How to Trip Rapid Review

Step 1: Select articles relevant to your search (remember the system is only optimised for single intervention studies)

Step 2: press

Step 3: review the result, and maybe amend the or if you know better! If we're unsure of the overall sentiment of the trial we will display the conclusion under the article title. We then require you to tell us what the correct sentiment is.

685 results for

Pulmonary Hypertension in Sickle Cell Anemia

by
...
Alerts

Export results

Use check boxes to select individual results below

SmartSearch available

Trip's SmartSearch engine has discovered connected searches & results. Click to show

381. Alefacept and Allogeneic Hematopoietic Stem Cell Transplantation

hospitalization or outpatient treatment with parenteral opioids/opiates). Must have also (iii) Recurrent (≥ 3 in lifetime) acute chest syndrome events which have necessitated exchange transfusion or chronic transfusion therapy. (iv) Any combination of ≥ 3 acute chest syndrome episodes and vasoocclusive pain episodes (defined as above) yearly for 3 years. (v) Stage I or II sickle lung disease (see appendix 1) (vi) Pulmonary hypertension, measured by tricuspid regurgitant jet velocity (TRV) of greater than 2.5m (...) (l) Chediak-Higashi syndrome (m) Acquired (immune; non-inherited, non-congenital) severe aplastic anemia (only patients whose best graft source is a mismatched related donor, unrelated marrow donor or cord blood unit) (n) Other inherited or congenital marrow failure syndromes complicated by severe aplastic anemia (o) Other inherited or congenital red blood cell disorders requiring monthly chronic transfusion therapy. (p) Other inherited or congenital platelet disorders resulting in at least three

2010 Clinical Trials

382. Study to Determine How Cialis Effects the Renal Function in Response to Volume Expansion in Preclinical Diastolic Cardiomyopathy (Aim3)

. Patients taking the following selective alpha blockers and who are unable to stop for the duration of the study; Alfuzosin Prazosin Doxazosin Tamsulosin Terazosin Silodosin Patients with retinitis pigmentosa, previous diagnosis of nonischemic optic neuropathy, untreated proliferative retinopathy or unexplained visual disturbance Patients with sickle cell anemia, multiple myeloma, leukemia or penile deformities placing them at risk for priapism (angulation, cavernosal fibrosis or Peyronie's disease (...) to Arm Intervention/treatment Active Comparator: tadalafil Tadalafil dose varies from 5 mg to 20 mg for 12 weeks. If blood pressure is >95 then subject dismissed from the Clinical Research Unit (CRU) on 2 (5 mg) tabs of tadalafil or placebo. If blood pressure is between 90 - 95 mmHg systolic, then dismiss on 1 (5 mg) tab of Tadalafil. At 2 weeks (± 5 days) if blood pressure is> 100 than add 1 (5 mg) tab of Tadalafil to make a total of 3 (5mg) tabs of Tadalafil. At 4 weeks(± 5 days) if blood pressure

2014 Clinical Trials

383. Telaprevir in Genotype 3 HCV

of the investigator, precludes therapy Evidence of ascites seen on previous liver ultrasound Haemoglobin concentration <11 g/dL in females or <12 g/dL in males or any patient with an increased risk for anaemia (e.g., thalassemia, sickle cell anaemia, spherocytosis, history of gastrointestinal bleeding) or for whom anaemia would be medically problematic Albumin levels <35 G/L Females who are pregnant or breast-feeding History of severe psychiatric disease, including psychosis and/or depression, characterized (...) when used for treatment of pulmonary arterial hypertension) and orally administered midazolam or triazolam. Concomitant administration with Class Ia or III antiarrhythmics, except for intravenous lidocaine (see section 4.5). Concomitant administration of INCIVO with active substances that strongly induce CYP3A e.g. rifampicin, St John's wort (Hypericum perforatum), carbamazepine, phenytoin and phenobarbital and thus may lead to lower exposure and loss of efficacy of INCIVO. Contacts and Locations

