Background: Sickle cell anaemia (SCA) is a health problem worldwide. Almost all the organs of the body are affected by the combined effect of chronic hypoxia, repeated infarction and recurrent infections. Renal function may be progressively impaired in them as a result of sickling in the renal medulla. Microscopic ...
Bernard, J.F.; Bournier, O.; Renoux, M.; Charron, D.; Boivin, P.
An unclassified case of haemolytic anaemia with voluminous splenomegaly is reported. This anaemia was normocytic without any specific morphologic aspect of red blood cells (RBC); Coombs test was negative; the osmotic fragility was normal; the increased autohaemolysis was not affected by the presence of glucose; Hb studies were normal; no RBC enzyme deficiency was found; RBC lipids and membrane proteins were normal; there was a marked reduction in RBC survival with exclusive splenic uptake of erythrocytes. Before splenectomy, RBC cations and water content were abnormal: 1) the RBC water was decreased moderately; 2) the RBC sodium was about twice the normal mean with an increased 22 Na turn-over; 3) the RBC potassium was markedly reduced and 42 K influx was twice the normal mean; 4) the RBC calcium content was increased. Splenectomy was followed by rapid disappearance of haemolysis and RBC water and cation disturbances. Because of this extremely rapid disappearance after splenectomy the authors suggest this case of haemolytic anaemia could be a primary disease of the spleen. (author)
Fujita, Naoya; Tosaka, Masako; Io, Noriko
A 30-year-old man began to experience palpitation, chest pain and fever 3 weeks prior to admission. An electrocardiogram showed evidence suggestive of left atrial overloading, and frequent atrial premature beats. A chest roentgenogram revealed an abnormal shadow behind the right upper portion of the heart. A cross-sectional echocardiogram demonstrated abnormal echoes with ill-defined margins in the left atrium and a picture of Computed Tomography (CT) was thought to show a left atrial tumor. However left atriography suggested it to be an extracardiac tumor which was compressing the left atrium. Therefore, reconstruction CT was performed and with the use of high CT numbers, the cyst was considered to be subcarinal in position. The CT also showed a calcified mass which was mobile within the cyst. At thoracotomy, an 6 x 3 cm cyst was removed completely and a diagnosis of bronchogenic cyst was established histopathologically. In this report, ECG abnormalities suggestive of left atrial damage and the diagnostic usefulness of reconstruction CT are stressed. (author).
Interpretation & conclusions: Five (11.9% patients with acquired aplastic anaemia had chromosomal abnormalities. Trisomy was found to be the commonest abnormality. Cytogenetic abnormalities may be significant in acquired aplastic anaemia although further studies on a large sample are required to confirm the findings.
Full Text Available Behavioral research has revealed deficits in the development of joint attention (JA as one of the earliest signs of autism. While the neural basis of JA has been studied predominantly in adults, we recently demonstrated a protracted development of the brain networks supporting JA in typically developing children and adolescents. The present eye-tracking/fMRI study now extends these findings to adolescents with autism. Our results show that in adolescents with autism JA is subserved by abnormal activation patterns in brain areas related to social cognition abnormalities which are at the core of ASD including the STS and TPJ, despite behavioral maturation with no behavioral differences. Furthermore, in the autism group we observed increased neural activity in a network of social and emotional processing areas during interactions with their mother. Moreover, data indicated that less severely affected individuals with autism showed higher frontal activation associated with self-initiated interactions. Taken together, this study provides first-time data of JA in children/adolescents with autism incorporating the interactive character of JA, its reciprocity and motivational aspects. The observed functional differences in adolescents ASD suggest that persistent developmental differences in the neural processes underlying JA contribute to social interaction difficulties in ASD.
A prospective study of incidence of anaemia in pregnancy at Abia state University Teaching Hospital, Aba was conducted over a six-month period spanning from 31st January 2000 to 31st July 2000. The incidence of anaemia in pregnancy was 29%. The vast majority (97.6%) had mild anaemia. The result showed that most ...
Background: Anaemia is the most commonly encountered haematological abnormality in human immunodeficiency virus (HIV) positive patients with estimates climbing as high as 95% depending on clinical settings. The twin effects of HIV infection and anaemia in pregnancy is associated with adverse maternal and ...
Bohon, Cara; Stice, Eric; Spoor, Sonja
Objective To test the hypothesis that emotional eaters show greater neural activation in response to food intake and anticipated food intake than nonemotional eaters and whether these differences are amplified during a negative versus neutral mood state. Method Female emotional eaters and nonemotional eaters (N = 21) underwent functional magnetic resonance imaging (fMRI) during receipt and anticipated receipt of chocolate milkshake and a tasteless control solution while in a negative and neutral mood. Results Emotional eaters showed greater activation in the parahippocampal gyrus and anterior cingulate (ACC) in response to anticipated receipt of milkshake and greater activation in the pallidum, thalamus, and ACC in response to receipt of milkshake during a negative relative to a neutral mood. In contrast, nonemotional eaters showed decreased activation in reward regions during a negative versus a neutral mood. Discussion Results suggest that emotional eating is related to increased anticipatory and consummatory food reward, but only during negative mood. PMID:19040270
Full Text Available Background: Sickle cell anaemia is an inherited disease in which the red blood cells become rigid and sticky, and change from being disc-shaped to being crescent-shaped. The change in shape is due to the presence of an abnormal form of haemoglobin. This results in severe pain and damage to some organs. Aim and Objective: The study was carried out to determine the levels of cytokine in sickle cell anemia. Material and Methods: Thirty confirmed sickle cell patients in steady state (HbSS-SS and thirty persons with normal haemoglobin (HbAA as well as sixteen sickle cell disease in crises (HbSS-cr between the ages of 15 to 30 years were selected in this study. Cytokines including interleukin 1 beta (IL- 1β, interleukin 2 (IL- 2, interleukin (IL-6, tumour necrosis factor alpha (TNF-α, and interferon gamma (IFN- λ were measured by commercially available ELISA kits. Results: The results obtained showed that the levels of TNF-α and IL-6 in sickle cell anaemia patients in crisis were significantly elevated when compared with sickle cell in steady state (P<0.05. Similarly, the levels of IL-1β, IL-6, and IFN- λ were significantly increased in sickle cell anaemia stable state when compared to HbAA subjects (P<0.05. Conclusion: This may probably implies that cytokine imbalance is implicated in the pathogenesis of sickle cell crisis. Also, cytokines could be used as an inflammatory marker as well as related marker in disease severity and hence therapeutic intervention.
Donald, D; Dawson, A A
A case of microangiopathic haemolytic anaemia associated with malignant haemangio-endothelioma is described. It is suggested that haemolysis may have been due to mechanical trauma sustained by the red blood cells on passage through the tumour's abnormal vasculature.
Gupta, Vineeta; Kumar, Akash; Saini, Isha; Saxena, Ajit Kumar
Aplastic anaemia is a rare haematological disorder characterized by pancytopenia with a hypocellular bone marrow. It may be inherited/genetic or acquired. Acquired aplastic anaemia has been linked to many drugs, chemicals and viruses. Cytogenetic abnormalities have been reported infrequently with acquired aplastic anaemia. Majority of the studies are in adult patients from the West. We report here cytogenetic studies on paediatric patients with acquired aplastic anaemia seen in a tertiary care hospital in north India. Patients (n=71, age 4-14 yr) were diagnosed according to the guidelines of International Agranulocytosis and Aplastic Anaemia Study. Conventional cytogenetics with Giemsa Trypsin Giemsa (GTG) banding was performed. Karyotyping was done according to the International System for Human Cytogenetics Nomenclature (ISCN). Of the 71 patients, 42 had successful karyotyping where median age was 9 yr; of these 42, 27 (64.3%) patients had severe, nine (21.4%) had very severe and six (14.3%) had non severe aplastic anaemia. Five patients had karyotypic abnormalities with trisomy 12 (1), trisomy 8 (1) and monosomy 7 (1). Two patients had non numerical abnormalities with del 7 q - and t (5:12) in one each. Twenty nine patients had uninformative results. There was no difference in the clinical and haematological profile of patients with normal versus abnormal cytogenetics although the number of patients was small in the two groups. Five (11.9%) patients with acquired aplastic anaemia had chromosomal abnormalities. Trisomy was found to be the commonest abnormality. Cytogenetic abnormalities may be significant in acquired aplastic anaemia although further studies on a large sample are required to confirm the findings.
Full Text Available Iron deficiency anaemia is a public health problem that affects all age groups. In Mexico, it is a common cause of morbidity, and accounts for 50% of cases of anaemia worldwide. It is more prevalent during the first 2 years of life, during adolescence and pregnancy. It is characterised by fatigue, weakness, pallor and koilonychia. Treatment is based on dietary recommendations and oral and intravenous iron supplements. In this review article, we summarise the characteristics of iron efficiency anaemia, its metabolism, epidemiology, symptoms and diagnosis, and explore different therapeutic approaches.
Ganguly, A.; Boswell, W.; Aniq, H.
Sickle cell anaemia is an autosomal recessive genetic condition producing abnormal haemoglobin HbS molecules that result in stiff and sticky red blood cells leading to unpredictable episodes of microvascular occlusions. The clinical and radiological manifestations of sickle cell anaemia result from small vessel occlusion, leading to tissue ischemia/infarction and progressive end-organ damage. In this paper we discuss and illustrate the various musculoskeletal manifestations of sickle cell dis...
Barragán-Ibañez, G.; Santoyo-Sánchez, A.; Ramos-Peñafiel, C.O.
Iron deficiency anaemia is a public health problem that affects all age groups. In Mexico, it is a common cause of morbidity, and accounts for 50% of cases of anaemia worldwide. It is more prevalent during the first 2 years of life, during adolescence and pregnancy. It is characterised by fatigue, weakness, pallor and koilonychia. Treatment is based on dietary recommendations and oral and intravenous iron supplements. In this review article, we summarise the characteristics of iron efficiency...
clinical stage 3). Children who were malnourished were 15 (22.4%). Conclusion: Hematological abnormalities and malnutrition occur in HIV positive children. Key words: Haematological, malnutrition, anaemia, children.
Roine, Ulrika; Salmi, Juha; Roine, Timo; Wendt, Taina Nieminen-von; Leppämäki, Sami; Rintahaka, Pertti; Tani, Pekka; Leemans, Alexander; Sams, Mikko
The aim of this study was to investigate potential differences in neural structure in individuals with Asperger syndrome (AS), high-functioning individuals with autism spectrum disorder (ASD). The main symptoms of AS are severe impairments in social interactions and restricted or repetitive patterns of behaviors, interests or activities. Diffusion weighted magnetic resonance imaging data were acquired for 14 adult males with AS and 19 age, sex and IQ-matched controls. Voxelwise group differences in fractional anisotropy (FA) were studied with tract-based spatial statistics (TBSS). Based on the results of TBSS, a tract-level comparison was performed with constrained spherical deconvolution (CSD)-based tractography, which is able to detect complex (for example, crossing) fiber configurations. In addition, to investigate the relationship between the microstructural changes and the severity of symptoms, we looked for correlations between FA and the Autism Spectrum Quotient (AQ), Empathy Quotient and Systemizing Quotient. TBSS revealed widely distributed local increases in FA bilaterally in individuals with AS, most prominent in the temporal part of the superior longitudinal fasciculus, corticospinal tract, splenium of corpus callosum, anterior thalamic radiation, inferior fronto-occipital fasciculus (IFO), posterior thalamic radiation, uncinate fasciculus and inferior longitudinal fasciculus (ILF). CSD-based tractography also showed increases in the FA in multiple tracts. However, only the difference in the left ILF was significant after a Bonferroni correction. These results were not explained by the complexity of microstructural organization, measured using the planar diffusion coefficient. In addition, we found a correlation between AQ and FA in the right IFO in the whole group. Our results suggest that there are local and tract-level abnormalities in white matter (WM) microstructure in our homogenous and carefully characterized group of adults with AS, most
Theurl, Igor; Finkenstedt, Armin; Schroll, Andrea; Nairz, Manfred; Sonnweber, Thomas; Bellmann-Weiler, Rosa; Theurl, Milan; Seifert, Markus; Wroblewski, Victor J; Murphy, Anthony T; Witcher, Derrick; Zoller, Heinz; Weiss, Günter
Recently, the iron and erythropoiesis-controlled growth differentiation factor 15 (GDF15) has been shown to inhibit the expression of hepcidin in beta-thalassaemia patients, thereby increasing iron absorption despite iron overload. To access the diagnostic and pathogenic impact of GDF15 in inflammatory anaemia the association of GDF15 expression with serum iron parameters and hepcidin was studied in patients suffering from iron deficiency anaemia (IDA), anaemia of chronic disease (ACD) and ACD subjects with true iron deficiency (ACD/IDA). GDF15 was significantly increased in both ACD and ACD/IDA, but not in IDA subjects as compared to controls. In contrast, hepcidin levels were significantly lower in IDA and ACD/IDA subjects than in ACD patients. IDA and ACD/IDA, but not ACD, showed an association between GDF15 and soluble transferrin receptor, an indicator of iron requirement for erythropoiesis. However, GDF15 did not correlate to hepcidin in either patient group. While GDF15 levels were linked to the needs for erythropoiesis and iron homeostasis in IDA, the immunity-driven increase of GDF15 may not primarily affect iron homeostasis and hepcidin expression. This indicates that other ACD-related factors may overcome the regulatory effects of GDF15 on hepcidin expression during inflammation.
Oristaglio, Jeff; West, Susan Hyman; Ghaffari, Manely; Lech, Melissa S.; Verma, Beeta R.; Harvey, John A.; Welsh, John P.; Malone, Richard P.
Children with autism spectrum disorder (ASD) and age-matched typically-developing (TD) peers were tested on two forms of eyeblink conditioning (EBC), a Pavlovian associative learning paradigm where subjects learn to execute an appropriately-timed eyeblink in response to a previously neutral conditioning stimulus (CS). One version of the task, trace EBC, interposes a stimulus-free interval between the presentation of the CS and the unconditioned stimulus (US), a puff of air to the eye which causes subjects to blink. In delay EBC, the CS overlaps in time with the delivery of the US, usually with both stimuli terminating simultaneously. ASD children performed normally during trace EBC, exhibiting no differences from typically-developing (TD) subjects with regard to learning rate or the timing of the CR. However, when subsequently tested on delay EBC, subjects with ASD displayed abnormally-timed conditioned eye blinks that began earlier and peaked sooner than those of TD subjects, consistent with previous findings. The results suggest an impaired ability of children with ASD to properly time conditioned eye blinks which appears to be specific to delay EBC. We suggest that this deficit may reflect a dysfunction of cerebellar cortex in which increases in the intensity or duration of sensory input can temporarily disrupt the accuracy of motor timing over short temporal intervals. PMID:23769889
Bohon, Cara; Stice, Eric; Spoor, Sonja
To test the hypothesis that emotional eaters show greater neural activation in response to food intake and anticipated food intake than nonemotional eaters and whether these differences are amplified during a negative versus neutral mood state. Female emotional eaters and nonemotional eaters (N = 21) underwent functional magnetic resonance imaging (fMRI) during receipt and anticipated receipt of chocolate milkshake and a tasteless control solution while in a negative and neutral mood. Emotional eaters showed greater activation in the parahippocampal gyrus and anterior cingulate (ACC) in response to anticipated receipt of milkshake and greater activation in the pallidum, thalamus, and ACC in response to receipt of milkshake during a negative relative to a neutral mood. In contrast, nonemotional eaters showed decreased activation in reward regions during a negative versus a neutral mood. Results suggest that emotional eating is related to increased anticipatory and consummatory food reward, but only during negative mood. (c) 2008 by Wiley Periodicals, Inc.
Aplastic anaemia (AA) can precede acute lymphoblastic leukaemia (ALL) in 2% of children but this is rarely reported to occur in adults. A 21-year-old male presented with bone marrow failure and bone marrow biopsy showed a profoundly hypocellular marrow. He recovered spontaneously but represented 2 months later when he was diagnosed with pre-B acute lymphoblastic leukaemia. Chromosomal examination revealed 46,XY,del(9)(q13q34). To the best of our knowledge this is the first case to be reported of aplasia preceding ALL with 9q minus as the sole chromosomal abnormality.
Nakatsukasa, T; Nomura, N; Miyazaki, G; Imai, K; Wada, Y; Ishimori, K; Morishima, I; Morimoto, H
It was previously reported that Hb Philly with a mutation of Phe for Tyr at 35(C1)beta showed non-cooperative oxygen binding with a very high affinity and instability leading to hemolysis. Further, it lacked the 1H-NMR signal at 13.1 ppm from 2,2-dimethyl-2-silapentane-5-sulfonate in normal hemoglobin (Hb A), so that this signal was assigned to a hydrogen bond formed by Tyr-35(C1)beta. Surprisingly, our artificial mutant hemoglobin with the same mutation as Hb Philly showed slightly lowered oxygen affinity, almost normal cooperativity, the 1H-NMR signal at 13.1 ppm and no sign of instability. Our results indicate that the mutation reported for Hb Philly and the assignment of the 13.1 ppm signal need reexamination.
Ganguly, A; Boswell, W; Aniq, H
Sickle cell anaemia is an autosomal recessive genetic condition producing abnormal haemoglobin HbS molecules that result in stiff and sticky red blood cells leading to unpredictable episodes of microvascular occlusions. The clinical and radiological manifestations of sickle cell anaemia result from small vessel occlusion, leading to tissue ischemia/infarction and progressive end-organ damage. In this paper we discuss and illustrate the various musculoskeletal manifestations of sickle cell disease focusing primarily on marrow hyperplasia, osteomyelitis and septic arthritis, medullary and epiphyseal bone infarcts, growth defects, and soft tissue changes.
Full Text Available Sickle cell anaemia is an autosomal recessive genetic condition producing abnormal haemoglobin HbS molecules that result in stiff and sticky red blood cells leading to unpredictable episodes of microvascular occlusions. The clinical and radiological manifestations of sickle cell anaemia result from small vessel occlusion, leading to tissue ischemia/infarction and progressive end-organ damage. In this paper we discuss and illustrate the various musculoskeletal manifestations of sickle cell disease focusing primarily on marrow hyperplasia, osteomyelitis and septic arthritis, medullary and epiphyseal bone infarcts, growth defects, and soft tissue changes.
Objectives: To determine the frequency of anaemia in married women in Jutial, and to find out the relationship of risk factors of anaemia with levels of anaemia. Study Design: Cross-sectional study. Place and Duration of Study: Household survey carried out in Jutial, Gilgit 1st February 2008 to 30th April 2009. Patients and Method: Interview administered questionnaire along with blood sample collection using sterilized disposable syringes was used in this study on a total of 382 randomly selected, willing, married, non-pregnant, non-lactating women with one or more children. Results were considered significant if r-value was more than 0.5 with p-value less than 0.05. Results: Clinical analysis of the blood samples showed that the average haemoglobin (Hb) level was 12.8 g/dl. According to WHO standards, no woman had severe anaemia with Hb level below 7 g/dl. Majority of the women (77.5%) had normal Hb >= 12 g/dl. The calculated anaemia frequency of 22.5% was found to be little lower than that of national anaemia frequency of around 29 to 33%. Conclusion: Frequency of anaemia 22.5% can be attributed to good education system in Northern Area and the awareness of people towards health concerns. Another reason can be the initiatives by different NGOs working in the area specially Aga Khan Foundation to eradicate anaemia by developing a vast network of health facilities. Further research on the native foods, their extract nutritional values / iron contents and any special foods at higher altitudes may be more than 1500 meters can open new horizon to our understanding of anaemia in the northern areas. (author)
Full Text Available Objective This study aims to evaluate “in vivo” the integrity of the normal-appearing spinal cord (NASC in patients with multiple sclerosis (MS compared to controls, using diffusion tensor MR imaging. Methods We studied 32 patients with MS and 17 without any neurologic disorder. Fractional anisotropy (FA, axial diffusivity (AD, radial diffusivity (RD and mean diffusivity (MD were calculated within regions of interest at C2 and C7 levels in the four columns of the spinal cord. Results At C2, FA value was decreased in MS patients. Besides, RD value was higher in MS than in controls. At C7, MD values were increased in MS. Conclusion The NASC in the right column of the cervical spinal cord showed abnormal FA, RD and MD values, which is possibly related to demyelination, since the FA abnormality was related to the RD and not to the AD.
Dey, Sanku; Goswami, Sankar; Dey, Tanujit
The objective of this study is to examine the factors that influence the occurrence of childhood anaemia in North-East India by exploring dataset of the Reproductive and Child Health-II Survey (RCH-II). The study population consisted of 10,137 children in the age-group of 0-6 year(s) from North-East India to explore the predictors of childhood anaemia by means of different background characteristics, such as place of residence, religion, household standard of living, literacy of mother, total children ever born to a mother, age of mother at marriage. Prevalence of anaemia among children was taken as a polytomous variable. The predicted probabilities of anaemia were established via multinomial logistic regression model. These probabilities provided the degree of assessment of the contribution of predictors in the prevalence of childhood anaemia. The mean haemoglobin concentration in children aged 0-6 year(s) was found to be 11.85 g/dL, with a standard deviation of 5.61 g/dL. The multiple logistic regression analysis showed that rural children were at greater risk of severe (OR = 2.035; p = 0.003) and moderate (OR = 1.23; p = 0.003) anaemia. All types of anaemia (severe, moderate, and mild) were more prevalent among Hindu children (OR = 2.971; p = 0.000), (OR = 1.195; p = 0.010), and (OR = 1.201; p = 0.011) than among children of other religions whereas moderate (OR = 1.406; p = 0.001) and mild (OR = 1.857; p=0.000) anaemia were more prevalent among Muslim children. The fecundity of the mother was found to have significant effect on anaemia. Women with multiple children were prone to greater risk of anaemia. The multiple logistic regression analysis also confirmed that children of literate mothers were comparatively at lesser risk of severe anaemia. Mother's age at marriage had a significant effect on anaemia of their children as well.
Dec 1, 2009 ... Uganda – its impact on treatment outcomes. Julius Kabbali Kuule ... causes include hypertension, rheumatic heart disease and cardiomyopathies, and .... *31 females were menopausal (15 did not have anaemia, 11 had mild anaemia, 4 had moderate anaemia and 1 had severe anaemia). NN = normocytic ...
Dugdale Alan E
Full Text Available Abstract Background Developing countries have high prevalence of diseases, but facilities to diagnose and treat them are limited. We must use available resources in ways not needed where there are sophisticated equipment and trained staff. Anaemia is common; iron deficiency affects health and productivity; folate deficiency in pregnant women causes foetal abnormalities. Few developing countries can measure serum folate or ferritin, but standard automated blood analyses are widely available and can help predict folate and iron deficiency. The RDW-CV% (coefficient of variation of the red cell width measures the variability in the size of red blood cells (RBC in routine automated analysis of blood cells, but is seldom reported. Levels of RDW-CV% and haemoglobin (Hb can predict iron deficiency anaemia. Method and results I have written a computer model based on the standard mechanism for blood formation and destruction. This shows that before anaemia develops and during recovery, there are both normal and abnormal RBC (small in iron deficiency and large in folate deficiency in the circulation. The model calculates the abnormality in the RDW-CV% in standard automated blood analyses. In early iron deficiency and during recovery the full blood count shows the Hb near the lower limit of normal, a low MCV and a high RDW-CV%. A similar pattern, but with a higher MCV, develops in folate deficiency. Folate deficiency is often brief and may not cause anaemia. The high RDW-CV% may persist for three months. Conclusion This long footprint could be medically useful for detecting folate deficiency and so limiting foetal damage in individuals and communities. Few clinicians or public health workers know about RDW-CV%. Standard blood reports for clinical use should include the RDW-CV% and note the possible significance of abnormal values.
Mocroft, Amanda; Lifson, Alan R; Touloumi, Giota
Data from randomized trials on the development of anaemia after interruption of therapy are not well-described.......Data from randomized trials on the development of anaemia after interruption of therapy are not well-described....
El Hioui, M; Ahami, A O T; Aboussaleh, Y; Rusinek, S; Dik, K; Soualem, A; Azzaoui, F-Z; Loutfi, H; Elqaj, M
To determine the prevalence of anaemia and factors associated with iron deficiency among school children in rural Kenitra, Morocco. 295 students between 6 and 16 years old composed the study group. The level of haemoglobin was measured in a group of 295 school children. The iron status was determined by ferritin level in serum, and anaemia was defined when haemoglobin educational status of the parents. The mean haemoglobin concentration was 12.4 g/dl in boys and 12.5 g/dl in girls, whereas the mean ferritin level was 26.7 microg/l in boys and 27.9 microg/l in girls. The overall prevalence of anaemia in the studied population was 12.2% and iron deficiency was 20.4%. There was a significant relationship between education of the mother and anaemia in children (p= 0.01). Serum ferritin (SF), serum iron concentrations and mean corpuscular volume (MCV) were significantly correlated with haemoglobin by multiple regression analysis. However, using logistic regression analysis, the results showed that anaemia was not significantly associated with gender, parents' employment and monthly family income. Anaemia remains a common problem in the young children particularly the primary education school boys of the households of low income. The results suggest also, that iron deficiency is an important determinant of anaemia in this population; however, whole anaemia cannot be solely explained by iron deficiency. Further studies are needed to consider micronutrients status and exposure to environmental pollutants.
Anaemia, often due to iron deficiency, is one of the most widespread causes of mortality and morbidity in ... Pregnant women must make many new red blood cells, provide iron for the foetus and may lose much blood during .... Do not give tea and coffee to children. • Eat fermented porridges and germinate/malt cereals and ...
Souza, Sfc; de Carvalho, Hlcc; Costa, Cps; Thomaz, Ebaf
To estimate the association between sickle cell anaemia and trait with dental and jaw bone abnormalities. Subjects (n = 369) were allocated to three groups: sickle cell anaemia, trait and control. Dental shape, number, size and position and changes in pulp chamber, root and periapex were analysed by intra-oral periapical radiographs. Integrity of lamina dura, quality of cancellous bone and bone trabeculation were also evaluated. Prevalence ratios (PR) were calculated (α = 0.05). Sickle cell anaemia had higher prevalence (PR:8.31) and number of teeth (PR:13.40) with external resorption; higher number of teeth with pulp calcification; partial and total loss of lamina dura; and higher prevalence of changes in trabecular structure of maxilla (PR:6.45) and mandible (PR:5.34). Sickle cell trait showed higher prevalence (PR:1.26) and higher number of teeth (PR:1.98) with partial loss of lamina dura; higher number of teeth with hypercementosis, changes in shape, size, periapex, total loss of lamina dura; and higher prevalence of changes in mandibular trabecular bone (PR:1.43). Pulp calcification and external resorption of the root were the most frequent dental alterations in sickle cell anaemia group, while in trait was higher frequency of changes in shape, size, periapex and root. Jaw bone changes were most prevalent in both homozygous and heterozygous subjects. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved.
In a double-blind placebo-eontrolled study we showed a 3-fold decrease in blood transfusions (BTFs) given to preterm infants with anaemia of prematurity who received recombinant erythropoietin. However, only 50% of placebo recipients required a BTF. Data from the placebo group indicated that either mean daily weight ...
Mar 3, 1996 ... In a double-blind placebo-eontrolled study we showed a. 3-fold decrease in blood transfusions (BTFs) given to preterm infants with anaemia of prematurity who received recombinant erythropoietin. However, only 50% of placebo recipients required a BTF. Data from the placebo group indicated that either ...
Schaumburg, F.; Biallas, B.; Ngoune Feugap, E.; Alabi, A. S.; Mordmüller, B.; Kremsner, P. G.; Grobusch, M. P.; Lell, B.; van der Linden, M.; Peters, G.; Adegnika, A. A.
Sickle cell anaemia (SCA) is a haemoglobin disorder that alters the deformability of erythrocytes through abnormal polymerization of haemoglobin. Children with SCA have an increased risk of infections with encapsulated bacteria. To guide the antibiotic prophylaxis and vaccinations in children with
Piek, C.J.; Brinkhof, B.; Teske, E.; Rothuizen, J.; Dekker, A.; Penning, L.C.
A high mortality occurs in dogs with idiopathic immune-mediated haemolytic anaemia (IMHA) during the first 2 weeks after the diagnosis. The aim of this study was to investigate the inflammatory response and coagulation abnormalities in dogs with IMHA in relation to the prognosis and to establish the
Full Text Available Abstract Background In autoimmune haemolytic anaemia (AIHA, autoreactive antibodies directed against red blood cells are up-regulated, leading to erythrocyte death. Mycoplasma suis infections in pigs induce AIHA of both the warm and cold types. The aim of this study was to identify the target autoantigens of warm autoreactive IgG antibodies. Sera from experimentally M. suis-infected pigs were screened for autoreactivity. Results Actin-reactive antibodies were found in the sera of 95% of all animals tested. The reactivity was species-specific, i.e. reactivity with porcine actin was significantly higher than with rabbit actin. Sera of animals previously immunised with the M. suis adhesion protein MSG1 showed reactivity with actin prior to infection with M. suis indicating that molecular mimicry is involved in the specific autoreactive mechanism. A potentially cross-reactive epitope was detected. Conclusions This is the first report of autoreactive anti-actin antibodies involved in the pathogenesis of autoimmune haemolytic anaemia.
Saboor, M.; Moinuddin, A.; Naureen, A.
Background: Iron deficiency anaemia and anaemia of chronic disorders are the two major causes of microcytic and hypochromic anaemia. Many times the diagnosis of these conditions becomes difficult through conventional laboratory tests. Determination of soluble transferrin receptors is a helpful laboratory test for the differential diagnosis of these conditions. The study was conducted to evaluate the role of soluble transferrin receptors in the differential diagnosis between iron deficiency anaemia and anaemia of chronic disorders. Methods: A total of 80 blood samples were evaluated, i.e., 20 samples from normal adult male, 20 samples from normal adult female, 20 samples from iron deficiency anaemia group and 20 samples from patients with anaemia of chronic disorders. Soluble transferrin receptors were determined by ELISA technique using Quantikine IVD kit (R and D Systems). Results: There was significant difference in the levels of sTfR in iron deficiency anaemia and anaemia of chronic disorders. Statistically non-significant difference was observed between the levels of sTfR in patients with anaemia of chronic disorders as compared to normal control group. Conclusion: The sTfR determination can be used as a reliable differentiating marker in the diagnosis of iron deficiency anaemia and anaemia of chronic disorders. (author)
Full Text Available Vitamin B12 deficiency is uncommon in pregnancy, it occurs in 10–28% of uncomplicated pregnancies, and is associated with a few complications. We present a case report of a 21-year-old patient with severe anaemia during late pregnancy caused by vitamin B12 deficiency. At 38 weeks gestation and with a BMI of 48.9, a history of rupture of membranes was given but not confirmed. On examination, she appeared pale and therefore full blood counts were done. Interestingly her haemoglobin (Hb levels were 3.7 g/dL. Folate and vitamin B12 levels were also found to be low, and the diagnosis of anaemia caused by vitamin B12 deficiency was made. After treatment with vitamin B12 injections, folic acid and blood transfusions, the patient’s haemoglobin levels improved from 3.7 g/dL to 10.7 g/dL. The conclusion is that effective history taking, diagnosis, and management can prevent many complications that are usually associated with vitamin B12 deficiency anaemia.
Pettit, Tristan; Cole, Nyree; Leung, Wingchi; Ballantine, Kirsten; Macfarlane, Scott
The frequency of common cytogenetic abnormalities in pediatric acute lymphoblastic leukemia (ALL) is known to vary by geographic location and ethnic origin. This study aimed to determine the frequency of hypodiploidy, ETV6-RUNX1, BCR-ABL1, and MLL rearrangement within New Zealand's pediatric ALL population and to assess whether the frequency of these ALL prognostic markers varies according to ethnicity. The New Zealand Children's Cancer Registry provided information for all registered pediatric ALL patients that were diagnosed between 2000 and 2009, with medical records available for 246 patients. Each patient's medical record was reviewed to determine the frequency of hypodiploidy, ETV6-RUNX1, BCR-ABL1, MLL rearrangement, and cell lineage. Chi-square tests for independence were undertaken to compare the frequencies of cytogenetic abnormalities according to prioritized ethnicity. The frequency of cytogenetic ALL abnormalities in the New Zealand pediatric population were consistent with international reference values. A low frequency of ETV6-RUNX1 was evident for Maori pediatric ALL patients (5.4%, P = 0.018), when compared to Pacific peoples (21.1%) and non-Maori/non-Pacific peoples (27.4%). This has not impacted on outcome, however, with equivalent 5-year overall survival being observed in Maori (89.4%) compared to Pacific peoples (92.0%) and non-Maori/non-Pacific peoples (90.2%). A lower frequency of the favorable prognostic marker ETV6-RUNX1 was observed in Maori pediatric ALL patients. This did not translate into poorer survival. Future research into biological and nonbiological prognostic factors in this patient population may assist in explaining this finding. © 2017 Wiley Periodicals, Inc.
Siu, K K; Li, Rever; Lam, S Y
This report demonstrates pulmonary haemorrhage as a differential cause of anaemia. Idiopathic pulmonary hemosiderosis is a rare disease in children; it is classically described as a triad of haemoptysis, pulmonary infiltrates on chest radiograph, and iron-deficiency anaemia. However, anaemia may be the only presenting feature of idiopathic pulmonary hemosiderosis in children due to occult pulmonary haemorrhage. In addition, the serum ferritin is falsely high in idiopathic pulmonary hemosiderosis which increases the diagnostic difficulty. We recommend that pulmonary haemorrhage be suspected in any child presenting with iron-deficiency anaemia and persistent bilateral pulmonary infiltrates.
In the management of anaemic patients, the type and severity of the anaemia will dictate the appropriate therapeutic strategy. Globally, iron deficiency is the most common cause of anaemia.1. Once iron therapy is initiated, regular follow-up visits are essential to monitor the therapeutic response, and to manage unpleasant ...
Nutritionists should understand deficiency anaemia, and physicians, particularly general practitioners, should be aware of dietary requirements. In this article, therefore, both health care professionals have come together to briefly explain, with examples, the type of diet that should be recommended to patients with deficiency anaemia.
K. Stouten (Karlijn)
markdownabstractAnaemia is often encountered in general practice but the prevalence of the different aetiology remains elusive. We analysed a large database of general practice patients newly diagnosed with anaemia, allowing for the detailed study of the prevalence of a wide range of causes and a
Full Text Available New challenges and priorities are given in the EU Health programme 2007-2013. The objectives of the programme are to improve citizens’ health security, to promote health to improve prosperity and solidarity, and to generate and disseminate health knowledge. If challenges and priorities have been defined globally for rare diseases by the European Commission, persons involved in rare anaemias have taken the opportunity to contribute to the empowerment of patients with rare anaemias. One of the ENERCA partners objectives was the mapping of existing centres that take care of patients with rare anaemias in Europe. Another goal was to obtain a directory of facilities available per centre for patients with rare anaemias. We thought that with those results it could realistically help to define a consensus regarding the criteria to be recognised as a centre of expertise for haemoglobinopathies and very rare anaemias.
Dr David Zadock Munisi
Conclusion: Anaemia is very common among patients presenting with kidney diseases. These patients require a thorough evaluation to identify and correct causes of anaemia other than erythropoietin deficiency. Keywords: chronic kidney disease, prevalence, predictors, anaemia, Tanzania. Introduction. Anaemia is defined ...
Rusia, U; Madan, N; Agarwal, N; Sikka, M; Sood, S K
One hundred and two pregnant women and their neonates were examined to evaluate the effect of maternal haemoglobin concentration (Hb. conc) and iron deficiency anaemia on the placental weight and the foetal outcome. Haematological and serum ferritin values were determined. It was observed that 34.3% of the pregnant women were anaemic. Maternal Hb conc. and serum ferritin showed a highly significant correlation (r = 0.40, p < 0.001) indicating that iron deficiency was the most important cause of anaemia amongst them. The maternal Hb conc. showed a significant correlation with placental weight (p < 0.05), birth weight (p < 0.01), Apgar score (p < 0.001) and birth asphyxia. Maternal serum ferritin also correlated positively with cord ferritin (p < 0.001). The study did not reveal any association between high Hb and adverse foetal outcome.
Haroun, Faysal; Mener, Andrew; Elkon, Jacob; Tabbara, Imad
We present a case of a 73-year-old woman with transfusion-dependent anaemia thought to be secondary to an unidentifiable inflammatory condition. Anaemia evaluation including multiple bone marrow biopsies was unrevealing, with the exception of a non-specific elevation of her erythrocyte sedimentation rate and C-reactive protein. She had no identifiable inflammatory condition and did not meet the criteria for myelodysplastic syndrome. She was empirically treated with lenalidomide and achieved a complete response, suggesting that this immunomodulatory drug could potentially have a role in treating a subgroup of patients with immune-mediated anaemia. 2016 BMJ Publishing Group Ltd.
Xie, Haiwei; Zhang, Yan
The relationship between dynamic infrared (IR) thermal images and blood perfusion rate of the tongues of anaemia patients was investigated. Blood perfusion rates at multiple locations on the tongues of 62 anaemia patients and 70 control subjects were measured. For both groups of subjects, dynamic IR thermal images were also recorded within 16 s after the mouth opened. The results showed that the blood perfusion rates at different sites (apex, middle, left side and right side) on the tongues in anaemia patients (3.49, 3.71, 3.85 and 3.77 kg/s m-3) were significantly lower than those at the corresponding sites in control subjects (4.45, 4.66, 4.81 and 4.70 kg/s m-3). After the mouth opened, the tongue temperature decreased more rapidly in anaemia patients than in control subjects. To analyse the heat transfer mechanism, a transient heat transfer model of the tongue was developed. The tongue temperatures in anaemia patients and control subjects were calculated using this model and compared to the tongue temperatures measured by the IR thermal imager. The relationship between the tongue surface temperature and the tongue blood perfusion rate was analysed. The simulation results indicated that the low blood perfusion rate and the correlated changes in anaemia patients can cause faster temperature decreases of the tongue surface.
Kamanuru Ethirajulu Govindarajulu
Full Text Available BACKGROUND It is well known that diabetes adversely affects the kidneys finally leading to anaemia by various mechanisms. Several studies had postulated that anaemia developing before renal complications has an independent association with microvascular complication in type 2 diabetic patients. The aim of the study is to estimate the prevalence of anaemia in persons with type 2 diabetes mellitus and its role as a risk factor for the presence and the severity of microvascular complication in a populationbased study. MATERIALS AND METHODS This is a cross-sectional study conducted in patients coming to OPD of the Department of General Medicine in Government Vellore Medical College for a duration of 3 months from June 01, 2016, to August 31, 2016. Type 2 DM patients between the age group 20-60 years attending our diabetic clinic of both sex were included in our study. RESULTS From a total of 100 patients, 41% had anaemia including 34% with normochromic normocytic, 65.85% with hyperchromic microcytic anaemia and none of the patient had macrocytic anaemia. Patients who are anaemic had more frequent microvascular complications. There was no significant difference between males and females. The average duration of diabetes has a positive correlation with anaemia. All the microvascular complications like neuropathy, nephropathy and retinopathy had significant association with the presence of anaemia in type 2 patients. Nephropathy had a significant higher frequency compared to others as a complication in type 2 DM. CONCLUSION Our study shows that there is increased prevalence of anaemia in type 2 DM patients and the prevalence of microvascular complications is significantly higher among the diabetic patients with anaemia.
Jakobsen, Dorrit; Bager, Palle
of erythrocytes due to inflammatory inhibition of the bone marrow (chronic inflammatory anaemia) and/or lack of "building material" such as iron, folate or Vitamin-B12 are often found in IBD patients - especially Crohn´s disease patients. Furthermore blood loss due to gastrointestinal bleeding is seen. Anaemia...... due to iron deficiency can be treated with oral- or intravenous iron replacement. To systematize management of anaemia in IBD patients' different tools has been developed at Aarhus University Hospital since 2006. Patients and Methods: Data related to 111 IBD-patients treated with intravenous iron......-physicians. The monitoring form include registration of vital signs, administration of intravenous iron, quality of life assessments (QoL), disease activity and scheduled blood samples monitoring status of the anaemia. The monitoring form was completed by IBD nurses. Results: Results based on a sample of one third...
Full Text Available Anaemia is accepted amongst critically ill patients as an alternative to elective blood transfusion. This practice has been extrapolated to head injury patients with only one study comparing the effects of mild anaemia on neurological outcome. There are no studies quantifying microcirculation during anaemia. Experimental studies suggest that anaemia leads to cerebral hypoxia and increased rates of infarction, but the lack of clinical equipoise when testing the cerebral effects of transfusion amongst critically injured patients, supports the need of experimental studies. The aim of this study was to quantify cerebral microcirculation and the potential presence of axonal damage in an experimental model exposed to normovolaemic anaemia, with the intention of describing possible limitations within management practices in critically ill patients. Under non-recovered anaesthesia, six Merino sheep were instrumented using an intracardiac transeptal catheter to inject coded microspheres into the left atrium to ensure systemic and non-chaotic distribution. Cytometric analyses quantified cerebral microcirculation at specific regions of the brain. Amyloid precursor protein staining was used as an indicator of axonal damage. Animals were exposed to normovolaemic anaemia by blood extractions from the indwelling arterial catheter with simultaneous fluid replacement through a venous central catheter. Simultaneous data recording from cerebral tissue oxygenation, intracranial pressure and cardiac output was monitored. A regression model was used to examine the effects of anaemia on microcirculation with a mixed model to control for repeated measures. Homogeneous and normal cerebral microcirculation with no evidence of axonal damage was present in all cerebral regions, with no temporal variability, concluding that acute normovolaemic anaemia does not result in short term effects on cerebral microcirculation in the ovine brain.
We describe the case of a 17-month-old boy with a hypochromic microcytic anaemia, refractory to oral iron treatment. After exclusion of dietary and gastrointestinal causes of iron deficiency, a genetic cause for iron deficiency was confirmed by finding two mutations in the TMPRSS6 gene, consistent with a diagnosis of iron-refractory iron deficiency anaemia (IRIDA).
thalassaemia is known to modulate sickle cell anaemia, its magnitude and significance in Uganda have hitherto not been described. Objectives: To determine the prevalence of α+thalassaemia among sickle cell anaemia patients in Mulago ...
Walters, Thomas R.; Reddy, B. Narasimha
Patients with sickle cell anaemia have an increased susceptibility to bacterial infections Previous reports of false-negative nitro blue tetrazolium (NBT) tests in the presence of bacteria infection and of a faulty phagocytic response following stimulation in vitro have suggested the possibility of polymorphonuclear dysfunction in certain patients with sickle cell anaemia. In the present study an unstimulated, histochemical NBT technique was used to evaluate the test in patients with sickle cell anaemia. There was a significant difference between the results in the group of patients with infection (mean NBT-positive cells 42·7%) compared to those without infection (mean 9·4%). There was no significant correlation between the total white blood cell count, absolute number of polymorphonuclear cells, and infectious complications. These findings indicate an appropriate polymorphonuclear cell response, as evaluated by the NBT test, in patients with sickle cell anaemia and bacterial infection. The NBT test may be used as an additional parameter in the differentiation of those patients with sickle cell anaemia with bacterial infection. PMID:4426971
... Stages Ages and Stages Prenatal Baby (0-12 mos.) Toddler 1-3yrs. Preschool 3-5yrs Grade School ... Categories of Congenital Abnormalities Chromosome Abnormalities Chromosomes are structures that carry genetic material inherited from one generation ...
Cipolotti, R; Costa, G B; Lima, W H; Franco, R P; Mello, E V; Dal Fabbro, A L; Gurgel, R Q; Cuevas, L E
This study describes the cardiac size and function of patients with sickle cell anaemia, in Segipe, Brazil, and its association to the clinical severity, duration of illness and haemoglobin levels. Heart measurements were obtained by echocardiography from 38 children and adolescents and compared to international reference values. Sickle cell patients had increased left atrial and ventricular dimensions in systole and an increased end diastolic septal and left ventricular free wall thickness. These findings correlated with age. There were no abnormalities in the ejection or shortening fractions. These results suggest early haemodynamic changes with progressive cardiac chamber dilation and diastolic dysfunction that become increasingly abnormal with growth.
Anaemia is a leading cause of maternal morbidity, mortality and poor birth outcomes in developing countries. In Malawi, education on anaemia and provision of prophylaxis iron supplements during pregnancy are key strategies that are used to reduce the high prevalence of anaemia in this population. Therefore, as part of
Maternal anaemia is a risk factor for infant iron deficiency anaemia and, if left uncorrected, can be associated with adverse behavioural and cognitive development in children. The prevalence of anaemia in pregnancy is estimated at between 35% and 75% in sub-Saharan Africa. However, the area-specific health problems ...
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formal education were 1.38 times more likely to be anaemic (p<0.01). The poorest and poorer wealth index groups had 1.52 and. 1.25 increased odds of childhood anaemia respectively (p< 0.01). Childhood anaemia in Ethiopia is a severe public health problem. Maternal anaemia and socio-economic status were found to ...
being 2.7 times more likely to have anaemia (OR. 2.7, CI 1.06-6.70) univariate. Conclusion: Anaemia remains ... education on importance of vegetable intake during pregnancy and involvement in legal income generating ... rates iron deficiency anaemia (IDA) to be among the most important contributing factors to the global.
Background: Anaemia is the commonest extra articular manifestation of Rheumatoid Arthritis (RA). Anaemia is an independent predictor of morbidity and mortality in the population. When RA is complicated by anaemia it is associated with a more severe disease and significant reduction in the quality of life in the affected ...
Visceral leishmaniasis is a rare cause of anaemia. We report a case of visceral leishmaniasis presenting as severe anaemia and pyrexia of unknown origin in an adult female Nigerian. The objective was to highlight the importance of exhaustive investigations in the diagnosis of anaemia and pyrexia of unknown origin in our ...
Introduction: Anaemia is common among HIV infected patients; causes of anaemia in these patients are multifactorial. Anemia is noted as one of important predictors of outcome in HIV infected patients. Tis study was carried out to determine the prevalence of anaemia among HIV infected children attending HIV clinic at ...
Mohamed, Hager Elrasheed Ali
A survey was carried out in Khartoum North Ahmed Gasim specialist Hospital for children to identify aetiological factors that lead to incidence of nutritional anaemia among children under under five years of age. The sample consists of 192 patients taken from the hospital wards (experimental group), and 60 healthy children taken from out patient vaccination department of same hospital. A questionnaire was used as a tool for collection data regarding children and their families with emphasis to general information, socio-economic information, dietary information, anthropometric information, medical history and laboratory investigations including haemoglobin, hematocrit (PCV)%, peripheral blood picture, serum ferritin, serum folate and serum B 12 . Results show no correlation between anaemia and age R(0.1048) p 1 2 deficiency. Some children affected had mixed deficiency anaemia (3.182). Iron deficiency without anaemia was common among healthy children (control) 22.8%. Some recommendations were set for the improvement of the existing situation e.g. health education, nutrition education with emphasis on intake of supplements and weaning diets rich in iron and folate. Follow up and surveillance program to compact nutritional anaemia should be adopted.(Author)
Information on social-clinical characteristics, cancer type and associated factors as well as haemoglobin level before and after radiation were obtained. The prevalence of anaemia was determined as a proportion and linear regression was used to determine factors associated with haemoglobin change. Results: A total of ...
Background: There is a direct relationship between health and social position, especially between anaemia, level of education and social development. ... Among female students 69.4% had hypochromic red cells while all the male students had normochromic red cell; 75.0% of female students had mircrocytic red cells ...
Hepatitis B virus infection is contracted through contact with body fluid of infected persons. Patientswith sickle cell anaemia (SCA), a common haematological disorder inNigeria, have tendencies to visit traditional healerswho administer scarifications and ritualmarks thatmay expose themtoHBVinfection. To determine the ...
who presented with an acute auto-immune haemolytic anaemia. In addition to a persistently positive Coombs test, with specific red cell auto-antibodies, the acidified serum test and the sucrose haemolysis test were repeatedly positive. CASE REPORT. A 24-year-old Indian woman was admitted to hospital in. July 1969.
Although nutritional deficiencies, hookworm infection, HIV and ... Study Area. The study was carried out in the Ejisu-Juaben municipality which is one of the 27 districts and municipalities of the Ashanti Region,. Ghana. Its population in the year 2004 ..... malaria plays a key etiologic role in anaemia in endemic countries, it is ...
The complications of anemia and its' treatment include pulmonary oedema, hypotension, prolong recovery and urticaria (n=35 i.e. 44%, p<0.05). A significant number of patients of paediatric age undergoing surgery and general anaesthesia who had preoperative anaemia required blood transfusion when compared to ...
Objective: To find out if indeed anaemia is a major sign in human trypanosomiasis caused by Trypanosoma brucei rhodensiense. Design: A one year cross-sectional study of all admitted and surveyed Trypanosoma brucei rhodensiense infected patients (June 2001-June 2002) Setting: Nkhotakota District Hospital-Central ...
anaemia and nutritional deficiencies. Biological Risk Factors ... P<0.01) 13. Nutritional Deficiencies. Iron deficiency. Despite the lack of stringent criteria, problems with definitions and lack of substantial supportive data, in sub Saharan Africa ...... reducing tea and coffee consumption, particularly dur- ing meals. This alone can ...
Objective: The study aims at investigating, identifying and classifying the various causes of anaemia necessitating bone marrow aspiration cytology in our environment. Methodology: A retrospective review of all bone marrow aspiration cytology reports of patients referred to Haematology and Blood Transfusion department ...
The commonest cause of nutritional anaemia in the Sri Lankan population is iron deficiency. The diets of the population belonging to the lower socio-economic groups contain little food of animal origin. Thus, their diets are deficient in easily absorbable (haem) iron; and are also heavily cereal-based. Therefore interference in the absorption of dietary iron also occurs. Iron-deficiency anaemia is not restricted to the so-called ''vulnerable groups'' in Sri Lanka, however, their greater demands make the problem not only commoner but also more severe. Among pregnant and lactating women anaemia is often associated with folate deficiency. It must also be noted that the low availability of dietary iron is compounded in large population groups. Malaria, presently raging on an epidemic scale is also a major contributory factor to the incidence of anaemia. The purpose of this study was to examine the iron status of pre-school children and pregnant women; to establish normal levels of biochemical indices at different trimesters; to record the effect of iron supplementation during pregnancy; and to record the bioavailability of iron from weaning foods and common adult diets. 6 figs, 14 tabs
Chapter 19, describes meiotic abnormalities. These include nondisjunction of autosomes and sex chromosomes, genetic and environmental causes of nondisjunction, misdivision of the centromere, chromosomally abnormal human sperm, male infertility, parental age, and origin of diploid gametes. 57 refs., 2 figs., 1 tab.
Full Text Available Hookworm infection is among the major causes of anaemia in poor communities, but its importance in causing maternal anaemia is poorly understood, and this has hampered effective lobbying for the inclusion of anthelmintic treatment in maternal health packages. We sought to review existing evidence on the role of hookworm as a risk factor for anaemia among pregnant women. We also estimate the number of hookworm infections in pregnant women in sub-Saharan Africa (SSA.Structured searches using MEDLINE and EMBASE as well as manual searches of reference lists were conducted, and unpublished data were obtained by contacting authors. Papers were independently reviewed by two authors, and relevant data were extracted. We compared haemoglobin concentration (Hb according to intensity of hookworm infection and calculated standardised mean differences and 95% confidence intervals. To estimate the number of pregnant women, we used population surfaces and a spatial model of hookworm prevalence.One hundred and five reports were screened and 19 were eligible for inclusion: 13 cross-sectional studies, 2 randomised controlled trials, 2 non-randomised treatment trials and 2 observational studies. Comparing uninfected women and women lightly (1-1,999 eggs/gram [epg] infected with hookworm, the standardised mean difference (SMD was -0.24 (95% CI: -0.36 to -0.13. The SMD between women heavily (4000+ epg infected and those lightly infected was -0.57 (95% CI: -0.87 to -0.26. All identified intervention studies showed a benefit of deworming for maternal or child health, but since a variety of outcomes measures were employed, quantitative evaluation was not possible. We estimate that 37.7 million women of reproductive age in SSA are infected with hookworm in 2005 and that approximately 6.9 million pregnant women are infected.Evidence indicates that increasing hookworm infection intensity is associated with lower haemoglobin levels in pregnant women in poor countries
... include: Arthritis of the leg or foot joints Conversion disorder (a mental disorder) Foot problems (such as a ... injuries. For an abnormal gait that occurs with conversion disorder, counseling and support from family members are strongly ...
