sickle cell anemia

镰状细胞性贫血
  • 文章类型: Journal Article
    目的:本研究的目的是确定牙齿组织与镰状细胞性贫血(SCA)之间的关系,以及它如何影响与口腔健康相关的生活质量。
    方法:这是一项队列研究,在Yolo中心的SCA牙科服务中,对154名有或没有SCA的刚果参与者进行了研究,金沙萨,年龄至少6岁,没有临床严重疾病史(住院和输血),他们经常被监控。纳入标准是在纳入本研究之前至少6个月内,在卫生服务机构中进行SCA的诊断确认。使用牙科镜和探针通过临床检查评估牙科组织。使用牙齿缺失指数(DMFT)评估参与者的牙齿状态。对于口腔健康相关的生活质量(OHrQoL),刚果版本的感知问卷,根据口腔健康影响概况(OHIP-23)修改,用于参与者。每个问题都必须用是或否回答,取决于参与者对口腔健康相关生活质量是否满意(结局=1)或不满意(结局=0).
    结果:在154名参与者中,年龄从6岁到64岁,平均年龄为19.5±7(SD)岁,96例出现SCA,只有68例正确随访;102例没有出现SCA,只有86例正确随访。SCA组的DMFT和dmft指数较高,分别为2.9和2.5。对于龋齿,SCA组与对照组之间的差异是显着的,缺失的牙齿,牙齿填充,没有龋齿。SCA组和对照组生活质量的不同维度比较,23个项目中有15个有统计学意义。
    结论:本研究强烈证实了龋齿和牙齿缺失与镰状细胞性贫血之间的关联。其次,SCA参与者的生活质量似乎很差,与对照组相比。
    OBJECTIVE: The aim of this study was to determine the association between dental tissues and sickle cell anemia (SCA) and how it impacts the quality of life related to oral health.
    METHODS: It was a cohort study of 154 Congolese participants with and without SCA conducted in the dental service of SCA at the Yolo Center, Kinshasa, aged at least 6 years and without a history of clinically severe conditions (hospitalization and blood transfusion), who were regularly monitored. The inclusion criteria were the diagnosis confirmation of SCA at the health service in a period of at least 6 months before enrollment in this study. Dental tissues were assessed by a clinical examination using a dental mirror and probe. The index of Decayed-Missing-Filled Teeth (DMFT) was used to assess the dental state of the participants. For Oral Health-related Quality of Life (OHrQoL), the Congolese versions of the perception questionnaires, modified from the Oral Health Impacts Profile (OHIP-23), were used for participants. Each question had to be answered by yes or no, depending on whether the participant was satisfied (outcome = 1) or dissatisfied (outcome = 0) about an oral health-related quality of life.
    RESULTS: Of the 154 participants, aged from 6 to 64 years, with a mean age of 19.5 ± 7 (SD) years, 96 presented with SCA and only 68 were correctly followed; 102 did not present SCA and only 86 were correctly followed. The DMFT and dmft indexes were higher in the SCA group, being 2.9 and 2.5, respectively. The difference between the SCA group and the control group was significant for decayed teeth, missing teeth, filled teeth and no caries. Of the different dimensions of quality of life that were compared between the SCA group and control group, 15 of 23 items were statistically significant.
    CONCLUSIONS: The present study strongly confirmed an association between dental caries and missing teeth with sickle cell anemia. Secondly, the quality of life for SCA participants seems to be poor, compared to the control group.
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  • 文章类型: Journal Article
    血红蛋白(Hb)异常,如地中海贫血和结构Hb变体,是最普遍的遗传性疾病之一,并与世界范围内的显著死亡率和发病率有关。然而,没有针对不同临床分析技术的全面审查,研究方法和人工智能(AI)用于临床筛查和血红蛋白病研究。因此,这篇综述全面总结了检测异常Hbs的最新进展和突破,研究方法和人工智能用途以及目前血红蛋白病的限制和困难。阳离子交换高效液相色谱(HPLC)的最新进展,毛细管区带电泳(CZE),等电聚焦(IEF),流式细胞术,质谱(MS)和聚合酶链反应(PCR)等已允许通过使用先进的AI和便携式护理点测试(POCT)结合智能手机显微镜分类进行确定性检测,机器学习(ML)模型,全血细胞计数(CBC),基于成像的方法,快速免疫测定,和电化学-,微流体和传感相关平台。此外,为了确认和验证身份不明和新颖的HBS,高度专业化的基于基因的技术,如PCR,逆转录(RT)-PCR,DNA微阵列,基因组DNA测序,已使用RT-PCR扩增的目的基因的珠蛋白cDNA的测序。因此,适当利用和改进现有的诊断和筛查技术对于血红蛋白病的控制和管理非常重要.
