#Sickle cell nephropathy

[jcrmhscasereports]

Sickle cell nephropathy, a complication not to be ignored, through a Moroccan case by Asmaa Biaz in Journal of Clinical Case Reports Medical Images and Health Sciences 

SUMMARY

Nephropathy is a major complication of sickle cell disease. Indeed, the kidneys are particularly sensitive organs to this disease.

We report a case of a patient with a major sickle cell syndrome; she was hospitalized in the nephrology department of Mohammed V Military Training Hospital, forend-stage renal failure. The family investigation revealed a composite S/O-Arab heterozygosity responsible for the severity of the clinical disorder.

Key words: Sickle cell nephropathy - End stage renal failure - Sickle cell major syndrome S/O-Arab.

INTRODUCTION

Sickle cell nephropathy (SCN) is a major complication of sickle cell disease. It manifest’s in various forms, including glomerulopathy, proteinuria, hematuria, and Renal tubular disorders, and frequently results in end-stage renal disease(ESRD). Hemolysis and vascular occlusion are the main factors promoting the manifestations of this disease. Dialysis and renal transplantation are the last resort for patient with SCN [1].

Through the case of a patient with a major sickle cell syndrome S/O-Arab complicated by end-stage renal failure, we will explain the pathophysiological mechanisms of this complication and emphasize the importance of biological monitoring.

CASE REPORT

The patient was 24 years old and was admitted to the nephrology department of the Mohammed V Military Training Hospital for incidental renal failure in the context of an impure nephrotic syndrome revealing sickle cell nephropathy. In his history, we retained a

follow-up since the age of 5 years in another hospital structure for a hemoglobinosis S treated by iterative transfusions with notion of acute renal failure during sickle cell crises.

The biological result showed an anemia at 7.7 g/dL, corrected serum calcium at 82 mg/L, serum phosphorus at 64 mg/L, intact parathyroid hormone 1-84 at 543 pg/L, Alkaline Phosphatase at 201 U/L.

Hemoglobin electrophoresis was ordered to this patient, but due to repeated transfusions, her electrophoretic profile remains uninterpretable (Figure 1). Therefore, hemoglobin electrophoresis (HBE) was performed in the parents as part of the hemoglobin phenotypic study. The HBE of both parents is performed on Capillarys (Sebia®) at alkaline pH followed by electrophoresis at acidic pH on Hydrasys (Sebia®) which showed a heterozygous Hb O-Arab variant in the mother (Figure 2) and a heterozygous hemoglobinosis S (A/S) in the father (Figure 3).

Figure 1: Electrophoretic profile of the patient uninterpretable due to recent transfusion

Figure 2: Electrophoretic profile of the mother showing hemoglobinosis O-Arab in the heterozygous state

Figure 3: Electrophoretic profile of the father showing hemoglobinosis S in the heterozygous state

Referring to the phenotypic study of Hb performed in the parents, it is concluded that the patient has a composite heterozygosity S/O-Arab explaining the severity of the renal manifestations.

The evolution was marked by the absence of improvement of her renal function and the aggravation of the uremic syndrome motivating her setting in peritoneal dialysis. The patient was treated with erythropoietin ARANESP 30µg/ per 2 weeks with a blood transfusion of 2 packed red blood cells on average every two months.

The patient died at the age of 26 years before benefiting from either a hemoglobin genotyping study or a renal transplant.

DISCUSSION

Sickle cell disease is the most common hereditary hemoglobinopathy in the world. An estimated 300,000 children are born with this disease each year, three quarters of whom are born in sub-Saharan Africa [2]. It is characterized by extreme variability in terms of clinical manifestations, the most serious of which are renal manifestations.

The association S/O Arab is responsible for a major sickle cell syndrome, as in the case of our patient. Indeed, Hb O Arab stabilizes the intracellular polymerization of Hb S and leads to an irreversible sickle cell disease of red blood cells, thus expressing by a more severe clinical disorder. The clinical and biological manifestation of this association is similar to homozygous sickle cell disease and the association Hb S / Hb D Punjab. The onset is usually early, in infancy, and is marked by the classic triad of chronic hemolysis: anemia, jaundice and splenomegaly. Anemia is usually moderate outside of hemolytic attacks (Hb = 7 - 10 g/dL). The evolution is often marked by sickle cell complications. Osteoarticular complications are the most frequent, such as vaso-occlusive crises, septic arthritis and osteoporosis. Pneumonia, leg ulcers and vesicular lithiasis are also reported [3].

Sickle cell nephropathy is a major complication of sickle cell disease. The kidneys are particularly sensitive organs to the disease. Sickle cell disease substantially alters the structure and function of the kidneys and is the cause of several renal diseases and syndromes. Renal damage is more severe in SS homozygous patients than in other major sickle cell syndromes [4]. Approximately 5-18% of patients have SCN, thus increasing the risk of morbidity and mortality of the disease [5].

A number of studies have focused on this pathology, its evolution includes several stages; it starts with hyperfiltration, then the occurrence of microalbuminuria, then macroalbuminuria and finally the progression to renal failure. The prevalence of these complications increases with the age of the patients but can also be seen from a young age.

Two models have been proposed to explain the pathophysiology of SCN. Becker et al. showed that prostaglandin release following ischemic injury causes an increase in glomerular filtration rate (GFR). This increase leads to glomerular injury and eventually manifests as proteinuria and glomerulosclerosis [6]. Alternatively, Nath and Katusic [7] classified the manifestations of SCN into two different phenotypes: the hemolysis-endothelial dysfunction phenotype and the viscosity-vaso-occlusive phenotype. The hemolysis-endothelial dysfunction phenotype affects the renal cortex and leads to hyperfiltration and glomerulopathy; heme released due to intravascular hemolysis predisposes to proteinuria through its accumulation on the glomerular filtration barrier, which disrupts membrane selectivity by exerting cytotoxic effects on podocytes and endothelial cells [8]. On the other hand, the viscosity-vaso-occlusive phenotype is responsible for hematuria, papillary necrosis, and tubular acidosis [9].

Microalbuminuria, reflecting the early stages of renal damage, should be routinely sought in the follow-up assessment in this category of patients.

Decreased GFR, which suggests loss of kidney function, occurs with the progression of sickle cell disease and may be a sign of uncontrolled disease. Sickle cell patients have a higher risk of developing chronic kidney disease compared to the general population.

Specific treatment with an angiotensin-converting enzyme inhibitor or an angiotensin II

receptor antagonist should be considered in these patients in order to slow the progression of the renal disease. The prevention of microthrombosis and thus of renal damage requires the maintenance of a hemoglobin A level of more than 50% by regular blood transfusion as soon as sickle cell disease is diagnosed. The role of hydroxyurea in the prevention and/or treatment of renal function abnormalities in sickle cell disease remains to be studied [10].