2014 Clinical Trials

384. Optimal Oxygenation in the Intensive Care Unit

or hypothermia <36 deg.C Heart rate >90 bpm Respiratory rate >20 /min or pCO2 <32 mmHg (4.3 kPa) Number of leucocytes >12 x 10^9/l of <4 x 10^9/l of >10% bands Within 12 hours of admittance to the ICU Expected stay of more than 48 hours as estimated by the attending physician Exclusion Criteria: Elective surgery Carbon monoxide poisoning Cyanide intoxication Methemoglobinemia Sickle cell anemia Severe pulmonary arterial hypertension (WHO class III or IV) Known severe Acute Respiratory Distress Syndrome (ARDS (...) (SIRS) criteria. To study underlying mechanisms of hyperoxia by determining differences in oxidative stress response between the hyperoxic and the normoxic patients. Study design: Randomized, prospective multicentre clinical trial Study population: Patients admitted to the Intensive Care unit with ≥ 2 positive SIRS-criteria and an expected ICU stay of more than 48 hours Intervention: Group 1: target PaO2 120 (105 - 135) mmHg (high-normal) Group 2: target PaO2 75 (60 - 90) mmHg (low-normal) Primary

2014 Clinical Trials

385. Safety Evaluation of the KLOX BioPhotonic System in Diabetic Foot Ulcers

method; The ulcer to be treated is planned for operative debridement; The ulcer has significant necrotic tissue (e.g., more than 20% of the ulcer area); Major uncontrolled medical disorder(s) such as serious cardiovascular, renal, liver or pulmonary disease, lupus, palliative care or sickle cell anemia; Severe or significant hypoalbuminemia (albuminemia < 30 g/L, and/or pre-albumin < 5 mg/dL), or hypoproteinemia (proteinemia < 55g/L); Patient with moderate to severe anemia (Hb < 90g/L); Patient (...) fork 128 Hz); Wound area has not changed by more than +/- 30% between Screening visit and Week 1/Visit 1 (before treatment). Adequate arterial blood perfusion (ABI (ankle brachial index) between 0.7 and 1.3, inclusive, or toe pressure > 50 mmHg, or tcPO2 > 40 mmHg). Exclusion Criteria: Diabetic foot ulcer present for more than 12 months; Target ulcer is over a deformity (such as Charcot deformity) that interferes with off-loading based on investigator's opinion; Patient cannot tolerate off-loading

2014 Clinical Trials

386. Safety Evaluation of the KLOX BioPhotonic System in Venous Leg Ulcers

0.7 and 1.3, inclusive). Exclusion Criteria: Venous leg ulcer present for more than 12 months; The ulcer to be treated is planned for operative debridement; The ulcer has significant necrotic tissue (e.g., more than 20% of the ulcer area); Major uncontrolled medical disorder(s) such as serious cardiovascular, renal, liver or pulmonary disease, lupus, palliative care or sickle cell anemia; Severe or significant hypoalbuminemia (albuminemia < 30 g/L, and/or pre-albumin < 5 mg/dL), or hypoproteinemia (...) leg ulcer, clinically defined and confirmed by duplex, refilling time or venous hypertension; Open venous leg ulcer present for more than 4 weeks prior to study entry (Screening/Visit 1); Ulcer area between 5 and 100 cm2 inclusive, with a maximum depth of 1 cm. The maximum diameter of the wound must not exceed 10 cm; Wound area has not changed by more than +/- 30% between Screening visit and Week 1/Visit 1 (before treatment). Adequate arterial blood perfusion (ABI (ankle brachial index) between

2014 Clinical Trials

387. Transfusion-Induced Iron Overload (Diagnosis)

patients with transfusion-dependent thalassemia in the National Institutes of Health (NIH) registry, 23% had iron overload as documented by a liver iron concentration of 15 mg/g dry weight or greater. [ ] Around 15,000 patients with sickle cell disorder and estimated and 5,000 with myelodysplastic syndromes and other acquired refractory anemias require blood transfusions. [ ] International In a Japanese cohort of transfusion-dependent patients with myelodysplastic syndrome and aplastic anemia, one (...) . Hepatitis C virus in sickle cell disease. J Natl Med Assoc . 2003 Oct. 95(10):939-42. . Halonen P, Mattila J, Suominen P, et al. Iron overload in children who are treated for acute lymphoblastic leukemia estimated by liver siderosis and serum iron parameters. Pediatrics . 2003 Jan. 111(1):91-6. . . Files B, Brambilla D, Kutlar A, et al. Longitudinal changes in ferritin during chronic transfusion: a report from the Stroke Prevention Trial in Sickle Cell Anemia (STOP). J Pediatr Hematol Oncol . 2002 May