    Hemoglobin (Hb) abnormalities, such as thalassemia and structural Hb variants, are among the most prevalent inherited diseases and are associated with significant mortality and morbidity worldwide. However, there were not comprehensive reviews focusing on different clinical analytical techniques, research methods and artificial intelligence (AI) used in clinical screening and research on hemoglobinopathies. Hence the review offers a comprehensive summary of recent advancements and breakthroughs in the detection of aberrant Hbs, research methods and AI uses as well as the present restrictions anddifficulties in hemoglobinopathies. Recent advances in cation exchange high performance liquid chromatography (HPLC), capillary zone electrophoresis (CZE), isoelectric focusing (IEF), flow cytometry, mass spectrometry (MS) and polymerase chain reaction (PCR) etc have allowed for the definitive detection by using advanced AIand portable point of care tests (POCT) integrating with smartphone microscopic classification, machine learning (ML) model, complete blood counts (CBC), imaging-based method, speedy immunoassay, and electrochemical-, microfluidic- and sensing-related platforms. In addition, to confirm and validate unidentified and novel Hbs, highly specialized genetic based techniques like PCR, reverse transcribed (RT)-PCR, DNA microarray, sequencing of genomic DNA, and sequencing of RT-PCR amplified globin cDNA of the gene of interest have been used. Hence, adequate utilization and improvement of available diagnostic and screening technologies are important for the control and management of hemoglobinopathies.
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  • 文章类型: Case Reports
    尽管镰状细胞病中存在胆石症和血管闭塞危象等危险因素,急性胰腺炎及其复发被认为是罕见的并发症,表现为急腹症。
    UNASISIGNED:一名33岁女性,患有镰状细胞病和胆石症,并发急腹症。检查后,调查,和对比增强计算机断层扫描,诊断为急性胰腺炎。进行保守管理,计划进行胆囊切除术,但由于血红蛋白低而延迟。在间隔中,她再次表现出相似的特征,并被诊断为复发。经过保守管理和优化患者的血流动力学状态后,最后进行了腹腔镜胆囊切除术。术后2个月随访顺利。
    UNASSIGNED:由于胰腺炎和血管闭塞性危象的特征相似,前者应作为镰状细胞患者急腹症的鉴别诊断。腹腔镜胆囊切除术是这些患者有症状的胆石症的首选治疗方法。然而,与术前输血和预防性胆囊切除术等管理相关的一些问题仍存在争议。这种不确定性导致手术延迟,这可能导致我们患者的胰腺炎复发。由于第一次发作后可能有复发的风险,明确的病因管理需要标准指南。
    UNASSIGNED:本病例报告补充了关于镰状细胞患者复发性急性胰腺炎的有限文献,并指出需要研究制定此类患者的管理指南,以及需要预防性治疗。
    Although risk factors such as cholelithiasis and vaso-occlusive crises exist in sickle cell disease, acute pancreatitis and its recurrence are considered rare complications manifesting as acute abdomen.
    UNASSIGNED: A 33-year-old female with sickle cell disease and established cholelithiasis presented to the center with acute abdomen. After examination, investigation, and contrast enhanced computed tomography, acute pancreatitis was diagnosed. Conservative management was done and cholecystectomy was planned but delayed due to low hemoglobin. In the interval she presented again with similar features and diagnosed with of recurrence. After conservative management and after optimization of patient\'s hemodynamic status, laparoscopic cholecystectomy was finally performed. Postoperative period and follow-up visit after 2 months were uneventful.
    UNASSIGNED: As the features of pancreatitis and vaso-occlusive crisis are similar, the former should be considered as a differential diagnosis of acute abdomen in sickle cell patients. Laparoscopic cholecystectomy is the treatment of choice for symptomatic cholelithiasis in these patients. However, some issues related to management such as preoperative transfusion and prophylactic cholecystectomy are still debated. This uncertainty caused delay in surgery which may have contributed to the recurrence of pancreatitis in our patient. As the risk of recurrence is possible after the first attack, standard guidelines are required for the definite management of the cause.
