The characteristics of megaloblastic anemia associated with thalassemia.
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Biomedical subjects
Publications and source records attributed to Chih-Cheng Chen.
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Activated partial thromboplastin time (aPTT) and prothrombin time (PT) are 2 major methods of screening patients for bleeding tendency. Heparin is an anticoagulant commonly used for various clinical conditions and will thus affect the coagulation profile. The influence of heparin on PT vs aPTT, seldom addressed in the past, should be carefully investigated. Prospective data on 35 patients who were heparinized for clinically indicated conditions were collected and analyzed for the change in PT (dPT) and aPTT (daPTT) at 3 time points after treatment, all of which were compared with baseline data checked before therapy. Age, sex, and the results of a complete blood count and liver and renal function tests were also evaluated for each patient to determine their effects on dPT and daPTT. The therapeutic goal of keeping the aPTT within a desirable range was achieved in approximately 75% of patients by the last day of heparin therapy. Within this range, dPTs were not statistically significant, nor was the effect of age, sex, hemoglobin level, serum albumin level, white cell count, platelet count, or renal or hepatic function. In patients with thrombosis, dPT was not significantly influenced by heparin dose. During an overlap in the periods of coumadin and heparin administration, PT was used as a guide for adjusting the coumadin dose. The anticoagulant effect, indicated by a PT in the target range, would occur primarily secondary to coumadin administration and would make it relatively easy to decide when to discontinue heparin.
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Neonatal hyperammonemia is a medical emergency requiring a multidisciplinary teamwork for early recognition and early treatment. The causes of neonatal hyperammonemia vary. The transient hyperammonemia of the neonate (THAN) occurs mostly in premature babies, and the prognosis is usually better than for urea cycle disorders. Here we present a near-term premature male infant with THAN. He exhibited the symptoms during the first 36 hours of life and survived after continuous arteriovenous hemodiafiltration (CAVHD). Nutritional support and sodium benzoate were also given. The diagnosis was based on laboratory tests. Long-term follow-up of neurodevelopment was suggested.