2014 eMedicine.com

388. Transfusion Reactions (Diagnosis)

transfusions, because such patients may be at risk of delays in the future if they require urgent transfusion of compatible RBCs. [ ] Alloimmunization to RBC blood group antigens may also delay solid-organ transplantation if a significant number of serologically compatible RBCs are required. [ ] Race In the United States, is found predominantly in the black population. Patients with sickle cell anemia require repeated red cell transfusions and, as a result, may form multiple alloantibodies to common Rh (...) , Kell, Kidd, or other blood group antigens. The presence of such alloantibodies may increase the time required for a transfusion service to supply serologically compatible red cells. If undetected, these red cell alloantibodies may cause shortened survival of transfused red cells and extravascular hemolysis, but severe acute hemolytic reactions are uncommon. [ , ] In addition, patients with sickle cell anemia may experience delayed hemolytic transfusion reactions. The first clinical signs

2014 eMedicine.com

389. Urinary Tract Infection, Males (Diagnosis)

UTI is dependent on the suspected diagnosis. Routine laboratory studies include urine studies, such as urinalysis, Gram staining, and urine culture. The threshold for establishing true UTI includes finding 2-5 or more white blood cells (WBCs) or 15 bacteria per high-power field (HPF) in a centrifuged urine sediment. Note that a positive nitrite test is poorly sensitive but highly specific for UTI; false-positives are uncommon. Proteinuria is commonly observed in UTIs, but it is usually low grade (...) , sickle cell anemia, underlying carcinoma, or intercurrent cancer chemotherapy). Surgery Surgical intervention may be required in the patients with the following conditions: Prostatitis involving bladder neck obstruction, prostatic or bladder calculi, or recurrent prostatitis with the same bacteria [ ] Emphysematous pyelonephritis (ie, emergent nephrectomy) Epididymitis involving spermatic cord torsion See and for more detail. Next: Background The incidence of true urinary tract infection (UTI

2014 eMedicine.com

390. Hematologic Disease and Pregnancy (Diagnosis)

, hypertensive disorders, intrauterine growth restriction (IUGR), and cesarean delivery among women with sickle cell disease. [ ] The following odds ratios were significantly increased for women with sickle cell disease: pneumonia (9.8), sepsis (6.8), cerebral venous thrombosis (4.9), eclampsia (3.2), IUGR (2.9), DVT (2.5), stroke (2.0), pulmonary embolism (1.7), postpartum infection (1.4), and pyelonephritis (1.3). The mortality rate for women with sickle cell disease was 6 times that for women without (...) by hemoglobin electrophoresis. Anemia occurs as a result of the sickle hemoglobinopathies. Deoxygenation of the abnormal red blood cells (RBCs) results in sickling. These permanently damaged RBCs are then removed by the reticuloendothelial system, with the average RBC lifespan reduced to 17 days. The result is a chronic compensated anemia, with Hb typically measured between 6.5 and 9.5 g/dL. The sickle shape also results in altered motion through the microvasculature. This altered motion can predispose

2014 eMedicine.com

391. Hypercoagulability: Hereditary Thrombophilia and Lupus Anticoagulants Associated With Venous Thrombosis and Emboli (Diagnosis)

individuals. Venous thrombosis and are associated with significant morbidity and mortality. The most common acquired risk factors for hypercoagulability and thrombosis are as follows [ ] : Advanced age Immobilization Inflammation Pregnancy Oral contraceptive use Obesity Diabetes mellitus Hormone replacement therapy Cancer (especially adenocarcinoma) Antiphospholipid syndrome Sickle cell anemia and other hemolytic anemias Given the high prevalence of obesity and diabetes in the United States, and the aging (...) of hereditary hypercoagulable disorders in the general population and the risk for thrombosis and recurrent thrombosis. [ , ] Other underlying risk factors are elevated levels of , , and other coagulation factors. Increases in type-1 plasminogen activator inhibitor (PAI-1), D-dimers, and homocysteine are also reported to be risk factors. Table 1. Prevalence of Acquired or Hereditary Hypercoagulable Disorders and Risks of Venous Thrombosis. Condition Prevalence in General Population (%) Relative Risk of VTE

2014 eMedicine.com

392. Medical Treatment of Stroke (Diagnosis)

stroke prevention may include the use of antihypertensive medications, anticoagulants, platelet antiaggregants, 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins), smoking cessation, dietary intervention, weight loss, and exercise. Modifiable risk factors include the following: Hypertension Air pollution Cigarette smoking Diabetes Dyslipidemia Atrial fibrillation Sickle cell disease Postmenopausal HRT Depression Diet and activity Weight and body fat Secondary Prevention (...) and will be discussed in Secondary Prevention. Hypertension Hypertension is the most important modifiable risk factor for stroke and intracerebral hemorrhage (ICH), and the risk of stroke increases progressively with increasing blood pressure, independent of other factors. [ , ] Both behavioral lifestyle changes and pharmacologic therapy are important parts of the comprehensive strategy recommended in the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High