CONCLUSION

Sickle cell nephropathy is a major complication of sickle cell disease. It must be systematically and early sought in all sickle cell patients to reduce the risk of morbidity and mortality of this disease.

The development of new biomarkers has become increasingly essential for the early detection of sickle cell disease in order to improve the survival of patients with sickle cell disease.

Declaration of interest:

The authors declare no conflict of interest.

For more information: https://jmedcasereportsimages.org/about-us/

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[jcsmicasereports]

Sickle cell nephropathy, a complication not to be ignored, through a Moroccan case by Asmaa Biaz in Journal of Clinical Case Reports Medical Images and Health Sciences

Summary

Nephropathy is a major complication of sickle cell disease. Indeed, the kidneys are particularly sensitive organs to this disease.

We report a case of a patient with a major sickle cell syndrome; she was hospitalized in the nephrology department of Mohammed V Military Training Hospital, forend-stage renal failure. The family investigation revealed a composite S/O-Arab heterozygosity responsible for the severity of the clinical disorder.

Key words: Sickle cell nephropathy - End stage renal failure - Sickle cell major syndrome S/O-Arab.

Introduction

Sickle cell nephropathy (SCN) is a major complication of sickle cell disease. It manifest’s in various forms, including glomerulopathy, proteinuria, hematuria, and Renal tubular disorders, and frequently results in end-stage renal disease(ESRD). Hemolysis and vascular occlusion are the main factors promoting the manifestations of this disease. Dialysis and renal transplantation are the last resort for patient with SCN [1].

Through the case of a patient with a major sickle cell syndrome S/O-Arab complicated by end-stage renal failure, we will explain the pathophysiological mechanisms of this complication and emphasize the importance of biological monitoring.

Case report

The patient was 24 years old and was admitted to the nephrology department of the Mohammed V Military Training Hospital for incidental renal failure in the context of an impure nephrotic syndrome revealing sickle cell nephropathy. In his history, we retained a

follow-up since the age of 5 years in another hospital structure for a hemoglobinosis S treated by iterative transfusions with notion of acute renal failure during sickle cell crises.

The biological result showed an anemia at 7.7 g/dL, corrected serum calcium at 82 mg/L, serum phosphorus at 64 mg/L, intact parathyroid hormone 1-84 at 543 pg/L, Alkaline Phosphatase at 201 U/L.

Hemoglobin electrophoresis was ordered to this patient, but due to repeated transfusions, her electrophoretic profile remains uninterpretable. Therefore, hemoglobin electrophoresis (HBE) was performed in the parents as part of the hemoglobin phenotypic study. The HBE of both parents is performed on Capillarys (Sebia®) at alkaline pH followed by electrophoresis at acidic pH on Hydrasys (Sebia®) which showed a heterozygous Hb O-Arab variant in the mother and a heterozygous hemoglobinosis S (A/S) in the father.

Referring to the phenotypic study of Hb performed in the parents, it is concluded that the patient has a composite heterozygosity S/O-Arab explaining the severity of the renal manifestations.

The evolution was marked by the absence of improvement of her renal function and the aggravation of the uremic syndrome motivating her setting in peritoneal dialysis. The patient was treated with erythropoietin ARANESP 30µg/ per 2 weeks with a blood transfusion of 2 packed red blood cells on average every two months.

The patient died at the age of 26 years before benefiting from either a hemoglobin genotyping study or a renal transplant.

Discussion

Sickle cell disease is the most common hereditary hemoglobinopathy in the world. An estimated 300,000 children are born with this disease each year, three quarters of whom are born in sub-Saharan Africa [2]. It is characterized by extreme variability in terms of clinical manifestations, the most serious of which are renal manifestations.

The association S/O Arab is responsible for a major sickle cell syndrome, as in the case of our patient. Indeed, Hb O Arab stabilizes the intracellular polymerization of Hb S and leads to an irreversible sickle cell disease of red blood cells, thus expressing by a more severe clinical disorder. The clinical and biological manifestation of this association is similar to homozygous sickle cell disease and the association Hb S / Hb D Punjab. The onset is usually early, in infancy, and is marked by the classic triad of chronic hemolysis: anemia, jaundice and splenomegaly. Anemia is usually moderate outside of hemolytic attacks (Hb = 7 - 10 g/dL). The evolution is often marked by sickle cell complications. Osteoarticular complications are the most frequent, such as vaso-occlusive crises, septic arthritis and osteoporosis. Pneumonia, leg ulcers and vesicular lithiasis are also reported [3].

Sickle cell nephropathy is a major complication of sickle cell disease. The kidneys are particularly sensitive organs to the disease. Sickle cell disease substantially alters the structure and function of the kidneys and is the cause of several renal diseases and syndromes. Renal damage is more severe in SS homozygous patients than in other major sickle cell syndromes [4]. Approximately 5-18% of patients have SCN, thus increasing the risk of morbidity and mortality of the disease [5].

A number of studies have focused on this pathology, its evolution includes several stages; it starts with hyperfiltration, then the occurrence of microalbuminuria, then macroalbuminuria and finally the progression to renal failure. The prevalence of these complications increases with the age of the patients but can also be seen from a young age.

Two models have been proposed to explain the pathophysiology of SCN. Becker et al. showed that prostaglandin release following ischemic injury causes an increase in glomerular filtration rate (GFR). This increase leads to glomerular injury and eventually manifests as proteinuria and glomerulosclerosis [6]. Alternatively, Nath and Katusic [7] classified the manifestations of SCN into two different phenotypes: the hemolysis-endothelial dysfunction phenotype and the viscosity-vaso-occlusive phenotype. The hemolysis-endothelial dysfunction phenotype affects the renal cortex and leads to hyperfiltration and glomerulopathy; heme released due to intravascular hemolysis predisposes to proteinuria through its accumulation on the glomerular filtration barrier, which disrupts membrane selectivity by exerting cytotoxic effects on podocytes and endothelial cells [8]. On the other hand, the viscosity-vaso-occlusive phenotype is responsible for hematuria, papillary necrosis, and tubular acidosis [9].

Microalbuminuria, reflecting the early stages of renal damage, should be routinely sought in the follow-up assessment in this category of patients.

Decreased GFR, which suggests loss of kidney function, occurs with the progression of sickle cell disease and may be a sign of uncontrolled disease. Sickle cell patients have a higher risk of developing chronic kidney disease compared to the general population.

Specific treatment with an angiotensin-converting enzyme inhibitor or an angiotensin II

receptor antagonist should be considered in these patients in order to slow the progression of the renal disease. The prevention of microthrombosis and thus of renal damage requires the maintenance of a hemoglobin A level of more than 50% by regular blood transfusion as soon as sickle cell disease is diagnosed. The role of hydroxyurea in the prevention and/or treatment of renal function abnormalities in sickle cell disease remains to be studied [10].

