Hashemi S J, Shohani M,
Volume 62, Issue 3 (6-2004)
Abstract
Background: Bone Marrow Transplantation is one of the most important therapeutic methods in much malignant and nonmalignant disease. Patients with Bone Marrow Transplantation (BMT) following radiotherapy and chemotherapy will suffer from immuno-suppression. Therefore they are susceptible to get saprophytic fungi infection that sometimes are killer.
Materials and Methods: The purpose of this cross-sectional survey is isolation of saprophytic fungi from patients with BMT and wards space and instruments. Therefore sampling from ventilator system (HEPA filter and common filter), air canal, air, hospital instruments and clinical samples (nasal discharge, sputum, urine) were done and cultured in sabouro dextrose agar with choloramphenicol (SC). In assessing total frequency from 4838 plates of wards space and instruments, 985 fungi colonies includes 21 genus were isolated.
Results and Conclusion: Most fungi colonies present were Penicillium , Aspergillus and Cladosporium and low present were Trichoderma ,Stereptomyses, Chrysosporium, Rhizopus.
Esfahani A, Iravani M, Khoshnyat M, Ghoreishi Z, Shamshiri A R, Moghadam Z, Jahani M, Ghavamzadeh A,
Volume 65, Issue 5 (8-2007)
Abstract
Background: Bone marrow transplantation (BMT) is the treatment of choice for many patients with malignant and nonmalignant diseases. Long-term complications such as osteoporosis should be considered, because it is directly associated with the morbidity and mortality. The purpose of this study is to assess the bone mineral density after allogenic or autologous bone marrow transplantation in patients with leukemia or lymphoma.
Methods: We prospectively investigated 63 patients undergoing BMT for acute and chronic leukemia and lymphoma. At the end of the study, a total of 28 patients were assessed. Bone mineral density (BMD) was measured prior BMT, and 6 and 12 months after BMT. Osteocalcin, bone alkaline phosphatase and C-terminal telopeptides of type 1 collagen (ICTP) were assessed. Serum concentration of calcium, phosphorous, vitamin D, PTH and sex hormones (FSH, LH, testosterone and estradiol) were also measured.
Results: There was a significant decrease in the bone mineral density of the femoral neck six months after BMT (p<0.001), 1.01±0.13g/cm² prior to BMT and 0.96±0.13 g/cm² at six months, but no considerable changes were seen in lumbar vertebrae. Bone loss between the 6th and 12th months was not observed. The levels of ICTP and phosphorus increased significantly by the 12th month (p=0.04). The level of calcium was higher at the 6th month (p=0.002) but the level of vitamin D and PTH decreased by the end of the study (p=0.04 and p=0.01, respectively) and the average of osteocalcin did not increase significantly. In women, the level of estradiol decreased by the 6th month (p=0.01), but the testosterone changes were not significant.
Conclusion: The risk of bone loss in both allogeneic and autologous BMT is higher in the femoral neck than the lumbar vertebrae, occurring mainly in the first six months after BMT. Preventive and clinical procedures should be considered.
Mortazavizadeh Smr, Owlia Mb, Mehrpoor G,
Volume 67, Issue 1 (4-2009)
Abstract
Background: Reflex Sympathetic Dystrophy Syndrome (RSDS) is a rarely described complication which characterized by pain, edema, movement and vasomotor disorders, trophic changes in the skin and patchy demineralization of bone in extremities. There are numerous risk factors such as trauma, surgery, myocardial infraction and drugs. Cyclosporine (CsA) is one of the drugs which can induce RSDS.
Case report: Herein we described a 33- years old man (known case of ALL) with severe painful and edematous extremities, which was being treated with cyclosporine because of Graft Versus Host Disease (GVHD) after bone marrow transplantation. His laboratory tests were normal except for AST and ALT. With impression of Reflex Sympathetic Dystrophy Syndrome triple-phase bone scan was done, Increased uptake and delayed wash-out in vascular and bony phase is considered typical for RSDS. Due to clinical and triple-phase bone scan findings the diagnosis was established. Symptoms of RSDS improved when CsA was discontinued.
Conclusion: According to this case report and the other ones, Cyclosporine should be considered as the etiology of Reflex Sympathetic Dystrophy Syndrome.