2014 eMedicine.com

393. Priapism (Diagnosis)

be necessary to treat underlying sickle cell disease (SCD), a cause of low-flow priapism Penile blood gas (PBG) measurement: Allows differentiation between high- and low-flow priapism Imaging studies Penile duplex Doppler ultrasonography: To help identify and locate fistulas in patients with high-flow priapism Pelvic angiography: To help confirm the fistula’s location Chest radiography or computed tomography (CT) scanning: Used if the patient’s history is consistent with a malignant or metastatic condition (...) to treat priapism and as a possible means of preventing full-blown episodes in patients with sickle cell disease. [ ] High-flow priapism may result from the following forms of genitourinary trauma: Straddle injury Intracavernous injections resulting in direct cavernosal artery injury Rare causes of priapism include the following: (massive amyloid infiltration) (one case report) Black widow spider bites [ ] Asplenia (rare association, occasionally noted to be priapism of the high-flow type) Vigorous

2014 eMedicine.com

394. Osteoporosis (Secondary) (Diagnosis)

Ankylosing spondylitis Rheumatoid arthritis Systemic lupus erythematosus Hematologic and neoplastic disorders Hemochromatosis Hemophilia Leukemia Lymphoma Multiple myeloma Sickle cell anemia Systemic mastocytosis Thalassemia Metastatic disease Medications Anticonvulsants Antipsychotic drugs Antiretroviral drugs Aromatase inhibitors Chemotherapeutic/transplant drugs: cyclosporine, tacrolimus, platinum compounds, cyclophosphamide, ifosfamide, high-dose methotrexate [ ] Furosemide Glucocorticoids (...) difficulties may be evident, especially in patients with an altered center of gravity from severe kyphosis. [ ] Patients may have difficulty performing tandem gait and performing single limb stance. See for more detail. Diagnosis Baseline laboratory studies include the following: Complete blood count: May reveal anemia Serum chemistry levels: Usually normal in persons with primary osteoporosis Liver function tests Thyroid-stimulating hormone level: Thyroid dysfunction has been associated with osteoporosis

2014 eMedicine.com

395. Osteoporosis (Primary) (Diagnosis)

Ankylosing spondylitis Rheumatoid arthritis Systemic lupus erythematosus Hematologic and neoplastic disorders Hemochromatosis Hemophilia Leukemia Lymphoma Multiple myeloma Sickle cell anemia Systemic mastocytosis Thalassemia Metastatic disease Medications Anticonvulsants Antipsychotic drugs Antiretroviral drugs Aromatase inhibitors Chemotherapeutic/transplant drugs: cyclosporine, tacrolimus, platinum compounds, cyclophosphamide, ifosfamide, high-dose methotrexate [ ] Furosemide Glucocorticoids (...) difficulties may be evident, especially in patients with an altered center of gravity from severe kyphosis. [ ] Patients may have difficulty performing tandem gait and performing single limb stance. See for more detail. Diagnosis Baseline laboratory studies include the following: Complete blood count: May reveal anemia Serum chemistry levels: Usually normal in persons with primary osteoporosis Liver function tests Thyroid-stimulating hormone level: Thyroid dysfunction has been associated with osteoporosis

2014 eMedicine.com

396. Osteoporosis (Diagnosis)

Ankylosing spondylitis Rheumatoid arthritis Systemic lupus erythematosus Hematologic and neoplastic disorders Hemochromatosis Hemophilia Leukemia Lymphoma Multiple myeloma Sickle cell anemia Systemic mastocytosis Thalassemia Metastatic disease Medications Anticonvulsants Antipsychotic drugs Antiretroviral drugs Aromatase inhibitors Chemotherapeutic/transplant drugs: cyclosporine, tacrolimus, platinum compounds, cyclophosphamide, ifosfamide, high-dose methotrexate [ ] Furosemide Glucocorticoids (...) be evident, especially in patients with an altered center of gravity from severe kyphosis. [ ] Patients may have difficulty performing tandem gait and performing single limb stance. See for more detail. Diagnosis Baseline laboratory studies include the following: Complete blood count: May reveal anemia Serum chemistry levels: Usually normal in persons with primary osteoporosis Liver function tests Thyroid-stimulating hormone level: Thyroid dysfunction has been associated with osteoporosis 25