    UNASSIGNED: This case report adds to the limited literature on recurrent acute pancreatitis in sickle cell patients and points out the need for studies on developing management guidelines in such patients and need for prophylactic treatment.
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  • 文章类型: Journal Article
    To define morphological changes in carotid and cerebral arteries in sickle cell transgenic mice (SS) as they age, a combination of ultrasound and microcomputed tomography of plastinated arteries was used to quantify arterial dimensions and changes in mice 4, 12, and 24 weeks of age. 12-week SS mice had significantly larger common carotid artery diameters than AS mice, which continued through to the extracranial and intracranial portions of the internal carotid artery (ICA). There were also side specific differences in diameters between the left and right vessels. Significant ICA tapering along its length occurred by 12- and 24-weeks in SS mice, decreasing by as much as 70%. Significant narrowing along the length was also measured in SS anterior cerebral arteries at 12- and 24-weeks, but not AS. Collectively, these findings indicate that sickle cell anemia induces arterial remodeling in 12- and 24-weeks old mice. Catalog of measurements are also provided for the common carotid, internal carotid, anterior cerebral, and middle cerebral arteries for AS and SS genotypes, as a reference for other investigators using mathematical and computational models of age-dependent arterial complications caused by sickle cell anemia.
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  • 文章类型: Journal Article
    目标:尽管龋齿已在镰状细胞病(SCD)患者中得到广泛报道,关于SCD与龋齿之间的关联,文献中仍存在争议.这项系统评价的目的是调查患有SCD的个体是否比非SCD的个体有更多的龋齿。方法:搜索PubMed和Embase数据库以寻找合格的研究。永久衰变的参数,缺失和填充牙齿(DMFT)指数和永久腐烂,缺失和填充表面(DMFS)指数被视为结局指标。DMFT和DMFS指数的总体荟萃分析以及各种亚组分析(龋齿成分,年龄,和基因型)的DMFT指数来计算SCD患者与非SCD患者之间的加权平均差(WMD)。结果:本荟萃分析共纳入9项研究,涵盖1478名个体。总体荟萃分析的结果表明,SCD患者和非SCD参与者的DMFT和DMFS指数得分没有显着差异。根据龋齿成分进行亚组分析的结果,年龄,基因型在大多数项目中没有显着差异。SCD患者牙齿缺失的结果明显低于非SCD患者(WMD,-0.14;95%置信区间[CI],-0.25至-0.03;P=0.01)。讨论与结论:结果表明,与非SCD个体相比,SCD患者没有患更严重的龋齿.考虑到局限性,需要进一步精心设计的研究来揭示SCD与龋齿之间的关联.
    Objectives: Although dental caries has been widely reported in individuals with sickle cell disease (SCD), there is still controversial in the literature regarding the association between SCD and dental caries. The aim of this systematic review was to investigate whether individuals with SCD have more dental caries than individuals with non-SCD. Methods: PubMed and Embase databases were searched for eligible studies. The parameters of the permanent decayed, missing and filled teeth (DMFT) index and the permanent decayed, missing and filled surface (DMFS) index were considered as outcome measures. The overall meta-analyses of the DMFT and DMFS index and various subgroup analyses (caries components, age, and genotypes) of DMFT index were performed to calculate the weighted mean differences (WMD) between patients with SCD and non-SCD individuals. Results: A total of 9 studies covering 1478 individuals were included in this meta-analysis. The results of overall meta-analyses indicated that the scores of the DMFT and DMFS index were not significantly different between patients with SCD and non-SCD participants. The results of subgroup analyses by caries components, age, and genotypes showed no significant difference in most items. The result of the missing teeth was significantly lower in patients with SCD than in non-SCD individuals (WMD, -0.14; 95% confidence interval [CI], -0.25 to -0.03; P = 0.01). Discussion and Conclusions: The results revealed that compared with non-SCD individuals, patients with SCD did not suffer from worse dental caries. Considering the limitations, further well-designed studies are necessary to reveal the association between SCD and dental caries.
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