Conclusion

Sickle cell nephropathy is a major complication of sickle cell disease. It must be systematically and early sought in all sickle cell patients to reduce the risk of morbidity and mortality of this disease.

The development of new biomarkers has become increasingly essential for the early detection of sickle cell disease in order to improve the survival of patients with sickle cell disease.

Declaration of interest:

The authors declare no conflict of interest.

[periwinklemeanderings]

Vitamin C (Ascorbic Acid):

Contraindications

"Vitamin C supplementation is contraindicated in blood disorders like thalassemia, G6PD deficiency, sickle cell disease, and hemochromatosis. Avoid taking supplements immediately before or following angioplasty. Diabetic patients should take vitamin C supplements with care as it raises blood sugar levels.

Vitamin C should be used cautiously in oxalate nephropathy or nephrolithiasis as acidification by ascorbic acid increases the chances of precipitation of cysteine, urate, and oxalate stones."

[poonamcmi]

The Global Focal Segmental Glomerulosclerosis Market: Share, Size, Growth, Opportunity and Forecast, 2022-2028

Focal Segmental Glomerulosclerosis (FSGS) is a rare kidney disease that impairs the filtration mechanism of the kidneys, resulting in severe scarring and end-stage renal failure. Proteinuria is a symptom of Focal Segmental Glomerulosclerosis Market, which is characterised by progressive scarring of the kidney. It's an uncommon condition that damages and attacks the glomeruli, impairing kidney function. Obesity, birth, sickle cell anaemia, obstructive sleep apnea, and viruses such as HIV are all factors that contribute to kidney failure.

Increased Incidences of Rare Disease Increase Market Demand

Proteinuria and severe scarring are symptoms of Focal Segmental Glomerulosclerosis Market, a rare kidney disease that damages the kidney's filtration mechanism (glomeruli). Focal segmental glomerulosclerosis (FSGS) is usually fatal since it leads to renal failure, dialysis, and death within four to nine years. FSGS progresses more faster than diabetic nephropathy. Proteinuria, nephrotic syndrome, edoema, hyperlipidemia, and hypoalbuminemia are only a few of the disease's symptoms. Obesity, infection, sickle cell disease, and reflux nephropathy are all risk factors.

 Read More @ https://cmiinfopiece.blogspot.com/2022/06/focal-segmental-glomerulosclerosis.html

[healthcare-market]

Focal Segmental Glomerulosclerosis Market Status and Forecast, by Players, Types and Applications

The focal segmental glomerulosclerosis (FSGS) market is highly competitive due to presence of numerous large players and presence of local players. Some of the key participants in the global market for focal segmental glomerulosclerosis (FSGS) are Variant Pharmaceuticals, Inc., GlaxoSmithKline plc., Novartis AG, ChemoCentryx, Inc., and Retrophin, Inc. The global focal segmental glomerulosclerosis (FSGS) market will likely see continued changes in its contours with the successful launch of pipeline products in the next couple of years.

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As per a report by Transparency Market Research, the global focal segmental glomerulosclerosis (FSGS) market will likely rise at a solid 8.0% CAGR over the course of the forecast period from 2017 to 2025. Expanding at this pace, the market which was worth US$7.82 bn in 2016, is projected to attain a value of US$15.83 bn by 2025-end. Based upon the type of disease, the market can be bifurcated into primary focal segmental glomerulosclerosis and secondary focal segmental glomerulosclerosis. Between the two, the primary focal segmental glomerulosclerosis held a substantial 79.8% share in the market in 2016. Growing awareness about the disease and its management is at the forefront of driving growth in the segment. North America, of them, leads with a dominant share on the back of a properly structured healthcare industry and availability of reimbursement policies with wider coverage.

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Rising Instances of the Rare Disease Boosts Demand in Market

Focal segmental glomerulosclerosis (FSGS) is a type of rare kidney disease that affects the kidney’s filtering system (glomeruli) resulting in proteinuria and serious scarring. Focal segmental glomerulosclerosis (FSGS) is usually fatal since it causes kidney failure within four to nine years followed by dialysis and then death. FSGS advances much more swiftly than diabetic nephropathy. Massive proteinuria, nephrotic syndrome, edema, hyperlipidemia, and hypoalbuminemia are some of the common symptoms of the disease. Risk factors include obesity, infection, sickle cell disease and reflux nephropathy.

“Focal segmental glomerulosclerosis affects approximately 210,200 patients worldwide with 14,000 to 16,000 new cases every year. This has been a major growth driver in the market.

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Efforts by NGOs to Generate Awareness about FSGS to Bolster Market

Apart from the rising cases of the medical condition, other factors that can benefit the market are efforts by non-government organizations to increase awareness and increasing allocation towards research on rare diseases. NephCure Kidney International, The Kidney & Urology Foundation of America (KUFA), EURORDIS, and The National Organization for Rare Disorders (NORD) are some of the non-governmental organizations that are helping out patients with focal segmental glomerulosclerosis and generating awareness about the disease. Besides, research in the renal treatment field have resulted in several new drugs being developed and approved every year.

Rising kidney transplants and dialysis procedures are other factors promoting the said market. As per the analyst, the market holds out a lot of opportunity due to a limited number of pipeline products at present.

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This information is included the report titled, “Focal Segmental Glomerulosclerosis (FSGS) Market (Disease Type - Primary Focal Segmental Glomerulosclerosis and Secondary Focal Segmental Glomerulosclerosis; Disease Management - Diagnosis (Kidney Biopsy and Creatine Test) and Treatment (Drug Therapy, Dialysis, and Kidney Transplant) Global Industry Analysis, Size, Share, Growth, Trends, & Forecast 2017-2025”

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[goodhealthiseverything]

Focal Segmental Glomerulosclerosis(FSGS)

Focal Segmental Glomerulosclerosis(FSGS) is a kind of disease that the glomeruli has been damaged. FSGS affects both adults and children. Men and boys are affected slightly more often than women and girls, and it also occurs more often in African Americans.Inherited genetic problems, heroin use, HIV, reflux nephropathy, sickle cell disease, obesity and other factors can cause FSGS. 

Proteinuria, poor appetite, swelling, blood in urine, hyperlipemia, weight gain are the common symptoms of FSGS.Nephrotic Syndrome, Chronic Kidney Failure, malnutrition, thrombus and embolism, infections are the common complications of FSGS. So, not only FSGS itself also its complications torture patients a lot.FSGS develops fast and it may develop into Renal Failure within 1-2 years if the condition can not be controlled well. A healthy diet can slow the progressing of the condition to some extent. 

Low-protein and low salt diets should be the basic requirements for diet. Besides, FSGS patients should limit foods containing much oil, animal fat or cholesterol and forbid cigarette and alcohol.Before FSGS develops Renal Failure, patients are usually treated with the healthy diets and medicines, however, it seems that Renal Failure still can come. 