De Kerviler, E.; Guermazi, A.; Zagdanski, A.-M.; Gluckman, E.; Frija, J.
Fanconi's anaemia is a severe refractory anaemia, associated with congenital malformations in approximately two-thirds of cases. Although these malformations may involve every organ system, suggestive dysmorphic features include growth retardation, radial ray deformities and urinary malformations. These malformations are not specific for Fanconi's anaemia, but should be recognized during pregnancy, or later in childhood, and suggest the possibility of inherited haematopoiesis disorders. De Kerviler, E. (2000)
van Goor, S A; Schaafsma, A; Erwich, J J H M; Dijck-Brouwer, D A J; Muskiet, F A J
We showed that docosahexaenoic acid (DHA) supplementation during pregnancy and lactation was associated with more mildly abnormal (MA) general movements (GMs) in the infants. Since this finding was unexpected and inter-individual DHA intakes are highly variable, we explored the relationship between GM quality and erythrocyte DHA, arachidonic acid (AA), DHA/AA and Mead acid in 57 infants of this trial. MA GMs were inversely related to AA, associated with Mead acid, and associated with DHA/AA in a U-shaped manner. These relationships may indicate dependence of newborn AA status on synthesis from linoleic acid. This becomes restricted during the intrauterine period by abundant de novo synthesis of oleic and Mead acids from glucose, consistent with reduced insulin sensitivity during the third trimester. The descending part of the U-shaped relation between MA GMs and DHA/AA probably indicates DHA shortage next to AA shortage. The ascending part may reflect a different developmental trajectory that is not necessarily unfavorable. Copyright 2009 Elsevier Ltd. All rights reserved.
Suresh Moothezhathu Kesavadas
Full Text Available BACKGROUND Liver plays an important role in normal erythropoiesis and synthesis of clotting factors. Chronic liver disease (CLD patients are frequently associated with abnormalities in haematological parameters. MATERIALS AND METHODS This was an observational study conducted among diagnosed CLD patients over a period of 1 year from 2013 to 2014. Various haematological abnormalities in 75 CLD patients were studied. Relevant details were obtained in structured format. RESULTS The mean age of the study group 49.2 years. Male-to-female ratio was 5.8:1. Aetiologies of cirrhosis were alcoholism (61.3%, diabetes mellitus (26.7% and dyslipidaemia (13%. 88% patients were anaemic with severe anaemia (Hb <8 gm% observed in 33.3% patients with mean Hb being 8.76 gm%. Mean Hb in alcohol-related CLDs were lower than CLDs due to other aetiologies (8.62 gm% vs. 9.36 gm%. Most common anaemia observed was normocytic normochromic anaemia (40.9%. 26.7% had leucopenia and 88% had thrombocytopenia. Normal ferritin levels were observed in 6.7%, decreased in 16% and increased in the remaining cases of which a level of more than 900 ng/mL was observed in 18.7% cases. Mean CTP (ChildTurcotte-Pugh score of the study group was 11.1. 80% of patients belong to child C. Patients with high ferritin levels had high CTP score (P-0.001. Platelet count decreases as CTP score increases (P-0.000 and as spleen size increases (P-0.001. CONCLUSION Most common haematological abnormalities observed were thrombocytopenia and anaemia. Severe anaemia was seen in males and alcoholics. Thrombocytopenia was more in those with advanced liver disease and large spleen. High serum ferritin level correlate well with advanced liver disease.
Full Text Available Abstract Background A Phase 1-2b study of the blood stage malaria vaccine AMA1-C1/Alhydrogel was conducted in 336 children in Donéguébougou and Bancoumana, Mali. In the Phase 2 portion of the study (n = 300, no impact on parasite density or clinical malaria was seen; however, children who received the study vaccine had a higher frequency of anaemia (defined as haemoglobin Methods To further investigate the possible impact of vaccination on anaemia, additional analyses were conducted including patients from the Phase 1 portion of the study and controlling for baseline haemoglobin, haemoglobin types S or C, alpha-thalassaemia, G6PD deficiency, and age. A multiplicative intensity model was used, which generalizes Cox regression to allow for multiple events. Frailty effects for each subject were used to account for correlation of multiple anaemia events within the same subject. Intensity rates were calculated with reference to calendar time instead of time after randomization in order to account for staggered enrollment and seasonal effects of malaria incidence. Associations of anaemia with anti-AMA1 antibody were further explored using a similar analysis. Results A strong effect of vaccine on the incidence of anaemia (risk ratio [AMA1-C1 to comparator (Hiberix]= 2.01, 95% confidence interval [1.26,3.20] was demonstrated even after adjusting for baseline haemoglobin, haemoglobinopathies, and age, and using more sophisticated statistical models. Anti-AMA1 antibody levels were not associated with this effect. Conclusions While these additional analyses show a robust effect of vaccination on anaemia, this is an intensive exploration of secondary results and should, therefore, be interpreted with caution. Possible mechanisms of the apparent adverse effect on haemoglobin of vaccination with AMA1-C1/Alhydrogel and implications for blood stage vaccine development are discussed. The potential impact on malaria-associated anaemia should be closely
Dennenberg BS, Criner G, Jones R, Spann JF. Car- diac function in sickle cell anaemia. Am J Cardiol 1983;. 51: 1674-1678. 5. Rees AH, Stefadouros MA, Strong WB, et al. Left ven- tricular performance in children with homozygous sickle cell anaemia. Br Heart J 1978; 40: 690-696 PubMed . 6. Balfour IC, Covitz W, Davis H, ...
... students (93.4%) stool examination was negative , while 11 students (6.6%) had intestinal worms (Enterobius vermicularis). Conclusion: majority of the study participants had iron deficiency anaemia, followed by haemolytic, macrocytic and sickle cell anaemia. This might have negative health and educational implications.
Abstract. Background: Iron deficiency, and specifically iron deficiency anaemia, remains one of the most severe and important nu- tritional deficiencies in the world today. Objective: To estimate the prevalence and associated factors for iron deficiency anaemia among pre-school children in. Lagos. Methodology: The study ...
Background: Iron deficiency anaemia has been described as the commonest type of nutritional anaemia in infancy and childhood. The associated adverse health sequelae include permanent behavioural and cognitive impairments. Early detection and prompt treatment are necessary to prevent these complications. Aim: To ...
Background: Iron deficiency, and specifically iron deficiency anaemia, remains one of the most severe and important nutritional deficiencies in the world today. Objective: To estimate the prevalence and associated factors for iron deficiency anaemia among pre-school children in Lagos. Methodology: The study was ...
Screening for childhood anaemia using copper sulphate densitometry. M Funk, T Hambrock, G C van Niekerk, D F Wittenberg. Abstract. Objective. To evaluate copper sulphate densitometry to screen for childhood anaemia in a primary care setting, with a view to identifying children requiring definitive diagnostic testing and ...
Objective: To assess the magnitude and contributing factors of anaemia among refugee preschool children of the Kebribeyah refugee camp. Methodology: A ... However, the predisposing factors to anaemia have not been clearly identified or ... established in 1991 in the Somali region, Ethiopia, after the fall of the Siad Barre ...
Erlingmark, Julia; Hedström, Mariann; Lindberg, Magnus
Current trends in renal anaemia management place greater emphasis, and thus increased workload, on the role of the nurse in haemodialysis settings. However, there is little evidence that demonstrates the relationship between nurse staffing and patient outcomes. To describe nurse staffing in haemodialysis settings, its relationship with target levels of renal anaemia management and to describe target level achievement for different ways of organising anaemia management. Cross-sectional audit. Forty (out of 78) haemodialysis centres in Sweden reported quality assurance data. The numbers of bedside registered nurses, licensed nurse assistants and patients undergoing haemodialysis during a predefined morning shift; type of anaemia management and achieved target levels of anaemia management. The mean patient:registered nurse ratio was 2.4 and the mean patient:nurse assistant ratio was 12.8. There were no significant relationships between registered nurse staffing and target level achievement. On average, 45.6% of the patients had haemoglobin within the target levels at centres applying nurse-driven anaemia management, compared with 47.3% at physician-driven centres. These cross-sectional data suggest that renal anaemia outcomes are unrelated to the patient:registered nurse ratio. There is, however, room for improvement in renal anaemia management in the units included in this study, particularly the achievement of target levels of haemoglobin and transferrin saturation. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.
Background: Severe anaemia in children with cerebral malaria has been associated with respiratory distress secondary to lactic acidosis and/or hypoxia. ... Thirty percent of those with severe anaemia had deep sighing (acidotic) breathing compared to only 15% of those with haemoglobin (Hb) > 5 g/dl, OR 1.21 (CI 0.90 ...
Objective: To determine the prevalence of anaemia and factors associated with iron deficiency among school children in rural Kenitra, Morocco. Methods: ... Conclusion: Anaemia remains a common problem in the young children particularly the primary education school boys of the households of low income. The results ...
Background: Anaemia is a public health problem affecting children with potential consequences on physical and mental development. Children living in resource poor countries where micro-nutrient deficiency and infections are prevalent are mostly affected. Objective: To determine the prevalence of anaemia in a rural ...
Low educational attainment [Adjusted Odds Ratio (AOR)=2.13], being single or divorced [AOR=2.02], high parity [AOR=2.06], late booking [AOR=2.71] and short intervals between pregnancies [AOR=2.37] were significant predictors of anaemia in pregnancy. The high prevalence of anaemia in pregnancy related to low ...
Background: Anaemia and vitamin A deficiency are two major public health problems affecting many developing countries world-wide. Vitamin A deficiency, in addition to other health problems, can contribute to anaemia. Therefore, the objective of this study is to determine the relationship between vitamin A status and ...
Background: Anaemia in pregnancy persists, especially in third world countries where poor diet, low levels of literacy, infections, infestations and cultural practices predispose pregnant women to being anaemic. The aim of this study was to determine the prevalence of anaemia in pregnancy and to identify the possible ...
with no limitation on date of publishing and study design. Articles in English were searched using keywords ... reported that mice lacking TNF-α were able to control anaemia, and that IFN-γ was linked to severe anaemia ... Immunological mechanisms have also been advanced, related to the removal of erythrocytes, mostly ...
Background: Anaemia is a common complication of chronic kidney disease. There is paucity of published local and regional data regarding its associated factors and management. Objective: To assess the correlates and management of anaemia in chronic kidney disease. Design: Cross sectional descriptive study
This study was designed to evaluate the ameliorative effect of dietary supplementation of Cnidoscolus aconitifolius leaf on anaemia and changes in erythrocyte osmotic fragility in protein energy malnourished rats. Protein energy malnutrition has been associated with anaemia and changes in osmotic fragility, deformability ...
wide and yet in Uganda, there is little national data on anaemia and its likely causes amongst school children. The aim of this study was to assess the prevalence, dietary and health risk factors of nutritional anaemia amongst 11-14 year old girls ...
Context: Severe anaemia from menorrhagia is a common complication of uterine fibroids. If all patients with such a problem were to accept blood transfusion and if blood transfusion were risk free, then it is the ideal treatment for correcting severe anaemia preoperatively. However, this is not the case and so alternatives have ...
Background: There is increasing evidence suggesting the contribution of platelets in the vaso-occlusive phenomena found in sickle cell anaemia. This study is aimed at using simple, inexpensive parameters to determine the role of platelets in the steady state and vaso-occlusive crisis state of Nigerian sickle cell anaemia ...
Background: Anaemia in pregnancy remains a common problem affecting women in northern Nigeria. It is associated with several adverse consequences. Objective: The aim of this study was to determine the prevalence of anaemia and its associated factors among pregnant women in Koko/Besse local government area of ...
In pregnancy megaloblastic anaemia commonly results from folic acid deficiency partly due to placenta transfer to fetus, but mainly because of increased folate catabolism due to cleavage of folate coenzymes in rapidly proliferating tissues. Cobalamin deficiency causing megaloblastic anaemia has been described in infants ...
Jun 3, 2008 ... Accepted 28 April, 2008. This study was designed to evaluate the ameliorative effect of dietary supplementation of Cnidoscolus aconitifolius leaf on anaemia and changes in erythrocyte osmotic fragility in protein energy malnourished rats. Protein energy malnutrition has been associated with anaemia and ...
However, in a multivariate logistic regression analysis, female sex was the only predictor of anaemia . Conclusion: Anaemia is a common complication seen among HIV patients in view of the prevalence rate of 76% observed in our study. The risk factors associated with anemia were female sex, living in urban area and low ...
There is paucity of data describing the risk factors for anaemia among HIV infected children in Tanzania. This cross sectional study was carried out to determine the contributing factors for anaemia among HIV-infected children attending Muhimbili National Hospital in Dar es Salaam. Both univariate and multivariate logistic ...
health measures for anaemia in Tanga Region of Tanzania risk factors were investigated in school children. ... prevalence of infections and nutritional deﬁciencies are important risk factors for anaemia in this community. ... Li C iii iiiiiiiy Piiiis oi the dive oping Woi ii development in children (Nokes et al., 1998; iiiiaciiiiii iii ...
Background: Worm infection and anaemia are common childhood conditions in Nigeria. We assessed the status of helminthiasis and associated anaemia among pre school children of peasant farmers aged 1-5 years living in a rubber plantation near Calabar, Nigeria. Design: Cross sectional. Method: Three hundred and ...
Barbara De La Salle
Full Text Available Since its introduction in the 1960s, external quality assessment has developed to become an essential component of the quality management system of the diagnostic laboratory. External quality assessment provides a long term, retrospective view of laboratory performance, demonstrating the competence of the laboratory to others. The ENERCA project (the European Network for Rare and Congenital Anaemias has established a list of core laboratory tests that are used in the diagnosis of rare and congenital anaemias, which has been used as the basis for questionnaires to laboratories, to establish the use and quality assurance of diagnostic testing in the congenital and rare anaemias, and to European EQA providers for services in this key area. In general, the provision of EQA for rare and congenital anaemias is widely variable with little provision for the very rare disorders. For the more common congenital anaemias, such as the haemoglobinopathies and thalassaemias, provision is better but there is variation in aspects of the scheme design, especially the frequency of distribution. Where laboratories did not take part in EQA for individual tests, or there was no EQA available, a desire to participate was expressed in 66% (102/154 of cases. The provision of external quality assessment (EQA services for rare disorders is a challenge. For many of these conditions, the number of patients in any one member state is very small with only a few laboratories providing diagnostic testing. In these cases, the development of pan-European or cross-border EQA may be the only means by which standardisation of methods and results can be achieved. An EQA survey of 243 laboratories for performance in Hb A2 quantification showed encouraging results in that there was a clear differentiation in the results from a beta Thalassaemia carrier and an individual with no evidence of Thalassaemia; however, a bias was observed between different methods of measurement.
Full Text Available Anaemia is a common clinical finding in HIV infected women and has been associated with advanced disease. The use of antiretroviral drugs such as Zidovudine (ZDV either for prevention of mother to child transmission (MTCT of HIV or used in combination with other antiretrovirals have been implicated in the development or increased severity of anaemia. We report the prevalence, type, severity and incidence of anaemia in a cohort of HIV infected women who initiated antiretroviral prophylaxis or treatment during pregnancy.This is a retrospective cohort data analysis of 408 HIV infected pregnant women who participated in a breastfeeding intervention study (HPTN 046 Study, ClinicalTrials.gov NCT 00074412 in South Africa. Women initiated zidovudine prophylaxis for PMTCT or triple antiretroviral treatment in pregnancy according to the standard of care. Laboratory and clinical data in pregnancy, <72 hours and 2 weeks postdelivery were extracted from the main database and analysed.The mean Hb concentration was 10.6 g/dL at baseline and 262/408 (64.2% women were diagnosed with anaemia (Hb<11 g/dL in pregnancy, 48/146 (32.9% subsequently developed anaemia intrapartum or postpartum and 89/310 (28.7% of all cases of anaemia remained unresolved by 2 weeks postdelivery. In a univariate analysis, CD4 count and gravidity were significant risk factors for anaemia in pregnancy, RR 1.41; 1.23-1.61 (p<0.001 and 1.10; 1.01-1.18 (p = 0.02 respectively. After adjusting for antiretroviral regimen, age and gravidity in a multivariable analysis, only the CD4 count remains a significant risk factor for anaemia in pregnancy and postdelivery.In conclusion, anaemia was most common among women in the advanced stage of HIV infection (CD4<200 cells/mm3. There was no evidence of an association between ZDV or triple ARVs and anaemia.
Kurniawan, Yustina Anie Indriastuti; Muslimatun, Siti; Achadi, Endang L; Sastroamidjojo, Soemilah
Anaemia due to iron deficiency is still a widespread problem. Among adolescent girls, it will bring negative consequences on growth, school performance, morbidity and reproductive performance. This cross sectional study aimed to identify the different nutritional and iron status characteristics of young adolescent girls 10-12 years old with iron deficiency anaemia and anaemia without iron deficiency in the rural coastal area of Indonesia. Anaemic girls (N =133) were recruited out of 1358 girls from 34 elementary schools. Haemoglobin, serum ferritin, serum transferrin receptor and zinc protophorphyrin were determined for iron status, whilst weight and height were measured for their nutritional status. General characteristics and dietary intake were assessed through interview. Out of 133 anaemic subjects, 29 (21.8%) suffered from iron deficiency anaemia, which was not significantly related to age and menarche. About 50% were underweight and stunted indicating the presence of acute and chronic malnutrition. The proportion of thinness was significantly higher (P < 0.05) among subjects who suffered from iron deficiency anaemia (51.7% vs. 29.8%). Furthermore, thin subjects had a 5 fold higher risk of suffering from iron deficiency anaemia (P< 0.05) than non-thin subjects (OR: 5.1; 95%CI 1.34-19.00). Further study was recommended to explore other factors associated with anaemia and iron deficiency anaemia, such as the thalassemia trait and vitamin A deficiency. The current iron-folate supplementation program for pregnant women should be expanded to adolescent girls.
Hanley John P
Full Text Available Abstract Introduction Unexplained anaemia is a rare mode of presentation for prolactinoma. We describe a case of a man, with chronic anaemia ascribed to old age. Six years later, he was evaluated and diagnosed with a prolactinoma and resultant osteoporosis. Prolactinoma in old people may present insidiously with chronic anaemia and osteoporosis with or without sexual dysfunction. Case presentation We describe the case of a 70-year-old Caucasian man who presented with mild anaemia and tiredness. His anaemia was investigated and ascribed to senescence. Endocrine causes were not considered or tested for. Six years later, he was again referred. Reassessment and direct questioning revealed long-standing sexual dysfunction. It was also discovered that our patient had fractured his radius twice, with minor trauma, during the preceding year. His serum prolactin was massively increased and a magnetic resonance imaging (MRI scan of the head demonstrated a pituitary mass consistent with a prolactinoma. Dual X-ray absorptiometry revealed osteoporosis. Treatment of the prolactinoma led to a reduction in his serum prolactin with a rise in his haemoglobin to normal levels. This suggested that the prolactinoma was present during the initial presentation and was the cause of his anaemia. Conclusion This case highlights the importance of fully evaluating and investigating unexplained anaemia in older people and that endocrine causes should be considered. Osteoporosis also requires evaluation with secondary causes considered.
Barkley, Jonathan S; Wheeler, Kathleen S; Pachón, Helena
The effectiveness of flour fortification in reducing anaemia prevalence is equivocal. The goal was to utilise the existing national-level data to assess whether anaemia in non-pregnant women was reduced after countries began fortifying wheat flour, alone or in combination with maize flour, with at least Fe, folic acid, vitamin A or vitamin B12. Nationally representative anaemia data were identified through Demographic and Health Survey reports, the WHO Vitamin and Mineral Nutrition Information System database and other national-level nutrition surveys. Countries with at least two anaemia surveys were considered for inclusion. Within countries, surveys were excluded if altitude was not consistently adjusted for, or if the blood-draw site (e.g. capillary or venous) or Hb quantification method (e.g. HemoCue or Cyanmethaemoglobin) differed. Anaemia prevalence was modelled for countries that had pre- and post-fortification data (n 12) and for countries that never fortified flour (n 20) using logistic regression models that controlled for time effects, human development index (HDI) and endemic malaria. After adjusting for HDI and malaria, each year of fortification was associated with a 2.4% reduction in the odds of anaemia prevalence (PR 0.976, 95% CI 0.975, 0.978). Among countries that never fortified, no reduction in the odds of anaemia prevalence over time was observed (PR 0.999, 95% CI 0.997, 1.002). Among both fortification and non-fortification countries, HDI and malaria were significantly associated with anaemia (P,0.001). Although this type of evidence precludes a definitive conclusion, results suggest that after controlling for time effects, HDI and endemic malaria, anaemia prevalence has decreased significantly in countries that fortify flour with micronutrients, while remaining unchanged in countries that do not.
Førland, Elizabeth Siren Bjerga; Lindberg, Mats Jacob Hermansson
Nutritional deficiency anaemia in vegans is common and usually due to lack of vitamin B12, as this vitamin is found almost exclusively in animal-based food products. In this case report we present a 39-year-old male vegan with severe macrocytic anaemia due to vitamin B12 deficiency as well as secondary hyperparathyroidism due to severe vitamin D deficiency. We want to emphasize the importance of a detailed nutritional history for patients with anaemia, and the need for vitamin B12 and vitamin D supplements for people who comply with a vegan diet.
Tulika Goswami Mahanta
Full Text Available Background: Nutritional anaemia, one of the major public health problems in India is associated with lower productivity, higher sickness rate and absenteeism having inter-generational effect. Morbidity during adolescent has implication on future safe motherhood, optimum growth and development of foetus and children. Aims and Objective: To assess, prevalence and determinants of anaemia and effect of different interventions amongst tea tribe adolescent girls. Materials & Methods: A community based intervention study was conducted covering 16 tea estates of Dibrugarh District, Assam. Variables includes socio-demographic, environmental, anthropometry, history of present and past illness, clinical examination and laboratory investigation including haemoglobin, serum ferritin, haemoglobin typing and routine stool examination. Interventions given were weekly IFA supplementation, dietary diversification, health promotion by monthly NHED, cooking demonstration, cooking competition and kitchen garden promotion and counselling to improve IFA compliance and remove barriers was done. SPSS and EpiInfo software, used to calculate of rates, ratios, chi-square test, Fisher Exact test and multiple logistic regression analysis. Results: Enrolments were 802, with mean age, 14.8 years. Anaemia prevalence was 96.3% with median serum ferritin, 22.9 ng/ml. Prevalence of Sickle cell anaemia was,12% and helminthiasis 84.20%. History of passage of worms (9.1%, night blindness (5.6%, weakness (62.1%, loss of appetite (37.5%, gum bleeding (23.6%, loose motion (13%, loss of weight (9.9%, menstrual problem (19.3% was common. Following intervention mean haemoglobin difference was 1.48 gm/dl with 13.5% difference in prevalence. Associated morbidities showed significant reduction following active intervention. Conclusions: High anaemia prevalence requires urgent attention to avoid preventable morbidities. Implementation of different intervention in an integrated manner was
Markova, Veronika; Norgaard, Astrid; Jørgensen, Karsten Juhl
BACKGROUND: Postpartum iron deficiency anaemia is caused by bleeding or inadequate dietary iron intake/uptake. This condition is defined by iron deficiency accompanied by a lower than normal blood haemoglobin concentration, although this can be affected by factors other than anaemia and must...... sample sizes. No analysis of our primary outcomes contained more than two studies.Intravenous iron was compared to oral iron in 10 studies (1553 women). Fatigue was reported in two studies and improved significantly favouring the intravenously treated group in one of the studies. Other anaemia symptoms....... The quality of evidence was low.Clinical outcomes were rarely reported. Laboratory values may not be reliable indicators for efficacy, as they do not always correlate with clinical treatment effects. It remains unclear which treatment modality is most effective in alleviating symptoms of postpartum anaemia...
Foss, N.B.; Kristensen, M.T.; Kehlet, H.
mobility in the early post-operative phase after a hip fracture surgery and is an independent risk factor for patients not being able to walk post-operatively. The potential for a liberal transfusion policy to improve the rehabilitation potential in hip fracture patients with anaemia should be investigated......BACKGROUND: the impact of anaemia on the outcome after a hip fracture surgery is controversial, but anaemia can potentially decrease the physical performance and thereby impede post-operative rehabilitation. We therefore conducted a prospective study to establish whether anaemia affected functional...... mobility in the early post-operative phase after a hip fracture surgery. PATIENTS AND METHODS: four hundred and eighty seven consecutive hip fracture patients, treated according to a well-defined multimodal rehabilitation programme with a uniform, liberal transfusion threshold, were studied. Hb...
Investigation of manganese homeostasis in dogs with anaemia and chronic enteropathy. Marisa da Fonseca Ferreira, Arielle Elizabeth Ann Aylor, Richard John Mellanby, Susan Mary Campbell, Adam George Gow ...
Chatard, J C; Mujika, I; Guy, C; Lacour, J R
Trained athletes frequently experience low levels of blood haemoglobin (13 to 14 g/100ml in men and 12 g/100ml in women) plus low haematocrit and low ferritin levels. These parameters define the concept of 'sports anaemia'. Low iron levels may be due to mechanical haemolysis, intestinal bleeding, haematuria, sweating, low iron intake or poor intestinal absorption. The resulting decrease in blood gas transport and muscle enzyme activity impairs performance. The concept of sports anaemia can be criticised. Simply measuring the blood levels does not take into account the haemodilution that occurs in athletes because of training. The lack of these measurements makes it difficult to diagnose anaemia or evaluate any treatment. Anaemia is treated by preventing decreased iron stores through a balanced food intake or iron supplements. Self-medications must be discouraged because of intolerance, risk of overdose and many other drug interactions.
This study demonstrated that overall adiposity correlates positively with inflammation but this is not applicable to indices of visceral fat. However, no correlation was established between obesity and anaemia in this study.
uptodate. [Online] 2013. 3. WHO.Reducing Risks, Promoting Healthy. Lifestyles. Geneva : WHO, 2002. 4. Luo, C, Mwela, CM and Campbell, J. National. Baseline Survey on Prevalence and Aetiology of. Anaemia in Zambia. Lusaka : s.n., 1999.
Publications on the cytokines studied in trypanosomiasis-associated anaemia ordered by year. Publication. Infecting trypanosome. Clinical sample. Cytokines. Other factors associated with anaemia. Magez et al. 1999. T.b.b AnTat1.1E. Blood from TNF-α -/-. TNF-α. -. Namangala et al. 2001. T.b.b AnTat1.1E. T.b.b PLC-/-.
les femmes qui ont les antécédents des facteurs de risque obstétrique exigent la vigilance, une éducation de santé soutenue et la chémoprophylaxie pour les femmes enceintes (Afr J Reprod Health 2011; 15: 33-41). Keywords: Anaemia, pregnancy, prevalence, risk factors, Kano. Introduction. Anaemia in pregnancy ...
Full Text Available BACKGROUND India is one of the countries with very high prevalence of anaemia in the world. In India, almost 59% of pregnant women are anaemic and it accounts for 20-40% of total maternal deaths. Anaemia in pregnancy is one of the major risks and associated with abortions, premature births, postpartum haemorrhage and low birth weight. In view of the above, the present study was carried out to find out the prevalence of anaemia amongst pregnant women and sociodemographic factors associated with anaemia in pregnancy. MATERIALS AND METHODS A community-based cross-sectional study was carried out among 200 pregnant women with gestational period 12-20 weeks attending the antenatal sessions in 4 tea garden areas under Dholai BPHC, Cachar District, for 6 months from April 2016 to September 2016. Data were presented in proportion, mean and standard deviation. Association was seen by using Chi-square test and Fischer’s exact test. RESULTS Among 200 pregnant women, majority (38.5% were in 20-24 years of age, 98% Hindu by religion and 56% from class IV socioeconomic class. Regarding the educational status, 34.5% were educated up to primary school, while 33.5% were illiterate. Majority, i.e. 45.5% and 31.5% were having parity 0 and 1, respectively. Prevalence of anaemia in the present study was found to be 81% and among which 77.2% were moderately anaemic. The study showed significant association of anaemia among pregnant women with lower socioeconomic status and high parity. CONCLUSION In the present study, there is high prevalence (81% of anaemia among pregnant women. The study also noted that lower socioeconomic status and high parity had a significant role in anaemia during pregnancy. So, there is a need to intensify IEC activities to promote early antenatal care, increased compliance of intake of iron and folic acid tablets, dietary modification and utilisation of family planning services among pregnant women of this region.
Full Text Available BACKGROUND Haemolytic anaemia is a well-recognised clinical problem. This study looks into the clinical profile of haemolytic anaemia and also attempts to find out the common underlying causative disease. It also tries to group the patients according to the clinical manifestations and underlying causes. MATERIALS AND METHODS This is a hospital-based observational study conducted in a tertiary care centre in Northern Kerala. Forty-four adult patients with clinical manifestations and laboratory evidence of haemolytic anaemia were identified and studied for a period of one year. RESULTS Maximum number of cases were seen in the age group of 20-40 years. The overall male-female ratio was 1.1:1. The most common presenting symptoms were features of anaemia like breathlessness, easy fatigability, headache and tiredness. Family history of anaemia was present in 34.1%. The most common signs observed were pallor and jaundice. The most common causes were autoimmune haemolytic anaemia and sickle cell anaemia. CONCLUSION Haemolytic anaemia mostly affects individuals in their 3rd and 4th decade. There is no significant difference in gender distribution of haemolytic anaemia. Haemolytic anaemia most commonly presents with symptoms of anaemia and jaundice. Commonest causes of haemolytic anaemia are autoimmune haemolytic anaemia and sickle cell anaemia.
De Coster, Greet; De Neve, Liesbeth; Lens, Luc
Many passerine species lay eggs that are speckled with dark protoporphyrin pigmentation. Because protoporphyrin is mainly derived from the blood, we here formulate and test a new hypothesis that links an increase in anaemia along the laying sequence to within-clutch variation in egg pigmentation. More intense pigmentation is expected if pigments accumulate during enhanced red blood cell production in response to anaemia. Reduced pigmentation is expected if pigments are derived from the degradation of red blood cells that circulate in smaller numbers due to blood loss. To test this hypothesis, we manipulated anaemia in great tit (Parus major) females by infesting the nests with hen fleas (Ceratophyllus gallinae) prior to egg laying. Polychromatophil (i.e., immature red blood cells) percentage, as a measure of blood cell production, was positively correlated with parasite load confirming that female great tits experienced stronger anaemia when infested with haematophagous parasites during egg laying. We found a positive relationship between spot darkness and laying order that weakened under high parasite load. This result suggests that anaemia in females due to blood-sucking parasites led to diminished protoporphyrin from disintegrated red blood cells and hence a decreased deposition of protoporphyrin. However, the overall increase in pigment darkness along the laying sequence suggests that pigments also accumulate by enhanced red blood cell production caused by anaemia due to egg production itself.
Mahon, A; Bennett, L
The global burden of chronic kidney disease (CKD) and associated anaemia is substantial. With the increasing numbers of patients that are likely to be affected in the future, approaches are required to improve anaemia management without increasing the workload of renal units. Advocating early treatment may improve patient outcomes and nurses are in an ideal position to identify and manage anaemia at an early stage in patients with CKD. In addition, adopting a multidisciplinary approach, alongside nephrologists, diabetologists, cardiologists, social workers, nutritionists and pharmacists, may allow nurses to detect and treat anaemia earlier in patients with CKD. Maintaining awareness of factors associated with decreased erythropoiesis-stimulating agents (ESAs) efficacy (e.g. iron deficiency or poor nutritional status) is also important. To reduce the burden on healthcare providers, anaemia management could be simplified by extending the administration interval of ESAs. Recent studies have explored the clinical efficacy of administration of currently available agents at intervals of up to once monthly in highly selected, stable patients. The use of an ESA that can control anaemia while maintaining haemoglobin levels within guideline ranges with extended administration intervals in all patients without the need for additional screening or stepwise dose adjustments with attendant monitoring may help improve patient care while reducing the workload of healthcare providers.
Lubega, Irene; Ndugwa, Christopher M; Mworozi, Edison A; Tumwine, James K
Sickle cell anaemia is prevalent in sub Saharan Africa. While α+-thalassaemia is known to modulate sickle cell anaemia, its magnitude and significance in Uganda have hitherto not been described. To determine the prevalence of α+thalassaemia among sickle cell anaemia patients in Mulago Hospital and to describe the clinical and laboratory findings in these patients. A cross sectional study was carried out on patients with sickle cell anaemia in Kampala. Dried blood spots were used to analyze for the deletional α+ thalassaemia using multiplex polymerase chain reaction. Of the 142 patients with sickle cell anaemia, 110 (77.5%) had the αα+thalassaemia deletion. The gene frequency of (-α) was 0.425. Ninety one percent (100/110) of those with α+thalassaemia were heterozygous (αα/α-). Amongst the patients older than 60 months, 15 (83.3%) of those without αα+thalassaemia had significant hepatomegaly of greater than 4 cm compared to 36 (45.6%) of those with α+thalassaemia (p=0.003). The gene frequency of (-α) of 0.425 noted in this study is higher than that reported from many places in Africa. Concurrent alpha thalassemia might be a protective trait against significant hepatomegaly in sickle cell anaemia patients more than 60 months of age at Mulago hospital.
Wańha, Wojciech; Kawecki, Damian; Roleder, Tomasz; Pluta, Aleksandra; Marcinkiewicz, Kamil; Dola, Janusz; Morawiec, Beata; Krzych, Łukasz; Pawłowski, Tomasz; Smolka, Grzegorz; Ochała, Andrzej; Nowalany-Kozielska, Ewa; Tendera, Michał; Wojakowski, Wojciech
Coexisting anaemia is associated with an increased risk of major adverse cardiac and cerebrovascular events (MACCE) and bleeding complications after percutaneous coronary intervention (PCI), especially in patients with acute coronary syndrome. To assess the impact of anaemia in patients with coronary artery disease (CAD) treated with first- and second-generation drug-eluting stents (DES) on one-year MACCE. The registry included 1916 consecutive patients (UA: n = 1502, 78.3%; NSTEMI: n = 283, 14.7%; STEMI/LBBB: n = 131, 6.8%) treated either with first- (34%) or second-generation (66%) DES. The study population was divided into two groups: patients presenting with anaemia 217 (11%) and without anaemia 1699 (89%) prior to PCI. Anaemia was defined according to World Heart Organisation (haemoglobin [Hb] level < 13 g/dL for men and < 12 g/dL for women). Patients with anaemia were older (69, IQR: 61-75 vs. 62, IQR: 56-70, p < 0.001), had higher prevalence of co-morbidities: diabetes (44.7% vs. 36.4%, p = 0.020), chronic kidney disease (31.3% vs. 19.4%; p < 0.001), peripheral artery disease (10.1% vs. 5.4%, p = 0.005), and lower left ventricular ejection fraction values (50, IQR: 40-57% vs. 55, IQR: 45-60%; p < 0.001). No difference between gender in frequency of anaemia was found. Patients with anaemia more often had prior myocardial infarction (MI) (57.6% vs. 46.4%; p = 0.002) and coronary artery bypass grafting (31.3% vs. 19.4%; p < 0.001) in comparison to patients without anaemia. They also more often had multivessel disease in angiography (36.4% vs. 26.1%; p = 0.001) and more complexity CAD as measured by SYNTAX score (21, IQR: 12-27 points vs. 14, IQR: 8-22 points; p = 0.001). In-hospital risk of acute heart failure (2.7% vs. 0.7%; p = 0.006) and bleeding requiring transfusion (3.2% vs. 0.5%; p < 0.001) was significantly higher in patients with anaemia. One-year follow-up showed that there was higher rate of death in patients with anaemia. However, there were no
Full Text Available Background: Anaemia continues to be a severe public health nutritional problem in India affecting all physiological groups, even after the National Nutritional Anaemia Prophylaxis Programme has been in operation for more than three decades. Objective: To assess the prevalence of anaemia among rural pre-school (1-5-years children of Maharashtra. Methods: A community based cross-sectional study was carried by National Nutrition Monitoring Bureau (NNMB covering a total of 404 (Boys-243; Girls-161 pre-school children. Information of socio-demographic particulars was obtained and the finger prick blood samples were collected for the estimation of haemoglobin levels by cyanmethmoglobin method. Results: The result shows that 59.2 % (CI: 54.4-64.0 of the rural pre-school children of Maharashtra were anaemic, and the prevalence was significantly (p40% among rural pre-school children of Maharashtra. Therefore, appropriate intervention measures such as supplementary iron & folic acid, periodic deworming and health & nutrition education should be strengthened. The community needs to be encouraged to diversify their diets by consuming iron rich foods.
Jørgensen, C. C.; Jans, Ø.; Kehlet, H.
BACKGROUND: Preoperative anaemia is a well-established risk factor for use of blood transfusions and postoperative morbidity. Consequently, focus on preoperative evaluation of haemoglobin levels is increasing. In this context, iron deficiency anaemia may be a symptom of undiscovered gastrointesti......BACKGROUND: Preoperative anaemia is a well-established risk factor for use of blood transfusions and postoperative morbidity. Consequently, focus on preoperative evaluation of haemoglobin levels is increasing. In this context, iron deficiency anaemia may be a symptom of undiscovered...
Nunia, V.; Goyal, P.K.
Intraperitoneal administration of diltiazem (DTZ), half an hour prior to whole body gamma irradiation (2.5, 5.0, and 7.5 Gy), showed the protection of animals from radiation-induced anaemia. Radiation exposure significantly (p<0.001) reduced the number of pro- and normoblasts in bone marrow and red blood cell (RBC) counts, hemoglobin (Hb), hematocrit (Hct), and erythropoietin (EPO) level in blood, but increased myeloid/erythroid ratio. At all the radiation doses, the maximum decrease in these values was noted on the 3rd day, followed by a gradual recovery from the 7th day, but it was not recorded as normal even until the end of experimentation. In animals pretreated with DTZ, these values were measured higher at all the time periods in comparison to corresponding control, and these were almost normal at the last autopsy interval only at 2.5 Gy radiation dose. DTZ maintained the higher EPO level in blood, which acted on bone marrow and spleen colony forming unit for erythroblast (CFU-E), and stimulated such cells to produce RBCs. These results confirm that DTZ has the potency to alter anaemic condition favorably through the protection of bone marrow stem cells, and subsequently it maintains the higher number of pro-and normoblasts in bone marrow, RBC counts, Hb, Hct percentage, and EPO level in blood and the lower myeloid/erythroid ratio in bone marrow. (author)
Luo, Renfu; Zhang, Linxiu; Liu, Chengfang; Zhao, Qiran; Shi, Yaojiang; Miller, Grant; Yu, Elaine; Sharbono, Brian; Medina, Alexis; Rozelle, Scott; Martorell, Reynaldo
Although the past few decades have seen rising incomes and increased government attention to rural development, many children in rural China still lack regular access to micronutrient-rich diets. Insufficient diets and poor knowledge of nutrition among the poor result in nutritional problems, including iron-deficiency anaemia, which adversely affect attention and learning of students in school. Little research has been conducted in China documenting the prevalence of nutritional problems among vulnerable populations, such as school-age children, in rural areas. The absence of programmes to combat anaemia among students might be interpreted as a sign that the Government does not recognize its severity. The goals of this paper were to measure the prevalence of anaemia among school-age children in poor regions of Qinghai and Ningxia, to identify individual-, household- and school-based factors that correlate with anaemia in this region, and to report on the correlation between the anaemic status and the physical, psychological and cognitive outcomes. The results of a cross-sectional survey are reported here. The survey involved over 4,000 fourth and fifth grade students from 76 randomly-selected elementary schools in 10 poor counties in rural Qinghai province and Ningxia Hui Autonomous Region, located in the northwest region of China. Data were collected using a structured questionnaire and standardized tests. Trained professional nurses administered haemoglobin (Hb) tests (using Hemocue finger prick kits) and measured heights and weights of children. The baseline data showed that the overall anaemia rate was 24.9%, using the World Health Organization's blood Hb cut-offs of 120 g/L for children aged 12 years and older and 115 g/L for children aged 11 years and under. Children who lived and ate at school had higher rates of anaemia, as did children whose parents worked in farms or were away from home. Children with parents who had lower levels of education were more
Association of malaria and anaemia in under five children in a rural general hospital in northern Nigeria. ... Conclusion: This study has shown a high prevalence of anaemia among febrile children and brings to light the need for urgent interventions including the need for attending clinicians to always screen for anaemia ...
Kessell, A E; Boulton, J G; Dutton, G J; Woodgate, R; Shamsi, S; Peters, A; Connolly, J H
The clinical and laboratory findings in an orphaned juvenile female platypus (Ornithorhynchus anatinus) that presented with a severe anaemia and tick infestation are reported. The animal developed a terminal septicaemia and died. Antemortem clinical pathology, postmortem histopathology and 18S rDNA sequencing supported a diagnosis of extravascular haemolytic anaemia secondary to Theileria ornithorhynchi infection. Although T. ornithorhynchi infection is common in the platypus, this is the first case in which it has been shown to cause a haemolytic anaemia in this species and molecular characterisation of the organism has been described. A review of the previous literature concerning T. ornithorhynchi and possible treatment options for future cases are discussed. © 2014 Australian Veterinary Association.
von Garnier Christophe
Full Text Available Abstract Introduction Iron deficiency is the most common cause of anaemia worldwide. Pica, the ingestion of substances that are inappropriate for consumption, is associated with iron deficiency and may be under-diagnosed. Case presentation A 34-year-old woman presented with iron deficiency anaemia refractory to treatment for more than a decade. The clinical presentation, endoscopic findings and laboratory investigations were consistent with pica. Subsequent geophysical analysis confirmed that the ingested material was kaolin, a negatively charged silicate. Conclusion Prolonged unexplained iron deficiency anaemia should prompt clinicians to remember and inquire about pica. In our patient, this would have averted numerous unnecessary investigations and prevented a decade-long suffering.
Full Text Available Folic acid and cobalamin are B-group vitamins that play an essential role in many cellular processes. Deficiency in one or both of these vitamins causes megaloblastic anaemia, a disease characterized by the presence of megaloblasts. Megaloblasts occur when inhibition of DNA synthesis causes asynchronous maturation between the nucleus and the cytoplasm. Clinical manifestations are similar to those of other types of anaemia, with the exception of cobalamin deficiency megaloblastic anaemia, which presents distinctive neurological symptoms. An understanding of the metabolism of these vitamins will enable clinicians to make the best use and interpretation of laboratory studies and monitor therapeutic strategies, which consist mainly of administering supplements to restore body reserves.
... Frequently Asked Questions Español Condiciones Chinese Conditions Abnormal Head Position En Español Read in Chinese What is an abnormal head posture? An abnormal or compensatory head posture occurs ...
Iron absorption from a simple breakfast meal by a normal adult was done by the whole body counting system and blood radioactivity measurement. Results seem to be in good agreement and both the methods are found to be standard for measurements of iron absorption from food. In iron deficiency anaemia associated with malnutrition improvement of nutritional condition has been found to increase both haemoglobin level and iron absorption possibly by way of improving the ability of intestinal mucosa to absorb more iron from food and by better utilization of iron by erythropoietic system. Thus improvement of nutritional status is a prerequisite to treatment of iron deficiency anaemia. (author)
Full Text Available Use of current models of Automated Haematology Analysers help in calculating the haemoglobin contents of the mature Red cells, Reticulocytes and percentages of Microcytic and hypochromic Red cells. This has helped the clinician in reaching early diagnosis and management of Different haemopoietic disorders like Iron Deficiency Anaemia, Thalassaemia and anaemia of chronic diseases. AIM This study is conducted using an Automated Haematology Analyser to evaluate anaemia using the Red Cell and Reticulocyte parameters. Three types of anaemia were evaluated; iron deficiency anaemia, anaemia of long duration and anaemia associated with chronic disease and Iron deficiency. MATERIALS AND METHODS The blood samples were collected from 287 adult patients with anaemia differentiated depending upon their iron status, haemoglobinopathies and inflammatory activity. Iron deficiency anaemia (n=132, anaemia of long duration (ACD, (n=97 and anaemia associated with chronic disease with iron deficiency (ACD Combi, (n=58. Microcytic Red cells, hypochromic red cells percentage and levels of haemoglobin in reticulocytes and matured RBCs were calculated. The accuracy of the parameters was analysed using receiver operating characteristic analyser to differentiate between the types of anaemia. OBSERVATIONS AND RESULTS There was no difference in parameters between the iron deficiency group or anaemia associated with chronic disease and iron deficiency. The hypochromic red cells percentage was the best parameter in differentiating anaemia of chronic disease with or without absolute iron deficiency with a sensitivity of 72.7% and a specificity of 70.4%. CONCLUSIONS The parameters of red cells and reticulocytes were of reasonably good indicators in differentiating the absolute iron deficiency anaemia with chronic disease.
Osterlund, M K; Overstreet, D H; Hurd, Y L
The possible link between estrogen and serotonin (5-HT) in depression was investigated using a genetic animal model of depression, the Flinders Sensitive Line (FSL) rats, in comparison to control Flinders Resistant Line rats. The mRNA levels of the estrogen receptor (ER) alpha and beta subtypes and the 5-HT(1A) and 5-HT(2A) receptors were analyzed in several limbic-related areas of ovariectomized FSL and FRL rats treated with 17beta-estradiol (0.15 microg/g) or vehicle. The FSL animals were shown to express significantly lower levels of the 5-HT(2A) receptor transcripts in the perirhinal cortex, piriform cortex, and medial anterodorsal amygdala and higher levels in the CA 2-3 region of the hippocampus. The only significant difference between the rat lines in ER mRNA expression was found in the medial posterodorsal amygdala, where the FSL rats showed lower ERalpha expression levels. Overall, estradiol treatment increased 5-HT(2A) and decreased 5-HT(1A) receptor mRNA levels in several of the examined regions of both lines. Thus, in many areas, estradiol was found to regulate the 5-HT receptor mRNA expression in the opposite direction to the alterations found in the FSL rats. These findings further support the implication of 5-HT receptors, in particular the 5-HT(2A) subtype, in the etiology of affective disorders. Moreover, the ability of estradiol to regulate the expression of the 5-HT(1A) and 5-HT(2A) receptor genes might account for the reported influence of gonadal hormones in mood and depression.
Poggesi, Anna; Gouw, Alida; van der Flier, Wiesje
To investigate the role of neurological abnormalities and magnetic resonance imaging (MRI) lesions in predicting global functional decline in a cohort of initially independent-living elderly subjects. The Leukoaraiosis And DISability (LADIS) Study, involving 11 European centres, was primarily aimed...... at evaluating age-related white matter changes (ARWMC) as an independent predictor of the transition to disability (according to Instrumental Activities of Daily Living scale) or death in independent elderly subjects that were followed up for 3 years. At baseline, a standardized neurological examination.......0 years, 45 % males), 327 (51.7 %) presented at the initial visit with ≥1 neurological abnormality and 242 (38 %) reached the main study outcome. Cox regression analyses, adjusting for MRI features and other determinants of functional decline, showed that the baseline presence of any neurological...
Shill, Kumar B; Karmakar, Palash; Kibria, Md G; Das, Abhijit; Rahman, Mohammad A; Hossain, Mohammad S; Sattar, Mohammad M
Iron-deficiency anaemia (IDA) is a common health problem in rural women and young children of Bangladesh. The university students usually take food from residential halls, and the food value of their diets is not always balanced. This cross-sectional study was conducted to estimate the prevalence of iron-deficiency anaemia among the university students of Noakhali region, Bangladesh. Haemoglobin level of 300 randomly-selected students was measured calorimetrically, using Sahli's haemoglobinometer during October to December 2011. Statistical analysis was done by using SPSS software for Windows (version 16) (SPSS Inc., Chicago, IL, USA). In the study, 55.3% students were found anaemic, of whom 36.7% were male, and 63.3% were female. Students aged 20-22 years were more anaemic (43.4%) than other age-groups. Majority (51.3%) of male students showed their haemoglobin level in the range of 13-15 g/dL, followed by 26.0% and 21.3% with 10-12 g/dL and 16-18 g/dL respectively. Although 50.5% anaemic and 51.1% non-anaemic female students showed normal BMI--lower percentage than anaemic (60.7%) and non-anaemic (71.9%) male students, the underweight students were found more anaemic than the overweight and obese subjects. Regular breakfast-taking habit showed significant (p = 0.035, 95% CI 0.5-1.0) influence on IDA compared to non-regular breakfast takers. Consumption of meat, fish, poultry, eggs, or peanut butter regularly; junk food; multivitamins; and iron/iron-rich food showed insignificant (p = 0.097, 95% CI 0.5-1.1; p = 0.053, 95% CI 1.1-2.3; p = 0.148, 95% CI 0.6-1.2; and p = 0.487, 95% CI 0.7-1.4 respectively) role in provoking IDA. In the case of non-anaemic subjects, all of the above parameters were significant, except the junk food consumption (p = 0.342, 95% CI 0.5-1.2). Our study revealed that majority of university students, especially female, were anaemic that might be aggravated by food habit and lack of awareness. The results suggest that anaemia can be
Quintero, Juan Pablo; Siqueira, André Machado; Tobón, Alberto; Blair, Silvia; Moreno, Alberto; Arévalo-Herrera, Myriam; Lacerda, Marcus Vinícius Guimarães; Valencia, Sócrates Herrera
Malaria is the most important parasitic disease worldwide, responsible for an estimated 225 million clinical cases each year. It mainly affects children, pregnant women and non-immune adults who frequently die victims of cerebral manifestations and anaemia. Although the contribution of the American continent to the global malaria burden is only around 1.2 million clinical cases annually, there are 170 million inhabitants living at risk of malaria transmission in this region. On the African continent, where Plasmodium falciparum is the most prevalent human malaria parasite, anaemia is responsible for about half of the malaria-related deaths. Conversely, in Latin America (LA), malaria-related anaemia appears to be uncommon, though there is a limited knowledge about its real prevalence. This may be partially explained by several factors, including that the overall malaria burden in LA is significantly lower than that of Africa, that Plasmodium vivax, the predominant Plasmodium species in the region, appears to display a different clinical spectrus and most likely because better health services in LA prevent the development of severe malaria cases. With the aim of contributing to the understanding of the real importance of malaria-related anaemia in LA, we discuss here a revision of the available literature on the subject and the usefulness of experimental animal models, including New World monkeys, particularly for the study of the mechanisms involved in the pathogenesis of malaria.
The main contributor to high maternal mortality in Nigeria is anaemia in pregnancy which can be prevented. Descriptive cross sectional study. Total sampling was done. Consecutive pregnant women presenting at the antenatal clinic, state hospital, Osogbo were requested to complete an interviewer administered ...
A study on the prevalence of malaria parasitaemia and anaemia among pregnant women attending Federal Medical Centre (FMC), Umuahia and Nwachinemere Maternity and Child-Care (NMCCD) Ihie in Umuahia metropolis in Abia State Nigeria was carried out between April and October 2010. Blood samples were ...
The role of alpha () and beta () haemolysins in blood transfusion has been well documented. However, the occurrence of haemolysins and its attending problems in sickle cell anaemia (SCA) patients has limited appearance in the literatures especially in black Africa. This study was therefore designed to investigate the ...
Nov 6, 2016 ... ABSTRACT. BACKGROUND: Genes for haemoglobin S are found in high frequencies in Nigeria. However, there is little information on beta thalassemia in sickle cell anaemia in this population. The clinical presentation of HbS- β thalassemia is enormously variable, ranging from an asymptomatic state to a ...
black population as a whole2i and is endemic in eastern. Caprivi.27 In this study a history of malaria was not found to have a statistically significant effect on a woman's risk for anaemia but thick films and inspection of the placenta after delivery would more definitively assess the role played by. Plasmodium falciparum in the ...
Teenagers are frequently at very high risk of developing nutrient deficiencies, including iron deficiency and folate deficiency anaemia.1. A survey in the Western Cape among nonpregnant teenagers has also shown some serious dietary inadequacies with regard to a number of nutrients, including iron.2 This was partly ...
A total of 450 serum samples were collected from commercial chicken of 25 farms in different areas in Khartoum State (210 layers and 240 broilers) in 2012. the samples were analysed for chicken anaemia virus antibodies using indirect enzyme linked immuno-sorbant assay The overall prevalence rate of CAV antibodies ...
Iron deficiency (ID) is the most common nutritional disorder in the developing world and, as a result, a large number of children under the age of 5 years do not reach their developmental potential.[1,2]. ID and ID anaemia (IDA) are widespread health problems among children. Approximately 40% of children are anaemic ...
There is a need to suspect, investigate and treat anaemia in patients with diabetes presenting with non-specific complaints such as numbness and weakness. The services of dieticians should be employed for dietary counseling because some patients may omit important food items in their daily diet for fear of increasing ...
