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Biomedical subjects

D K Guiliotis

Publications and source records attributed to D K Guiliotis.

5 recordsLinked to original sources
PubMed1994

Thalassemia major in Connecticut: a 20-year study of changing age distribution and survival.

There has been a near doubling of the mean age (10.7 to 19.0 years) of Yale-New Haven Hospital patients with transfusion-dependent homozygous beta thalassemia between 1973 and 1994. This change is, in part, a result of improved transfusion procedures and effective chelation therapy with deferoxamine mesylate. A concomitant trend has been a decrease in the number of births of new cases resulting in fewer thalassemia major patients less than 10 years of age in 1985 and 1994 compared to a decade earlier. Identification of individuals at risk of having children with thalassemia major by extensive screening for heterozygous thalassemia and the availability of prenatal diagnosis may have contributed to this change. Thalassemia major has become a disease of adolescents and young adults. The increasing age has resulted in "new" issues in thalassemia major patients such as sexuality and marriage as well as economic problems involving health-care insurance and employment.

Adolescent↗
PubMed1987

Patient age distribution in thalassemia major: changes from 1973 to 1985.

Major advances have occurred in the treatment and prevention of thalassemia major, but their impact on incidence and survival have not been well assessed. In 1973, a survey was done of the ages of 243 living patients with thalassemia major followed at 12 centers in the United States and Canada. Twenty-two percent were younger than 5 years and 2.1% were older than 25 years of age (mean 11.4 +/- 6.7 [SD] years). In 1985, there were 303 patients at the same centers; 11% were younger than 5 years and 7.9% were older than 25 years (mean 14.2 +/- 7.3 years). A similar pattern was found in Connecticut, characterized by a marked decrease of new cases of thalassemia major during the past 15 years. This was not a result of fewer persons at genetic risk or a change in marital ethnic choices. Eleven of 14 families who had a child with thalassemia major assured that another affected child would not be born by having no more children, using prenatal diagnosis, or having therapeutic abortions. Extensive community programs of education and testing for thalassemia trait in Connecticut may also have contributed to the observed reduction in new cases.

Adolescent↗
PubMed1980

Hematology of beta-thalassemia trait--age-related developmental aspects and intrafamilial correlations.

Beta-thalassemia trait is a frequent cause of microcytic anemia in Mediterranean children. Because striking age-related changes occur in hemoglobin and mean corpuscular volume during childhood, we assessed developmental hematologic characteristics of 132 patients less than or equal to 18 years of age with beta-thalassemia trait. Thirty-nine kindred were studied to examine intrafamilial correlations of hematologic abnormalities. Patients with beta-thalassemia trait demonstrated Hgb values about 2 gm/dl below normal standards, with a progressive rise with age paralleling normal trends. Thalassemic MCV values showed a far greater deviation from normal than Hgb levels. In contrast to normal developmental trends which show a sharp increase in the first five years of life, the MCV in thalassemia trait showed no age-related increase prior to adolescence. No age-related changes in hemoglobin A2 levels were noted. Kindred studies demonstrate a correlation of the degree of anemia, microcytosis, and elevated hemoglobin A2 levels in affected family members (r = 0.318 P < 0.004, r = 0.525 P < 0.001, r = 0.416 P < 0.0015, respectively). Our findings support the use of electronically determined MCV values as an initial screening procedure for children with beta-thalassemia trait. Values of < 70 fl prior to adolescence and < 75 fl during adolescence were present in nearly all thalassemic subjects. Intrafamilial correlations of Hgb, MCV, and hemoglobin A2 levels suggest that these characteristics are genetically determined.

Adolescent↗