When the condition develops Renal Failure, the treatment options will be dialysis, kidney transplant and Immunotherapy.

[pathologydiscussionforum]

Causes of renal papillary necrosis: Diabetes (most common), obstructive uropathy, analgesic nephropathy and sickle cell disease.

#Pathology

#pathologydiscussion

#renalpath

#neetpgpreparation

#usmleprep

[ijtsrd]

Co relation of Lipid Profile with Proteinuria in Sickle Cell Nephropathy Patients for Local Area of Chhattisgarh

by Dr. Prafull Dawale | Neha Jain "Co-relation of Lipid Profile with Proteinuria in Sickle Cell Nephropathy Patients for Local Area of Chhattisgarh"

Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021,

URL: https://www.ijtsrd.compapers/ijtsrd42438.pdf

Paper URL: https://www.ijtsrd.commedicine/other/42438/corelation-of-lipid-profile-with-proteinuria-in-sickle-cell-nephropathy-patients-for-local-area-of-chhattisgarh/dr-prafull-dawale

ugcjournallist, listofugcapprovedjournals, researchpublication

Pulmonary hypertension PH in sickle cell disease SCD is an emerging and important clinical problem. In a single institution adult cohort of 75 patients, we investigated lipid and lipoprotein levels and their relationship to markers of intravascular hemolysis, vascular dysfunction and PH. In agreement with prior studies, we confirm significantly decreased plasma levels of total cholesterol, high density lipoprotein cholesterol HDL C , and low density lipoprotein cholesterol LDL C in SCD vs. ethnically matched healthy controls. Several cholesterol parameters correlate significantly with markers of anemia, but not endothelial activation or PH. More importantly, serum triglyceride levels are significantly elevated in SCD compared to controls. Elevated triglyceride levels correlate significantly with markers of hemolysis lactate dehydrogenase and arginase both p 0.0005 , endothelial activation soluble E selectin, p 0.0001 soluble P selectin, p=0.02 soluble vascular cell adhesion molecule 1, p=0.01 , inflammation leukocyte count, p=0.0004 erythrocyte sedimentation rate, p=0.02 and PH amino terminal brain natriuretic peptide, p=0.002 prevalence of elevated tricuspid regurgitant velocity TRV , p 0.001 . In a multivariate analysis, triglyceride levels correlate independently with elevated TRV p=0.002 . Finally, forearm blood flow studies in adult patients with SCD demonstrate a significant association between increased triglyceride HDL C ratio and endothelial dysfunction p 0.05 . These results characterize elevated plasma triglyceride levels as a potential risk factor for PH in SCD. 

[alliedanalytics]

Positive impact of covid-19 on Rare hematology disorders market

Rare hematology disorders market Outlook - 2027

Rare blood diseases include sickle cell disease, beta thalassemia, follicular lymphoma, multiple myeloma, antiphospholipid syndrome, thrombotic thrombocytopenic purpura, and others. Blood develops from hematopoietic stem cells (HSC) and formation takes place in the bone marrow through a sequence of the regulated process known as hematopoiesis. Blood contains component such as plasma, RBS, WBC, and platelets. Blood disorders include bleeding disorders such as hemophilia, blood clots; blood cancers (leukemia, lymphoma, and myeloma). When the normal process of the blood development fails, abnormal blood cell type is produced, which causes blood cancer and other blood disorders. The rare hematological disease includes anemia-type red blood cell conditions, white blood cell dysfunctions, immuno-disorders and other platelet-based abnormalities. The other hemoglobinopathies are also on the rise due to increasing immigration of carriers from underdeveloped nations to developed regions of the world. The rare blood disorders are difficult to diagnose and treat.

The coronavirus COVID-19 has affected 213 countries and territories around the world. COVID-19 has created new challenges that are requiring manufacturers to innovate at speeds they never have before. Supply chain disruptions, social distancing on high-touch assembly lines, limited ability to travel, and the need for oversight add significant complexity to today’s processes. The outbreak of coronavirus disease 2019 (COVID-19) has created a global health crisis that has had a deep impact on the manufacturing market there is a shortage in supply of raw materials from Chinese manufacturers which has resulted in a severe demand-supply gap. The manufacturers are further expected to be stranded on raw material orders owing to the logistics industry being significantly impacted due to lockdown amid COVID-19. This has all affected the market adversely causing a slowdown in the rare hematology disorders market due to shortage of supply and manufacturing drugs.

Download Sample Report at: https://www.alliedmarketresearch.com/request-sample/11306

Top impacting factors: Market Scenario Analysis, Trends, Drivers and Impact analysis:

Drivers:

Increased prevalence:

Rare diseases comprise a growing public health priority, as they affect above 300 million people globally and they are difficult to diagnose and treat. There is a pressing need for better ways to detect and diagnose rare diseases, as well as to provide companion diagnostics for therapy guidance, clinical trials enrollment and therapy monitoring applications. In the U.S., the condition is considered as rare when it affects less than 200,000 people in the United States or prevalence of 5 per 10,000. In Europe, 5 in 10,000 citizens are considered as rare diseases. According to Eurordis (European organization of rare diseases), there are approximately 6000 to 8000 rare diseases. Around 15 million people across the globe suffer from thalassemic disorders and nearly 1.5% of the world population is estimated to be a carrier of β-thalassemia. Rare hematology disorder treatment among the geriatric population base will show boast in future. An overall occurrence of anemia ranges from 10% to 24% among the senior adults. As the age of patient increases, the need for hematology disorder care also increases. Thus, the growing population of geriatric age group will increase the chances of developing rare blood disorders among adults, thereby boosting the demand for hematology disorder treatment in the forecast period.

Development of new therapies:

Global Blood Therapeutics (GBT) is developing biologics for the treatment of sickle cell disease. The company lead candidate, voxelotor (GBT440) is in Phase 3 trials and being investigated for the treatment of sickle cell disease. The candidate is a hemoglobin S polymerization inhibitor and its mechanism of action is modulation hemoglobin affinity for oxygen. FDA has granted has breakthrough therapy, fast track, orphan drug and rare pediatric disease designations to Vozelotor. Imara is developing novel therapeutics for patients suffering from sickle cell disease and other hemoglobinopathies. Sickle cell disease is a rare, genetic blood disease that causes red blood cells to sickle and become damaged, activating immune cells and blocking blood flow in capillaries, injuring many organs and causing daily pain. Its lead candidate is IMR-687, a small molecule inhibitor of phosphodiesterase-9 (PDE9i) for the treatment of sickle cell disease. Launched in April 2016 by orphan drug accelerator Cydan Development. Cyclerion is involved in developing therapies for treating sickle cell disease (SCD) and diabetic nephropathy. They are focused on the nitric oxide-cyclic guanosine monophosphate (cGMP) signaling pathway. Their lead candidate, Olinciguat, which is a vascular guanylate cyclase agonist. The candidate is in phase II clinical trial. They have granted Orphan Drug Designation for SCD by the U.S. Food and Drug Administration. The development of such therapies and treatment for the diseases will drive the Rare hematology disorders market growth.

