2.Effect of NaFeEDTA on hemoglobin level in iron deficient population: a systematic review.
Bo WANG ; Si-yan ZHAN ; Yin-yin XIA ; Li-ming LI
Chinese Journal of Epidemiology 2008;29(1):65-70
OBJECTIVETo evaluate the effect of NaFeEDTA on hemoglobin level in iron deficient population.
METHODSComprehensive literature retrieval was performed via searching electronic databases, hand searching bibliographies of books and relevant journals, collecting grey literatures, looking into conference abstracts, contacting fields experts and reviewing references and citations. Criteria from Cochrane EPOC review group were used to assess the quality of included studies. Generic inverse variance method was used to undertake meta-analysis.
RESULTSThe pooled estimate for hemoglobin level (weighted mean difference) was 12.14 g/L (95% CI: 5.60-18.69; P < 0.001). Subgroup analysis indicated that lower baseline hemoglobin level and higher dose for intervention were associated to greater increase in hemoglobin level.
CONCLUSIONThis systematic review indicated that NaFeEDTA improved hemoglobin significantly in iron deficient population.
Anemia, Iron-Deficiency ; blood ; drug therapy ; metabolism ; Edetic Acid ; therapeutic use ; Ferric Compounds ; therapeutic use ; Hemoglobins ; metabolism ; Humans ; Iron Chelating Agents ; therapeutic use
3.Prognosis and treatment of fulminant Wilson's disease.
Yi TIAN ; Guozhong GONG ; Xu YANG
Journal of Central South University(Medical Sciences) 2011;36(11):1111-1114
OBJECTIVE:
To explore the effective treatment and prognostic factors for fulminant Wilson's disease (FWD).
METHODS:
We retrospectively analyzed the clinical characteristics, therapeutic Methods and outcomes of 13 FWD patients. We investigated the treatment effect of the joint use of hormones, decoppering, and plasma exchange therapy in patients with FWD, compared the difference in the clinical features, biochemical data and treatment between the survival group and the death group.
RESULTS:
Thirteen patients with FWD presented with acute hepatic failure and severe jaundice: 7 accompanied with severe hemolytic anemia, 5 with primary peritonitis, 8 with hepatic encephalopathy. Prothrombin activity (PTA) of 5 was below 30% in the 13 patients. Plasma exchange (PE), dimercaptopropansulfonate sodium (DMPS) and short-term methylprednisolone /dexamethasone administration were performed in 7 patients, in which 6 survived and the other 1 who had primary peritonitis with PTA below 30% died. The other 6 patients without above-mentioned treatments all died, in which 4 accompanied with primary peritonitis with PTA all below 30%.
CONCLUSION
The level of hepatic failure and the occurrence of infection are the decisive factors for prognosis of patients with FWD. PE with decoppering treatment and corticosteroid administration are effective.
Chelating Agents
;
therapeutic use
;
Combined Modality Therapy
;
Copper
;
blood
;
Female
;
Hepatolenticular Degeneration
;
therapy
;
Humans
;
Male
;
Methylprednisolone
;
therapeutic use
;
Plasma Exchange
;
methods
;
Prognosis
;
Retrospective Studies
;
Unithiol
;
therapeutic use
4.New Treatment for Band Keratopathy: Superficial Lamellar Keratectomy, EDTA Chelation and Amniotic Membrane Transplantation.
Young Sam KWON ; Young Soo SONG ; Jae Chan KIM
Journal of Korean Medical Science 2004;19(4):611-615
We report two cases of band keratopathy who were treated with thick amniotic membrane that contained a basement membrane structure as a graft, after ethylenediaminetetraacetic acid chelation with trephination and blunt superficial lamellar keratectomy in the anterior stroma. In each case, basement membrane was destroyed and calcium plaque invaded into anterior stroma beneath Bowman's membrane. The calcified lesions were removed surgically, resulting in a smooth ocular surface, and the fine structures of band keratopathy were confirmed by pathologic findings. After that, amniotic membrane transplantation was performed to replace the excised epithelium and stroma. Wound healing was completed within 10 days. Stable ocular surface was restored without pain or inflammation. During the mean follow-up period of 13.5 months, no recurrence of band keratopathy was observed. This combined treatment is a safe and effective method for the removal of deep-situated calcium plaque and allowing the recovery of a stable ocular surface.
Amnion/*anatomy & histology/*transplantation
;
Calcium/metabolism
;
Chelating Agents/*therapeutic use
;
Cornea/pathology/surgery
;
Corneal Diseases/*drug therapy/pathology/*surgery
;
Edetic Acid/*therapeutic use
;
Female
;
Humans
;
Male
;
Middle Aged
5.Efficacy of solution form of ethylenediaminetetraacetic acid on removing smear layer of root canal at different exposure time In Vitro.