A blood sample was collected from each child, and haemoglobin levels were assessed with a point-of-care haemoglobin testing system. Anaemia was defined as having a haemoglobin value <2 standard deviations below age-altitude adjusted normal values. Results. Three-quarters (39/52 – 75%) of children were anaemic.
Keywords: Left ventricular systolic function, sickle cell anaemia, echocardiographic evaluation, adult Nigerian patients. ..... Quadratic .505. -0.390. 12.231. 8.587 .001*. Cubic .510. -0.180. 8.264. 8.619 .001*. This relationship was further evaluated by means of scat- ter plots and subsequently by regression analysis. The.
Estimating the burden of disease attributable to deficiency anaemia in South Africa in 2000. ... Direct sequelae of IDA, maternal andperinatal deaths and disability-adjusted life years (DALYs) from mild mental disability related to IDA. Results. It is estimated that 5.1 % of children and 9 - 12% of pregnant women had IDA and ...
Conclusion: Anaemia remains a public health problem among pregnant women in Zambia. Risk factors include HIV infection, Low intake of vegetables and low family income. Recommendations: Women need continued education on importance of vegetable intake during pregnancy and involvement in legal income ...
Hirst, D.G.; Wood, P.J.
Exchange transfusion methods have been developed to alter the haematocrit of tumour-bearing mice. The effects of anaemia and its correction by blood transfusion on the radiosensitivity of two mouse tumours (SCCVII/St and RIF-1) were studied using excision, in vivo/in vitro assay. Acute reduction in haematocrit caused a high degree of radioresistance equivalent to an increase in the hypoxic fractions by factors of 10 (SCCVII/St) and 30 (RIF-1). As the duration of anaemia was prolonged, radioresistance was lost until within about 6 h normal radiosensitivity was observed even though the anaemia persisted. The restoration of the normal haematocrit by red blood cell transfusion after 24 h of anaemia caused increased radiosensitivity equivalent to a reduction in the hypoxic fraction by factors of 5 (SCCVII/St) and 10 (RIF-1), but again the effect was transient and normal radiosensitivity re-established within 24-48 h of retransfusion. Measurements of 14 C misonidazole (MISO) binding to RIF-1 tumours after these procedures indicated changes in the number of hypoxic cells which were qualitatively almost identical to those using the cell survival endpoint, leading to the belief that changes in oxygenation were reponsible for the altered radiosensitivity. (author)
Dec 12, 2016 ... ABSTRACT. Iron deficiency anaemia causes adverse pregnancy outcome. Studies reveal its generalized effects on histomorphometry of the placenta, without details on specific zones nor effect of gestational age. These data are important for planning intervention. This study was, therefore, designed to ...
The effect of aqueous extract of Hibiscus sabdariffa Calyces on anaemia-induced and normal wistar albino rats were investigated using standard protocols. The haematological parameters which include haemoglobin concentration, packed cell volume, erythrocyte sedimentation rate, Red Blood Cell count and White Blood ...
Methods. Dietary intakes of 101 schoolchildren aged 7 - 12 years were assessed using a pre-tested food frequency questionnaire. Haemoglobin (Hb), haematocrit, erythrocyte protoporphyrin (EP) and serum ferritin (SF) were used to determine their anaemia and iron status. Other socio-economic variables were collected ...
Introduction: Sports anaemia is a physiological activity that occurs amongst footballers and may be due to poor diet, over-training, as well as an increase in plasma volume in endurance training activities. High plasma volume leads to changes in haematological parameters that may impact on endurance of footballers.
The study assessed their lifestyle, nutrient adequacy ratio (NAR), body mass index (BMI), haemoglobin (Hb) level. risks of developing anaemia and binary logistic regression analysis with significance set at p<0.05. Biochemical and clinical examinations revealed that 18.8% of the participants were anaemic (Hb ≤13b/dL).
Background. Fanconi anaemia (FA) is a rare genetic disorder of impaired DNA repair that results in physical and haematological consequences in affected individuals. In South Africa (SA), individuals with Afrikaner ancestry are at an increased risk of inheriting disease-causing FA mutations, owing to the three common ...
Ionic fluxes in erythrocyte membranes of sickle cell anaemia subjects at different tonicities. ... Journal of African Association of Physiological Sciences ... The aim of this study was to investigate ionic fluxes in membrane of erythrocytes at different tonicities with a view to highlighting any selective ionic-fluxing potential of ...
Background : Sickle cell anaemia (SCA) is an important cause of morbidity and mortality in tropical Africa. Recurrent episodes of vaso-occlusive crisis often lead to organ ischaemia and/or infarction. Arrythmias are common and reliable manifestations of myocardial ischaemia and often follow infarction. The prevalence and ...
First aid treatment offered by caregivers included, paracetamol only, paracetamol and chloroquine at sub-optimal doses in 39.2% of cases. Moderate- severe anaemia was significantly associated with time of presentation in hospital (χ2 = 4.97, p<0.05). The need for transfusion was also significantly more in those presented ...
Children are the most nutritionally vulnerable group of society as children are dependants and they are also at a critical stage of the growing process. They need adequate vitamin A, zinc, iron and iodine for their development and school performance. Most often iron deficiency causes anaemia with resultant fatigue and low ...
Yürek, Salih; Mayer, Beate; Almahallawi, Mohammed; Pruss, Axel; Salama, Abdulgabar
Background It is very evident that many precautions are taken regarding transfusion of red blood cells in patients with autoimmune haemolytic anaemia. Frequently, considerable efforts are made to examine the indication and serological compatibility prior to transfusion in such patients. However, at times, this may unnecessarily jeopardize patients who urgently require a red blood cell transfusion. Materials and methods Thirty-six patients with warm-type autoimmune haemolytic anaemia were included in this study. All patients had reactive serum autoantibodies and required blood transfusion. Standard serological assays were employed for the detection and characterization of antibodies to red blood cells. Results A positive direct antiglobulin test was observed in all 36 patients, in addition to detectable antibodies in both the eluate and serum. Significant alloantibodies were detected in the serum samples of three patients (anti-c, anti-JKa, and anti-E). In 32 patients, red blood cell transfusion was administered with no significant haemolytic transfusion reactions due to auto- and/or allo-antibodies. Due to overestimation of positive cross-matches three patients received no transfusion or delayed transfusion and died, and one patient died due to unrecognised blood loss and anaemia which was attributed to an ineffective red blood cell transfusion. Discussion Many of the reported recommendations regarding transfusion of red blood cells in autoimmune haemolytic anaemia are highly questionable, and positive serological cross-matches should not result in a delay or refusal of necessary blood transfusions. PMID:26192772
Markvardsen, Lars Høj; Harbo, Thomas; Christiansen, Ingelise
performed before and two weeks after infusion of IVIg. Following treatment blood haemoglobin declined from 8.6±0.8 to 8.1±1.3mmol/l, p... naive patients are susceptible to develop haemolysis. Haemolytic anaemia is a severe side effect that seems to be more frequent after immunoglobulin infusions than previously recognized....
Themain symptomat presentation was fever in 132 (86.8%) patients, while pallor was the most frequent physical sign in all the patients. Malaria was the leading cause of anaemia with asexual form of being present in 93 (61.2%) of the patients, 68 (44.7%) had sickle cell disease. Other identified causes include PEM in 13 ...
Background: Anaemia contributes significantly to neonatal morbidity and mortality. This study describes the aetiology of anemia in ill babies in order to highlight the underlying conditions, proffer preventive measures and sensitize Physicians to improve on the management of anemia in babies. Methods: This was a ...
A number of studies have implicated inflammatory cytokines, but these data are limited and inconsistent. In this article, we reviewed the published literature on ... The mechanism of anaemia is multifactorial and therefore requires further, more elaborate research. Data from human subjects would also shed more light.
The purpose of this study was to compare the response of sickle cell anaemia patients with their age-matched counterparts to exercise test. This was to see whether patients with sickle cell disease could be given exercise therapy without any risk of adverse cardio-respiratory response during the course of physical ...
These three patients (1.2%) were found to have positive co-inheritance of thalassaemia trait and sickle cell anaemia. The erythrocyte indices were all reduced in these selected families except for one family whose mean cell haemoglobin concentration was within normal range. Peripheral blood film revealed the presence of ...
Objective: The aim of this study was to estimate the effect of an antihelminthic drug, given at booking and at term to antenatal care visits, on the prevalence of anaemia at term and 4 months post-partum in Rufiji district, Tanzania, the area with high prevalence of intestinal parasites. Methods: A cluster randomised controlled ...
Objective: To determine the status of iron deficiency anaemia (IDA) and malnutrition in lactating women. Design: A cross-sectional study. Setting: Six urban slum communities in Teklehaimanot district, Addis Ababa. Subjects: One thousand and seventeen lactating women were enrolled and assessed for their haemoglobin ...
Autoimmune haemolytic anaemia and fever of undetermined origin as presenting manifestations of Hodgkin disease: A case report. ... Subjects and Methods: We report a 14 year-old male adolescent who presented with protracted recurrent fever, as well as clinical and laboratory findings suggestive of autoimmune ...
Nov 21, 2017 ... Investigation of manganese homeostasis in dogs with anaemia and chronic enteropathy. Marisa da Fonseca Ferreira*, Arielle Elizabeth Ann Aylor, Richard John Mellanby, Susan Mary Campbell and. Adam George Gow. Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, The ...
These findings suggest that changes from nomadic to sedentary lifestyles may have negative impacts on the health of nomadic Fulani pastoralists. Keywords: prevalence, malaria, anaemia, sedentarization, life style changes, Fulani pastoralists, south-western Nigeria. Nigerian Journal of Parasitology Vol. 29 (2) 2008: pp.
BACKGROUND: Genes for haemoglobin S are found in high frequencies in Nigeria. However, there is little information on beta thalassemia in sickle cell anaemia in this population. The clinical presentation of HbS- β thalassemia is enormously variable, ranging from an asymptomatic state to a severe disorder similar to ...
Genotype test before contracting marriages has become very imperative because of the danger it poise on the couples, the offspring and in fact the society at large. This work used Cartesian product of sets and relations on sets, to explain how sickle cell anaemia can easily be spread fast, if measures are not taken. Finally ...
Objective. To describe the prevalence, character and possible aetiology of anaemia in the study region. Design. A cross-sectional study involving a lifestyle and dietary questionnaire, a clinical examination and an analysis of blood and stool samples. Setting. Katima Mulilo antenatal clinic, East Caprivi, Namibia. Subjects.
Prevalence of iron deficiency and megaloblastic Anaemia at booking in a secondary health facility in north eastern Nigeria. ... Nigerian Medical Journal ... This further supports the continued use of iron supplements for all pregnant women preferably at no cost in the short run and economic empowerment of the women folk in ...
Mockenhaupt, Frank P.; Ehrhardt, Stephan; Eggelte, Teunis A.; Markert, Miriam; Anemana, Sylvester; Otchwemah, Rowland; Bienzle, Ulrich
In 366 Ghanaian children with symptomatic Plasmodium falciparum malaria, low haemoglobin levels and severe anaemia were associated with a high multiplicity of infection (MOI) and with distinct merozoite surface protein alleles. High MOI not only reflects premunition but may also contribute to
The study investigated the episode of malaria infection and anaemia in pregnancy of 226 women. The overall prevalence of malaria infection among pregnant women was 23.08%, while only 7.1% of non-pregnant women were malaria positive. The mean parasite density was significantly higher in the primigravidae than in ...
Several complications of sickle cell anaemia (SCA) are well known including hepatobiliary dysfunction. We here present a study 151 randomly selected SCA patients to highlight the contributory role of blood transfusion to the development of viral hepatitis in them. Twenty (13.2%) had not received blood transfusion and no ...
Iron deficiency anaemia causes adverse pregnancy outcome. Studies reveal its generalized effects on histomorphometry of the placenta, without details on specific zones nor effect of gestational age. These data are important for planning intervention. This study was, therefore, designed to describe the histomorphometric ...
... the 25-34 years group, but highest in the 35-44 years group in the third trimester. The implications of the findings were discussed and recommendations proffered. Keywords: malaria, anaemia, pregnant women, Makurdi, gravidity, Plasmodium spp. Nigerian Journal of Parasitology, Vol. 32  September 2011, pp.193-196 ...
Southern African Journal of Critical Care. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 20, No 1 (2004) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Anaemia and blood transfusion in the ICU. GS Wilson. Abstract.
Golding, Paul Henry
The currently accepted theory, that the human liver store of folate is limited to about four months, is based on the findings of Victor Herbert and others of the era before folate fortification of food. A recent model, developed by Lin et al., predicts far greater liver folate storage capacity than reported by Herbert. The conflict between Herbert's and Lin's models needs to be resolved experimentally, however current research is restricted because ethical considerations prevent such risky experimentation on patients or healthy human volunteers. The objective was to provide a detailed record of the biochemical and haematological responses to the development of severe experimental folate deficiency in an initially replete human subject. This 58 year old male severely depleted himself of folate, using a folate-deficient diet, until overt megaloblastic anaemia developed. The biochemical and haematological responses were monitored by routine blood tests. Daily intake of dietary supplements prevented deficiencies of other relevant nutrients. The rate of change of all analytes was significantly slower, and the delay before any change for several analytes was significantly longer, than reported for previous experiments. The time before reporting of abnormal biochemical and haematological results was therefore very significantly longer than reported by Herbert, but was consistent with the recent model of Lin et al. Serum folate and red-cell folate became abnormally low after 219 and 413 days respectively. Macrocytic anaemia was produced after 469 days, and megaloblastic anaemia was confirmed by bone marrow biopsy on day 575. Folate starvation ceased on day 586, and recovery was complete on day 772. The currently accepted four month time scale for development of megaloblastic anaemia from folate deficiency, based on the early work of Herbert and others, is not consistent with the results from this study. The > 300 day liver folate storage time, predicted by the
Osman, Faiza Mohamed
iron deficiency anaemia (IDA) is a public health problem throughout the world. Childhood iron deficiency anaemia. A prospective survey (systematic, cluster sampling) was carried out among pre-school children in Alshigla area (Khartoum State), to study the prevalence and aetological factors of IDA. 170 children selected for general nutritional evaluation, 110 of them for haemoglobin levels and morphological classification of anaemia, 70 for further investigations(serum iron, unsaturated iron binding capacity, total iron binding capacity). The population at Alshigla were living in poor condition 85.3% relied on water brought by tankers which showed poor hygienic standard, 90% lived in extended families 54.1% had income level less than LS 3000/day irrespective of family size or mode of spending. A sample of 170 children showed (84.1%) normal nutritional status with 4.7% severe cases with high consumption of cereals low meat, fish and poultry group and vitamin C(22.9%). Disease episodes showed 67.7% had diarrhoea, 22.4% had giardia, 12.9% had malaria and 10.6% had worm infestation. This most probably due to unsanitary living condition. Haemoglobin analysis using Enzyme Linked Immunosorbent assay technique (ELISA) for 110 of the children, showed high prevalence of anaemia (96.4%), 66% prevalence of IDA. Further haematological investigations of 50 of the children confirmed them as IDA cases.Thus the high prevalence of IDA in Alshigla was multi-factorial, inadequate take of dietary iron and of vitamin C, high intake of cereals and legumes, low intake of meat, poultry and fish group (MPF),and high tea consumption, thus food provides inadequate supply of iron and were rich in inhibitors of iron absorption. In addition episodes of diseases that may influence food (hence iron) utilisation contributed to the prevalence of IDA
Ezenwosu, Osita U; Emodi, Ifeoma J; Ikefuna, Anthony N; Chukwu, Barth F; Osuorah, Chidiebere D
Some factors are known to influence the academic performance of children with Sickle Cell Anaemia (SCA). Information on their effects in these children is limited in Nigeria. The factors which influence academic performance of children with SCA in Enugu, Nigeria are determined in this study. Consecutive children with SCA aged 5-11 years were recruited at the weekly sickle cell clinic of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. Their age- and sex- matched normal classmates were recruited as controls. The total number of days of school absence for 2009/2010 academic session was obtained for each pair of pupils from the class attendance register. Academic performance was assessed using the average of the overall scores in the three term examinations of same session. Intelligence ability was determined with Draw-A-Person Quotient (DAPQ) using the Draw-A-Person Test while socio-economic status was determined using the occupational status and educational attainment of each parent. Academic performance of children with SCA showed statistically significant association with their socio-economic status (χ2 = 9.626, p = 0.047), and significant correlation with DAPQ (r = 0.394, p = 0.000) and age (r = -0.412, p = 0.000). However, no significant relationship existed between academic performance and school absence in children with SCA (r = -0.080, p = 0.453). Academic performance of children with SCA is influenced by their intelligence ability, age and socio-economic status but not negatively affected by their increased school absenteeism.
Kaur, Manpreet; Chauhan, Aarti; Manzar, Md Dilshad; Rajput, Mohammad Muntafa
Maternal anaemia is a major contributor of adverse neonatal outcomes, particularly compromised birth weight and head circumference. To assess the relationship between maternal anaemia and neonatal measures in a sample of low-middle income group urban mothers. One hundred pregnant women with population representative prevalence of anaemia were enrolled. Socio-demographic, anthropometry, obstetric profile (parity, abortion history, food habits, gap period with last pregnancy etc), and systolic/diastolic blood pressure were documented. Neonatal outcomes (gestational age and type of delivery), and birth anthropometry (weight, length, and head circumference) were measured at delivery. Univariate and multivariate regression analysis for associating maternal haemoglobin levels and neonatal outcomes were performed. The anaemic and non-anaemic pregnant women differed significantly in interval between previous & index pregnancy (p=0.031), parity (p=0.009), systolic blood pressure (p=0.026), diastolic blood pressure (p=0.042), maternal Hb (p<0.01). The mean gestational age (p<0.01), weight (p<0.01), length (p<0.01) and head circumference (p<0.01) of the neonates differed significantly between the two groups. On using maternal haemoglobin as a continuous variable, these anthropometric birth outcomes were positively correlated with maternal haemoglobin (p<0.05). Further, univariate linear regression showed similar associations between maternal haemoglobin (g/dL) and birth weight (p=0.004), length (p=0.010) and head circumference (p=0.003). Maternal haemoglobin has a positive relationship with the neonatal measures of weight, length and head circumference.
Mudge, David W; Tan, Ken-Soon; Miles, Rhianna; Johnson, David W; Campbell, Scott B; Hawley, Carmel M; Isbel, Nicole M; Van Eps, Carolyn L; Nicol, David L
Post-transplant anaemia remains a common problem after kidney transplantation, with an incidence ranging from nearly 80% at day 0 to about 25% at 1 year. It has been associated with poor graft outcome, and recently has also been shown to be associated with increased mortality.Our transplant unit routinely administers oral iron supplements to renal transplant recipients but this is frequently accompanied by side effects, mainly gastrointestinal intolerance. Intravenous iron is frequently administered to dialysis patients and we sought to investigate this mode of administration in transplant recipients after noticing less anaemia in several patients who had received intravenous iron just prior to being called in for transplantation. This study is a single-centre, prospective, open-label, randomised, controlled trial of oral versus intravenous iron supplements in renal transplant recipients and aims to recruit approximately 100 patients over a 12-month period. Patients will be randomised to receive a single dose of 500 mg iron polymaltose (intravenous iron group) or 2 ferrous sulphate slow-release tablets daily (oral iron group). The primary outcome is time to normalisation of haemoglobin post-transplant. Prospective power calculations have indicated that a minimum of 48 patients in each group would have to be followed up for 3 months in order to have a 90% probability of detecting a halving of the time to correction of haemoglobin levels to > or =110 g/l in iron-treated patients, assuming an alpha of 0.05. All eligible adult patients undergoing renal transplantation at the Princess Alexandra Hospital will be offered participation in the trial. Exclusion criteria will include iron overload (transferrin saturation >50% or ferritin >800 microg/l), or previous intolerance of either oral or intravenous iron supplements. If the trial shows a reduction in the time to correction of anaemia with intravenous iron or less side effects than oral iron, then intravenous iron may
Ebner, Nicole; Jankowska, Ewa A; Ponikowski, Piotr; Lainscak, Mitja; Elsner, Sebastian; Sliziuk, Veronika; Steinbeck, Lisa; Kube, Jennifer; Bekfani, Tarek; Scherbakov, Nadja; Valentova, Miroslava; Sandek, Anja; Doehner, Wolfram; Springer, Jochen; Anker, Stefan D; von Haehling, Stephan
Anaemia and iron deficiency (ID) are important co-morbidities in patients with chronic heart failure (HF) and both may lead to reduced exercise capacity. We enrolled 331 out-patients with stable chronic HF (mean age: 64 ± 11 years, 17% female, left ventricular ejection fraction [LVEF] 35 ± 13%, body mass index [BMI] 28.5 ± 5.2 kg/m(2), New York Heart Association [NYHA] class 2.2 ± 0.7, chronic kidney disease 35%, glomerular filtration rate 61.7 ± 20.1 mL/min). Anaemia was defined according to World Health Organization criteria (haemoglobin [Hb] < 13 g/dL in men, < 12 g/dL in women). ID was defined as serum ferritin < 100 μg/L or ferritin < 300 μg/L with transferrin saturation (TSAT) < 20%. Exercise capacity was assessed as peak oxygen consumption (peak VO2) by spiroergometry and 6-minute walk test (6MWT). A total of 91 (27%) patients died from any cause during a mean follow-up of 18 months. At baseline, 98 (30%) patients presented with anaemia and 149 (45%) patients presented with ID. We observed a significant reduction in exercise capacity in parallel to decreasing Hb levels (r = 0.24, p < 0.001). In patients with anaemia and ID (n = 63, 19%), exercise capacity was significantly lower than in patients with ID or anaemia only. Cox regression analysis showed that after adjusting for NYHA, age, hsCRP and creatinine anaemia is an independent predictor of mortality in patients with HF (hazard ratio [HR]: 0.56, 95% confidence interval [CI]: 0.33-0.97, p = 0.04). The impact of anaemia on reduced exercise capacity and on mortality is stronger than that of ID. Anaemia remained an independent predictor of death after adjusting for clinically relevant variables. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Kim, C J; Connell, H; McGeorge, A D; Hu, R
The prevalence of anaemia is increasing globally. It has a close association with perioperative blood transfusion which, in turn, results in an increased risk of postoperative complications. Undesirable effects are not only limited to short-term, but also have long-term implications. Despite this, many patients undergo cardiac surgery with undiagnosed and untreated anaemia. We designed a retrospective, observational study to estimate the prevalence of anaemia in patients having cardiac surgery in Auckland District Health Board, blood transfusion rates and associated clinical outcome. Two hundred of seven hundred and twelve (28.1%) patients were anaemic. Red blood cell (RBC) transfusion rates were significantly higher in the anaemic group compared to the non-anaemic group (160 (80%) vs. 192 (38%), p-value rates for fresh frozen plasma (FFP), cryoprecipitate and platelets were also higher in the anaemic group. Anaemia was significantly associated with the development of new infection (14 (7%) vs. 15 (2.9%), p-value 0.0193, RR (CI 95%) 2.389 (1.175-4.859)), prolonged ventilation time (47.01 hours vs. 23.59 hours, p-value 0.0076) and prolonged intensive care unit (ICU) stay (80.23 hours vs. 50.27, p-value 0.0011). Preoperative anaemia is highly prevalent and showed a clear link with significantly higher transfusion rates and postoperative morbidity. It is vital that a preoperative management plan for the correction of anaemia should be sought to improve patient safety and outcome. © The Author(s) 2014.
Porter, John B; Lin, Kai-Hsin; Beris, Photis; Forni, Gian Luca; Taher, Ali; Habr, Dany; Domokos, Gabor; Roubert, Bernard; Thein, Swee Lay
Objectives It is widely assumed that, at matched transfusional iron-loading rates, responses to chelation therapy are similar, irrespective of the underlying condition. However, data are limited for rare transfusion-dependent anaemias, and it remains to be elucidated if response differs, depending on whether the anaemia has a primary haemolytic or production mechanism. Methods The efficacy and safety of deferasirox (Exjade®) in rare transfusion-dependent anaemias were evaluated over 1 yr, with change in serum ferritin as the primary efficacy endpoint. Initial deferasirox doses were 10–30 mg/kg/d, depending on transfusion requirements; 34 patients had production anaemias, and 23 had haemolytic anaemias. Results Patients with production anaemias or haemolytic anaemias had comparable transfusional iron-loading rates (0.31 vs. 0.30 mL red blood cells/kg/d), mean deferasirox dosing (19.3 vs. 19.0 mg/kg/d) and baseline median serum ferritin (2926 vs. 2682 ng/mL). Baseline labile plasma iron (LPI) levels correlated significantly with the transfusional iron-loading rates and with serum ferritin levels in both cohorts. Reductions in median serum ferritin levels were initially faster in the production than the haemolytic anaemias, but at 1 yr, similar significant reductions of 940 and 617 ng/mL were attained, respectively (−26.0% overall). Mean LPI decreased significantly in patients with production (P deferasirox are similar at 1 yr, irrespective of the underlying pathogenic mechanism. PMID:21649735
Ballas, Samir K
The phenotypic expression of sickle cell anaemia varies greatly among patients and longitudinally in the same patient. It influences all aspects of the life of affected individuals including social interactions, intimate relationships, family relations, peer interactions, education, employment, spirituality and religiosity. The clinical manifestations of sickle cell anaemia are protean and fall into three major categories: anaemia and its sequelae;pain and related issues; andorgan failure including infection. Recent studies on the pathogenesis of sickle cell anaemia have centred on the sequence of events that occur between polymerisation of deoxy haemoglobin (Hb) S and vaso-occlusion. Cellular dehydration, inflammatory response and reperfusion injury seem to be important pathophysiological mechanisms. Management of sickle cell anaemia continues to be primarily palliative in nature, including supportive, symptomatic and preventative approaches to therapy. Empowerment and education are the major aspects of supportive care. Symptomatic management includes pain management, blood transfusion and treatment of organ failure. Pain managment should follow certain priniciples that include assessment, individualisation of therapy and proper utilisation of opioid and nonopioid analgesics in order to acheive adequate pain relief. Blood selected for transfusion should be leuko-reduced and phenotypically matched for the C, E and Kell antigens. Exchange transfusion is indicated in patients who are transfused chronically in order to prevent or delay the onset of iron-overload. Acute chest syndrome is the most common form of organ failure and its management should be agressive, including adequate ventilation, multiple antibacterials and simple or exchange blood transfusion depending on its severity. Preventitive therapy includes prophylactic penicillin in infants and children, blood transfusion (preferably exchange transfusion) in patients with stroke, and hydroxyurea in patients
Al-Mekhlafi, Hesham M; Al-Zabedi, Ebtesam M; Al-Maktari, Mohamed T; Atroosh, Wahib M; Al-Delaimy, Ahmed K; Moktar, Norhayati; Sallam, Atiya A; Abdullah, Wan Ariffin; Jani, Rohana; Surin, Johari
Iron deficiency anaemia (IDA) is the most common nutritional deficiency in the world including developed and developing countries. Despite intensive efforts to improve the quality of life of rural and aboriginal communities in Malaysia, anaemia and IDA are still major public health problems in these communities particularly among children. A randomized, double-blind, placebo-controlled trial was conducted on 250 Orang Asli (aboriginal) schoolchildren in Malaysia to investigate the effects of a single high-dose of vitamin A supplementation (200,000 IU) on iron status indices, anaemia and IDA status. The effect of the supplement was assessed after 3 months of receiving the supplements; after a complete 3-day deworming course of 400 mg/day of albendazole tablets. The prevalence of anaemia was found to be high: 48.5% (95% CI=42.3, 54.8). Moreover, 34% (95% CI=28.3, 40.2) of the children had IDA, which accounted for 70.1% of the anaemic cases. The findings showed that the reduction in serum ferritin level and the increments in haemoglobin, serum iron and transferrin saturation were found to be significant among children allocated to the vitamin A group compared to those allocated to the placebo group (pvitamin A group compared with only 2.3% reduction among children in the placebo group. In conclusion, vitamin A supplementation showed a significant impact on iron status indices and IDA among Orang Asli children. Hence, providing vitamin A supplementation and imparting the knowledge related to nutritious food should be considered in the efforts to improve the nutritional and health status of these children as a part of efforts to improve the quality of life in rural and aboriginal communities.
Kobto G Koura
Full Text Available BACKGROUND: Anaemia during pregnancy and at delivery is an important public health problem in low- and middle-income countries. Its association with the children's haemoglobin level over time remains unclear. Our goals were to identify distinct haemoglobin level trajectories using latent class analysis and to assess the association between these trajectories and maternal anaemia and other risk factors. METHOD: A prospective study of children from birth to 18 months of life was conducted in a rural setting in Tori-Bossito, Benin. The main outcome measure was the haemoglobin levels repeatedly measured at 3, 6, 9, 12, 15 and 18 months. Variables were collected from the mothers at delivery and from their children at birth and during the follow-up. The analyses were performed by means of Latent Class Analysis which has never been used for this kind of data. All the analyses were performed with Stata software, version 11.0, using the generalized linear latent and mixed model (GLLAMM framework. RESULTS: We showed that 33.7% of children followed a low haemoglobin trajectory and 66.3% a high trajectory during the first 18 months of life. Newborn anaemia, placental malaria, malaria attack, sickle cell trait and male gender were significantly associated with a lower children's haemoglobin level over time, whereas maternal age, children living in a polygamous family and with good feeding practices had a higher Hb level in the first18 months. We also showed that maternal anaemia was a predictor for 'low haemoglobin level trajectory' group membership but have no significant effect on children haemoglobin level over time. CONCLUSION: Latent Class Analyses framework seems well suited to analyse longitudinal data under the hypothesis that different subpopulations of subjects are present in the data, each with its own set of parameters, with distinctive evolutions that themselves may reflect distinctive aetiologies.
Hesham M. Al-Mekhlafi
Full Text Available Iron deficiency anaemia (IDA is the most common nutritional deficiency in the world including developed and developing countries. Despite intensive efforts to improve the quality of life of rural and aboriginal communities in Malaysia, anaemia and IDA are still major public health problems in these communities particularly among children. A randomized, double-blind, placebo-controlled trial was conducted on 250 Orang Asli (aboriginal schoolchildren in Malaysia to investigate the effects of a single high-dose of vitamin A supplementation (200,000 IU on iron status indices, anaemia and IDA status. The effect of the supplement was assessed after 3 months of receiving the supplements; after a complete 3-day deworming course of 400 mg/day of albendazole tablets. The prevalence of anaemia was found to be high: 48.5% (95% CI = 42.3, 54.8. Moreover, 34% (95% CI = 28.3, 40.2 of the children had IDA, which accounted for 70.1% of the anaemic cases. The findings showed that the reduction in serum ferritin level and the increments in haemoglobin, serum iron and transferrin saturation were found to be significant among children allocated to the vitamin A group compared to those allocated to the placebo group (p < 0.01. Moreover, a significant reduction in the prevalence of IDA by almost 22% than prevalence at baseline was reported among children in the vitamin A group compared with only 2.3% reduction among children in the placebo group. In conclusion, vitamin A supplementation showed a significant impact on iron status indices and IDA among Orang Asli children. Hence, providing vitamin A supplementation and imparting the knowledge related to nutritious food should be considered in the efforts to improve the nutritional and health status of these children as a part of efforts to improve the quality of life in rural and aboriginal communities.
Quashie, Neils Ben; Akanmori, Bartholomew D; Ofori-Adjei, David
A major manifestation of complicated malaria especially among children is severe anaemia, the pathogenesis of which is not well understood. Among other factors, suppression of the bone marrow's response to erythropoietin, which is rapidly reversed after successful treatment of the malaria, has be......-treatment blood levels of chloroquine did not differ much between the two groups. Findings from this study could not therefore implicate drug-resistant parasites in the pathogenesis of severe malarial anaemia....... compared the prevalence of drug-resistant malaria between severe malarial anaemia SA and non-anaemic malaria NAM patients. Assessment of treatment outcome using the WHO in vivo criteria showed no significant difference in parasite resistance between the two groups. The mean parasite clearance time was also...... comparable. Treatment failures of about 14 per cent and 12 per cent were observed between SA and NAM patients respectively. The in vitro drug susceptibility test showed overall mean IC50 values of 0.41x10(-6) mol/l and 0.32x10(-6) mol/l blood for SA and NAM groups respectively. Geometric mean pre...
Kadima, Bertin Tshimanga; Gini Ehungu, Jean Lambert; Ngiyulu, René Makwala; Ekulu, Pépé Mfutu; Aloni, Michel Ntetani
Neonatal screening for sickle cell anaemia is not common practice in the Democratic Republic of Congo, and we determined the prevalence in children with unknown electrophoresis of haemoglobin and anaemia. A cross-sectional study was conducted in four hospitals in the country's capital Kinshasa. We screened 807 patients with anaemia (Hb history of hand foot syndrome, in children who had received more than three transfusions and in children up to 36 months of age at their first transfusion. The high prevalence of sickle cell anaemia in children in Sub-Saharan Africa underlines the need for neonatal screening or, if that is not possible, screening of all children with severe anaemia to identify patients with the disease and provide early management. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Anovulatory bleeding; Abnormal uterine bleeding - hormonal; Polymenorrhea - dysfunctional uterine bleeding ... ACOG committee opinion no. 557: Management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women. Reaffirmed 2015. ACOG. ...
Full Text Available The aim of this study was to evaluate efficiency of elemental iron preparation in the form of carbonyl iron in prevention of iron deficiency in piglets. The piglets in group I (n = 14 were given 210 mg of carbonyl iron orally at the age of 3 days. The piglets in group II (n = 15 received 210 mg of carbonyl iron orally on days 3 and 9. In group III (n = 14 the piglets were injected i.m. with 200 mg Fe3+ as iron dextran. Fourteen days after birth, haemoglobin concentration in group I started to decrease and the piglets developed anaemia. In group II, at the age of 28 days, Hb dropped below 80 g/l and the piglets developed anaemia. Under conditions of this trial, the oral administration of carbonyl iron did not prevent development of iron deficiency in piglets.
Al-Mekhlafi, Hesham M.; Al-Zabedi, Ebtesam M.; Al-Maktari, Mohamed T.; Atroosh, Wahib M.; Al-Delaimy, Ahmed K.; Moktar, Norhayati; Sallam, Atiya A.; Abdullah, Wan Ariffin; Jani, Rohana; Surin, Johari
Iron deficiency anaemia (IDA) is the most common nutritional deficiency in the world including developed and developing countries. Despite intensive efforts to improve the quality of life of rural and aboriginal communities in Malaysia, anaemia and IDA are still major public health problems in these communities particularly among children. A randomized, double-blind, placebo-controlled trial was conducted on 250 Orang Asli (aboriginal) schoolchildren in Malaysia to investigate the effects of a single high-dose of vitamin A supplementation (200,000 IU) on iron status indices, anaemia and IDA status. The effect of the supplement was assessed after 3 months of receiving the supplements; after a complete 3-day deworming course of 400 mg/day of albendazole tablets. The prevalence of anaemia was found to be high: 48.5% (95% CI = 42.3, 54.8). Moreover, 34% (95% CI = 28.3, 40.2) of the children had IDA, which accounted for 70.1% of the anaemic cases. The findings showed that the reduction in serum ferritin level and the increments in haemoglobin, serum iron and transferrin saturation were found to be significant among children allocated to the vitamin A group compared to those allocated to the placebo group (p Orang Asli children. Hence, providing vitamin A supplementation and imparting the knowledge related to nutritious food should be considered in the efforts to improve the nutritional and health status of these children as a part of efforts to improve the quality of life in rural and aboriginal communities. PMID:24384995
Ezenwosu, Osita U; Emodi, Ifeoma J; Ikefuna, Anthony N; Chukwu, Barth F; Osuorah, Chidiebere D
Background Some factors are known to influence the academic performance of children with Sickle Cell Anaemia (SCA). Information on their effects in these children is limited in Nigeria. The factors which influence academic performance of children with SCA in Enugu, Nigeria are determined in this study. Methods Consecutive children with SCA aged 5?11?years were recruited at the weekly sickle cell clinic of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. Their age- and sex- m...
T Wainstein,1 MSc (Med); R Kerr,1 PhD; C L Mitchell,1 MSc (Med);S Madaree,1 BSc (Hons); F B Essop,1 MSc (Med); E Vorster,1 BSc. (Hons); R Wainwright,2 MB BCh; J Poole,3 MB BCh; A Krause,1 MB BCh, PhD ..... Grompe M, D'Andrea AD. Fanconi anaemia and DNA repair. Hum Mol Genet 2001;10(20)2253-2259.
The effect of combined administration of 1000 i.u/100g body weight (bd.wt.) vitamin A and 100 mg/kg bd wt. vitamin C to Trypanosoma brucei brucei-infected rats daily for twenty-one days was investigated. The anaemia caused by T. brucei infection in rats not administered the vitamins was significantly (P<0.05) more severe ...
Gribsholt, Sigrid Bjerge; Nielsen, Joan Bach; Melén, Charlotte-Joséphine Ström; Richelsen, Bjørn
Treatment of severe obesity with Roux-en-Y gastric bypass (RYGB) results in pronounced weight loss but also in various nutritional complications. Iron deficiency anaemia is one of the most common nutritional complications due to reduced uptake of iron after this operation. Premenopausal women are particularly at risk of developing iron deficiency anaemia because of menstruation. In the present article the pathophysiology, diagnostic considerations, and treatment of iron deficiency anaemia after RYGB are discussed.
Blundell, R; Adam, F
We describe a case of zinc toxicity in a 14-month-old, female, neutered, Cavalier King Charles spaniel with a 48-hour history of haematochezia, icterus and collapse. Regenerative anaemia with a packed-cell volume of 7 per cent was seen. Prior to referral, radiography had revealed a gastric, metallic foreign body which was removed at exploratory laparotomy. On presentation, the dog was comatose, hypothermic and bradycardic - resuscitation was performed successfully, but the dog then displayed marked abdominal pain. The dog died 12 hours after presentation. At postmortem examination, the animal showed severe icterus. Both kidneys were diffusely dark red; the pancreas was diffusely pale and nodular. Histopathological examination revealed evidence of intravascular haemolysis with blood vessel lumens containing haemoglobin. The renal tubules also contained large amounts of intraluminal haemoglobin with haemoglobin crystals scattered throughout the cortex and medulla. The pancreas exhibited multifocal coagulative necrosis, surrounded by a neutrophil-dominated inflammatory infiltrate. Zinc levels were markedly increased above the normal reference range in both liver and kidney. This report describes the clinical and pathological findings of a case of acute zinc toxicity in a dog following ingestion of a metallic object which resulted in marked haemolytic anaemia and acute pancreatitis.
Sun, Pei-Long; Lv, Shu-Xia; Zhou, Jian-Hua; Liu, Xin-Qi
The equine infectious anaemia virus gp45 ectodomain was cloned, expressed and crystallized. Preliminary crystallographic analysis showed that the protein belonged to space group P6 3 and contained one molecule per asymmetric unit. Like human immunodeficiency virus (HIV), equine infectious anaemia virus (EIAV) belongs to the lentivirus genus. The first successful lentiviral vaccine was developed for EIAV. Thus, EIAV may serve as a valuable model for HIV vaccine research. EIAV glycoprotein 45 (gp45) plays a similar role to gp41 in HIV by mediating virus–host membrane fusion. The gp45 ectodomain was constructed according to the structure of HIV gp41, with removal of the disulfide-bond loop region. The protein was expressed in Escherichia coli and crystallized following purification. However, most of the crystals grew as aggregates and could not be used for data collection. By extensively screening hundreds of crystals, a 2.7 Å resolution data set was collected from a single crystal. The crystal belonged to space group P6 3 , with unit-cell parameters a = b = 46.84, c = 101.61 Å, α = β = 90, γ = 120°. Molecular replacement was performed using the coordinates of various lengths of HIV gp41 as search models. A long bent helix was identified and a well defined electron-density map around the long helix was obtained. This primary model provided the starting point for further refinement
Parodis López, Yanet; Santana Estupiñán, Raquel; Marrero Robayna, Silvia; Gallego Samper, Roberto; Henríquez Palop, Fernando; Rivero Vera, José Carlos; Camacho Galán, Rafael; Pena López, María José; Sablón González, Nery; González Cabrera, Fayna; Oliva Dámaso, Elena; Vega Díaz, Nicanor; Rodríguez Pérez, José Carlos
Infections remain an issue of particular relevance in renal transplant patients, particularly viral infections. Human parvovirus B19 infection causes severe refractory anaemia, pancytopenia and thrombotic microangiopathy. Its presence is recognized by analysing blood polymerase chain reaction (PCR) and by the discovery of typical giant proerythroblasts in the bone marrow. We report the case of a 65 year-old man with a history of deceased donor renal transplant in September 2014. At 38 days after the transplant, the patient presented progressive anaemia that was resistant to erythropoiesis-stimulating agents. At 64 days after transplant, hyperthermia occurred with progressive deterioration of the patient's general condition. The viral serology and the first blood PCR for human parvovirus B19 were both negative. At 4 months and 19 days after, a bone marrow biopsy was conducted, showing giant erythroblasts with nuclear viral inclusions that were compatible with parvovirus; a PCR in the tissue confirmed the diagnosis. A second blood PCR was positive for parvovirus. After treatment with intravenous immunoglobulin and the temporary discontinuation of mycophenolate mofetil, a complete remission of the disease occurred, although the blood PCR for parvovirus B19 remained positive, so monitoring is necessary for future likely recurrence. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.
Gomber, S; Kumar, S; Rusia, U; Gupta, P; Agarwal, K N; Sharma, S
The present study was carried out to find out the prevalence and etiology of nutritional anaemia among preschool children from an urban slum. Randomly selected 300 children aged 3 months-3 yr were analysed over a period of one year for estimating prevalence of nutritional anaemia. Prevalence was also assessed by the rise in haemoglobin after 8 wk of haematinic supplementation in 159 of the 300 subjects. Ninety anaemic children were evaluated for the etiology of anaemia. Prevalence of anaemia, as judged by WHO recommended 'cut-off' value of haemoglobin < 11 g/dl, was 76 per cent while comparable value of 74.8 per cent was derived by response to haematinic supplementation. Pure iron deficiency anaemia (IDA) was detected in 41.4 per cent (37/90) of anaemic children. Vitamin B12 deficiency alone or in combination with iron was diagnosed in 14.4 and 22.2 per cent anaemic children respectively. Similarly folate deficiency, IDA with infection and anaemia of chronic diseases (ACD) was diagnosed in 2.2, 3.3 and 12.2 per cent cases respectively. Childhood anaemia continues to be a significant public health problem in preschoolers and iron deficiency is by far the commonest nutritional cause of anaemia. Vitamin B12 deficiency per se or in combination with iron is an important yet not commonly recognised cause of anaemias in preschool children in the community.
Charlot, Mette; Torp-Pedersen, Christian; Valeur, Nana
Anaemia has been demonstrated as a risk factor in patients with heart failure over periods of a few years, but long term data are not available. We examined the long-term risk of anaemia in heart failure patients during 15 years of follow-up.......Anaemia has been demonstrated as a risk factor in patients with heart failure over periods of a few years, but long term data are not available. We examined the long-term risk of anaemia in heart failure patients during 15 years of follow-up....
Ribeiro, Sandra; Garrido, Patrícia; Fernandes, João; Vala, Helena; Rocha-Pereira, Petronila; Costa, Elísio; Belo, Luís; Reis, Flávio; Santos-Silva, Alice
Clinical studies showed that high doses of recombinant human erythropoietin (rHuEPO) used to correct anaemia in chronic kidney disease (CKD) hyporesponsive patients may lead to deleterious effects. The aim of this study was to analyze the effects of rHuEPO in doses usually used to correct CKD-anaemia (100, 200 IU/kg body weight (BW) per week) and in higher doses used in the treatment of hyporesponsive patients (400, 600 IU/kg BW per week), focusing on renal damage, hypoxia, inflammation and fibrosis. Male Wistar rats with chronic renal failure (CRF) induced by 5/6 nephrectomy were treated with rHuEPO or with vehicle, over a 3-week period. Haematological, biochemical and renal function analyses were performed. Kidney and liver mRNA levels were evaluated by quantitative real-time polymerase chain reaction (qPCR) and protein expression by Western blot and immunohistochemistry. Kidney histopathological evaluations were also performed. The CRF group developed anaemia, hypertension and a high score of renal histopathologic lesions. Correction of anaemia was achieved with all rHuEPO doses, with improvement in hypertension, renal function and renal lesions. In addition, the higher rHuEPO doses also improved inflammation. Blood pressure was reduced in all rHuEPO-treated groups, compared to the CRF group, but increased in a dose-dependent manner. The current study showed that rHuEPO treatment corrected anaemia and improved urinary albumin excretion, particularly at lower doses. In addition, it is suggested that a short-term treatment with high doses, used to overcome an episode of hyporesponsiveness to rHuEPO therapy, can present benefits by reducing inflammation, without worsening of renal lesions; however, the pro-hypertensive effect should be considered, and carefully managed to avoid a negative cardiorenal impact. © 2016 John Wiley & Sons Australia, Ltd.
Full Text Available Objective. The Third US National Health and Nutrition Examination Survey (NHANES III prompted the recognition of geriatric anaemia as a public health concern since ~10% of people aged 65 years or older were anaemic. The objective of this study was to design and implement a continuing medical education (CME event that motivates and guides Primary Care Health Practitioners (PCHPs to adopt medical practices that improve outcomes among geriatric patients with anaemia by employing effective diagnostic workup. Research design and methods. A total of 4196 PCHPs participated in 11 highly interactive 75-minute live conferences conducted throughout the US from 2011 through 2013 that featured case-based interactive discussions on the workup of microcytic, normocytic, and macrocytic anaemia by a PCHP and local haematologist expert. A standardised diagnostic algorithm for geriatric anaemia was used and distributed as a handout at the live activity. A reinforcing mobile application based on this algorithm was introduced in 2012. Main outcome measures. Data from participants were gathered immediately after the event, 10–12 weeks post-event, and 1–3 years post-event. Outcomes were evaluated according to Moore's levels. Chi-squared analyses compared the proportion of respondents who committed to one or more of the five major behavioural changes over time. Results. The Chi-squared test analysed data from each of the three timelines for five medical behavioural changes. A comparison of participants’ responses showed that there was a significant increase in the proportion of responders committing to behavioural change #1, “Avoid indiscriminant use of erythropoiesis-stimulating agents” and #5, “Refer patients with unexplained mild anaemia to a haematologist” from post-event to 1–3 years (p<0.001 (see Table 2. The proportion of respondents who committed to the other three behavioural changes remained consistent over time, suggesting that actual change
A working diagnosis of traverse colonic neoplasm was made. Abdominal ultrasonography showed a roundish ... function tests were normal. Stool microscopy showed red blood cells of. 4-5/hpf; no ova or cysts were seen ... parasites or diverticular disease. For this reason, adult intussusception should be resected, but this is.
Sarper, Nazan; Akansel, Guer; Aydogan, Metin; Gedikbasi, Demet; Babaoglu, Kadir; Goekalp, Ayse Sevim
Griscelli's disease is a rare autosomal recessive immunodeficiency syndrome. We report a 7-1/2-month-old white girl who presented with this syndrome, but initially without neurological abnormalities. Initial CT of the brain was normal. Despite haematological remission with chemotherapy, she developed neurological symptoms, progressing to coma. At this time, CT showed areas of coarse calcification in the globi pallidi, left parietal white matter and left brachium pontis. Hypodense areas were present in the genu and posterior limb of the internal capsule on the right side, as well as posterior aspects of both thalami, together with minimal generalised atrophy. MRI revealed areas of increased T2 signal and a focal area of abnormal enhancement in the subcortical white matter. Griscelli's disease should be added to the list of acquired neuroimaging abnormalities in infants. (orig.)
Background: Anaemia in pregnancy is a global public health challenge. It is the commonest medical disorder of pregnancy and a major cause of morbidity and mortality in most developing countries. Aim : This study aimed at assessing the prevalence of anaemia in pregnancy and to identify the confounding ...
Aim: To deterime the prevalence of anaemia in patients with clinical AIDS. Methodology: A retrospective small observational study of the prevalence of anaemia in 114 patients with confirmed HIV/AIDS seen at the department of medicine of the university of Maiduguri Teaching Hospital between January, 2002 and June, ...
Mogensen, Christian B; Sørensen, Jeff E; Bjorkman, Anders
Anaemia is a major complication of Plasmodium falciparum malaria among small children in sub-Saharan Africa. We studied the performance of the Integrated Management of Childhood Illness (IMCI) recommended assessment of no/some/severe pallor as predictor of anaemia in health surveys at community...
Megaloblastic anaemia in childhood usually occurs as a result of dietary folate deficiency or, rarely, congenital disorders of vitamin B12 metabolism. We present a 2-year-old girl with megaloblastic anaemia and insulin-dependent diabetes mellitus, both of which proved responsive to pharmacological doses of thiamine.
Calis, Job C. J.; Rotteveel, Hellen P.; van der Kuyl, Antoinette C.; Zorgdrager, Fokla; Kachala, David; Boele van Hensbroek, Michael; Cornelissen, Marion
BACKGROUND: Anaemia is the most common haematological complication of HIV and associated with a high morbidity and a poor prognosis. The pathogenesis of HIV-associated anaemia is poorly understood and may include a direct effect of HIV on erythropoiesis. In vitro studies have suggested that specific
Aim: To identify the risk factors for anaemia in pregnancy and evaluate the effects of these risk factors of anaemia in pregnancy among pregnant women ... were low socioeconomic status ( OR = 2.3), primigravidity ( OR = 3.2 ), inter-delivery interval of 2 years or less ( OR = 35.2 ), twin pregnancy (OR = 3.2), HIV infection ( OR ...
Anaemia -a frequent complication of HIV infection- is multi-factorial, and its incidence is associated with progression of HIV disease. Recognition of iron related anaemia in HIV infection remains a challenge. Exploring red cell indices and iron profile may provide easier and more efficient diagnostic option. This study aims to ...
Jul 26, 2014 ... Background: Anaemia in pregnancy is a global public health challenge. It is the commonest medical disorder of pregnancy and a major cause of morbidity and mortality in most developing countries. Aim: This study aimed at assessing the prevalence of anaemia in pregnancy and to identify the confounding ...
K. Stouten (Karlijn); J.A. Riedl (Jurgen); J. Droogendijk (Jolanda); Castel, R. (Rob); J.M. van Rosmalen (Joost); R.J. Van Houten; P.B. Berendes (Paul); P. Sonneveld (Pieter); M.-D. Levin (Mark-David)
textabstractBackground: Macrocytic anaemia (MCV ≥ 100 fL) is a relatively common finding in general practice. However, literature on the prevalence of the different causes in this population is limited. The prevalence of macrocytic anaemia and its underlying aetiology were analysed in a general
Low birth weight (LBW) and fetal anaemia (FA) are common in malaria endemic areas. To investigate the .... with 95% confidence and 80% power, with a 6 to 1 ratio of infants in the NBW to LBW group, a sample of 162 NBW ..... community and in order to improve prevention strategies. Fetal anaemia and morbidity incidence.
van Eijk, Anna M.; Ayisi, John G.; Slutsker, Laurence; ter Kuile, Feiko O.; Rosen, Daniel H.; Otieno, Juliana A.; Shi, Ya-Ping; Kager, Piet A.; Steketee, Richard W.; Nahlen, Bernard L.
OBJECTIVE: To evaluate the effect of routine antenatal haematinic supplementation programmes and intermittent preventive treatment (IPT) with sulphadoxine-pyrimethamine (SP) in Kenya. METHODS: Anaemia [haemoglobin (Hb) <11 g/dl), severe anaemia (Hb <8 g/dl) and placental malaria were compared among
anaemia in school-aged children is attributed to iron deficiency. . Subclinical iron deficiency is even more common and has comparable developmental consequences. In the present study, anaemia was used as an indicator of deprived nutrition and poor health status. This study was conducted in a rural community.