Restrains:

High cost of treatment and late detection in developing countries will prove as the restrain for market growth.

Key benefits of the report:

This     study presents the analytical depiction of the global rare hematology     disorders industry along with the current trends and future estimations to     determine the imminent investment pockets.

The     report presents information related to key drivers, restraints, and     opportunities along with detailed analysis of the global rare hematology     disorders market share.

The     current market is quantitatively analyzed from 2020 to 2027 to highlight     the global rare hematology disorders market growth scenario.

Porter’s     five forces analysis illustrates the potency of buyers & suppliers in     the market.

The     report provides a detailed global rare hematology disorders market     analysis based on competitive intensity and how the competition will take     shape in coming years.

Read more: https://www.alliedmarketresearch.com/rare-hematology-disorders-market-A10941

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[rnomics]

#RNA sequencing of isolated cell populations expressing human APOL1 G2 risk variant reveals molecular correlates of sickle cell nephropathy in zebrafish podocytes

by Joseph L. Bundy, Blair R. Anderson, Ludmila Francescatto, Melanie E. Garrett, Karen L. Soldano, Marilyn J. Telen, Erica E. Davis, Allison E. Ashley-Koch Kidney failure occurs in 5–13% of individuals with sickle cell disease and is associated with early mortality. Two APOL1 alleles (G1 and G2) have been identified as risk factors for sickle cell disease nephropathy. Both risk alleles are prevalent in individuals with recent African ancestry and have been associated with nephropathic complications in other diseases. Despite the association of G1 and G2 with kidney dysfunction, the mechanisms by which these variants contribute to increased risk remain poorly understood. Previous work in zebrafish models suggest that the G2 risk allele functions as a dominant negative, whereas the G1 allele is a functional null. To understand better the cellular pathology attributed to APOL1 G2, we investigated the in vivo effects of the G2 risk variant on distinct cell types using #RNA sequencing. We surveyed APOL1 G2 associated transcriptomic alterations in podocytes and vascular endothelial cells isolated from zebrafish larvae expressing cell-type specific reporters. Our analysis identified many transcripts (n = 7,523) showing differential expression between APOL1 G0 (human wild-type) and APOL1 G2 exposed podocytes. Conversely, relatively few transcripts (n = 107) were differentially expressed when comparing APOL1 G0 and APOL1 G2 exposed endothelial cells. Pathway analysis of differentially expressed transcripts in podocytes showed enrichment for autophagy associated terms such as “Lysosome” and “Phagosome”, implicating these pathways in APOL1 G2 associated kidney dysfunction. This work provides insight into the molecular pathology of APOL1 G2 nephropathy which may offer new therapeutic strategies for multiple disease contexts such as sickle cell nephropathy. http://bit.ly/2WsbWko

[optometrist0]

Acute Angle Glaucoma

Contents

Turned 75 years old and have

And treatment for

Open angle glaucoma

When internal eye structures

Get Acute angle glaucoma here. Check it now

Glaucoma, Diabetic Nephropathy, Pulmonary Hypertension, Sickle Cell Disease, …

ACUTE GLAUCOMA. Unlike POAG (Primary Open-Angle Glaucoma), where the IOP increases slowly, in acute angle-closure, it increases suddenly. This sudden rise in pressure can occur within a matter of hours and become very painful. If the pressure rises high enough, the pain may become so intense that it can cause …

I just turned 75 years old and have had glaucoma for … glaucoma, the pressure of the fluid inside the eyeball increases when fluid is unable to drain fast enough. The two types of glaucoma are angle-closure and openangle. …

Postoperative blindness is a devastating and fortunately rare complication of general anesthesia. The incidence of postoperative blindness is low (Ref. 1).

Read about acute angle-closure glaucoma signs, symptoms, diagnosis, risk factors, surgery, and treatment. A sudden increase in intraocular pressure (IOP) causes acute …

The consultant ophthalmologist said Angle-Closure Glaucoma is often chronic, like POAG, but can sometimes be acute, in which case it usually presents as a very …

Though the major part of glaucoma patients comprise of open angle but the severity of vision loss seems to be more disproportionate in acute angle …

professor of ophthalmology at the Doheny Eye Institute. There are two predominant types of glaucoma: open-angle and closed-angle. Chronic, or open-angle, glaucoma is by far the most common. Known as the “thief of sight” among …

May 25, 2017 … Angle closure is defined as the apposition of iris to the trabecular meshwork, which results in increased intraocular pressure (IOP). In acute angle closure ( AAC), the process occurs suddenly with a dramatic onset of symptoms, including blurred vision, red eye, pain, headache, and nausea and vomiting.

May 15, 2017  · who presents with Headache. Most likely 2/2 tension headache, migraine, or headache of non-emergent etiology. No focal neurological symptoms. Neuro exam is …

Ophthalmology Millburn NJ – Dr Ian Kaden offers the latest in Ophthalmology. Our practices serve Millburn NJ, Randolph NJ, Hackettstown NJ and surrounding areas.

Acute angle-closure glaucoma occurs when the pressure inside your eye rises quickly. The usual symptoms are sudden eye pain, a red eye and reduced vision….

It is considered a lifelong condition. Closed-angle glaucoma: Also known as acute angle-closure glaucoma or narrow-angle glaucoma, it develops very quickly and seeks immediate medical attention. The patient experiences pain and …

Severe eye pain can mean acute angle closure glaucoma. Learn about the causes, symptoms, and treatment for this serious eye condition.

Acute angle closure glaucoma caused by anterior subluxated lens is rare. To the best of our knowledge, there are …

Acute angle closure crisis deserves its own special mention, as it is one of the few true emergencies in the glaucoma world. Of all of the forms of glaucoma, angle closure has a much greater chance to cause permanent vision loss than open angle glaucoma, and the acute crisis (frequently called an acute attack) probably …

Mar 30, 2017 … Severe eye pain can mean acute angle closure glaucoma. Learn about the causes, symptoms, and treatment for this serious eye condition.

Dec 18, 2013 … Acute angle closure is an urgent but uncommon dramatic symptomatic event with blurring of vision, painful red eye, headache, nausea, and vomiting. Diagnosis.