Sitashi POUDYAL ; Wei-hong PAN ; Liu ZHAN
Journal of Huazhong University of Science and Technology (Medical Sciences) 2014;34(3):420-424
This study was aimed to evaluate the effectiveness of solution form of 17% ethylenediaminetetraacetic acid (EDTA) on removing smear layer of root canals at different exposure time periods and to provide scientific basis for EDTA as a choice of root canal irrigation in clinical practice. Twenty-five single-rooted teeth were randomly divided into 5 groups: control group (group A) was given 2.5% NaOCl, and 4 experimental groups were given 2.5% NaOCl and 17% EDTA, including groups B, C, D and E with exposure time of 1, 3, 5 and 7 min, respectively. After preparation of the root canals, the teeth were split along their longitudinal axis, and the root sections were examined under scanning electron microscope for evaluation of smear layer removal and erosion on the surface of the root canal walls. The specimens in group B showed presence of smear layer on the walls of the root canal with no statistical difference from that in group A (P>0.05). In groups C and D, partial removal of smear layer was obtained, and there was no significant difference between the two groups (P>0.05), but there was significant difference in removal of smear layer between group C and group B (P<0.05). Root canal walls in group E specimens showed almost complete removal of smear layer, and the removal of smear layer was significantly different from that in group D (P<0.01). There was no significant change in the structure of the surface of root canal for each sample. It was concluded that combined irrigation with 17% EDTA and 2.5% NaOCl could remove the smear layer with no significant alteration in dentinal structure when the chelating agent was applied for 7 min. At 3 and 5 min of application, partial removal of smear layer was observed and at 1 min negligible removal of smear layer was achieved.
Adolescent
;
Bicuspid
;
surgery
;
ultrastructure
;
Chelating Agents
;
therapeutic use
;
Edetic Acid
;
therapeutic use
;
Humans
;
Microscopy, Electron, Scanning
;
Root Canal Irrigants
;
therapeutic use
;
Root Canal Preparation
;
methods
;
Smear Layer
;
Sodium Hypochlorite
;
therapeutic use
;
Solutions
;
Time Factors
;
Treatment Outcome
;
Young Adult
6.Clinical study on manifestation of hepatolenticular degeneration complicated with epilepsy and therapeutic effect of integrative Chinese and Western medicine treatment.
Ji-yuan HU ; Gong-qiang WANG ; Nan CHENG ; Xun WANG ; Mingfan HONG ; Yongzhu HAN ; Renmin YANG
Chinese Journal of Integrated Traditional and Western Medicine 2004;24(9):793-797
OBJECTIVETo observe the clinical manifestation of 155 patients with hepatolenticular degeneration (HLD) complicated with epilepsy and the therapeutic effect of integrative Chinese and Western medicine treatment on them.
METHODSClinical manifestation of patients and its relationship with abnormalities in cranial CT and/or MRI were observed. Patients were treated by combined treatment of copper repellent with sodium dimercaptosulfonate 20 mg/kg per day by intravenous dripping, and modified Gandou Decoction (GDD) by oral intake and antiepileptics as well, after treatment for 8-10 courses, the clinical effect, copper levels in urine and serum were compared between groups.
RESULTSIn the 155 HLD patients, 96 were complicated with petit mal and 59 with grand mal. In the CT and/or MRI conducted in 72 patients, all showed abnormal images, besides such frequently met images as bilateral symmetrical basal ganglia focal lesion in 65 case-episode (90.3%) and brain atrophy of various degrees in 61 case-episode (84.7%), the massive lesions in cerebral white matter as principal, with the cortex involved, were also found in 54 patients (74%), which were mostly bilateral and symmetric or located in 2 adjecent lobes of brain, the sites of damage, in sequence of occurrence, were frontal lobe, parietal lobe, temporal lobe and callosal gyrus. Brain atrophy was found in all the remained patients without above-mentioned lesions. Abnormal EEG was shown in 29 patients (40.2%), which mainly manifested as theta wave of moderate to high potential and/or short paroxysmal spike-slow or sharp-slow complex wave evoked. The urinary copper level in patients after treatment was 34.5 +/- 21.6 micromol/24 hrs, significantly higher than that before treatment, 4.49 +/- 1.93 micromol/24 hrs (P < 0.01). And the serum copper level in patients also lowered significantly (P< 0.01). Epileptic seizure was controlled completely along with the gradually improving of extrapyramidal symptoms.