Sekine, Yuji; Yamamoto, Shin; Fujikawa, Takuya; Oshima, Susumu; Ono, Makoto; Sasaguri, Shiro
Haemolytic anaemia after acute aortic dissection surgery is extremely rare. We report 4 cases of haemolytic anaemia with different aetiologies. Four patients underwent emergency operation for acute type A aortic dissection and subsequently developed haemolytic anaemia. Case 1: a 41-year old man underwent hemiarch replacement. We performed total arch replacement 3 years postoperatively, which revealed that haemolytic anaemia was induced by proximal anastomotic stenosis caused by inverted internal felt strip. Case 2: a 28-year old man diagnosed with Marfan syndrome underwent total arch replacement. Five months postoperatively, we noted severe stenosis at the previous distal anastomotic site, which caused the haemolytic anaemia, and performed descending thoracic aortic replacement for a residual dissecting aneurysm. Case 3: a 49-year old man underwent hemiarch replacement. Three years postoperatively, we performed total arch replacement for a residual dissecting aortic arch aneurysm and repaired a kinked graft responsible for haemolytic anaemia. Case 4: a 42-year old man underwent total arch replacement. Eighteen months later, we performed descending thoracic aortic replacement. We repaired a portion of the ascending aorta as haemolityc anaemia was induced by kinking of a total arch replacement redundant graft. All the haemolityc anaemia patients were successfully released after surgical reintervention.
Background: Anaemia in pregnancy is a major public health problem in developing countries. It is associated with an increased risk of maternal and perinatal morbidity and mortality. A high rate of anaemia in pregnancy in the rural population of KwaZulu-Natal (30% according to national and 57% according to the World ...
BACKGROUND: Prompt and accurate diagnosis is needed to prevent the untoward effects of anaemia on children. Although haematology analyzers are the gold standard for accurate measurement of haemoglobin or haematocrit for anaemia diagnosis, they are often out of the reach of most health facilities in resource-poor ...
Hoeksma, Marco R.; Kemner, Chantal; Kenemans, J. Leon; van Engeland, Herman
This paper studied whether abnormal P3 amplitudes in PDD are a corollary of abnormalities in ERP components related to selective attention in visual and auditory tasks. Furthermore, this study sought to clarify possible age differences in such abnormalities. Children with PDD showed smaller P3 amplitudes than controls, but no abnormalities in…
Full Text Available Anaemia is one of the significant public health problems among children in the world. Understanding risk factors of anaemia provides more insight to the nature and types of policies that can be put up to fight anaemia. We estimated the prevalence and risk factors of anaemia in a population-based, cross-sectional survey.Blood samples from 11,711 children aged between 6 months and 14 years were collected using a single-use, spring-loaded, sterile lancet to make a finger prick. Anaemia was measured based on haemoglobin concentration level. The generalized linear model framework was used to analyse the data, in which the response variable was either a child was anemic or not anemic.The overall prevalence of anaemia among the children in Kenya was estimated to be 28.8%. Across each band of age within which the definition of anaemia remained constant (0–4, 5–11, and 12–14 years old, the prevalence of anaemia declined with each year of age. [corrected]. The risk of anaemia was significantly higher in male than female children. Mothers with secondary and above education had a protective effect on the risk of anaemia on their children. Malaria diagnosis status of a child was positively associated with risk anaemia.Controlling co-morbidity of malaria and improving maternal knowledge are potential options for reducing the burden of anaemia.
Ngesa, Oscar; Mwambi, Henry
Anaemia is one of the significant public health problems among children in the world. Understanding risk factors of anaemia provides more insight to the nature and types of policies that can be put up to fight anaemia. We estimated the prevalence and risk factors of anaemia in a population-based, cross-sectional survey. Blood samples from 11,711 children aged between 6 months and 14 years were collected using a single-use, spring-loaded, sterile lancet to make a finger prick. Anaemia was measured based on haemoglobin concentration level. The generalized linear model framework was used to analyse the data, in which the response variable was either a child was anemic or not anemic. The overall prevalence of anaemia among the children in Kenya was estimated to be 28.8%. Across each band of age within which the definition of anaemia remained constant (0–4, 5–11, and 12–14 years old), the prevalence of anaemia declined with each year of age. [corrected]. The risk of anaemia was significantly higher in male than female children. Mothers with secondary and above education had a protective effect on the risk of anaemia on their children. Malaria diagnosis status of a child was positively associated with risk anaemia. Controlling co-morbidity of malaria and improving maternal knowledge are potential options for reducing the burden of anaemia.
Mogensen, Christian B; Soerensen, Jeff; Bjorkman, Anders
Anaemia among small children in tropical Africa is common and often caused by infection with Plasmodium falciparum. The diagnosis of anaemia is difficult without a laboratory estimation of haemoglobin. The aim of this study was to examine if clinical findings related to malaria and anaemia would ...
Sun, Jing; Dai, Yaohua; Zhang, Shuaiming; Huang, Jian; Yang, Zhenyu; Huo, Junsheng; Chen, Chunming
In China, a full fat soy powder mixed with multiple micronutrient powders (Ying Yang Bao (YYB)) was developed, and the efficacy of YYB was shown in controlling anaemia and improving child growth and development. However, prior to 2008, there was no sustainable way to provide YYB to vulnerable populations, except through free distribution by the government. This study was to test the concept of public-private partnership (PPP) to deliver YYB and to evaluate the effectiveness of marketing YYB through PPP. Programme activities included development of a complementary food supplement (CFS) national standard, product concept test, product development and marketing, behavior change communication, monitoring and evaluation. Baseline and end-line surveys were used to evaluate product awareness, purchasing and the impacts of the project on anaemia and feeding practices. A Chinese CFS standard was approved. Caregivers and their 6- to-24-month-old children participated in the baseline (n=226) and the end-line survey (n=221). A concept test at the baseline survey showed that 78% of caregivers were willing to buy YYB at 0.1 USD. After developing the product and implementing the intervention for 8 months, 59.6% of surveyed caregivers purchased YYB. While not significant, the prevalence of anaemia was marginally lower at the end line (28.8%) than at the baseline (36.2%). For those purchasing YYB, the risk of anaemia was significantly reduced by 87% of odds (Pend-line survey found that feeding practices had improved significantly following the intervention. An enabling policy and regulatory environment in which CFSs are defined and parameters for appropriate marketing are identified as a prerequisite for marketing YYB or other nutritious CFS. Public and private advocacy and marketing could successfully increase awareness of YYB and access and use through market channels. The YYB project may be effective for reducing anaemia and improving feeding practices. © 2011 Blackwell
Gerard J Casey
Full Text Available BACKGROUND: To estimate the cost and cost-effectiveness of a project administering de-worming and weekly iron-folic acid supplementation to control anaemia in women of reproductive age in Yen Bai province, Vietnam. METHODS AND FINDINGS: Cost effectiveness was evaluated using data on programmatic costs based on two surveys in 2006 and 2009 and impact on anaemia and iron status collected in 2006, 2007, and 2008. Data on initial costs for training and educational materials were obtained from the records of the National Institute of Malariology, Parasitology and Entomology and the Yen Bai Malaria Control Program. Structured questionnaires for health workers at district, commune and village level were used to collect ongoing distribution and monitoring costs, and for participants to collect transport and loss of earnings costs. The cost per woman treated (defined as consuming at least 75% of the recommended intake was USD0.76 per annum. This estimate includes financial costs (for supplies, training, and costs of health care workers' time. Prevalence of anaemia fell from 38% at baseline, to 20% after 12 months. Thus, the cost-effectiveness of the project is assessed at USD 4.24 per anaemia case prevented per year. Based on estimated productivity gains for adult women, the benefit:cost ratio is 6.7∶1. Cost of the supplements and anthelminthics was 47% of the total, while costs of training, monitoring, and health workers' time accounted for 53%. CONCLUSION: The study shows that weekly iron-folic acid supplementation and regular de-worming is a low-cost and cost-effective intervention and would be appropriate for population-based introduction in settings with a high prevalence of anaemia and iron deficiency and low malaria infection rates.
Full Text Available Abstract Introduction Cold agglutinin disease usually develops as a result of the production of a specific immunoglobulin M auto-antibody directed against the I/i and H antigens, precursors of the ABH and Lewis blood group substances, on red blood cells. Autoimmune and lymphoproliferative disorders, Mycoplasma pneumoniae and other infections can be associated with the production of cold agglutinins. In its classic presentation with haemolytic anaemia and Raynaud's syndrome, cold agglutinin disease is usually idiopathic. Several factors play a role in determining the ability of a cold agglutinin to induce a haemolytic anaemia such as antibody concentration and temperature range, in particular the highest temperature at which antibodies interact with red blood cells. Case presentation A 48-year-old Caucasian man presented to our hospital with symptoms of extreme asthenia caused by severe anaemia. The transfusion of red blood cells (O Rh-positive, started as prescribed by the emergency guidelines in force without pre-transfusion tests, induced fatal haemolysis because of the presence of high levels of anti-H antibodies in his blood, that reacted with the large amount of H antigen in universal (0 red blood cells. Conclusion Emergency transfusion of universal red blood cells (0 Rh-positive or negative is usually accepted by the international guidelines in force in emergency departments. In this report we describe a rare complication caused by the very high concentration in the recipient of cold agglutinins and the activation of the complement system, responsible for red blood cell lysis and consequent fatal cardiovascular shock. We conclude that emergency transfusion of universal red blood cells (0 Rh-positive or negative may be dangerous and its risk should be assessed against the risk of delaying transfusion until the pre-transfusion tests are completed.
Ølykke, Grith Skovgaard; Nyström, Johan
The concept of an abnormally low tender is not defined in EU public procurement law. This article takes an interdisciplinary law and economics approach to examine a dataset consisting of Swedish and Danish judgments and verdicts concerning the concept of an abnormally low tender. The purpose...
Achouri, I; Aboussaleh, Y; Sbaibi, R; Ahami, A; El Hioui, M
Iron deficiency anaemia is an important health problem in Morocco. This study was conducted to estimate the prevalence of anaemia among school children in Kenitra. The sample represents school children of all educational levels and age ranged between 6-15 years. The level of hemoglobin, haematocrit, mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration was measured in a group of 271 school children. The seric iron was assessed and anaemia was defined when hemoglobin education of the mother and anaemia in children (p = 0.004) but not with the family income. It is concluded that improving the economic status of the family, women education and health education about balanced animal and plant food consumption are recommended strategies to reduce the burden of anaemia.
Khanbhai, M; Dubb, S; Patel, K; Ahmed, A; Richards, T
As bariatric surgery rates continue to climb, anaemia will become an increasing concern. We assessed the prevalence of anaemia and length of hospital stay in patients undergoing bariatric surgery. Prospective data (anaemia [haemoglobin bariatric surgery. Results from a prospective database of 1530 patients undergoing elective general surgery were used as a baseline. Fifty-seven patients (14%) were anaemic pre-operatively, of which 98% were females. Median MCV (fL) and overall median ferritin (μg/L) was lower in anaemic patients (83 vs. 86, p=0.001) and (28 vs. 61, psurgery patients, prevalence of anaemia was similar (14% vs. 16%) but absolute iron deficiency was more common in those undergoing bariatric surgery; microcytosis pbariatric surgery. In bariatric patients with anaemia there was an overall increased length of hospital stay. Copyright © 2013 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.
Nardo-Marina, Amina Nielsen; Williams, Thomas N; Olupot-Olupot, Peter
BACKGROUND: There are a paucity of data on epistaxis as it pertains to sickle cell anaemia. Some case studies suggest epistaxis to be a significant complication in patients with sickle cell anaemia in sub-Saharan Africa; however, no robust studies have sought to establish the epidemiology...... or pathophysiology of this phenomenon. METHODS: We conducted a case-control study with the aim of investigating the importance of epistaxis among children presenting with sickle cell anaemia at the Mbale Regional Referral Hospital in eastern Uganda. Cases were children aged 2-15 years with an existing diagnosis...... of laboratory confirmed sickle cell anaemia, while controls were children without sickle cell anaemia who were frequency matched to cases on the basis of age group and gender. The frequency and severity of epistaxis was assessed using a structured questionnaire developed specifically for this study. Odds ratios...
Andre Pascal Kengne
Full Text Available Both anaemia and cardiovascular disease (CVD are common in people with diabetes. While individually both characteristics are known to raise mortality risk, their combined influence has yet to be quantified. In this pooling project, we examined the combined impact of baseline haemoglobin levels and existing CVD on all-cause and CVD mortality in people with diabetes. We draw comparison of these effects with those apparent in diabetes-free individuals.A combined analyses of 7 UK population-based cohorts resulted in 26,480 study members. There were 946 participants with physician-diagnosed diabetes, 2227 with anaemia [haemoglobin<13 g/dl (men or <12 (women], 2592 with existing CVD (stroke, ischaemic heart disease, and 21,396 with none of the conditions. Across diabetes and anaemia subgroups, and using diabetes-free, non-anaemic participants as the referent group, the adjusted hazard ratios (HR were 1.46 (95% CI: 1.30-1.63 for anaemia, 1.67 (1.45-1.92 for diabetes, and 2.10 (1.55-2.85 for diabetes and anaemia combined. Across combined diabetes, anaemia and CVD subgroups, and compared with non-anaemic, diabetes-free and CVD-free participants, HR (95% CI for all-cause mortality were 1.49 (1.32-1.69 anaemia, 1.60 (1.46-1.76 for existing CVD, and 1.66 (1.39-1.97 for diabetes alone. Equivalents were 2.13 (1.48-3.07 for anaemia and diabetes, 2.68 (2.14-3.36 for diabetes and existing CVD, and 3.25 (1.88-5.62 for the three combined. Patterns were similar for CVD mortality.Individually, anaemia and CVD confer similar mortality risks in people with diabetes, and are excessively fatal in combination. Screening for anaemia would identify vulnerable diabetic patients whose outcomes can potentially be improved.
Schellenberg, D.; Schellenberg, J. R. M. Armstrong; Mushi, A.; Savigny, D. de; Mgalula, L.; Mbuya, C.; Victora, C. G.
OBJECTIVE: To document the prevalence, age-distribution, and risk factors for anaemia in Tanzanian children less than 5 years old, thereby assisting in the development of effective strategies for controlling anaemia. METHODS: Cluster sampling was used to identify 2417 households at random from four contiguous districts in south-eastern United Republic of Tanzania in mid-1999. Data on various social and medical parameters were collected and analysed. FINDINGS: Blood haemoglobin concentrations (Hb) were available for 1979 of the 2131 (93%) children identified and ranged from 1.7 to 18.6 g/dl. Overall, 87% (1722) of children had an Hb <11 g/dl, 39% (775) had an Hb <8 g/dl and 3% (65) had an Hb <5 g/dl. The highest prevalence of anaemia of all three levels was in children aged 6-11 months, of whom 10% (22/226) had an Hb <5 g/dl. However, the prevalence of anaemia was already high in children aged 1-5 months (85% had an Hb <11 g/dl, 42% had an Hb <8 g/dl, and 6% had an Hb <5 g/dl). Anaemia was usually asymptomatic and when symptoms arose they were nonspecific and rarely identified as a serious illness by the care provider. A recent history of treatment with antimalarials and iron was rare. Compliance with vaccinations delivered through the Expanded Programme of Immunization (EPI) was 82% and was not associated with risk of anaemia. CONCLUSION: Anaemia is extremely common in south-eastern United Republic of Tanzania, even in very young infants. Further implementation of the Integrated Management of Childhood Illness algorithm should improve the case management of anaemia. However, the asymptomatic nature of most episodes of anaemia highlights the need for preventive strategies. The EPI has good coverage of the target population and it may be an appropriate channel for delivering tools for controlling anaemia and malaria. PMID:14576890
Marie, I; Antonietti, M; Houivet, E; Hachulla, E; Maunoury, V; Bienvenu, B; Viennot, S; Smail, A; Duhaut, P; Dupas, J-L; Dominique, S; Hatron, P-Y; Levesque, H; Benichou, J; Ducrotté, P
To date, there are no large studies on videocapsule endoscopy in systemic sclerosis (SSc). Consequently, the prevalence and features of gastrointestinal mucosal abnormalities in SSc have not been determined. To determine both prevalence and characteristics of gastrointestinal mucosal abnormalities in unselected patients with SSc, using videocapsule endoscopy. To predict which SSc patients are at risk of developing potentially bleeding gastrointestinal vascular mucosal abnormalities. Videocapsule endoscopy was performed on 50 patients with SSc. Prevalence of gastrointestinal mucosal abnormalities was 52%. Potentially bleeding vascular mucosal lesions were predominant, including: watermelon stomach (34.6%), gastric and/or small intestinal telangiectasia (26.9%) and gastric and/or small intestinal angiodysplasia (38.5%). SSc patients with gastrointestinal vascular mucosal lesions more often exhibited: limited cutaneous SSc (P = 0.06), digital ulcers (P = 0.05), higher score of nailfold videocapillaroscopy (P = 0.0009), anaemia (P = 0.02), lower levels of ferritin (P correlation between gastrointestinal vascular mucosal lesions and presence of severe extra-digestive vasculopathy (digital ulcers and higher nailfold videocapillaroscopy scores). This latter supports the theory that SSc-related diffuse vasculopathy is responsible for both cutaneous and digestive vascular lesions. Therefore, we suggest that nailfold videocapillaroscopy may be a helpful test for managing SSc patients. In fact, nailfold videocapillaroscopy score should be calculated routinely, as it may result in identification of SSc patients at higher risk of developing potentially bleeding gastrointestinal vascular mucosal lesions. © 2014 John Wiley & Sons Ltd.
Mudge David W
Full Text Available Abstract Background Post-transplant anaemia remains a common problem after kidney transplantation, with an incidence ranging from nearly 80% at day 0 to about 25% at 1 year. It has been associated with poor graft outcome, and recently has also been shown to be associated with increased mortality. Our transplant unit routinely administers oral iron supplements to renal transplant recipients but this is frequently accompanied by side effects, mainly gastrointestinal intolerance. Intravenous iron is frequently administered to dialysis patients and we sought to investigate this mode of administration in transplant recipients after noticing less anaemia in several patients who had received intravenous iron just prior to being called in for transplantation. Methods This study is a single-centre, prospective, open-label, randomised, controlled trial of oral versus intravenous iron supplements in renal transplant recipients and aims to recruit approximately 100 patients over a 12-month period. Patients will be randomised to receive a single dose of 500 mg iron polymaltose (intravenous iron group or 2 ferrous sulphate slow-release tablets daily (oral iron group. The primary outcome is time to normalisation of haemoglobin post-transplant. Prospective power calculations have indicated that a minimum of 48 patients in each group would have to be followed up for 3 months in order to have a 90% probability of detecting a halving of the time to correction of haemoglobin levels to ≥110 g/l in iron-treated patients, assuming an α of 0.05. All eligible adult patients undergoing renal transplantation at the Princess Alexandra Hospital will be offered participation in the trial. Exclusion criteria will include iron overload (transferrin saturation >50% or ferritin >800 μg/l, or previous intolerance of either oral or intravenous iron supplements. Discussion If the trial shows a reduction in the time to correction of anaemia with intravenous iron or less side
The device of the present invention diagnose an abnormal event occurred in a large-scaled plant, such as a nuclear power plant. The device comprises the following four functions. (1) Abnormality candidates are estimated based on an intelligence base storing characteristics established between the characteristics/functions and physical amounts of the plant components, and detected abnormality and measured values. Among the candidates, one which coincidents with the measured value such as an actual process amount is judged as a first cause. (2) In addition, a real time plant behavior is estimated based on parameters determining a plant operation mode. The candidate for the abnormality cause is estimated by the comparison between the result of the estimation and the measured value such as a process amount. (3) Characteristics established between the characteristics/functions and the physical amount of the plant components are structured stepwise thereby identifying the first abnormality cause. (4) Inactuated or failed portions of the components for restoring the abnormality to normal state are identified based on the intelligence base simultaneously with the estimation for the first abnormality cause. (I.S.)
J Gordon Millichap
Full Text Available The prevalence of fragile X syndrome, velocardiofacial syndrome (VCFS, and other cytogenetic abnormalities among 100 children (64 boys with combined type ADHD and normal intelligence was assessed at the NIMH and Georgetown University Medical Center.
Keutzer, Carolin S.
Describes the use of the board game, Jeopardy, in a college level abnormal psychology course. Finds increased student interaction and improved application of information. Reports generally favorable student evaluation of the technique. (CFR)
Conclusion: Chromosomal abnormalities were not detected in the studied autistic children, and so the relation between the genetics and autism still needs further work up with different study methods and techniques.
Ferrokinetic parameters were evaluated with 59 Fe and red-cell survival with 51 Cr by classical techniques in a total of 17 patients with sickle-cell disease. The mean plasma 59 Fe half-disappearance time in these patients was 29.5 min as compared with a normal value of 92 min, and the t1/2 51 Cr 8.0 days as compared with a normal value of 26.0 days. The mean red-cell iron turnover rate was elevated to 9 times normal. The increased destruction of red cells appeared to take place predominantly, though not entirely, in the spleen. Eight of the 17 patients studied were identified as having intercurrent complications, but these did not significantly affect the results of the investigations. A group of 5 boys in whom the red-cell iron turnover rate was elevated to a lesser degree than in the other patients were subjected to more detailed studies of plasma 59 Fe clearance with particular reference to ineffective erythropoiesis. In these patients, the plasma 59 Fe clearance curves showed precocious humps characteristic of ineffective erythropoiesis. Detailed analysis of the results indicated ineffective erythropoiesis corresponding to 3.6, 16.0, 22.6, 32.0 and 50.0 % of the iron initially taken up by the bone marrow. It is concluded that while the anaemia in most patients with sickle-cell disease is mainly due to shortened survival of the circulating red cells, with increased destruction of red cells in the spleen, ineffective erythropoiesis may none the less be an important factor determining the actual degree of this anaemia
Ikeda, Tokunori; Masuda, Teruaki; Ueda, Mitsuharu; Yamashita, Taro; Misumi, Yohei; Shinriki, Satoru; Ando, Yukio
Background This retrospective longitudinal study was performed to determine whether tafamidis treatment leads to improvements in commonly used blood data for transthyretin familial amyloid polyneuropathy (TTR-FAP). Methods Commonly used blood data (complete blood count [including a haemogram], total protein, albumin, blood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, lactate dehydrogenase, γ-glutamyl transpeptidase, total bilirubin [T-Bil], creatine kinase, choline esterase, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, estimated glomerular filtration rate [eGFR], serum amyloid A protein, TTR, haemoglobin A1c, free triiodothyronine [FT3] and free thyroxine [FT4]) were investigated in 33 TTR-FAP patients. These values included longitudinal data at three time points: six months before or after tafamidis treatment and one year after tafamidis treatment. Longitudinal changes in each blood item were examined using a linear mixed model, adjusting for age at starting tafamidis, sex, TTR-FAP stage and value before tafamidis treatment. Results Our results show elevated TTR concentrations after tafamidis treatment. In contrast, haemoglobin, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, mean platelet volume, platelet distribution width, T-Bil, eGFR, FT3 and FT4, gradually decreased through a reference range. There were no characteristic observations in any other items. TTR binds to thyroid hormone; therefore, FT3 and FT4 decreased in inverse proportion to increased TTR concentrations. Conclusion Unfortunately, progression to anaemia may occur regardless of tafamidis treatment. Because anaemia is sometimes present in TTR-FAP, attention should be paid to longitudinal changes in commonly used blood data, irrespective of tafamidis treatment.
Full Text Available Background. Maternal anaemia is a worldwide public health problem affecting particularly developing countries. In Burkina Faso, little data is available for rural areas. This study aimed to determine the prevalence of maternal anaemia and the risk factors associated with it in the rural health district of Hounde in Burkina Faso but also to define better control measures of maternal anaemia. Methods. This cross-sectional study conducted in 2010 had a sample of 3,140 pregnant women attending antenatal care in all the 18 primary health care facilities of the district. The women’s characteristics and their knowledge about contraceptives and sexually transmitted infections (STI were collected. Also, physical and gynaecological examination, completed by vaginal, cervix, blood, and stool samplings, were collected. Results. A prevalence of 63.1% was recorded for maternal anaemia. Geophagy rate was 16.3% and vitamin A deficiency 69.3%. In addition, anaemia was independently associated with low education, low brachial perimeter, geophagy, and primigravida. But no statically significant relationship was found between maternal anaemia and infectious diseases or vitamin A deficiency. Conclusion. The magnitude of maternal anaemia was found to be higher in rural Hounde health district and should be addressed by adequate policy including education and the fight against malnutrition.
Man-Fai Sim, Victor; Nam, Michael Chi Yuen Yuen; Riley, Steve; Yousef, Zaheer; Hurley, Joanna; Cheung, Wai-Yee; O'Mahony, Sinead
Studies suggest benefits from correcting anaemia in heart failure using a combination of erythropoiesis-stimulating agents (ESAs) and intravenous iron. We set out to investigate the number of older patients who would require treatment of anaemia in a large teaching hospital in the United Kingdom and the cost implications. The prevalence of anaemia and chronic kidney disease (CKD) in patients 65 years and older with systolic dysfunction attending the local heart failure clinic was determined. The projected numbers of patients in our health district who would meet published kidney disease guidelines for treatment of anaemia was then estimated. The costs of treatment with combination ESAs and IV iron were calculated for these patients based on the treatment costs for renal anaemia in our local renal unit. Sensitivity analysis for different thresholds of haemoglobin and eGFR was performed. In our study of 86 heart failure patients, mean age 81 years, 34% have anaemia and 73% have stage III CKD with estimated glomerular filtration rate heart failure patients with stage III CKD, 1031 elderly heart failure patients in our health district (total population 424,654) would require treatment with IV iron and erythropoietin, at a cost of pound2.7 million per annum. The estimated cost of treating anaemia in elderly patients with heart failure using ESAs and IV iron is substantial and its cost effectiveness is unknown.
Richards, Toby; Musallam, Khaled M.; Nassif, Joseph; Ghazeeri, Ghina; Seoud, Muhieddine; Gurusamy, Kurinchi S.; Jamali, Faek R.
Objective To evaluate the effect of preoperative anaemia and blood transfusion on 30-day postoperative morbidity and mortality in patients undergoing gynecological surgery. Study Design Data were analyzed from 12,836 women undergoing operation in the American College of Surgeons National Surgical Quality Improvement Program. Outcomes measured were; 30-day postoperative mortality, composite and specific morbidities (cardiac, respiratory, central nervous system, renal, wound, sepsis, venous thrombosis, or major bleeding). Multivariate logistic regression models were performed using adjusted odds ratios (ORadj) to assess the independent effects of preoperative anaemia (hematocrit preoperative anaemia was 23.9% (95%CI: 23.2–24.7). Adjusted for confounders by multivariate logistic regression; preoperative anaemia was independently and significantly associated with increased odds of 30-day mortality (OR: 2.40, 95%CI: 1.06–5.44) and composite morbidity (OR: 1.80, 95%CI: 1.45–2.24). This was reflected by significantly higher adjusted odds of almost all specific morbidities including; respiratory, central nervous system, renal, wound, sepsis, and venous thrombosis. Blood Transfusion increased the effect of preoperative anaemia on outcomes (61% of the effect on mortality and 16% of the composite morbidity). Conclusions Preoperative anaemia is associated with adverse post-operative outcomes in women undergoing gynecological surgery. This risk associated with preoperative anaemia did not appear to be corrected by use of perioperative transfusion. PMID:26147954
Yamada, Izumi; Matsui, Yuji.
Only components synchronized with rotation of pumps are sampled from detected acoustic sounds, to judge the presence or absence of abnormality based on the magnitude of the synchronized components. A synchronized component sampling means can remove resonance sounds and other acoustic sounds generated at a synchronously with the rotation based on the knowledge that generated acoustic components in a normal state are a sort of resonance sounds and are not precisely synchronized with the number of rotation. On the other hand, abnormal sounds of a rotating body are often caused by compulsory force accompanying the rotation as a generation source, and the abnormal sounds can be detected by extracting only the rotation-synchronized components. Since components of normal acoustic sounds generated at present are discriminated from the detected sounds, reduction of the abnormal sounds due to a signal processing can be avoided and, as a result, abnormal sound detection sensitivity can be improved. Further, since it is adapted to discriminate the occurrence of the abnormal sound from the actually detected sounds, the other frequency components which are forecast but not generated actually are not removed, so that it is further effective for the improvement of detection sensitivity. (N.H.)
Kiran Kumar Epari
Full Text Available BACKGROUND In this tertiary care hospital, one of the common condition of all the patients attending the hospital is Anaemia, which is a decrease in haemoglobin content or decrease in haematocrit below the lower limit of the 95% reference range for the individual’s age and sex. The patient presents with varied symptoms of different grades, depending on the severity of anaemia, in different clinical settings. Common presenting symptoms of anaemia are generalised weakness, malaise, loss of appetite and muscular pains. METHODS All the patient samples received at the central laboratory for haemogram, complete blood counts and peripheral smear examination over the period of two years between June 2014 to May 2016 were included in the study. Anaemia cases were diagnosed depending on the criteria of the definition of anaemia, and morphological typing of anaemia was done based on the peripheral smear examination of all the cases with decreased haemoglobin level. Standard cell counter was used to estimate the Hb and other red cell indices, and corroborated with peripheral blood smear examination by standard Romanowsky stains. RESULTS A total of 810 cases of anaemia were diagnosed over the period of two years, of which morphological typing yielded 685 cases of Microcytic and hypochromic anaemia, 15 cases of Dimorphic anaemia, 22 cases of Macrocytic anaemia and 88 cases of Normocytic and normochromic anaemia. CONCLUSION Anaemia is one of the most common problems of patients attending this tertiary care hospital, and detection and morphological typing of anaemia is very helping in guiding the clinicians in diagnosis and further management of anaemias for better patient care.
Adznam, Siti Nur'Hidayah; Sedek, Razalee; Kasim, Zalifah Mohd
Anaemia during pregnancy is a common problem which affects both the mother's and her child's health. The aim of this study was to determine knowledge level on anaemia among pregnant women in Putrajaya. This study was also been carried out to identify the relationship between knowledge according to socio-demographic and antenatal characteristics. A total of 370 subjects were participated in this study. Subjects comprised of pregnant women who attended four health clinics in Putrajaya to undergo first antenatal visit for the current pregnancy. Socio-demographic information, antenatal characteristics and knowledge related to anaemia were collected using questionnaires. Blood samples were taken to identify hemoglobin level of subjects using Sysmex Hematology Analyzer machine (Sysmex Europe GmbH). The mean age of subjects was 30.2 ± 4.2 years and the mean hemoglobin level was 12.1 ± 4.8 g/dL. The median score for subject's knowledge towards anaemia was 84.2 corresponding to a high level of anaemia knowledge. Result of this study revealed that 55.7% of subjects had high knowledge on anaemia during pregnancy while 28.6% had moderate knowledge followed by 15.7% with low knowledge score. Most subjects correctly answered the general questions on the survey but under the assumption regarding the cause of anaemia. They were also lacking in knowledge regarding the risks of anaemia. Knowledge score was significantly associated with gestational week (ppregnancy. The results of this study have identified specific areas of health education for pregnant women with regard to anaemia.
Adewara, E O; Omokanye, L O; Olatinwo, A W O; Durowade, K A; Panti, A A; Salaudeen, A G
This study was carried out to determine the prevalence of anaemia at booking clinic, describe the antenatal booking pattern, and categorize the degree of anaemia with certain demographic features. This is a descriptive cross-sectional study carried out over a six month period between 1st April and 30th September 2008. A questionnaire was used to obtain demographic information and venous blood samples were collected from 1,086 consecutive patients who consented to participate in the study. The blood samples were tested for haemoglobin levels, genotype and blood group. Seven hundred and thirty two (67.4%) of the women anaemic at booking. Anaemia was more prevalent among multgravidae than primigravidae (p<0.05). Six hundred and sixty nine (61.6%) had mild anaemia while 40(4.4%) had moderate anaemia and 15 (1.4%) were severely anaemic, of which 8 (53.3%) were below 18 years of age. Varied degrees of anaemia were more common among women aged 24-28 years and in the 3rd trimester of pregnancy (80.7%) (p<0.05). One hundred and seventy (15.7%) of the enrolled booked for antenatal care in the 1st trimester, while 703(64.7%) booked in the 2nd trimester and 213 (19.6%) in the 3rd trimester of their pregnancies. Thirteen (1.2%) had sickle cell anaemia. Prevalence of anaemia at booking remains high in our society. Urgent need for public health education on early antenatal booking and improved literacy level of women is suggested to reduce the burden of anaemia in pregnancy.
Full Text Available Background: About one-third of the global population is anaemic. WHO has estimated that prevalence of anaemia in pregnant women is 18% in developed countries and relatively high 56% in developing countries. Prevalence of anaemia in South East Asian countries is highest in the world. WHO estimates that even among the South East Asian countries, India has the highest prevalence of anaemia. Aims & Objectives: To determine the prevalence of anaemia among pregnant women and to determine association of anaemia with its socio-demographic factors. Material & Methods: A descriptive cross sectional study was conducted among pregnant women 2nd trimester onwards who came to ante natal clinic of obstetrics and gynaecology department during January-March 2014 by using pre-designed, pretested schedule. A total of 300 pregnant women were clinically examined. Written consent was taken. Haemoglobin estimation was done by Cyanmethaemoglobin method and anaemia was graded according to WHO criteria. Statistical analysis was done using Microsoft Excel 2007 and SPSS Version 17. Results: Overall prevalence of anaemia among the pregnant women was found to be 58.3%. It was seen that 31% of women were illiterate and 38.7% of them belong to upper middle class. Factors such as level of education of women, occupation and consumption of Iron Folic Acid were found to be significantly associated with prevalence of anaemia in pregnancy. Conclusion: A very high prevalence of anaemia in pregnancy needs awareness about late marriage, birth spacing, one or two child norm, antenatal care, green leafy vegetable in diet, mandatory regular supply of IFA tablets to adolescent and pregnant women along with correction of other nutritional deficiencies.
Xu, Xiaoyue; Hall, John; Byles, Julie; Shi, Zumin
Epidemiological data of dietary patterns and anaemia among older Chinese remains extremely scarce. We examined the association between dietary patterns and anaemia in older Chinese, and to assess whether biomarkers of serum magnesium, C-reactive protein (CRP) and serum ferritin can mediate these associations. We analysed the 2009 China Health and Nutrition Survey data (2401 individuals aged ≥60 years for whom both dietary and biomarker data are available). Dietary data was obtained using 24 h-recall over three consecutive days. Fasting blood samples and anthropometry measurement were also collected. Factor analysis was used to identify dietary patterns. Factor scores representing dietary patterns were used in Poisson regression models to explore the association between each dietary pattern and anaemia. Of the 2401 participants, 18.9% had anaemia, 1.9% had anaemia related to inflammation (AI), and 1.3% had iron-deficiency anaemia (IDA). A traditional dietary pattern (high intake of rice, pork and vegetables) was positively associated with anaemia; a modern dietary pattern (high intake of fruit and fast food) was inversely associated with anaemia. Progressively lower magnesium and BMI levels were associated with increasing traditional dietary quartiles; while a progressively higher magnesium and BMI levels were associated with increasing modern dietary quartiles (p 0.05) in CRP and serum ferritin across quartiles for either dietary pattern. In the fully adjusted model, the prevalence ratio (PR) of anaemia, comparing the fourth quartile to the first quartile, was 1.75 (95% CI: 1.33; 2.29) for a traditional dietary pattern, and 0.89 (95% CI: 0.68; 1.16) for a modern dietary pattern. The association between dietary patterns and anaemia is mediated by serum magnesium. Traditional dietary pattern is associated with a higher prevalence of anaemia among older Chinese. Future studies need to examine whether correcting micronutrient deficiency (e.g. magnesium) by
Muñoz, M.; Acheson, A. G.; Auerbach, M.
Despite current recommendations on the management of pre-operative anaemia, there is no pragmatic guidance for the diagnosis and management of anaemia and iron deficiency in surgical patients. A number of experienced researchers and clinicians took part in an expert workshop and developed...... in the peri-operative period. These statements include: a diagnostic approach for anaemia and iron deficiency in surgical patients; identification of patients appropriate for treatment; and advice on practical management and follow-up. We urge anaesthetists and peri-operative physicians to embrace...... these recommendations, and hospital administrators to enable implementation of these concepts by allocating adequate resources....
Ikama, Méo Stéphane; Nsitou, Bernice Mesmer; Kocko, Innocent; Mongo, Ngamami Solange; Kimbally-Kaky, Gisèle; Nkoua, Jean Louis
Heart failure (HF) is a frequent cause of ospitalisation in cardiology. Its prognosis depends on several risk factors, one of which is anaemia. We aimed to determine the prevalence of anaemia in patients with heart failure, and evaluate its impact on their prognosis. This article describes a cross-sectional study with prospective collection of data, carried out from 1 January to 31 December 2010 in the Department of Cardiology at Brazzaville University Hospital, Congo. Patients admitted for heart failure were included. Anaemia was defined as a haemoglobin level failure, and it had a negative effect on the prognosis.
Elhassan Elhassan M
Full Text Available Abstract Background Reducing the incidence of Low birth weight (LBW neonates by at least one third between 2000 and 2010 is one of the major goals of the United Nations resolution "A World Fit for Children". This was a case-control study conducted between August-October 2009 in Medani Hospital, Sudan to investigate the risk factors for LBW. Cases were mothers who delivered singleton baby Findings Out of 1224 deliveries, 97 (12.6% of the neonates were LBW deliveries. While maternal socio-demographic characteristics (age, parity and mother education and anthropometrics measurements were not associated with LBW, lack of antenatal care (OR = 5.9, 95% CI = 1.4-24.4; P = 0.01 and maternal anaemia (OR = 9.0, 95% CI = 3.4-23.8; P Conclusion Thus, more care on antenatal care and nutrition may prevent LBW.
Full Text Available Inosine triphosphatase (ITPA single nucleotide polymorphisms (SNPs are strongly associated with protection against ribavirin (RBV-induced anaemia in European, American and Asian patients; however, there is a paucity of data for Brazilian patients. The aim of this study was to evaluate the ITPA SNP (rs7270101/rs1127354 frequency in healthy and hepatitis C virus (HCV-infected patients from Brazil and the association with the development of severe anaemia during antiviral therapy. ITPA SNPs were determined in 200 HCV infected patients and 100 healthy individuals by sequencing. Biochemical parameters and haemoglobin (Hb levels were analysed in 97 patients who underwent antiviral therapy. A combination of AArs7270101+CCrs1127354 (100% ITPase activity was observed in 236/300 individuals. Anaemia was observed in 87.5% and 86.2% of treated patients with AA (rs7270101 and CC genotypes (rs1127354, respectively. Men with AA (rs7270101 showed a considerable reduction in Hb at week 12 compared to those with AC/CC (p = 0.1475. In women, there was no influence of genotype (p = 0.5295. For rs1127354, men with the CC genotype also showed a sudden reduction in Hb compared to those with AC. Allelic distribution of rs7270101 and rs1127354 shows high rates of the genotypes AA and CC, respectively, suggesting that the study population had a great propensity for developing RBV-induced anaemia. A progressive Hb reduction during treatment was observed; however, this reduction was greater in men at week 12 than in women.
deficiency anaemia were randomly allocated to two treatment groups. Group A received the usual recom. mended dose of iron dextran (Imferon; Fisons) and group 8 received two-thirds of the recommended dose. A further 30 patients ...
Wall, C; Grant, C; Taua, N; Wilson, C; Thompson, J
Aims: To compare iron fortified follow-on milk (iron follow-on), iron fortified partially modified cows' milk (iron milk), and iron medicine for the treatment of iron deficiency anaemia (IDA) in hospitalised infants.
is known about their impact on micronutrient deficiencies such as iron deficiency (ID) and resulting anaemia, which are likely to accompany MAM. Assessing the impact of supplements on ID firstly requires estimating prevalence of ID, which is a challenge because biomarkers of ID, such as serum ferritin (SF...... not only because it complicates diagnosis of ID but also because it is an important cause of anaemia, may affect response to treatment and because the safety of iron and micronutrient supplements has been questioned particularly in settings where malaria is common. The objectives of this PhD study were...... to determine prevalence of inflammation, infection, ID and anaemia in children with MAM, to investigate the use of regression models to adjust iron status biomarkers for inflammation and to determine the impact of supplements for MAM treatment on iron status, anaemia and inflammation. Methods A randomised 2x2x...
Hasegawa, Chihiro; Kudo, Masaharu; Maruyama, Haruhiko; Kimura, Mikio
Delayed haemolytic anaemia has been reported in association with intravenous artesunate treatment in patients with severe Plasmodium falciparum malaria, and furthermore, oral artemisinin-based combination therapies including artemether-lumefantrine (AL) have also been incriminated. However, definite cases of delayed haemolytic anaemia associated with AL appear to be scarce, as reported cases were often treated concomitantly with other anti-malarials. In this study, we report a severe case of delayed haemolytic anaemia following AL alone in a Japanese traveller with severe parasitaemia caused by numerous P. falciparum parasites and a few P. vivax parasites. We also stress the need by further studies to differentiate between delayed haemolytic anaemia and blackwater fever, the latter being another malaria-related haemolytic condition, more clearly than they are now. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Full Text Available BACKGROUND Anaemia is perceived to be a major public health problem especially among adolescent females .Findings from National Family Health Survey NFHS (2005-06 indicate that 56% of the adolescent girls in India are anaemic and, of these 17% suffer from moderate to severe anaemia. The prevalence of anaemia in female adolescent age group is still an understudied subject. The aims of this study were to evaluate the recently initiated WIFS program for government school girls with respect to implementation and impact on trends in prevalence of Anaemia among adolescent girls in a Bengaluru rural school. MATERIALS AND METHODS Cross-sectional, descriptive exploratory research study was used. The choice of the school was based on commitment to administration of weekly iron-folic acid supplements (WIFS programme. All the girl students from class 6 th to 10th of Government High and Senior Secondary school (age group, 11-19 years who were a part of WIFS were enrolled as study participants. Qualitative data on anaemia awareness and diet history, compliance, side effects were taken from these girls. General information on age, height, weight were collected and BMI calculated. Hb estimation was done by Haemocue method. Statistical Analysis- Analysis were prepared by IBM SPSS Statistics version 22. RESULTS Out of the 95girls in the school, there were 81 girls (85.26% reported to consume one tablet of Iron folic acid (IFA weekly in the past 1 year, with no major side effects. The girls had knowledge about symptoms of anaemia and iron-rich diet. Hb estimates indicated 79.01% non anaemic, prevalence of anaemia was 20.99%; none of the girls had severe anaemia, 1.2% had moderate anaemia and the remaining 19.8% belonged to mild anaemia category, indicating a significant decline. The mean BMI of the study sample was 17.53 kg/m2 with 67.9% underweight and 6.2% overweight. CONCLUSION Overall, in this school, the WIFS program was found to be well implemented with good
Parker Jacqui A
Full Text Available Abstract Background Anaemia, in particular due to iron deficiency, is common in pregnancy with associated negative outcomes for mother and infant. However, there is evidence of significant variation in management. The objectives of this review of systematic reviews were to analyse and summarise the evidence base, identify gaps in the evidence and develop a research agenda for this important component of maternity care. Methods Multiple databases were searched, including MEDLINE, EMBASE and The Cochrane Library. All systematic reviews relating to interventions to prevent and treat anaemia in the antenatal and postnatal period were eligible. Two reviewers independently assessed data inclusion, extraction and quality of methodology. Results 27 reviews were included, all reporting on the prevention and treatment of anaemia in the antenatal (n = 24 and postnatal periods (n = 3. Using AMSTAR as the assessment tool for methodological quality, only 12 of the 27 were rated as high quality reviews. The greatest number of reviews covered antenatal nutritional supplementation for the prevention of anaemia (n = 19. Iron supplementation was the most extensively researched, but with ongoing uncertainty about optimal dose and regimen. Few identified reviews addressed anaemia management post-partum or correlations between laboratory and clinical outcomes, and no reviews reported on clinical symptoms of anaemia. Conclusions The review highlights evidence gaps including the management of anaemia in the postnatal period, screening for anaemia, and optimal interventions for treatment. Research priorities include developing standardised approaches to reporting of laboratory outcomes, and information on clinical outcomes relevant to the experiences of pregnant women.
Full Text Available Abstract Background Early diagnosis of anaemia represents an important task within primary care settings. This study reports on the frequency of new cases of anaemia among patients attending rural primary care settings in Crete (Greece and to offer an estimate of iron deficiency anaemia (IDA frequency in this study group. Methods All patients attending the rural primary health care units of twelve general practitioners (GPs on the island of Crete for ten consecutive working days were eligible to participate in this study. Hemoglobin (Hb levels were measured by portable analyzers. Laboratory tests to confirm new cases of anaemia were performed at the University General Hospital of Heraklion. Results One hundred and thirteen out of 541 recruited patients had a low value of Hb according to the initial measurement obtained by the use of the portable analyzer. Forty five (45.5% of the 99 subjects who underwent laboratory testing had confirmed anaemia. The mean value of the Hb levels in the group with confirmed anaemia, as detected by the portable analyzer was 11.1 g/dl (95% Confidence Interval (CI from 10.9 to 11.4 and the respective mean value of the Hb levels obtained from the full blood count was 11.4 g/dl (95% CI from 11.2 to 11.7 (P = 0.01. Sixteen out of those 45 patients with anaemia (35.6% had IDA, with ferritin levels lower than 30 ng/ml. Conclusion Keeping in mind that this paper does not deal with specificity or sensitivity figures, it is suggested that in rural and remote settings anaemia is still invisible and point of care testing may have a place to identify it.
Jin, Lei; Yeung, Lorraine F; Cogswell, Mary E; Ye, Rongwei; Berry, Robert J; Liu, Jianmeng; Hu, Dale J; Zhu, Li
To report the prevalence of anaemia by demographic characteristics and its secular trend over 13 years for south-east Chinese pregnant women, and to determine the focus of anaemia prevention in Chinese pregnant women. Prospective study of the data on Hb concentration and other demographic information from a large-scale population-based perinatal health surveillance system in south-east China. Fourteen cities or counties in Jiangsu and Zhejiang provinces. A total of 467 057 prenatal women who had participated in the perinatal health-care surveillance system and delivered babies from 1 January 1993 to 31 December 2005 and had a record of Hb in all three pregnancy trimesters. The overall prevalence of anaemia among pregnant women was 39.6 % from 1993 to 2005. Anaemia prevalence increased from the first (29.6 %) to the second (33.0 %) and third (56.2 %) trimesters. The prevalence of anaemia was higher in villagers, in women with less education and in women with higher gravidity or parity. The prevalence of anaemia in all of the trimesters was higher in the spring, summer and autumn and lower in the winter. The prevalence decreased from 1993 to 2005, from 53.3 % to 11.4 % for the first trimester, 45.6 % to 22.8 % for the second trimester and 64.6 % to 44.6 % for the third trimester. The prevalence of anaemia among pregnant women in Jiangsu and Zhejiang provinces decreased substantially from 1993 to 2005. However, anaemia in the third trimester is still a severe public health problem among pregnant women in these areas.
Czeizel, A.E.; Rockenbauer, M.; Sørensen, Henrik Toft
Objective: To study human teratogenic potential of oral nitrofurantoin treatment during pregnancy. Materials and Methods: Pair analysis of cases with congenital abnormalities and matched population controls in the population-based dataset of the Hungarian Case-Control Surveillance of Congenital...
Briefly discussed were CT diagnosis of pleural thickening, CT technique for examining the pleura or pleuro-pulmonary disease, diagnosis of pleural collections, diagnosis of pleural fluid abnormalities in patients with pneumonia, pleural neoplasms, malignant (diffuse) mesothelioma, metastases, local fibrous tumor of the pleura (benign mesothelioma) (21 refs.)
Jun 19, 2015 ... ORIGINAL ARTICLE. Chromosomal abnormalities and autism. Farida El-Baz a. , Mohamed Saad Zaghloul a. , Ezzat El Sobky a. ,. Reham M Elhossiny a,. *, Heba Salah a. , Neveen Ezy Abdelaziz b a Pediatric Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt b Children with Special ...
The present study investigates the socioeconomic risk factors of anaemia among women belonging to eastern Indian states. An attempt has been made to find out differences in anaemia related to social class and place of residence, and age and marital status. It was hypothesized that rural women would have a higher prevalence of anaemia compared with their urban counterparts, particularly among the poorest social strata, and that ever-married women would be at elevated risk of anaemia compared with never-married women, particularly in the adolescent age group. Using data from National Family Health Survey-3, 2005-6, a nationally representative cross-sectional survey that provided information on anaemia level among 19,695 women of this region, the present study found that the prevalence of anaemia was high among all women cutting across social class, location and other attributes. In all 47.9% were mildly anaemic (10.0-11.9.9 g/dl), 16.1% were moderately anaemic (7.0-9.9 g/dl) and 1.6% were severely anaemic (nutritional status of women throughout the life-cycle.
Full Text Available We compared the blood thixotropic/shear-thinning properties and the red blood cells' (RBC rheological properties between a group of patients with sickle cell anaemia (SS and healthy individuals (AA. Blood thixotropy was determined by measuring blood viscosity with a capillary viscometer using a "loop" protocol: the shear rate started at 1 s-1 and increased progressively to 922 s-1 and then re-decreased to the initial shear rate. Measurements were performed at native haematocrit for the two groups and at 25% and 40% haematocrit for the AA and SS individuals, respectively. RBC deformability was determined by ektacytometry and RBC aggregation properties by laser backscatter versus time. AA at native haematocrit had higher blood thixotropic index than SS at native haematocrit and AA at 25% haematocrit. At 40% haematocrit, SS had higher blood thixotropic index than AA. While RBC deformability and aggregation were lower in SS than in AA, the strength of RBC aggregates was higher in the former population. Our results showed that 1 anaemia is the main modulator of blood thixtropy and 2 the low RBC deformability and high RBC aggregates strength cause higher blood thixotropy in SS patients than in AA individuals at 40% haematocrit, which could impact blood flow in certain vascular compartments.
Christopher Bismarck Eke
Full Text Available Microalbuminuria is a pre-clinical marker of renal damage in children with sickle cell anaemia and can predict renal failure. Reported prevalence rates increased with age. In Nigeria, burden of disease and prevailing poor health facilities necessitate its screening, determination of prevalence and associated risk factors. It is a cross-sectional as well as descriptive study. Screening microalbuminuria used subjects’ early morning urine. Socio-demographic as well as clinical details were ascertained using semi-structured questionnaires and case files. Associations and statistical relationship of prevalence rates and clinical/epidemiological data were ascertained using chi-squared and multivariate analysis . Two hundred children with sickle cell anaemia (4–17 years in steady state and 200 age/gender-matched controls were enrolled. Prevalence of microalbuminuria was ,respectively, 18.5% and 2.5% for subjects and controls . Microalbuminuria was commoner in females (19.8% than males (17.4% , increased with age , significantly associated with haemoglobin level and hospitalizations (0.001. Subjects had normal renal function. Hospitalizations and haemoglobin levels showed statistical significance on multivariate analysis. Prevalence of microalbuminuria is 18.5%. Age, haemoglobin concentrations, and higher hospitalizations influenced microalbuminuria among subjects. Screening for microalbuminuria should be incorporated in the case management of subjects with identified risk factors.
Schroers, Roland; Bonella, Francesco; Tötsch, Martin; Costabel, Ulrich
A 19-year-old woman presented with repeated episodes of haemoptysis and shortness of breath. Blood tests revealed iron deficiency anaemia and chest imaging studies showed bilateral lung opacities. In further laboratory tests and technical examination including bronchoalveolar lavage and transbronchial lung biopsy, pulmonary embolism, cardiac disease, and pulmonary vasculitis due to autoimmune disease were ruled out. Finally, a diagnosis of idiopathic pulmonary haemosiderosis (IPH) was made in January 2008. The patient was treated with prednisone, azathioprine, and oral iron supplementation. Subsequently, the patient's condition and haemoglobin value improved notably. In May 2009, the patient was in full disease remission including a normal blood count and normal iron parameters. IPH is a rare cause of diffuse alveolar haemorrhage of unknown origin. It occurs most frequently in children and adolescents and typically presents with recurrent haemoptysis due to alveolar bleeding. However, pulmonary signs and symptoms often are obscure in children. In these cases iron deficiency anaemia is the prominent clinical finding. The purpose of this case report is to increase awareness of IPH as a possible cause of recurrent haemoptysis and anaemia.