Open-angle glaucoma is painless and does not have acute attacks, thus the lack of clear symptoms make screening via regular eye check-ups important. The only signs are gradually progressive visual field loss, and optic nerve changes ( increased cup-to-disc ratio on fundoscopic examination). About 10% of people with …

The second type of glaucoma, acute angle-closure glaucoma, is caused by the iris bulging forward to block the drainage angle formed by the cornea and iris so that pressure increases abruptly. It has more sudden, dramatic …

Acute angle closure glaucoma of the right eye (intraocular pressure was … Yat-sen University in China have shown that acute glaucoma in mice is largely an inflammatory disease and that high pressure in the eye causes vision loss by …

Acute narrow-angle glaucoma occurs suddenly, when the colored portion of your eye (iris) is pushed or pulled forward. This causes blockage of the drainage angle of the eye, where the trabecular meshwork allows outflow of fluids. when internal eye structures are blocked in this way, your eye's internal pressure ( intraocular …

Apr 13, 2017 … Glaucoma is a nonspecific term used for several ocular diseases that ultimately result in increased intraocular pressure (IOP) and decreased visual acuity. Acute angle-closure glaucoma (AACG) is an ocular emergency and receives distinction due to its acute presentation, need for immediate treatment, and …

Some patients have acute attacks where the vision drops, the eye becomes red and inflamed, and the pressure in the eye increases. In most cases of narrow angle glaucoma, the attack of high pressure can be relieved with medications, …

Acute angle-closure glaucoma is caused by a rapid or sudden increase in intraocular pressure (IOP), the pressure within the eye. Fluid is continually produced inside, and drains out of, the normal eye. This fluid, called aqueous humor, is unrelated to the tears, which are only on the outside of the eye. High pressure inside …

Acute angle-closure glaucoma (AACG) is an ocular emergency and receives distinction due to its acute presentation, need for immediate treatment, …

Glaucoma Risk Factors Contents Americans currently have glaucoma Usually without any Many factors can Your risk for getting glaucoma Than normal.most eye care Relationship between specific caffeinated drinks A staggering four million americans currently have glaucoma, a condition that causes increased pressure to the optic nerves within the eyeball and lead gradually to … Sep 15, 2004 … Is Glaucoma Treatable Contents Controlled with proper Help patients and their families Eyes without glaucoma. concomitant Million people worldwide with Glaucoma is an eye disease that cannot be cured, but it can be controlled with proper treatment, depending on the type of glaucoma you are diagnosed with. Oct 29, 2017 … Currently, regular eye exams are the best Glaucoma Surgery Contents The leading cause Surgical operation which lowers The eye and protect Surgery can help lower pressure Eyes without glaucoma. concomitant cataract Glaucoma is a group of diseases affecting the optic nerve that results in vision loss and is frequently characterized by raised intraocular pressure (IOP). Mar 1, 2017 … Operating room surgery. Some glaucoma

from http://bestoptometrists.net/acute-angle-glaucoma-2/

[healthcare-market]

Focal Segmental Glomerulosclerosis Market Detailed Analysis and Forecast up to 2025

The focal segmental glomerulosclerosis (FSGS) market is highly competitive due to presence of numerous large players and presence of local players. Some of the key participants in the global market for focal segmental glomerulosclerosis (FSGS) are Variant Pharmaceuticals, Inc., GlaxoSmithKline plc., Novartis AG, ChemoCentryx, Inc., and Retrophin, Inc. The global focal segmental glomerulosclerosis (FSGS) market will likely see continued changes in its contours with the successful launch of pipeline products in the next couple of years.

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As per a report by Transparency Market Research, the global focal segmental glomerulosclerosis (FSGS) market will likely rise at a solid 8.0% CAGR over the course of the forecast period from 2017 to 2025. Expanding at this pace, the market which was worth US$7.82 bn in 2016, is projected to attain a value of US$15.83 bn by 2025-end. Based upon the type of disease, the market can be bifurcated into primary focal segmental glomerulosclerosis and secondary focal segmental glomerulosclerosis. Between the two, the primary focal segmental glomerulosclerosis held a substantial 79.8% share in the market in 2016. Growing awareness about the disease and its management is at the forefront of driving growth in the segment. North America, of them, leads with a dominant share on the back of a properly structured healthcare industry and availability of reimbursement policies with wider coverage.

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Rising Instances of the Rare Disease Boosts Demand in Market

Focal segmental glomerulosclerosis (FSGS) is a type of rare kidney disease that affects the kidney’s filtering system (glomeruli) resulting in proteinuria and serious scarring. Focal segmental glomerulosclerosis (FSGS) is usually fatal since it causes kidney failure within four to nine years followed by dialysis and then death. FSGS advances much more swiftly than diabetic nephropathy. Massive proteinuria, nephrotic syndrome, edema, hyperlipidemia, and hypoalbuminemia are some of the common symptoms of the disease. Risk factors include obesity, infection, sickle cell disease and reflux nephropathy.

“Focal segmental glomerulosclerosis affects approximately 210,200 patients worldwide with 14,000 to 16,000 new cases every year. This has been a major growth driver in the market.

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Efforts by NGOs to Generate Awareness about FSGS to Bolster Market

Apart from the rising cases of the medical condition, other factors that can benefit the market are efforts by non-government organizations to increase awareness and increasing allocation towards research on rare diseases. NephCure Kidney International, The Kidney & Urology Foundation of America (KUFA), EURORDIS, and The National Organization for Rare Disorders (NORD) are some of the non-governmental organizations that are helping out patients with focal segmental glomerulosclerosis and generating awareness about the disease. Besides, research in the renal treatment field have resulted in several new drugs being developed and approved every year.

Rising kidney transplants and dialysis procedures are other factors promoting the said market. As per the analyst, the market holds out a lot of opportunity due to a limited number of pipeline products at present.

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This information is included the report titled, “Focal Segmental Glomerulosclerosis (FSGS) Market (Disease Type - Primary Focal Segmental Glomerulosclerosis and Secondary Focal Segmental Glomerulosclerosis; Disease Management - Diagnosis (Kidney Biopsy and Creatine Test) and Treatment (Drug Therapy, Dialysis, and Kidney Transplant) Global Industry Analysis, Size, Share, Growth, Trends, & Forecast 2017-2025”

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[healthcare-research-report-blog]

Focal Segmental Glomerulosclerosis Market to Reap Excessive Revenues by 2025

Some of the key participants in the global market for focal segmental glomerulosclerosis (FSGS) are Variant Pharmaceuticals, Inc., GlaxoSmithKline plc., Novartis AG, ChemoCentryx, Inc., Retrophin, Inc., AbbVie, Inc., AstraZeneca plc., Pfizer, Inc., Sanofi S.A, and Teva Pharmaceutical Industries Ltd.

The global Focal Segmental Glomerulosclerosis (FSGS) Market will likely see continued changes in its contours with the successful launch of pipeline products in the next couple of years.

As per a report by Transparency Market Research, the global focal segmental glomerulosclerosis (FSGS) market will likely rise at a solid 8.0% CAGR over the course of the forecast period from 2017 to 2025. Expanding at this pace, the market which was worth US$7.82 bn in 2016, is projected to attain a value of US$15.83 bn by 2025-end.

