the past 2 years, she had an unintentional 40-lb weight loss, which she attributed to decreased appetite.

ATLANTA -- As the severe acute respiratory syndrome (SARS) epidemic moved round the world in 2002-03, clinicians tried a range of interventions against the coronavirus. Now it seems that they may have been futile, at best.

Hepatomegaly is detected during the routine physical examination of a healthy 40-year-old woman who is employed as a secretary. She has noticed some fullness in the right upper abdomen for many years, but it has not been accompanied by pain or GI symptoms.

Hepatomegaly is detected during the routine physical examination of a healthy 40-year-old woman. She has noticed some fullness in the right upper abdomen for many years, but it has not been accompanied by pain or GI symptoms.

A 44-year-old African American woman presented to the emergency department with constipation of 4 days' duration. She also complained of a sticking sensation in her throat over the past year and dysphagia to solids but not liquids. Over the past 2 years, she had an unintentional 40-lb weight loss, which she attributed to decreased appetite.

To what do you attribute symptoms of rash and fever in: a man with type 2 diabetes; a woman with systemic lupus erythematosus; a previously healthy girl.

Three case studies of patients with fever and rash challenge you to distinguish infectious from other causes and serious from non-threatening.

NANTES, France --The seventh trial of adjuvant Navelbine (vinorelbine)-Platinol (cisplatin) tips the balance toward improved survival in patients with stage IB to IIIA non-small-cell lung cancer (NSCLC).

BOSTON -- Serious side effects and the cost of chemotherapy for younger breast cancer patients are greater than previously estimated, researchers reported.

DALLAS -- For patients with cardiovascular disease, chronic kidney disease is often a fellow traveler, necessitating more sensitive diagnostic tools than serum creatinine alone.

ROCHESTER, Minn. -- An elevated inflammatory response in patients with atopic allergic diseases, especially allergic rhinitis, may predispose them to Parkinson's disease, suggested researchers here.

SAN FRANCISCO -- Even though anticoagulation for atrial fibrillation may boost the chance of an intracranial bleed slightly in older patients, the benefits of the therapy outweigh the risk of a hemorrhage, according to researchers here.

These hyperkeratotic, hemorrhagic, depressed ulcerations developed on the feet of a 45-year-old white man with a 4-year history of systemic lupus erythematosus (SLE).

BETHESDA, Md. -- A simple blood test for brain natriuretic peptide (BNP) has identified sickle cell patients with pulmonary hypertension, researchers here reported.

INDIANAPOLIS -- The FDA has approved Gemzar (gemcitabine) in combination with Paraplatin (carboplatin) for treatment of recurrent ovarian cancer, Eli Lilly announced today.

LEIDEN, The Netherlands -- Noninvasive Doppler ultrasonography is superior to traditional amniocentesis for detecting severe hemolytic fetal disease in Rh-alloimmunized pregnancies, according to an international study.

VALENCIA, Spain -- With a combination of pegylated interferon and Rebetol (ribavirin), liver transplant recipients with recurrent hepatitis C (HCV) infection respond as well as non-transplants patients, researchers here reported.

Abstract: Elderly persons with active tuberculosis may present with the classic features, such as cough, hemoptysis, and fever, but some patients present with less typical signs, such as hepatosplenomegaly, liver function abnormalities, and anemia. A high index of suspicion is required when a patient presents with cough or pneumonia unresponsive to conventional therapy. Acid-fast smear and mycobacterial culture of a sputum specimen are recommended for diagnosis. For an elderly patient who tests positive with purified protein derivative, 9 months of isoniazid prophylaxis is recommended. For patients who are intolerant of isoniazid or have been exposed to or infected by an isoniazid-resistant strain, rifampin single-agent preventive therapy may be an effective alternative. (J Respir Dis. 2006;27(7):307-315)

A 37-year-old man presents with new-onset fever and abdominal pain of several days' duration. What does the PA film show, and what further action would you take to arrive at a diagnosis?

ROCKVILLE, Md. - The FDA today granted accelerated approval to Sprycel (dasatinib) for adults with chronic myeloid leukemia who are intolerant to Gleevec (imatinib) or become resistant to it.

OAKLAND, Calif. ? Anemia, polycythemia, and chronic kidney disease are independent predictors of outcome for patients with heart failure, researchers here reported.

ATLANTA ? With a new class of drugs, researchers are on the trail of killer receptors on the surface of cancer cells.

A 22-year-old woman presents with fever and malaise of1 month’s duration. About 3 weeks earlier she went to theemergency department. Erythromycin was prescribed,and the patient was told to seek medical attention if hercondition did not improve. Since that time, her healthhas worsened, the fever has continued, and she has lostweight. She says she has had painful areas on her handsand feet but no rash.