Assa, Amit; Frenkel-Nir, Yael; Tzur, Dorit; Katz, Lior H; Shamir, Raanan
Celiac disease (CD) is a systemic disorder that is associated with various autoimmune disorders and a higher prevalence of other diagnoses and complications. This large, cross-sectional, population-based study investigated the associations between CD and various medical conditions during late adolescence. We included 2 001 353 Jewish Israeli adolescents who underwent a general health examination at a median age of 17.1 (16.9-17.4) years from 1988 to 2015. Comprehensive data regarding medical status were available for 1 588 041 (79%) subjects. A definite diagnosis of CD was based on accepted criteria. Covariate data included demographic measures and data on associated medical conditions. Overall, data on 7145 subjects with CD and 1 580 896 controls were analysed. Multivariate analyses showed that autoimmune diseases were significantly more common in subjects with CD, including insulin dependent diabetes, with an odds ratio (OR) of 5.5, inflammatory bowel diseases (OR = 3.8), arthritis (OR = 2.4), thyroid diseases (OR = 1.8) and psoriatic skin disorders (OR = 1.6). Further associations included asthma (OR = 1.5), bile stones (OR = 3.6), migraine (OR = 2.3), anaemia (OR = 1.7) and menstrual abnormalities (OR = 1.5). Long bone fractures and axial fractures were no more common in adolescents with CD than controls. CD was already associated with multiple comorbidities by adolescence, and these were not limited to autoimmune disorders. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
When an operator hears sounds in a plantsite, the operator compares normal sounds of equipment which he previously heard and remembered with sounds he actually hears, to judge if they are normal or abnormal. According to the method, there is a worry that abnormal conditions can not be appropriately judged in a case where the number of objective equipments is increased and in a case that the sounds are changed gradually slightly. Then, the device of the present invention comprises a plurality of monitors for monitoring the operation sound of equipments, a recording/reproducing device for recording and reproducing the signals, a selection device for selecting the reproducing signals among the recorded signals, an acoustic device for converting the signals to sounds, a switching device for switching the signals to be transmitted to the acoustic device between to signals of the monitor and the recording/reproducing signals. The abnormality of the equipments can be determined easily by comparing the sounds representing the operation conditions of equipments for controlling the plant operation and the sounds recorded in their normal conditions. (N.H.)
Fernández Ibieta, M; Ramos Amador, J T; González Tomé, M I; Guillén Martín, S; Bellón Cano, J M; Navarro Gómez, M; de José, M I; Beceiro, J; Iglesias, E; Rubio, B; Relaño Garrido, P; Santos, M J; Martínez Guardia, N; Roa, M A; Regidor, J
Mother-to-child HIV transmission is currently around 1% in western countries, due to prevention measures. Antiretroviral drugs do have adverse effects, anaemia and myelosupression caused by AZT being the most observed effects. In the present study, we analyse the prevalence of anaemia and neutropenia in an uninfected children cohort born to HIV-infected women. We followed up 623 uninfected children belonging to the FIPSE cohort according to standardised protocols. This cohort groups 8 hospitals from Madrid and follows up HIV infected pregnant women and their children. Anaemia and neutropenia were defined according to the ACTG (AIDS Clinical Trails Group) toxicity tables. Children were classified according to prematurity, ethnic origin, birth weight, withdrawal syndrome, in-utero treatment and neonatal prophylaxis. Categorical variables were compared with the chi2 or the Fisher tests. Anaemia was observed in 188 (30.1%) children during follow-up and 161 (25.8%) had anaemia grade 2 or higher. Prematurity (p triple therapy) did not influence either cytopenia. In our series, the proportion of children with anaemia is high: 30.1% Prematurity, low birth weight and HAART with IP were associated with a higher proportion of anaemia, which was transient and had little clinical relevance. The proportion of children with neutropenia was higher (41.9%) and was associated with prematurity, low birth weight and African origin. The type of neonatal prophylaxis does not seem to influence the development of cytopenias. Persistence of neutropenia (without clinical significance) was observed in a small percentage of the children 12.5%, at 18 months of age.
Sherjil, A.; Saeed, Z.U.; Shehzad, S.; Amjad, R.
Background: Iron deficiency anaemia and febrile seizures are two common diseases in children worldwide as well as in our country. Iron insufficiency is known to cause neurological symptoms like behavioural changes, poor attention span and learning deficits in children. Therefore, it may also be associated with other neurological disturbances like febrile seizures in children. Objective of our case-control study was to find association between iron deficiency anaemia and febrile seizures in children. Methods: This multicentre study was conducted in Department of Paediatrics HIT Hospital Taxila Cantt, Department of Paediatrics CMH Mangla and Department of Paediatrics POF Hospital Wah Cantt, from June 2008 to June 2010. Three hundred and ten children aged between 6 months to 6 years were included in the study. One hundred and fifty-seven children who presented with febrile seizures were our cases, while, 153 children who presented with febrile illnesses without seizures were recruited as controls. All patients were assessed for iron deficiency anaemia by measuring haemoglobin level, serum ferritin level, Mean Corpuscular Haemoglobin Concentration (MCHC) and Mean Corpuscular Volume (MCV). Patients with iron deficiency anaemia amongst controls and cases were documented. Percentages and Odds ratio were derived from the collected data. Results: 31.85% of cases (50 out of 157) had iron deficiency anaemia whereas, 19.6% of controls (30 out of 153) were found to have iron deficiency anaemia as revealed by low levels of haemoglobin level, serum ferritin level, Mean Corpuscular Haemoglobin Concentration and Mean Corpuscular Volume. Odds ratio was 1.93. Conclusion: Patients with febrile seizures are 1.93 times more likely to have iron deficiency anaemia compared to febrile patients without seizures. (author)
Antonio-Rubio, I; Madrid-Navarro, C J; Salazar-López, E; Pérez-Navarro, M J; Sáez-Zea, C; Gómez-Milán, E; Mínguez-Castellanos, A; Escamilla-Sevilla, F
An autonomic denervation and abnormal vasomotor reflex in the skin have been described in Parkinson's disease (PD) and might be evaluable using thermography with cold stress test. A cross-sectional pilot study was undertaken in 35 adults: 15 patients with PD and abnormal [(123)I]-metaiodobenzylguanidine cardiac scintigraphy and 20 healthy controls. Baseline thermography of both hands was obtained before immersing one in cold water (3 ± 1 °C) for 2 min. Continuous thermography was performed in: non-immersed hand (right or with lesser motor involvement) during immersion of the contralateral hand and for 6 min afterward; and contralateral immersed hand for 6 min post-immersion. The region of interest was the dorsal skin of the third finger, distal phalanx. PD patients showed a lower mean baseline hand temperature (p = 0.037) and greater thermal difference between dorsum of wrist and third finger (p = 0.036) and between hands (p = 0.0001) versus controls, regardless of the motor laterality. Both tests evidenced an adequate capacity to differentiate between groups: in the non-immersed hand, the PD patients did not show the normal cooling pattern or final thermal overshoot observed in controls (F = 5.29; p = 0.001), and there was an AUC of 0.897 (95%CI 0.796-0.998) for this cooling; in the immersed hand, thermal recovery at 6 min post-immersion was lesser in patients (29 ± 17% vs. 55 ± 28%, p = 0.002), with an AUC of 0.810 (95%CI 0.662-0.958). PD patients reveal abnormal skin thermal responses in thermography with cold stress test, suggesting cutaneous autonomic dysfunction. This simple technique may be useful to evaluate autonomic dysfunction in PD. Copyright © 2015 Elsevier Ltd. All rights reserved.
Fernald, Charles D.
Describes activity in which student in abnormal psychology and psychology of exceptional children classes personally experience being judged abnormal. The experience allows the students to remember relevant research, become sensitized to the feelings of individuals classified as deviant, and use caution in classifying individuals as abnormal.…
Discussion. Regardless of varying diagnostic classification, abnormal glucose tolerance is a well-documented risk factor. 16 Abnormalities in. Because ofthe small number offemale MI survivors, the effect of obesity and abnormal glucose tolerance on lipid levels was studied in the male patients only. There was no significant.
Ricardo J. Soares Magalhães
Full Text Available Anaemia is known to have an impact on child development and mortality and is a severe public health problem in most countries in sub-Saharan Africa. We investigated the consistency between ecological and individual-level approaches to anaemia mapping by building spatial anaemia models for children aged ≤15 years using different modelling approaches. We aimed to (i quantify the role of malnutrition, malaria, Schistosoma haematobium and soil-transmitted helminths (STHs in anaemia endemicity; and (ii develop a high resolution predictive risk map of anaemia for the municipality of Dande in northern Angola. We used parasitological survey data for children aged ≤15 years to build Bayesian geostatistical models of malaria (PfPR≤15, S. haematobium, Ascaris lumbricoides and Trichuris trichiura and predict small-scale spatial variations in these infections. Malnutrition, PfPR≤15, and S. haematobium infections were significantly associated with anaemia risk. An estimated 12.5%, 15.6% and 9.8% of anaemia cases could be averted by treating malnutrition, malaria and S. haematobium, respectively. Spatial clusters of high risk of anaemia (>86% were identified. Using an individual-level approach to anaemia mapping at a small spatial scale, we found that anaemia in children aged ≤15 years is highly heterogeneous and that malnutrition and parasitic infections are important contributors to the spatial variation in anaemia risk. The results presented in this study can help inform the integration of the current provincial malaria control programme with ancillary micronutrient supplementation and control of neglected tropical diseases such as urogenital schistosomiasis and STH infections.
Full Text Available Aim. We determined the prevalence of anaemia and evaluated markers of iron homeostasis in a cohort of HIV patients. Methods. A comparative cross-sectional study on 319 participants was carried out at the Tamale Teaching Hospital from July 2013 to December 2013, 219 patients on HAART (designated On-HAART and 100 HAART-naive patients. Data gathered include sociodemography, clinical history, and selected laboratory assays. Results. Prevalence of anaemia was 23.8%. On-HAART participants had higher CD4/CD3 lymphocyte counts, Hb, HCT/PCV, MCV, MCH, iron, ferritin, and TSAT (P<0.05. Hb, iron, ferritin, and TSAT decreased from grade 1 to grade 3 anaemia and CD4/CD3 lymphocyte count was lowest in grade 3 anaemia (P<0.05. Iron (P=0.0072 decreased with disease severity whilst transferrin (P=0.0143 and TIBC (P=0.0143 increased with disease severity. Seventy-six (23.8% participants fulfilled the criteria for anaemia, 86 (26.9% for iron deficiency, 41 (12.8% for iron deficiency anaemia, and 17 (5.3% for iron overload. The frequency of anaemia was higher amongst participants not on HAART (OR 2.6 for grade 1 anaemia; OR 3.0 for grade 3 anaemia. Conclusion. In this study population, HIV-associated anaemia is common and is related to HAART status and disease progression. HIV itself is the most important cause of anaemia and treatment of HIV should be a priority compared to iron supplementation.
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Khan, M.; Jehangir, W.; Daood, M.S.; Khan, A.; Mallick, N.H.
Background: Heart Failure (HF) is a common disease with a high mortality rate. Anaemia and renal failure (RF) are often present in patients with HF and associated with worse prognosis. Objective of study was to evaluate the prevalence of anaemia and RF in patients with HF. Methods: Patients admitted in Punjab institute of cardiology Lahore with diagnosis of heart failure were enrolled from February, 2008 to December, 2008. Anaemia was defined as haemoglobin levels <13 mg/dl for men and 12 mg/dl for women. Renal function was assessed by the glomerular filtration rate (GFR), calculated by the simplified formula of the MDRD (Modification of Diet in Renal Disease) study. Results : Of the 276 patients included in this study, 42.03% (116) had anaemia and 38.40% (106) had moderate to severe renal failure (GFR <60 ml/min). Conclusion: The prevalence of anaemia and renal failure was high in this population and was associated with the severity of the HF (functional classes III and IV). (author)
Malyszko, Jolanta; Anker, Stefan D
Iron deficiency anaemia is a global health problem that manifests as fatigue and poor physical endurance. Anaemia can be caused by dietary iron deficiency, blood loss or a combination of poor iron absorption and ineffective iron mobilization in patients with chronic disease. Nephrologists caring for patients with impaired renal function understand that iron treatment is necessary to provide adequate iron for erythropoiesis during the treatment of overt anaemia. However, a less well-understood health problem is iron deficiency, which creates symptoms that overlap with those of anaemia and often occurs in concert with chronic disease. Recently, several randomized controlled clinical trials have been conducted to investigate the effects of treatment with intravenous iron in heart failure patients with iron deficiency who may or may not also have anaemia. Given that heart and kidney disease are often comorbid, these clinical trials may have implications for the way nephrologists view their patients with iron deficiency. In this article, we review several clinical studies of intravenous iron therapy for patients with iron deficiency and heart failure and discuss possible implications for the treatment of patients with kidney disease.
Barsotti, Giovanni; Sgorbini, Micaela; Marmorini, Paola; Corazza, Michele
To determine the prevalence and describe ocular abnormalities in healthy Standardbred foals within 48 h of birth. One hundred and two neonatal foals. All foals had an unassisted delivery. On the basis of physical examination and the results of hematological and biochemical parameters, all foals were unaffected by systemic diseases. A complete ophthalmic examination was performed within 48 h of birth. Foals with ocular hemorrhages were re-examined weekly until the abnormalities were resolved. 65/102 (63.7%) foals did not show ocular abnormalities, while in 37/102 (36.3%) cases, ocular abnormalities were present. Retinal and subconjunctival hemorrhages were recorded in 19/102 (18.6%), and in 13/102 (12.7%), respectively. In 4/102 (3.9%) animals, an entropion of the lower eyelid was present. Only one foal (1%) showed a congenital nuclear unilateral cataract. No other ocular abnormalities were detected. However, all foals showed various degrees of remnants of hyaloid system. One week after the first ocular examination, retinal hemorrhages had resolved in 100% of the eyes, whereas subconjunctival hemorrhages had disappeared in all eyes by the second week following the first examination. The acquired ocular lesions observed with relatively high frequency in the examined healthy Standardbred foals were ocular hemorrhages, which always showed a good outcome. Although these abnormalities were present at birth, they were not considered strictly congenital but likely acquired during parturition. Instead, congenital ocular abnormalities were rarely diagnosed, and the entropion of the lower eyelid was the most common disease in the breed. © 2012 American College of Veterinary Ophthalmologists.
Boillot, B; Teklali, Y; Moog, R; Droupy, S
Congenital abnormalities of the penis are usually diagnosed at birth and pose aesthetic and functional problems sometimes requiring surgical management. A literature review was conducted on Medline considering the articles listed until January 2012. Hypospadias is the most common malformation (1 in 250 boys. Familial forms: 7%). The causes remain hypothetical but the doubling of the incidence in 30 years could be linked to fetal exposure to endocrine disruptors "estrogen-like" used in the food industry in particular. Surgical treatment is usually intended to improve the aesthetic appearance but sometimes, in case of significant curvature or posterior meatus, necessary for normal sexual life and fertility. Other malformations (epispades, buried penis, transpositions, twists and preputial abnormalities) as well as management for functional or aesthetic consequences of these malformations in adulthood require complex surgical care in a specialized environment. The improvement of surgical techniques and pediatric anesthesia allows an early and effective specialized surgical approach of penile malformations. Management of sequelae in adulthood must be discussed and requires experience of surgical techniques on pediatric and adult penis. Copyright © 2013 Elsevier Masson SAS. All rights reserved.
Kehinde, M O; Ogungbemi, S I; Anigbogu, C N; Jaja, S I
The effect of oral, low-dose l-arginine supplementation (1g/day for 6 weeks) on antioxidant activity, haematological parameters and osmotic fragility of red blood cells was investigated in sickle cell disease sufferers. Twenty eight sickle cell anaemia subjects were recruited for the study. Five millilitres of blood was withdrawn from an ante-cubital vein for the estimation of plasma arginine concentration ([R]), total antioxidant enzymes (TAE) activity, malondialdehyde concentration ([MDA]), RBC count, [Hb], PCV, MCHC, MCV, MCH, percent irreversibly sickled cells (%ISC)) and osmotic fragility of red blood cells in the subjects. l-arginine supplementation increased [R] (pSupplementation shifted the osmotic fragiligram to the right and reduced the concentrations of NaCl at which initial and complete lyses of erythrocytes occurred. Study showed that low-dose, oral l-arginine increased antioxidant activity, red blood cell resistance to osmotic lysis but reduced red cell density in SCD. Copyright © 2015 Elsevier B.V. All rights reserved.
Alano Martins Pedrosa
Full Text Available Hydroxyurea (HU is the most important advance in the treatment of sickle cell anaemia (SCA for preventing complications and improving quality of life for patients. However, some aspects of treatment with HU remain unclear, including their effect on and potential toxicity to other blood cells such as neutrophils. This study used the measurement of Lactate Dehydrogenase (LDH and Methyl ThiazolTetrazolium (MTT and the comet assay to investigate the cytotoxicity and damage index (DI of the DNA in the neutrophils of patients with SCA using HU.In the LDH and MTT assays, a cytoprotective effect was observed in the group of patients treated, as well as an absence of toxicity. When compared to patients without the treatment, the SS group (n=20, 13 women and 07 men, aged 18-69 years, and the group of healthy individuals (AA used as a control group (n=52, 28 women and 24 men, aged 19-60 years, The SSHU group (n=21, 11 women and 10 men, aged 19-63 years showed a significant reduction (p20 months, demonstrating that despite the cytoprotective effects in terms of cell viability, the use of HU can induce DNA damage in neutrophils.
Have, Simon Hartmann; Ren, Huamin; Moeslund, Thomas B.
Automatic abnormality detection in video sequences has recently gained an increasing attention within the research community. Although progress has been seen, there are still some limitations in current research. While most systems are designed at detecting specific abnormality, others which...... are capable of detecting more than two types of abnormalities rely on heavy computation. Therefore, we provide a framework for detecting abnormalities in video surveillance by using multiple features and cascade classifiers, yet achieve above real-time processing speed. Experimental results on two datasets...... show that the proposed framework can reliably detect abnormalities in the video sequence, outperforming the current state-of-the-art methods....
Donker, A.E.; Raymakers, R.A.P.; Nieuwenhuis, H.K.; Coenen, M.J.H.; Janssen, M.C.H.; MacKenzie, M.A.; Brons, P.P.T.; Swinkels, D.W.
BACKGROUND: X-linked sideroblastic anaemia (XLSA; OMIM#300751) is the most common inherited form of sideroblastic anaemia and is associated with several mutations in the erythroid specific 5-aminolevulinate synthase gene (ALAS(2)). This gene encodes for aminolevulinic acid synthase 2 (ALAS(2)), the
Nutritional anaemia affects 50-70% of pregnant women in the developing world where vitamin A deficiency is also a problem. Since previous studies have indicated that vitamin A deficiency can be involved in the aetiology of nutritional anaemia, the role of vitamin A deficiency in nutritional
de Los Rios, P José F; López, R Claudia; Cifuentes, P Carolina; Angulo, C Mónica; Palacios-Barahona, Arlex U
To evaluate the effectiveness of the hysteroscopic polypectomy in terms of the decrease of the abnormal uterine bleeding. A cross-sectional and analytical study was done with patients to whom a hysteroscopic polypectomy was done for treating the abnormal uterine bleeding, between January 2009 and December 2013. The response to the treatment was evaluated via a survey given to the patients about the behavior of the abnormal uterine bleeding after the procedure and about overall satisfaction. The results were obtained after a hysteroscopic polypectomy done to 128 patients and were as follows. The average time from the polypectomy applied until the survey was 30.5 months, with a standard deviation of 18 months. 67.2% of the patients reported decreased abnormal uterine bleeding and the 32.8% reported a persistence of symptoms. On average 82.8% of the. patients were satisfied with the treatment. Bivariate and multivariate analysis showed no association between the variables studied and no improvement of abnormal uterine bleeding after surgery (polypectomy). There were no complications. Hysteroscopic polypectomy is a safe surgical treatment, which decreases on two of three patients the abnormal uterine bleeding in the presence of endometrial polyps, with an acceptable level of satisfaction.
Ullah, K.; Satti, T.M.; Ahmed, P.; Raza, A.; Akhtar, F.M.; Tariq, W.U.Z.
Aplastic anaemia is characterized by severe compromise of haematopoiesis and hypocellular bone marrow. Haemorrhagic episodes in patients with aplastic anemia occur usually secondary to thrombocytopenia and require frequent support with platelet concentrates and other blood products. Infection with dengue virus (particularly dengue sero type-2 of South Asian genotype) is associated with dengue haemorrhagic fever. Dengue infection further worsens the disease process in patients with aplastic anaemia due to uncontrolled haemorrhagic diathesis and major organ failure, which may prove fatal in these already immunocompromised patients, if not treated in time. Recent epidemics of dengue haemorrhagic fever has not only affected the southern region of our country but also spread to other areas of the country. With this background, we report a case of aplastic anaemia complicated by dengue haemorrhagic fever who achieved successful engraftment after allogeneic stem cell transplantation from sibling brother and is having normal healthy post transplant life. (author)
Siân E. Robson
Full Text Available Subtle disturbances of visual and motor function are known features of schizophrenia and can greatly impact quality of life; however, few studies investigate these abnormalities using simple visuomotor stimuli. In healthy people, electrophysiological data show that beta band oscillations in sensorimotor cortex decrease during movement execution (event-related beta desynchronisation (ERBD, then increase above baseline for a short time after the movement (post-movement beta rebound (PMBR; whilst in visual cortex, gamma oscillations are increased throughout stimulus presentation. In this study, we used a self-paced visuomotor paradigm and magnetoencephalography (MEG to contrast these responses in patients with schizophrenia and control volunteers. We found significant reductions in the peak-to-peak change in amplitude from ERBD to PMBR in schizophrenia compared with controls. This effect was strongest in patients who made fewer movements, whereas beta was not modulated by movement in controls. There was no significant difference in the amplitude of visual gamma between patients and controls. These data demonstrate that clear abnormalities in basic sensorimotor processing in schizophrenia can be observed using a very simple MEG paradigm.
Full Text Available The aim of this study is to increase awareness of rare presentations, diagnostic difficulties alongside management of conductive hearing loss and ossicular abnormalities. We report the case of a 13-year-old female reporting progressive left-sided hearing loss and high resolution computed tomography was initially reported as normal. Exploratory tympanotomy revealed an absent stapedius tendon and lack of connection between the stapes superstructure and footplate. The footplate was fixed. Stapedotomy and stapes prosthesis insertion resulted in closure of the air-bone gap by 50 dB. A review of world literature was performed using MedLine. Middle ear ossicular discontinuity can result in significant conductive hearing loss. This can be managed effectively with surgery to help restore hearing. However, some patients may not be suitable or decline surgical intervention and can be managed safely conservatively.
Dwinger, R.H.; Holland, W.G.; Ndegwa, T.K.; Wint, W.; Kassim, S.S.; Hongjie, P.; Slingenbergh, J.H.W.
A large number of cattle has been monitored regularly during a ten-year period on Unguja island, United Republic of Tanzania, as part of a number of consecutive programmes to initially control and eventually eradicate tsetse and trypanosomosis. Haematological and parasitological results were used among others to monitor and adjust the control and eradication programmes from 1988 to 1997. A Geographic Information System (GIS) was applied to the data set to assess changes of animal health parameters in time and space. Analysis of the data showed significant changes over the years in infection status and degree of anaemia. Moreover, differences in health status of cattle populations between adjacent geographic areas were detected. Regular monitoring using standardized protocols by a multidisciplinary team resulted eventually in the eradication of tsetse flies from the island. (author)
Christie, K.E.; Hjeltnes, B.; Uglenes , I.; Winton, J.R.
Plasma was collected from Atlantic salmon Salrno salar with acute infectious salmon anaemia (ISA) and used to challenge Atlantic salmon parr by intraperitoneal injection. Treatment of plasma with the lipid solvent, chloroform, showed that the etiological agent of ISA contained essential lipids, probably as a viral envelope. Some infectivity remained following treatment with freon. Injection challenges using fractions from equilibrium density gradient centrifugation of plasma from fish with acute ISA revealed a band of infectivity in the range 1.184 to 1.262 g cm-3. The band was believed to conta~n both complete ISA-virus particles and infectious particles lacking a complete envelope, nucleocapsid or genome. Density gradient centrifugation of infectious plasma for enrichment of the putative ISA virus appeared to offer a suitable method for obtaining virus-specific nucleic acid for use in the construction of cDNA libraries.
Kjøglum, Sissel; Henryon, Mark; Aasmundstad, Torunn
We reasoned that by challenging large numbers of Atlantic salmon families with the causative agents of furunculosis, infectious salmon anaemia (ISA) and infectious pancreatic necrosis (IPN), we could show unequivocally that resistance to these diseases expresses moderate-to-high levels of additive...... genetic variation, and that the resistances are weakly correlated genetically. We tested this reasoning by challenging Atlantic salmon from 920 (approximately) full-sib families with the causative agents of furunculosis and ISA, and fish from 265 of these families with the causative agent of IPN. Additive...... genetic variation and genetic correlations were estimated by fitting a threshold liability model to the resistances assessed as binary traits. Resistance to furunculosis, ISA and IPN was moderate â€"to highly heritable. The marginal posterior means for heritability on the underlying liability scale were 0...
Ngui, Romano; Lim, Yvonne Ai Lian; Chong Kin, Liam; Sek Chuen, Chow; Jaffar, Shukri
Given that micronutrient deficiency, neglected intestinal parasitic infections (IPIs) and poor socioeconomic status are closely linked, we conducted a cross-sectional study to assess the relationship between IPIs and nutritional status of children living in remote and rural areas in West Malaysia. A total of 550 children participated, comprising 520 (94.5%) school children aged 7 to 12 years old, 30 (5.5%) young children aged 1 to 6 years old, 254 (46.2%) boys and 296 (53.8%) girls. Of the 550 children, 26.2% were anaemic, 54.9% iron deficient and 16.9% had iron deficiency anaemia (IDA). The overall prevalence of helminths was 76.5% comprising Trichuris trichiura (71.5%), Ascaris lumbricoides (41.6%) and hookworm infection (13.5%). It was observed that iron deficiency was significantly higher in girls (p = 0.032) compared to boys. Univariate analysis demonstrated that low level of mother's education (OR = 2.52; 95% CI = 1.38-4.60; p = 0.002), non working parents (OR = 2.18; 95% CI = 2.06-2.31; p = 0.013), low household income (OR = 2.02; 95% CI = 1.14-3.59; p = 0.015), T. trichiura (OR = 2.15; 95% CI = 1.21-3.81; p = 0.008) and A. lumbricoides infections (OR = 1.63; 95% CI = 1.04-2.55; p = 0.032) were significantly associated with the high prevalence of IDA. Multivariate analysis confirmed that low level of mother's education (OR = 1.48; 95 CI% = 1.33-2.58; peconomy, education, sanitation status and personal hygiene are taken into consideration to improve the nutritional status of these children.
McCormack, Tessa; Ayub, Rukhsana; Aziz, Faisal; Motta, Lara; Spaeth, Brooke; Shephard, Mark
To use point-of-care testing to screen and facilitate treatment for anaemia and to establish an estimate of the prevalence of anaemia in the local population. An uncontrolled before and after study design was used to evaluate the effectiveness of the intervention on the anaemia status of participants. This study took place in a rural mountain community (population approximately 1000) in the Haripur district in northern Pakistan. Women of child-bearing age (15-49 years) and children (12-14 years) were included in this study. The intervention included point-of-care testing for haemoglobin, treatment with mebendazole and oral iron supplementation, and an education campaign about anaemia delivered by community health workers and medical students. The main outcome measure was an increase in blood haemoglobin over the study period. A secondary outcome measure was a positive change in anaemia status or classification post-intervention. Anaemia was initially detected in 64 (53%) women and 15 (47%) children. The mean haemoglobin concentration increased significantly (P Point-of-care testing used for the detection of anaemia in this rural community helped to identify the burden of disease and to reduce this significantly by way of rapid diagnosis, education and immediate medical intervention. © 2017 National Rural Health Alliance Inc.
Vicario, Carmelo Mario; Rappo, Gaetano; Pepi, Annamaria; Pavan, Andrea; Martino, Davide
Recent imaging studies have associated Developmental dyscalculia (DD) to structural and functional alterations corresponding Parietal and the Prefrontal cortex (PFC). Since these areas were shown also to be involved in timing abilities, we hypothesized that time processing is abnormal in DD. We compared time processing abilities between 10 children with pure DD (8 years old) and 11 age-matched healthy children. Results show that the DD group underestimated duration of a sub-second scale when asked to perform a time comparison task. The timing abnormality observed in our DD participants is consistent with evidence of a shared fronto-parietal neural network for representing time and quantity.
Kurtzhals, J A; Adabayeri, V; Goka, B Q
BACKGROUND: Severe anaemia is a major complication of malaria but little is known about its pathogenesis. Experimental models have implicated tumour necrosis factor (TNF) in induction of bone-marrow suppression and eythrophagocytosis. Conversely, interleukin 10 (IL-10), which mediates feed...
Kurtzhals, J A; Adabayeri, V; Goka, B Q
BACKGROUND: Severe anaemia is a major complication of malaria but little is known about its pathogenesis. Experimental models have implicated tumour necrosis factor (TNF) in induction of bone-marrow suppression and eythrophagocytosis. Conversely, interleukin 10 (IL-10), which mediates feed-back r...
deficiency anaemia were randomly allocated to two treatment groups. Group A received the usual recommended dose of iron dextran (Imferon; Fisons) and group 8 received two-thirds of the recommended dose. A further 30 patients received oral iron ...
O'connor, T M
Patients with chronic hypoxaemia develop secondary polycythaemia that improves oxygen-carrying capacity. Therefore, normal haemoglobin and haematocrit values in the presence of chronic arterial hypoxaemia in cystic fibrosis constitute \\'relative anaemia\\'. We sought to determine the cause of this relative anaemia in patients with cystic fibrosis. We studied haematological indices and oxygen saturation in healthy volunteers (n=17) and in adult patients with cystic fibrosis (n=15). Patients with cystic fibrosis had lower resting arterial oxygen saturation when compared with normal volunteers (P<0.0001), and exercise led to a greater reduction in arterial oxygen saturation (P<0.0001). However, haemoglobin and haematocrit values in patients with cystic fibrosis did not significantly differ from normal volunteers. Serum iron (P=0.002), transferrin (P=0.02), and total iron-binding capacity (P=0.01) were lower in patients with cystic fibrosis. There were no significant differences in serum ferritin, percentage iron saturation, serum erythropoietin or red cell volume between the groups. The data presented demonstrate a characteristic picture of anaemia of chronic disease in adult patients with cystic fibrosis, except for normal haemoglobin and haematocrit values. Normal haemoglobin and haematocrit values in patients with cystic fibrosis appear to represent a combination of the effects of arterial hypoxaemia promoting polycythaemia, counterbalanced by chronic inflammation promoting anaemia of chronic disease.
Mar 11, 2009 ... A large percentage of women had anaemia of chronic disease, with HIV-infected women afflicted more often. ... is of paramount importance in evaluating laboratory results of iron levels to determine future treatment or nutritional recommendations. HIV- ..... HIV/AIDS: A guide for nutrition, care and support.
Assessment of renal function in children with sickle cell anaemia in University of Maiduguri Teaching Hospital. A.G. Farouk, A.H. Elechi, M.S. Yauba, M.G. Mustapha, B.A. Ibrahim, H.A. Ibrahim, L.M. Ibrahim, J.P. Ambe ...
Mahmud, Mahmud Abdulkader; Spigt, Mark; Mulugeta Bezabih, Afework; López Pavon, Ignacio; Dinant, Geert-Jan; Blanco Velasco, Roman
Research on associated risk factors for intestinal parasitic infections and malnutrition in various geographic regions is needed for the development of appropriate control strategies. The aim of this study was to determine the risk factors associated with intestinal parasitic infections, anaemia, and malnutrition in school children, living in urban and rural areas of northern Ethiopia. Six hundred school children, aged 6–15 years, were randomly selected in a cross-sectional survey from 12 primary schools. Sociodemographic and anthropometric data were collected. Faecal samples were examined using direct, concentration, and the Kato–Katz methods. Urine specimens were analysed for Schistosoma haematobium ova. Haemoglobin was measured using a HemoCue spectrometer. The overall prevalence of intestinal parasitosis was 72% (95% confidence interval (CI): 66–76%). The prevalence of anaemia, stunting, and thinness were 11% (95% CI: 8–13%), 35% (95% CI: 31–38%), and 34% (95% CI: 30–38%), respectively. Poor personal hygiene habits were generally associated with anaemia and nutritional deficiency (low body mass index). Multivariate logistic regression models related Schistosoma mansoni infection with boys. Boys were also more likely to be malnourished. Hookworm infection was associated with anaemia and unhygienic finger nails. Access to clean water and latrines, with some hygiene and sanitation communication activities, could improve health of children in Ethiopia. The use of smartphone technology in demographic data collection proved to be successful. The potential advantage offered by this technology for parasitological field surveys merits further investigation. PMID:23683331
and is implicated as both a cause and an effect of adverse social and economic family circumstances.. Global estimates of ... This high anaemia burden among children of sub-Saharan Africa is generally attributed to poverty, communicable diseases, food insecurity, HIV and other associated concerns such as access to.
Jonker, Femkje A. M.; te Poel, Elodie; Bates, Imelda; Boele van Hensbroek, Michael
Globally, anaemia, iron deficiency and infections are responsible for a majority of the morbidity and mortality that occurs among children. As iron is essential for erythropoiesis and the human immune system, as well as a crucial element for many pathogens, these three conditions often interact.
Schaumburg, F.; Biallas, B.; Alabi, A. S.; Grobusch, M. P.; Feugap, E. N.; Lell, B.; Mellmann, A.; Peters, G.; Kremsner, P. G.; Becker, K.; Adegnika, A. A.
Children with sickle cell anaemia (SCA) might carry hospital-associated bacterial lineages due to frequent hospital stays and antibiotic treatments. In this study we compared Staphylococcus aureus from SCA patients (n=73) and healthy children (n=143) in a cross-sectional study in Gabon. S. aureus
Muller, A.; Jacobsen, Helene; Healy, E.
Haemolytic anaemia is often induced following prolonged exposure to chemical substances. Currently, under EU Council Directive 67/548/EEC, substances which induce such effects are classified as dangerous and assigned the risk phrase R48 'Danger of serious damage to health by prolonged exposure...
Background: Vitamin A deficiency makes children vulnerable to infections and influences the outcome of various infections. In 1993 vitamin A deficiency was found to be a public health problem in Bungoma district of western Kenya. Objective: To determine the prevalence of vitamin A deficiency, anaemia and malaria ...
Sickle cell disease is one of the common haemoglobinopathies in the world. It can affect any organ in the body and one of the most common and an early organ to be affected in SCA is the spleen. Reports have shown that patients with sickle cell anaemia (HbSS) have an increased susceptibility to infection leading to ...
The article aims to draw attention of clinicians to the addictive potentials of Pentazocine use in sickle cell anaemia patients and to highlight some of the associated problems of pentazocine abuse. It also hopes to stimulate the need to review guidelines for the use of analgesics in the management of bone pain crisis or other ...
le Cessie, S.; Verhoeff, F. H.; Mengistie, G.; Kazembe, P.; Broadhead, R.; Brabin, B. J.
Objectives: To examine the effect of low birth weight (LBW) and fetal anaemia (FA) on haemoglobin (Hb) patterns in infancy. To study the additional contribution of other risk factors known at birth. To examine the effect of iron supplementation during infancy on Hb levels. Methods: A stratified
Esan, Michael O.; Jonker, Femkje A. M.; Hensbroek, Michael Boele van; Calis, Job C. J.; Phiri, Kamija S.
We conducted a systematic review and meta-analysis to determine the prevalence of iron deficiency in HIV-infected children from high- and low-income settings and compared it with that of HIV-uninfected controls. We searched five major databases for primary studies reporting on anaemia and iron
Rani, Ningappa Asha; Arasegowda, Rajeshwari; Mukherjee, Pramit; Dhananjay, Shilpashree Yeliyur
Nutritional deficiency anaemia can lead to development of headache, fatigue, lethargy, apathy, exertional dyspnoea, palpitations and tinnitus and thereby decrease the quality of everyday life to a great extent. Such symptoms may pose a hindrance for students in their academic life and have a negative impact on their career. To determine prevalence of nutritional deficiency anaemia and its correlation with academic performance among medical students. A cross-sectional study was conducted at Adichunchanagiri Institute of Medical Sciences. Two hundred eighty nine healthy undergraduate medical students of both genders were included in this study. A predesigned and pre-structured questionnaire was used as a tool to obtain information regarding demographic profile, dietary habits and academic performance. Haemoglobin level was estimated. Student's t-test and Chi-square test were employed. Majority of the participants were within the age group of 17-20 years (84.4%). The overall prevalence of anaemia was 15.6% with high rates among female students (93.3%), this gender difference was statistically significant (pperformers. There was no association between the anaemic status and students scholastic performance (χ 2 =3.1533, p=0.368). The mean haemoglobin level was higher among low performer, indicating that nutritional anaemia may not \\play a major role in educational performance and intelligence in higher education.
Anaemia, Malaria and malnutrition in the first two years of life in Nigeria. B M Afolabi, A G Mafe. Abstract. No Abstract. Journal of Malaria in Africa and the Tropics Vol. 1 (3) 2005: pp. 15-27. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.
The acidosis known to be associated with sickle cell anaemia is exploited in this work to estimate its energy cost to the kidney that has to dialyse the excess protons from the blood into urine against a concentration gradient, thereby doing significant extra work. The mean blood and urine pHs measured for the four discrete ...
Cost-effective on-site screening for anaemia in pregnancy in primary care clinics. David Wilkinson, Martene E Sach. Objective. To determine the feasibility, accuracy and .... day. There it was stored at 4°C until haemoglobin concentration was estimated with the Sysmex analyser (CA. Milsch, Johannesburg) within 48 hours.
Sickle cell anaemia (SCA) is the most common form of haemoglobinopathy in Nigeria affecting 1-3% of the population and it is associated with physical, psychosocial and emotional suffering. Prenatal diagnosis (PND) and genetic counseling are ways of preventing the spread of the disease; however these means of ...
Olde Rikkert, M.G.M.
Recent epidemiological findings on the risk factors for mortality and functional impairment do not support lower cut-off values than the official WHO reference values for the definition of anaemia in the elderly, and even suggest higher limits. However, wide-scale application of such high Hb values
Jan 18, 2007 ... The acidosis known to be associated with sickle cell anaemia is exploited in this work to estimate its energy cost to the kidney that has to dialyse the excess protons from the blood into urine against a concentration gradient, thereby doing significant extra work. The mean blood and urine pHs measured.
INTRODUCTION. Sickle cell anaemia (SCA) is the predominant haemoglobinopathy in Nigeria affecting about 1-3% of the Nigerian population1. The disease is associated with a lot of physical, psychosocial, emotional and financial burden and could lead to a disruption of family life 2. Studies from Nigeria have shown ...
Catherine Qiu Hua Chan
Full Text Available Many patients with pernicious anaemia are treated with lifelong intramuscular vitamin B12 replacement. As early as the 1950s, there were studies suggesting that oral vitamin B12 replacement may provide adequate absorption. Nevertheless, oral vitamin B12 replacement in patients with pernicious anaemia remains uncommon in clinical practice. The objective of this review is to provide an update on the effectiveness of oral vitamin B12 for the treatment of pernicious anaemia, the recommended dosage and the required frequency of laboratory test and clinical monitoring. Relevant articles were identified by PubMed search from 1 January 1980 to 31 March 2016 and through hand search of relevant reference articles. Two randomised controlled trials, three prospective papers, one systematic review and three clinical reviews fulfilled our inclusion criteria. We found that oral vitamin B12 replacement at 1000mcg daily was adequate to replace vitamin B12 levels in patients with pernicious anaemia. We conclude that oral vitamin B12 is an effective alternative to vitamin B12 intramuscular injections. Patients should be offered this alternative after an informed discussion on the advantages and disadvantages of both treatment options.
Autoimmune haemolytic anaemia (AIHA) is a rare disease. In clinical practice, diagnosis and treatment of AIHA turns out to be troublesome. Correct diagnosis is dependent on proper comprehension of the pathophysiology and the laboratory tests performed by the transfusion laboratory. The present
Adnan, Ja'afar; Ahmad, K. A.; Mat, Muhamad Hadzren; Rizman, Zairi Ismael; Ahmad, Shahril
Cardiac abnormality often occurs regardless of gender, age and races but depends on the lifestyle. This problem sometimes does not show any symptoms and usually detected once it already critical which lead to a sudden death to the patient. Basically, cardiac abnormality is the irregular electrical signal that generate by the pacemaker of the heart. This paper attempts to develop a program that can detect cardiac abnormality activity through implementation of Hybrid Multilayer Perceptron (HMLP) network. A certain amount of data of the heartbeat signals from the electrocardiogram (ECG) will be used in this project to train the MLP and HMLP network by using Modified Recursive Prediction Error (MRPE) algorithm and to test the network performance.
To assess reproductive risk factors for anaemia among pregnant women in urban and rural areas of India. The International Institute of Population Sciences, India, carried out third National Family Health Survey in 2005-2006 to estimate a key indicator from a sample of ever-married women in the reproductive age group 15-49 years. Data on various dimensions were collected using a structured questionnaire, and anaemia was measured using a portable HemoCue instrument. Anaemia prevalence among pregnant women was compared between rural and urban areas using chi-square test and odds ratio. Multinomial logistic regression analysis was used to determine risk factors. Anaemia prevalence was assessed among 3355 pregnant women from rural areas and 1962 pregnant women from urban areas. Moderate-to-severe anaemia in rural areas (32.4%) is significantly more common than in urban areas (27.3%) with an excess risk of 30%. Gestational age specific prevalence of anaemia significantly increases in rural areas after 6 months. Pregnancy duration is a significant risk factor in both urban and rural areas. In rural areas, increasing age at marriage and mass media exposure are significant protective factors of anaemia. However, more births in the last five years, alcohol consumption and smoking habits are significant risk factors. In rural areas, various reproductive factors and lifestyle characteristics constitute significant risk factors for moderate-to-severe anaemia. Therefore, intensive health education on reproductive practices and the impact of lifestyle characteristics are warranted to reduce anaemia prevalence. © 2014 John Wiley & Sons Ltd.
Urquizu I Brichs, Xavier; Rodriguez Carballeira, Mónica; García Fernández, Antonio; Perez Picañol, Emilio
The objective of the study was to assess the prevalence of anaemia in the immediate postpartum period (48-72hours), determine the risk factors and the value of haemoglobin before birth to reduce postpartum anaemia. A prospective, observational and longitudinal study that included 1,426 women who delivered consecutively and agreed to participate in the study. Different variables, analytical, epidemiological, foetal and maternal symptoms were studied. The prevalence of anaemia in the postpartum period was 49.7%. The most important risk factors were antepartum anaemia and type of delivery. The types of delivery most influencing postpartum anaemia were, forceps (82.3%), the ventouse 67%, cesarean section (58,2%) and vaginal delivery (37.2%). In the multivariate study was found as the most important independent risk factors, the haemoglobin in the delivery day (OR 6.16, CI: 3.73 to 10.15) and instrumental delivery (OR: 4.61, CI: 3.44 to 6, 19). Other independent risk factors were haemoglobin in the third trimester, episiotomy and perineal tears, ethnicity, birth weight, parity and intra/postpartum complications. Anaemia in the immediate postpartum is a prevalent problem. The factors most associated postpartum anaemia were antepartum anaemia and instrumental delivery. If patients arrive at the day of delivery with haemoglobins≥12,6g/dl and were restricted to necessary instrumented deliveries and cesarean sections, episiotomies and we could avoid perineal tears we can decrease anaemia in the immediate postpartum period very significantly. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.
Donker, A E; Raymakers, R A; Nieuwenhuis, H K; Coenen, M J H; Janssen, M C; MacKenzie, M A; Brons, P P T; Swinkels, D W
X-linked sideroblastic anaemia (XLSA; OMIM#300751) is the most common inherited form of sideroblastic anaemia and is associated with several mutations in the erythroid specific 5-aminolevulinate synthase gene (ALAS₂). This gene encodes for aminolevulinic acid synthase 2 (ALAS₂), the catalytic enzyme involved in the first en rate-limiting step of haem biosynthesis.1-3 The disorder is characterised by mostly mild hypochromic microcytic anaemia with bone marrow ring sideroblasts. Even untransfused patients with mild or no anaemia are at risk for severe systemic iron overload due to ineffective erythropoiesis. To date, 61 different ALAS₂ mutations have been reported in 120 families with XLSA. Descriptions of molecularly confirmed case series from the Netherlands, however, are lacking. We reviewed age of presentation, clinical and biochemical features, ALAS₋₂ defects and treatment characteristics of 15 Dutch patients from 11 unrelated families diagnosed with XLSA. In one family a novel pathogenic c.1412G>A (p.Cys471Tyr) mutation was found. All other families shared the previously described c.1355G>A (p.Arg452His) mutation. Haplotype analysis in seven probands with the p.Arg452His mutation strongly suggests that six of them were ancestrally related. Nevertheless, their phenotype was very different. Our patients illustrate the phenotypical heterogeneity in the presentation of XLSA patients, the effectiveness of treatment regimens and the various pitfalls associated with the diagnosis, follow-up and treatment of the disease. A timely diagnosis avoids unnecessary investigations and allows adequate treatment that can prevent systemic iron load with subsequent severe life-threatening complications. Therefore, we suggest considering XLSA in both male and female patients with unexplained iron overload and÷or (mild) microcytic anaemia, also at older age.
Smith, Jennifer L; Brooker, Simon
To summarise age- and intensity-stratified associations between human hookworm infection and anaemia and to quantify the impact of treatment with the benzimidazoles, albendazole and mebendazole, on haemoglobin and anaemia in non-pregnant populations. Electronic databases (MEDLINE, EMBASE, PubMed) were searched for relevant studies published between 1980 and 2009, regardless of language, and researchers contacted about potential data. Haemoglobin concentration (Hb) was compared between uninfected individuals and individuals harbouring hookworm infections of different intensities, expressed as standardised mean differences (SMD) and 95% confidence intervals (CI). Meta-analysis of randomised control trials (RCTs) investigated the impact of treatment on Hb and anaemia. Twenty-three cross-sectional studies, six pre- and post-intervention studies and 14 trials were included. Among cross-sectional studies, moderate- and heavy-intensity hookworm infections were associated with lower Hb in school-aged children, while all levels of infection intensity were associated with lower Hb in adults. Among RCTs using albendazole, impact of treatment corresponded to a 1.89 g/l increase (95%CI: 0.13-3.63) in mean Hb while mebendazole had no impact. There was a positive impact of 2.37 g/l (95%CI: 1.33-3.50) on mean Hb when albendazole was co-administered with praziquantel, but no apparent additional benefit of treatment with benzimidazoles combined with iron supplementation. The mean impact of treatment with benzimidazoles alone on moderate anaemia was small (relative risk (RR) 0.87) with a larger effect when combined with praziquantel (RR 0.61). Anaemia is most strongly associated with moderate and heavy hookworm infection. The impact of anthelmintic treatment is greatest when albendazole is co-administered with praziquantel.
Joseph O Mugisha
Full Text Available BACKGROUND: Studies conducted in high income countries have shown that anaemia is a common medical condition among older people, but such data are scarce in Africa. The objectives of this study were to estimate the prevalence, types, risk factors and clinical correlates of anaemia in older people. METHODS: Participants were aged (≥ 50 years recruited from a general population cohort from January 2012 to January 2013. Blood samples were collected for assessing hemoglobin, serum ferritin, serum vitamin B12, serum folate, C-reactive protein, malaria infection and stool samples for assessment of hookworm infection. HIV status was assessed using an algorithm for HIV rapid testing. Questionnaires were used to collect data on sociodemographic characteristics and other risk factors for anaemia. RESULTS: In total, 1449 people participated (response rate 72.3%. The overall prevalence of anaemia was 20.3 % (95% CI 18.2-22.3%, and this was higher for males (24.1%, 95% CI=20.7-27.7% than females (17.5%, 95% CI=15.0-20.1%. In males, the prevalence of anaemia increased rapidly with age almost doubling between 50 and 65 years (p-trend<0.001. Unexplained anaemia was responsible for more than half of all cases (59.7%. Anaemia was independently associated with infections including malaria (OR 3.49, 95% CI 1.78-6.82, HIV (OR 2.17, 1.32-3.57 heavy hookworm infection (OR 3.45, 1.73-6.91, low fruit consumption (OR 1.55, 1.05-2.29 and being unmarried (OR 1.37 , 95% CI 1.01-1.89. However, the odds of anaemia were lower among older people with elevated blood pressure (OR 0.47, 95% CI 0.29-0.77. CONCLUSION: Anaemia control programmes in Uganda should target older people and should include interventions to treat and control hookworms and educational programs on diets that enhance iron absorption. Clinicians should consider screening older people with HIV or malaria for anaemia. Further studies should be done on unexplained anaemia and serum ferritin levels that predict
Nybo, M; Kristensen, S R; Mickley, H
the prevalence of renal affection, smoking and heart failure was lower. At 6 months follow-up, 23 patients were dead, and anaemia had an odds ratio of 4.7 when adjusted for age, Scandinavian Stroke Scale and a combined variable of heart and/or renal failure and/or elevation of troponin T using logistic...... regression. The median NT-proBNP level in the anaemic group was significantly higher than in the non-anaemic group, and in a multivariate linear regression model, anaemia remained an independent predictor of NT-proBNP. Conclusively, anaemia was found to be a negative prognostic factor for ischemic stroke...
Mohamed, M; Bates, G; Richardson, D; Burrows, L
A 60-year-old woman was diagnosed with non-severe aplastic anaemia when she presented with anaemia and thrombocytopenia. She developed recurrent life-threatening hypotensive reactions during transfusion of leukodepleted platelet concentrates, and washed platelet concentrates prevented the development of such reactions subsequently. A paroxysmal nocturnal haemoglobinuria clone was detected on investigating for aplastic anaemia, which has been speculated to play a role in the recurrent hypotensive reactions. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.
Law, B.E.; Spencer, C.W.
Abnormal pressures, pressures above or below hydrostatic pressures, occur on all continents in a wide range of geological conditions. According to a survey of published literature on abnormal pressures, compaction disequilibrium and hydrocarbon generation are the two most commonly cited causes of abnormally high pressure in petroleum provinces. In young (Tertiary) deltaic sequences, compaction disequilibrium is the dominant cause of abnormal pressure. In older (pre-Tertiary) lithified rocks, hydrocarbon generation, aquathermal expansion, and tectonics are most often cited as the causes of abnormal pressure. The association of abnormal pressures with hydrocarbon accumulations is statistically significant. Within abnormally pressured reservoirs, empirical evidence indicates that the bulk of economically recoverable oil and gas occurs in reservoirs with pressure gradients less than 0.75 psi/ft (17.4 kPa/m) and there is very little production potential from reservoirs that exceed 0.85 psi/ft (19.6 kPa/m). Abnormally pressured rocks are also commonly associated with unconventional gas accumulations where the pressuring phase is gas of either a thermal or microbial origin. In underpressured, thermally mature rocks, the affected reservoirs have most often experienced a significant cooling history and probably evolved from an originally overpressured system.
Full Text Available BACKGROUND: Iron-refractory iron deficiency anaemia (IRIDA is a rare disorder which was linked to mutations in two genes (SLC11A2 and TMPRSS6. Common polymorphisms within these genes were associated with serum iron levels. We identified a family of Serbian origin with asymptomatic non-consanguineous parents with three of four children presenting with IRIDA not responding to oral but to intravenous iron supplementation. After excluding all known causes responsible for iron deficiency anaemia we searched for mutations in SLC11A2 and TMPRSS6 that could explain the severe anaemia in these children. METHODOLOGY/RESULTS: We sequenced the exons and exon-intron boundaries of SLC11A2 and TMPRSS6 in all six family members. Thereby, we found seven known and fairly common SNPs, but no new mutation. We then genotyped these seven SNPs in the population-based SAPHIR study (n = 1,726 and performed genetic association analysis on iron and ferritin levels. Only two SNPs, which were top-hits from recent GWAS on iron and ferritin, exhibited an effect on iron and ferritin levels in SAPHIR. Six SAPHIR participants carrying the same TMPRSS6 genotypes and haplotype-pairs as one anaemic son showed lower ferritin and iron levels than the average. One individual exhibiting the joint SLC11A2/TMPRSS6 profile of the anaemic son had iron and ferritin levels lying below the 5(th percentile of the population's iron and ferritin level distribution. We then checked the genotype constellations in the Nijmegen Biomedical Study (n = 1,832, but the profile of the anaemic son did not occur in this population. CONCLUSIONS: We cannot exclude a gene-gene interaction between SLC11A2 and TMPRSS6, but we can also not confirm it. As in this case candidate gene sequencing did not reveal causative rare mutations, the samples will be subjected to whole exome sequencing.
The anti-reenactment 'Show-Bix &' consists of 5 dias projectors, a dial phone, quintophonic sound, and interactive elements. A responsive interface will enable the Dias projectors to show copies of original dias slides from the Show-Bix piece ”March på Stedet”, 265 images in total. The copies are...