Based upon the type of disease, the market can be bifurcated into primary focal segmental glomerulosclerosis and secondary focal segmental glomerulosclerosis. Between the two, the primary focal segmental glomerulosclerosis held a substantial 79.8% share in the market in 2016. Growing awareness about the disease and its management is at the forefront of driving growth in the segment.

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 Latin America, North America, Asia Pacific, Europe, and the Middle East and Africa are some of the prominent geographic segments in the global focal segmental glomerulosclerosis market. North America, of them, leads with a dominant share on the back of a properly structured healthcare industry and availability of reimbursement policies with wider coverage. The U.S. is mainly serving to drive the market in North America due to the greater uptake of advanced and high-cost drug therapies, considerable penetration of treatment, and helpful reimbursement policies. Another factor stoking market growth in the U.S. is the classification of focal segmental glomerulosclerosis (FSGS) drugs under orphan disease drugs categories.

 Rising Instances of the Rare Disease Boosts Demand in Market

Focal segmental glomerulosclerosis (FSGS) is a type of rare kidney disease that affects the kidney’s filtering system (glomeruli) resulting in proteinuria and serious scarring. Focal segmental glomerulosclerosis (FSGS) is usually fatal since it causes kidney failure within four to nine years followed by dialysis and then death. FSGS advances much more swiftly than diabetic nephropathy. Massive proteinuria, nephrotic syndrome, edema, hyperlipidemia, and hypoalbuminemia are some of the common symptoms of the disease. Risk factors include obesity, infection, sickle cell disease and reflux nephropathy.

“Focal segmental glomerulosclerosis affects approximately 210,200 patients worldwide with 14,000 to 16,000 new cases every year. This has been a major growth driver in the market,” explains the lead analyst of the report.

 Request to View Brochure of Report -

https://www.transparencymarketresearch.com/sample/sample.php?flag=B&rep_id=31505

 Efforts by NGOs to Generate Awareness about FSGS to Bolster Market

Apart from the rising cases of the medical condition, other factors that can benefit the market are efforts by non-government organizations to increase awareness and increasing allocation towards research on rare diseases. NephCure Kidney International, The Kidney & Urology Foundation of America (KUFA), EURORDIS, and The National Organization for Rare Disorders (NORD) are some of the non-governmental organizations that are helping out patients with focal segmental glomerulosclerosis and generating awareness about the disease. Besides, research in the renal treatment field have resulted in several new drugs being developed and approved every year.

Rising kidney transplants and dialysis procedures are other factors promoting the said market. As per the analyst, the market holds out a lot of opportunity due to a limited number of pipeline products at present.

 Enquiry for discount on this report -

https://www.transparencymarketresearch.com/sample/sample.php?flag=D&rep_id=31505

 About Us

Transparency Market Research (TMR) is a market intelligence company, providing global business information reports and services. Our exclusive blend of quantitative forecasting and trends analysis provides forward-looking insight for thousands of decision makers. TMR’s experienced team of analysts, researchers, and consultants, use proprietary data sources and various tools and techniques to gather, and analyze information. Our business offerings represent the latest and the most reliable information indispensable for businesses to sustain a competitive edge.

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[cancersfakianakis1]

Nephrin as a biomarker of sickle cell glomerulopathy in Malawi

Abstract

Background

Glomerulopathy is an increasingly identified complication in young patients with sickle cell disease (SCD). Hyperfiltration and albuminuria followed by declining glomerular filtration rates and eventual end-stage renal disease (ESRD) is assumed to be the typical progression of glomerular disease. There are only a few reported biomarkers to identify early-stage renal disease in SCD.

Procedures

We detail the renal profile of 101 children with SCD in Malawi and propose a novel urinary biomarker for the identification of early renal disease.

Results

Among children with sickle cell anemia, 24.8% had a urine albumin–creatinine ratio of 30 mg/g or above. In univariate analysis, only patients with higher urinary nephrin, a urinary marker of glomerular injury, had significantly greater odds of having albuminuria. In multivariable analysis, nephrin remained significantly associated with albuminuria. A nephrin–creatinine ratio (NCR) cut-point of 622 ng/mg, the 50th percentile, was associated with a 45.8 times greater odds of having albuminuria in children with nephrinuria above this value. Further analysis revealed this urinary NCR cut-point to have 96% sensitivity, 64% specificity, 47% positive predictive value, and 98% negative predictive value for the presence of albuminuria.

Conclusions

These data suggest that a substantial number of children with SCD in Malawi have renal disease and could be at risk for worsening nephropathy and ESRD as they age. Our data suggest that urinary nephrin could be utilized as an early marker of glomerular disease in SCD.

http://ift.tt/2sl4SYb

[improv-motherhood]

Sitting here doing my annotated bibliographies on sickle cell trait and renal medullary cancer. Learned it’s 1 of 7 renal nephropathies and has a survival rate of 0% after 5 months. AND it’s found in SCT people age 18-39.

Woooo that’s what I get for picking subjects that personally affect me. I’ll just be here having a panic attack now, don’t mind me.

[hwcampus]

New Post has been published on Online Professional Homework Help

New Post has been published on https://hwcampus.com/shop/nur-631-weeks-discussions/

NUR 631 All Weeks Discussions

Discussions Topic 1 DQ 1 What are the benefits and consequences of genetic testing? Indicate which question you have chosen using the format displayed in the Discussion Forum Sample. What are the benefits and consequences of genetic testing? What is your personal stance on genetic testing? Provide two current (within the last 5 years) scientific or evidence-based resources to support your answer. What are the effects of nutritional deficits on cellular functioning and tissue healing? Support your answer with current research that has been conducted within the last 3 years. What is the difference between physiological and pathological atrophy? Provide at least two clinical examples for each.

Topic 1 DQ 2

Topic 1 DQ 2 5.0 Select one of the articles listed below. Indicate which article you have chosen and craft a scholarly summary highlighting key points and takeaways. Your summary should be between 150-250 words.

Topic 2 DQ 1 Select one of the following discussion questions for your discussion response. Indicate which question you have chosen using the format displayed in the Discussion Forum Sample. Inflammation is a process that accompanies many different disease processes. In addition, a diet that is high in sugars and processed foods can also cause inflammation. What are health risk factors related to dietary habits and inflammation? What are the differences between the primary and secondary line of defense? What factors interfere with these mechanisms? How are these levels of immunity affected in a child, an elderly person, or a person with a chronic disease? Ms. Smith presents to her PCP for a comprehensive medical exam. Included in the exam are titers for various childhood diseases since she is not able to find her immunization records. What are “titers” and what type of testing is required to establish immunity? Explain the difference between primary and secondary immune deficiencies and give an example of a disorder seen with each. Be sure to include the pathophysiology seen with each disorder and the role of the immune deficiency in each disorder.