CONCLUSIONPartial seizure was the most common type of seizure of HLD patient complicated with epilepsy, the next is systemic seizure. Cerebral damage lesion and obvious brain atrophy could be the main etiological factors of HLD complicated with epilepsy, combined copper repellent therapy of integrative Chinese and Western medicine, and antiepileptics produced good clinical effect on the patients.
Adolescent ; Adult ; Anticonvulsants ; therapeutic use ; Chelating Agents ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Epilepsy ; complications ; drug therapy ; Female ; Hepatolenticular Degeneration ; complications ; drug therapy ; Humans ; Male ; Phytotherapy ; Unithiol ; therapeutic use
7.Korean Guideline for Iron Chelation Therapy in Transfusion-Induced Iron Overload.
Jun Ho JANG ; Je Hwan LEE ; Sung Soo YOON ; Deog Yeon JO ; Hyeoung Joon KIM ; Jooseop CHUNG ; Jong Wook LEE
Journal of Korean Medical Science 2013;28(11):1563-1572
Many Korean patients with transfusion-induced iron overload experience serious clinical sequelae, including organ damage, and require lifelong chelation therapy. However, due to a lack of compliance and/or unavailability of an appropriate chelator, most patients have not been treated effectively. Deferasirox (DFX), a once-daily oral iron chelator for both adult and pediatric patients with transfusion-induced iron overload, is now available in Korea. The effectiveness of deferasirox in reducing or maintaining body iron has been demonstrated in many studies of patients with a variety of transfusion-induced anemias such as myelodysplastic syndromes, aplastic anemia, and other chronic anemias. The recommended initial daily dose of DFX is 20 mg/kg body weight, taken on an empty stomach at least 30 min before food and serum ferritin levels should be maintained below 1000 ng/mL. To optimize the management of transfusion-induced iron overload, the Korean Society of Hematology Aplastic Anemia Working Party (KSHAAWP) reviewed the general consensus on iron overload and the Korean data on the clinical benefits of iron chelation therapy, and developed a Korean guideline for the treatment of iron overload.
Anemia, Aplastic/therapy
;
Benzoates/therapeutic use
;
Blood Transfusion/*adverse effects
;
Chelation Therapy/*methods
;
Humans
;
Iron Chelating Agents/*therapeutic use
;
Iron Overload/*therapy
;
Myelodysplastic Syndromes/therapy
;
Pyridones/therapeutic use
;
Republic of Korea
;
Triazoles/therapeutic use
8.Complete Hematopoietic Recovery after Continuous Iron Chelation Therapy in a Patient with Severe Aplastic Anemia with Secondary Hemochromatosis.
Journal of Korean Medical Science 2008;23(2):320-323
A 16-yr-old male patient with hemochromatosis due to multiple packed red blood cell transfusions was referred to our emergency center for the treatment of severe aplastic anemia and dyspnea. He was diagnosed with aplastic anemia at 11-yr of age. He had received continuous transfusions because an HLA-matched marrow donor was unavailable. Following a continuous, approximately 5-yr transfusion, he was noted to develop hemochromatosis. He had a dilated cardiomyopathy and required diuretics and digitalis, multiple endocrine and liver dysfunction, generalized bleeding, and skin pigmentation. A total volume of red blood cell transfusion before deferoxamine therapy was about 96,000 mL. He received a regular iron chelation therapy (continuous intravenous infusion of deferoxamine, 50 mg/kg/day for 5 days q 3-4 weeks) for approximately seven years after the onset of multiple organ failures. His cytopenia and organ dysfunctions began to be gradually recovered since about 2002, following a 4-yr deferoxamine treatment. He showed completely normal ranges of peripheral blood cell counts, heart size, and liver function two years ago. He has not received any transfusions for the last four years. This finding suggests that a continuous deferoxamine infusion may play a role in the immune regulation in addition to iron chelation effect.
Adolescent
;
Anemia, Aplastic/pathology/*therapy
;
Chelation Therapy/*methods
;
Deferoxamine/therapeutic use
;
Erythrocyte Transfusion
;
Hemochromatosis/*complications/therapy
;
Humans
;
Immune System
;
Iron/*therapeutic use
;
Iron Chelating Agents/therapeutic use
;
Male
;
Radiography, Thoracic/methods
;
Time Factors
;
Treatment Outcome
9.Efficacy and safety of deferasirox in aplastic anemia patients with iron overload: a single arm, multi-center,prospective study in China.