Hoppenbrouwers, Sylco S; De Jesus, Danilo R; Sun, Yinming; Stirpe, Tania; Hofman, Dennis; McMaster, Jeff; Hughes, Ginny; Daskalakis, Zafiris J; Schutter, Dennis J L G
Psychopathic offenders inevitably violate interpersonal norms and frequently resort to aggressive and criminal behaviour. The affective and cognitive deficits underlying these behaviours have been linked to abnormalities in functional interhemispheric connectivity. However, direct neurophysiological evidence for dysfunctional connectivity in psychopathic offenders is lacking. We used transcranial magnetic stimulation combined with electroencephalography to examine interhemispheric connectivity in the dorsolateral and motor cortex in a sample of psychopathic offenders and healthy controls. We also measured intracortical inhibition and facilitation over the left and right motor cortex to investigate the effects of local cortical processes on interhemispheric connectivity. We enrolled 17 psychopathic offenders and 14 controls in our study. Global abnormalities in right to left functional connectivity were observed in psychopathic offenders compared with controls. Furthermore, in contrast to controls, psychopathic offenders showed increased intracortical inhibition in the right, but not the left, hemisphere. The relatively small sample size limited the sensitivity to show that the abnormalities in interhemispheric connectivity were specifically related to the dorsolateral prefrontal cortex in psychopathic offenders. To our knowledge, this study provides the first neurophysiological evidence for abnormal interhemispheric connectivity in psychopathic offenders and may further our understanding of the disruptive antisocial behaviour of these offenders.
Burisch, Johan; Vegh, Zsuzsanna; Katsanos, Konstantinnos H; Christodoulou, Dimitrios K; Lazar, Daniela; Goldis, Adrian; O'Morain, Colm; Fernandez, Alberto; Pereira, Santos; Myers, Sally; Sebastian, Shaji; Pedersen, Natalia; Olse, Jóngerð; Rubek Nielsen, Kári; Schwartz, Doron; Odes, Selwyn; Almer, Sven; Halfvarson, Jonas; Turk, Niksa; Cukovic-Cavka, Silvja; Nikulina, Inna; Belousova, Elena; Duricova, Dana; Bortlik, Martin; Shonová, Olga; Salupere, Riina; Barros, Louisa; Magro, Fernando; Jonaitis, Laimas; Kupcinskas, Limas; Turcan, Svetlana; Kaimakliotis, Ioannis; Ladefoged, Karin; Kudsk, Karen; Andersen, Vibeke; Vind, Ida; Thorsgaard, Niels; Oksanen, Pia; Collin, Pekka; Dal Piaz, Giulia; Santini, Alessia; Niewiadomski, Ola; Bell, Sally; Moum, Bjørn; Arebi, Naila; Kjeldsen, Jens; Carlsen, Katrine; Langholz, Ebbe; Lakatos, Peter Laszlo; Munkholm, Pia; Gerdes, Lars Ulrik; Dahlerup, Jens Frederik
Anaemia is an important complication of inflammatory bowel disease [IBD]. The aim of this study was to determine the prevalence of anaemia and the practice of anaemia screening during the first year following diagnosis, in a European prospective population-based inception cohort. Newly diagnosed IBD patients were included and followed prospectively for 1 year in 29 European and one Australian centre. Clinical data including demographics, medical therapy, surgery and blood samples were collected. Anaemia was defined according to the World Health Organization criteria. A total of 1871 patients (Crohn's disease [CD]: 686, 88%; ulcerative colitis [UC]: 1,021, 87%; IBD unclassified [IBDU] 164. 81%) were included in the study. The prevalence of anaemia was higher in CD than in UC patients and, overall, 49% of CD and 39% of UC patients experienced at least one instance of anaemia during the first 12 months after diagnosis. UC patients with more extensive disease and those from Eastern European countries, and CD patients with penetrating disease or colonic disease location, had higher risks of anaemia. CD and UC patients in need of none or only mild anti-inflammatory treatment had a lower risk of anaemia. In a significant proportion of patients, anaemia was not assessed until several months after diagnosis, and in almost half of all cases of anaemia a thorough work-up was not performed. Overall, 42% of patients had at least one instance of anaemia during the first year following diagnosis. Most patients were assessed for anaemia regularly; however, a full anaemia work-up was frequently neglected in this community setting. Copyright © 2017 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: email@example.com
David Enrique Aguilar Rodriguez
Full Text Available Fanconi anaemia (FA is a recessive autosomal disease determined by mutations in genes of at least eleven complementation groups, with distinct distributions in different populations. As far as we know, there are no reports regarding the molecular characterisation of the disease in unselected FA patients in Brazil. OBECTIVE: This study aimed to investigate the most prevalent mutations of FANCA and FANCC genes in Brazilian patients with FA. METHODS: Genomic DNA obtained from 22 racially and ethnically diverse unrelated FA patients (mean age ± SD: 14.0 ± 7.8 years; 10 male, 12 female; 14 white, 8 black was analysed by polymerase chain reaction and restriction site assays for identification of FANCA (delta3788-3790 and FANCC (delta322G, IVS4+4A -> T, W22X, L496R, R548X, Q13X, R185X, and L554P gene mutations. RESULTS: Mutations in FANCA and FANCC genes were identified in 6 (27.3% and 14 (63.6% out of 22 patients, respectively. The disease could not be attributed to the tested mutations in the two remaining patients enrolled in the study (9.1%. The registry of the two most prevalent gene abnormalities (delta3788-3790 and IVS4 + 4 -> T revealed that they were present in 18.2% and 15.9% of the FA alleles, respectively. Additional FANCC gene mutations were found in the study, with the following prevalence: delta322G (11.4%, W22X (9.1%, Q13X (2.3%, L554P (2.3%, and R548X (2.3% of total FA alleles. CONCLUSION: These results suggest that mutations of FANCA and FANCC genes are the most prevalent mutations among FA patients in Brazil.
Buhari Hauwa Ali
Full Text Available Objective: To investigate the prevalence and socio-demographic factors associated with iron deficiency anaemia among blood donors in Sokoto, North Western, Nigeria using a combination of haemoglobin haematocrit and serum ferritin measurements. Methods: One hundred and fifty consecutively recruited whole blood donors, comprising of 148 (98.7% family replacement donors and 2 (1.3% voluntary non-remunerated donors aged 18-60 years and mean age 39±21 years constituted the subjects for this study. The full blood count was carried out using Mythic 22 CT fully automated haematology analyser (Orphee SA, Switzerland. Serum was tested for ferritin using a human ferritin enzyme immunoassay kitACCU Diag™ ELISA Ferritin kit (Diagnostic Automation/Cortez Diagnostic Inc. California, USA. Results: The prevalence of anaemia (haemoglobin<11.0 g/dL was evident in 24 (16% and iron deficiency anaemia (serum ferritin<12 ng/mL+haemoglobin<11 g/dL in 5 (10% of donors. The haemoglobin and ferritin levels was significantly lower among regular voluntary remunerated blood donors (13.50±0.00 and 34.88±0.00 compared to family replacement donors (14.10±2.40 and 74.12±45.20 respectively (P=0.01 and 0.05 respectively. The mean haemoglobin and ferritin level was compared among donors based on gender. The haemoglobin and ferritin was significantly higher among male donors (14.20±2.00, 78.02±49.10 compared to female donors (12.35±2.5 and 42.20±32.13 (P=0.01. The mean haemoglobin and ferritin level was compared among donors based on occupational groups. The haemoglobin and ferritin was significantly higher among civil servants compared to farmers and students (P=0.01. Conclusions: Iron deficiency anaemia is prevalent among blood donors in Sokoto, North Western, Nigeria. There is need to include routine ferritin in the blood donor testing protocol in the area to enable the diagnosis of donors with latent iron deficiency anaemia to facilitate iron supplementation for
BACKGROUND: The simultaneous occurrence of cardiovascular disease (CVD), kidney disease, and anaemia is associated with increased morbidity and mortality. In the community setting, little data exists about the risk associated with milder levels of anaemia when it is present concurrently with CVD and chronic kidney disease (CKD). The aim of this study was to establish the prevalence of CKD and anaemia in patients with CVD in the community and to examine whether the presence of anaemia was associated with increased morbidity and mortality. METHODS: This study was designed as a retrospective cohort study and involved a random sample of 35 general practices in the West of Ireland. A practice-based sample of 1,609 patients with established cardiovascular disease was generated in 2000\\/2001 and followed for five years. The primary endpoint was death from any cause. Statistical analysis involved using one-way ANOVA and Chi-squared tests for baseline data and Cox proportional-hazards models for mortality data. RESULTS: Of the study sample of 617 patients with blood results, 33% (n = 203) had CKD while 6% (n = 37) had CKD and anaemia. The estimated risk of death from any cause, when compared to patients with cardiovascular disease only, was almost double (HR = 1.98, 95% CI 0.99 to 3.98) for patients with both CVD and CKD and was over 4 times greater (HR = 4.33, 95% CI 1.76 to 10.68) for patients with CVD, CKD and anaemia. CONCLUSION: In patients with cardiovascular disease in the community, chronic kidney disease and anaemia occur commonly. The presence of chronic kidney disease carries an increased mortality risk which increases in an additive way with the addition of anaemia. These results suggest that early primary care diagnosis and management of this high risk group may be worthwhile.
Senadheera, D; Goonewardene, M; Mampitiya, I
In Sri Lanka the current prevalence of anaemia during pregnancy is estimated to be less than 20%. To determine the rate of anaemia defined as hemoglobin concentration < 11 g/dl, and the rate of iron deficiency using the best cut off level of serum ferritin, in women presenting for antenatal care. Three hundred and fifty consecutive pregnant women with gestations between 12 to 20 weeks, presenting to the Academic Obstetric Unit at the Teaching Hospital Mahamodera, Galle, Sri Lanka from 10.11.2014 to 13.01.2015 had their heamoglobin and hematocrit measured by flowcytometry and hydro-dynamic focusing methods using a Sysmex- XS-500i System and serum ferritin measured by electro-chemiluminescence method using a Cobas-e411 Analyzer. The rate of anaemia was calculated. The best cut off level of serum ferritin for the detection of anaemia was obtained using a Receiver Operator Characteristics (ROC) curve, and using this cut off, the rate of iron deficiency was calculated. The rate of anaemia was 16.6%. The best cut off level of serum ferritin for the detection of anaemia was < 30 μg/L (the area under the ROC curve was 0.77; 95% CI -0.72 to0.81), with a sensitivity of 78.3% (95% CI 65.8 - 87.9) and a specificity of 74% (95% CI 68.6 -79.0) in detecting anaemia. Using this cut off, 36.9% of the pregnant women had iron deficiency. Rates of anaemia (16.6%) and iron deficiency (36.9%) in pregnancy are at levels of mild to moderate public health significance respectively.
Jans, Ø; Nielsen, C S; Khan, N
BACKGROUND AND OBJECTIVES: Preoperative anaemia is prevalent in elderly patients scheduled for major orthopaedic surgery and is associated with increased transfusion risk and postoperative morbidity. New guidelines recommend preoperative correction of anaemia and iron deficiency in all patients......-five (10·8%) and 243 (27·6%) of the study population were WHO anaemic or had a Hb Transfusion was more common in anaemic vs. non-anaemic patients 43 vs. 13%; (P 13 g/dl 28 vs. 11% (P
Jahnavi Daru, MBBS
Full Text Available Summary: Background: Anaemia affects as many as half of all pregnant women in low-income and middle-income countries, but the burden of disease and associated maternal mortality are not robustly quantified. We aimed to assess the association between severe anaemia and maternal death with data from the WHO Multicountry Survey on maternal and newborn health. Methods: We used multilevel and propensity score regression analyses to establish the relation between severe anaemia and maternal death in 359 health facilities in 29 countries across Latin America, Africa, the Western Pacific, eastern Mediterranean, and southeast Asia. Severe anaemia was defined as antenatal or postnatal haemoglobin concentrations of less than 70 g/L in a blood sample obtained before death. Maternal death was defined as death any time after admission until the seventh day post partum or discharge. In regression analyses, we adjusted for post-partum haemorrhage, general anaesthesia, admission to intensive care, sepsis, pre-eclampsia or eclampsia, thrombocytopenia, shock, massive transfusion, severe oliguria, failure to form clots, and severe acidosis as confounding variables. These variables were used to develop the propensity score. Findings: 312 281 women admitted in labour or with ectopic pregnancies were included in the adjusted multilevel logistic analysis, and 12 470 were included in the propensity score regression analysis. The adjusted odds ratio for maternal death in women with severe anaemia compared with those without severe anaemia was 2·36 (95% CI 1·60–3·48. In the propensity score analysis, severe anaemia was also associated with maternal death (adjusted odds ratio 1·86 [95% CI 1·39–2·49]. Interpretation: Prevention and treatment of anaemia during pregnancy and post partum should remain a global public health and research priority. Funding: Barts and the London Charity.
Liang, Christine; Morris, Andrea; Schlücker, Sebastian; Imoto, Kyoko; Price, Vera H; Menefee, Emory; Wincovitch, Stephen M; Levin, Ira W; Tamura, Deborah; Strehle, Katrin R; Kraemer, Kenneth H; DiGiovanna, John J
We examined hair from 15 patients with trichothiodystrophy (TTD), a rare inherited disorder with brittle, cystine-deficient hair. They had a wide variety of phenotypes, from brittle hair only to severe intellectual impairment and developmental delay. Polarizing light microscopic examination showed alternating light and dark (tiger tail) bands under polarizing microscopy. Confocal microscopy captured structural features of breaks in intact TTD hairs. The autofluorescent appearance was regular and smooth in normal donors and markedly irregular in sections of TTD hairs possibly reflecting abnormalities in melanin distribution. Scanning electron microscopy revealed numerous surface irregularities. All TTD hair samples had reduced sulfur content. We observed an inverse correlation (R(val)=0.9) between sulfur content and percent of hairs with shaft abnormalities (trichoschisis, trichorrhexis nodosa, or ribbon/twist). There was no association between clinical disease severity and percent of abnormal hairs. Raman spectra of hairs from TTD patients and normal donors revealed a larger contribution of energetically less favored disulfide conformers in TTD hairs. Our data indicate that the brittleness of the TTD hair is dependent upon abnormalities at several levels of organization. These changes make TTD hairs excessively prone to breakage and weathering.
Isobe, Yusuke; Uchida, Shunsuke; Fujimori, Haruo.
The present invention provides a method and a device capable of detecting abnormal symptoms of equipments having failed portions and portions to be repaired and requiring concentrated monitoring in a plant during operation, for example, nuclear power plants, in an early stage without losing reliability. Namely, the abnormality of the plant is judged based on the comparison of plant operation parameters and their allowable values in the method of monitoring plant abnormality. In this case, the allowable values of the plant operation parameters allowed to be changed based on the information on the state of equipments which shows the state of constitutional equipments of the plant. In addition, when a measured plant operation parameter exceeds the allowable value of each of the previously set plant operation parameters, allowable values of other plant operation parameters having relation with the plant operation parameters can be changed. According to the present invention, since the allowable range of the plant operation parameters for the equipments to be repaired and failed equipments can be made narrower than that of ordinary equipments, abnormal symptoms can be detected on the normal side in an early stage. (I.S.)
Wylde, Vikki; Palmer, Shea; Learmonth, Ian D; Dieppe, Paul
The aim of this study was to use quantitative sensory testing (QST) to explore the range and prevalence of somatosensory abnormalities demonstrated by patients with advanced knee OA. One hundred and seven knee OA patients and 50 age- and sex-matched healthy participants attended a 1-h QST session. Testing was performed on the medial side of the knee and the pain-free forearm. Light-touch thresholds were assessed using von Frey filaments, pressure pain thresholds using a digital pressure algometer, and thermal sensation and pain thresholds using a Thermotest MSA. Significant differences in median threshold values from knee OA patients and healthy participants were identified using Mann-Whitney U-tests. The z-score transformations were used to determine the prevalence of the different somatosensory abnormalities in knee OA patients. Testing identified 70% of knee OA patients as having at least one somatosensory abnormality. Comparison of median threshold values between knee OA patients and healthy participants revealed that patients had localized thermal and tactile hypoaesthesia and pressure hyperalgesia at the osteoarthritic knee. Tactile hypoaesthesia and pressure hyperalgesia were also present at the pain-free forearm. The most prevalent somatosensory abnormalities were tactile hypoaesthesia and pressure hyperalgesia, evident in between 20 and 34% of patients. This study found that OA patients demonstrate an array of somatosensory abnormalities, of which the most prevalent were tactile hypoaesthesia and pressure hyperalgesia. Further research is now needed to establish the clinical implications of these somatosensory abnormalities.
Burisch, Johan; Vegh, Zsuzsanna; Katsanos, Konstantinnos H.
with more extensive disease and those from Eastern European countries, and CD patients with penetrating disease or colonic disease location, had higher risks of anaemia. CD and UC patients in need of none or only mild anti-inflammatory treatment had a lower risk of anaemia. In a significant proportion......Background and aims: Anaemia is an important complication of inflammatory bowel disease (IBD). The aim of this study was to determine the prevalence of anaemia and the practice of anaemia screening during the first year following diagnosis in a European prospective population-based inception cohort....... Methods: Newly diagnosed IBD patients were included and followed prospectively for one year in 29 European and 1 Australian centre. Clinical data including demographics, medical therapy, surgery and blood samples were collected. Anaemia was defined according to the World Health Organization. Results...
Kasfiki, A.G.; Antipas, S.E.; Dimitriou, P.A.; Gritzali, F.A.; Melissinos, K.G.
The parameters of 51 Cr labelled red cell survival curves were calculated in 26 patients with homozygous β-thalassaemia, 8 with sickle-cell anaemia and 3 with s-β-thalassaemia, using a non-linear weighted least squares analysis computer program. In thalassaemic children the calculated parameters denote that the shorting of the mean cell life is due to early senescence alone, while there is some evidence that in thalassaemic adults additional extracellular destruction mechanisms participate as well. Red cell survival curves from patients with sickle-cell anaemia and s-β-thalassaemia resemble each other, while their parameters indicate an initial rapid loss of radioactivity, early senescence and the presence of extracellular red cell destruction factors. (orig.)
Autoimmune haemolytic anaemias (AIHAs) are well-characterized disorders. They can be differentiated from one another and from other non-immune haemolytic anaemias by clinical, laboratory and serological testing. However, several misleading clinical presentations and/or serological findings may result in misinterpretation, delay and/or misdiagnosis. Such failures are avoidable by adequate clinical and serological experience of the responsible physicians and serologists or, at least, by an optimised bidirectional communication. As long as this has not been achieved, unpleasant failures are to be expected. A true diagnosis of AIHA can neither be verified by clinical nor serological findings alone. Thus, a collective clinical and serological picture remains obligatory for fulfilling the criteria of optimal diagnosis and therapy. Ultimately, the majority of pioneer scientific and practical work in this field stems from scientists who were simultaneously involved in both the clinic and serology.
Necrotizing fasciitis (NF) is an uncommon soft-tissue infection in children that carries a high mortality rate. We present a 15-year-old girl with chronic pancytopenia secondary to Fanconi anaemia who developed extensive NF of the lower limb, which unfortunately resulted in a fatal outcome. Immunodeficiency is a known risk factor for the development of this condition. The findings in this case demonstrate that patients with Fanconi anaemia may be susceptible to NF and that the clinical course may be more aggressive due to underlying immunosuppression. Prompt diagnosis of NF is vital in order to initiate appropriate treatment and to optimize patient outcome. Radiological investigation demonstrated extensive soft-tissue gas and destruction affecting the entire lower limb, abdominal wall and retroperitoneum, which led to timely definitive diagnosis and management.
O' Regan, Kevin; Maher, Michael M. [Mercy University Hospital, Department of Radiology, Cork (Ireland); Cork University Hospital, Department of Radiology, Cork (Ireland); O' Mahony, Edward; MacEneaney, Peter; Fitzgerald, Edward [Mercy University Hospital, Department of Radiology, Cork (Ireland)
Necrotizing fasciitis (NF) is an uncommon soft-tissue infection in children that carries a high mortality rate. We present a 15-year-old girl with chronic pancytopenia secondary to Fanconi anaemia who developed extensive NF of the lower limb, which unfortunately resulted in a fatal outcome. Immunodeficiency is a known risk factor for the development of this condition. The findings in this case demonstrate that patients with Fanconi anaemia may be susceptible to NF and that the clinical course may be more aggressive due to underlying immunosuppression. Prompt diagnosis of NF is vital in order to initiate appropriate treatment and to optimize patient outcome. Radiological investigation demonstrated extensive soft-tissue gas and destruction affecting the entire lower limb, abdominal wall and retroperitoneum, which led to timely definitive diagnosis and management. (orig.)
Necrotizing fasciitis (NF) is an uncommon soft-tissue infection in children that carries a high mortality rate. We present a 15-year-old girl with chronic pancytopenia secondary to Fanconi anaemia who developed extensive NF of the lower limb, which unfortunately resulted in a fatal outcome. Immunodeficiency is a known risk factor for the development of this condition. The findings in this case demonstrate that patients with Fanconi anaemia may be susceptible to NF and that the clinical course may be more aggressive due to underlying immunosuppression. Prompt diagnosis of NF is vital in order to initiate appropriate treatment and to optimize patient outcome. Radiological investigation demonstrated extensive soft-tissue gas and destruction affecting the entire lower limb, abdominal wall and retroperitoneum, which led to timely definitive diagnosis and management.
Stein, J M; Hartmann, F; Cordes, H-J; Dignass, A U
Anaemia is the most frequent extraenteric complication of inflammatory bowel disease (IBD, Crohn's disease and ulcerative colitis). A disabling complication of IBD, anaemia worsens the patient's general condition and quality of life, and increases hospitalization rates. The main types of anemia in IBD are iron deficiency anemia and anemia of chronic disease. The combination of the serum transferrin receptor with ferritin concentrations and inflammatory markers allows a reliable assessment of the iron status. Iron deficiency is usually treated with oral iron supplements. However, it is less effective in IBD and may lead to an increased inflammatory activity through the generation of reactive oxygen species. A systematic review of anemia in IBD, its pathogenetic features, epidemiology, diagnosis and therapy based on the evidence from recent studies will be the focus of this article.
Odetunde, Odutola Israel; Chinawa, Josephat Maduabuchi; Achigbu, Kingsley Ihedioha; Achigbu, Eberechukwu O
The objectives of this study were to determine the anthropometric variables of children with sickle cell anaemia and comparing it with those with normal haemoglobin genotype. A cross sectional study of anthropometric measurements was conducted over a period of six months. Children with sickle cell anaemia in steady state aged between 6-20 years were recruited. Nutritional assessment was done using anthropometrical variables. Data were analyzed using the Statistical Package for Social Sciences program (SPSS), version 20. The sickle cell patients comprised of 20 males and 20 females. There were an equal number of controls with an equal male to female ratio of 1:1. Forty eight percent (19) of the children with sickle cell anemia were underweight (sickle cell anemia were low when compared with children with normal Haemoglobin genotype.
Jáuregui-Renaud, K; Domínguez-Rubio, B; Ibarra-Olmos, A; González-Bárcena, D
To assess the auditory and vestibular function in patients with diabetes. We studied and followed for three years, 10 patients (6 females) of 20.6 years of age (SD 5.5 years), with insulindependent diabetes mellitus of 9.5 years (SD 3.7 years). The patients were selected for having peripheral neuropathy without prolipherative retinopathy and otologic disease or individual factors which could cause neurootologic symptoms. Their glomerular filtration rate and renal plasma flow were 150 mL/min (SD 50) and 543 mL/min (SD 113). Initially all patients had normal audiologic responses, including auditory brainstem responses, but had abnormally and simetrically diminished horizontal vestibulo-ocular responses. A year later one patient had vertigo and asymmetric vestibulo-ocular responses. In the third year, another patient showed similar abnormalities and a third one showed sensorineural hearing loss. Our results suggest that patients with insulindependent diabetes mellitus may suffer neuro-otological deterioration.
Moore, Mitzi Ruth
Proposes having students perform skits in which they play the roles of the science concepts they are trying to understand. Provides the dialog for a skit in which hot and cold gas molecules are interviewed on a talk show to study how these properties affect wind, rain, and other weather phenomena. (MDH)
Schwartz, Peter J; Stramba-Badiale, Marco
The recognition of ventricular repolarization abnormalities in the newborn carries several and significant implications, because it calls attention to the possibility of dealing with an infant affected by the long QT syndrome (LQTS). This article provides key elements for the correct measurement of the QT interval in newborns and succinctly reviews some aspects of the disease. It gives normative values on the QT interval distribution in the first month of life based on a prospective study in more than 44,000 infants. It shows the probability, based on the QTc observed in two recordings, to find disease-causing mutations. The data indicate clearly that widespread electrocardiographic screening in the newborn allows early identification of most, if not all, the infants affected by LQTS with marked QT prolongation and thus of those at higher risk for life-threatening arrhythmias and sudden death. Through the affected infants, it becomes possible to identify the family members affected by LQTS, including the "silent mutation carriers"; our study shows that disease-causing mutations are found in 51% of the family members. Because early recognition leads to the implementation of effective preventive strategies, it follows that electrocardiographic screening will avoid preventable deaths either in the first year of life when they are usually labeled as "sudden infant death syndrome" or later in life. The case is made for medicolegal implications whenever neonatologists and pediatricians fail to inform the parents of a newborn child of the prevalence of LQTS (one in 2000), of the effectiveness of existing therapies, and of the diagnosis with a simple electrocardiogram.
Recurrent gastrointestinal haemorrhage is an uncommon manifestation of systemic sclerosis. We report a case of gastrointestinal bleeding due to gastric antral vascular ectasia (GAVE) in a patient with systemic sclerosis. Failure to recognise the condition as a cause of gastrointestinal bleeding may delay the instigation of appropriate treatment. GAVE should be considered in the differential diagnosis of anaemia in patients with autoimmune conditions such as systemic sclerosis and primary biliary cirrhosis.
Fanconi’s Anaemia is a rare autosomal recessive disease for which the incidence of head and neck cancer can be increased 700-fold1. We report a case of a 31-year old Caucasian male with FA who initially presented in July 2007 with oral squamous cell carcinoma for which he received radical surgery and radiotherapy. He was disease-free until August 2015 when he presented with an extremely aggressive recurrence.
Parker Jacqui A; Barroso Filipa; Stanworth Simon J; Spiby Helen; Hopewell Sally; Doree Carolyn J; Renfrew Mary J; Allard Shubha
Abstract Background Anaemia, in particular due to iron deficiency, is common in pregnancy with associated negative outcomes for mother and infant. However, there is evidence of significant variation in management. The objectives of this review of systematic reviews were to analyse and summarise the evidence base, identify gaps in the evidence and develop a research agenda for this important component of maternity care. Methods Multiple databases were searched, including MEDLINE, EMBASE and Th...
Ou, S-C; Lin, H-L; Liu, P-C; Huang, H-J; Lee, M-S; Lien, Y-Y; Tsai, Y-L
Chicken infectious anaemia (CIA) is a disease with a highly economic impact in the poultry industry. The infected chickens are characterized by aplastic anaemia and extreme immunosuppression, followed by the increased susceptibility to secondary infectious pathogens and suboptimal immune responses for vaccination. Commercially available CIA vaccines are routinely used in the breeders in Taiwan to protect their progeny with maternal-derived antibodies. However, CIA cases still occur in the field and little is known about the genetic characteristics of Taiwanese chicken anaemia viruses (CAVs). In this study, CAV DNA was detected in 72 of 137 flocks collected during 2010-2015. Among the PCR-positive samples, the coding regions of 51 CAVs were sequenced. Phylogenetic analysis of the VP1 gene revealed that, although most of Taiwanese CAVs belonged to genotypes II and III, some isolates were clustered into a novel genotype (genotype IV). Moreover, a Taiwanese isolate in this novel genotype IV appeared to be derived from a recombination event between genotypes II and III viruses. Five Taiwanese CAV isolates were highly similar to the vaccine strains, 26P4 or Del-Ros. Taken together, these results indicate that the sequences of CAVs in Taiwan are variable, and inter-genotypic recombination had occurred between viruses of different genotypes. Moreover, vaccine-like strains might induce clinical signs of CIA in chickens. Our findings could be useful for understanding the evolution of CAVs and development of a better control strategy for CIA. © 2018 Blackwell Verlag GmbH.
Luczyński, Włodzimierz; Muszyńska-Rosłan, Katarzyna; Krawczuk-Rybak, Maryna; Lebensztejn, Dariusz M
We present history of 16-year-old boy, HBsAg carrier, treated with interferon alpha at the age of 6 because of hepatitis B (HBeAg/antyHBe seroconversion). In August 2002--admitted to Department of Pediatric Oncology due to pancytopenia--diagnosis of severe aplastic anaemia was made (bone marrow cellularity--10%). We found no relative donor for hematopoietic cells transplantation and started immunosuppresive therapy (ATG, G-CSF, methyloprednisolon, cyclosporin). Haematologic parameters were improving. At day +60 he was admitted to our Department due to the increase in aminotransferases and cyclosporin activity. He was treated with cefuroxim, acyclovir and drugs improving liver cell function, cyclosporin was stopped. Presence of HBV DNA in serum confirmed HBV reactivation--a boy received lamivudine and cyclosporin again (as a maintenance therapy of aplastic anaemia). Aminotransferase activity and haematological parameters returned to normal. This case indicates the possibility of HBV reactivation in the course of immunosuppressive therapy (e.g. after antithymocytic globulin and cyclosporin) for aplastic anaemia.
Viecelli, Andrea; Hessamodini, Hannah; Augustson, Bradley; Lim, Wai Hon
We report a case of a 57-year-old woman with type I diabetes who had received a simultaneous pancreas-kidney (SPK) transplant maintained on tacrolimus, mycophenolic acid (MPA) and prednisolone. Her renal allograft failed 6 years post-transplant but she continued to have a normal functioning pancreatic allograft. Over the course of 5 years, she developed progressive bone marrow failure with repeat bone marrow aspirates demonstrating an evolution from erythroid hypoplasia to hypocellular marrow and eventual aplastic anaemia despite discontinuation of MPA and reduction of tacrolimus. She was transfusion-dependent and had frequent admissions for sepsis. Despite treatment with antithymocyte globulin and cyclosporine for aplastic anaemia, she developed fatal invasive pulmonary aspergillosis within 3 weeks of treatment. Even though the cause of aplastic anaemia is likely multifactorial, this case highlights the difficulty in balancing the need for versus the risk of ongoing immunosuppression in a SPK transplant recipient who continues to have normal pancreatic graft function. 2014 BMJ Publishing Group Ltd.
Lee, Anselm C W
The underlying diagnosis of severe anaemic illnesses in children may not be easy to identify at times, especially when regular blood transfusion has been started. International children patients attending a haematology clinic for diagnostic evaluation were identified retrospectively if they had to receive repeated blood transfusions with an undiagnosed illness or an incorrect diagnosis. Their demographic data, presenting features, and eventual diagnosis were described. Twelve children including 7 boys were enrolled from March 2007 to August 2011. Five came from Vietnam; 2 each came from Bangladesh and Indonesia; and 1 each from Hong Kong, Myanmar, and Ukraine. Their illnesses started at a mean age of 1.5 years (0.1 to 6.6) and they had been receiving blood transfusion for a mean duration of 2.5 years (0.1 to 9.9) years prior to the evaluation. Thalassemia major was the fi rst diagnosis in 5 cases; one had been treated for autoimmune haemolytic anaemia while the rest had not been given a diagnosis. After the evaluation, 4 children were diagnosed with Diamond Blackfan anaemia, 3 were diagnosed with hereditary spherocytosis, and one each with hereditary pyropoikilocytosis, congenital sideroblastic anaemia, congenital thrombotic thrombocytopenic purpura, transient erythroblastopenia of childhood, and autoimmune myelofibrosis associated with human immunodeficiency virus infection. A definitive diagnosis can be identified in this cohort of children on medical tourism with severe anaemic illnesses requiring repeated transfusions with diagnostic approaches that circumvent the interference of transfused cells.
Karimzadeh, Mohammad Ali; Dehghani Firouzabadi, Razieh; Goharzad, Farzaneh
Abnormal uterine bleeding is a common presentation of uterine abnormalities among premenopausal and postmenopausal women. To evaluate and compare the diagnostic accuracy of saline contrast sonohysterography and hysteroscopy for detecting the cause of abnormal uterine bleeding. A total of 65 women with abnormal uterine bleeding were enrolled in this study. A prior saline contrast sonohysetrography followed by a hysteroscopy was performed in all cases. Sensitivity, specificity, positive and negative predictive value and test accuracy were calculated. As the most common abnormality, SCSH showed hyperplasia in 19 patients while hysteroscopy diagnosed polyp in 15 cases. A sensitivity of 73.3%, 71.4% and 90.9% were reported for polyp, hyperplasia and submucous myoma respectively whereas the specificity was calculated 96% for polyps, 82.3% for hyperplasia and 90.7% for submucous myoma. Comparing with hysteroscopy, sonohysterography showed a high sensitivity and specificity for detecting submucous myoma but not for endometrial polyp and endometrial hyperplasia.
The attention span of K-12 students is very short; they are used to digesting information in short snippets through social media and TV. To get the students interested in physics, we created the Physics Reality Show: a series of staged short videos with duration no longer than a few minutes. Each video explains and illustrates one physics concept or law through a fast-paced sequence of physics demonstrations and experiments. The cast consists entirely of physics undergraduate students with artistic abilities and substantial experience in showing physics demonstrations at current outreach events run by the department: Physics Shows and Physics & Engineering Festival. Undergraduate students are of almost the same age as their high-school audience. They are in the best position to connect with kids and convey their fascination with physics. The PI and other faculty members who are involved in the outreach advise and coach the cast. They help students in staging the episodes and choosing the most exciting and relevant demonstrations. Supported by the APS mini-outreach Grant.
Zwang, Julien; D'Alessandro, Umberto; Ndiaye, Jean-Louis; Djimdé, Abdoulaye A; Dorsey, Grant; Mårtensson, Andreas A; Karema, Corine; Olliaro, Piero L
Anaemia is common in malaria. It is important to quantitate the risk of anaemia and to distinguish factors related to the natural history of disease from potential drug toxicity. Individual-patient data analysis based on nine randomized controlled trials of treatments of uncomplicated falciparum malaria from 13 sub-Saharan African countries. Risk factors for reduced haemoglobin (Hb) concentrations and anaemia on presentation and after treatment were analysed using mixed effect models. Eight thousand eight hundred ninety-seven patients (77.0% <5 years-old) followed-up through 28 days treated with artemisinin combination therapy (ACT, 90%, n = 7968) or non-ACT. At baseline, under 5's had the highest risk of anaemia (77.6% vs. 32.8%) and higher parasitaemia (43,938 μl) than older subjects (2784 μl). Baseline anaemia increased the risk of parasitological recurrence. Hb began to fall after treatment start. In under 5's the estimated nadir was ~35 h (range 29-48), with a drop of -12.8% from baseline (from 9.8 g/dl to 8.7 g/dl, p = 0.001); in under 15's, the mean Hb decline between day 0-3 was -4.7% (from 9.4 to 9.0 g/dl, p = 0.001). The degree of Hb loss was greater in patients with high pre-treatment Hb and parasitaemia and with slower parasite reduction rates, and was unrelated to age. Subsequently, Hb increased linearly (+0.6%/day) until day 28, to reach +13.8% compared to baseline. Severe anaemia (<5 g/dl, 2 per 1000 patients) was transient and all patients recovered after day 14, except one case of very severe anaemia associated with parasite recurrence at day 28. There was no systematic difference in Hb concentrations between treatments and no case of delayed anaemia. On presentation with acute malaria young children with high parasitaemia have the highest risk of anaemia. The majority of patients experience a drop in Hb while on treatment as early as day 1-2, followed by a linear increase through follow-up. The degree of the early Hb dip is
Abanyie, Francisca A; McCracken, Courtney; Kirwan, Patrick; Molloy, Síle F; Asaolu, Samuel O; Holland, Celia V; Gutman, Julie; Lamb, Tracey J
Co-infection with malaria and intestinal parasites such as Ascaris lumbricoides is common. Malaria parasites induce a pro-inflammatory immune response that contributes to the pathogenic sequelae, such as malarial anaemia, that occur in malaria infection. Ascaris is known to create an anti-inflammatory immune environment which could, in theory, counteract the anti-malarial inflammatory immune response, minimizing the severity of malarial anaemia. This study examined whether Ascaris co-infection can minimize the severity of malarial anaemia. Data from a randomized controlled trial on the effect of antihelminthic treatment in Nigerian preschool-aged (6-59 months) children conducted in 2006-2007 were analysed to examine the effect of malaria and Ascaris co-infection on anaemia severity. Children were enrolled and tested for malaria, helminths and anaemia at baseline, four, and eight months. Six hundred and ninety subjects were analysed in this study. Generalized linear mixed models were used to assess the relationship between infection status and Ascaris and Plasmodium parasite intensity on severity of anaemia, defined as a haemoglobin less than 11 g/dL. Malaria prevalence ranged from 35-78% over the course of this study. Of the malaria-infected children, 55% were co-infected with Ascaris at baseline, 60% were co-infected four months later and 48% were co-infected eight months later, underlining the persistent prevalence of malaria-nematode co-infections in this population. Over the course of the study the percentage of anaemic subjects in the population ranged between 84% at baseline and 77% at the eight-month time point. The odds of being anaemic were four to five times higher in children infected with malaria compared to those without malaria. Ascaris infection alone did not increase the odds of being anaemic, indicating that malaria was the main cause of anaemia in this population. There was no significant difference in the severity of anaemia between children
Background Co-infection with malaria and intestinal parasites such as Ascaris lumbricoides is common. Malaria parasites induce a pro-inflammatory immune response that contributes to the pathogenic sequelae, such as malarial anaemia, that occur in malaria infection. Ascaris is known to create an anti-inflammatory immune environment which could, in theory, counteract the anti-malarial inflammatory immune response, minimizing the severity of malarial anaemia. This study examined whether Ascaris co-infection can minimize the severity of malarial anaemia. Methods Data from a randomized controlled trial on the effect of antihelminthic treatment in Nigerian preschool-aged (6–59 months) children conducted in 2006–2007 were analysed to examine the effect of malaria and Ascaris co-infection on anaemia severity. Children were enrolled and tested for malaria, helminths and anaemia at baseline, four, and eight months. Six hundred and ninety subjects were analysed in this study. Generalized linear mixed models were used to assess the relationship between infection status and Ascaris and Plasmodium parasite intensity on severity of anaemia, defined as a haemoglobin less than 11 g/dL. Results Malaria prevalence ranged from 35-78% over the course of this study. Of the malaria-infected children, 55% were co-infected with Ascaris at baseline, 60% were co-infected four months later and 48% were co-infected eight months later, underlining the persistent prevalence of malaria-nematode co-infections in this population. Over the course of the study the percentage of anaemic subjects in the population ranged between 84% at baseline and 77% at the eight-month time point. The odds of being anaemic were four to five times higher in children infected with malaria compared to those without malaria. Ascaris infection alone did not increase the odds of being anaemic, indicating that malaria was the main cause of anaemia in this population. There was no significant difference in the severity
Wrong, Terence; Baumgart, Erica
The authors of the preceding articles raise legitimate questions about patient and staff rights and the unintended consequences of allowing ABC News to film inside teaching hospitals. We explain why we regard their fears as baseless and not supported by what we heard from individuals portrayed in the filming, our decade-long experience making medical documentaries, and the full un-aired context of the scenes shown in the broadcast. The authors don't and can't know what conversations we had, what documents we reviewed, and what protections we put in place in each televised scene. Finally, we hope to correct several misleading examples cited by the authors as well as their offhand mischaracterization of our program as a "reality" show.
Kalifa A Bojang
Full Text Available In malaria endemic countries, children who have experienced an episode of severe anaemia are at increased risk of a recurrence of anaemia. There is a need to find ways of protecting these at risk children from malaria and chemoprevention offers a potential way of achieving this objective.During the 2003 and 2004 malaria transmission seasons, 1200 Gambian children with moderate or severe anaemia (Hb concentration <7 g/dL were randomised to receive either monthly sulfadoxine-pyrimethamine (SP or placebo until the end of the malaria transmission season in which they were enrolled, in a double-blind trial. All study subjects were treated with oral iron for 28 days and morbidity was monitored through surveillance at health centres. The primary endpoint was the proportion of children with moderate or severe anaemia at the end of the transmission season. Secondary endpoints included the incidence of clinical episodes of malaria during the surveillance period, outpatient attendances, the prevalence of parasitaemia and splenomegaly, nutritional status at the end of the malaria transmission season and compliance with the treatment regimen.The proportions of children with a Hb concentration of <7 g/dL at the end of the malaria transmission season were similar in the two study groups, 14/464 (3.0% in children who received at least one dose of SP and 16/471 (3.4% in those who received placebo, prevalence ratio 0.89 (0.44,1.8 P = 0.742. The protective efficacy of SP against episodes of clinical malaria was 53% (95% CI 37%, 65%. Treatment with SP was safe and well tolerated; no serious adverse events related to SP administration were observed. Mortality following discharge from hospital was low among children who received SP or placebo (6 in the SP group and 9 in the placebo group respectively.Intermittent treatment with SP did not reduce the proportion of previously anaemic children with moderate or severe anaemia at the end of the malaria season, although it
Stack, Austin G; Alghali, Ahmed; Li, Xia; Ferguson, John P; Casserly, Liam F; Cronin, Cornelius J; Reddan, Donal N; Hussein, Wael; Elsayed, Mohamed E
Although anaemia is a common complication of advanced chronic kidney disease (CKD), knowledge of quality of care and management practices in specialist clinics varies. We examined anaemia practices at specialist nephrology clinics within the Irish health system and evaluated the opinions of practicing nephrologists. A multicentre cross-sectional study was conducted at specialist nephrology clinics across six geographic regions in Ireland. Clinical characteristics and treatment practices were evaluated in a sample of 530 patients with CKD. An accompanying national survey questionnaire captured opinions and treatment strategies of nephrologists on anaemia management. The prevalence of anaemia [defined as haemoglobin (Hb) <12.0 g/dL] was 37.8%, which increased significantly with advancing CKD (from 21% to 63%; P < 0.01) and varied across clinical sites (from 36% to 62%; P < 0.026). Iron deficiency (ID) was present in 46% of all patients tested and 86% of them were not on treatment. More than 45% of anaemic patients were not tested for ID. Respondents differed in their selection of clinical guidelines, threshold targets for erythropoiesis-stimulating agent (ESA) and intravenous iron therapy and anaemia management algorithms were absent in 47% of the clinics. The unexpectedly low rates of ESA use (4.7%) and iron therapy (10.2%) in clinical practice were in contrast to survey responses where 63% of nephrologists indicated ESA therapy initiation when Hb was <10.0 g/dL and 46% indicated commencement of iron therapy for ferritin <150 ng/mL. This study highlights substantial variability in the management of anaemia and ID at specialist nephrology clinics with low testing rates for ID, high rates of anaemia and ID and underutilization of effective treatments. Variability in the adoption and implementation of different clinical guidelines was evident.
Full Text Available When Su Cleyle and I first decided to start Evidence Based Library and Information Practice, one of the things we agreed upon immediately was that the journal be open access. We knew that a major obstacle to librarians using the research literature was that they did not have access to the research literature. Although Su and I are both academic librarians who can access a wide variety of library and information literature from our institutions, we belong to a profession where not everyone has equal access to the research in our field. Without such access to our own body of literature, how can we ever hope for practitioners to use research evidence in their decision making? It would have been contradictory to the principles of evidence based library and information practice to do otherwise.One of the specific groups we thought could use such an open access venue for discovering research literature was school librarians. School librarians are often isolated and lacking access to the research literature that may help them prove to stakeholders the importance of their libraries and their role within schools. Certainly, school libraries have been in decline and the use of evidence to show value is needed. As Ken Haycock noted in his 2003 report, The Crisis in Canada’s School Libraries: The Case for Reform and Reinvestment, “Across the country, teacher-librarians are losing their jobs or being reassigned. Collections are becoming depleted owing to budget cuts. Some principals believe that in the age of the Internet and the classroom workstation, the school library is an artifact” (9. Within this context, school librarians are looking to our research literature for evidence of the impact that school library programs have on learning outcomes and student success. They are integrating that evidence into their practice, and reflecting upon what can be improved locally. They are focusing on students and showing the impact of school libraries and
Aina Ayoola O
Full Text Available Abstract Background Several studies have shown that the pathophysiology of homozygous sickle cell anaemia (SCA results in a myriad of metabolic, nutritional, haematological and clinical effects that interact with other co-morbid factors to determine the quality of life and life expectancy of afflicted patients. Because of its critical roles in nutrition and metabolism, inflammation, haematopoiesis and cellular immunity, this study determined the plasma levels of leptin in steady and unsteady states of HbSS in Nigerian patients. Methods A total of 51 SCA patients aged 5 - 35 years with 34 (61.8% being females who were either on admission or visiting four medical centres in Lagos, Nigeria together with 22 non-SCD controls aged 5 -30 years comprising 12 (54.5% females were enrolled after obtaining their informed consent and ethical approval. Patients were further stratified into steady and unsteady cases of SCA based on clinical presentations, while blood samples collected by venipuncture from each of the study participants were analyzed haematologically for full blood count and HbF level and microscopically for malaria, while plasma leptin was assayed using ELISA method. Body composition defined by weight, fat mass and body mass index (BMI was determined using standard methods. Data obtained for cases and controls were analyzed statistically. Results Twenty - one patients had unsteady HbSS and elicited greater and significant (P P. falciparum parasitaemia (4613.7 vs. 749.6 - 1078.4 parasites/uL, pyrexia rate (58.3 vs. 25.8% when compared with steady state patients or non-SCD controls. Compared to the control, significant decreases in plasma leptin before and after controlling for body fat that was worsened by crisis were observed among the SCD patients. Unlike the non-SCD controls, leptin correlated non-significantly (P > 0.05 with all body composition indices measured in the patients except for fat mass in unsteady cases. Multivariate regression
Rondonotti, Emanuele; Giannakou, Andry; Avni, Tomer; Rosa, Bruno; Toth, Ervin; Lucendo, Alfredo J; Sidhu, Reena; Beaumont, Hanneke; Ellul, Pierre; Negreanu, Lucian; Jiménez-Garcia, Victoria Alejandra; McNamara, Deidre; Kopylov, Uri; Elli, Luca; Triantafyllou, Konstantinos; Shibli, Fahmi; Riccioni, Maria Elena; Bruno, Mauro; Dray, Xavier; Plevris, John N; Koulaouzidis, A; Argüelles-Arias, Federico; Becq, Aymeric; Branchi, Federica; Tejero-Bustos, María Ángeles; Cotter, Jose; Eliakim, Rami; Ferretti, Francesca; Gralnek, Ian M; Herrerias-Gutierrez, Juan Manuel; Hussey, Mary; Jacobs, Maarten; Johansson, Gabriele Wurm; McAlindon, Mark; Montiero, Sara; Nemeth, Artur; Pennazio, Marco; Rattehalli, Deepa; Stemate, Ana; Tortora, Annalisa; Tziatzios, Georgios
Background Recent data imply young patients (age ≤50 years) undergoing small-bowel (SB) capsule endoscopy (CE) for iron deficiency anaemia (IDA) show higher diagnostic yield (DY) for sinister pathology. We aimed to investigate DY of CE in a large cohort of young IDA patients, and evaluate factors predicting significant SB pathology. Materials and methods This was a retrospective, multicentre study (2010–2015) in consecutive, young patients (≤50 years) from 18 centres/12 countries, with negative bidirectional gastrointestinal (GI) endoscopy undergoing SBCE for IDA. Exclusion criteria: previous/ongoing obscure-overt GI bleeding; age 50 years; comorbidities associated with IDA. Data retrieved: SBCE indications; prior investigations; medications; SBCE findings; final diagnosis. Clinical and laboratory data were analysed by multivariate logistic regression. Results Data on 389 young IDA patients were retrieved. In total, 169 (43.4%) were excluded due to incomplete clinical data; data from 220 (122F/98M; mean age 40.5 ± 8.6 years) patients were analysed. Some 71 patients had at least one clinically significant SBCE finding (DY: 32.3%). They were divided into two groups: neoplastic pathology (10/220; 4.5%), and non-neoplastic but clinically significant pathology (61/220; 27.7%). The most common significant but non-neoplastic pathologies were angioectasias (22/61) and Crohn’s disease (15/61). On multivariate analysis, weight loss and lower mean corpuscular volume(MCV) were associated with significant SB pathology (OR: 3.87; 95%CI: 1.3–11.3; p = 0.01; and OR: 0.96; 95%CI: 0.92–0.99; p = 0.03; respectively). Our model also demonstrates association between use of antiplatelets and significant SB pathology, although due to the small number of patients, definitive conclusions cannot be drawn. Conclusion In IDA patients ≤50 years with negative bidirectional GI endoscopy, overall DY of SBCE for clinically significant findings was 32.3%. Some 5% of our
Full Text Available A 26-year-old healthy male patient's fundus revealed findings consistent with torpedo maculopathy. Swept-source optical coherence tomography (OCT showed a dome-shaped elevation of the retina at the level of ellipsoid zone. On OCT angiography segmented at the level of the choriocapillaris, a cluster of convoluted fine vessels was seen, and further, deeper scans of the larger choroidal vessels showed a slower flow. From these observations along with the embryological correlation of choriocapillaris development, a possibility of an abnormality preventing proper fenestration of the choriocapillaris along the horizontal raphe being responsible for this anomaly is suggested.
During early adulthood it will be carried out by palpation, ultrasonography, semen analysis, serum testosterone and follicle stimulating hormone levels and during late adulthood follow up will be done by ultrasonography for malignancy every 2 years. CONCLUSION. Polyorchidism is a rare genitourinary abnormality and its.
Fetuses with omphalocele have an increased risk for chromosomal abnormalities. The risk varies with maternal age, gestational age at diagnosis, association with umbilical cord cysts, complexity of associated anomalies, and the contents of omphalocele. There is considerable evidence that genetics contributes to the etiology of omphalocele. This article provides an overview of chromosomal abnormalities associated with omphalocele and a comprehensive review of associated full aneuploidy such as trisomy 18, trisomy 13, triploidy, trisomy 21, 45,X, 47,XXY, and 47,XXX, partial aneuploidy such as dup (3q), dup (11p), inv (11), dup (1q), del (1q), dup (4q), dup (5p), dup (6q), del (9p), dup (15q), dup(17q), Pallister-Killian syndrome with mosaic tetrasomy 12p and Miller-Dieker lissencephaly syndrome with deletion of 17p13.3, and uniparental disomy (UPD) such as UPD 11 and UPD 14. Omphalocele is a prominent marker for chromosomal abnormalities. Perinatal identification of omphalocele should alert chromosomal abnormalities and familial unbalanced translocations, and prompt thorough cytogenetic investigations and genetic counseling.
Full Text Available Fetuses with omphalocele have an increased risk for chromosomal abnormalities. The risk varies with maternal age, gestational age at diagnosis, association with umbilical cord cysts, complexity of associated anomalies, and the contents of omphalocele. There is considerable evidence that genetics contributes to the etiology of omphalocele. This article provides an overview of chromosomal abnormalities associated with omphalocele and a comprehensive review of associated full aneuploidy such as trisomy 18, trisomy 13, triploidy, trisomy 21, 45,X, 47,XXY, and 47,XXX, partial aneuploidy such as dup(3q, dup(11p, inv(11, dup(1q, del(1q, dup(4q, dup(5p, dup(6q, del(9p, dup(15q, dup(17q, Pallister-Killian syndrome with mosaic tetrasomy 12p and Miller-Dieker lissencephaly syndrome with deletion of 17p13.3, and uniparental disomy (UPD such as UPD 11 and UPD 14. Omphalocele is a prominent marker for chromosomal abnormalities. Perinatal identification of omphalocele should alert chromosomal abnormalities and familial unbalanced translocations, and prompt thorough cytogenetic investigations and genetic counseling.
Admission haematological abnormalities and postoperative outcomes in neonates with acute surgical conditions in Alexandria, Egypt. HL Wella, SMM Farahat. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals ...