2014 eMedicine.com

397. Osler-Weber-Rendu Syndrome (Diagnosis)

be either hemorrhagic or ischemic. Of patients who have pulmonary AVMs, 2% per year are estimated to have a stroke, and 1% per year are estimated to develop a brain abscess. Retinal arteriovenous aneurysms occur only rarely. Patients are also at risk for high-output cardiac failure, migraines and further sequelae. Frequent nosebleeds and melena may result from telangiectasia in the nose and GI tract. Patients with the severe form of HHT have heavy bleeding and resultant iron-deficiency anemia. Recurrent (...) . Pulmonary arteriovenous malformations in hereditary hemorrhagic telangiectasia: a series of 126 patients. Medicine (Baltimore) . 2007 Jan. 86(1):1-17. . Pierucci P, Murphy J, Henderson KJ, et al. New definition and natural history of patients with diffuse pulmonary arteriovenous malformations: twenty-seven-year experience. Chest . 2008 Mar. 133(3):653-61. . Trembath RC, Thomson JR, Machado RD, et al. Clinical and molecular genetic features of pulmonary hypertension in patients with hereditary

2014 eMedicine.com

398. Oral Manifestations of Systemic Diseases (Diagnosis)

, and—in the case of heparin-induced thrombocytopenia—skin necrosis. [ ] In the oral cavity, petechiae and ecchymoses may be visible on the soft palate and buccal mucosa. [ ] Gingival bleeding is common and often spontaneous. [ ] Hemorrhagic bullae that appear as deep‒red-to-violaceous or black blisters may appear on mucosal surfaces in cases of severe thrombocytopenia. [ ] Red blood cell disorders Anemias Common anemias associated with oral manifestations include iron-deficiency anemia and macrocytic anemia (...) : Hematologic Disorders Hematologic malignancies and blood cell dyscrasias are a remarkably diverse collection of diseases with numerous systemic sequelae. The etiology, diagnostic criteria, prognosis, and treatment of each condition is unique and complex. As such, a complete analysis is not within the scope of this review. The oral manifestations of numerous hematologic disorders are summarized. Please refer to the references for more detailed information. [ ] White blood cell disorders Leukemia Leukemia

2014 eMedicine.com

399. Medical Treatment of Stroke (Overview)

stroke prevention may include the use of antihypertensive medications, anticoagulants, platelet antiaggregants, 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins), smoking cessation, dietary intervention, weight loss, and exercise. Modifiable risk factors include the following: Hypertension Air pollution Cigarette smoking Diabetes Dyslipidemia Atrial fibrillation Sickle cell disease Postmenopausal HRT Depression Diet and activity Weight and body fat Secondary Prevention (...) and will be discussed in Secondary Prevention. Hypertension Hypertension is the most important modifiable risk factor for stroke and intracerebral hemorrhage (ICH), and the risk of stroke increases progressively with increasing blood pressure, independent of other factors. [ , ] Both behavioral lifestyle changes and pharmacologic therapy are important parts of the comprehensive strategy recommended in the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High

2014 eMedicine.com

400. Hypercoagulability: Hereditary Thrombophilia and Lupus Anticoagulants Associated With Venous Thrombosis and Emboli (Overview)

individuals. Venous thrombosis and are associated with significant morbidity and mortality. The most common acquired risk factors for hypercoagulability and thrombosis are as follows [ ] : Advanced age Immobilization Inflammation Pregnancy Oral contraceptive use Obesity Diabetes mellitus Hormone replacement therapy Cancer (especially adenocarcinoma) Antiphospholipid syndrome Sickle cell anemia and other hemolytic anemias Given the high prevalence of obesity and diabetes in the United States, and the aging (...) of hereditary hypercoagulable disorders in the general population and the risk for thrombosis and recurrent thrombosis. [ , ] Other underlying risk factors are elevated levels of , , and other coagulation factors. Increases in type-1 plasminogen activator inhibitor (PAI-1), D-dimers, and homocysteine are also reported to be risk factors. Table 1. Prevalence of Acquired or Hereditary Hypercoagulable Disorders and Risks of Venous Thrombosis. Condition Prevalence in General Population (%) Relative Risk of VTE

2014 eMedicine.com

To help you find the content you need quickly, you can filter your results via the categories on the right-hand side >>>>