Pain status in patients with hemophilia: evaluation of routine pain assessment in an unselected cohort of patients with hemophilia A and B

2021 ◽  
Author(s):  
K Holstein ◽  
K Veltrup ◽  
M Tetzlaff ◽  
G Schröder ◽  
S von Mackensen ◽  
...  
Blood ◽  
2013 ◽  
Vol 121 (19) ◽  
pp. 3946-3952 ◽  
Author(s):  
Manuel D. Carcao ◽  
H. Marijke van den Berg ◽  
Rolf Ljung ◽  
Maria Elisa Mancuso ◽  
C Altisent ◽  
...  

Key Points Previously untreated patients with severe hemophilia A caused by F8 null mutations show a more severe phenotype than previously untreated patients with non-null mutations. The phenotypic differences are modest, and as such not likely to affect decisions regarding when and how to start prophylaxis.


2006 ◽  
Vol 175 (4S) ◽  
pp. 359-359
Author(s):  
Sompol Permpongkoso ◽  
Aaron Sulman ◽  
Stephen B. Solomon ◽  
GaryX Gong ◽  
Louis R. Kavoussi

Pflege ◽  
2001 ◽  
Vol 14 (3) ◽  
pp. 171-181 ◽  
Author(s):  
Evas Cignacco

Während Erwachsene und Kinder Schmerzerlebnisse durch Sprache deuten und ihnen so Ausdruck verleihen, ist die Schmerzerfassung bei Neugeborenen wegen der fehlenden Verbalisierung nicht möglich. Die Schmerzerfassung beim Neugeborenen erfolgt indirekt und schließt physiologische, verhaltensbezogene und biochemische Parameter in die Einschätzung mit ein. Diese Literaturübersicht beschreibt die Schwierigkeiten, die der Objektivierung des Schmerzes von Neugeborenen, insbesondere Frühgeborenen, zugrunde liegen. Die meisten der existierenden Schmerzskalen wurden zu Forschungszwecken entwickelt und sind auf ihre Praktikabilität im klinischen Alltag nicht überprüft. Pflegende und ÄrztInnen stehen darum immer noch vor der Schwierigkeit, zwischen einigen zwar validierten, aber auf ihre Anwendbarkeit in der Praxis kaum überprüften Instrumente wählen zu müssen. Dies ist umso bedenklicher, als in der Literatur die kurz- und langfristigen Folgen von anhaltenden Schmerzen bei Neugeborenen mit intraventrikulären Blutungen, Veränderungen im Ernährungs- sowie im Schlafmuster und Beeinträchtigungen im sensiblen Bereich der Eltern-Kind-Beziehung beschrieben werden.


PsycCRITIQUES ◽  
1989 ◽  
Vol 34 (9) ◽  
Author(s):  
James M. Raczynski
Keyword(s):  

physiopraxis ◽  
2020 ◽  
Vol 18 (06) ◽  
pp. 52-53
Author(s):  
Marjan Laekeman

Schmerzerkennung bei Menschen mit Demenz, die nicht mehr zur Selbstauskunft in der Lage sind, ist für Therapeuten eine Herausforderung. Mit der PAIC-15-Skala steht ein adäquates Beobachtungsinstrument zur Verfügung, um bei dieser Patientengruppe Schmerzen rechtzeitig zu erfassen. In mehreren internationalen Studien zeigt sich, dass die 15 Items der Skala sehr gute Indikatoren dafür sind, ob ein Mensch unter Schmerzen leidet.


1996 ◽  
Vol 76 (01) ◽  
pp. 017-022 ◽  
Author(s):  
Sylvia T Singer ◽  
Joseph E Addiego ◽  
Donald C Reason ◽  
Alexander H Lucas

SummaryIn this study we sought to determine whether factor VUI-reactive T lymphocytes were present in hemophilia A patients with inhibitor antibodies. Peripheral blood mononuclear cells (MNC) were obtained from 12 severe hemophilia A patients having high titer inhibitors, 4 severe hemophilia A patients without inhibitors and 5 normal male subjects. B cell-depleted MNC were cultured in serum-free medium in the absence or presence of 2 µg of recombinant human factor VIII (rFVIII) per ml, and cellular proliferation was assessed after 5 days of culture by measuring 3H-thymidine incorporation. rFVIII induced marked cellular proliferation in cultures of 4 of 12 inhibitor-positive hemophilia patients: fold increase over background (stimulation index, SI) of 7.8 to 23.3. The remaining 8 inhibitor-positive patients, the 4 hemophilia patients without inhibitors and the 5 normal subjects, all had lower proliferative responses to rFVIII, SI range = 1.6 to 6.0. As a group, the inhibitor-positive subjects had significantly higher proliferative responses to rFVIII than did the inhibitor-negative and normal subjects (p < 0.05 by t-test). Cell fractionation experiments showed that T lymphocytes were the rFVIII-responsive cell type, and that monocytes were required for T cell proliferation. Thus, rFVIII-reactive T lymphocytes are present in the peripheral circulation of some inhibitor-positive hemophilia A patients. These T cells may recognize FVIII in an antigen-specific manner and play a central role in the regulation of inhibitor antibody production


1995 ◽  
Vol 74 (05) ◽  
pp. 1255-1258 ◽  
Author(s):  
Arnaldo A Arbini ◽  
Pier Mannuccio Mannucci ◽  
Kenneth A Bauer

SummaryPatients with hemophilia A and B and factor levels less than 1 percent of normal bleed frequently with an average number of spontaneous bleeding episodes of 20–30 or more. However there are patients with equally low levels of factor VIII or factor IX who bleed once or twice per year or not at all. To examine whether the presence of a hereditary defect predisposing to hypercoagulability might play a role in amelio rating the hemorrhagic tendency in these so-called “mild severe” hemophiliacs, we determined the prevalence of prothrombotic defects in 17 patients with hemophilia A and four patients with hemophilia B selected from 295 and 76 individuals with these disorders, respectively, followed at a large Italian hemophilia center. We tested for the presence of the Factor V Leiden mutation by PCR-amplifying a fragment of the factor V gene which contains the mutation site and then digesting the product with the restriction enzyme Mnll. None of the patients with hemophilia A and only one patient with hemophilia B was heterozygous for Factor V Leiden. None of the 21 patients had hereditary deficiencies of antithrombin III, protein C, or protein S. Our results indicate that the milder bleeding diathesis that is occasionally seen among Italian hemophiliacs with factor levels that are less than 1 percent cannot be explained by the concomitant expression of a known prothrombotic defect.


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