Osazuwa, Favour; Ayo, Oguntade Michael; Imade, Paul
Anaemia is estimated to affect half the school-age children and adolescents in developing countries. This study aimed to determine the prevalence of anaemia and evaluate the relationship of intestinal helminth infection on the anaemia status of children in the rural communities of Evbuomore, Isiohor, and Ekosodin. in the Ovia North East local government area of Edo State, Nigeria. Faecal samples and blood samples were obtained from 316 children aged 1-15 years. Faecal samples were examined using standard parasitological techniques, and anaemia was defined as blood haemoglobin <11 g/dL. Of the 316 children, 38.6% were anaemic: 75.9% of children in Evbuomore, 42.3% in Isiohor and 26.8% in Ekosodin. The overall parasite prevalence in the three communities were: Ascaris lumbricoides (75.6%), hookworm (16.19%) and Trichuris trichiura (7.3%). Malnutrition was patent; 37.0% of the children were stunted, 19.3% wasted, and 44.0% underweight. There was a statistically significant association between hookworm and Ascaris lumbricoides infection and anaemia (P < .001). Serum ferritin levels were more sensitive than haemoglobin in detecting anemia and were correlated with intestinal helminth infection. Intestinal helminth infection in a concomitant state of malnutrition is observed in this population. Intervention programmes should be aimed at control of intestinal helminth infection and iron supplementation.
Njua-Yafi, Clarisse; Achidi, Eric A; Anchang-Kimbi, Judith K; Apinjoh, Tobias O; Mugri, Regina N; Chi, Hanesh F; Tata, Rolland B; Njumkeng, Charles; Nkock, Emmanuel N; Nkuo-Akenji, Theresa
Malaria and helminthiases frequently co-infect the same individuals in endemic zones. Plasmodium falciparum and helminth infections have long been recognized as major contributors to anaemia in endemic countries. Several studies have explored the influence of helminth infections on the course of malaria in humans but how these parasites interact within co-infected individuals remains controversial. In a community-based longitudinal study from March 2011 to February 2012, the clinical and malaria parasitaemia status of a cohort of 357 children aged 6 months to 10 years living in Mutengene, south-western region of Cameroon, was monitored. Following the determination of baseline malaria/helminths status and haemoglobin levels, the incidence of malaria and anaemia status was determined in a 12 months longitudinal study by both active and passive case detection. Among all the children who completed the study, 32.5 % (116/357) of them had at least one malaria episode. The mean (±SEM) number of malaria attacks per year was 1.44 ± 0.062 (range: 1-4 episodes) with the highest incidence of episodes occuring during the rainy season months of March-October. Children co-infected with Plasmodium and helminths was higher (p = 0.006) compared to participants infected with Plasmodium or helminths alone. Children below 5 years of age were more susceptible to malaria and anaemia. The high prevalence of anaemia in this community was largely due to malaria parasitaemia. Malaria and helminths co-infection was protective against anaemia.
Jeppesen, Signe Søndergaard; Debes, Nanette Mol; Simonsen, Helle Juhl
BACKGROUND: Imaging studies of patients with Tourette's syndrome (TS) across different cohorts have shown alterations in gray and white matter in areas associated with the cortico-striato-thalamic-cortical (CSTC) pathways; however, no consistent findings have subsequently established a clear...... indication of the pathophysiology of TS. METHODS: This study was designed to investigate changes in gray and white matter in medication-free children with TS in the CSTC areas. With MRI, 24 children with TS and 18 healthy controls were analyzed using three complementary methods. RESULTS AND CONCLUSION...
Chidgey, M; Brakebusch, C; Gustafsson, E
The desmosomal cadherin desmocollin (Dsc)1 is expressed in upper epidermis where strong adhesion is required. To investigate its role in vivo, we have genetically engineered mice with a targeted disruption in the Dsc1 gene. Soon after birth, null mice exhibit flaky skin and a striking punctate ep...
Full Text Available Healthy aging is one of the most important social issues. In this paper, we propose a method for abnormal activity detection without any manual labeling of the training samples. By leveraging the Field of View (FOV modulation, the spatio-temporal characteristic of human activity is encoded into low-dimension data stream generated by the ceiling-mounted Pyroelectric Infrared (PIR sensors. The similarity between normal training samples are measured based on Kullback-Leibler (KL divergence of each pair of them. The natural clustering of normal activities is discovered through a self-tuning spectral clustering algorithm with unsupervised model selection on the eigenvectors of a modified similarity matrix. Hidden Markov Models (HMMs are employed to model each cluster of normal activities and form feature vectors. One-Class Support Vector Machines (OSVMs are used to profile the normal activities and detect abnormal activities. To validate the efficacy of our method, we conducted experiments in real indoor environments. The encouraging results show that our method is able to detect abnormal activities given only the normal training samples, which aims to avoid the laborious and inconsistent data labeling process.
Full Text Available Objective. To measure spermatogenesis abnormalities in transwomen at the time of sex reassignment surgery (SRS and to analyze the association between hormonal therapy duration and infertility severity. Design. Retrospective study. Setting. University hospital. Patients. One-hundred seventy-three transwomen who underwent SRS from January 2000 to December 2015. Interventions. All orchidectomy specimens were retrospectively reviewed and classified. History of hormonal therapy duration was retrieved from medical records. Main Outcome Measures. Histological examinations of orchidectomy specimens were performed to assess spermatogenesis. Results. One-hundred seventy-three orchidectomy specimens were evaluated. Histological examinations showed maturation arrest in 36.4%, hypospermatogenesis in 26%, Sertoli cell-only syndrome in 20.2%, normal spermatogenesis in 11%, and seminiferous tubule hyalinization in 6.4% of the specimens. Spermatogenesis abnormality severity was not associated with the total therapy duration (P=0.81 or patient age at the time of surgery (P=0.88. Testicular volumes and sizes were associated with spermatogenesis abnormality severity (P=0.001 and P=0.026, right testicle and left testicle, resp.. Conclusion(s. Feminizing hormonal treatment leads to reductions in testicular germ cell levels. All transwomen should be warned about this consequence, and gamete preservation should be offered before starting hormonal treatment.
Adnan, Ja'afar; Daud, Nik Ghazali Nik; Ishak, Mohd Taufiq; Rizman, Zairi Ismael; Rahman, Muhammad Izzuddin Abd
Heart abnormality often occurs regardless of gender, age and races. This problem sometimes does not show any symptoms and it can cause a sudden death to the patient. In general, heart abnormality is the irregular electrical activity of the heart. This paper attempts to develop a program that can detect heart abnormality activity through implementation of Multilayer Perceptron (MLP) network. A certain amount of data of the heartbeat signals from the electrocardiogram (ECG) will be used in this project to train the MLP network by using several training algorithms with Tansig activation function.
Binder, Laurence M; Spector, Jack; Youngjohn, James R
Three cases are presented of peculiar speech and language abnormalities that were evaluated in the context of personal injury lawsuit or workers compensation claims of brain dysfunction after mild traumatic brain injuries. Neuropsychological measures of effort and motivation showed evidence of suboptimal motivation or outright malingering. The speech and language abnormalities of these cases probably were not consistent with neurogenic features of dysfluent speech including stuttering or aphasia. We propose that severe dysfluency or language abnormalities persisting after a single, uncomplicated, mild traumatic brain injury are unusual and should elicit suspicion of a psychogenic origin.
Kerkhoff, Andrew D.; Wood, Robin; Cobelens, Frank G.; Gupta-Wright, Ankur; Bekker, Linda-Gail; Lawn, Stephen D.
Background: Anaemia is frequently associated with both HIV-infection and HIV-related tuberculosis (TB) in antiretroviral therapy (ART)-naive patients in sub-Saharan Africa and is strongly associated with poor prognosis. However, the effect of ART on the resolution of anaemia in patient cohorts with
Soekarjo, D.D.; Pee, S. de; Bloem, M.W.; Tjiong, R.; Yip, R.; Schreurs, W.H.P.; Muhilal
Objective: To determine prevalence and contributing factors of anaemia in adolescents. Design: Cross-sectional study of anaemia prevalence, socio-economic status and puberty. Setting: Schools in East Java, Indonesia. Subjects: Male and female adolescent pupils (age 12-15 y; n = 6486). Results:
Borges, Álvaro H; Weitz, Jeffrey I; Collins, Gary
OBJECTIVE: The objective of this study is to determine the relationship between inflammatory interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP)] and coagulation (D-dimer) biomarkers and the presence and type of anaemia among HIV-positive individuals. DESIGN: A cross-sectional st......OBJECTIVE: The objective of this study is to determine the relationship between inflammatory interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP)] and coagulation (D-dimer) biomarkers and the presence and type of anaemia among HIV-positive individuals. DESIGN: A cross...... with anaemia, by type [microcytic (MCV 100 fl)]. We analysed the association between inflammation (IL-6 and hsCRP) and coagulation (D-dimer) and haemoglobin, controlling for demographics (age, race and sex), BMI, HIV plasma RNA levels, CD4⁺ T-cell counts (nadir...
Freya J I Fowkes
Full Text Available The heritable haemoglobinopathy alpha(+-thalassaemia is caused by the reduced synthesis of alpha-globin chains that form part of normal adult haemoglobin (Hb. Individuals homozygous for alpha(+-thalassaemia have microcytosis and an increased erythrocyte count. Alpha(+-thalassaemia homozygosity confers considerable protection against severe malaria, including severe malarial anaemia (SMA (Hb concentration 1.1 x 10(12/l as a result of the reduced mean cell Hb in homozygous alpha(+-thalassaemia. In addition, children homozygous for alpha(+-thalassaemia require a 10% greater reduction in erythrocyte count than children of normal genotype (p = 0.02 for Hb concentration to fall to 50 g/l, the cutoff for SMA. We estimated that the haematological profile in children homozygous for alpha(+-thalassaemia reduces the risk of SMA during acute malaria compared to children of normal genotype (relative risk 0.52; 95% confidence interval [CI] 0.24-1.12, p = 0.09.The increased erythrocyte count and microcytosis in children homozygous for alpha(+-thalassaemia may contribute substantially to their protection against SMA. A lower concentration of Hb per erythrocyte and a larger population of erythrocytes may be a biologically advantageous strategy against the significant reduction in erythrocyte count that occurs during acute infection with the malaria parasite Plasmodium falciparum. This haematological profile may reduce the risk of anaemia by other Plasmodium species, as well as other causes of anaemia. Other host polymorphisms that induce an increased erythrocyte count and microcytosis may confer a similar advantage.
Engwa, Godwill Azeh; Unaegbu, Marcellus; Unachukwu, Marian N; Njoku, Mary-Gloria C; Agbafor, Kingsley N; Mbacham, Wilfred Fon; Okoh, Anthony
Though iron deficiency is known to be a major risk factor of anaemia, the association of G6PD deficiency and malaria with anaemia still remains unclear. Hence, a cross-sectional study involving 95 pregnant women visiting Prime Care Hospital in Trans-Ekulu region of Enugu Nigeria was conducted to determine possible predictors of anaemia in pregnancy. The prevalence of anaemia, malaria and G6PD deficiency were 53.7, 12.6 and 60% respectively. Low serum ferritin (OR 5.500, CI 2.25-13.42, p G6PD deficiency (OR 0.087, CI 0.03-0.23, p G6PD deficiency as high risk factors of anaemia.
Rodulfo Garcia, Maikel; Tornes Perez, Victor Manuel; Castellanos Tardo, Juan Ramon
A descriptive cross-sectional study was carried out in 120 hypertensive patients with a course of 5 or more years, who went to the emergency room of 'Saturnino Lora' Provincial Teaching Hospital from November 2010 to November 2011 in order to determine the presence or absence of echocardiographic abnormalities typical of hypertension. Of these, 78,3 % was affected, most of whom reported not to continue with regular previous medical treatment, and 21,7 % had not these abnormalities. Age group of 50-60 years, males and blacks prevailed in the case material. The most significant echocardiographic findings were left ventricular hypertrophy and heart failure with ejection fraction of left ventricle preserved
Öngür, Dost; Bechtholt, Anita J; Carlezon, William A; Cohen, Bruce M
Multiple lines of evidence indicate that mood disorders are associated with abnormalities in the brain's cellular composition, especially in glial cells. Considered inert support cells in the past, glial cells are now known to be important for brain function. Treatments for mood disorders enhance glial cell proliferation, and experimental stimulation of cell growth has antidepressant effects in animal models of mood disorders. These findings suggest that the proliferation and survival of glial cells may be important in the pathogenesis of mood disorders and may be possible targets for the development of new treatments. In this article we review the evidence for glial abnormalities in mood disorders, and we discuss glial cell biology and evidence from postmortem studies of mood disorders. The goal is not to carry out a comprehensive review but to selectively discuss existing evidence in support of an argument for the role of glial cells in mood disorders.
0.01 0.12 81 A.A. 51 M 0 ɘ.01 0.09 Schizophrenia 85a W.G. 67 M 0 ɘ.01 0.21 Proteins & Ketones in Urine b 0 ɘ.01 0.11 86a W.H. 67 M 0 ɘ.01 0.15 b 0...AD-AS 90 TOTTS GAP MEDICAL RESEARCH LABS INC BANGOR PA F/G 6/5 ABNORMAL METABOLITE IN ALCOHOLIC SUBJECTS, U) 1982 R L BEECH, M E FELVER, M R...LAKSCHMANAN NOOBIN 70 C 0233 UNJCLASSIFIED NL I ,I/ ABNORMAL METABOLITE IN ALCOHOLIC SUBJECTS Richard L . Veech, Michael E. Felver, M.R. Lakschmanan, Stewart
Bianco, F.; Floris, R.
The CT pattern of bilateral and symmetrical round low density areas in the globi pallidi has been observed in a young man who attempted suicide by hanging. These CT abnormalities are similar to those described in other conditions such as carbon monoxide, hydrogen sulfide, cyanide and methanol poisoning, hypoglycaemia, drowning and acute global central nervous system hypoperfusion.The findings appear to be correlated with acute cerebral hypoxia. (orig.)
Öngür, Dost; Bechtholt, Anita J.; Carlezon, William A.; Cohen, Bruce M.
Multiple lines of evidence indicate that mood disorders are associated with abnormalities in the brain's cellular composition, especially in glial cells. Considered inert support cells in the past, glial cells are now known to be important for brain function. Treatments for mood disorders enhance glial cell proliferation, and experimental stimulation of cell growth has antidepressant effects in animal models of mood disorders. These findings suggest that the proliferation and survival of glia...
Glass, R.B.J.; Yousefzadeh, D.K.; Roizen, N.J.
Hearing loss and otitis media are commonly associated with Down syndrome. Hypoplasia of the mastoids is seen in many affected children and sclerosis of mastoid bones is not uncommon in Down syndrome. Awareness and early recognition of mastoid abnormality may lead to appropriate and timely therapy, thereby preserving the child's hearing or compensating for hearing loss; factors which are important for learning and maximum development. (orig.)
Glass, R.B.J.; Yousefzadeh, D.K.; Roizen, N.J.
Hearing loss and otitis media are commonly associated with Down syndrome. Hypoplasia of the mastoids is seen in many affected children and sclerosis of mastoid bones is not uncommon in Down syndrome. Awareness and early recognition of mastoid abnormality may lead to appropriate and timely therapy, thereby preserving the child's hearing or compensating for hearing loss; factors which are important for learning and maximum development.
Guo, Jian; Zheng, Cong; Xiao, Qiang; Gong, Sugang; Zhao, Qinhua; Wang, Lan; He, Jing; Yang, Wenlan; Shi, Xue; Sun, Xingguo; Liu, Jinming
This study intended to search for potential correlations between anaemia in patients with severe chronic obstructive pulmonary disease (COPD; GOLD stage III) and pulmonary function at rest, exercise capacity as well as ventilatory efficiency, using pulmonary function test (PFT) and cardiopulmonary exercise testing (CPET). The study was undertaken at Shanghai Pulmonary Hospital, a tertiary-level centre affiliated to Tongji University. It caters to a large population base within Shanghai and referrals from centres in other cities as well. 157 Chinese patients with stable severe COPD were divided into 2 groups: the anaemia group (haemoglobin (Hb) patients. (1) Diffusing capacity for carbon monoxide (DLCO) corrected by Hb was significantly lower in the anaemia group ((15.3±1.9) mL/min/mm Hg) than in the non-anaemia group ((17.1±2.1) mL/min/mm Hg) (p0.05). (2) Peak Load, Peak oxygen uptake (VO2), Peak VO2%pred, Peak VO2/kg, Peak O2 pulse and the ratio of VO2 increase to WR increase (ΔVO2/ΔWR) were significantly lower in the anaemia group (p0.05). (3) A strong positive correlation was found between Hb concentration and Peak VO2 in patients with anaemia (r=0.702, pexercise tolerance during exercise in patients with severe COPD. The decrease in amplitude of Hb levels is related to the quantity of oxygen uptake. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Müller, Sophie A; Amoah, Stephen K B; Meese, Stefanie; Spranger, Joachim; Mockenhaupt, Frank P
Haematological parameters differ between individuals of African and European ancestry. However, respective data of first-generation African migrants are virtually absent. We assessed these in Ghanaian migrants living in Berlin, compared them with reference data from Germany and Ghana, and estimated the role of iron deficiency (ID) and erythrocyte polymorphisms in anaemia. A total of 576 Ghanaians (median age, 45 years) were analysed. Blood counts were performed, haemoglobinopathies and glucose-6-phosphate dehydrogenase (G6PD) deficiency were genotyped, and concentrations of ferritin and C-reactive protein were measured to define ID. Most individuals had resided in Germany for more than a decade (median, 18 years). By WHO definition, anaemia was present in 30.9% of females and 9.4% of males. Median haemoglobin (Hb) levels were lower than among Germans (women, -0.8 g/dl, men, -0.7 g/dl). However, applying reference values from Ghana, only 1.9% of the migrants were considered anaemic. Alpha-thalassaemia, Hb variants and G6PD deficiency were observed in 33.9%, 28.3% and 23.6%, respectively. ID was highly prevalent in women (32.0%; men, 3.9%). The population fraction of anaemia cases attributable to ID was 29.0% (alpha-thalassaemia, 13.6%; G6PD deficiency, 13.5%). Nevertheless, excluding ID, alpha-thalassaemia, G6PD deficiency and sickle cell disease, anaemia prevalence remained high (women, 18.4%; men, 6.5%), and was also high when applying uncensored thresholds proposed for African Americans (females, 19.3%; males, 7.8%). Iron deficiency and erythrocyte polymorphisms are common among first-generation Ghanaian migrants but explain only part of the increased prevalence of anaemia. Common Hb thresholds for the definition of anaemia may not be appropriate for this group. © 2015 John Wiley & Sons Ltd.
Full Text Available Abstract Background Anaemia is known to be one of the outcomes of parasitic infection and it may result in impaired cognitive development, reduced physical work capacity and in severe cases increased risk of mortality, particularly during the prenatal period. The aim of this study was to determine the prevalence and associated risk factors of anaemia among pregnant women in Gilgel-Gibe dam area, southwestern Ethiopia. Methods A cross-sectional community based study was conducted on 388 pregnant women living in three districts around Gilgel Gibe Dam area, southwestern Ethiopia. Socio-demographic and socio-economic data were collected from each participant. A single stool sample was also collected from each selected pregnant woman. Haemoglobin concentration was determined by the cyanmethemoglobin method. Plasmodium infection prevalence and intensity were assessed with thin and thick blood film examination. Results Of the total 388 study participants, 209 (53.9% were anaemic. Pregnant woman who were rural residents (Adjusted odds ratio (AOR = 1.62, 95% C.I: 1.02-2.62, P= 0.042, not using insecticide treated nets (ITNs during the study period (AOR = 2.84, 95% C.I: 1.33-6.05, p = 0.007, those who were Plasmodium malaria infected (AOR = 11.19, 95% C.I: 3.31-37.7, p= 0.01 and those with Soil Transmitted Helminth (STH infections (AOR=1.82, 95% C.I: 1.16-2.87, p=0.001 had higher odds of being anaemic than those who were urban residents, using ITNs, free of Plasmodium malaria and Soil transmitted helminth infection, respectively. There was a significant correlation between increasing hookworm parasite load (r = −.110, PAscaris lumbricoides (r = −.122, P Trichuris trichiura (r = −.025, P Conclusion The high prevalence of anaemia indicates it is currently a serious health problem of pregnant women living in Gilgel Gibe Dam area. Plasmodium malaria and soil transmitted helminth infections were significantly associated with anaemia. Antenatal care
Full Text Available Background & objectives: Iron deficiency anaemia (IDA is the most common nutritional deficiency in pregnancy. Prophylactic oral iron is recommended during pregnancy to meet the increased requirement. In India, women become pregnant with low baseline haemoglobin level resulting in high incidence of moderate to severe anaemia in pregnancy where oral iron therapy cannot meet the requirement. Pregnant women with moderate anaemia are to be treated with parentral iron therapy. This study was undertaken to evaluate the response and effect of intravenous iron sucrose complex (ISC given to pregnant women with IDA. Methods: A prospective study was conducted (June 2009 to June 2011 in the department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi. One hundred pregnant women with haemoglobin between 5-9 g% with diagnosed iron deficiency attending antenatal clinic were given intravenous iron sucrose complex in a dose of 200 mg twice weekly schedule after calculating the dose requirement. Results: The mean haemoglobin raised from 7.63 ± 0.61 to 11.20 ± 0.73 g% (P<0.001 after eight wk of therapy. There was significant rise in serum ferritin levels (from 11.2 ± 4.7 to 69 ± 23.1 μg/l (P<0.001. Reticulocyte count increased significantly after two wk of starting therapy (from 1.5 ± 0.6 to 4.6±0.8%.Other parameters including serum iron levels and red cell indices were also improved significantly. Only one woman was lost to follow up. No major side effects or anaphylactic reactions were noted during study period. Interpretation & conclusions: Parentral iron therapy was effective in increasing haemoglobin, serum ferritin and other haematological parameters in pregnant women with moderate anaemia. Intravenous iron sucrose can be used in hospital settings and tertiary urban hospitals where it can replace intramuscular therapy due to injection related side effects. Further, long-term comparative studies are required to recommend its
Full Text Available Introduction: Heterozygous β-thalassemia represents the mild form of the β-thalassemic syndromes, being compatible with normal lifetime. The importance of β-thalassemia consists in the fact that it maintains the "defective gene" in the population, favoring the appearance of new cases of Cooley's anaemia, the severe form of β-thalassemic syndromes. Current data estimate that 7% of the world's population is bearing β-thalassemia, over 400,000 children with β thalassemia being born annually, therefore the WHO estimates the doubling of this figure in the coming years.
Miguéns Blanco, I; Bravo Amaro, M
Ischaemic heart disease is the leading cause of mortality and morbidity and one of the primary causes of morbidity in Spain. The variability in the clinical presentation of this condition at both primary care and emergency services level requires a careful history and a thorough physical examination. In the case presented, the main symptoms of angina and dyspnea reported in the anamnesis, and the obvious pallor in the physical examination, were the key data to identify anaemia as a cause of angina. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.
Goldstein, S R; Lumsden, M A
Abnormal uterine bleeding is one of the commonest presenting complaints encountered in a gynecologist's office or primary-care setting. The wider availability of diagnostic tools has allowed prompt diagnosis and treatment of an increasing number of menstrual disorders in an office setting. This White Paper reviews the advantages and disadvantages of transvaginal ultrasound, blind endometrial sampling and diagnostic hysteroscopy. Once a proper diagnosis has been established, appropriate therapy may be embarked upon. Fortunately, only a minority of such patients will have premalignant or malignant disease. When bleeding is sufficient to cause severe anemia or even hypovolemia, prompt intervention is called for. In most of the cases, however, the abnormal uterine bleeding will be disquieting to the patient and significantly affect her 'quality of life'. Sometimes, reassurance and expectant management will be sufficient in such patients. Overall, however, in cases of benign disease, some intervention will be required. The use of oral contraceptive pills especially those with a short hormone-free interval, the insertion of the levonorgestrel intrauterine system, the incorporation of newer medical therapies including antifibrinolytic drugs and selective progesterone receptor modulators and minimally invasive treatments have made outpatient therapy increasingly effective. For others, operative hysteroscopy and endometrial ablation are proven therapeutic tools to provide both long- and short-term relief of abnormal uterine bleeding, thus avoiding, or deferring, hysterectomy.
were no accompanying neurological or endocrinologi- cal diseases in patients with IDA. ... sleep disturbance, use of sleep medications and day- time dysfunction. Greater PSQI scores show worse sleep quality. A global sum of 6 or greater indicates a ..... bowel syndrome patients with a Type D personality. Sleep and ...
disease presented with pain on pronation and supination of both elbows, particularly on the lateral side. These movements were restricted in both elbows. Plain radiograph of his elbows showed fragmentation of the capitellum with signs of revascularisation. We have performed a thorough literature search and have not ...
Abdullah, Hairil Rizal; Sim, Yilin Eileen; Hao, Ying; Lin, Geng Yu; Liew, Geoffrey Haw Chieh; Lamoureux, Ecosse L; Tan, Mann Hong
Studies in western healthcare settings suggest that preoperative anaemia is associated with poor outcomes after elective orthopaedic surgery. We investigated the prevalence of preoperative anaemia among patients with primary unilateral total knee arthroplasty (TKA) in Singapore and its association with length of hospital stay (LOS), perioperative blood transfusion and hospital readmission rates. Retrospective cohort study performed in a tertiary academic medical centre in Singapore, involving patients who underwent primary unilateral TKA between January 2013 and June 2014. Demographics, comorbidities, preoperative haemoglobin (Hb) level, LOS and 30-day readmission data were collected. Anaemia was classified according to WHO definition. Prolonged LOS was defined as more than 6 days, which corresponds to >75th centile LOS of the data. We analysed 2394 patients. The prevalence of anaemia was 23.7%. 403 patients (16.8%) had mild anaemia and 164 patients (6.8%) had moderate to severe anaemia. Overall mean LOS was 5.4±4.8 days. Based on multivariate logistic regression, preoperative anaemia significantly increased LOS (mild anaemia, adjusted OR (aOR) 1.71, p70 years were associated with prolonged LOS. Our 30-day related readmission rate was 1.7% (42) cases. Anaemia is common among patients undergoing elective TKA in Singapore and is independently associated with prolonged LOS and increased perioperative blood transfusion. We suggest measures to correct anaemia prior to surgery, including the use of non-gender-based Hb cut-off for establishing diagnosis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Akinbo, Frederick O; Okaka, Christopher E; Omoregie, Richard
Parasitic infections continue to take their toll on HIV positive patients by influencing the blood qualitatively and quantitatively. The objective of this study was to determine the prevalence of intestinal parasitic infections in relation to anaemia and CD4 counts among HIV-infected patients in Benin City, Nigeria. Using a serial sampling method, a total of 2000 HIV-infected patients were recruited on their first visit prior to highly active anti-retroviral therapy (HAART) at the University of Benin Teaching Hospital from August 2007 to August 2009. Stool and blood samples were collected from each patient. The stool samples were processed using the modified Ziehl-Neelsen staining technique to microscopically identify the oocysts of Cryptosporidium species, Isospora belli, Cyclospora species and spores of Microsporidium species while saline and iodine preparations were used for identifying the ova, cysts and parasites of Ascaris lumbricoides, hookworm, Taenia spp and other parasites. The blood specimens were equally analyzed using the flow cytometry for CD4+ T-lymphocyte count and autoanalyzer - sysmex kx - 21 for haemoglobin concentration. The overall prevalence of anaemia was 93.3% while 18% had parasitic infections. There was a significant relationship between CD4 count <200cells/microL and anaemia (P<0.0001). Cryptosporidium species (P= 0.005), A. lumbricoides (P=0.035), hookworm and Taenia species (P=0.014) were associated with anaemia. Anaemia was associated with CD4 count while Cryptosporidium species, Ascaris lumbricoides, hookworm and Taenia species were the intestinal parasitic agents associated with anaemia. In conclusion the prevalence of anaemia in HIV-infected patients is high low CD4 count is a significant risk factor of acquiring anaemia. Except for isosporiasis, cryptosporidiosis, A. lumbricoides, hookworm and Taenia species in HIV infected individuals are parasitic agents associated with anaemia. Routine screening for intestinal parasites and
Howard, Natasha; Enayatullah, Sayed; Mohammad, Nader; Mayan, Ismail; Shamszai, Zohra; Rowland, Mark; Leslie, Toby
Afghanistan has some of the worst maternal and infant mortality indicators in the world and malaria is a significant public health concern. Study objectives were to assess prevalence of malaria and anaemia, related knowledge and practices, and malaria prevention barriers among pregnant women in eastern Afghanistan. Three studies were conducted: (1) a clinical survey of maternal malaria, maternal anaemia, and neonatal birthweight in a rural district hospital delivery-ward; (2) a case-control study of malaria risk among reproductive-age women attending primary-level clinics; and (3) community surveys of malaria and anaemia prevalence, socioeconomic status, malaria knowledge and reported behaviour among pregnant women. Among 517 delivery-ward participants (1), one malaria case (prevalence 1.9/1000), 179 anaemia cases (prevalence 346/1000), and 59 low-birthweight deliveries (prevalence 107/1000) were detected. Anaemia was not associated with age, gravidity, intestinal parasite prevalence, or low-birthweight at delivery. Among 141 malaria cases and 1010 controls (2), no association was found between malaria infection and pregnancy (AOR 0.89; 95 % CI 0.57-1.39), parity (AOR 0.95; 95 % CI 0.85-1.05), age (AOR 1.02; 95 % CI 1.00-1.04), or anaemia (AOR 1.00; 95 % CI 0.65-1.54). Those reporting insecticide-treated net usage had 40 % reduced odds of malaria infection (AOR 0.60; 95 % CI 0.40-0.91). Among 530 community survey participants (3), malaria and anaemia prevalence were 3.9/1000 and 277/1000 respectively, with 34/1000 experiencing severe anaemia. Despite most women having no formal education, malaria knowledge was high. Most expressed reluctance to take malaria preventive medication during pregnancy, deeming it potentially unsafe. Given the low malaria risk and reported avoidance of medication during pregnancy, intermittent preventive treatment is hard to justify or implement. Preventive strategy should instead focus on long-lasting insecticidal nets for all pregnant
Thach Duc Tran
Full Text Available Little evidence about the effects of antenatal iron supplementation on infant anaemia is available. The aim was to compare effects on six-month-old infants' Haemoglobin (Hb concentration and anaemia of daily iron-folic acid (IFA, twice-weekly IFA with or without other micronutrients (MMN and usual antenatal care in rural Vietnam.Secondary data analysis from: a prospective population-based observational study (OS which examined effects of antenatal psychosocial factors, anaemia and iron deficiency on infant development and health; and a three-arm cluster randomised trial (CRT of different antenatal iron supplementation regimens. In the OS 497 women (<20 weeks gestation from 50 randomly-selected communes participated, and in the CRT 1,258 pregnant women (<16 weeks gestation in 104 communes were allocated randomly to trial arms. The main outcome was six-month-old infant Hb concentration. Baseline data included women's socio-demographic characteristics, reproductive health, Hb and serum ferritin. Mean differences in infant Hb and odds ratios of infant anaemia between CRT arms and OS were calculated by multivariable regression models, controlling for baseline differences and clustering, using robust standard errors. Infant anaemia prevalence was 68.6% in the OS, 47.2% daily IFA, 53.5% weekly IFA, and 50.3% MMN conditions. After adjustment, mean infant haemoglobin levels in daily IFA (mean difference = 0.95 g/dL; 95%CI 0.7-11.18; weekly IFA (0.91; 95%CI 0.69-1.12 and MMN (1.04; 95%CI 0.8-1.27 were higher than in the OS. After adjustment there were lower odds ratios of anaemia among infants in the daily IFA (OR = 0.31; 95% CI 0.22-0.43, weekly IFA (0.38; 95%CI 0.26-0.54 and MMN (0.33; 95%CI 0.23-0.48 groups than in the OS.Infant anaemia is a public health problem in Vietnam and other resource-constrained countries. All supplementation regimens could have clinically significant benefits for Hb and reduce anaemia risk among six-month-old infants
Javier E. Mirazo
Full Text Available Upper airway endoscopy at rest has been the diagnostic method of choice for equine upper respiratory tract (URT conditions. Development of high-speed treadmill endoscopy improved the sensitivity of URT endoscopy by allowing observation of the horse’s nasopharynx and larynx during exercise. However, treadmill exercise may not always accurately represent the horse’s normal exercise as track surface, rider, tack and environmental variables are altered. Recently, the development of dynamic overground endoscopy (DOE has addressed some of these shortcomings. A retrospective study was undertaken to describe the URT abnormalities detected during DOE in racehorses presenting with poor performance and/or abnormal respiratory noise. Patient records of Thoroughbred racehorses undergoing DOE from November 2011 to August 2012 were reviewed. Data collected included signalment, primary complaint, distance exercised, maximum speed and dynamic airway abnormalities detected. Fifty-two horses underwent DOE for investigation of poor performance and/or abnormal respiratory noise. The main abnormalities detected included axial deviation of the aryepiglottic folds (40%, vocal cord collapse (35%, abnormal arytenoid function (33% and dorsal displacement of the soft palate (25%. A total of 40 horses were diagnosed with one or more abnormalities of the URT (77%. Fifteen horses (29% had a single abnormality and 25 horses (48% had multiple abnormalities. This study showed that DOE is a useful technique for investigating dynamic disorders of the URT in racehorses in South Africa. The total number and type of dynamic pathological conditions were comparable with those identified in similar populations in other geographical locations.
Liu Ming; Zhang Yuzhen; Wang Qiuyan; Zhang Zhongyang; Li Yuhua
Objective: To illustrate the important complemental function of MRI in dignosing the urinary abnormalities of the fetus by analyzing MR features. Methods: MRI findings in 34 fetal urinary abnormalities were retrospectively analyzed. Results: Upper urinary tract dilatation was found in 12 cases: one case presented obstructed right renal dysplasia and was on the follow-up, postnatal MR imaging proved the duplex anomaly in one case, one case showed left PUJO on postnatal US imaging and prepared to surgery, 7 cases were normal on postnatal US imaging, 2 cases were lost to follow up. Bilateral urinary anomalies were found in 7 cases: Muhicystic renal dysplasia (n=3), Combined horseshoe kidney in 2 fetuses and bilateral renal aplasia in one case. Bilateral renal dysplasia was diagnosed in 2 cases, one was still bom and proved by autopsy and the other was lost to follow up. The case of bilateral renal agenesis displayed the appearance of sirenomelia on general specimen. The case of right renal agenesis associated contralateral kidney dyspalsia (n=1) was lost to follow up. MR imaging showed low signal intensity of lung and oligohydramnios in the bilateral anomalies. Unilateral urinary anomalies was found in 15 cases, including 9 cases of unilateral renal dysplasia. Two fetuses were aborted and 3 fetuses were proved with postnatal US or MR. One was lost to follow up; 3 cases were on the follow-up. There were 4 cases of unilateral renal agenesis, two fetuses were aborted and 2 fetuses were proved with postnatal US or MR imaging. The case of ectopic kidney was proved with postnatal US imaging. One case of urachal cyst was aborted without autopsy. In the unilateral anomalies, the volume of amniotic fluid was normal, and the fetal lung presented homogenious high signal intensity. Conclusion: As a complemental method, MRI is of great value in displaying and dignosing the urinary abnormalities of fetus. (authors)
Fanton, N; Michelazzi, M; Cornegliani, L
Abnormal maternal behaviour has been reported in cats, but is generally not included among the causes of alopecia in kittens. A litter of four kittens, 2 months old, was referred for evaluation of facial alopecia of differing severity. The 2-year-old queen was unaffected. Dermatological examination of the kittens did not find any infectious cause. Trichograms showed broken hair shafts with longitudinal splitting. Congenital alopecia was unlikely based on the clinical presentation. A behavioural consultation revealed abnormal grooming behaviour by the mother, who chewed and removed the hair from the kittens. The kittens were separated from the queen and alopecia resolved within a few weeks. To the authors' knowledge, this is the first report of alopecia caused by abnormal maternal licking behaviour. Abnormal maternal behaviour should be considered in cases of alopecia affecting a litter of kittens, when infectious and congenital causes have been ruled out. © 2015 Australian Veterinary Association.
Pickham, David; Hickey, Kathleen; Doering, Lynn; Chen, Belinda; Castillo, Carmen; Drew, Barbara J
Describe ECG abnormalities in the first year following transplant surgery. Analysis of 12-lead ECGs from heart transplant subjects enrolled in an ongoing multicenter clinical trial. 585 ECGs from 98 subjects showed few with abnormal cardiac rhythm (99% of ECGs were sinus rhythm/tachycardia). A majority of subjects (69%) had either right intraventricular conduction delay (56%) or right bundle branch block (13%). A second prevalent ECG abnormality was atrial enlargement (64% of subjects) that was more commonly left atrial (55%) than right (30%). Right intraventricular conduction delay or right bundle branch block is prevalent in heart transplant recipients in the first year following transplant surgery. Whether this abnormality is related to acute allograph rejection or endomyocardial biopsy procedures is the subject of the ongoing clinical trial. Atrial enlargement ECG criteria (especially, left atrial) are also common and are likely due to transplant surgery with subsequent atrial remodeling. © 2013 Elsevier Inc. All rights reserved.
Breymann, C; Honegger, C; Hösli, I; Surbek, D
Iron deficiency occurs frequently in pregnancy and can be diagnosed by serum ferritin-level measurement (threshold value iron-deficiency anemia is recommended in every pregnant women, and should be done by serum ferritin-level screening in the first trimester and regular hemoglobin checks at least once per trimester. In the case of iron deficiency with or without anaemia in pregnancy, oral iron therapy should be given as first-line treatment. In the case of severe iron-deficiency anemia, intolerance of oral iron, lack of response to oral iron, or in the case of a clinical need for rapid and efficient treatment of anaemia (e.g., advanced pregnancy), intravenous iron therapy should be administered. In the postpartum period, oral iron therapy should be administered for mild iron-deficiency anemia (haemorrhagic anemia), and intravenous iron therapy for moderately severe-to-severe anemia (Hb iron therapy in pregnancy or postpartum, iron-containing drugs which have been studied in well-controlled clinical trials in pregnancy and postpartum such as ferric carboxymaltose must be preferred for safety reasons. While anaphylactic reactions are extremely are with non-dextrane products, close surveillance during administration is recommended for all intravenous iron products.
Alemu, Megbaru; Kinfe, Birhane; Tadesse, Desalegn; Mulu, Wondemagegn; Hailu, Tadesse; Yizengaw, Endalew
The aim of this cross-sectional study was to determine the magnitude of intestinal parasitosis and anaemia in a Health Center, North Ethiopia. A total of 427 outpatients were enrolled and the median age of the participants was 22 years. The prevalence of intestinal parasitosis was 143 (33.5%). Age, place of residence and occupation were significantly associated with intestinal parasitosis. When we see parasite specific factors, significant associations were observed for source of drinking water (P = 0.02), age (P intestinal parasite -infected and non-infected participants was 10.7 and 7.0%, respectively. Study participants infected with S. stercoralis and hookworm were more likely to develop anaemia than the non- infected ones; AOR (adjusted odds ratio) = 5.3, 95% CI (1.01-27.4); P = 0.028 and AOR = 11.1, 95% CI (3.36-36.9); P = 0.000, respectively.
Elegbe, I; Ojofeitimi, E O; Olegbe, I A
Investigation of 122 women early in the second trimester of pregnancy who complained of constant dizziness during pregnancy, and used traditional "black rings on their middle fingers" as a prophylactic measure, revealed that 59% were anaemic (haemoglobin less than 10 g/100 ml). None of them had blood pressure above 120/70 mmHg. After two months of treatment with ferrous gluconate 300 mg three times daily, folic acid, weekly antimalarial drug, and individual regular nutrition counselling, the incidence of anaemia was reduced to 22.7%. The mean haemoglobin levels before and after initiation of drug therapy were 8.5 and 10.8 g/100 ml respectively. There was a significant difference between the two means (P less than 0.05). There was also a marked difference between the mean haemoglobin levels of ring-wearers and non-ring-wearers in the less educated members of the two groups (P less than 0.001). It can be inferred from this study that the wearing of black rings indicates that the patients are likely to be anaemic, and that educated women seem less likely to rely on this type of traditional treatment of pregnancy anaemia.
Plichta, Piotr; Pawelec, Katarzyna
Avascular necrosis (AVN) is a pathological condition associated with numerous processes. Most frequent causes of ischaemia of the femoral head include trauma, corticosteroid therapy, radiation therapy, alcoholism, Gaucher's disease, systemic lupus erythematosus, rheumatoid arthritis. Corticosteroid therapy is considered the most frequent risk factor for developing avascular necrosis. In this paper we report a case of a 19-year old female patient who developed avascular necrosis of the right femoral head following treatment of severe aplastic anaemia. Clinical symptoms included groin pain and fever, painful abduction and internal rotation, tenderness over the right hip joint. The plain X-ray was not specific. However magnetic resonance imaging of the hip revealed changes characteristic for avascular necrosis. Conservative treatment was administrated. Two years after the onset of first clinical symptoms the patient is able to walk without pain, although the range of motion of the right hip joint is partially diminished. We evaluated the possible risk factors of AVN, diagnostic methods and prognosis. The onset of avascular necrosis should be considered as one of the relevant complications in patients with severe aplastic anaemia following immunosuppressive treatment.
Garabedian, C; Philippe, M; Vaast, P; Wibaut, B; Salleron, J; Delsalle, A; Rakza, T; Subtil, D; Houfflin-Debarge, V
To study modalities and complications of intrauterine exchange transfusion (IUET) for the management of severe fetal anaemia. Retrospective study of all IUET procedures performed between January 1999 and January 2012 at a regional centre. Characteristics of each procedure were studied to identify risk factors for complications. Survival rates according to the different aetiologies of anaemia were evaluated. In total, 225 IUET procedures were performed in 96 fetuses. Major indications were feto-maternal erythrocyte alloimmunization (n=80/96, 83.3%) and parvovirus B19 infection (n=13/96, 13.5%). Twenty-six percent of the fetuses (25/96) had hydrops fetalis before the first IUET. Intrauterine fetal death occurred after 2.7% (6/225) of procedures, premature rupture of the membranes occurred after 0.9% (2/225) of procedures, and emergency caesarean section was required after 3.6% (8/225) of procedures. Fetal bradycardia [odds ratio (OR) 37, 95% confidence interval (CI) 8.3-170; prate in the study cohort was 87.5% (84/96): 90% (72/80) in the alloimmunization group and 76.9% (10/13) in the parvovirus-infected group (NS). IUET has a higher complication rate than simple intrauterine transfusion, and should be performed by well-trained specialists. Copyright © 2014. Published by Elsevier Ireland Ltd.
Samuel Olufemi Akodu
Full Text Available Background. Sickle cell disorders are known to have a negative effect on linear growth. This could potentially affect proportional growth and, hence, Cormic Index. Objective. To determine the Cormic Index in the sickle cell anaemia population in Lagos. Methodology. A consecutive sample of 100 children with haemoglobin genotype SS, aged eight months to 15 years, and 100 age and sex matched controls (haemoglobin genotype AA was studied. Sitting height (upper segment and full length or height were measured. Sitting height was then expressed as a percentage of full length/height (Cormic Index. Results. The mean Cormic Index decreased with age among primary subjects (SS and AA controls. The overall mean Cormic Index among primary subjects was comparable to that of controls (55.0±4.6% versus 54.5±5.2%; 54.8±4.5% versus 53.6±4.9% in boys and girls, respectively. In comparison with AA controls, female children with sickle cell anaemia who were older than 10 years had a significantly lower mean Cormic Index. Conclusion. There was a significant negative relationship between Cormic Index and height in subjects and controls irrespective of gender. Similarly, a significant negative correlation existed between age, sitting height, subischial leg length, weight, and Cormic Index in both subjects and controls.
Full Text Available Background: A combination of low-dose thalidomide and corticosteroids is a treatment option for anaemic patients with primary myelofibrosis (PMF who are not eligible for allogeneic hematopoietic stem cell transplantation. Methods: We describe the outcomes of 13 patients with PMF treated with thalidomide 50 mg daily in combination with prednisone 0.5 mg/kg daily. Treatment responses were seen in 10/13 (77% patients with a median onset of therapeutic effect at 4 weeks (range 3–7 weeks after treatment initiation. Improvements of anaemia and thrombocytopenia and reduction in splenomegaly were observed in 70%, 38%, and 30% of patients, respectively. Four of six initially transfusion-dependent patients became transfusion independent following the therapy. The median duration of treatment response was 18 months (range 3–35 months. The treatment was well tolerated, with only one patient discontinuing therapy due to toxicity. Responders included both patients with and without JAK2 V617F, and included patients with both newly diagnosed and longstanding PMF. Conclusions: Our retrospective analysis confirmed that the therapy with low-doses thalidomide with prednisone in patients with PMF achieves significant response rate in anaemia with low treatment toxicity.
Casner, Stephen M; Geven, Richard W; Williams, Kent T
To evaluate the effectiveness of airline pilot training for abnormal in-flight events. Numerous accident reports describe situations in which pilots responded to abnormal events in ways that were different from what they had practiced many times before. One explanation for these missteps is that training and testing for these skills have become a highly predictable routine for pilots who arrive to the training environment well aware of what to expect. Under these circumstances, pilots get plentiful practice in responding to abnormal events but may get little practice in recognizing them and deciding which responses to offer. We presented 18 airline pilots with three abnormal events that are required during periodic training and testing. Pilots were presented with each event under the familiar circumstances used during training and also under less predictable circumstances as they might occur during flight. When presented in the routine ways seen during training, pilots gave appropriate responses and showed little variability. However, when the abnormal events were presented unexpectedly, pilots' responses were less appropriate and showed great variability from pilot to pilot. The results suggest that the training and testing practices used in airline training may result in rote-memorized skills that are specific to the training situation and that offer modest generalizability to other situations. We recommend a more complete treatment of abnormal events that allows pilots to practice recognizing the event and choosing and recalling the appropriate response. The results will aid the improvement of existing airline training practices.
... lesion? • What are the different types of abnormal Pap test results? • What testing is needed after an abnormal ... that could lead to cancer. Screening includes the Pap test and, for some women, testing for a virus ...
Quinn, S.F.; Sanchez, R.; Murray, W.T.; Silbiger, M.L.; Ogden, J.; Cochran, C.
MR imaging can directly image abnormal synovium. The authors reviewed over 50 cases with abnormal synovial processes. The abnormalities include Baker cysts, semimembranous bursitis, chronic shoulder bursitis, peroneal tendon ganglion cyst, periarticular abscesses, thickened synovium from rheumatoid and septic arthritis, and synovial hypertrophy secondary to Legg-Calve-Perthes disease. MR imaging has proved invaluable in identifying abnormal synovium, defining the extent and, to a limited degree, characterizing its makeup
Murat, Semiz; Ali, Uslu; Serdal, Korkmaz; Süleyman, Demir; İlknur, Parlak; Mehmet, Sencan; Bahattin, Aydın; Tunahan, Uncu
We aimed to assess the effect of anemia on subjective sleep quality in patients with iron deficiency anemia (IDA). One hundred and four patients diagnosed with IDA and 80 healthy individuals, who are gender and age matched, were included in the study. All participants were requested to fill 3 forms: a socio-demographic form (age, gender, marital status, income level and educational status), hospital anxiety and depression (HAD) scale and pittsburgh sleep quality index (PSQI). According to the HAD scale, the average anxiety score was found 9.24±4.37 in patients and 7.58± 4.07 in controls. And, the average depression score was 7.53±4.10 in patients and 6.41±2.74 in controls. The total sleep quality score was 6.71±3.02 in patients and 4.11±1.64 in controls. There was a statistically significant difference in terms of anxiety, depression and sleep quality scores. Linear regression analysis showed no association between anxiety and depression with poor sleeping. IDA affects sleep quality irrespective of psychological symptoms such as depression and anxiety.
Full Text Available Abstract Background Infectious salmon anaemia (ISA virus (ISAV, an important pathogen of fish that causes disease accompanied by high mortality in marine-farmed Atlantic salmon, is the only species in the genus Isavirus, one of the five genera of the Orthomyxoviridae family. The Isavirus genome consists of eight single-stranded RNA species, and the virions have two surface glycoproteins; haemagglutinin-esterase (HE protein encoded on segment 6 and fusion (F protein encoded on segment 5. Based on the initial demonstration of two 5'-coterminal mRNA transcripts by RT-PCR, ISAV genomic segment 7 was suggested to share a similar coding strategy with segment 7 of influenza A virus, encoding two proteins. However, there appears to be confusion as to the protein sizes predicted from the two open reading frames (ORFs of ISAV segment 7 which has in turn led to confusion of the predicted protein functions. The primary goal of the present work was to clone and express these two ORFs in order to assess whether the predicted protein sizes match those of the expressed proteins so as to clarify the coding assignments, and thereby identify any additional structural proteins of ISAV. Results In the present study we show that ISAV segment 7 encodes 3 proteins with estimated molecular masses of 32, 18, and 9.5 kDa. The 18-kDa and 9.5-kDa products are based on removal of an intron each from the primary transcript (7-ORF1 so that the translation continues in the +2 and +3 reading frames, respectively. The segment 7-ORF1/3 product is variably truncated in the sequence of ISAV isolates of the European genotype. All three proteins are recognized by rabbit antiserum against the 32-kDa product of the primary transcript, as they all share the N-terminal 22 amino acids. This antiserum detected a single 35-kDa protein in Western blots of purified virus, and immunoprecipitated a 32-kDa protein in ISAV-infected TO cells. Immunofluorescence staining of infected cells with the
Training of nuclear power plant control room operators, on actions to be taken for an abnormal event, has classically been limited to discussion, on-shift and/or during requalification training classes, of symptoms, logical thought processes, systems analysis, and operator experience. The prerequisites for these discussions are a common technical vocabulary, and a minimum basic comprehension of nuclear power plant fundamentals, plant component theory of operation, system configuration, system control philosophy and operating procedures. Nuclear power plant control room operators are not the only personnel who are or should be involved in these discussions. The shift supervisors, operations management, and auxiliary equipment operators require continuing training in abnormal operations, as well. More in-depth training is necessary for shift supervisors and control room operators. The availability of vendor simulators has improved the effectiveness of training efforts for these individuals to some extent by displaying typical situations and plant performance characteristics and by providing a degree of ''hands on'' experience. The evolution of in-depth training with these simulators is reviewed
Tuberculosis remains the leading cause of death among people living with HIV in sub-Saharan Africa and worldwide. The clinical presentation in such patients is often so non-specific that much tuberculosis remains unsuspected, undiagnosed and is therefore untreated prior to death. Anaemia is one of
Attempts were made to increase the effectiveness of HBO in overcoming tumor hypoxia. Tumor blood flow and O/sub 2/ content were modified by inducing moderate anaemia and giving a perfluorochemical emulsion (PFC-E). Mice were anaesthetized with Ketamine and Diazepam. The PFC-E, FC-43 (0.35 ml/25 g mouse), given iv 1-2 h before irradiation, produced a favourable effect on regrowth delay in those mice treated with HBO. A 25 Gy dose produced a significantly longer regrowth delay (p<0.01) of 44 days in PFC-treated mice compared with a delay of 29 days for mice treated with HBO alone. O/sub 2/ toxicity was observed in some anesthetized mice, with or without PFC-E. Attempts were made to increase the O/sub 2/ sensitization afforded by FC-43/HBO/anaesthesia. Blood viscosity was reduced by inducing a moderate level of acute anaemia by the administration of a single of acute anaemia by the administration of a single ip injection of Phenylhydrazine HCl (40 mg/kg). This reduced the haematocrit from 42% to 32%. Tumour regrowth delay after 25 Gy was significantly reduced (p<0.02) from 44 to 37.3 days be anaemia. PFC's may prove the be useful adjuncts to radiotherapy. However, it must be established that they have no adverse effects and that normal tissue radiosensitivity is not enhanced
Piek, C.J.; Teske, E.; van Leeuwen, M.W.; Day, M.J.