Jun SHI ; Hong CHANG ; Li ZHANG ; Yinqi SHAO ; Neng NIE ; Jing ZHANG ; Jinbo HUANG ; Li ZHANG ; Xudong TANG ; Richeng QUAN ; Chunmei ZHENG ; Haiyan XIAO ; Dengming HU ; Lingyan HU ; Feng LIU ; Yongming ZHOU ; Yizhou ZHENG ; Fengkui ZHANG
Chinese Journal of Hematology 2016;37(1):1-6
OBJECTIVETo explore the efficacy and safety of deferasirox in aplastic anemia (AA)patients with iron overload.
METHODSA single arm, multi- center, prospective, open- label study was conducted to evaluate absolute change in serum ferritin (SF)from baseline to 12 months of deferasirox administration, initially at a dose of 20 mg·kg(-1)·d(-1), and the safety in 64 AA patients with iron overload.
RESULTSAll patients started their deferasirox treatment with a daily dose of 20 mg · kg(-1) ·d(-1). The mean actual dose was (18.6±3.60) mg · kg(-1)·d(-1). The median SF decreased from 4 924 (2 718- 6 765)μg/L at baseline (n=64) to 3 036 (1 474- 5 551)μg/L at 12 months (n=23) with the percentage change from baseline as 38%. A median SF decrease of 651 (126-2 125)μg/L was observed at the end of study in 23 patients who completed 12 months' treatment, the median SF level decreased by 1 167(580-4 806)μg/L [5 271(3 420-8 278)μg/L at baseline; 3 036(1 474-5 551)μg/L after 12 months' treatment; the percentage change from baseline as 42% ] after 12 months of deferasirox treatment. The most common adverse events (AEs) were increased serum creatinine levels (40.98%), gastrointestinal discomfort (40.98%), elevated liver transaminase (ALT: 21.31%; AST: 13.11%)and proteinuria (24.59%). The increased serum creatinine levels were reversible and non-progressive. Of 38 patients with concomitant cyclosporine use, 12(31.8%)patients had two consecutive values >ULN, 10(26.3%)patients had two consecutive values >1.33 baseline values, but only 1(2.6%)patient's serum creatinine increased more than 1.33 baseline values and exceeded ULN. For both AST and ALT, no patients experienced two post- baseline values >5 ×ULN or >10 × ULN during the whole study. In AA patients with low baseline PLT count (less than 50 × 10(9)/L), there was no decrease for median PLT level during 12 months' treatment period.
CONCLUSIONSAA patients with iron overload could achieve satisfactory efficacy of iron chelation by deferasirox treatment. The drug was well tolerated with a clinically manageable safety profile and no major adverse events.
Anemia, Aplastic ; drug therapy ; Benzoates ; therapeutic use ; Blood Transfusion ; China ; Ferritins ; blood ; Humans ; Iron ; blood ; Iron Chelating Agents ; therapeutic use ; Iron Overload ; drug therapy ; Liver ; Prospective Studies ; Triazoles ; therapeutic use
10.Recent advances in treatment of aplastic anemia.
Seung Hwan SHIN ; Sung Eun LEE ; Jong Wook LEE
The Korean Journal of Internal Medicine 2014;29(6):713-726
Recent advances in the treatment of aplastic anemia (AA) made most of patients to expect to achieve a long-term survival. Allogeneic stem cell transplantation (SCT) from HLA-matched sibling donor (MSD-SCT) is a preferred first-line treatment option for younger patients with severe or very severe AA, whereas immunosuppressive treatment (IST) is an alternative option for others. Horse anti-thymocyte globuline (ATG) with cyclosporin A (CsA) had been a standard IST regimen with acceptable response rate. Recently, horse ATG had been not available and replaced with rabbit ATG in most countries. Subsequently, recent comparative studies showed that the outcomes of patients who received rabbit ATG/CsA were similar or inferior compared to those who received horse ATG/CsA. Therefore, further studies to improve the outcomes of IST, including additional eltrombopag, are necessary. On the other hand, the upper age limit of patients who are able to receive MSD-SCT as first-line treatment is a current issue because of favorable outcomes of MSD-SCT of older patients using fludarabine-based conditioning. In addition, further studies to improve the outcomes of patients who receive allogeneic SCT from alternative donors are needed. In this review, current issues and the newly emerging trends that may improve their outcomes in near futures will be discussed focusing the management of patients with AA.
Anemia, Aplastic/blood/diagnosis/mortality/*therapy
;
Humans
;
Immunosuppressive Agents/adverse effects/*therapeutic use
;
Iron Chelating Agents/adverse effects/*therapeutic use
;
Risk Factors
;
*Stem Cell Transplantation/adverse effects/mortality
;
Survival Analysis
;
Time Factors
;
Treatment Outcome