Topic 2 DQ 2

DQ – 2

Select one of the articles listed below. Indicate which article you have chosen and craft a scholarly summary highlighting key points and takeaways. Your summary should be between 150-250 words. “Toward a Molecular Understanding of Adaptive Immunity: A Chronology, Part I,” by Smith, from Frontiers in Immunology (2012). https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=85343462&site=eds-live&scope=site “Do Inhibitory Immune Receptors Play a Role in the Etiology of Autoimmune Disease?” by Olde Nordkamp, Koeleman, and Meyaard, from Clinical Immunology (2014). https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1521661613002994&site=eds-live&scope=site “Impact of Prenatal Stress and Adulthood Stress on Immune System: A Review,” by Wu, from Biomedical Research (2012). https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=83533005&site=eds-live&scope=site

Topic 3 DQ 1

DQ – 1

Select one of the following discussion questions for your discussion response. Indicate which question you have chosen using the format displayed in the Discussion Forum Sample. Explain how acid-base physiology leads to the regulation of fluid balance and extra cellular pH. What is the equation for the carbonic acid/bicarbonate buffering system? How do actions at the lungs and kidneys affect this equation and thus compensate for alterations in plasma pH levels? How can an aspirin overdose cause a respiratory alkalosis and a metabolic acidosis? Be sure to thoroughly explain the pathophysiological mechanisms involved. Based on your clinical experiences, what is the most commonly dangerous electrolyte imbalance and why? Explain the pathophysiology of the imbalance. How do changes in plasma osmolality affect the physiology of erythrocytes?

Based on your clinical experiences, what is the most commonly dangerous electrolyte imbalance and why? Explain the pathophysiology of the imbalance.

Topic 3 DQ 2

DQ 2

Select one of the articles listed below. Indicate which article you have chosen and craft a scholarly summary highlighting key points and takeaways. Your summary should be between 150-250 words. “Fluid Balance and Sodium Losses During Indoor Tennis Match Play,” by Lott and Galloway, from International Journal of Sport Nutrition & Exercise Metabolism (2011). https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=69665497&site=eds-live&scope=site “Hepatic Encephalopathy Complicated With Hyponatremia and Acid-Base Disturbance and Its Prognosis,” by Chengshan et al., from Journal of Medical Colleges of PLA (2012). https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1000194812600161&site=eds-live&scope=site “Measuring and Managing Fluid Balance,” by Shepherd, from Nursing Times (2011). http://search.proquest.com/docview/1038833471?accountid=7374

Article chosen to summarize “Measuring and Managing Fluid Balance,” by Shepherd, from Nursing Times (2011). http://search.proquest.com/docview/1038833471?accountid=7374

Topic 4 DQ – 1

Select one of the following discussion questions for your discussion response. Indicate which question you have chosen using the format displayed in the Discussion Forum Sample. Anemia of chronic disease is a common occurrence in elderly patients. What is the pathophysiological mechanism behind this disease process? Virchow’s triad refers to states that can produce hypercoagulability. What are the three categories? Give an example for each and explain the pathophysiological changes seen. Hemolytic anemias may be inherited (such as in sickle cell anemia) or acquired. What are the etiologies for each and what is the pathophysiological mechanism shared by both?

Topic 4 DQ – 2

Select one of the articles listed below. Indicate which article you have chosen and craft a scholarly summary highlighting key points and takeaways. Your summary should be between 150-250 words. “Thalassemia Intermedia: An Overview” by Shawky and Kamal, from Egyptian Journal of Medical Human Genetics (2012). https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=83717104&site=eds-live&scope=site “Pathophysiology of Anemia and Erythrocytosis,” by Hodges, Rainey, Lappin, and Maxwell, from Critical Reviews in Oncology/Hematology (2007). http://www.sciencedirect.com.library.gcu.edu:2048/science/article/pii/S1040842807001199 “Sickle-Cell Anemia” in The Cambridge Historical Dictionary of Disease (2003). https://lopes.idm.oclc.org/login?url=http://search.credoreference.com/content/entry/cupdisease/sickle_cell_anemia/0

Topic 5 DQ 1 DQ – 1 Select one of the following discussion questions for your discussion response. Indicate which question you have chosen using the format displayed in the Discussion Forum Sample. With endocrine disorders, just like any other disorder, it is essential to determine the root cause of the disorder. What are primary, secondary, and tertiary disorders? Compare the differences between primary, secondary, and tertiary forms of hyposecretion and hypersecretion? The hypothalamic-pituitary system is the main controlling factor for normal endocrine function. What are some of the common ways for this finely balanced system to become unstable? Explain how the circadian rhythm is related to cortisol secretion from the adrenal cortex. What factors cause disturbances in this system?

Explain how the circadian rhythm is related to cortisol secretion from the adrenal

DQ – 2

Select one of the articles listed below. Indicate which article you have chosen and craft a scholarly summary highlighting key points and takeaways. Your summary should be between 150-250 words. “Neuroendocrine, Immune and Oxidative Stress in Shift Workers,” by Faraut, Bayon, and Leger, from Sleep Medicine Reviews (2013). http://dx.doi.org.library.gcu.edu:2048/10.1016/j.smrv.2012.12.006

“Pathology of the Pituitary, Parathyroid, Thyroid and Adrenal Glands,” by Okpohkam and Johnson, from Surgery (Oxford) (2011). http://dx.doi.org.library.gcu.edu:2048/10.1016/j.mpsur.2011.06.004

Topic 6 DQ – 1 Select one of the following discussion questions for your discussion response. Indicate which question you have chosen using the format displayed in the Discussion Forum Sample. What are some of the key pathophysiological differences between neurogenic and nephrogenic diabetes insipidus? Explain the diagnostic criteria for metabolic syndrome and explain the pathophysiology behind the systems seen. Diabetic neuropathies are a major cause of morbidity and mortality. Explain the etiology, pathophysiology, and outcomes of one of the following: retinopathy, nephropathy, or neuropathy. Explain the role of leptin in the role of obesity.

Topic 6 DQ – 2

Select one of the following articles. Indicate which article you have chosen and craft a scholarly summary highlighting key points and takeaways. Your summary should be between 150-250 words. “The Use of Neuroimaging for Assessing Disorders of Pituitary Development,” by Iorgi et al., from Clinical Endocrinology (2012). https://lopes-idm-oclc-org.library.gcu.edu:2443/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=70117536&site=ehost-live&scope=site “Thyroid Disorders and Other Endocrinological Disorders in Pregnancy,” by Girling and Sykes, from Obstetrics, Gynaecology and Reproductive Medicine (2013). http://dx.doi.org.library.gcu.edu:2048/10.1016/j.ogrm.2013.03.009 “Endocrinology Review: Adrenal and Thyroid Disorders,” by Gorman and Chiasera, from Clinical Laboratory Science (2013). https://library.gcu.edu:2443/login?url=http://search.proquest.com.library.gcu.edu:2048/docview/1355280668?accountid=7374