Abstract Background The aim of this study was to compare a gel-based test with the traditional direct agglutination test (DAT) for the diagnosis of immune-mediated haemolytic anaemia (IMHA). Methods Canine (n = 247) and feline (n = 74) blood samples were submitted for DAT testing to two
Olatunbosun, Olujimi A; Abasiattai, Aniekan M; Bassey, Emem A; James, Robert S; Ibanga, Godwin; Morgan, Anyiekere
Anaemia with an estimated prevalence of 35-75% among pregnant women is a major cause of maternal deaths in Nigeria. objective: To determine the prevalence of anaemia, associated sociodemographic factors and red cell morphological pattern among pregnant women during booking at the University Teaching Hospital, Uyo. A cross-sectional analytical study of 400 women at the booking clinic over a 16-week period. The packed cell volume and red cell morphology of each pregnant woman were determined. Their biodata, obstetric and medical histories, and results of other routine investigations were obtained with questionnaires and analyzed with SPSS Package version 17.0. The mean packed cell volume was 31.8% ±3.2 and 54.5% of the women were anaemic. The commonest blood picture was microcytic hypochromia and normocytic hypochromia suggesting iron deficiency anaemia. Anaemia was significantly and independently related to a history of fever in the index pregnancy (OR = 0.4; P = 0.00; 95% CI = 0.3-0.7), HIV positive status (OR = 0.2; P = 0.01; 95% CI = 0.1-0.6), and low social class (OR = 0.3; P = 0.00; 95% CI = 0.2-0.7). Women need to be economically empowered and every pregnant woman should be encouraged to obtain antenatal care, where haematinics supplementation can be given and appropriate investigations and treatment of causes of fever and management of HIV can be instituted.
Mockenhaupt, Frank P.; Mandelkow, Jantina; Till, Holger; Ehrhardt, Stephan; Eggelte, Teunis A.; Bienzle, Ulrich
Glucose-6-phosphate dehydrogenase (G6PD) deficiency confers protection against malaria in children, yet its role in malaria in pregnancy is unknown. In a cross-sectional study among 529 pregnant Ghanaian women, Plasmodium falciparum infection, anaemia and G6PD genotypes were assessed. Of these,
Mickley, H; Sørensen, P G
A case of severe immune haemolytic anaemia in a 54-year-old man suffering from Mycoplasma pneumonia is presented. A strongly positive direct Coombs test with erythrocyte bound IgG, C3d and C4 was demonstrated during the haemolytic process. Further, serologic investigations revealed ampicillin-dep...
Salinas, Maria; López-Garrigós, Maite; Flores, Emilio; Leiva-Salinas, Carlos
To study the regional variability of requests for anaemia chemistry tests in primary care in Spain and the associated economic costs of potential over-requesting. Requests for anaemia tests were examined in a cross-sectional study. Clinical laboratories from different autonomous communities (AACCs) were invited to report on primary care anaemia chemistry tests requested during 2014. Demand for iron, ferritin, vitamin B12 and folate tests per 1000 inhabitants and the ratios of the folate/vitamin B12 and transferrin/ferritin requests were compared between AACCs. We also calculated reagent costs and the number of iron, transferrin and folate tests and the economic saving if every AACC had obtained the results achieved by the AACC with best practice. 110 laboratories participated (59.8% of the Spanish population). More than 12 million tests were requested, resulting in reagent costs exceeding €16.5 million. The serum iron test was the most often requested, and the ferritin test was the most costly (over €7 million). Close to €4.5 million could potentially have been saved if iron, transferrin and folate had been appropriately requested (€6 million when extrapolated to the whole Spanish population). The demand for and expenditure on anaemia chemistry tests in primary care in Spain is high, with significant regional differences between different AACCs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Birgens, Henrik; Frederiksen, Henrik; Hasselbalch, Hans C
The impact of first-line treatment with the anti-CD 20 chimeric monoclonal antibody rituximab in patients with warm-antibody reactive autoimmune haemolytic anaemia (WAIHA) is unknown. We report the first randomized study of 64 patients with newly diagnosed WAIHA who received prednisolone and ritu...
Bryce, Renata M; Salas, Aquiles; Acosta, Daisy; Jimenez-Velazquez, Ivonne Z; Llibre-Rodriguez, Juan J; Sosa, Ana Luisa; Teruel, Beatriz Marcheco; Valhuerdi, Adolfo; Ferri, Cleusa P; McKeigue, Paul; Prince, Martin J
Anaemia among older people is increasingly recognized as a matter of public health concern. Data from low- and middle-income countries are sparse. We surveyed 10915 people aged 65 years and over (8423 with blood tests) in catchment areas in Cuba, Dominican Republic, Puerto Rico, Venezuela and Mexico, to assess prevalence and correlates of anaemia and impact on disability. Prevalence varied widely between sites, from 6·4% in rural Mexico to 9·2% in urban Mexico, 9·8% in Venezuela, 19·2% in Cuba, 32·1% in Puerto Rico and 37·3% in Dominican Republic. Prevalence was higher in men and increased with age, but sociodemographic composition did not account for prevalence differences between sites. Standardized morbidity ratios indicated a much higher prevalence in Cuba (173), Puerto Rico (280) and Dominican Republic (332) compared with USA National Health and National Examination Surveys. Anaemia was associated with undernutrition, physical impairments, and serum creatinine. There was an association with greater African admixture in Dominican Republic but not in Cuba. African admixture is therefore unlikely to fully explain the high prevalence in the Caribbean islands, which may also arise from environmental, possibly dietary factors. Given an important independent contribution of anaemia to disability, more research is needed to identify preventable and treatable causes. © 2012 Blackwell Publishing Ltd.
Erol, Ilknur; Alehan, Fusun; Gumus, Ayten
Vitamin B[subscript 12] deficiency in infants often produces haematological and neurological deficits, including macrocytic anaemia, neurodevelopmental delay or regression, irritability, weakness, hypotonia, ataxia, apathy, tremor, and seizures. The diagnosis of vitamin B[subscript 12] deficiency can be difficult when the typical macrocytic…
Minniti, Caterina P; Gorbach, Alexander M; Xu, Dihua; Hon, Yuen Yi; Delaney, Kara-Marie; Seidel, Miles; Malik, Nitin; Peters-Lawrence, Marlene; Cantilena, Carly; Nichols, James S; Mendelsohn, Laurel; Conrey, Anna; Grimes, George; Kato, Gregory J
Summary Background Well-tolerated and effective treatments are needed for chronic leg ulcers in sickle cell anaemia. Topical sodium nitrite, a known nitric oxide donor, enhances blood flow in ulcers and has known bacteriostatic effects. We aimed to assess the safety, tolerability, and pharmacokinetics of topical sodium nitrite in patients with sickle cell disease and chronic leg ulcers. Methods We enrolled adult patients from an ambulatory clinic at the National Institutes of Health (Bethesda, MD, USA) with sickle cell anaemia with leg ulcers (with a surface area of 2.5–100 cm2) persisting for at least 4 weeks into a safety and tolerability phase 1 dose-escalation trial of topical sodium nitrite. Increasing concentrations of sodium nitrite cream were applied twice weekly for 4 weeks to one ulcer per patient at five dose levels (0.5%, 1%, 1.5%, 1.8%, and 2%). The primary endpoints were safety and tolerability, with secondary endpoints of pharmacokinetics, blood flow, and wound healing. Pain relief was analysed post hoc. Endpoints were analysed over time for the whole study population and according to dose level. This study is registered with ClinicalTrials.gov, number NCT01316796. Findings Between April 4, 2011, and March 19, 2013, we enrolled 18 adult patients with sickle cell anaemia and leg ulcers into our trial. We assigned three patients into each cohort, and each cohort was treated with a different concentration of sodium nitrite cream (cohort 1: 0.5%, cohort 2: 1.0%, cohort 3: 1.5%, and cohort 4: 2.0%). Patients were not enrolled into the next cohort dose until we were able to establish that no dose-limiting toxicities were observed. An additional six patients were enrolled to cohort 3a: 1.8%, after two patients in cohort 4 had asymptomatic drops in diastolic blood pressure. No grade 3–4 adverse events were observed, and there were no serious adverse events or dose-limiting side-effects. Pharmacokinetic analysis showed that systemic absorption of sodium
Jones, Andrew D; Colecraft, Esi K; Awuah, Raphael B; Boatemaa, Sandra; Lambrecht, Nathalie J; Adjorlolo, Leonard Kofi; Wilson, Mark L
Livestock ownership may influence anaemia through complex and possibly contradictory mechanisms. In this study, we aimed to determine the association of household livestock ownership with anaemia among women aged 15-49 years and children aged 6-59 months in Ghana and to examine the contribution of animal source foods (ASFs) to consumption patterns as a potential mechanism mediating this association. We analysed data on 4,441 women and 2,735 children from the 2014 Ghana Demographic and Health Survey and 16,772 households from the Ghana Living Standards Survey Round 6. Haemoglobin measurements were used to define anaemia (non-pregnant women: <120 g/L; children: <110 g/L). Child- and household-level ASF consumption data were collected from 24-hour food group intake and food consumption and expenditure surveys, respectively. In multiple logistic regression models, household livestock ownership was associated with anaemia among children (OR, 95% CI: 1.5 [1.1, 2.0]), but not women (1.0 [0.83, 1.2]). Household ownership of chickens was associated with higher odds of anaemia among children (1.6 [1.2, 2.2]), but ownership of other animal species was not associated with anaemia among women or children. In path analyses, we observed no evidence of mediation of the association of household livestock ownership with child anaemia by ASF consumption. Ownership of livestock likely has limited importance for consumption of ASFs among young children in Ghana and may in fact place children at an increased risk of anaemia. Further research is needed to elucidate if and how pathogen exposure associated with livestock rearing may underlie this increased risk of anaemia. © 2018 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.
Ren, Huamin; Moeslund, Thomas B.
We propose to detect abnormal events via a sparse subspace clustering algorithm. Unlike most existing approaches, which search for optimized normal bases and detect abnormality based on least square error or reconstruction error from the learned normal patterns, we propose an abnormality...... measurement based on the difference between the normal space and local space. Specifically, we provide a reasonable normal bases through repeated K spectral clustering. Then for each testing feature we first use temporal neighbors to form a local space. An abnormal event is found if any abnormal feature...
Brummelman, Pauline; Sattler, Margriet G.A.; Meiners, Linda C.; Berg, Gerrit van den; Klauw, Melanie M. van der; Elderson, Martin F.; Dullaart, Robin P.F.; Koerts, Janneke; Werumeus Buning, Jorien; Tucha, Oliver; Wolffenbuttel, Bruce H.R.; Bergh, Alfons C.M. van den; Beek, André P. van
Highlights: • Cognitive impairments are frequently observed in treated NFA patients. • NFA patients with cognitive impairments do not show brain abnormalities on MRI more frequently than patients without cognitive impairments. • The absence of brain abnormalities on brain MRI does not exclude impairments of cognition. - Abstract: Purpose: The extent to which cognitive dysfunction is related to specific brain abnormalities in patients treated for pituitary macroadenoma is unclear. Therefore, we compared brain abnormalities seen on Magnetic Resonance Imaging (MRI) in patients treated for nonfunctioning pituitary macroadenoma (NFA) with or without impairments in cognitive functioning. Methods: In this cross-sectional design, a cohort of 43 NFA patients was studied at the University Medical Center Groningen. White matter lesions (WMLs), cerebral atrophy, (silent) brain infarcts and abnormalities of the temporal lobes and hippocampi were assessed on pre-treatment and post-treatment MRI scans. Post-treatment cognitive examinations were performed using a verbal memory and executive functioning test. We compared our patient cohort with large reference populations representative of the Dutch population. Results: One or more impairments on both cognitive tests were frequently observed in treated NFA patients. No treatment effects were found with regard to the comparison between patients with and without impairments in executive functioning. Interestingly, in patients with one or more impairments on verbal memory function, treatment with radiotherapy had been given more frequently (74% in the impaired group versus 40% in the unimpaired group, P = 0.025). Patients with or without any brain abnormality on MRI did not differ in verbal memory or executive functioning. Conclusions: Brain abnormalities on MRI are not observed more frequently in treated NFA patients with impairments compared to NFA patients without impairments in verbal memory or executive functioning
Brummelman, Pauline [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); Sattler, Margriet G.A. [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen (Netherlands); Department of Radiation Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Meiners, Linda C. [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Berg, Gerrit van den; Klauw, Melanie M. van der [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); Elderson, Martin F. [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); LifeLines Cohort Study and Biobank, University of Groningen, University Medical Center Groningen (Netherlands); Dullaart, Robin P.F. [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); Koerts, Janneke [Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen (Netherlands); Werumeus Buning, Jorien, E-mail: firstname.lastname@example.org [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); Tucha, Oliver [Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen (Netherlands); Wolffenbuttel, Bruce H.R. [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); LifeLines Cohort Study and Biobank, University of Groningen, University Medical Center Groningen (Netherlands); Bergh, Alfons C.M. van den [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen (Netherlands); Beek, André P. van, E-mail: email@example.com [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands)
Highlights: • Cognitive impairments are frequently observed in treated NFA patients. • NFA patients with cognitive impairments do not show brain abnormalities on MRI more frequently than patients without cognitive impairments. • The absence of brain abnormalities on brain MRI does not exclude impairments of cognition. - Abstract: Purpose: The extent to which cognitive dysfunction is related to specific brain abnormalities in patients treated for pituitary macroadenoma is unclear. Therefore, we compared brain abnormalities seen on Magnetic Resonance Imaging (MRI) in patients treated for nonfunctioning pituitary macroadenoma (NFA) with or without impairments in cognitive functioning. Methods: In this cross-sectional design, a cohort of 43 NFA patients was studied at the University Medical Center Groningen. White matter lesions (WMLs), cerebral atrophy, (silent) brain infarcts and abnormalities of the temporal lobes and hippocampi were assessed on pre-treatment and post-treatment MRI scans. Post-treatment cognitive examinations were performed using a verbal memory and executive functioning test. We compared our patient cohort with large reference populations representative of the Dutch population. Results: One or more impairments on both cognitive tests were frequently observed in treated NFA patients. No treatment effects were found with regard to the comparison between patients with and without impairments in executive functioning. Interestingly, in patients with one or more impairments on verbal memory function, treatment with radiotherapy had been given more frequently (74% in the impaired group versus 40% in the unimpaired group, P = 0.025). Patients with or without any brain abnormality on MRI did not differ in verbal memory or executive functioning. Conclusions: Brain abnormalities on MRI are not observed more frequently in treated NFA patients with impairments compared to NFA patients without impairments in verbal memory or executive functioning
Huebner, Thomas; Vloet, Timo D.; Marx, Ivo; Konrad, Kerstin; Fink, Gereon R.; Herpertz, Sabine C.; Herpertz-Dahlmann, Beate
Conduct disorder (CD) is associated with antisocial personality behavior that violates the basic rights of others. Results, on examining the structural brain aberrations in boys' CD, show that boys with CD and cormobid attention-deficit/hyperactivity disorder showed abnormalities in frontolimbic areas that could contribute to antisocial…
Ninety (90) velocity control points derived from seismic data processing were examined and analyzed to evaluate abnormal pressure zones in parts of onshore western Niger - Delta. Compaction trend graphs and a map showing the distribution of top of overpressure were produced. The graphs show that compaction ...
Neervoort, Femke; von Rosenstiel, Ines; Bongers, Karlien; Demetriades, Matthew; Shacola, Marina; Wolffers, Ivan
To reduce malnutrition and improve child survival, school feeding programmes have been established in many parts of Africa, although prevalence of child malnutrition and anaemia remains high, especially in urban slums. The objective of this study is to evaluate the effect of a school feeding programme in the slums of Nairobi (Kenya) on anaemia and nutritional status, together with an investigation for socioeconomic determinants that may overrule this effect. Sixty-seven children at the St. George primary school in Kibera participated in the school feeding programme for 1 year and data concerning anaemia rate, nutritional status and socioeconomic status were collected during a medical health check. Data were compared with a control group of children attending the same school, of the same age and with the same gender distribution without participation in a feeding programme. Data were analyzed with statistical software (SPSS 17.0). Children participating in the school feeding programme were less stunted (p = 0.02) and wasted (p = 0.02) than children in the control group, and levels of anaemia were lower (p = 0.01). Having no father (p = 0.01) and living in small families (p = 0.003) overruled the effect of the feeding programme. Also, the higher the mother's education, the more wasting was seen (p = 0.04) despite participation in the programme. The programme reduced anaemia and malnutrition and has improved child growth in our study group greatly, but we found that education level of the mother, family size and absence of a father overruled the effect of the school feeding programme. Because sample size of our study is small, we encourage further large-scaled research on reviewing programmatic interventions to develop optimal feeding strategies and improve nutritional status of children.
Mishra, Vineet; Roy, Priyankar; Gandhi, Khushali; Choudhary, Sumesh; Aggarwal, Rohina; Sokabaj, Shaheen
Iron deficiency is the commonest treatable cause of postpartum anaemia. Parenteral iron therapy results in faster and higher replenishment of iron stores and correction of haemoglobin levels with better compliance. Ferric Carboxy Maltose is an effective and a safe option which can be administered intravenously in single total correction dose without any serious adverse effects.The study was done to evaluate the efficacy and safety of Ferric Carboxy Maltose in the treatment of iron deficiency anaemia in post-natal patients. It was an open, single arm study including 615 women with diagnosis of Iron deficiency anaemia and haemoglobin (Hb) levels between 4gm% and 11gm% from January 2013 to December 2016. Intravenous Ferric Carboxy Maltose(500-1500mg) was administered and the improvement in haemoglobin levels and iron stores were assessed after three weeks of total dose infusion. Out of the 615 women, 595 women were included in the analysis. Most of the women were in the age group of 27-30 years. Most of the women had mild anaemia as per World Health Organisation guidelines. Mean hemoglobin levels significantly increased over a period of three weeks after Ferric Carboxy Maltose administration. Other parameters like total iron binding capacity, Ferritin and Iron also had a significant improvement after Ferric Carboxy Maltose administration. No serious adverse events were observed after Ferric Carboxy Maltose. Intravenous Ferric Carboxy Maltose was an effective and a safe treatment option for iron deficiency anaemia and has an advantage of single administration of high doses without serious adverse effects.
with chronic sinusitis by physician. Conclusion: Our results showed that there was a high rate of incidental abnormalities in the paranasal sinuses that are unrelated to the patient's presenting problems.
Megan L. McGill
Full Text Available Magnetic resonance imaging (MRI techniques have been used to quantitatively assess focal and network abnormalities. Idiopathic generalized epilepsy (IGE is characterized by bilateral synchronous spike–wave discharges on electroencephalography (EEG but normal clinical MRI. Dysfunctions involving the neocortex, particularly the prefrontal cortex, and thalamus likely contribute to seizure activity. To identify possible morphometric and functional differences in the brains of IGE patients and normal controls, we employed measures of thalamic volumes, cortical thickness, gray–white blurring, fractional anisotropy (FA measures from diffusion tensor imaging (DTI and fractional amplitude of low frequency fluctuations (fALFF in thalamic subregions from resting state functional MRI. Data from 27 patients with IGE and 27 age- and sex-matched controls showed similar thalamic volumes, cortical thickness and gray–white contrast. There were no differences in FA values on DTI in tracts connecting the thalamus and prefrontal cortex. Functional analysis revealed decreased fALFF in the prefrontal cortex (PFC subregion of the thalamus in patients with IGE. We provide minimum detectable effect sizes for each measure used in the study. Our analysis indicates that fMRI-based methods are more sensitive than quantitative structural techniques for characterizing brain abnormalities in IGE.
Full Text Available Human gait analysis plays an important role in musculoskeletal disorder diagnosis. Detecting anomalies in human walking, such as shuffling gait, stiff leg or unsteady gait, can be difficult if the prior knowledge of such a gait pattern is not available. We propose an approach for detecting abnormal human gait based on a normal gait model. Instead of employing the color image, silhouette, or spatio-temporal volume, our model is created based on human joint positions (skeleton in time series. We decompose each sequence of normal gait images into gait cycles. Each human instant posture is represented by a feature vector which describes relationships between pairs of bone joints located in the lower body. Such vectors are then converted into codewords using a clustering technique. The normal human gait model is created based on multiple sequences of codewords corresponding to different gait cycles. In the detection stage, a gait cycle with normality likelihood below a threshold, which is determined automatically in the training step, is assumed as an anomaly. The experimental results on both marker-based mocap data and Kinect skeleton show that our method is very promising in distinguishing normal and abnormal gaits with an overall accuracy of 90.12%.
Opoku-Okrah, Clement; Sam, Daniel Kwasi; Nkum, Bernard; Dogbe, Elliot Eli; Antwi-Boateng, Lilian; Sackey, Benedict; Gyamfi, Daniel; Danquah, Kwabena Owusu
Sports anaemia is a physiological activity that occurs amongst footballers and may be due to poor diet, over-training, as well as an increase in plasma volume in endurance training activities. High plasma volume leads to changes in haematological parameters that may impact on endurance of footballers. The objective of the study was to determine the correlation between haematological and an-thropometric indices and their role in sports anaemia in a tropical setting. Venous blood was taken into EDTA for 12 soccer players of KNUST soccer team before training and after training for the first (W1) and fifth (W5) weeks of training sessions. Complete blood count analysis was done for each blood sample and anthropometric parameters such as height, weight, body mass index, body fat percent and lean body mass were also measured. Cross-tabulations with mean and standard deviation or median and range were computed. Paired t-test & and Mann-Whitney test for parametric and non-parametric data computations were carried out and a p-value ≤ 0.05 was taken to rep-resent significant difference between data groups. There was significant reduction in haemoglobin (p = 0.003), haematocrit (p = 0.002), mean cell volume (MCV) (p = 0.034) and red blood cell (RBC) count (p = 0.011) as a result of a significant expansion of plasma volume (p= 0.006). Neutrophil, lymphocyte and eosinophil counts were reduced significantly (p= 0.043, 0.001 and 0.007, respectively) after the training at W5. Lean body mass (LBM) inversely correlated with haemoglobin (r = -0.787, p = 0.002) and haematocrit (r = -0.588, p = 0.044). Body fat percentage (BFP) also negatively correlated with lymphocyte count (r = -0.700, p = 0.011). Furthermore, there was a positive correlation between body mass index (BMI) and plasma volume change after the training programme (r = 0.689, p = 0.013). The results suggest that sports anaemia was induced by an increase in plasma volume that resulted in changes in haematological
Full Text Available We test the hypothesis that strategies which are long on portfolios of looser stocks and short on portfolios of winner stocks generate abnormal returns in Brazil. This type of evidence for the US stock market was interpreted by The Bondt and Thaler (1985 as reflecting systematic evaluation mistakes caused by investors overreaction to news related to the firm performance. We found evidence of contrarian strategies profitability for horizons from 3 months to 3 years in a sample of stock returns from BOVESPA and SOMA from 1986 to 2000. The strategies are more profitable for shorter horizons. Therefore, there was no trace of the momentum effect found by Jagadeesh and Titman (1993 for the same horizons with US data. There are remaing unexplained positive returns for contrarian strategies after accounting for risk, size, and liquidity. We also found that the strategy profitability is reduced after the Real Plan, which suggests that the Brazilian stock market became more efficient after inflation stabilization.
Tüysüz, Beyhan; Gazioğlu, Nurperi; Ungür, Savaş; Aji, Dolly Yafet; Türkmen, Seval
A 1-month-old boy with shortness of extremities on prenatal US was referred to our department with a provisional diagnosis of achondroplasia. His height was normal but he had short extremities and platyspondyly, premature carpal epiphyses on both hands, and short tubular bones with irregular metaphyses on radiographs. Re-evaluation of the patient at the age of 1 year revealed very short height and premature calcification of the costal cartilages and epiphyses. Spondylometaepiphyseal dysplasia (SMED), short limb-abnormal calcification type was diagnosed. This condition is a very rare autosomal recessively inherited disorder, and most of the patients die in early childhood due to neurological involvement. At the age of 2 years and 5 months, a CT scan showed narrowing of the cervical spinal canal. One month later he died suddenly because of spinal cord injury. In conclusion early diagnosis is very important because the recurrence risk is high and patients may die due to early neurological complications. The time of onset of abnormal calcifications, a diagnostic finding of the disease, is at the age of around 1 year in most patients. When abnormal calcifications are not yet present, but radiological changes associated with SMED are present, this rare disease must be considered.
Tueysuez, Beyhan [Istanbul University, Department of Pediatric Genetics, Cerrahpasa Medical School, Istanbul (Turkey); Gazioglu, Nurperi [Istanbul University, Department of Neurosurgery, Cerrahpasa Medical School, Istanbul (Turkey); Uenguer, Savas [Istanbul University, Department of Pediatric Radiology, Cerrahpasa Medical School, Istanbul (Turkey); Aji, Dolly Yafet [Istanbul University, Department of Pediatrics, Cerrahpasa Medical School, Istanbul (Turkey); Tuerkmen, Seval [Istanbul University, Department of Pediatric Genetics, Cerrahpasa Medical School, Istanbul (Turkey); Universitatsklinikum Berlin, Charite Virchow-Klinik, Berlin (Germany)
A 1-month-old boy with shortness of extremities on prenatal US was referred to our department with a provisional diagnosis of achondroplasia. His height was normal but he had short extremities and platyspondyly, premature carpal epiphyses on both hands, and short tubular bones with irregular metaphyses on radiographs. Re-evaluation of the patient at the age of 1 year revealed very short height and premature calcification of the costal cartilages and epiphyses. Spondylometaepiphyseal dysplasia (SMED), short limb-abnormal calcification type was diagnosed. This condition is a very rare autosomal recessively inherited disorder, and most of the patients die in early childhood due to neurological involvement. At the age of 2 years and 5 months, a CT scan showed narrowing of the cervical spinal canal. One month later he died suddenly because of spinal cord injury. In conclusion early diagnosis is very important because the recurrence risk is high and patients may die due to early neurological complications. The time of onset of abnormal calcifications, a diagnostic finding of the disease, is at the age of around 1 year in most patients. When abnormal calcifications are not yet present, but radiological changes associated with SMED are present, this rare disease must be considered. (orig.)
Full Text Available Locating the assignable causes by use of the abnormal patterns of control chart is a widely used technology for manufacturing quality control. If there are uncertainties about the occurrence degree of abnormal patterns, the diagnosis process is impossible to be carried out. Considering four common abnormal control chart patterns, this paper proposed a characteristic numbers based recognition method point by point to quantify the occurrence degree of abnormal patterns under uncertain conditions and a fuzzy inference system based on fuzzy logic to calculate the contribution degree of assignable causes with fuzzy abnormal patterns. Application case results show that the proposed approach can give a ranked causes list under fuzzy control chart abnormal patterns and support the abnormity eliminating.
Hou, Shi-Wang; Feng, Shunxiao; Wang, Hui
Locating the assignable causes by use of the abnormal patterns of control chart is a widely used technology for manufacturing quality control. If there are uncertainties about the occurrence degree of abnormal patterns, the diagnosis process is impossible to be carried out. Considering four common abnormal control chart patterns, this paper proposed a characteristic numbers based recognition method point by point to quantify the occurrence degree of abnormal patterns under uncertain conditions and a fuzzy inference system based on fuzzy logic to calculate the contribution degree of assignable causes with fuzzy abnormal patterns. Application case results show that the proposed approach can give a ranked causes list under fuzzy control chart abnormal patterns and support the abnormity eliminating.
Oluwayelu, D O; Todd, D; Olaleye, O D
This work reports the first molecular analysis study of chicken anaemia virus (CAV) in backyard chickens in Africa using molecular cloning and sequence analysis to characterize CAV strains obtained from commercial chickens and Nigerian backyard chickens. Partial VP1 gene sequences were determined for three CAVs from commercial chickens and for six CAV variants present in samples from a backyard chicken. Multiple alignment analysis revealed that the 6% and 4% nucleotide diversity obtained respectively for the commercial and backyard chicken strains translated to only 2% amino acid diversity for each breed. Overall, the amino acid composition of Nigerian CAVs was found to be highly conserved. Since the partial VP1 gene sequence of two backyard chicken cloned CAV strains (NGR/CI-8 and NGR/CI-9) were almost identical and evolutionarily closely related to the commercial chicken strains NGR-1, and NGR-4 and NGR-5, respectively, we concluded that CAV infections had crossed the farm boundary.
Full Text Available Sub-Saharan Africa records each year about thirty-two million pregnant women living in areas of high transmission of Plasmodium falciparum causing malaria. The aim of this study was to carve out the prevalence of asymptomatic malaria among pregnant women and to emphasize its influence on haematological markers. The prevalence of Plasmodium falciparum asymptomatic infection among pregnant women was 30% and 24% with rapid detection test (RDT and microscopy, respectively. The prevalence of P. falciparum asymptomatic malaria was reduced among pregnant women using sulfadoxine-pyrimethamine's intermittent preventive treatment and 61% of them were anaemic. Anaemia was significantly more common in women infected with P. falciparum compared with the uninfected pregnant women. Most of the women had normal levels of homocysteine and low levels of folate, respectively. Therefore, the systematic diagnosis of malaria should be introduced to pregnant women as a part of the antenatal care.
Quarello, Paola; Garelli, Emanuela; Carando, Adriana; Mancini, Cecilia; Foglia, Luiselda; Botto, Carlotta; Farruggia, Piero; De Keersmaecker, Kim; Aspesi, Anna; Ellis, Steve R; Dianzani, Irma; Ramenghi, Ugo
Diamond-Blackfan anaemia (DBA) is an inherited disease characterized by pure erythroid aplasia that has been tagged as a 'ribosomopathy'. We report a multi-centre study focused on the analysis of rRNA processing of 53 Italian DBA patients using capillary electrophoresis analysis of rRNA maturation of the 40S and 60S ribosomal subunits. The ratio of 28S/18S rRNA was higher in patients with mutated ribosomal proteins (RPs) of the small ribosomal subunit. In contrast, patients with mutated RPs of the large ribosomal subunit (RPLs) had a lower 28S/18S ratio. The assay reported here would be amenable for development as a diagnostic tool. © 2016 John Wiley & Sons Ltd.
Sudharsanan, Sundaramurthi; Vijayakumar, Chellappa; Manish, Kumar; Elamurugan, T P; Manwar, Ali S
Gas gangrene is one of the most serious infections of traumatic and surgical wounds. The importance lies in the fact that, if not managed at the right time, the condition is fatal. Though perianal cellulitis and gangrene are commonly reported in immunocompromised patients, we report the case of a patient with gas gangrene involving only the anal canal extending to the rectum, a rare presentation to be reported in literature. An 18-year-old lady, a patient of aplastic anaemia - immunodeficiency, developed gas gangrene of the anal canal possibly due to faecal contamination of anal fissures. The patient was managed with surgical debridement and intravenous antibiotics. The clinical manifestations of gas gangrene are due to the liberation of toxins by Clostridium perfringens. The infection spreads rapidly and results in necrosis and devitalisation of tissues, unless intervened surgically. The clinical manifestations are more rapid and a high index of suspicion is needed for the diagnosis.
Bolfă, Pompei Florin; Leroux, Caroline; Pintea, Adela; Andrei, Sanda; Cătoi, Cornel; Taulescu, Marian; Tăbăran, Flaviu; Spînu, Marina
This study assesses the impact of equine infectious anaemia virus (EIAV) infection on the oxidant/antioxidant equilibrium of horses. Blood samples from 96 Romanian horses aged 1-25 years, were divided into different groups according to their EIAV-infection status, age, and time post-seroconversion. The effect of infection on oxidative stress was estimated by measuring enzymatic antioxidants (superoxide dismutase [SOD], glutathione peroxidase [GPx] and catalase), non-enzymatic antioxidants (uric acid and carotenoids), and lipid peroxidation (malondialdehyde [MDA]). Infection modified the oxidant/antioxidant equilibrium in the horses, influencing GPx and uric acid levels (P5 years old, represented the most vulnerable category in terms of oxidative stress, followed by recently infected animals <5 years old. The results of this study are novel in implicating EIAV infection in the development of oxidative stress in horses. Copyright © 2011 Elsevier Ltd. All rights reserved.
Onwubalili, J K
The belief in reincarnation, widely held in Nigeria for many centuries, has waned in the past 30 years. It is most probable that the "reincarnate" child had sickle-cell anaemia, since this disease would explain all the clinical features and natural history of "reincarnation". Most reincarnate children died of Plasmodium falciparum or bacterial infection. The prevailing high birth rate and familial predisposition almost ensured that another sickler was born to the family. The widespread introduction of antimalarial chemoprophylaxis and therapy, the recognition of sickle-cell disease, and some measure of improvement in health care and socioeconomic standards have resulted in an increase in life expectancy for children with HbSS and consequently near-total total extinction of the people's belief in reincarnation.
Sinha, Aish; Davies, Timothy; Saif, Ahmad; Apps, Andrew
Primary cardiac lymphoma (PCL) is rare, accounting for 2% of all primary cardiac malignancies. Diagnosis is sometimes slow due to the non-specific nature of symptoms, causing a delay to treatment with potentially curative anthracycline chemotherapy. We report an unusual presentation of primary cardiac lymphoma in an immunocompetent man presenting with subacute isolated right-sided heart failure with pericarditis on a background of chronic anaemia and constitutional upset. Echocardiography demonstrated a pericardial mass invading the right atrium and compressing the tricuspid annulus. Diffuse large B-cell lymphoma was diagnosed after biopsy. This case highlights the importance of early imaging and hospitalisation in pericarditis with high-risk features such as high inflammatory markers, myocardial involvement (with troponin elevation), fever, immunosuppression or evidence of heart failure. The differential and diagnostic pathway of an intracardiac mass, and the treatment and prognosis of PCL, are discussed. 2016 BMJ Publishing Group Ltd.
Musa A. Sani
Full Text Available Objectives. Sickle cell anaemia (SCA is one of the commonest genetic disorders in the world. It is characterized by anaemia, periodic attacks of thrombotic pain, and chronic systemic organ damage. Recent studies have suggested that individuals with SCA especially from developing countries are more likely to be iron deficient rather than have iron overload. The study aims to determine the iron status of SCA patients in Ilorin, Nigeria. Methods. A cross-sectional study of 45 SCA patients in steady state and 45 non-SCA controls was undertaken. FBC, blood film, sFC, sTfR, and sTfR/log sFC index were done on all subjects. Results. The mean patients’ serum ferritin (589.33 ± 427.61 ng/mL was significantly higher than the mean serum ferritin of the controls (184.53 ± 119.74 ng/mL. The mean serum transferrin receptor of the patients (4.24 ± 0.17 μg/mL was higher than that of the controls (3.96 ± 0.17 μg/mL (p=0.290. The mean serum transferrin receptor (sTfR/log serum ferritin index of the patients (1.65 ± 0.27 μg/mL was significantly lower than that of the control (1.82 ± 0.18 μg/mL (p=0.031. Conclusion. Iron deficiency is uncommon in SCA patients and periodic monitoring of the haematological, biochemical, and clinical features for iron status in SCA patients is advised.
Droz, Nina; De Lauzanne, Agathe; Holvoet, Laurent; Missud, Florence; Benkerrou, Malika; Brousse, Valentine; Odièvre, Marie-Hélène; Faye, Albert; Koehl, Berengere
Tuberculosis (TB) and sickle cell anaemia (SCA) may affect the same population of patients, particularly in Africa but also in high-TB incidence areas in developed countries. However, few data are available from children with SCA who develop TB. The aim of this study was to describe the clinical features and outcome of TB diagnosed in children with SCA. We conducted a retrospective, descriptive study in three referral centre of Sickle Cell Disease in Paris, France. We included 11 patients with SCA who develop TB. The median age at TB diagnosis was 11 years [7.5-14.5]. Two patients were asymptomatic and nine patients were symptomatic. Six patients had pulmonary TB (pulmonary, pleural and mediastinal lesions). Five patients had extrapulmonary TB (osteoarticular TB, hepatic TB, cervical and mediastinal TB). Mycobacterium tuberculosis was isolated in four of the 11 cases. All patients recovered after a median of 6 months of anti-TB treatment. The localisation of TB and outcome after treatment in our SCA patients were similar to the one observed in an age-and sex-matched control group of non-SCA patient with TB. despite the low number of patients included in our study, SCA does not seem to be a risk factor for severe TB. What is Known: • Tuberculosis (TB) remains a global health problem particularly in developing countries, and Sickle cell anaemia (SCA) is currently one of the most common genetic diseases in the world that mainly affects African populations. • Very few data are available on TB in SCA patients. What is New: • The features of TB in children with SCA seem to be comparable to those expected in general population, with favourable outcomes in response to standard treatment. • Monitoring the dosage of anti-TB treatments could be of interest because of the possible impact of SCA on drug metabolism.
Stein, Jürgen; Bager, Palle; Befrits, Ragnar
in correcting anaemia, and worse baseline Hb and iron status compared to a prior survey. The on-going lack in awareness of evidence-based recommendations on iron supplementation emphasises the need for new educational strategies to improve implementation of current and upcoming guidelines.......Background: In 2009, a survey on anaemia management in patients with inflammatory bowel disease (IBD) revealed that treatment practice is not in line with treatment recommendations. Despite a high prevalence of severe anaemia and absolute iron deficiency, most patients received oral instead...... of intravenous (i.v.) iron. Since additional data on effective correction of anaemia with i.v. iron emerged in the meantime (FERGIcor), a new survey was performed in 2011 to evaluate whether treatment practice changed. Methods: Gastroenterologists in France, Germany, Spain, UK and Switzerland completed...
Kerkhoff, Andrew D; Wood, Robin; Cobelens, Frank G; Gupta-Wright, Ankur; Bekker, Linda-Gail; Lawn, Stephen D
Anaemia is frequently associated with both HIV-infection and HIV-related tuberculosis (TB) in antiretroviral therapy (ART)-naïve patients in sub-Saharan Africa and is strongly associated with poor prognosis. However, the effect of ART on the resolution of anaemia in patient cohorts with a high prevalence and incidence of tuberculosis is incompletely defined and the impact of TB episodes on haemoglobin recovery has not previously been reported. We therefore examined these issues using data from a well-characterised cohort of patients initiating ART in South Africa. Prospectively collected clinical and haematological data were retrospectively analysed from patients receiving ART in a South African township ART service. TB diagnoses and time-updated haemoglobin concentrations, CD4 counts and HIV viral loads were recorded. Anaemia severity was classified according to WHO criteria. Multivariable logistic regression analysis was used to determine factors independently associated with anaemia after 12 months of ART. Of 1,140 patients with baseline haemoglobin levels, 814 were alive in care and had repeat values available after 12 months of ART. The majority of patients were female (73%), the median CD4 count was 104 cells/uL and 30.5% had a TB diagnosis in the first year of ART. At baseline, anaemia (any severity) was present in 574 (70.5%) patients and was moderate/severe in 346 (42.5%). After 12 months of ART, 218 (26.8%) patients had anaemia of any severity and just 67 (8.2%) patients had moderate/severe anaemia. Independent predictors of anaemia after 12 months of ART included greater severity of anaemia at baseline, time-updated erythrocyte microcytosis and receipt of an AZT-containing regimen. In contrast, prevalent and/or incident TB, gender and baseline and time-updated CD4 cell count and viral load measurements were not independent predictors. Although anaemia was very common among ART-naive patients, the anaemia resolved during the first year of ART in a
Lawrence, K E; Forsyth, S F; Vaatstra, B L; McFadden, Amj; Pulford, D J; Govindaraju, K; Pomroy, W E
AIM To determine the most commonly used words in the clinical histories of animals naturally infected with Theileria orientalis Ikeda type; whether these words differed between cases categorised by age, farm type or haematocrit (HCT), and if there was any clustering of the common words in relation to these categories. METHODS Clinical histories were transcribed for 605 cases of bovine anaemia associated with T. orientalis (TABA), that were submitted to laboratories with blood samples which tested positive for T. orientalis Ikeda type infection by PCR analysis, between October 2012 and November 2014. χ 2 tests were used to determine whether the proportion of submissions for each word was similar across the categories of HCT (normal, moderate anaemia or severe anaemia), farm type (dairy or beef) and age (young or old). Correspondence analysis (CA) was carried out on a contingency table of the frequency of the 28 most commonly used history words, cross-tabulated by age categories (young, old or unknown). Agglomerative hierarchical clustering, using Ward's method, was then performed on the coordinates from the correspondence analysis. RESULTS The six most commonly used history words were jaundice (204/605), lethargic (162/605), pale mucous membranes (161/605), cow (151/605), anaemia (147/605), and off milk (115/605). The proportion of cases with some history words differed between categories of age, farm type and HCT. The cluster analysis indicated that the recorded history words were grouped in two main clusters. The first included the words weight loss, tachycardia, pale mucous membranes, anaemia, lethargic and thin, and was associated with adult (pcluster included the words deaths, ill-thrift, calves, calf and diarrhoea, and was associated with young (pCluster analysis of words recorded in clinical histories submitted with blood samples from cases of TABA indicates that two potentially different disease syndromes were associated with T. orientalis Ikeda type
Full Text Available Background: Abnormal uterine bleeding is a common presentation of uterine abnormalities among premenopausal and postmenopausal women.Objective: To evaluate and compare the diagnostic accuracy of saline contrast sonohysterography and hysteroscopy for detecting the cause of abnormal uterine bleeding.Materials and Methods: A total of 65 women with abnormal uterine bleeding were enrolled in this study. A prior saline contrast sonohysetrography followed by a hysteroscopy was performed in all cases. Sensitivity, specificity, positive and negative predictive value and test accuracy were calculated.Results: As the most common abnormality, SCSH showed hyperplasia in 19 patients while hysteroscopy diagnosed polyp in 15 cases. A sensitivity of 73.3%, 71.4% and 90.9% were reported for polyp, hyperplasia and submucous myoma respectively whereas the specificity was calculated 96% for polyps, 82.3% for hyperplasia and 90.7% for submucous myoma.Conclusion: Comparing with hysteroscopy, sonohysterography showed a high sensitivity and specificity for detecting submucous myoma but not for endometrial polyp and endometrial hyperplasia
Sami F. Al-Rawas
Full Text Available Objectives: The aim of this study was to establish the relationship between background amplitude and interictal abnormalities in routine electroencephalography (EEG. Methods: This retrospective audit was conducted between July 2006 and December 2009 at the Department of Clinical Physiology at Sultan Qaboos University Hospital (SQUH in Muscat, Oman. A total of 1,718 electroencephalograms (EEGs were reviewed. All EEGs were from patients who had been referred due to epilepsy, syncope or headaches. EEGs were divided into four groups based on their amplitude: group one ≤20 μV; group two 21–35 μV; group three 36–50 μV, and group four >50 μV. Interictal abnormalities were defined as epileptiform discharges with or without associated slow waves. Abnormalities were identified during periods of resting, hyperventilation and photic stimulation in each group. Results: The mean age ± standard deviation of the patients was 27 ± 12.5 years. Of the 1,718 EEGs, 542 (31.5% were abnormal. Interictal abnormalities increased with amplitude in all four categories and demonstrated a significant association (P <0.05. A total of 56 EEGs (3.3% had amplitudes that were ≤20 μV and none of these showed interictal epileptiform abnormalities. Conclusion: EEG amplitude is an important factor in determining the presence of interictal epileptiform abnormalities in routine EEGs. This should be taken into account when investigating patients for epilepsy. A strong argument is made for considering long-term EEG monitoring in order to identify unexplained seizures which may be secondary to epilepsy. It is recommended that all tertiary institutions provide EEG telemetry services.
Schmuth, M; Yosipovitch, G; Williams, M L; Weber, F; Hintner, H; Ortiz-Urda, S; Rappersberger, K; Crumrine, D; Feingold, K R; Elias, P M
Epidermolytic hyperkeratosis is a dominantly inherited ichthyosis, frequently associated with mutations in keratin 1 or 10 that result in disruption of the keratin filament cytoskeleton leading to keratinocyte fragility. In addition to blistering and a severe disorder of cornification, patients typically display an abnormality in permeability barrier function. The nature and pathogenesis of the barrier abnormality in epidermolytic hyperkeratosis are unknown, however. We assessed here, first, baseline transepidermal water loss and barrier recovery kinetics in patients with epidermolytic hyperkeratosis. Whereas baseline transepidermal water loss rates were elevated by approximately 3-fold, recovery rates were faster in epidermolytic hyperkeratosis than in age-matched controls. Electron microscopy showed no defect in either the cornified envelope or the adjacent cornified-bound lipid envelope, i.e., a corneocyte scaffold abnormality does not explain the barrier abnormality. Using the water-soluble tracer, colloidal lanthanum, there was no evidence of tracer accumulation in corneocytes, despite the fragility of nucleated keratinocytes. Instead, tracer, which was excluded in normal skin, moved through the extracellular stratum corneum domains. Increasing intercellular permeability correlated with decreased quantities and defective organization of extracellular lamellar bilayers. The decreased lamellar material, in turn, could be attributed to incompletely secreted lamellar bodies within granular cells, demonstrable not only by several morphologic findings, but also by decreased delivery of a lamellar body content marker, acid lipase, to the stratum corneum interstices. Yet, after acute barrier disruption a rapid release of preformed lamellar body contents was observed together with increased organelle contents in the extracellular spaces, accounting for the accelerated recovery kinetics in epidermolytic hyperkeratosis. Accelerated recovery, in turn, correlated with a
Traissac, Pierre; El Ati, Jalila; Gartner, Agnès; Ben Gharbia, Houda; Delpeuch, Francis
The nutrition transition has exacerbated the gender gap in health in the Middle East and North Africa region as the increase in excess adiposity has been much higher among women than men. This is not exclusive of the persistence of anaemia, generally also more prevalent among women. We assessed the magnitude and sociodemographic factors associated with gender inequality vis-à-vis the double burden of excess adiposity and anaemia. Cross-sectional study, stratified two-stage cluster sample. BMI (=weight/height2) ≥25·0 kg/m2 defined overweight and BMI≥30·0 kg/m2 obesity. Anaemia was defined as Hb Gender inequalities vis-à-vis the within-subject coexistence of excess adiposity and anaemia were assessed by women v. men relative prevalence ratios (RPR). Their variation with sociodemographic characteristics used models including gender × covariate interactions. Greater Tunis area in 2009-2010. Adults aged 20-49 years (women, n 1689; men, n 930). Gender inequalities in excess adiposity were high (e.g. overweight: women 64·9 % v. men 48·4 %; RPR=2·1; 95 % CI 1·6, 2·7) and much higher for anaemia (women 38·0 % v. men 7·2 %; RPR=8·2; 95 % CI 5·5, 12·4). They were striking for overweight and anaemia (women 24·1 % v. men 3·4 %; RPR=16·2; 95 % CI 10·3, 25·4). Gender inequalities in overweight adjusted for covariates increased with age but decreased with professional activity and household wealth score; gender inequality in anaemia or overweight and anaemia was more uniformly distributed. Women were much more at risk than men, from both over- and undernutrition perspectives. Both the underlying gender-related and sex-linked biological determinants of this remarkable double burden of malnutrition inequality must be addressed to promote gender equity in health.
Full Text Available To find out the prevalence of nutritional anaemia and to know the dietary factors and socio-demographic characteristics associated with nutritional anaemia.Design : Cross sectional studySetting : Deptt. of Community Medicine. G.S.V.M. Medical College. KanpurParticipants: Undergraduate Students of G.S. V.M. Medical College, KanpurStudy variable : Age. Sex. Social class. Dietary habits and Body Mass IndexStatistical Analysis : Percentage and Chi-square test
Full Text Available In this study, 44 patients with liver cirrhosis were investigated for hemostatic parameters. Patients with spontaneous bacterial peritonitis, hepatocellular carcinoma, hepatorenal syndrome and cholestatic liver diseases were excluded. Patients were classified by Child-Pugh criterion and according to this 4 patients were in Class A, 20 in Class B and 20 in C. Regarding to these results, it was aimed to investigate the haematological disturbances in liver cirrhotic patients.In the result there was a correlation between activated partial thromboplastin time, serum iron, ferritin, transferrin, haptoglobin and Child-Pugh classification. Besides there was no correlation between prothrombin time, factor 8 and 9, protein C and S, anti-thrombin 3, fibrinogen, fibrin degradation products, serum iron binding capacity, hemoglobin, leukocyte, mean corpuscular volume and Child-Pugh classification.There were significant difference, in terms of AST, ferritin, haptoglobulin, sex and presence of ascites between groups (p0.05. In the summary, we have found correlation between hemostatic abnormalities and disease activity and clinical prognosis in patients with liver cirrhosis which is important in the management of these patients. This is also important for identification of liver transplant candidiates earlier.
Crippa, Beatrice Letizia; Leon, Eyby; Calhoun, Amy; Lowichik, Amy; Pasquali, Marzia; Longo, Nicola
Pearson marrow-pancreas syndrome is a multisystem mitochondrial disorder characterized by bone marrow failure and pancreatic insufficiency. Children who survive the severe bone marrow dysfunction in childhood develop Kearns-Sayre syndrome later in life. Here we report on four new cases with this condition and define their biochemical abnormalities. Three out of four patients presented with failure to thrive, with most of them having normal development and head size. All patients had evidence of bone marrow involvement that spontaneously improved in three out of four patients. Unique findings in our patients were acute pancreatitis (one out of four), renal Fanconi syndrome (present in all patients, but symptomatic only in one), and an unusual organic aciduria with 3-hydroxyisobutyric aciduria in one patient. Biochemical analysis indicated low levels of plasma citrulline and arginine, despite low-normal ammonia levels. Regression analysis indicated a significant correlation between each intermediate of the urea cycle and the next, except between ornithine and citrulline. This suggested that the reaction catalyzed by ornithine transcarbamylase (that converts ornithine to citrulline) might not be very efficient in patients with Pearson syndrome. In view of low-normal ammonia levels, we hypothesize that ammonia and carbamylphosphate could be diverted from the urea cycle to the synthesis of nucleotides in patients with Pearson syndrome and possibly other mitochondrial disorders. © 2015 Wiley Periodicals, Inc.
Evaluation of Chromosomal Abnormalities and Common Trombophilic Mutations in Cases with Recurrent Miscarriage. Ahmet Karatas, Recep Eroz, Mustafa Albayrak, Tulay Ozlu, Bulent Cakmak, Fatih Keskin ...
The results showed that 7.14% White Fulani Bulls, 16.32% Sokoto Gudali Bulls, 10.25% Red Bororo Bulls, 4.28% Yankasa rams and 36.40% West African Dwarf Bucks had various forms of external genitalia abnormalities. The possible causes of these conditions, the implication on the reproductive capabilities of
The results indicate that the high efficiency of this method as the CCR (train) and CCR (test) was about 96 and 93%, respectively. These results show that the neural network can be considered as a standard way to diagnose the spinal abnormalities. Moreover, the most important benefit of this method is the estimation of ...
Lajunen, Katariina; Kalliola, Satu; Kotaniemi-Syrjänen, Anne; Sarna, Seppo; Malmberg, L Pekka; Pelkonen, Anna S; Mäkelä, Mika J
Asthma often begins early in childhood. However, the risk for persistence is challenging to evaluate. This longitudinal study relates lung function assessed with impulse oscillometry (IOS) in preschool children to asthma in adolescence. Lung function was measured with IOS in 255 children with asthma-like symptoms aged 4-7 years. Baseline measurements were followed by exercise challenge and bronchodilation tests. At age 12-16 years, 121 children participated in the follow-up visit, when lung function was assessed with spirometry, followed by a bronchodilation test. Asthma symptoms and medication were recorded by a questionnaire and atopy defined by skin prick tests. Abnormal baseline values in preschool IOS were significantly associated with low lung function, the need for asthma medication, and asthma symptoms in adolescence. Preschool abnormal R5 at baseline (z-score ≥1.645 SD) showed 9.2 odds ratio (95%CI 2.7;31.7) for abnormal FEV1/FVC, use of asthma medication in adolescence, and 9.9 odds ratio (95%CI 2.9;34.4) for asthma symptoms. Positive exercise challenge and modified asthma-predictive index at preschool age predicted asthma symptoms and the need for asthma medication, but not abnormal lung function at teenage. Abnormal preschool IOS is associated with asthma and poor lung function in adolescence and might be utilised for identification of asthma persistence. Copyright © 2018. Published by Elsevier Inc.
Section 208 of the Energy Reorganization Act of 1974 identifies an abnormal occurrence as an unscheduled incident or event which the Nuclear Regulatory Commission determines to be significant from the standpoint of public health or safety and requires a quarterly report of such events to be made to Congress. This report covers the period from October 1 to December 31, 1986. The report states that for this reporting period, there were three abnormal occurrences at the nuclear power plants licensed to operate. The events were (1) loss of low pressure service water systems at Oconee, (2) degraded safety systems due to incorrect torque switch settings on Rotors motor operators at Catawba and McGuire Nuclear Stations, and (3) a secondary system pipe break resulting in the death of four persons at Surry Unit 2. There were six abnormal occurrences at the other NRC licensees. One involved release of americium-241 inside a waste storage building at Wright-Patterson Air Force Base; three involved medical misadministrations, one therapeutic and two diagnostic; one involved a suspension of license for servicing teletherapy and radiography units; and one involved an immediately effective order modifying license and order to show cause issued to an industrial radiography company. There were no abnormal occurrences reported by the Agreement States. The report also contains information updating some previously reported abnormal occurrences