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Objective: To evaluate safety and efficacy of first and second-line treatments for immune thrombocytopenic purpura (ITP) in patients older than 15 years. Material and method: A retrospective study was done with patients with immune thrombocytopenic purpura from January 2001 to December 2011. Treatment of first-line included: corticoids (prednisone or hydrocortisone) or immunoglobulin (IgG). Second-line: splenectomy, rituximab, immunosuppressive drugs (cyclophosphamide, azathioprine or mycophenolate) and danazol were prescribed. Respond criteria: complete (CR), platelets > 100 x 109/L; partial (PR), platelets > 30 x 109/L, without bleeding; no response, the remaining. Results: 116 patients were included, 74% women. Mean age was 45 years (15-90). The average initial platelets were 28 x 109/L (0-90). The mean follow-up was 19 months (12-120). The corticoids were administered on 108 and IgG on 8. They were cured 59 (51%); three deaths (3%) by intracranial hemorrhage. Complications: arterial hypertension and hyperglycemia (10 and 9). Fifty-four patients received second-line treatment. The most common was splenectomy but none showed more efficiency (p=0.5). Overall final results: CR 82%, temporal remissions with relapses 10% and without remission 3%. Complications: infections, cytopenias, increase of transaminases and pancreatitis (7, 4, 2, 1). All were related to the use of immunosuppressive drugs. Conclusions: First-line treatment is enough to cure 51% of the patients. The second-line treatments were effective in 31%. By lower toxicity, splenectomy and rituximab are preferable to immunosuppressant. [ABSTRACT FROM AUTHOR]

Introduction. The incidence and prevalence of head and neck injuries presented in the population served Unit Dental Specialties, allows us to generate hypotheses for conducting analytical studies to infer prevention policies and medical care, for the early identification of lesions, their comprehensive and immediate management, histopathological diagnoses1,965, organized by gender, age, type of benign nonmalignant lesion, anatomic site location by comparing our results with the published literature were processed. Objective. The aim of this study was to obtain accurate and reliable own statistics that allow us to determine the incidence and prevalence of histopathological diagnoses in soft, bone and dental head and neck tissues, with variables of gender, age, anatomical site location injury caused by the Pathology Oral and Maxillofacial Unit of Dental Specialties, Mexico City a 7-year period 1,965 histopathological diagnoses. Material and methods. The information was obtained from the1,965 histological reports with full details of age, gender, anatomic location of the lesion and lamellae present in the service file of Oral and Maxillofacial Pathology Unit Dental Specialties, generated for 7 years, were analyzed with the SPSS system, measures of central tendency to determine the gender, age and fashion media and anatomical location of the lesions, making a subdivision of each site and anatomical region where lesions, lesion type were presented according to their evolution, reporting 10 histopathological diagnoses presented in the study, comparing our results with those reported in the published literature. Results. The results allows us to detect the most common diseases presented in the oral cavity, with fibrous hyperplasia, coinciding with published reports comparing our study with a larger universe, coinciding in most variables, female gender 61% 1:1.59, 39% male, age ages presented in the study population was 1 to 90 years, the frequency of the ages of the patients had lesions was between 46-50 years old, the average was 41.9 years, the rate lesion presented was 97.4% benign lesions, 2.56% malignant lesions, the site of anatomical location was divided into soft, hard and skin tissue injuries occurred in lips 19%, followed by the buccal mucosa with 18%, language 16.3%, 8% lower gum, each of the anatomical regions was subdivided into specific sites, the hard tissues were subdivided into maxillary 9.5%, 8% jaw, salivary glands were divided into minor and major glands, malignant lesion present with was the most frequently squamous cell carcinoma 59%, followed by basal cell carcinoma 10%, comparing our results with those published in international and national literature. [ABSTRACT FROM AUTHOR]

Background: Current treatment of acute leukemia is chemotherapy; the liver toxicity is frequently observed which can avoid chemotherapy programs compliance. Iron overload is directly related to serum ferritin, to prevent organ dysfunction, it is necessary to consider chelation therapy in these patients. Objective: To evaluate the effect of reduced serum ferritin, administering deferasirox, on levels of AST and ALT, in patients with acute leukemia and receiving chemotherapy. Material and method: An experimental, prospective, longitudinal and non-random study was performed including patients older than 15 years diagnosed with acute leukemia and managed with a program of intensive chemotherapy, complete remission, with ALT + AST greater than 90 IU/L and serum ferritin greater than 1,000 ng/mL. Patients received deferasirox at doses of 30 mg/kg/day. Results: After beginning the use of deferasirox, the minimum observation time was 6 months and the maximum at the end of the study, 12 months. There were no notable changes in the numbers of bilirubin, alkaline phosphatase, albumin and creatinine. At the end of the study the mean of units transfused after the initial units was 9. Trend was noted receiving fewer transfusions in patients with acute myeloid leukemia treated with deferasirox. Conclusions: Deferasirox reduces the number of serum ferritin and influences the decrease of ALT and AST. The decrease in AST, ALT and serum ferritin allowed programs meet time and dose chemotherapy. Deferasirox tolerance was good. [ABSTRACT FROM AUTHOR]

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